Agents - Diathermy and Light Therapy

Is continuous shortwave diathermy a superficial or deep form of heating? How many cm deep does it go?

Deep

3-5 cm

Which of the following structures does coninuous shortwave diathermy target?

Joints, skin, large muscles, subcutaneous tissue/fluids

Large muscles and joints

Shortwave diathermy has a (short wavelength radio waves OR microwave range) and (2450 MHz OR 27 MHz)

Short wavelength radio waves

27 MHz

Microwave diathermy has a (short wavelength radio waves OR microwave range) and (2450 MHz OR 27 MHz)

Microwave range

2450 MHz

Pulsed SWB has (thermal and/or non-thermal effects), while continuous has (thermal and/or non-thermal effects)

PSWB: thermal and non thermal

Continuous: thermal

What are advantages of shortwave diathermy

Heats deep (3-5 cm) and larger areas

Minimal reflection of waves at tissue interfaces

Does not reflect off bones

Extensibility maintained 2-3x longer

Shortwave diathermy capacitive method is also known as what

Electric field method

What is the capacitor?

Device that can store electrical charge

What is a dielectric

Insulating sheet that causes an increase in capacitance

What serves as the dielectric

Da body

What is the effect of fat having a greater resistance to current compared to muscle?

Fat heats up quickly so make sure it’s not over lots of subcutaneous fat

When using the capacitive method, the plate guard should be placed __-__ cm from the skin. What happens if the plate comes in contact with the skin

2-10 cm (1-3 inches)

Severe electrical burn

When using the capacitive method, what additional step should you take to protect the patient if the method is thermal? What’s the purpose?

Single layer of towel

Take water off of skin

What are the two arrangements for the capacitive method?

Contraplanar or coplanar

When using hte capacitive method, the distance between plates is (< or >) the plate diameter

Distance between plates > plate diameter

The inductive method is also known as what

Magnetic field method

With the inductive method, there is (less or more) heating in higher conductivity/low impedance tissdue (muscle, nerve, blood)

More

T/f - a single layer of towel is required for the capacitive method, but you do not need one for the inductive method

False - you need one for both

Between the capacitive and inductive method, which method more effectively heats muscle/deep tissues

Inductive

For all of the following thermal effects, does diathermy increase or decrease it?

Blood flow, metabolism, tissue extensibility, pain, tissue healing

Increases blood flow, metabolism, tissue extensibility, and tissue healing

Decreases pain

What are the non-thermal effects of diathermy

Increased microvascular perfusion

Alters cellular activity

Stimulates ATP production

Stimulates protein synthesis

Tissue healing

What are the clinical indications for thermal diathermy

Pain control

Accelerated tissue healing

Increased joint ROM

Decreased joint stiffness

How long should thermal diathermy last?

20 minutes

What are the clinical indications for non-thermal diathermy

Control of pain and edema

Soft tissue, nerve, and bone healing

Incisional wounds

Pressure ulcers

What is the treatment time range for non-thermal diathermy

30-60 minutes

For dose 1 of diathermy, what is the response? Tissue temperature rise? What’s its clinical use?

Non-thermal response

No tissue temperature rise

Acute injuries, edema, cell repair

For dose 2 of diathermy, what is the response? Tissue temp rise? What is the clinical use?

Mild heat

1.8 F

Subacute injuries and inflammation

For dose 3 of diathermy, what is the response? What is the tissue temperature rise? What is the clinical use?

Moderate heat

3.6 F

Pain, muscle spasm, chronic inflammation

For dose 4 of diathermy, what is the response? Tissue temp rise? Clinical use?

Vigorous heat

7.2 F Subacute injuries

Inc blood flow, heating of collagen tissues for stretch of soft tissues

What are the contraindications of diathermy? (This one’s important)

Pacemakers/implanted devices

Metal in treatment area

Metal/cement/synthetic implants

Pregnancy (any treatment location)

Malignancy, recently irradiated tissue, hemorrhage, DVT/thrombophlebitis, over eyes/neck/heart/reproductive organs, impaired cognition

impaired circulation (thermal), Infection (thermal) damaged skin/skin disorders (thermal)

Acute injury/inflammation and obesity (non-thermal is okay)

What are the precautions for diathermy?

Active epiphysis, decreased sensation, synthetic materials

Chronic wounds (non-thermal is okay), superficial regenerating nerve (non-thermal is okay)

Infection (non-thermal), impaired circulation (non-thermal), damaged skin/skin disorders (non-thermal)

If the body part can accommodate both a contraplanar or coplanar arrangement, which should you choose>?

Coplanar

Inductive has a higher increase in (muscle or skin) temps, while capacitive has a higher increase in (muscle or skin) temps

Inductive: Higher increase in muscle temps

Capacitive: higher increase in skin temps

Match the following types of lasers with their definitions

Coherent, monochromatic, directional

Parallel waves in same direction, single wavelength, all waves in phase with each other

Monochromatic: single wavelength

Coherent: all waves in phase with each other

Directional: parallel waves in same direction

Of the following kinds of classes of lasers, which do PTs use?

1, 2, 3A, 3B, 4

3B

What kind of laser is the most widely accepted type for rehab

Low level laser therapy

T/f - low level laser therapy is a thermal modality

False - it’s non-thermal

What are the physiological effects of laser therapy

Stimulates ATP + RNA production

Promotes collagen production

Inhibits bacterial growth

Decr pain via chemical mediators

Promotes vasodilation

Modulates inflammation

T/f - LLLT is effective in reducing pain in adults with MSK disorders

True

T/f - LLLT is effective in relieving pain and increasing function in patients with chronic low back pain

False - effective for relieving pain but lack of evidence to support its effect on function

List the contraindications for laser

Direct eye exposure

Active malignancy in the area

Active hemorrhage

Over active epiphysis, thyroid/endocrine glands, or reproductive organs

Low back or abdomen during pregnancy

DVT or thrombophlebitis

What are the precautions for laser

Impaired mentation or sensation

Indirect eye exposure

Recently irradiated tissues

Photosensitivity or Systemic Lupus Erythematosus (SLE)

What are some adverse effects of laser

Transient tingling/burning

Skin rash

Inc pain/numbness

Retinal damage with exposure to the eyes

Burns

The diode is comprised of ___ (anode and cathode) in clusters

Electrodes

T/f - you do not calc the dosage - the machine does it for you

True

In continuous laser, the dosage (joules) = ___ (watts) x ___

Dosage = power output of the device x time (sec)

For laser, total energy = ___ x ___

Target dosage (joule/cm2) x treatment area

A higher wavelength of laser leads to more (superficial or deeper) penetration? How many cm?

Deeper

2-4 cm

Aside from the typical precautions, what additional precaution must the therapist AND the patient take during laser treatment

Protective eyewear

The benefits of LEDs in therapy are due to the photo-chemical reactions, inc microcirculation, and venous flow. The inc in venous flow is due to the release of ___ that serves as a vasodilator

Nitric oxide

What is the one indication for the use of super-luminous diodes (SLEDs)

Open skin wounds

What are the contraindications for the use of super luminous diodes (SLEDs)?

Impaired sensation or cognition

Vascular disease/insufficiency

Thrombophlebitis

Over recent/potential hemorrhage or area of malignancy

Over infected area or lidocaine patches

SAME AS SUPERFICIAL HEAT

What are the precautions for the use of super luminous diodes (SLEDs)

Over acute injury/inflammation

Over abdomen or low back during pregnancy

Impaired circulation

Metal in area or edema

Are where liniments of what rubs were applied

Cardiac insufficiency

Open wound or demyelinated nerves

SAME AS SUPERIFICIAL HEAT

What are the clinical indications for the use of monochromatic infrared energy (MIRE)

Inc circulation

Decr pain and falls

Heal open wounds

Improve diabetic neuropathy

What are hte contraindications for the use of monochromatic infrared energy (MIRE)

Direct eye exposure

Active malignancy or hemorrhage

Over active epiphysis or thyroid/endocrine glands Or reproductive organs

Low back or abdomen during pregnancy

DVT or thrombophlebitis

SAME AS LASWER

What are the precautions for the use of monochromatic infrared energy (MIRE)?

Impaired mentation or sensation

Indirect eye exposure

Recently irradiated tissues

Photosensitivity or Systemic Lupus Erythematosus (SLE)

SAME AS LASER

T/f MIRE has solid evidence to support its use

TRUE IT DOES