Electromagnetic Energy Modalities

Non-ionizing radiation (low frequency)

shortwave (SWD)

Microwave

Infrared (IR)

Visible light

UV light

Ionizing radiation (high frequency)

X-rays

Gamma rays

Clinical/therapeutic uses of IR radiation

superficial heating (thermotherapy)

Clinical/therapeutic uses of UV radiation

treatment for psoriasis and other skin disorders, wound healing

Clinical/therapeutic uses of SWD

deep tissue heating

decrease pain and edema

facilitate wound healing

lower intensity LASER

Light Amplification by Stimulated Emission of Radiation

General effects of UV Radiation

skin erythema, tanning, epidural hyperplasia, vitamin D synthesis

What are the three types of UV radiation?

UVA (320-400 nm) - fluorescence

UVB (290-320 nm) - sunburns, vit D

UVC (<290 nm) - histamine release

Indications for UV radiation

Treatment of skin disorders - psoriasis, acne, eczema, alopecia, scleroderma, atopic dermatitis

Wound healing (w/ UVC) - granulation, increased blood flow, increased vitamin D production, bactericidal

Contraindications for UV Radiation

Irradiation of eyes

Systemic conditions: skin cancer, pulmonary TB, cardiac/kidney/liver disease, lupus, febrile patient

Precautions for UV Radiation

Photosensitizing medications and dietary supplements

Photosensitivity

Recent x-ray radiation exposure

Erythema from prior UV dose

Minimal erythemal dose (MED)

smallest dose of UV that causes erythema within 8 hours and disappears within 24 hours

What is the dose-response assessment for UV radiation treatment?

Determining minimal erythemal dose (MED)

How much should the exposure time for UV treatment be increase at each consecutive treatment?

25-50%

What is the maximum treatment time for UV radiation?

5 minutes

Advantages of diathermy over other therapeutic modalities

Heats deeper tissues

Treatment of larger surface areas

Not reflected by bones

Primary clinical uses of diathermy

pain management

wound healing

deep tissue heating

Diathermy

application of shortwave (3 to 200 m wavelength) or microwave (1 mm to 1 m wavelength) EM energy

What are the two types of setups for diathermy?

Inductive coil and capacitive plates

Thermal effects of diathermy

Increased tissue temperature

Vasodilation

Increased rate of nerve conduction

Elevation of pain threshold

Increased soft tissue extensibility

Indications for diathermy

Decrease pain/spasm

Improve ROM

Non-Thermal effects of Diathermy

Increased microvascular perfusion

Altered cell membrane permeability and cellular activity

Indications of Diathermy

Pain and edema control

Soft tissue healing

Peripheral nerve regeneration

Osteogenesis

Osteoarthritis (OA)

Contraindications for non-thermal diathermy

Biomedical devices, metal implants

Over internal organs

Implanted biomedical devices including transcutaneous nerve stimulators

Pregnancy

Contraindications for thermal diathermy

Metal implants

Malignancy

Irradiation over eyes

Irradiation over testes

Irradiation over growing epiphyses

Biomedical devices, metal implants

Over internal organs

Precautions of diathermy

Near other electronic or magnetic equipment

Obesity

Treatment time for thermal diathermy

20 minutes

Treatment time for non-thermal diathermy

30-60 minutes 2x day

LED

low intensity, non-directional, low power output - spread out

SLD

high intensity, nearly monochromatic, not coherent - divergence tighter than LED

Aspects of LASER light

monochromatic (single wavelength)

coherent

directional

high intensity light concentrated in one area

promotes tissue healing, controls pain and inflammation

Photobiomodulation

light absorbed by chromophores to increase production of ATP by mitochondria, increase production of RNA for collagen synthesis, altered prostaglandin synthesis, altered serotonin and endorphin metabolism, and reduced nociceptor activity

Photostimulation

promote ATP production

promote collagen production

increase prostaglandin production (decreasing inflammation)

Photoinhibition

Inhibit bacterial growth

alter nerve conduction velocity and nociceptor activity