Review of Shortwave Diathermy Continuous and Pulsed Patters

doi:10.1016/S0031-9406(10)61434-4

Physiotherapy

Volume 78, Issue 4, 10 April 1992, Pages 243-252

https://doi.org/10.1016/S0031-9406(10)61434-4 Get rights and content

Summary

Both continuous and pulsed forms of shortwave diathermy (SWD) are used by physiotherapists in the treatment of a range of conditions including soft tissue lesions and the arthritises. The known physiological effects, clinical efficacy and hazards associated with the use of these two forms of SWD are considered and the need for further research both in the field of basic science and clinical application is highlighted.

References (78)

DH Aronofsky
‘Reduction of dental post-surgical symptoms using non-thermal pulsed high-peak-power electromagnetic energy’
Oral Surgery
(1971)
JD Constable et al.
‘Studies of the effects of Diapulse treatment on various aspects of wound healing in experimental animals’
Journal of Surgical Research
(1971)
V Delpizzo et al.
‘On the safe use of microwave and shortwave diathermy units’
Australian Journal of Physiotherapy
(1987)
T Gibson et al.
‘Controlled comparison of shortwave diathermy treatment with osteopathic treatment in non-specific low back pain’
The Lancet
(1985)
JH Goldin et al.
‘The effects of Diapulse on the healing of sounds: ‘A double blind randomised controlled trial in man’
British Journal of Plastic Surgery
(1981)
AD McDowell et al.
‘Electromagnetic field strength measurements on Megapulse units’
Physiotherapy
(1991)
AM Raji
‘An experimental study of the effects of pulsed electromagnetic field (Diapulse) on nerve repair’
The Journal of Hand Surgery
(1984)
TY Tsong
‘Deciphering the language of cells’
Trends in the Biological Sciences
(1989)
DL Abramson et al.
‘Changes in blood flow, oxygen uptake and tissue temperatures produced by therapeutic physical agents’
American Journal of Physical Medicine
(1960)
DL Abramson et al.
‘Effect of tissue temperature and blood flow on motor nerve conduction velocity’
Journal of the American Medical Association
(1966)

WR Adey

‘Electromagnetic field effects on tissue’

Physiological Review

(1981)

WR Adey

‘Physiological signalling across cell membranes and co-operative influences of extremely low frequency electromagnetic fields’

CF Babbs et al.

‘Physical principles of local heat therapy for cancer’

Medical Instrumentation

(1981)

Bansal, P S, Sobti, V K and Roy, K S (190). ‘Histomorphochemical effects of shortwave diathermy on healing of...

V Barclay et al.

‘Treatment of various hand injuries by pulsed electromagnetic energy’

Physiotherapy

(1983)

AT Barker et al.

‘A double-blind clinical trial of low-power pulsed shortwave therapy in the treatment of a soft tissue injury’

Physiotherapy

(1985)

JR Basford

‘Low energy laser therapy: Controversies and new research findings’

Lasers in Surgery and Medicine

(1989)

TB Benson et al.

‘The effect of therapeutic forms of heat and ice on the pain threshold of the normal shoulder’

Rheumatology and Rehabilitation

(1974)

RHC Bentall et al.

‘A trial involving the use of pulsed electromagnetic therapy on children undergoing orchidopexy’

Kinderchirugie

(1975)

M Brown et al.

‘Effect of pulsed shortwave diathermy on skeletal muscle injury in rabbits’

Physical Therapy

(1987)

PDC Brown-Woodman et al.

‘Evaluation of reproductive function of female rats exposed to radio frequency fields (27.12 MHz) near a shortwave diathermy device’

Health Physics

(1989)

Burr, B (1974). ‘Heat as a therapeutic modality against cancer’, Report 16, US National Cancer Institute, Bethesda,...

BM Cameron

‘Experimental acceleration of wound healing’

American Journal of Orthopaedics

(1961)

MA Chamberlain et al.

‘Physiotherapy in osteo-arthrosis of the knee’

Annals of Rheumatic Diseases

(1982)

DA Christensen et al.

‘Hyperthermia production for cancer therapy — A review of fundamentals and methods’

Journal of Microwave Power

(1981)

GR Clarke et al.

‘Evaluation of physiotherapy in the treatment of osteo-arthrosis of the knee’

Rheumatology and Rehabilitation

(1974)

DP Currier et al.

‘Changes in motor conduction velocity induced by exercise and diathermy’

Physical Therapy

(1969)

Department of Health

‘Evaluation Report: Shortwave therapy units’

Journal of Medical Engineering and Technology

(1987)

Department of Health and Welfare (Canada) (1980). ‘Canada wide survey of non-ionising radiation-emitting medical...

Department of Health and Welfare (Canada) (1983). ‘Safety code 25; Shortwave diathermy guidelines for limited radio...

Dyson, M and Luke, D A (1986). ‘Induction of mast cell degranulation in skin by ultrasound’, Institute of Electrical...

MJ Edwards

‘Congenital defects in guinea pigs following induced hyperthermia during gestation’

Archives of Pathology and Laboratory Medicine

(1967)

MJ Edwards

‘Congenital defects due to hyperthermia’

Advances in veterinary Sciences and Comparative Medicine

(1978)

WJ Erdman

‘Peripheral blood flow measurements during application of pulsed high frequency currents’

American Journal of Orthopaedics

(1960)

JE Fenn

‘Effect of pulsed electromagnetic energy (Diapulse) on experimental haematomas’

Canadian Medical Association Journal

(1969)

D Foley-Nolan et al.

‘Pulsed high frequency (27 MHz) electromagnetic therapy for persistent neck pain’

Orthopaedics

(1990)

AJ Ginsberg

‘Pulsed shortwave in the treatment of bursitis with calcification’

International Record of Medicine

(1961)

A Grant et al.

‘Ultrasound and pulsed electromagnetic energy treatment for peroneal trauma. A randomised placebo-controlled trial’

British Journal of Obstetrics and Gynaecology

(1989)

Cited by (50)

Tissue heating in different short wave diathermy methods: A systematic review and narrative synthesis
2021, Journal of Bodywork and Movement Therapies
Citation Excerpt :
Although the application of SWD to areas with plastic and metal is contraindicated (Rennie 2010) because electromagnetic energy tends to concentrate and heat up these materials (Prentice 2009), Draper et al. (2013) and Hawkes et al. (2013) did not remove the thermocouple during it, whereas Garrett et al. (2000) did not remove the thermistors during application. To our knowledge, the last review that comprehensively assessed temperature change through diathermy application was conducted by Kitchen et al., in 1992 (Kitchen and Partridge 1992). The authors included three studies analyzing CSWD on capacitive method at 1 cm of depth, two analyzing inductive method on this same depth and one of these also analyzed skin temperature, besides that, another two studies analyzing skin temperature change through PSWD.
To assess the change in temperature caused by different short wave diathermy (SWD) methods of application in different healthy tissues.
The Cochrane Central Register of Controlled Trials, MEDLINE, Science Direct, CINAHL, SciELO, PEDro, ClinicalTrials.gov, Brazilian Registry of Clinical Trials and the World Health Organization ICTRP were searched (1990–April 2020).
Randomized, quasi-randomized, and single-arm controlled trials assessing temperature change after SWD application in healthy adults were included. Group analysis was done according to SWD mode and where temperature was collected, risk of bias was assessed using the Cochrane tool and the quality of evidence using GRADE. A narrative synthesis was conducted since methodological homogeneity was not sufficient to undertake a meta-analysis.
Eleven studies were included, reporting data of 240 subjects. Regarding skin temperature change, the application that increased temperature the most was under the electrode using continuous SWD on coplanar arrangement of capacitive technique (7.9 [1.76] °C), coplanar arrangement also had the slowest temperature decay, and the lowest temperature found was through a low dose application of pulsed SWD (0.34 [0.69] °C). Regarding muscle temperature change, the application that increased temperature the most was using the inductive technique of pulsed SWD (4.58 [0.87] °C), this technique also had the slowest temperature decay, and the lowest temperature found was through ReBound shortwave diathermy (2.31 [0.87] °C).
SWD efficacy depends on setting choices. This review provides a detailed description of SWD methods of application and a quantitative data set of resulting temperature change.
Coplanar arrangement of shortwave diathermy is the most effective in skin temperature change: A randomized crossover trial
2021, Journal of Bodywork and Movement Therapies
Continuous shortwave diathermy (CSWD) efficacy relies on change in temperature, which had been evaluated previously. However, the studies are not comparable enough, consequently the primary goal of this study was to analyze which SWD capacitive technique arrangement is the most effective in skin temperature change.
A randomized, single-blinded crossover trial conducted in a university research laboratory. Twenty young healthy male subjects were randomly allocated using a website to receive 20 min of CSWD application to the anterior aspect of the thigh through coplanar, contraplanar and longitudinal arrangement. Skin temperature was collected under the proximal electrode and at the thigh center over 25 min after electrodes removal, using an infrared thermography camera.
There were two losses to follow up, remaining 18 subjects for analysis (age = 21.4 ± 2.09 years, BMI = 23.6 ± 2.46 kg/m²). Under the electrode all arrangements achieved vigorous heating (coplanar = 7.9 ± 1.76 °C; contraplanar = 6.52 ± 2.68 °C; longitudinal = 7.46 ± 1.8 °C) immediately after electrodes removal and temperature decreased with a similar rate across arrangements. At the thigh center, coplanar arrangement achieved mild heating (1–2 °C) until 17 min after electrodes removal; meanwhile, the other arrangements did not increase temperature sufficiently for post intervention therapeutic effects. No unintended effect was detected.
Coplanar arrangement increased skin temperature the most, heated the greatest area, and had the slowest temperature decay. If the body part accommodates any of the capacitive technique arrangements, coplanar should be used to treat superficial tissues.
Effectiveness of thermal and athermal short-wave diathermy for the management of knee osteoarthritis: A systematic review and meta-analysis
2012, Osteoarthritis and Cartilage
Citation Excerpt :
The physiological effects attributed to PSWD include increased blood flow, decreased joint pain and stiffness, reduced inflammation, faster resolution of oedema and accelerated would healing16. The use of PSWD for arthritic joint treatment has increased dramatically in the last decade, probably due to the possible link between increased temperature resulting from CSWD and synovial inflammatory activity, and between synovial inflammatory activity and worsening of cartilage degeneration in OA13,17. Thus, in a recent survey in England the availability and use of CSWD has decreased while the opposite is true for PSWD18.
To assess the effectiveness of short-wave diathermy (SWD) treatment in the management of knee osteoarthritis (KOA) and to assess whether the effects are related to the induction of a thermal effect.
A systematic literature search was conducted in PubMed, CINAHL, PEDro, EMBASE, SPORTdiscus and Scholar Google. Included were trials that compared the use of SWD treatment in patients diagnosed with KOA with a control group (placebo SWD treatment or no intervention) and studies that used high-frequency electromagnetic energy (i.e., 27.12 MHz) with sufficient information regarding treatment dosage. Methodological quality of the included studies was assessed in accordance with the PEDro classification scale. A minimum of a 6/10 score was required for inclusion.
Seven studies were included in the final analysis. Treatment protocols (dosage, duration, number of treatments) varied extensively between studies. The meta-analysis of the studies with low mean power did not favour SWD treatment for pain reduction, while the results of studies employing some thermal effect were significant. No treatment effect on functional performance measures was determined.
This meta-analysis found small, significant effects on pain and muscle performance only when SWD evoked a local thermal sensation. However, the variability in the treatment protocols makes it difficult to draw definitive conclusions about the factors determining the effectiveness of SWD treatment. More research (using comparable protocols and outcome measurements) is needed to evaluate possible long-term effects of thermal SWD treatment and its cost effectiveness in patients with KOA.
Comparison of the efficacy of transcutaneous electrical nerve stimulation, interferential currents, and shortwave diathermy in knee osteoarthritis: A double-blind, randomized, controlled, multicenter study
2012, Archives of Physical Medicine and Rehabilitation
Atamaz FC, Durmaz B, Baydar M, Demircioglu OY, Iyiyapici A, Kuran B, Oncel S, Sendur OF. Comparison of the efficacy of transcutaneous electrical nerve stimulation, interferential currents, and shortwave diathermy in knee osteoarthritis: a double-blind, randomized, controlled, multicenter study.
To compare the effectiveness of transcutaneous electrical nerve stimulation (TENS), interferential currents (IFCs), and shortwave diathermy (SWD) against each other and sham intervention with exercise training and education as a multimodal package.
A double-blind, randomized, controlled, multicenter trial.
Departments of physical medicine and rehabilitation in 4 centers.
Patients (N=203) with knee osteoarthritis (OA).
The patients were randomized by the principal center into the following 6 treatment groups: TENS sham, TENS, IFCs sham, IFCs, SWD sham, and SWD. All interventions were applied 5 times a week for 3 weeks. In addition, exercises and an education program were given. The exercises were carried out as part of a home-based training program after 3 weeks' supervised group exercise.
Primary outcome was a visual analog scale (0–100mm) to assess knee pain. Other outcome measures were time to walk a distance of 15m, range of motion, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Nottingham Health Profile, and paracetamol intake (in grams).
We found a significant decrease in all assessment parameters (P<.05), without a significant difference among the groups except WOMAC stiffness score and range of motion. However, the intake of paracetamol was significantly lower in each treatment group when compared with the sham groups at 3 months (P<.05). Also, the patients in the IFCs group used a lower amount of paracetamol at 6 months (P<.05) in comparison with the IFCs sham group.
Although all groups showed significant improvements, we can suggest that the use of physical therapy agents in knee OA provided additional benefits in improving pain because paracetamol intake was significantly higher in the patients who were treated with 3 sham interventions in addition to exercise and education.
Therapeutic Modalities As an Adjunct to Rehabilitation
2012, Physical Rehabilitation of the Injured Athlete: Expert Consult - Online and Print
Therapeutic modalities as an adjunct to rehabilitation
2012, Physical Rehabilitation of the Injured Athlete

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Literature ReviewReview of Shortwave Diathermy Continuous and Pulsed Patters

Summary

Oral Surgery

Journal of Surgical Research

Australian Journal of Physiotherapy

The Lancet

British Journal of Plastic Surgery

Physiotherapy

The Journal of Hand Surgery

Trends in the Biological Sciences

‘Changes in blood flow, oxygen uptake and tissue temperatures produced by therapeutic physical agents’

American Journal of Physical Medicine

‘Effect of tissue temperature and blood flow on motor nerve conduction velocity’

Journal of the American Medical Association

‘Electromagnetic field effects on tissue’

Physiological Review

‘Physiological signalling across cell membranes and co-operative influences of extremely low frequency electromagnetic fields’

‘Physical principles of local heat therapy for cancer’

Medical Instrumentation

‘Treatment of various hand injuries by pulsed electromagnetic energy’

Physiotherapy

‘A double-blind clinical trial of low-power pulsed shortwave therapy in the treatment of a soft tissue injury’

Physiotherapy

‘Low energy laser therapy: Controversies and new research findings’

Lasers in Surgery and Medicine

‘The effect of therapeutic forms of heat and ice on the pain threshold of the normal shoulder’

Rheumatology and Rehabilitation

‘A trial involving the use of pulsed electromagnetic therapy on children undergoing orchidopexy’

Kinderchirugie

‘Effect of pulsed shortwave diathermy on skeletal muscle injury in rabbits’

Physical Therapy

‘Evaluation of reproductive function of female rats exposed to radio frequency fields (27.12 MHz) near a shortwave diathermy device’

Health Physics

‘Experimental acceleration of wound healing’

American Journal of Orthopaedics

‘Physiotherapy in osteo-arthrosis of the knee’

Annals of Rheumatic Diseases

‘Hyperthermia production for cancer therapy — A review of fundamentals and methods’

Journal of Microwave Power

‘Evaluation of physiotherapy in the treatment of osteo-arthrosis of the knee’

Rheumatology and Rehabilitation

‘Changes in motor conduction velocity induced by exercise and diathermy’

Physical Therapy

‘Evaluation Report: Shortwave therapy units’

Journal of Medical Engineering and Technology

‘Congenital defects in guinea pigs following induced hyperthermia during gestation’

Archives of Pathology and Laboratory Medicine

‘Congenital defects due to hyperthermia’

Advances in veterinary Sciences and Comparative Medicine

‘Peripheral blood flow measurements during application of pulsed high frequency currents’

American Journal of Orthopaedics

‘Effect of pulsed electromagnetic energy (Diapulse) on experimental haematomas’

Canadian Medical Association Journal

‘Pulsed high frequency (27 MHz) electromagnetic therapy for persistent neck pain’

Orthopaedics

‘Pulsed shortwave in the treatment of bursitis with calcification’

International Record of Medicine

‘Ultrasound and pulsed electromagnetic energy treatment for peroneal trauma. A randomised placebo-controlled trial’

British Journal of Obstetrics and Gynaecology

Literature Review
Review of Shortwave Diathermy Continuous and Pulsed Patters