SHORT WAVE: Is electromagnetic waves which are forms of energy.

SWD: Is a means of producing therapeutics heat in the tissues by the use of radio waves of high frequency. DIATHERMY MEANS: through heating. PRODUCTION OF SHORT WAVE DIATHERMY (SWD) : Radio waves in the short wave band have frequencies in the range (10 -100) MHz. SWD machines used by physiotherapy utilizes the frequency of (27.12) MHz. with wave length greater than (11) m. _TYPES OF ENERGY TRANSFER TO THE PATIENT:_ ELECTROSTATIC FIELD: (not moving) there are electrostatic forces MAGNETIC FIELD: (moving with a constant velocity) there are magnetic forces ELECTROMAGNETIC FIELD: (accelerating) increase movement of electric charges); there is emission of radiations. (there is production of electromagnetic radiation which radiates away from the moving charge. (both electric and magnetic fields occurs at the same time) _HEAT PRODUCTION IN THE TISSUES__:___ - The concentration of the electric field will be highest in the tissues with the greatest conductivity. * LIVING TISSUES HAVE THREE MOLECULAR TYPES: 3- Charged molecules. 4- Dipolar molecules. 5- Non-polar molecules. 1- CHARGED MOLECULES: - Tissues consist of a lot of charged molecules mainly ions and certain proteins. There is repulsion and attraction occurs between charged molecules. The exposure to a SWD field causes the charged molecules to be accelerated along the lines of electric force. And then the kinetic energy converted into heat. 2- DIPOLAR MOLECULES: - Tissues consist of water and some proteins. The positive pole of the molecule aligns towards the negative pole of the electric field.

The exposure to SWD field causes rotation of these molecules as the charge of the plates alters rapidly. Heat results from the friction between adjacent molecules. 3- NON- POLAR MOLECULES: - Fat cells are non-polar molecules. They don't have free ions or charged poles. The exposure to SWD field causes these molecules (electrons) to become distorted. Negligible heat is produced. So, the tissues that have a high ionic content in solution or a large number of free ions are the best conductor. E.g. blood (vascular tissues are a good conductor). Adipose tissue (fat) is poor conductor. So, the magnitude current setup in fat will be minimal. Charged molecules Dipolar molecules Non polar molecules PSWD: PULSED SHORT WAVE DIATHERMY: - When SWD machine allow EME to be applied to the patient in short bursts of energy is called PSWD. The physical characteristics of PSWD SWD are identical, the difference only is the interrupted or pulsed only. The concept under PSWD is to give the tissues electromagnetic field energy without thermal load. __ __ __ _TERMS DEFINITIONS:_ DIATHERMY: heating through CONDENSER: consist of two metal plates separated by an insulator, has ability to store a charge (electric energy) DIELECTRIC: is the insulating or non conducting material between the two plates of condenser. ELECTROSTATIC FIELD: is set up between two electrodes by application of a current to the electrodes. ELECTROMAGNETIC FIELD: is a set up around the loop of coil through which a current is passing. CONDENSER-FIELD METHOD: is a method of SWD use the patient in the circuit as part of condenser, that electrostatic field is set up in the tissues.

INDUCTOTHERMY METHOD: is a method of SWD use coil around tissues, that electromagnetic electrostatic field are set up in the tissues. CONVERSION: heat transference by non-thermal electro-magnetic energy absorbed by body tissues and changed to thermal energy. CONVERSION MODALITIES: SWD - MWD - US. ________________________________________________________________________________ _PHYSIOLOGICAL EFFECTS OF SWD: _ 4- Increase blood flow. 5- Assist in the resolution of inflammation. 6- Increase extensibility of deep collagen tissue. 7- Decrease joint stiffness. 8- Relieve deep muscle pain and spasm. _INDICATIONS AND THERAPEUTIC USES OF SWD: ___ 1- Soft tissue healing. 2- Resolution of haematoma. 3- Recent ankle injuries: PSWD produced greater improvement in pain, swelling and disability. 4- Relief of pain: mild degree of heating is effective in relieving pain (sedative effects on sensory nerve ending). Strong superficial heating probably relieves pain by counter irritation. 5- Pt. with osteoarthritis. 6- Induce relaxation and relief muscle spasm. 7- Effects on inflammatory process: e.g. boils and carbuncle- bacterial infection. Dilatation inc. blood flow inc. supply of O2 and nutrition bringing more antibodies and WBCs dilatation increase exudation of fluid into the tissues followed by increase absorption which assist in removal of waste products. - This effect helps in the resolution of inflammation. _CONTRAINDICATION:_ 1- Loss or impaired of skin sensation (Leads to burn). 2- Impaired circulation (ischemia or varicose veins).

3- Hemorrhage. (Sw increases hemorrhage). 4- Venous thrombosis. (Leads to dislodge the clot or aggravate the inflammation). 5- Abnormalities of blood pressure 6- Sever cardiac conditions 7- Pacemaker 8- Pregnancy (Defect the fetus and leads to abortion). 9- Menstruation 10- Metallic implant in the tissues (increase heating which leads to burn) 11- Tumors / Malignancy (Sw Increase growth of tumors). 12- Hyper sensitivity to heat 13- Dermatological problems Skin disease or infections) 14- Uncontrolled or unreliable patient (Mentally retarded patient, small children, pt unable to understand and unconsciousness patient. 15- After x-ray therapy-radiotherapy (Because x-ray already causes devitalization of the tissues, so when SWD is applied directly after x-ray, this will leads to damage of the tissues. 16- Analgesic therapy 17- Over wet dressing adhesive tape DANGERS: 1- Burn: happen due to: a) Excessive heating b) Hypersensitive skin. c) Impaired blood flow. d) Leads touching the skin. e) If the area to be treated is damp or moist. 2- Electric shock (if pt touch the machine or if machine is not earthed) 3- Exacerbation of symptoms, especially when thermal doses are used. 4- Spread of existing pathologies.E.g.tumors, tuberculosis or infection 5- Faintness: if anemia of brain happen during treatment caused by sudden fall in blood pressure.

6- Giddiness: if SWD applied to head. _PRECAUTIONS TO AVOID DANGERS:_ 1- Check all contraindications, by asking for pt. history, examine the treated area. 2- Always test thermal skin sensation 3- If SW apply over bony prominence electrode should be positioned with greater distance from the skin. 4- Never apply SW over clothing 5- Skin must be dry (avoid sweating) 6- Ensure that there is adequate spacing between electrodes skin 7- Ensure that the leads from machine or the electrodes are not touching the patient 8- Care must be taken to allow 2-3 min on each intensity setting 9- Ensure that machine is correctly earthed 10- Let the patient sit on wooden chair 11- Don't touch, or allow the patient to touch the machine 12- Don't increase the intensity unless leads or electrodes are correctly connected to the machine 13- Avoid wearing of any metal (watch, keys, or even belt metal.) 14- If patient is wearing hearing aid, should be switched off 15- Ensure wave set up by test tube lamp. _ADVANTAGES:_ 1. Can be applied for variety of indication 2. Can be applied to deep structure 3. Comfortable for the patient 4. Suitable for body curvature 5. Can heat through joint _DISADVANTAGES:_ 1. Need complex application 2. Deep tissue burn can occur

__________________________________________________________________________________ _______________ _CLINICAL APPLICATION_ __ _THE CIRCUIT USED:_ 1. Machine Circuit: which produces high frequency current amplifies its intensity. 2. Patient Circuit: which is coupled to the machine circuit by inductors, transfer the electric energy to pt inform of electrostatic or electromagnetic field. ELECTRO STATIC FIELD: By using condenser (capacitor) field method Includes patient's tissues in patient circuit as part of the condenser By apply two electrodes to the part; electrode work as condenser, pt tissue with the space between pt skin electrode as dielectric of condenser. High frequency alternate current will concentrate electric field between two electrodes i.e. (pt tissue) Effect of this current make vibration of charged tissue ions, lead to friction between them, that produce heat in tissue Types of electrodes (space plates, flexible pads) ELECTROMAGNETIC FIELD: By using inductothermy method. Use thick insulated cable to complete machine circuit. Cable is coiled around tissue, but separated from them by spacing. High frequency alternate current leads to electromagnetic field around center of cable, electrostatic between its ends i.e. two fields concentrated in pt tissues. Effects; electromagnetic produce eddy currents; make friction of tissue particles that produce heat. Types of electrodes (coil electrode, minode, drum elect.) TYPES OF ELECTRODES: 1. SPACE PLATES :consist of rigid metal electrode encased in a Perspex cover (insulating material) 2. FLEXIBLE PADS: consist of malleable metal covered with a thin layer of rubber. 3. COIL OR CABLE: consist of thickly insulated wire with plugs at either end.

4. MONODE: consist of a flat, rigid coil encased in a Perspex cover. 5. MINODE: consist of conical, rigid coil encased in a Perspex cover. 6. DIPLODE OR DRUM: consist of flat coil electrode encased with Perspex cover with two wings which are attached to central bar by hinges to fit angles. FACTORS AFFECTING FIELD DISTRIBUTION IN (SWD): 1. SPACING OF ELECTRODES: Space allows lines of force in electrostatic field to diverge before entering the tissues. This prevents concentration of heat in superficial tissues ensures more heat through the part. SIZE OF ELECTRODES : Different size of electrodes affects heating. The best is to apply electrodes little larger than the part. Smaller size, superficial field concentration. Marked larger size, the field will travel through air. POSITIONING OF ELECTRODES: The electrodes should be parallel to skin surface. That the electric field is directed through the deep tissues. 3. METAL INSIDE TISSUE: causes concentration of field in the metal that result in burning of adjacent tissues. 4. AIR IN CAVITIES: causes the field to deviate away from it, result in heating only the sides of this cavity. THERE ARE TWO METHODS OF APPLICATION: 1- Capacitor field method: cause deep heating. 2- Cable method: cause more deep heating. 1- CAPACITOR FIELD METHOD A) CONTRAPLANAR: the electrodes are placed on the opposite sides of the part, to treat DEEPLY PLACED STRUCTURES. E.g.: joints, distance between electrodes skin (25 mm). B) COPLANAR: the electrodes are placed on the same side of the part to treat more SUPERFICIAL STRUCTURES. E.g.: spinal musculature, distance between electrodes must be greater than the sum of skin electrode distance C) CROSS FIRE: Half of the treatment is given by contra planar position other half are repositioned at right angles. Used for deeply placed organ, as in pelvis for air filled cavities (sinus). 2- CABLE METHOD (INDUCTOTHERMY):

A) CABLE OR COIL: Wrapping a cable around the part, distance between the turns should be 2.5cm a part. Wrapped the cable in flat helix, put it over the part as in back (pancake coil). B) DRUM: Involve a small flat metal coil enclosed in a plastic drum with capacitor in parallel as in (Monode, Minode, and Diplode) EXAMPLES FOR THERAPEUTIC APPLICATIONS FOR THE ELECTRODES: Two flexible pads or two space plates application Coil application Diplode application Two limbs application (knees, hands) Cross fire application Combination application as: 1. Flexible pad space plates 2. Flexible pad coil DOSAGE: The intensity of the application should be sufficient to cause comfortable warmth which described by patient. For the treatment of CHRONIC INFLAMMATORY lesions: Duration of treatment: 20 - 30 min. On alternates days For the treatment of ACUTE INFLAMMATION or recent injury (only mild heating, need less intensity of heating than for chronic cases.). Duration of treatment: 5 - 10 min twice daily.