Shortwave

Definition
Shortwave means the application of high frequency electrical energy to the body tissues in order to bring physiological and therapeutic effects, these effects can be achieved by thermal or non thermal effect.

Shortwave is one of the diathermy family. Other modalities that can also heat the tissues are microwave and ultra sound. Shortwave, microwave and ultrasound can heat the tissues up to a very deep layer. The electromagnetic spectrum has a wild range of shortwave.

Shortwave Has Three Main :Frequencies

27.12 MHz, wavelength 11 M (most common used one).

13.56 MHz wavelength 22 M. 40.68 MHz 7.5 M.

Shortwave Diathermy Machine

First we have the power supply. Inside the machine there is a high frequency generator + an amplifier + oscillator coil + resonator coil + variable capacitor. Outside the machine we have two electrodes + the part being treated

:There Are Two Circuits Here

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Machine circuit : composed of a high frequency generator, amplifier, oscillator coil. Patient circuit: composed of a resonator coil, variable capacitor, electrodes and the treated tissue.

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Shortwave Can Be Used in Two :Modes

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Continuous (energy is emitted all the time). Pulsed (energy is emitted part of the time).

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When using the pulsed shortwave, there are certain parameters that we need to know:

Pulse width: measured by micro seconds. Pulse frequency: how many pulses we have per second measured by Hz or pulses per second (PPS)

Peak power output: usually is a set value that is determined by the manufacturer. Mean power output: is variable and is determined by factors such as the pulse width and the pulse frequency.

How could we produce energy into the body without causing heat production

The off time with pulsed shortwave is longer than the on time which allows the dissipation of heat. The interpulse period gives time for the heat to dissipate. If the interpulse is short heat will develop, because there is no time for the effect to dissipate within the body.

Continuous shortwave is always thermal. Pulsed shortwave can be thermal or non thermal. High parameters usually gives thermal effect. If we use long pulse duration, high pulse frequency, heat will develop. The mean power is affected by the parameters chosen and the time of treatment.

Pulsed shortwave can only be non thermal if short pulses, low pulse repetition rate and short treatment duration is being used.

Advantages of Shortwave

The deep penetration, it goes deep to 5cm. You can use it while attending to another patient, which allows you to manage your time in the clinic. It covers large areas. It can heat the deeper tissue without heating the superficial tissue It can be used with sensitive tissues because it doesnt need to be in contact with the treated tissue.

Effects of Shortwave on The :Molecules and Ions of Tissues

If it is charged there will be vibration. If it is dipole it will rotate. If it is not charged it wont be affected.

Factors Influencing The Field

Spacing between the electrodes. Electrode size. The technique applied. Metal (If the patient has a metal implants, or if the bed is metal).

Spacing The Electrodes

When using flexible electrodes a 2cm thick towel ensures the spacing between the electrode and the body part. When using coil electrode felt spacers ensures the distance between the turns. When using space electrodes the space between the electrode and the body part is 2-2.5cm.

The Size

If electrodes are smaller than the diameter of the part treated there will be superficial heating. If the electrode is larger than the part being treated there will be wasted energy. When using unequal electrodes size concentrates the field on the small electrode side.

Spacing more than 2.5cm should be used on the side where no concentration of the field is required.

When Choosing The Size of :Electrode We Should Consider

1) 2) 3) 4) 5)

The size of the area treated. Location of the area to be treated. The depth of the targeting tissue. Treatment goals. The contraindications.

Physiological Effects of Shortwave ((Thermal

Increase of tissue temperature by 1 degree increase metabolism (good for healing). Increase of tissue temperature by 2-3 degrees effective for pain and muscle spasm. Increase of tissue temperature by 3-4 degrees good for tissue extensibility (when we need to do stretching).

Patients Feeling

Continuous (Thermal) shortwave Tell the patient that they will feel mild gentle warmth. Pulsed, Non thermal shortwave the patient will feel nothing. Pulsed, Thermal shortwave Tell the patient that they will feel mild gentle warmth.

Important Rule

Chronic cases you can treat it with thermal or non thermal shortwave. Acute only use non thermal shortwave

Contraindications

Metal implants Pregnancy During menses Cardiac pacemaker Radiation therapy Malignant tissue After analgesic therapy Blood pressure abnormalities

Vascular diseases Hemorrhage Fever Inflammation Wet dressing Tuberculoses Impaired thermal sensation

Indications

Sprain Strain Muscle and tendon tear Capsule lesion Degenerative joint disease Joint stiffness Hematoma Synovitis Bursitis Abscess

Effects of Thermal Shortwave

Increase blood flow Promote tissue healing Decrease inflammation Decrease pain Increase tissue extensibility decrease muscle spasm Control infection

Dosage with the shortwave

Includes:
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Time of application. Parameters chosen (mode, frequency, type of electrodes, etc). How much do we apply the treatment.

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Duration

Average of 15 minutes depending on the site of the area and the patients response Can increase to 30 minutes. Longer treatment duration may result in reflect vasoconstriction noticed clearly in the toes and fingers

When increasing the intensity wait 2-3 minutes to allow the temperature to build in the tissue before moving to the next stage.

How To Set The Parameters When Using Pulsed Shortwave

If we want to set the pulsed shortwave:

In acute conditions, the mean power output should be 3 and the treatment time is 10 minutes. In sub acute, the mean power output should be 2-5 and the treatment time 10 to 15 minutes. In chronic conditions, the mean power output is from 5-7 and the treatment can go up to 30 minutes.

Mean power output = peak pulse power / percentage of on time On time = pulse duration / pulse period Pulse period = peak pulse power / pulse repetition rate

When Using Thermal Shortwave

1) 2) 3) 4)

Adjust the machine. Ask the patient. If the temperature is too hot decrease it. The patient is not feeling heat increase it. Dosage with the continuous shortwave depending on the thermal sensation reported from the patient. Use your clinical judgment in administering the dosage .

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Frequency of The treatment

Daily or every other day. Depends on the patients response. If the condition is very acute, daily treatment will give better results. Chronic condition, every other day treatment. If it didnt improve do it everyday.