Post on 08-Sep-2014
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PHYSIOTHERAPY METHODS
Dr.Sarthy.V. DNB (Ortho)
Asst Professor
Department of Orthopaedics
SSSMCRI
Will be introduced to:
Short Wave Diathermy :
SWD
Ultra Sound Therapy.
Inter Ferential Therapy :
IFT
Short Wave Diathermy : SWD
Principle• High frequency Electromagnetic energy.
SWD
Radio frequency vibration
Penetrates deep tissue
Molecular vibration
Thermal & Non thermal effects
Thermal Effects• Deep Heat• Increase Metabolism• Increase Extensibility• Muscle Relaxation• Modify Enzyme Reactions
Non Thermal Effects• Edema Reduction• Superficial wound healing• Heal venous stasis ulcers
types
Induction field
Capacitive field
Induction field
• Uses Coil & Drum.
• Places the patient in the electromagnetic field.
• Produces Eddy Current.
• Heat generated from friction.
Capacitive field
• Patients tissue is part of the circuit.
• tissue’s electrical resistance produces heat.
• Selectively heats Skin. . • Muscle heats up through conduction from Skin &
Adipose tissue.
precautions
• Heat produced directly related to the
tissue’s resistance.
• Adipose tissue / fat - provides
maximum resistance.
Mode of application
Continuous• Unsafe.
Pulsed• Allows prolonged use.• Allows more intensity to be used.
Therapeutic use
• Pain relief: Traumatic & Rheumatic.
• Relieves Spasm.
• Resolution of inflammation.
• Accelerate wound healing.
• Infection: • Increases circulation.• Brings in more WBCs.
• Increases Extensibility of Fibrous tissue.
contraindications
• Metal implants or metal jewelry
•Cardiac pacemakers
• •Ischemic areas
• •Peripheral vascular disease
• •Perspiration and moist dressings: The water collects and concentrates the heat.
• •Tendency to hemorrhage, including menstruation.
• •Pregnancy
• •Fever
contraindications
• Sensory loss
• •Cancer
• •Areas of particular sensitivity: • –Epiphyseal plates in children • –The genitals • –Sites of acute infection • –The abdomen with an implanted
intrauterine device (IUD) • –The eyes and face • –Application through the skull
Electrodes
Microwave diathermy
• Electromagnetic wave frequency range:
• Between:
• ShortWave & Infra Red.
Therapeutic ultrasound
• Mechanical waves in the form of sound energy.
• Normal sound range:• 16Hz – 20,000Hz
• Ultrasound frequency: > 20,000Hz.
• Therapeutic range:• 1.0 MHz – 3.0 MHz
(1MHz – 1 Million cycle / Second )
Mechanism of action
Ultra Sound Waves
Oscillation of Particles
Molecular Vibration
Thermal Reaction
Production of us waves
Crystals are exposed to alternating electrical current.
contract/expand/oscillate
Produce pressure waves
Ultra Sound Waves
indications
• To decrease pain & spasm.
• Increase collagen elasticity.
• Increase blood flow.
• Increase metabolic rate.
• Enhance tissue healing.
• Early organization of healing tissue.
precautions
• Anesthetic areas.
• Myositis Ossificans.
• Fibrotic myopathy.
• Implants: Plastic & Metallic.
• Carotid Sinus.
• Pregnant uterus.
contraindications
• Over heart.
• Over spinal cord.
• Epiphysis/Growth plate.
• Acute infection.
• Bleeding areas.
• Neoplasm.
• Thrombophlebitis.
Us - Frequency
• 1 MHz – Penetrate deeper tissue : 2-3 cm.
• 3 MHz – Heats superficial tissue : 0-3 cm.
Mode of application
Continuous• Thermal effect
Pulsed• Non Thermal effect.
Pulsed mode
• Pulse ratio determines the
concentration of energy.
• Acute conditions : Increased Pulse ratio.
• More Pause than Pass (1:3,1:4)
• Chronic Conditions : Decreased Pulse
Ratio.
• More Pass than Pause (1:1)
Interface reflection
• Temperature increase at tissue interfaces, due
to reflection.
• Always use low intensity over bony areas.
• Heating of the overlying periosteum very
painful.
• Maximum heat produced at a depth of 1cm.
mechanism
US waves
Unidirectional movement of fluid in the field.
Micro massage.
Increased Cell Diffusion & Permeability & Increase Calcium ion transport.
More rapid recruitment of endothelial cells & fibroblasts – help in healing.
INTERFERENTIAL THERAPY (IFT)
introduction
• Widely used electrotherapy modality
• Developed by Dr. Hans Nemec of Vienna in Australia 1950s
• Utilizes the therapeutic aspects of low frequency currents without the discomfort.
principle
Transcutaneous uses of two or three alternating medium frequency (2000 to 5000Hz) sinusoidal current
Introduce low frequency (1 to 250Hz) current
Stimulate sensory and motor nerves
principle
Depolarizes Sensory & Motor
Nerve Fibers
Why ift ?
• Low skin resistance.
• More comfortable.
• More tolerable.
• Deep penetration.
• Larger area.
Mode of application
2 Poles(Bipolar) 4 Poles
Stereodynamic
3D
Static Static Dynamic
Ovalfield
Clover leaffield
Circularfield
Smaller areas:AnkleElbow
Acute Conditions:Milder effect.
Larger areas:Diffuse pain..
ShoulderBackThigh
Duration of application
• 10 to 30 minutes.
• 12 to 24 sittings.
• NEVER FOR MORE THAN 30 minutes.
disadvantages
• Eliminates pain but not its cause.
• Not easily portable.
• Expensive.
Clinical effect
• Pain relief.
• Muscle Stimulation.
• Increased local blood flow.
• Decreases edema.
Pain alleviation
• Stimulation of Reticular formation in the
brain via the sensory nerve endings.
• Block “C “ fiber transmission (Gate
Control).
Edema reduction
• Ion vibration.
• Ion diffusion.
• Increased Permeability.
• Increased venous & lymphatic drainage.
Marked use
• Complex Regional Pain Syndrome.
• Stump Pain.
• Herpes Zoster.
• Vascular Insufficiency.
• Myofascial pain syndromes.
• Muscle re-education for patients with urinary incontinence.
Not of use
•In acute post traumatic pain.
contraindications
• Arterial/venous Thrombi.
• Infected areas.
• Cranium.
• Pregnant Uterus.
• Hemorrhagic areas.
• Malignancy.
• Implants : plastic & metallic.
• Unreliable Patients.
dangers
BURNS• Metal electrode over skin.• Increased intensity.• Insufficient Moisture pads.
ECCHYMOSES/HEMATOMA• Suction from the negative pressure
created.
Poor results
• Improper electrode placement.
• Incorrect choice of frequency.
• Incorrect balancing of the frequencies.
Thank you