For UG Students.

1. PHYSIOTHERAPY
METHODS
Dr.Sarthy.V. DNB (Ortho)
Asst Professor
Department of Orthopaedics
SSSMCRI

2. Will be introduced to:
Short Wave
Diathermy :
SWD
Ultra Sound
Therapy.
Inter
Ferential
Therapy : IFT

3. Short Wave Diathermy :
SWD

4. Principle
• High frequency Electromagnetic energy.

5. SWD
Radio frequency vibration
Penetrates deep tissue
Molecular vibration
Thermal & Non thermal effects

6. 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

7. types
Induction field Capacitive field

8. Induction field
• Uses Coil & Drum.
• Places the patient in the electromagnetic field.
• Produces Eddy Current.
• Heat generated from friction.

9. 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.

10. precautions
• Heat produced directly related to the
tissue’s resistance.
• Adipose tissue / fat - provides maximum
resistance.

11. Mode of application
Continuous
• Unsafe.
Pulsed
• Allows prolonged use.
• Allows more intensity to be used.

12. 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.

13. 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

14. 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

15. Electrodes

16. Microwave diathermy
• Electromagnetic wave frequency range:
• Between:
• ShortWave & Infra Red.

17. Therapeutic ultrasound

18. • 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 )

19. Mechanism of action
Ultra Sound Waves
Oscillation of Particles
Molecular Vibration
Thermal Reaction

20. Production of us waves
Crystals are exposed to
alternating electrical current.
contract/expand/oscillate
Produce pressure waves
Ultra Sound Waves

21. indications
• To decrease pain & spasm.
• Increase collagen elasticity.
• Increase blood flow.
• Increase metabolic rate.
• Enhance tissue healing.
• Early organization of healing tissue.

22. precautions
• Anesthetic areas.
• Myositis Ossificans.
• Fibrotic myopathy.
• Implants: Plastic & Metallic.
• Carotid Sinus.
• Pregnant uterus.

23. contraindications
• Over heart.
• Over spinal cord.
• Epiphysis/Growth plate.
• Acute infection.
• Bleeding areas.
• Neoplasm.
• Thrombophlebitis.

24. Us - Frequency
• 1 MHz – Penetrate deeper tissue : 2-3 cm.
• 3 MHz – Heats superficial tissue : 0-3 cm.

25. Mode of application
Continuous
• Thermal effect
Pulsed
• Non Thermal effect.

26. 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.

27. 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.

28. 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.

29. INTERFERENTIAL
THERAPY (IFT)

30. 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.

31. 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

32. principle

33. Why ift ?
• Low skin resistance.
• More comfortable.
• More tolerable.
• Deep penetration.
• Larger area.

34. Mode of application
2 Poles
(Bipolar)
4 Poles
Stereodynamic
3D
Static Static Dynamic
Oval
field
Clover
leaf
field
Circular
field
Smaller areas:
Ankle
Elbow
Acute Conditions:
Milder effect.
Larger areas:
Diffuse pain..
Shoulder
Back
Thigh

35. Duration of application
• 10 to 30 minutes.
• 12 to 24 sittings.
• NEVER FOR MORE THAN 30 minutes.

36. disadvantages
• Eliminates pain but not its cause.
• Not easily portable.
• Expensive.

37. Clinical effect
• Pain relief.
• Muscle Stimulation.
• Increased local blood flow.
• Decreases edema.

38. Pain alleviation
• Stimulation of Reticular formation in the brain
via the sensory nerve endings.
• Block “C “ fiber transmission (Gate Control).

39. Edema reduction
• Ion vibration.
• Ion diffusion.
• Increased Permeability.
• Increased venous & lymphatic drainage.

40. Marked use
• Complex Regional Pain Syndrome.
• Stump Pain.
• Herpes Zoster.
• Vascular Insufficiency.
• Myofascial pain syndromes.
• Muscle re-education for patients with urinary
incontinence.

41. Not of use
• In acute post traumatic pain.

42. contraindications
• Arterial/venous Thrombi.
• Infected areas.
• Cranium.
• Pregnant Uterus.
• Hemorrhagic areas.
• Malignancy.
• Implants : plastic & metallic.
• Unreliable Patients.

43. dangers
BURNS
• Metal electrode over skin.
• Increased intensity.
• Insufficient Moisture pads.
ECCHYMOSES/HEMATOMA
• Suction from the negative pressure
created.

44. Poor results
• Improper electrode placement.
• Incorrect choice of frequency.
• Incorrect balancing of the frequencies.

45. Thank you