Electrical Energy Devices PDF

Summary

This document provides a comprehensive overview of electrical energy devices, specifically focusing on shortwave diathermy (SWD). It details the physiological effects of SWD, including how it increases tissue temperature and its use in pain management and wound healing. The document also covers indications and contraindications.

Full Transcript

Electrical Energy Devices: A Comprehensive Overview Shortwave Diathermy (SWD): From the greek meaning ''through heating''. Diathermy of sufficient power can produce heat in large areas with evidence that low average power, pulsed diathermy has nonthermal effects that help control pain, edema, promo...

Electrical Energy Devices: A Comprehensive Overview Shortwave Diathermy (SWD): From the greek meaning ''through heating''. Diathermy of sufficient power can produce heat in large areas with evidence that low average power, pulsed diathermy has nonthermal effects that help control pain, edema, promote wound and tissue healing. SWD can be delivered in continuous or pulsed mode that can generate heat in the body at sufficient intensity. When SWD in in pulsed mode at lo intensity, that heat is dissipated before it can accumulate, but can produce physiological effects through nonthermal mechanisms. Shortwave Diathermy Physiological effects: 1 Diathermy increases tissue temperature; the amount of temperature depends on the amount of energy absorbed by the tissue which is determined by the average determined by the average intensity of the electromagnetic field output, the distance of the device from the tissue and the type of the tissue to which the field is which the field is applied. 2 It can be delivered continuously or pulsed. If the average power is greater than 38 watts, tissue temperature will increase. The advantage of diathermy over other diathermy over other thermal agents is that it can heat tissues more deeply than other thermal agents such as hot packs, and it can cover larger areas than ultrasound. It areas than ultrasound. It also produces thermal effects in superficial tissue as well. 3 SWD is not reflected by bones and therefore does not concentrate at the periosteum or pose a risk of periosteal burning, as ultrasound does. Shortwave Diathermy: Thermal Effects: Nonthermal Effects: Vasodilation from heat causes an increase in the rate of blood flow. When applied in pulsed mode with low average intensity, the tissue temperature is maintained due maintained due to the heat quickly dissipating through the blood perfusing in the area between area between pulses. Increase rate of nerve conduction. Alters ion binding at the cell membrane which causes growth factors activation in fibroblasts, chondrocytes and nerve cells, macrophage activation and changes in myosin phosphorylation. Note: do not apply in patients with multiple sclerosis as the nerve can cause a conduction conduction block due to the shortened duration of sodium channel opening the node of node of Ranvier during neuron depolarization. Elevated pain threshold. Accelerates calcium ion binding to calmodulin messenger protein that interacts with target proteins involved with inflammation and immune response. It's been suspected that SWD modulates pain, Increased activity of cutaneous thermoreceptors which can have a gating effect on edema and inflammation and improves tissue healing from nitric oxide through calcium- transmitting pain at the spinal cord level. Decreased ischemia via increased blood flow and reduce spasm in the muscles that compress calmodulin. blood vessels to enhance healing of damaged tissue. Reduced pain. Increased microvascular perfusion. Diabetic ulcers. Increased soft tissue extensibility. Increase local tissue oxygenation, nutrient availability and phagocytosis to accelerate tissue healing. When soft tissue is heated before stretching, it increases in length when the stretching is applied, so less force is needed to achieve the increased length, and the risk of tissue tearing is reduced. Shortwave Diathermy: Indications: Contraindications: Control of pain and edema. Patients with pacemakers or other implanted electronic devices. Metal implants (including jewelry). Improves edema drainage and reduces pain after soft tissue injury (ankle sprains, low back pain, and rotator cuff surgery). Also, improves wound healing. Soft tissue healing. Pregnancy. Incisional wounds, pressure ulcers, burn- related injuries and tendon injuries. After surgical wound sites, SWD showed increased collagen formation, formation, white blood cell infiltration, and phagocytosis and tendons tendons showed increased tensile strength. Bone healing. Malignancy. Can accelerate the healing of bone fractures but not nonunion acute fractures. Osteoarthritis. Over the eyes, testes and growing epiphyses. Sine Wave: Low frequency current, low voltage, low amperage. Alternating current (therefore, no polarity effects) biphasic symmetrical current. Utilized in 4 forms: Continuous alternating between 1-2000Hz (chemical changes; to decrease edema and/or congestion). Slow pulsating at 5-30 Hz (used for contracted smooth muscle). Surged sinusoidal current (develop strength and tone in muscles, tendons and ligaments). Tetanizing sinusoidal current (used for muscle spasms and pain to induce muscle relaxation and reduction in pain). Indications: Contraindications: Adhesions (trigger points). Over the eyes, brain hematoma. Muscle spasms, muscular atrophy, trigger points, restricted joint motion, passive Fracture. exercise. Metallic implant. Pain, edema. Pregnancy. Denervation, ischemia. Pacemaker. Cancerous lesion. High Voltage Galvanism: How to prepare for High Voltage Pulsed Current (HVPC)? 1 Indications: 2 Contraindications: 3 Mechanism: Pain reduction: Over low back or abdomen during Use of unidirectional, monophasic, Muscle spasm reduction. during pregnancy. monophasic, interrupted current of Over neoplasm. current of up to 500 volts. Muscle exercise and re- education. Pacemaker. Positive pole: analgesic effect over painful areas, tends to Circulation enhancement and Over eyes, brain, heart. constrict blood vessels; mild edema reduction. Over hemorrhage. germicidal effect. Negative pole: trigger points, soften adhesions, dilate blood vessels; exercise/ re-educate muscles. Low Voltage Galvanism: Amrex LVG325A Low Voltage Galvanic Stimulator General Operation Indications: Contraindications: Mechanism: Stimulate denervated muscles, restricted joint motion. Avoid abdominal and pelvic regions during pregnancy. Acid-base reaction under the active pad (risk for motion. chemical burn). Arthritis, neuralgia, sprains and strains. Cancerous lesions. Do not exceed therapeutic time that can cause burns. Acute and chronic pain. Pacemaker. Metallic implants. burns. Pressure ulcers. Do not treat on a metal table. Excessive scarring. Do not break circuit suddenly. Positive Pole (anode) Negative Pole (cathode) Oxidation reaction. Reduction reaction. Attracts oxygen. Attracts hydrogen. Hardens scar tissue. Softens scar tissue. Vasoconstriction. Vasodilation. Analgesic. Tissue relaxation. Antimicrobial. Iontophoresis: Iontophoresis for Dequevain's Tenosynovitis Wrist Pain with Dexamethasone Is the use of low amplitude electrical current to facilitate transdermal drug delivery. It is used to deliver therapeutic drugs while avoiding the side effects of some oral, nasal, or some oral, nasal, or parenteral routes of their administration. Transdermal delivery is a viable option only if the compound can enter through the skin at a high rate and high rate and concentrations that are effective. Fixed charge electrode: Contraindications: Challenge: The most common use of iontophoresis in rehabilitation Pacemaker or unstable arrhythmias. Control of delivering the precise dose of the drug and the is applying anti-inflammatory corticosteroid, Placement of electrodes over carotid sinus. Areas patient level of tolerance of the stimulation. dexamethasone. Others are lidocaine; epinephrine to where venous or arterial thrombosis or maintain local vasoconstriction to keep the drug in the thrombophlebitis is present. area. Penetration depth is 3 to 20mm. Pregnancy. Malignant tumors. Not to be used after the application of any physical agent such as heat, ice or ultrasound. Interferential current: Interferential Electrostimulator: What are the interferential currents? It is a form of TENS which uses two alternating medium frequency currents. The two currents ar applied simultaneously and where they cross, to form an area of constructive and destructive interference between them, which results in a modulated frequency equal to the difference in frequency of the two waves. Indications: Pain relief/ anesthetic effect by stimulating the release of endorphins and blocking the transmission of pain impulses (pain gate mechanism). Increase in blood flow to promote tissue healing and reduction in swelling and inflammation. Muscle stimulation to activate weak muscles caused by the injury. Contraindications: Recent sutures, open wounds or abscesses. Circulatory conditions. Deep vein thrombosis. Metal implants, over pacemakers. Near the low back or abdomen of pregnant women. Malignancy. Fracture or areas of bone fusion. Procedure: Place 4 pads over the area of desired effect. The further the pads are placed, the deeper the penetration. Treatment last 10-20 minutes. More chronic: longer the treatment. Microcurrent: Micro-current Treatment - YouTube Mechanism: Indications: Procedure: Contraindication: ATP is the main energy Increased wound healing, Select size of electrode and apply Pain syndromes where etiology molecule essential for cellular increased protein synthesis it with sterile hydrogel pad and has not been established. cellular regeneration. regeneration of broken tissue. position one electrode over Microcurrent stimulation wound surface and apply the Pregnancy. between 200-800 microamps Increased lymphatic flow. other electrode over healthy skin Pacemakers. microamps can flood the tissue 5cm away. Sprains, strains and contusions. Wounds that are infected. tissue with ATP to speed contusions. healing. Through malignant or benign Chronic and acute pain. tumors. Any stimulation over 1,000 OA. Through the eyes, carotid sinus, microamps causes plateauing and then sinus, laryngeal musculature and reduction in ATP. and over thorax intersecting the the heart. Transcutaneous Electrical Nerve Stimulation (TENS): What is TENS? - YouTube Small portable electrical unit to control pain via dorsal column stimulation. It is to modulate pain. Opioid release: Endorphin release: Enkephalin release: Release endorphins and enkephalins known as Hz setting: 1-15 Hz Hz setting: 80-140 Hz endogenous opioids, similar to morphine and Indication: chronic pain. Indication: Acute pain. modulate pain perception by binding to opiate receptors in the brain where they act as Duration: hours. Duration: as soon as treatment ends. neurotransmitters and neuromodulators. Gate Control Theory TENS works by stimulating large diameter sensory fibers which "closes the gate" to pain signals traveling up smaller diameter sensory fibers. TENS uses short-duration, high frequency biphasic pulses at a direct current amplitude enough to produce a comfortable sensation without muscle contractions to selectively stimulate non nociceptor A beta nerves to activate the gating mechanism to modulate pain. When A beta is increased (compared with C nerves) by electrical stimulation, pain perception is decreased. Transcutaneous Electrical Nerve Stimulation (TENS): (TENS): 1 Contraindications 2 Indications: Cardiac pacemaker, unstable arrhythmias. Moderate to severe acute pain. Placement of electrodes over carotid sinus. Postoperative pain. Pregnancy. TENS has been shown to reduce acute pain and Malignant tumors. significantly reduce analgesic intake after surgery. Do not use stimulated muscle contractions for pain control as it may disrupt healing (muscle or tendon tear, overuse, or Chronic pain: OA and diabetic neuropathy. acute injury)

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