Effectiveness of SWD on OA Knee

Effect of SHORTWAVE DIATHERMY(SWD) for osteoarthritis of knee joint : 

Effect of SHORTWAVE DIATHERMY(SWD) for osteoarthritis of knee joint By: Dr. Suketu Shah

DEFINITION : 

DEFINITION When radio frequency electromagnetic energy of sufficient high intensity is directed at biological tissues it will cause heating.

PARAMETERS : 

PARAMETERS Frequency is 27.12 MHz Wavelength is 11.06 m

TYPES : 

TYPES There are two basic types of the SWD: Continuous mode Pulsed mode

CONTINUOUS MODE : 

CONTINUOUS MODE In continuous mode there is constant output of the machine to achieve the heating of the deeper modalities Though the research on continuous mode of SWD is not much done.

PULSED MODE : 

PULSED MODE It allows cooling between the pulses, heats less strongly and enchances the non-theramal effect of the radiofrequency energy. Many studies have shown good results of the pulsed mode of SWD.

OUTLINE ON PHYSIOLOGICAL AND THERAPEUTIC EFFECTS : 

OUTLINE ON PHYSIOLOGICAL AND THERAPEUTIC EFFECTS Reduces pain and inflammation Reduces muscle spasm Increases the blood flow Increases enzymatic activities Increases metabolism Increases the ROM Increases elasticity of connective tissue

CONTRAINDICATIONS : 

CONTRAINDICATIONS Contraindications are more important to be noticed : 1. Metal implants2. Pregnancy3. Malignancy4. Pacemaker5. Ischemia or atherosclerosis6. Active bleeding7. Open wounds, skin lesions in treatment area8. Acute infection/fever

MANAGEMENT : 

MANAGEMENT

SHORTWAVE DIATHERMY Vs HYDROTHERAPY IN OA KNEE PTS. : 

SHORTWAVE DIATHERMY Vs HYDROTHERAPY IN OA KNEE PTS. A underlying conclusion is being drawn that short wave diathermy is more effective in the patients with OA knee in the acute stage. As the hydrotherapy would be much of help in the later stages once the pain is reduced and a better ROM is achieved, so the patient can be adviced for the strengthening program.

Slide 11: 

Refernce: rEF\An Examination of the Value of Shortwave Diathermy and Hydrotherapy for Patients With Osteoarthritis of Their Knees - Full Text View - ClinicalTrials_gov.mht

EFFECTS OF REPETITIVE SWD FOR REDUCING SYNOVITIS IN PTS. WITH OA KNEE : 

EFFECTS OF REPETITIVE SWD FOR REDUCING SYNOVITIS IN PTS. WITH OA KNEE This study attempted to quantify the thickness of synovial sac and pain index before and after application of SW diathermy for patients with knee osteoarthritis. The results of this study showed that the application of SW diathermy in patients with knee osteoarthritis can significantly reduce both synovial thickness and knee pain. Such reductions of synovial sac thickness and pain index continue with increases .

Slide 13: 

Reference: rEF\Effects of Repetitive Shortwave Diathermy for Reducing Synovitis in Patients With Knee Osteoarthritis An Ultrasonographic Study -- Jan et al_ 86 (2) 236 -- Physical Therapy.mht

CONTRAINDICATIONS FOR THE SWD SHOULD BE KNOW : 

CONTRAINDICATIONS FOR THE SWD SHOULD BE KNOW Conclusion: For safe and effective shortwave diathermy treatment, physiotherapists should be aware of all conditions or symptoms that contra-indicate treatment. Overall a lack of research-based evidence was found regarding most contra-indications to treatment.

Slide 15: 

Reference: REF\ScienceDirect - Physiotherapy Contra-indications to shortwave diathermy survey of Irish physiotherapists.mht

Comparing hot pack, short-wave diathermy, ultrasound, and TENS on isokinetic strength, pain, and functional status of women with osteoarthritic knees: a single-blind, randomized, controlled trial. : 

Comparing hot pack, short-wave diathermy, ultrasound, and TENS on isokinetic strength, pain, and functional status of women with osteoarthritic knees: a single-blind, randomized, controlled trial.

Slide 17: 

Conclusion: Using physical agents before isokinetic exercises in women with knee osteoarthritis leads to augmented exercise performance, reduced pain, and improved function. Hot pack with a transcutaneous electrical nerve stimulator or short-wave diathermy has the best outcome.

Slide 18: 

Reference: REF\Comparing hot pack, short-wave diathermy, ultrasou___[Am J Phys Med Rehabil_ 2008] - PubMed Result.mht

No additional benefit of shortwave diathermy over exercise program for knee osteoarthritis in peri-/post-menopausal women: an equivalence trial : 

No additional benefit of shortwave diathermy over exercise program for knee osteoarthritis in peri-/post-menopausal women: an equivalence trial

Slide 20: 

Conclusion: The addition of SWD to an exercise program for knee OA in peri-/post-menopausal women is not superior to the exercise program alone. Reference: REF\No additional benefit of shortwave diathermy over ___[Osteoarthritis Cartilage_ 2008] - PubMed Result.mht

Effect of short-wave diathermy on mobility and radiological stage of the knee in the development of experimental osteoarthritis : 

Effect of short-wave diathermy on mobility and radiological stage of the knee in the development of experimental osteoarthritis

Slide 22: 

A smaller effect was found on flexion mobility. Flexion deficiency decreased at the end of the immobilization period and increased during remobilization, though at the end of the experiment there were no differences compared with the control. Radiographic changes were similar during the development of osteoarthritis in treated and non-treated groups Refernce: REF\Effect of short-wave diathermy on mobility and rad___[Am J Phys Med_ 1982] - PubMed Result.mht

FINAL CONLUSION : 

FINAL CONLUSION Effects of the SWD on OA Knee patients is uncertain. And hence more of research and meta-analysis need to be done.

REFERNCES : 

REFERNCES www.pubmed.org www.findphysio.com Jagmohan Singh

Thank you : 

Thank you Dr. Suketu Shah B.P.T., C.M.T. M.I.A.P, Consultant Physiotherapist and Manual Therapist. Content Owner – www.findphysio.com