Heating capacity of rebound shortwave diathermy and moist hot packs at superficial depths

TECAR Therapy Associated with High-Intensity Laser Therapy (Hilt) and Manual Therapy in the Treatment of Muscle Disorders: A Literature Review on the Theorised Effects Supporting Their Use

Background: It has been estimated that between 30 and 50 per cent of all injuries that take place throughout participation in a sport are the consequence of soft tissue injuries, and muscle injuries are the primary cause of physical disability. Methods: The current literature review was designed between October 2021 and April 2022, according to the PRISMA standards, using the PubMed, Scopus, and Web of Science databases. At the screening stage, we eliminated articles that did not fit into the themes developed in all subchapters of the study (n = 70), articles that dealt exclusively with orthopaedics (n = 34), 29 articles because the articles had only the abstract visible, and 17 articles that dealt exclusively with other techniques for the treatment of musculoskeletal disorders. The initial search revealed 343 titles in the databases, from which 56 duplicate articles were automatically removed, and 2 were added from other sources. Results: The combination of these three techniques results in the following advantages: It increases joint mobility, especially in stiff joints, it increases the range of motion, accelerates tissue repair, improves tissue stability, and extensibility, and it reduces soft tissue inflammation (manual therapy). In addition, it decreases the concentration of pro-inflammatory mediators and improves capillary permeability, resulting in the total eradication of inflammation (HILT). It warms the deep tissues, stimulates vascularity, promotes the repose of tissues (particularly muscle tissue), and stimulates drainage (TECAR). Conclusions: TECAR therapy, combined with manual therapy and High-Intensity Laser therapy in treating muscle diseases, presented optimal collaboration in the recovery process of all muscle diseases.

Tissue heating in different short wave diathermy methods: A systematic review and narrative synthesis

OBJECTIVE

To assess the change in temperature caused by different short wave diathermy (SWD) methods of application in different healthy tissues.

DATA SOURCES

The Cochrane Central Register of Controlled Trials, MEDLINE, Science Direct, CINAHL, SciELO, PEDro, ClinicalTrials.gov, Brazilian Registry of Clinical Trials and the World Health Organization ICTRP were searched (1990-April 2020).

METHODS

Randomized, quasi-randomized, and single-arm controlled trials assessing temperature change after SWD application in healthy adults were included. Group analysis was done according to SWD mode and where temperature was collected, risk of bias was assessed using the Cochrane tool and the quality of evidence using GRADE. A narrative synthesis was conducted since methodological homogeneity was not sufficient to undertake a meta-analysis.

RESULTS

Eleven studies were included, reporting data of 240 subjects. Regarding skin temperature change, the application that increased temperature the most was under the electrode using continuous SWD on coplanar arrangement of capacitive technique (7.9 [1.76] °C), coplanar arrangement also had the slowest temperature decay, and the lowest temperature found was through a low dose application of pulsed SWD (0.34 [0.69] °C). Regarding muscle temperature change, the application that increased temperature the most was using the inductive technique of pulsed SWD (4.58 [0.87] °C), this technique also had the slowest temperature decay, and the lowest temperature found was through ReBound shortwave diathermy (2.31 [0.87] °C).

CONCLUSION

SWD efficacy depends on setting choices. This review provides a detailed description of SWD methods of application and a quantitative data set of resulting temperature change.

Efficacy of ReBound Diathermy as a Thermal Heating Agent: A Critically Appraised Topic

Clinical Scenario: ReBound is a portable shortwave diathermy unit used to heat tissues using the same principle as induction drum shortwave diathermy. It is unclear if ReBound can vigorously (4°C) heat intramuscular tissue as efficiently as other thermal agents. Clinical Question: In adults (P), is ReBound diathermy (I) compared with other thermal agents (C) effective at increasing intramuscular tissue temperature by 4°C (O)? Summary of Key Findings: (1) Three studies were included for review, all randomized crossover studies. (2) All studies agreed ReBound does not achieve vigorous (4°C) heating effects during a 30-minute treatment to the triceps surae muscle (depth = 1 and 3 cm). (3) Studies agreed that the heat generated by ReBound dissipates slower than (P < .001) or similar to pulsed shortwave diathermy at 3 cm and faster than moist hot packs (P < .001) at 1 cm. (4) One study found that intramuscular tissue temperatures increased more with ReBound (3.69°C [1.50°C]) than moist hot packs (2.82°C [0.90°C]) at superficial depths (1 cm, d = 0.70). (5) Two studies compared ReBound with MegaPulse II pulsed shortwave diathermy at a 3 cm depth. One found that the MegaPulse II increased intramuscular tissue temperature by 4.32°C (1.79°C) compared with the ReBound's 2.31°C (0.87°C) increase (d = 1.43). The final study reported that the MegaPulse II increased triceps surae muscle temperature by 3.47°C (0.92°C) versus ReBound at 3.08°C (1.19°C) (d = 0.37). (6) The combined results are an increase of 3.81 (1.38°C) for the MegaPulse II and 2.77 (1.12°C) for ReBound (d = 0.83). Clinical Bottom Line: Results strongly indicate that the ReBound should not be used for vigorous (4°C) heating effects in the triceps surae muscle at 1 and 3 cm. Clinicians can use ReBound when traveling or instead of moist hot packs for moderate (2°C-3°C) heating effects at deep and superficial levels (1 and 3 cm) for large treatment areas with subcutaneous fat thickness <15 mm. Strength of Recommendation: Consistent level B findings indicate that ReBound does not achieve vigorous heating effects (4°C).

KNEE PROPRIOCEPTION MAY BE ALTERED BY TREATMENT IN ATHLETES SUFFERING FROM DELAYED ONSET MUSCLE SORENESS

Delayed onset muscle soreness (DOMS) is a very common musculoskeletal problem in athletes involved in extreme competitions. The aim of this study is to compare the effect of diathermy, sham diathermy and massage on the knee proprioception of athletes treated for DOMS. Forty athletes were enrolled after the second day of a demanding ski mountaineering race. They were randomly assigned to four groups: no treatment [Formula: see text], massage [Formula: see text], diathermy [Formula: see text], and sham diathermy [Formula: see text]. The knee reposition error was measured after the treatments in order to assess knee proprioception. Significant differences between the diathermy and sham diathermy groups were found ([Formula: see text]) with an absolute effect size of [Formula: see text]. No other significant differences were found among groups. This means that diathermy has a negative impact on joint proprioception and can be explained by the spindle desensitization consequent to deeper tissue heating. This information can be important in the DOMS management of athletes, since an altered proprioception may interfere with the athlete’s performance and can increase the risk of injury.

Comparison of Muscle Temperature Increases Produced by Moist Hot Pack and ThermoStim Probe

Background: ThermoStim Probe (TSP) has recently joined the market as a superficial heating modality. Although there is limited research into the intramuscular heating capability of superficial heating modalities in general (moist hot pack [MHP], paraffin, warm whirlpool), no previous research has examined intramuscular heating capability of TSP. Objective: Evaluate rate and magnitude of intramuscular heating via TSP compared with hydrocollator MHP, and determine if TSP can increase tissue temperature 3°C-4°C (vigorous heating range). Design: Repeated-measures counterbalanced study. Setting: Multisite trial; 2 college/university research laboratories. Patients or Other Participants: A total of 18 healthy college-aged participants (11 females and 7 males, age: 23.0 [2.1] y, weight: 74.64 [18.64] kg, height: 168.42 [9.66] cm, subcutaneous adipose: 0.71 [0.17] cm) with calf subcutaneous adipose <1.2 cm. Interventions: MHP and TSP were applied to the posterior aspect of the nondominant calf for 20 minutes; participants underwent each treatment in a counterbalanced order. Main Outcome Measurements: Muscle temperature at a depth of 1.5 cm was measured via 21-gauge catheter thermocouple. Temperatures were recorded at baseline and during the 20-minute treatment. Results: There was a significant treatment-by-time interaction during the treatment period (F_5,85 = 14.149, P < .001), as well as significant main effects for treatment (F_1,17 = 7.264, P = .02) and for time (F_5,85 = 34.028, P < .001). Muscle temperature increased an average of 1.7° (0.9°) for the MHP and 0.6° (1.0°) for the TSP. Pairwise comparisons of the interaction (using least significant difference adjustment for multiple comparisons) indicated that MHP heated faster than TSP at minutes 12 (P = .02), 16 (P = .002), and 20 (P = .001). There was no significant correlation between subcutaneous adipose thickness and maximum temperature increase obtained with either MHP (r = -.033, P = .90) or TSP (r = -.080, P = .75). Conclusions: MHP increased intramuscular temperature significantly more than TSP; however, neither modality was capable of producing a 3°C-4°C temperature increase associated with increased tissue extensibility.

Muscle heating with Megapulse II shortwave diathermy and ReBound diathermy

CONTEXT

A new continuous diathermy called ReBound recently has been introduced. Its effectiveness as a heating modality is unknown.

OBJECTIVE

To compare the effects of the ReBound diathermy with an established deep-heating diathermy, the Megapulse II pulsed shortwave diathermy, on tissue temperature in the human triceps surae muscle.

DESIGN

Crossover study.

SETTING

University research laboratory.

PATIENTS OR OTHER PARTICIPANTS

Participants included 12 healthy, college-aged volunteers (4 men, 8 women; age = 22.2 ± 2.25 years, calf subcutaneous fat thickness = 7.2 ± 1.9 mm).

INTERVENTION(S)

Each modality treatment was applied to the triceps surae muscle group of each participant for 30 minutes. After 30 minutes, we removed the modality and recorded temperature decay for 20 minutes.

MAIN OUTCOME MEASURE(S)

We horizontally inserted an implantable thermocouple into the medial triceps surae muscle to measure intramuscular tissue temperature at 3 cm deep. We measured temperature every 5 minutes during the 30-minute treatment and each minute during the 20-minute temperature decay.

RESULTS

Tissue temperature at a depth of 3 cm increased more with Megapulse II than with ReBound diathermy over the course of the treatment (F₆,₆₆ = 10.78, P < .001). ReBound diathermy did not produce as much intramuscular heating, leading to a slower heat dissipation rate than the Megapulse II (F₂₀,₂₂₀ = 28.84, P < .001).

CONCLUSIONS

During a 30-minute treatment, the Megapulse II was more effective than ReBound diathermy at increasing deep, intramuscular tissue temperature of the triceps surae muscle group.