Pulsed Shortwave Diathermy and Joint Mobilizations for Achieving Normal Elbow Range of Motion After Injury or Surgery With Implanted Metal: A Case Series

Abstract

Context: Regaining full, active range of motion (ROM) after trauma to the elbow is difficult.Objective: To report the cases of 6 patients who lacked full ROM in the elbow because of trauma. The treatment regimen was thermal pulsed shortwave diathermy and joint mobilizations.Design Intervention(s): Treatment consisted of 20 minutes of pulsed shortwave diathermy at 800 pulses per second for 400 microseconds (40-48 W average power, 150 W peak power) applied to the cubital fossa, immediately followed by 7 to 8 minutes of joint mobilizations. After posttreatment ROM was recorded, ice was applied to the area for about 30 minutes.Main Outcomes Measure(s): Changes in extension active ROM were assessed before and after each treatment. Once the patient achieved full, active ROM or failed to improve on 2 consecutive visits, he or she was discharged from the study.Results: By the fifth treatment, 4 participants (67%) achieved normal extension active ROM, and 2 of the 4 (50%) exceeded the norm. Five participants (83%) returned to normal activities and full use of their elbows. One month later, the 5 participants had maintained, on average, (mean 6 SD) 92% 6 6% of their final measurements.Conclusions: A combination of thermal pulsed shortwave diathermy and joint mobilizations was effective in restoring active ROM of elbow extension in 5 of the 6 patients (83%) who lacked full ROM after injury or surgery.Key Words: deep heat, therapeutic modalities, rehabilitation Key PointsPulsed shortwave diathermy can increase the viscoelastic properties of collagen. Combined pulsed shortwave diathermy and joint mobilizations increased active elbow range of motion in 5 of 6 patients nearly 5 years after injury or surgery.

Continuous-mode 448 kHz capacitive resistive monopolar radiofrequency induces greater deep blood flow changes compared to pulsed mode shortwave: a crossover study in healthy adults

“…Similar studies involving only SWT that were conducted on either asymptomatic subjects (12,14,15,31) or patient groups (10,32,33) have been reported previously. However, to our knowledge this will be the first in vivo study that investigated the deep physiological responses to RF exposure below the shortwave frequency band.…”

“…Increasing muscle blood flow may potentially aid faster recovery from post exercise fatigue. In physiotherapy, radiofrequency (RF)-based EPAs are among those that claim to increase blood flow as well as improve soft tissue compliance, mainly by inducing tissue hyperthermia (9)(10)(11)(12)(13)(14)(15). Measures relating to blood flow and tissue compliance closely reflect the body's response when tissues are exposed to heat, with the radiofrequency energy potentially capable of inducing a hyperthermic effect at depth (16)(17)(18).…”

Short-wave diathermy in the clinical management of musculoskeletal disorders: a pilot observational study

“…pSWD was reported to be effective also for treatment of chronic low back pain (Ahmed et al 2009) and in entrapment neuropathies, such as carpal tunnel syndrome (Incebiyik et al 2015). The combination of thermal pulsed short-wave diathermy and joint mobilizations was effective in restoring active range of motion (ROM) of elbow extension in patients who lacked full ROM after injury or surgery (Draper 2014).…”

Acute Effects of Tecar Therapy on Skin Temperature, Ankle Mobility and Hyperalgesia in Myofascial Pain Syndrome in Professional Basketball Players: A Pilot Study

“…Applying TT alone on a MG latent MTP does not produce changes in ROM when it is measured with the lunge test. On the other hand, Draper et al reported that the combination of TT and joint mobilization is considered to be an effective treatment to recover joint ROM in elbow extension in post-surgical patients [47].…”