Therapeutic equipments

1. Therapeutic equipments Unit-IV Therapeutic equipments Need of Physiological and electrotherapy equipment, Cardiac pacemaker, Cardiac defibrillators, Nerve and Muscle stimulators, Diathermy- Short-wave, Microwave, Ultrasonic Dept. of Electronics and Telecommunication Engineering VM Umale

2. Unit-IV: Therapeutic equipments Need of physiological equipments and Electrotherapy equipments Nerve and muscle stimulators Cardiac pacemakers Cardiac defibrillators Diathermy Short wave Diathermy Microwave Diathermy Ultrasonic diathermy Dept. of Electronics and Telecommunication Engineering VM Umale

3. Physiotherapy Lecture-23 Need of physiological equipments Need of Electrotherapy equipments Dept. of Electronics and Telecommunication Engineering VM Umale

4. Physiotherapy Lecture-23 Need of physiological equipments Physiotherapy Physical stimulus in the form of heat Simple heat radiation Application of high frequency Shortwave therapy Microwave Ultrasonic wave Principle of HF heat therapy- a) dipole molecules of the body are placed randomly b) they rotate or align according to the polarity of their charge in the direction of the field lines Dept. of Electronics and Telecommunication Engineering VM Umale

5. Physiotherapy: • when the HF energy is utilized to get physical stimulus in the form of heat than that sort of physiotherapy is referred as thermotherapy • Merits of physiotherapy- • Considerable penetration of heat as compared with simple heat applications. • Uniform heating of deeper lying tissues i.e deep heating directly in the tissues of the body. ( Muscles, bones, internal organs) • No burning of skin, No injury, Non traumatic Dept. of Electronics and Telecommunication Engineering VM Umale

6. Merits of physiotherapy- • No discomfort and skin burns even before adequate heat has penetrated to the deeper tissues like conventional techniques such as hot towels, IR lamps, heating pads • Treatment can be controlled precisely by controlling amount of heat to be required. • Permits localization of the heat to the region that has to be treated • HF energy for heating is obtained by various equipments • HF of 3-30000MHz(27.12MHz, 11m) Dept. of Electronics and Telecommunication Engineering VM Umale

7. DIATHERMY ‘Diathermy' means 'through heating' or producing deep heating directly in the tissues of the body. Externally applied sources of heat like hot towels, infrared lamps and electric heating pads often produce discomfort and skin burns long before adequate heat has penetrated to the deeper tissues. In diathermy technique, the subject's body becomes a part of the electrical circuit and the heat is produced within the body and not transferred through the skin Dept. of Electronics and Telecommunication Engineering VM Umale

8. Electrotherapy • Need of Electrotherapy equipments • The biological reactions produced due to Low • volt, low freq. Impulse currents • The biological reactions are adopted in this • therapy for the management of many diseases • affecting muscles and nerves. • The technique is used for- • The treatment of paralysis with totally or partially • degenerated muscles • The treatment of pain, muscular spasm, peripheral • circulatory disturbances Dept. of Electronics and Telecommunication Engineering VM Umale

9. Electrotherapy Typical i-t curves of a normal muscle and degenerated muscle. The curve shows that decreasing excitability with progressive degeneration requires extended stimulation times and increased current strength for achieving successful stimulation Thechronaxie andrheobase can be easily read from the i-t curves. The rheobaseis the minimum intensity of current that will produce a response if the stimulus is of infinite duration, in practice an impulse of 100 ms being adequate for estimating this. The chronaxieis the min. duration of impulse that will produce a response with a current of double the rheobase. For example if the rheobase is 6 mA, the chronaxie is the duration of the shortest impulse that will produce a muscle contraction with a current of 12 mA. Dept. of Electronics and Telecommunication Engineering VM Umale

10. Electrotherapy • Different types of current impulses used in • electrotherapy • Galvanic current • Interrupted Galvanic current • Faradic current • Surging or faradic surge currents • Exponentially progressive current • Biphasic stimulation Dept. of Electronics and Telecommunication Engineering VM Umale

11. Electrotherapy: Current waveforms Current waveforms normally employed in electrodiagnosis and electrotherapy: galvanic Faradic Exponential Rectangular pulse with adjustable slope Surged Faradic. Dept. of Electronics and Telecommunication Engineering VM Umale

12. The most commonly used pulse waveforms are discussed below. 1. Galvanic Current: : • A steady flow of direct current is passed through a tissue, • its effect is primarily chemical. • It causes the movement of ions and their collection at the skin areas lying immediately beneath the electrodes. The effect is manifested most clearly in a bright red coloration. It is an expression of hyperaemia (increased blood flow). Galvanic current / direct current/ galvanism/ continuous current / constant current. • Used for the – • Preliminary treatment of atonic paralysis • Treatment of disturbance in the blood flow. • Iontophores Int. of drugs into the body thr. the skin by electrolytic means.) • The intensity of the current passed thr any part of the body < 0.3 to 0.5 ma/cm 2. • The duration of the treatment is generally 10–20 minutes. Dept. of Electronics and Telecommunication Engineering VM Umale

13. The most commonly used pulse waveforms are discussed below. 2. Faradic Current: : • Faradic Current: • It is a sequence of pulses with a defined shape and current intensity • The pulse duration is about 1 ms with a triangular waveform • Interval = 20msec • Duration of about 20 minutes. • It acts upon muscle tissue and upon the motor nerves to produce muscle contractions. • There is no ion transfer and consequently, no chemical effect. • Used for the treatment of muscle weakness after lengthy immobilization • Used in Disuse atrophy. Dept. of Electronics and Telecommunication Engineering VM Umale

14. The most commonly used pulse waveforms are discussed below. 3. Surged Faradic Current: : • Surging Current: The resulting shape of the current waveform is called a surging current when • The peak current intensity applied to the patient increases and decreases rhythmically along with the rate of increase and decrease of the peak amplitude is slow • Application of the Faradic surge current – • The treatment of functional paralysis. • The treatment of spasm and pain. • The surge rate is usually from 6-60 surges/min. in most of the inst. • The ratio of interval to the duration of the surging is also adjustable so that graded exercise may be administered Dept. of Electronics and Telecommunication Engineering VM Umale

15. The most commonly used pulse waveforms are discussed below. 4. Exponentially Progressive Current: : •  Useful for the treatment of severe paralysis • for the treatment of the paralysed muscles • The main advantage of this method lies in the possibility of providing selective stimulation. This means that the surrounding healthy tissues even in the immediate neighbourhood of the diseased muscles are not stimulated • The slope of the exponential pulse is kept variable. Dept. of Electronics and Telecommunication Engineering VM Umale

16. Other type of pulse Biphasic Stimulation: : • The cell recovery from the effect of a stimulus current can be hastened by the passage of a lower intensity current of opposing polarity over a longer period so that the net quantity of electricity is zero. • Combination of positive and negative pulses is called biphasic stimulation. • The stimulating pulse may be followed by a pulse of opposite polarity of one-tenth the amplitude and 10 times the width. • Biphasic stimulation also helps to neutralize the polarization of the recording electrodes in case silver-silver chloride electrodes are not used. This means that there are no electrolytic effects, nor are any macroscopic changes affecting either the skin or the electrodes observed. • Also, there is reduced muscle fatigue, since each current pulse is immediately followed by an opposite current phase of the same magnitude. • The stimulation current intensity required during treatment is less as compared with monophasic currents. Dept. of Electronics and Telecommunication Engineering VM Umale

17. Features of Electrotherapy: • To manage many diseases affecting muscles and nerves • For the treatment of paralysis with totally or partially • degenerated muscles • Used for the treatment of pain, muscular spasm • Widely used with availability of safe and simplified equipments • Apparatus are either of constant voltage or constant current types • Several types of commercial units are available which gives specific output waveforms for specific applications Dept. of Electronics and Telecommunication Engineering VM Umale

18. Cont….. • Devices produce output current waveforms to cover the • whole range of electro-diagnostic and therapeutic • possibilities • Modern electro-therapy units are up/uc controlled with automatic self test, automatic settings of the basic programs and also possible to indicate operating errors on the visual display Dept. of Electronics and Telecommunication Engineering VM Umale

19. Stimulators • Stimulators refers to an external influence • Electrical, mechanical or chemical • All cells are sensitive to some degree to artificial electrical • stimulation(Cells may depolarized and repolarised) • The physiological action of stimulation depends on the passage of current • across the cell membrane • Stimulators are the devices- • To stimulate innervated, denervated muscles and nerves • For the treatment of paralysis with totally or partially denervated • muscles • For the treatment of pain, muscular spasms and peripheral • circulatory disturbances Dept. of Electronics and Telecommunication Engineering VM Umale

20. Stimulators • TYPES OF STIMULATORS • The applied voltage & current are the important parameters and which are related with source and load impedance • Stimulators are classified based on the different types of current waveforms • Galvanic current • Interrupted galvanic current • Faradic current • Surged faradic current • Exponential current Dept. of Electronics and Telecommunication Engineering VM Umale

21. Electrotherapy The typical specifications of an electro-diagnostic therapy unit are as follows: Galvanic current up to 80 mA, ripple less than 0.5% as constant current or surging current with adjustable surge frequency from 6 to 30 surges per minute Exponentially progressive current pulse sequences with continuously variable pulse duration from 0.01 to 1000 ms and independently adjustable interval duration of 1 to 10,000 ms. The pulse form can be set continuously between triangular and rectangular forms; Faradic surging current with 25 surges per minute, up to 80 mA. Precision and constancy of the values set better than ±10%; peak current measurement facility. Constant current circuit, both poles earth-free. Dept. of Electronics and Telecommunication Engineering VM Umale

22. Stimulators 1.Versatile electro diagnostic therapeutic stimulator it covers whole range of electro diagnostic and therapeutic possibilities BLOCK DIAGRAM – Schematic diagram of a diagnostic/therapeutic stimulating unit Dept. of Electronics and Telecommunication Engineering VM Umale

23. Stimulators BLOCK DIAGRAM – 2. Nerve stimulator- Dept. of Electronics and Telecommunication Engineering VM Umale

24. Stimulators Other stimulators 3. Transcutaneous electrical Nerve stimulator(TENS) Transcutaneous electrical nerve stimulation (TENS) therapy involves the use of low-voltage electric currents to treat pain. Electrodes or mediums for electricity to travel to the body, placed on the body at the site of pain deliver electricity that travels through the nerve fibers. The electric currents block the pain receptors from being sent from the nerves to the brain. A patient will receive a small, battery operated TENS machine to use at home. In most cases, a doctor, physical therapist, or acupuncturist adjusts the machine to the correct settings. The provider shows the patient how to use the machine before sending him or her home with the TENS device. Dept. of Electronics and Telecommunication Engineering VM Umale

25. Stimulators • TENS therapy can be used to treat both chronic (long lasting) and acute (short-term) pain. The most common conditions that TENS therapy is used to treat are: • Osteoporosis-related joint, bone, or muscle problems • Fibromyalgia-related joint, bone, or muscle problems • Tendinitis (muscle tissue inflammation) • Bursitis (inflammation of the fluid-filled pads that cushion the joints) • Neck pain • Labor pain • Cancer pain Dept. of Electronics and Telecommunication Engineering VM Umale

26. Stimulators Other stimulators 4. Spinal cord stimulator 5. Magnetic stimulator 6. Bladder stimulator 7. Cerebellar stimulator Dept. of Electronics and Telecommunication Engineering VM Umale

27. Therapeutic Devices : THANKSA LOT Dept. of Electronics and Telecommunication Engineering VM Umale

28. Unit-IV: Therapeutic equipments Diathermy Dept. of Electronics and Telecommunication Engineering VM Umale

29. SHRI SANT GAJANAN MAHARAJ COLLEGE OF ENGINEERING, SHEGAON : Dept. of Electronics and Telecommunication Engineering VM Umale

30. Cont… • In diathermy technique, the subject's body becomes a part of the electrical circuit and the heat is produced within the body and not transferred through the skin • Draw back of externally applied sources of heat like hot towels, infrared lamps and electric heating pads often produce discomfort and skin burns long before adequate heat has penetrated to the deeper tissues, get eliminated in diathermy technique Dept. of Electronics and Telecommunication Engineering VM Umale

31. SHRI SANT GAJANAN MAHARAJ COLLEGE OF ENGINEERING, SHEGAON : Dept. of Electronics and Telecommunication Engineering VM Umale

32. SHRI SANT GAJANAN MAHARAJ COLLEGE OF ENGINEERING, SHEGAON : Dept. of Electronics and Telecommunication Engineering VM Umale

33. SHRI SANT GAJANAN MAHARAJ COLLEGE OF ENGINEERING, SHEGAON : Dept. of Electronics and Telecommunication Engineering VM Umale

34. SHRI SANT GAJANAN MAHARAJ COLLEGE OF ENGINEERING, SHEGAON Advantages of Diathermy: Considerable penetration of heat as compare to conventional techniques Deeper lying tissues, muscles, bones, internal organs gets uniform heat The treatment can be controlled precisely Careful placement of the electrodes permits the localization of the heat to the region to be treated The amount of heat can be closely adjusted by means of circuit parameters HF currents do not stimulate motor/sensory nerves, nor they produce any muscle contraction No discomfort is caused to the subject. Dept. of Electronics and Telecommunication Engineering VM Umale

35. Unit-IV: Therapeutic equipments Diathermy Short wave Diathermy Microwave Diathermy Ultrasonic diathermy Dept. of Electronics and Telecommunication Engineering VM Umale

36. SHRI SANT GAJANAN MAHARAJ COLLEGE OF ENGINEERING, SHEGAON : Dept. of Electronics and Telecommunication Engineering VM Umale

37. Unit-IV: Therapeutic equipments Diathermy Short wave Diathermy Dept. of Electronics and Telecommunication Engineering VM Umale

38. SHRI SANT GAJANAN MAHARAJ COLLEGE OF ENGINEERING, SHEGAON : O/P of RF Osc. Ckt 27.12MHz, 11m, 20min Continuous, pulsed Dept. of Electronics and Telecommunication Engineering VM Umale

39. SHRI SANT GAJANAN MAHARAJ COLLEGE OF ENGINEERING, SHEGAON : Dept. of Electronics and Telecommunication Engineering VM Umale

40. SHRI SANT GAJANAN MAHARAJ COLLEGE OF ENGINEERING, SHEGAON : Dept. of Electronics and Telecommunication Engineering VM Umale

41. SHRI SANT GAJANAN MAHARAJ COLLEGE OF ENGINEERING, SHEGAON : Power Supply RF Oscillator Monitor Control Panel Isolation Transformer To patient electrodes RF energy heats the tissues and promotes healing of injured tissues and inflammations Dept. of Electronics and Telecommunication Engineering VM Umale

42. SHORT-WAVE DIATHERMY • An Oscillating Circuit(HF Ckt) • A patient Circuit Tank circuit + Ve FB Patient’s resonator ckt Simplified circuit diagram of a short wave diathermy unit • Intensity of Current regulates by Controlling-1. Anode Voltage(4KV), 2. Filament I (ma), 3. adj. the grid bias thrRg, 4. adj. position of the resonator coil wrt the osc. coil Dept. of Electronics and Telecommunication Engineering VM Umale

43. SHRI SANT GAJANAN MAHARAJ COLLEGE OF ENGINEERING, SHEGAON : Dept. of Electronics and Telecommunication Engineering VM Umale

44. SHORT-WAVE DIATHERMY Application Techniques of Short-wave Therapy: Methods of applying electrodes in shortwave diathermy treatment (a) condenser method Dept. of Electronics and Telecommunication Engineering VM Umale

45. SHRI SANT GAJANAN MAHARAJ COLLEGE OF ENGINEERING, SHEGAON : Dept. of Electronics and Telecommunication Engineering VM Umale

46. SHORT-WAVE DIATHERMY Application Techniques of Short-wave Therapy: Methods of applying electrodes in shortwave diathermy treatment (c )Shortwave diathermy (with capacitive electrodes) in use  Dept. of Electronics and Telecommunication Engineering VM Umale

47. SHRI SANT GAJANAN MAHARAJ COLLEGE OF ENGINEERING, SHEGAON : Dept. of Electronics and Telecommunication Engineering VM Umale

48. SHORT-WAVE DIATHERMY Application Techniques of Short-wave Therapy: Methods of applying electrodes in shortwave diathermy treatment (a) Inductive method Dept. of Electronics and Telecommunication Engineering VM Umale

49. SHRI SANT GAJANAN MAHARAJ COLLEGE OF ENGINEERING, SHEGAON : Dept. of Electronics and Telecommunication Engineering VM Umale

50. SHORT-WAVE DIATHERMY Application Techniques of Short-wave Therapy: Methods of applying electrodes in shortwave diathermy treatment (d) Inductive heating by a coil housed in a drum. Dept. of Electronics and Telecommunication Engineering VM Umale