Electrotherapy &

Actinotherapy

RESOURCE PERSON: MAIDA MUSHTAQ

REFERENCE TEXT: JAGMOHAN
SEMESTER: 6
 REVIEW

UVR

Principles of radiations

Techniques of application
 Outlines

 Infra red rays

 Generation

 Luminous and non luminous generators

 Transmission
 Infra red rays

 Electromagnetic waves with wavelengths between 750 to

400,000 nm.

 They have frequency 4 × 1014 Hz and 7.5 × 1011 Hz.

 It lies beyond the red boundary of visible spectrum.

 Infra Red Rays

 Any hot body can produce infrared rays like the sun, electric bulb, coal fire, gas

fire, etc.

 Sun is the natural source of infrared radiations. Infrared radiations can be

produced by artificial generators.

 Infra Red Generators

 Non luminous generators

 Luminous generators
 Infra Red Rays

 Nonluminous generators provide infrared rays only

 Whereas luminous generators emit infrared rays, visible as well as ultraviolet rays.

 Therefore, nonluminous generators are termed as infrared radiation generators because they

emit only infrared rays.

 The heat produced by luminous generator is called the ‘radiant heat’

 They produce IRR with wave length between 150,000 to 7700 A.

 Non Luminous Generators

 Nonluminous generator consists of a simple type of element or coil wound on a cylinder of

some insulating material such as fireclay or porcelain.

 An electric current is passed through the wire which results in the production of heat.

 This heat produces infrared rays which are transmitted through the porcelain.

 Porcelain gets heated by the method of conduction but the radiations generated in this way also

include some of the visible rays.

 Non Luminous Generators

 Therefore to avoid this, the coil is embedded in fireclay or porcelain or placed

behind fireclay.

 Now the emission of rays is entirely from the fireclay which is commonly painted

black and thus very few visible rays are produced. The element or the coil is

thus placed at the focal point of a parabolic or spherical reflector.

 The reflector is mounted on a stand and its position can be adjusted as required
All non luminous elements
require 5 to 15 minutes to
produce effective IRR
 Luminous Generator

 Luminous generators emit infrared, visible and a few ultraviolet rays. These
generators are in the form of incandescent lamps or bulbs.

 An incandescent lamp consists of a wire filament enclosed in a glass bulb, which

may contain an inert gas at low pressure.

 The filament is a coil of fine wire which is usually made up of tungsten.

 Tungsten is a metal which is used because it can tolerate repeated heating and
cooling.

 The exclusion of air prevents oxidation of the filament, which would cause an
opaque deposit to form on the inside of the bulb.
 Luminous Generator

 Incandescent bulb is usually mounted at the center of the parabolic reflector and the

reflector is mounted on an adjustable stand.

 These luminous generators emit the electromagnetic waves with the wavelength in

between 350 and 4000 nm, the maximum proportion of the rays having wavelength

in the region of 1000 nm

 (40,000 to 35,00A) mostly in the range of 10,000A.

 The front of the bulb is usually red so as to filter out the shorter visible and the

ultraviolet rays.
 Depth of Penetration of Rays

 Luminous generator produces infrared rays having wavelength between 350 and

4000 nm.

 It can penetrate into dermis and epidermis of the subcutaneous tissue.

 Nonluminous generator produces infrared rays of wavelength 750 to 15000 nm

which can penetrate the superficial dermis only. The depth of the penetration

depends upon the wavelength and the nature of the material

Technique of Treatment

 Choice of apparatus

 Preparation of the patient

 The Choice Of Apparatus

 In most cases luminous and nonluminous generators are equally suitable, but in

some instances one proves more satisfactory than the other.

 When there is acute inflammation or recent injury, the sedative effect of rays
obtained from nonluminous generator may prove more effective for relieving pain
than the counter-irritant effect of those from the luminous source.

 For lesions of a more chronic type, the counter-irritant effect of the shorter rays may
prove to be of value, and under these circumstances a luminous generator is chosen.
 The Choice Of Apparatus

 Selection of the generator according to the area to be treated is done.

 If only one surface is to be treated, a lamp of a single element mounted on a reflector
is used.
 If several aspects are required to be irradiated, a tunnel bath is more effective.
 The temperature reached in a tunnel bath is higher than produced by other lamps
and this may be advantage if chronic lesions are to be treated.
 Before application the lamp must be checked to ensure that it is working correctly.
 Nonluminous generators must be switched on an adequate time before application.
 Preparation of Patient

 The clothes must be removed from the area to be treated

 Skin is checked for its sensation against heat and cold.

 It is unwise to give treatment if the skin sensation is found defective.

 The patient should be comfortable and fully supported so that he does not move unduly
during treatment.
 The patient is warned that he should experience comfortable warmth and he should
report immediately if the heating become excessive as undue heat may cause burn.

 He should be instructed not to touch the apparatus and nor to move nearer to the

apparatus.
 Preparation of Patient

 Arrangement of the lamp and patient: The lamp is positioned so that it is opposite to

the center of the area to be treated and the rays strike the skin at the right angle thus

ensuring maximum absorption. The distance of the lamp from the patient should be

measured.

 Optimum distance is around 50–75 cm depending upon the output of the generator.

 Care must be taken that the patient’s face is not exposed to infrared rays, eyes must be

shielded to avoid this.

 Laws Governing the Effects of
Electromagnetic Radiations
 When electromagnetic radiations strike or come in contact with other objects they may be
reflected, refracted or absorbed.

 As a general rule, those radiations that have a longest wavelengths tend to have greatest depth
of penetration, regardless of the frequency.

 It should also be noted that a number of other factors can also contribute to the depth of
penetration

 Arndt-Schultz principle
 Law of Grothus-Drapper
 Cosine law
 Law of inverse square
 Arndt-Schultz principle

 It states that no reaction or changes can occur in the body tissues if the amount of

energy absorbed is insufficient to stimulate the absorbing tissues.

 Addition of threshold energy and above quantity of energy will stimulate the

absorbing tissue to normal function and if too great a quantity of energy is absorbed

then added energy will prevent normal function or will destroy tissue.
 Law of Grothus-Drapper

 It states that the rays must be absorbed to produce the effect and the effects will

be produced at that point at which the rays are absorbed.

 Cosine law

 It is also known as Lambert-Cosine law. Cosine law explains the effect of angle at which the rays strike.

 It states that the proportion of rays absorbed varies as per the cosine of the angle between the incident and the

normal.

 Thus, the larger angle at which the rays strike at the body surface, lesser will be the absorption and vice versa.

 If the rays strike at 90º to the body part, then angle between the incident and normal are perpendicular will be

zero and the cosine of 0º is maximum, i.e. 1.

 Thus, there will be maximum absorption if the rays that will strike the body part at 90º as per this law.
 Law of inverse square

 Law of inverse square explains the effect of distance on the intensity of infrared

rays. It states that the intensity of a beam of rays from a point is inversely

proportional to the square of the distance from the source.

 Application of infrared treatment

 At the start of the treatment exposure the intensity of the radiation should be low, but

after 5–10 minutes when vasodilatation has taken place and the increased blood flow

has become established, the strength of the radiation may be increased.

 This can be achieved by moving the lamp closer to the patient or by adjusting the

variable resistance.
 Application of infrared treatment

 The physiotherapist should be near the patient throughout the treatment session and

should reduce the intensity of radiation if the heat becomes excessive.

 If the irradiation is extensive, it is desirable that sweating should occur to counteract

any excess rise in body temperature.

 Sweating is encouraged if the patient is provided water to drink during treatment.

 Application of infrared treatment

 At the end of the treatment the skin should be mild red, not excessively red.

 After extensive irradiation the patient should not rise suddenly from the recumbent

position or go out into the cold immediately.

 Duration and frequency of treatment: In cases of acute inflammation or recent injuries

and for the treatment of wounds, an exposure of 10–15 minutes is adequate, but it may

be applied several times during the day.

 In cases of chronic conditions longer exposures may be used.

 PHYSIOLOGICAL EFFECTS

 Infrared treatment produces heating effect in the superficial epidermis and dermis,

thus resulting in vasodilatation which increases blood circulation in that area.

 This will lead to more oxygen supply and nutrient supply in that area leading to

draining of waste products resulting in the relief of pain.

 The sedative effects on nerve endings lead to reduction in the muscle spasm.
 Physiological effects

 Increased metabolism

 Vasodilatation

 Effects on sensory nerves

 Effects on muscle tissues

 General rise in temperature

 Fall in blood pressure

 Increased activity of sweat glands

 Therapeutic effects & uses

 Relief of pain

 Muscle relaxation

 Increased blood supply

 Elimination of waste products

 RELIEF OF PAIN

 Infrared radiations are effective in relieving pain.

 Mild heating on the superficial tissues by infrared radiations causes sedative effects on the

superficial sensory nerve endings.

 Pain may be due to accumulation of waste products of metabolism, an increased flow of blood

through the part removes these substances and thus relieves the pain.

 The pain due to acute inflammation or recent injury is relieved most effectively by mild heating.

 When pain is due to chronic injury or inflammation, stronger heating is required. The treatment

may last up to 30 minutes

 MUSCLE RELAXATION

 Relaxation of muscles is achieved by heating the tissues.

 Mild heating by infrared causes relaxation of muscles and thus relieves spasm.

 Relief of pain also induces relaxation in muscles and helps relieving muscle spasm

associated with injury or inflammation.

 Relaxation of muscles provides greater range of motion to the exercising part as it

relieves muscular spasm.

 INCREASE IN BLOOD SUPPLY

 Infrared radiations increase the temperature in the superficial tissues, causing vasodilatation in

the superficial tissues. It provides more

 White blood cells and fresh nutrients to the area being treated. It also accelerates removal of

waste products and helps bring about resolution of inflammation.

 It is most beneficial in the treatment of various arthritic conditions of joints which leads to

inflammation and stiffness.

 Cases of post-immobilization stiffness, open wound and infections can also be effectively treated.
 Fresh supply of blood rejuvenates the tissues, removes waste products of metabolism and also
relieves muscular spasm
 Techniques of irradiation

 Choice of apparatus

 Preparation of the patient

 Arrangement of the lamp & patient

 Application of treatment

 Duration & frequency of treatment

 Dangers

 Burns

 Electric shock

 Precipitation of gangrene

 Headache

 Faintness

 Injury to the eyes

 Burn

 Excessive heating of superficial tissues causes burn.

 Sensation must be checked before starting the treatment.
 If sensation is not proper, the patient may not appreciate the extent of heating.
 The burn may be caused due to the following reasons:

i. If intensity of radiation is too high

ii. If sensation is not proper

iii. Patient fails to report over heating

iv. Unconscious patient

 Burn

v. Patient moves closer to the lamp

vi. Falls asleep during the treatment.

 The patient must be warned to inform undue heating immediately.

 The spacing must be reduced gradually in order to increase the heating.

 Impaired blood flow through the part, which may be due to some circulatory defect

or due tight garments reduces circulation and thus causes burn.

 Electric shock

 Electric shock can occur if some exposed part of the circuit is touched by the patient.

 Due to heating of the wires in the circuit, insulation of wires may go off and thus

regular checking of wires is necessary to avoid electric shock.

 Faintness or giddiness

 Extensive irradiation may cause fall in blood pressure which may result in faintness

or giddiness due to hypoxia of the brain.

 This is particularly common when the patient rises up suddenly from the recumbent

position after extensive treatment.

 Headache

 Irradiation of the back of the head may cause headache. Headache may also occur

when treatment is given during hot weather.

 Lots of fluid goes off the body in the form of sweating during treatment.

 Plenty of water needs to be replenished during or after the treatment especially in

hot weather.
 Gangrene

 Gangrene may be caused in the areas of defective arterial blood supply following

prolonged irradiation by infrared radiation.

 Arterial supply to the area being treated needs to be proper to avoid gangrene.
 Injury to the eyes

 Direct heating over the eyes causes drying up and thus leads to corneal or retinal

burns.

 Eyes needs to be protected following treatment to avoid injury.

 Contraindications

 Defective arterial blood supply

 Hemorrhage

 Defective sensation of skin

 Directly over the eyes

 After deep x-ray or cobalt therapy

 Known cases of tumors.

 SUMMARY

 Infra red rays

 Generation

 Luminous and non luminous generators

 Transmission