ULTRAVIOLET, DIATHERMY & LASER MODALITY TECHNIQUES

ULTRAVIOLET THERAPY

• One of the first modalities
• Used by ancient Greeks/Romans for felling of well-being associated with sun v. rain

• Part of Electromagnetic Spectrum between X-ray and visible light

• UV-A: 3200-4000A: tanning beds
• UV-B: 2900-3200A: sunburn & age-related changes
• UV-C: 2000-2900A: bacteriacidal
• Modalities are UV-B and UV-C
• Limited absorption within 1-2mm skin/very superficial effects

Effects on Cells:

Effects on Skin:

• Short-Term Effects:

• Long-Term Effects:

Photosensitivity

Tanning Process:

Artificial Tanning Devices:

Sunscreens:

SPF:

Minimal Erythemal Dose (MED):

Effects on Eyes:

Systemic Effects:

Psychological Effects:

Apparatus:

• Different types of generators (lamps)
• Surrounded by some type of reflector
• Carbon Arc Lamp
• Fluorescent lamp
• Xenon Compact Lamp
• Mercury Arc Lamp (most common)
• Mercury contained in quartz envelope/electricity passes through and vaporizes mercury
• Atoms emit UV-R, infrared and invisible light

Determining MED:

Estimate 1^st/2^nd Degree doses: 1^st: 2.5 x MED; 2^nd: 5xMED

Skin adapts to MED with successive txs (tanning)

Tx Time: +5 sec per successive tx

-5 sec for each day missed

Keep distance of lamp from patient constant (24-40”)

• Responds to inverse square law: closer the lamp/higher the dose
• Cosine Law

Clinical Applications:

• Acne: general body application (MED 3x/wk)
• Aseptic Wounds: Suberythemal dose (q3days)
• Folliculitis: suberythemal dose (q day until clear)
• Pityriasis Rosea: (inflammation of skin, scalp lesions due to infectious agent) general body radiation (MED 3x/wk)
• Tinea Capitum: local 1^st degree response; repeat when initial dose clears
• Septic Wounds: local 2^nd degree response (q 3days)
• Sinusitis: general body radiation
• Psoriasis: tx with some type of photosensitizing agent (tar, oral agent) then radiate
• Rickets/Tetany: general body radiation if diet or oral supplementation is ineffective
• Pressure Sores: 2^nd or 3^rd degree dose (must protect surrounding area)
• Sterilization: bacteria destroyed at 2500-2700A (air or water)
• Diagnosis: some organisms when irradiated will fluoresce in a certain color

New research: decreasing BP, asthma, decreasing cholesterol, URI

Contraindications:

• Porphyrias (skin lesions/highly photosensitive)
• Pellagra (Niacin deficiency/skin lesions: dry scalp, scaly thickened skin)
• Lupus Erythematosus: inflammatory autoimmune disease
• Sarcoidosis: unknown etiology: epithelial granulomas affects various organs like lungs, eyes
• Xeroderma pigmentosum: dry skin, discoloration
• Acute Psoriasis
• Acute Eczema
• Herpes Simplex
• Renal and Hepatic Insufficiencies
• Diabetes
• Hyperthyroidism
• Generalized Dermatitis
• Advanced Arteriosclerosis
• Active and Progressive pulmonary tuberculosis

LASERS

L

A

S

E

R

· For LASERs to operate a medium of excited atoms must be generated

· Occurs when outside energy source is applied to a medium (ruby, aluminum)

· To contain and generate more photons, mirrors are placed at both ends of a chamber

o One mirror is reflective the other is semi-permeable

· Photons are reflected in the chamber

o Release of one photon triggers release of other photons (amplifies and stimulates release of other photons)

· When # of photons exceeds that which can be contained in chamber they are ejected through the semi-permeable mirror as LASER

Properties of LASER light:

Classifications of LASERS

Safety Considerations:

• FDA regulates manufacture and sale of LASERs in US
• Class III medical device (new since 5/28/76)
• In research stages, no major side effects
• Not really sure if it actually does anything
• Not granted recognition by FDA as safe or effective modality

Common Application Techinques:

Gridding:

Scanning:

Wanding:

Clinical Applications:

Wound Healing:

Scar Tissue:

Inflammation/Edema:

Immune Response:

Pain Control:

Bone/Cartilage Healing:

Contraindications/Precautions:

No real damaging effects to cell/cell membranes or DNA can be proven

• Not over cancerous growths
• Avoid Direct eye exposure
• 1^st Trimester of pregnancy
• Syncope episodes in some patients

DIATHERMY

What is Diathermy?

Physiologic Responses

Thermal

Non-thermal

Types of Electrode Techniques

Capacitance

Induction:

Treatment of Choice:

• Costochondritis
• Intercostal Strains
• Discogenic pain (associated with annular tears)
• Prepare for Deep Massage (increases extensibility of deep collagen tissues)

Comparison of Diathermy to Ultrasound

Precautions