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INTRODUCTION: Removing ventricular catheters, particularly those implanted for extended periods, poses significant challenges for neurosurgeons due to potential complications such as bleeding from adhesions to the ependyma or choroid plexus. OBJECTIVE: This study aimed to review various techniques for safely removing ventricular catheters, emphasizing methods that minimize the risk of hemorrhagic complications. METHODS: A comprehensive narrative review focused on techniques developed and documented in the literature for safely detaching ventricular catheters adhered to brain structures. RESULTS: Various techniques have been identified that enhance the safety of catheter removal. Notably, the use of monopolar diathermy to coagulate and release adhesions has proven effective. Innovations such as insulated suction devices and the strategic use of flexible endoscopes have also contributed to safer removal procedures, minimizing the risk of damaging surrounding cerebral tissue and preventing catastrophic hemorrhage. CONCLUSION: The removal of ventricular catheters, especially those with long-term implantation, requires precise and cautious techniques to avoid severe complications. The study underscores the importance of adopting advanced surgical techniques and the continuous evolution of safer practices in neurosurgery. These methods not only ensure patient safety but also facilitate the handling of potentially complex and life-threatening situations during catheter removal.

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ABSTRACT Background: Anorectal functional pain syndrome, also called chronic proctalgia, represents a neglected clinical entity and often confused with other syndromes such as vulvodynia or acute proctalgia. It is a very often disabling disease with a consequent significant negative impact on the patient's quality of life. Chronic proctalgia, in many patients, is secondary to the paradoxical contraction of the pelvic floor and associated with a dissynergy between the thorax-abdomen and the pelvic floor. To improve symptoms in functional anorectal pain syndromes, various rehabilitation techniques are used with the aim of promoting relaxation of the pelvic floor; however, to improve defecatory dynamics in patients with levator ani syndrome, only biofeedback has shown efficacy in a randomized study. The aim of this work is to evaluate whether a rehabilitation protocol with manometric biofeedback and radiofrequency diathermy (mt100 Fremslife emotion Tecar) reduces pain and paradoxical contraction of the levator ani and improves the quality of life in patients with anorectal pain syndromes. functional. Methods: This was a prospective study on 30 patients (20 women and 10 men) with anorectal functional pain syndrome and paradoxical contraction of the pelvic floor enrolled at the UOC of General, Minimally Invasive, Oncological and Obesity Surgery of the AOU "Luigi Vanvitelli" of Naples, Italy, from September 2021 to May 2022. All patients were evaluated with a coloproctological specialist visit followed by anorectal manometry and evaluation of altered clinical physiatric parameters (Brusciano Score). The protocol consisted of 10 rehabilitation sessions of the pelvic floor once a week and lasting approximately 45 minutes. During the sessions the patients were subjected to diathermy / radiofrequency treatment (10 minutes) with a static resistive electrode on the diaphragm, during which they were required to breathe diaphragmatically and to become aware of the perineal muscles, under the supervision of a physiotherapist; followed by application of diathermy with static capacitive (5 minutes) and resistive (10 minutes) electrode at the lumbar level. This was followed by the use of manometric biofeedback (15 minutes of tonic / phasic exercises) in order to instruct the patient on the reflex mechanism to obtain a voluntary relaxation of the external anal sphincter. The variables evaluated were Pain (VAS 0-10) and the questionnaire on the impact of colorectal and anal pathologies on the quality of life (CRAIQ-7) at the beginning, after 3 months and at the end of the treatment. Results: After 10 weeks, the rehabilitation treatment combined with diathermy and manometric biofeedback proved effective in the short term with a reduction in the scores of the Vas scale and CRAIQ-7 questionnaire and an increase in the percentage of release of the anal muscles on anorectal manometry. Conclusion: The use of radiofrequency diathermy with a system of static electrodes associated with biofeedback represents a valid rehabilitation option for those patients suffering from anorectal functional pain syndrome because it reduces pain and paradoxical contraction of the levator ani and improves quality of life of the patient.

RESUMO Contexto: A síndrome de dor funcional anorretal, também conhecida como proctalgia crônica, representa uma entidade clínica negligenciada e frequentemente confundida com outras síndromes, como vulvodinia ou proctalgia aguda. Trata-se de uma doença frequentemente incapacitante, com um consequente impacto negativo significativo na qualidade de vida do paciente. A proctalgia crônica, em muitos pacientes, é secundária à contração paradoxal do assoalho pélvico e está associada a uma dissinergia entre o tórax-abdômen e o assoalho pélvico. Para melhorar os sintomas em síndromes de dor anorretal funcional, são utilizadas diversas técnicas de reabilitação com o objetivo de promover o relaxamento do assoalho pélvico. No entanto, para melhorar a dinâmica de evacuação em pacientes com síndrome do elevador do ânus, apenas o biofeedback demonstrou eficácia em um estudo randomizado. Objetivo: O objetivo deste trabalho é avaliar se um protocolo de reabilitação com biofeedback manométrico e diatermia por radiofrequência (mt100 Fremslife emotion Tecar) reduz a dor e a contração paradoxal do elevador do ânus e melhora a qualidade de vida em pacientes com síndromes de dor anorretal funcional. Métodos: Realizado estudo prospectivo com 30 pacientes (20 mulheres e 10 homens) com síndrome de dor anorretal funcional e contração paradoxal do assoalho pélvico inscritos na UOC de Cirurgia Geral, Minimamente Invasiva, Oncológica e de Obesidade da AOU "Luigi Vanvitelli" de Nápoles, Itália, de setembro de 2021 a maio de 2022. Todos os pacientes foram avaliados com uma consulta especializada em coloproctologia, seguida de manometria anorretal e avaliação dos parâmetros fisiátricos clínicos alterados (Escore de Brusciano). O protocolo consistiu em 10 sessões de reabilitação do assoalho pélvico, uma vez por semana, com duração aproximada de 45 minutos. Durante as sessões, os pacientes foram submetidos a tratamento de diatermia / radiofrequência (10 minutos) com um eletrodo resistivo estático no diafragma, durante o qual foram solicitados a respirar através do diafragma e a tomar consciência dos músculos perineais, sob a supervisão de um fisioterapeuta; seguido pela aplicação de diatermia com eletrodo capacitivo estático (5 minutos) e resistivo (10 minutos) no nível lombar. Isso foi seguido pelo uso de biofeedback manométrico (15 minutos de exercícios tônicos /fásicos) com o objetivo de instruir o paciente sobre o mecanismo reflexo para obter um relaxamento voluntário do esfíncter anal externo. As variáveis avaliadas foram Dor (EVA 0-10) e o questionário sobre o impacto das patologias colorretais e anais na qualidade de vida (CRAIQ-7) no início, após 3 meses e no final do tratamento. Resultados: Após 10 semanas, o tratamento de reabilitação combinado com diatermia e biofeedback manométrico mostrou-se eficaz a curto prazo, com uma redução nos escores da escala VAS e do questionário CRAIQ-7, e um aumento na porcentagem de relaxamento dos músculos anais na manometria anorretal. Conclusão: O uso de diatermia por radiofrequência com um sistema de eletrodos estáticos associado ao biofeedback representa uma opção de reabilitação válida para pacientes que sofrem com a síndrome de dor anorretal funcional, pois reduz a dor e a contração paradoxal do elevador do ânus, melhorando a qualidade de vida do paciente.

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Background and Objective: Choledocholithiasis is a frequent pathology, unfortunately when its endoscopic management fails, there is no consensus of how it should be addressed. The aim of this study was to evaluate the safety, feasibility, and long-term outcomes of laparoscopic common bile duct exploration (LCBDE) using electrosurgery (coagulation) for choledochotomy followed by primary closure after endoscopic treatment failure. Materials and Methods: A retrospective cohort study of patients who underwent LCBDE from 2013 to 2018 was conducted in Bogotá, Colombia. Clinical demographics, operative outcomes, recurrence rate of common bile duct stones, and long-term bile duct complications were analyzed. A descriptive analysis was performed. Results: A total of 168 patients were analyzed. Most of the patients were males (53.37%) with a median age of 73 years with no comorbidities (65%). Stone clearance was successful in 167 patients (99.4%). Nonlethal complications were noted in 3 patients during the surgery or in the immediate postoperative (1.79%) and managed with T-tube or endoscopically. No cases of mortality surgery related were observed. There were no signs of any type of biliary injury or stricture observed in any of the patients during the 24-month follow-up period. Conclusions: LCBDE with diathermy and primary closure is a safe and effective treatment option for choledocholithiasis for failed endoscopic retrograde cholangiopancreatography in terms of long-term outcome as well as short-term outcome.

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INTRODUÇÃO: A cervicalgia é uma importante causa de incapacidade em todo o mundo, causada por várias condições como doenças de base, anormalidades mecânicas e neuropáticas. A Diatermia por Ondas Longas (LWD) é uma modalidade de aquecimento terapêutico usada para tratar muitas condições musculoesqueléticas. OBJETIVO: Avaliar a eficácia da LWD na dor, incapacidade e amplitude de movimento (ADM) na dor no pescoço. MÉTODOS E MATERIAIS: O estudo foi conduzido após aprovação ética da universidade e registro em registro de ensaio clínico (PTY/2022/155 e CTRI/2022/06/043033). 30 pacientes com cervicalgia de 20-60 anos foram alocados aleatoriamente em dois grupos. O grupo controle (n=15) realizou exercícios domiciliares simples, enquanto no grupo experimental (n=15) a diatermia de ondas longas também foi administrada juntamente com exercícios domiciliares, 3 vezes/semana por 2 semanas. As medidas de resultado, como a escala visual analógica (EVA), índice de incapacidade do pescoço (IIP) e amplitude de movimento do pescoço, foram avaliadas na linha de base, no final de 2 semanas (pós-tratamento) e após um acompanhamento de 2 semanas. RESULTADOS E CONCLUSÃO: Houve melhora significativa da dor, incapacidade e ADM pós-intervenção no grupo controle e no grupo experimental. Além disso, houve diferença significativa na dor após o acompanhamento em ambos os grupos. A comparação entre os grupos sugeriu que houve uma diferença significativa para EVA, IIPe ADM de extensão do pescoço (p<0,05), mas não para ADM em outras direções. Portanto, pode-se concluir que a LWD é uma intervenção terapêutica eficaz para melhorar a dor, a incapacidade do pescoço e a amplitude de movimento do pescoço, juntamente com exercícios de pescoço em pacientes com dor no pescoço.

INTRODUCTION: Neck pain is a significant cause of disability worldwide, caused by various conditions like underlying diseases, mechanical and neuropathic abnormalities. Longwave Diathermy (LWD) is a therapeutic heating modality used to treat many musculoskeletal conditions. OBJECTIVE: To evaluate the efficacy of LWD on pain, disability, and range of motion (ROM) in neck pain. METHODS AND MATERIALS: The study was conducted after ethical approval from the university and registration in clinical trial registry (PTY/2022/155 & CTRI/2022/06/043033). Thirty patients with neck pain of 20-60 years were randomly allocated into two groups. The control group (n=15) performed simple home-based exercises, while in the experimental group (n=15) longwave diathermy was also given along with home exercises, 3 times/week for 2 weeks. The outcome measures like the Visual analogue scale (VAS), neck disability index (NDI), and Neck range of motion were assessed at baseline, at the end of 2 weeks (post-treatment), and after a followup of 2 weeks. RESULTS AND CONCLUSION: There was a significant improvement in pain, disability, and ROM post-intervention in the control group and experimental group. Additionally, there was a significant difference in pain after follow-up in both groups. The between-group comparison suggested that there was a significant difference for VAS, NDI, and neck extension ROM (p<0.05) but not for ROM in other directions. Therefore, it can be concluded that LWD is an effective therapeutic intervention for improving pain, neck disability, and neck range of motion along with neck exercises in patients with neck pain.

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SUMMARY OBJECTIVE: The aim of this study was to compare the effect of transcutaneous electrical nerve stimulation (TENS), ultrasound (US), and pulsed electromagnetic field (PEMF) combination with TENS and US therapy alone in patients with supraspinatus tear. METHODS: Forty patients were included in this study. The patients were randomly divided into two groups as follows: PEMF (n=20) and Sham (n=20) groups. PEMF was applied to the first group at a frequency of 50 Hz, 25 G intensity, and 20 min/session. The device was turned off while PEMF was applied to the second group. Diathermy (US) and electrotherapy (TENS) were applied to both groups for 10 sessions. Numerical Rating Scale (NRS), University of California-Los Angeles (UCLA) Shoulder Scale, and Shoulder Pain and Disability Index (SPADI) were used as outcome measures. RESULTS: In both groups, there was a significant improvement in the NRS, UCLA Shoulder Scale, and SPADI scores after treatment compared with pretreatment (p<0.05). In the comparison of the difference between the pretreatment and posttreatment measurement values between the groups, no significant difference was found between PEMF and Sham groups according to the NRS (p=0.165), UCLA Shoulder Scale (p=0.141), and SPADI (p=0.839) scores. CONCLUSIONS: In our study, a combination of PEMF therapy with conventional physical therapy modalities was not found to be superior to the conventional therapy alone, and adding it to the routine treatment of symptomatic supraspinatus tear would not provide any additional benefit.

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ABSTRACT The aim of this study was to evaluate the evidence of application of short-wave diathermy (SWD) in individuals with chronic low back pain (CLBP) and its prescription parameters. The data sources (MEDLINE, PubMed, LILACS, DARE, PsycINFO, AusportMed, SciELO, PEDro and the Cochrane Central Register of Controlled Trials) were systematically searched for articles published up to December 2017. Randomized and non-randomized clinical trial studies that investigated the effect of the application of SWD on CLBP were selected. Two independent reviewers assessed the risk of bias in studies using the Jadad and the Downs & Black scales. Five studies (731 patients) were included, all of whom presented improvements in CLBP. The majority used continuous mode SWD, with only one using pulsed mode (82 and 200 Hz). SWD produced improvements in CLBP, but there is limited evidence for its application, and a lack of standardization of the parameters used. Furthermore, the results that address this topic should be interpreted with caution due to their low methodological quality and limited number. Level of evidence II; Systematic review.

RESUMO O objetivo do presente estudo foi avaliar a evidência de aplicação da diatermia por ondas curtas (DOC) em indivíduos com dor lombar crônica (DLC) e seus parâmetros de prescrição. As fontes de dados (MEDLINE, PubMed, LILACS, DARE, PsycINFO, AusportMed, SciELO, PEDro e Cochrane Central Register of Controlled Trials) foram pesquisadas sistematicamente quanto aos artigos publicados até dezembro de 2017. Estudos de ensaios clínicos randomizados e não randomizados que investigaram o efeito da aplicação da DOC na DLC foram selecionados. Dois revisores independentes avaliaram o risco de viés em estudos usando as escalas Jadad e Downs & Black. Cinco estudos (731 pacientes) foram incluídos e todos apresentaram melhora na DLC. A maioria usou a DOC de modo contínuo, com apenas um utilizando o modo pulsado (82 e 200 Hz). A DOC apresentou melhora na DLC, no entanto, há evidências limitadas para sua aplicação e ausência de padronização dos parâmetros utilizados. Além disso, os resultados que se referem a esse tópico devem ser interpretados com cautela devido à baixa qualidade metodológica e ao número limitado de estudos. Nível de evidência II; Revisão sistemática.

RESUMEN El objetivo del presente estudio fue evaluar la evidencia de la diatermia por ondas cortas (DOC) en individuos con dolor lumbar crónico (DLC) y sus parámetros de prescripción. Las fuentes de datos (MEDLINE, PubMed, LILACS, DARE, PsycINFO, AusportMed, SciELO, PEDro y Cochrane Central Register of Controlled Trials) fueron utilizadas para búsquedas sistemáticas de artículos publicados hasta diciembre de 2017. Fueron seleccionados los estudios de ensayos clínicos aleatorizados y no aleatorizados que investigaron el efecto de la aplicación de DOC en DLC. Dos revisores independientes evaluaron el riesgo de sesgo en estudios usando las escalas Jadad y Downs & Black. Fueron incluidos cinco estudios (731 pacientes) y todos presentaron mejora en DLC. La mayoría usó la DOC de modo continuo, con sólo uno usando el modo pulsado (82 y 200 Hz). La DOC produjo mejoras en DLC, sin embargo, hay evidencias limitadas para su aplicación y ausencia de estandarización de los parámetros utilizados. Además, los resultados que se refieren a ese tópico deben interpretarse con cautela debido a la baja calidad metodológica y al número limitado de estudios. Nivel de evidencia II; Revisión sistemática.

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PURPOSE: To evaluate diathermy to minimize sclerotomy leakage during small-gauge vitrectomy and prevent ocular hypotony. METHODS: This observational prospective study included 327 patients (327 eyes) who underwent diathermy to close the sclerotomy sites during 23-gauge pars plana vitrectomy (PPV). All patients were operated by a single surgeon (ED) and evaluated at 30 and 60 days postoperatively. Patients with glaucoma, topical/systemic steroids use exceeding 30 days, ocular inflammation, or trauma were excluded. Chi-square, Kruskal-Wallis, Fisher Exact test, and multivariate statistical analyses were performed to evaluate potential risk factors. The primary outcomes were open sclerotomies, leakage, and ocular hypotony. RESULTS: Sclerotomies remained open in 12 (3.6%) and 2 (0.6%) patients, respectively, at 30 and 60 days postoperatively, revealing no case of ocular hypotony. Leakage only occurred in four patients (1.2%) during week 1 postoperatively. Multivariate analysis indicated that additional vitreoretinal surgeries and longer surgeries were risk factors for persistent sclerotomy opening. CONCLUSION: Diathermy was safe and feasible to close sclerotomies. Vitreoretinal surgery reoperations and longer surgeries were the most significant (P<0.05) risk factors for persistent sclerotomy opening, which may be functionally closed without evidence of leakage or ocular hypotony.

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RESUMO Esta pesquisa teve como objetivo identificar os principais efeitos adversos observados por fisioterapeutas com o uso de aparelhos de eletrotermofototerapia em clínicas da cidade de Cascavel, Paraná. A amostra contou com 35 clínicas e destas, 25 foram alvo de coleta após triagem, cujos dados foram obtidos por questionários em forma de entrevista semiestruturada. Nestes se questionava aos responsáveis pelo serviço de eletrotermofototerapia sobre a ocorrência de efeitos adversos experienciados durante atividades laborais na clínica. Observou-se que a Neuroestimulação Elétrica Transcutânea (TENS) apresentou problemas em 64% dos casos, com 36% devido a irritações cutâneas e 28% a dor. O aparelho de ondas curtas apresentou efeitos adversos em 60%, em que 40% foram queixas de dor e 20% causaram queimaduras leves. Já acerca do ultrassom terapêutico foram relatados efeitos adversos em 52%, sendo 32% de quadros de dor e 20% de casos com náuseas. A laserterapia de baixa potência demonstrou efeito adverso em 36%, com relatos de aumento da sensibilidade local. Por fim, os aparelhos de média frequência apresentaram efeitos adversos em apenas 20% dos casos, de queixas de náuseas. A quantidade de tais efeitos encontrados foi importante, porém sua gravidade não causou grande preocupação.

RESUMEN Este estudio propone identificar los principales efectos adversos observados por fisioterapeutas con el uso de aparatos de electrotermofototerapia en clínicas de la ciudad de Cascavel, Paraná (Brasil). De la muestra han participado 35 clínicas, de las cuales restaron 25 después del triaje, cuyos datos fueron obtenidos por cuestionarios en forma de entrevista semiestructurada. Estos contenían preguntas al responsable del servicio de electrotermofototerapia sobre la ocurrencia de los efectos adversos ocurridos durante el trabajo en la clínica. Se observó que el Electroestimulación Transcutánea (TENS, en inglés) presentó problemas en un 64 % de los casos, con un 36 % debido a irritaciones de la piel y un 28 % al dolor. En el aparato de ondas cortas se verificó efectos adversos en un 60 %, de las cuales un 40 % fueron de quejas de dolor y un 20 % de quemaduras leves. Sobre el ultrasonido terapéutico, se han divulgado los efectos adversos en un 52 %, de los cuales un 32 % fueron síntomas de dolor y un 20 % casos con náuseas. La terapia con láser de baja intensidad resultó en efectos adversos en el 36 %, con informes de aumento de la sensibilidad local. Por último, los dispositivos de frecuencia media revelaron efectos adversos en sólo el 20 % de los casos de las quejas de náuseas. La cantidad de estos efectos encontrados es importante, pero su gravedad no demostró gran preocupación.

ABSTRACT This study aimed to identify the main adverse effects observed by physical therapists using electrothermal phototherapy devices in clinics in the city of Cascavel, Paraná. The sample comprised 35 clinics, of which 25 were submitted to data collection after sorting. Data were collected through questionnaires in the form of semi-structured interview. In these questionnaires, the responsible for providing the electrothermal phototherapy service were asked about the occurrence of adverse effects experienced during labor activities at the clinic. Transcutaneous electrical nerve stimulation (TENS) showed problems in 64% of cases, being 36% due to skin irritations and 28% due to pain. The shortwave apparatus showed adverse effects in 60% of cases, of which 40% consisted of complaints of pain and 20% caused minor burns. Regarding therapeutic ultrasound, adverse effects were reported in 52% of cases, of which 32% were episodes of pain and 20% of nausea. The low-power laser therapy showed adverse effect on 36% of cases, with reports of increased local sensitivity. Finally, the medium frequency devices had adverse effect in only 20% of cases, being complaints of nausea. The amount of such effects found was important, but their gravity did not cause major concern.

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OBJETIVOS: Avaliar a eficácia do tratamento com ondas curtas por método indutivo em indivíduos sedentários com lombalgia crônica inespecífica. MÉTODOS: Um ensaio clínico quase-experimental e cruzado foi realizado com indivíduos lombálgicos e sedentários. A amostra foi recrutada entre acadêmicos da Universidade Estadual do Oeste do Paraná (Unioeste) na faixa etária entre 18 e 25 anos, que apresentavam dor lombar de origem postural não traumática há mais de três meses, eram sedentários, e aceitaram participar da pesquisa. O protocolo de intervenção consistiu na aplicação de ondas curtas por método indutivo por 15 minutos, uma vez ao dia, três vezes por semana, com intervalo de um dia entre cada aplicação. Na semana seguinte os voluntários recebiam tratamento placebo também por três vezes na semana, com tempo semelhante àquele realizado na semana tratamento, porém o equipamento era apenas ligado, sem emissão do campo eletromagnético. O protocolo foi aplicado por duas semanas. As variáveis analisadas foram o grau de incapacidade funcional, avaliado pelo Índice de Incapacidade de Oswestry (ODI) e pelo Questionário de Incapacidade de Roland-Morris (QIRM), no início do experimento e ao final de cada semana; e a dor, avaliada pela Escala Visual Analógica (EVA), antes e após cada sessão. Os dados foram apresentados em média e desvio-padrão ou mediana e quartis e o nível de significância aceito foi de 5%. RESULTADOS: Vinte voluntários participaram do estudo. Para a ODI houve redução dos valores de incapacidade ao longo da semana de tratamento, com retorno aos valores iniciais na semana placebo; já para o QIRM não houve diferenças entre o tratamento e o placebo. Pela EVA, houve redução na intensidade da dor ao longo dos três dias de terapia, fato que ocorreu apenas no segundo dia do placebo. CONCLUSÕES: O tratamento com ondas curtas na modalidade indutiva foi eficaz na diminuição da dor em pacientes sedentários com lombalgia crônica, contribuindo para melhora da capacidade funcional.

AIMS: To evaluate the efficacy of inductive shortwave treatment in sedentary individuals with non-specific chronic low back pain. METHODS: A quasi-experimental and cross-over trial was performed with sedentary individuals with chronic back pain. The sample was recruited among students from the State University of Western Paraná (Unioeste), aged between 18 and 25 years old, who had low back pain of non-traumatic postural origin for more than three months, were sedentary, and accepted to participate in the study. The intervention protocol consisted in the application of short waves by inductive method for 15 minutes, once a day, three times a week, with interval of one day between each application. In the following week, volunteers also received placebo treatment three times a week, with time similar to that performed in the treatment week, but the equipment was only switched on, without emission of the electromagnetic field. The protocol was applied for two weeks. The variables analyzed were the degree of functional disability, assessed by the Oswestry Disability Index (ODI) and the Roland-Morris Disability Questionnaire (QIRM), at the beginning of the experiment and at the end of each week; and pain, assessed by the Visual Analogue Scale (VAS), before and after each session. Data were presented as mean and standard deviation or median and quartiles, and the accepted level of significance was 5%. RESULTS: Twenty volunteers participated in the study. For ODI, there was a reduction in the disability values throughout the treatment week, with a return to previous values in the placebo week; there were no differences between treatment and placebo for the MIRR. By VAS, there was a reduction in pain intensity over the three days of therapy, which occurred only on the second day of the placebo. CONCLUSIONS: Treatment with short waves in the inductive modality was effective in reducing pain in sedentary patients with chronic low back pain, contributing to improve functional capacity

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BACKGROUND: Shortwave diathermy (SWD) and microwave diathermy (MWD) are frequently used by physical therapists to treat musculoskeletal conditions. The therapeutic benefits are usually associated with an increase in tissue temperature; however, there is no consensus on the changes in blood flow. OBJECTIVES: 1) To evaluate the behavior of temperature and arterial blood flow after the application of SWD and MWD to the lower limb of healthy women aged 18-30 and 2) to assess whether changes in limb positioning can influence SWD response. METHOD: Among the subjects analyzed, 40 women were eligible to participate in the trial and were randomly allocated to the SWD group or the MWD group. Each group received 20min of diathermy. After receiving the interventions, all patients crossed over to the other group, but the devices were detuned (sham). SWD was applied to the posterior compartment of the thigh and leg, with the knee in 0° and 90° of flexion, and the MWD applied to the posterior thigh. Skin temperature evaluation (digital infrared thermography) and assessment of blood flow velocity (Doppler ultrasound) were performed immediately before and 10 and 20min after the application. RESULTS: Arterial blood flow increased after SWD diathermy (vs. Sham), but not after MWD diathermy. SWD promoted skin heating at the end of therapy in all areas analyzed, remaining above baseline even 20min after the end of the application. MWD diathermy promoted skin heating in the posterior thigh, reflecting a rise in the temperature of the popliteal fossa area that remained for 10min after the end of the application. CONCLUSION: The increase in arterial blood flow velocity depends on the size of the heating area, since it was only observed in the application of the SWD. However, after 20min of application, the position of the lower leg did not affect the heating.

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