Contra-indications to shortwave diathermy: survey of Irish physiotherapists

Background and purpose Minimal research has been completed on contra-indications to electrotherapy, but one study has reported that a large percentage of adverse effects occurred due to shortwave diathermy application. Since most contra-indications are primarily based on a common-sense approach rather than on evidence-based practice, it was decided to examine the level of agreement among physiotherapists in Ireland on the contra-indications to continuous and pulsed shortwave diathermy.

Methods A questionnaire survey was carried out in all Irish hospital-based physiotherapy departments that use shortwave diathermy (41 departments). The participants were physiotherapists with 3 or more years post-qualification experience, working in these departments (74 respondents). They were asked to categorise 35 symptoms or conditions as either ‘always’, ‘sometimes’, or ‘never’ contra-indicated, or ‘don’t know’ whether contra-indicated for both continuous and pulsed shortwave diathermy.

Results There was a 75% response rate to the study. Good (>90%) agreement was found among respondents for traditional contra-indications to both continuous shortwave diathermy (metal implants, pacemakers, malignancy, tuberculous joints, over the eyes) and pulsed shortwave diathermy (malignancy and pacemakers). Higher levels of agreement were evident in the continuous shortwave diathermy section compared to pulsed shortwave diathermy. The use of pulsed shortwave diathermy where metal implants were present and in the treatment of rheumatoid arthritis were considered to be priority areas for future research.

Conclusions For safe and effective shortwave diathermy treatment, physiotherapists should be aware of all conditions or symptoms that contra-indicate treatment. Overall a lack of research-based evidence was found regarding most contra-indications to treatment.