Module IV Physiotherapy and
Telemetry
By
[Link],M.E., Ph.D
Professor/ECE
MKCE
Content
Diathermy
Shortwave diathermy
Surgical diathermy
Microwave diathermy
Ultrasonic diathermy
Biotelemetry
Elements of biotelemetry system
Advantages of biotelemetry system
Single channel system
Multichannel system (FDM,TDM)
Application of Bio Telemetry
Diathermy
• Diathermy is the process of producing internal
heat in body tissues using high-frequency
electrical currents, a principle used in both
therapeutic and surgical applications
• Application of High-Frequency
Electromagnetic Energy
• Used To Generate Heat In Body Tissues
• Heat Produced By Resistance of Tissues
• Also Used For Non-Thermal Effects
Physiologic Responses To Diathermy
• Therapeutic: Electrical currents are passed through
the body to generate heat, which can reduce pain and
stiffness and improve blood flow.
• Surgical: A high-frequency electrical current is used to
cut tissue or cauterize (seal) blood vessels to stop
bleeding.
• Physiologic Effects Are Those of Heat In General
– Tissue Temperature Increase
– Increased Blood Flow (Vasodilation)
– Increased Venous and Lymphatic Flow
– Increased Metabolism
– Changes In Physical Properties of Tissues
– Muscle Relaxation
– Analgesia
Types of diathermy
Shortwave diathermy: Uses radiofrequency currents to
generate heat deep within tissues.
Microwave diathermy: Uses microwaves to warm tissues
closer to the skin, such as the shoulders.
Ultrasound diathermy: Uses sound waves to generate heat. A
therapist continuously moves a wand-like device over the area.
Surgical diathermy: Uses a monopolar or bipolar circuit, where
current flows from the device through the active electrode, the
patient's body, and back to the device via a dispersive
electrode.
Shortwave Diathermy
• Radio Transmitter With FCC Assigned
Frequencies
– 27.12 MHz at 11 M
– 13.56 MHz at 22 M
– 40.68 MHz at 7.5 M
Shortwave Diathermy Unit
• Power Supply Powers
Radio Frequency
Oscillator (RFO)
• RFO Provides Stable Drift-
Free Oscillations at Given
Frequency
• Power Amplifier Generate
Power To Drive Electrodes
• Output Resonant Tank
Tunes In The Patient for
Maximum Power Transfer
Shortwave Diathermy Unit
• A=Power Switch
• B=Timer
• C=Power Meter(monitors current from power supply not current entering patient-
volume control)
• D=Output Intensity(%max power to patient)
• E=Tuning Control(tunes output from RFO)
Shortwave Diathermy Unit
• Power Output Should Provide Energy To Raise
Tissue Temp To Therapeutic Range (40-45 deg
C) (80-120 watts)
• Should Exceed SAR-Specific Absorption Rate
(rate of energy absorbed /unit area of tissue
mass)
Shortwave Diathermy Unit
• Generates Both an Electrical and a Magnetic
Field
• Ratio Depends on Characteristics of Both The
Generator and the Electrodes
– SWD Units at 13.56 MHz= Stronger Magnetic Field
– SWD Units at27.12 MHz = Stronger Electrical Field
SWD Electrodes
• Capacitor Electrodes
• Inductor Electrodes
• Selection of Appropriate Electrodes Can
Influence The Treatment
Ultrasonic Diathermy
Ultrasonic therapy is used where short wave treatment is failed and where localization of heat
effect is desired.
• It is very helpful to cure the diseases of peripheral nervous system.
• The heating effect is produced due to the absorption of ultrasonic energy by the tissues.
• The effect of ultrasonic on the tissues is a high speed vibration of micro massage. Micro
massage is used in the treatment of soft tissue lesions.
Ultrasonic massage is better because of greater depth of massage can be obtained without
any pain to the patient
R.F oscillator produces a high frequency alternating current which excites the piezo electric
transducer.
• The ultrasonic waves can be applied in continuous or pulsed mode. In case of pulsed mode,
micro massage is obtained effectively without any thermal effect.
• In front of crystal, there is a metal face plate which is made to vibrate
by the oscillations of crystal. Ultrasonic wave are emitted from this
plate.
• The amount of ultrasonic energy absorbed by the tissues is
depending upon the frequency of ultrasonic waves.
• The frequency ranges from 800 KHz to 1 MHz and the output power
can be varied from 0 to 3 w/cm2. The treatment timer is an
electrically operated contact which can be set from 1 to 15 min. It
switches off the output power often the present time.
• The transducer probe is in direct contact with the body through an
electrode gel.
• In case of large areas to be treated, the probe is moved up and down
to obtain uniform distribution of ultrasonic energy. If there is a
wound, the treatment is carried out in a warm water both to avoid
the mechanical contact with the already injured tissues.
• Ultrasonic therapy is used where short wave treatment is failed and
where localization of heat effect is desired.
Microwave Diathermy
• Two FCC Assigned Frequencies-2456 MHz and 915 MHz.
– 2450 MHz frequency with 12.33 cm wavelength
– 915 MHz frequency with 32.7 cm wavelength
– 433.9 MHz frequency with 69 cm wavelength
• MWD Has Higher Frequency and Shorter Wavelength
Than SWD
• Generates Strong Electrical Field and Relatively Little
Magnetic Field
• Depth Of Penetration Is Minimal In Areas With
Subcutaneous Fat > 1 cm
Microwave Diathermy Unit
• A= Power Switch
• B=Timer
• C=Output Meter (indicates relative output in watts
• D= Power Output Level Knob
• E= Amber Light-Warming up / Red Light- Ready
It comprises a power supply, timing
circuit, magnetron, and transducer. The
device directs the waves onto the
targeted tissues.
The antenna, with its specialized head
design, focuses the field directly at the
treatment area. High-frequency waves
are generated by a magnetron with tiny
perforations through which electrons
flow towards the treatment heads.
These waves then pass through the
space and are absorbed, heating the
tissues at the desired depth.
The effective depth of microwave
penetration is approximately 4.5 cm,
placing it between infrared (~2 cm) and
shortwave diathermy (>5 cm).
The treatment parameters for microwave diathermy include:
•Spacing of applicators: 2-6 cm for small treatment areas, 10-15 cm for
large treatment areas
•Time of treatment: 20 to 30 minutes
•Frequency of treatment: Daily or on alternate days, depending on the
patient’s response, condition, and availability
• Benefits or Advantages of Microwave Diathermy
• The technique and machine operation are straightforward and user-
friendly.
• It doesn’t require pads, electrodes, capacitor pads, or inductive coils,
as is the case with shortwave diathermy.
• It produces a more localized and concentrated heating effect
compared to shortwave diathermy.
• It offers more superficial tissue heating, depending on the specific
type of tissue involved. It is strongly absorbed by tissues with a high
fluid content, such as muscle or blood, leading to significant heating at
a superficial depth of around 0.7 cm. Tissues with low fluid content,
such as fat or bone, experience greater penetration.
• The patient doesn’t become part of the circuit in microwave
diathermy, eliminating the need for tuning as required in shortwave
diathermy.
• It’s a very comfortable treatment method for patients.
• Overheating is preventable when proper precautions are followed.
• Low-frequency microwaves cause selective heating in muscles.
• Drawbacks or Disadvantages of Microwave Diathermy
• No metal should be within 4 feet of the microwave
diathermy device, as it can interfere with the signal.
• Various factors influence heat absorption, including water
content, frequency, distance, and the principles of
reflection, refraction, absorption, and the inverse square
law.
• It’s not suitable for treating deep structures within the
body.
• Only one area of the body can be treated at a time.
• There’s a risk of skin burns if treatment procedures and
safety guidelines are not strictly followed.
• Patients should avoid looking directly at the applicator
during treatment to prevent burns. It is recommended
• In this method the tissues are heated by the absorption of microwave energy.
• Microwave diathermy treatments is highly focused electromagnetic radiation,
emitted from an instrument shaped like a stick at the damaged area.
• This form of diathermy is best use for more localized injuries or small muscles.
• Microwave diathermy treatments last about 20 to 30 mins.
• It consists of a power source that sends electrical current into a magnetron, a
tube-like structure with exterior magnets.
• The machine cabinet are one (or) two adjustable arms, each having an end
applicator which has a flat surface on one side that acts as an antenna through
which the microwave travel.
• Microwave diathermy is very simple, generally two designs of applicators are
common.
• 1. Circular: Used for small (or) large areas with different shed applications.
• 2. Rectangular: For enlongated areas.
• The frequency used is about 2450 MHz.
• Better results are obtained by the microwave method and it is more
advantageous than the short wave method.
• There is no pad electrodes and flexible cable.
• Microwave is transmitted into body and treat directly from the direction of unit.
• Microwaves are produced with the help of magnetron.
• Proper cooling arrangements are made for the purpose of cooling the magnetron.
• No tuning is necessary for individual treatments.
• Precautions:
• Necessary precautions should be taken during this method of treatment
• Excessive dosage causes skin burns and the skin should be dry as the waves are
rapidly absorbed by water.
• Advantages
• This type of remedy used to treat rigid joints and joint pains often associated with
arthritis without using electrodes and cable.
• Accelerate the healing of an injured area.
• Proper coding arrangements are made for the purpose of cooling the magnetron.
• Disadvantages
• Patients with implanted pacemaker should not undergo this treatment
• There are possibilities of over heating
• Care should be taken while the treatment is made near the eyes.
Surgical Diathermy
• Logic board is the main part of the unit which produces the
necessary waveforms
for cutting, coagulation and hemostasis modes of operation.
• An astable multivibrator generates 500 kHz square pulses. The
output from this oscillator is divided into a number of
frequencies using binary counters.
• These frequencies are used as system timing signals , A
frequency of 250 KHz provides a split phase signal to drive
output stages on the power output board.
• Frequency of 250 Hz is used for cutting , after the high power
amplification by push pull amplifier.
• The output of the push pull amplifier is given to a transformer so
that the voltage is stepped up and the output signal from the
unit is well isolated.
• The isolator switch provides an isolated switching control
between the active hand switch and the rest of the unit.
[Link]
When the electrode is held near the tissue without touching it and due to the
passage of electric are, destruction of superficial tissues take place. It is related
to the localized surface level destruction of tissues. Needle or Ball electrodes
are used.
[Link]
The needle point electrodes are stuck into tissue, while passing electric
current a local increase in heat creates drying of tissues. This is called
desiccation which produces dehydration in tissues.
• [Link] or cutting
• When the electrode is kept above the skin, an
electrical are is sent. The developed heat
produces a wedge shaped cutting of tissue on
surface. Continuous R.F current is used for
cutting
[Link]
When the electrode is kept above the skin, high frequency current is sent through
the tissues in the form of bursts and heating it locally so that it coagulates from
inside. The concurrent use of continuous R.F current for cutting and a R.F wave
burst for coagulation is called Hemostasis mode.
5. Blending
When the electrode is kept above the skin, the separated tissues can be combined together
by an electric arc. This is called blending. Logic board is the main part of the unit which
produces the necessary waveforms for cutting, coagulation and hemostasis mode of
operation. An astable multivibrator generates 500 KHz square pulses. The outputsdivided
into a number of frequencies using binary counters. These frequencies are used as system
timing signals. A frequencies of 250 KHz provides a split phase signal to drive output stage
on power output board. A frequency of 50 KHz provides a gating signal for making
coagulating output.
The frequency of 250 KHz is used for cutting. To indicate each mode of operation,
diathermy unit is provided with an audio tone generator. When coagulation output is
delivered, 1 KHz audio signal is heard. Similarly 500 Hz for cutting and 250 Hz for
hemostasis.
• The isolator switch provides an isolated switching control
between the active hand switch and rest of unit. The foot
switch is used to avoid any explosion formed by the an
aesthesia gases near electrical contacts.
• Special Features
• • To secure safety for the patient or operator, the output unit
is isolated and insulated from the low frequency primary and
secondary voltages.
• • The bipolar electrodes are used such that the active
electrode is mounted in an insulated handle and in different
electrode is placed at the back of patient in the form of plate.
• The output of the unit may be earth referenced or isolated.
The isolated output dose not produce any fibrillation and any
serious burns.
• • The active electrodes for cutting are in the form of needle
electrode and the active electrode for coagulation are in the
form of a ball or plate.
• • These are circuit integrity monitors like patient circuit
continuity monitor, alternate path current monitors etc.
• • The frequency of operation is from 20 KHz to 1 MHz. The
output power for cutting is about 400 w and for coagulation is
150 w.
Bio Telemetry
• Biotelemetry (short for biological telemetry) is
the process of measuring physiological
parameters (like heart rate, temperature,
blood pressure, ECG, etc.) from a living
organism and transmitting the data wirelessly
to a distant monitoring location.
• The use of telemetry to monitor, measure and
record physiological data of an organism
Frequency selection
• Choice of Carrier Frequency
• In every country there are regulations for the
use of frequency for medical telemetry.
• The radio frequencies normally used for
medical telemetry purposes are of the order of
37, 102, 153, 159, 220 and 450 MHz.
• In USA, two frequency bands (174-216MHz and
450-470MHz) are used.
• The transmitter is typically 50mW .
Basic Elements of Biotelemetry system
• Maximum Fidelity and simple
• Small size and light weight.
• More Stability and reliability.
• Less power consumption
• Shielding cable for wired transmission.
• Reduced noise
Elements of Telemetry
34
• Elements of Telemetry
1. Transducer or Sensor:
Converts the physical variable to be telemetered into an electrical
quantity.
2. Signal Conditioner-1:
Converts the electrical output of the transducer (or sensor) into an
electrical signal compatible with the transmitter.
3. Transmitter:
Its purpose is to transmit the information signal coming from the
signal conditioner-1 using a suitable carrier signal to the
receiving end.
• The transmitter may perform one or more of the following
functions:
• (i) Modulation: Modulation of a carrier signal by the information
signal.
• (ii) Amplification: As and if required for the purpose of transmission.
• (iii) Signal Conversion: As and if required for the purpose of
transmission.
• (iv) Multiplexing: If more than one physical variables need to be
telemetered simultaneously from the same location, then either
frequency-division multiplexing (FDM) or time-division multiplexing
(TDM) is used.
• Receiver: Its purpose is to receive the signal(s) coming
from the transmitter (located at the sending end of the
telemetry system) via the signal transmission medium and
recover the information from the same.
• It may perform one or more of the following functions:
• 1. Amplification
• 2. Demodulation:
• 3. Reverse Signal Conversion
• 4. De-multiplexing
• Signal Conditioner-2: Processes the receiver output as
necessary to make it suitable to drive the given end device.
• End Device: The element is so called because it appears at
the end of the system.
• End device may be performing one of the following
functions:
• 1. Analog Indication:
• 2. Digital Display
• 3. Digital Storage
• 4. Data Processing
• Subsystems of Telemetry System
• (a) Measurement Subsystem:
• It comprises the transducer (or sensor), signal conditioner
and the end device, like any conventional measurement
system.
• (b) Communication Subsystem:
• It comprises the transmitter and receiver along with the
transmission medium linking the two,
• Telemetry Classification Based on Transmission Medium
• 1. Wire-Link Telemetry or Wire Telemetry
• 2. Radio Telemetry or Wireless Telemetry like any
communication system.
Telemetry Classification Based on Transmission
Medium
Wire-Link Telemetry or Wire
Telemetry
Radio Telemetry or Wireless
Telemetry
38
Wired Telemetry
Elements of Wired Bio-Telemetry(Analog)
40 DEEPAK.P
Digital Wired Bio Telemetry
Elements of Wired Bio-Telemetry(Digital)
42
Elements of Wired Digital Bio-
Telemetry
43
Wireless Bio Telemetry
Elements of Wireless Bio-
Telemetry
Using wireless bio telemetry, physiological signals can be
obtained from swimmers, riders, athlets, pilots or manual labours.
It is two types
1. Short-Range Radio Telemetry
2. Satellite-Radio Telemetry
A typical biotelemetry system comprises:
1. Sensors appropriate for the particular signals to be monitored
2. Battery-powered, Patient worn transmitters
3. A Radio Antenna and Receiver
4. A display unit capable of concurrently presenting
information from multiple patients
45
Elements of Basic Wireless Bio-Telemetry
Elements of Wireless Bio-
Telemetry
47
Elements of Wireless Bio-Telemetry
48
Wireless Bio-telemetry
Transmitter
Bio Telemetry Modulation
50
Telemetry Classification Based on Modulation Method
▪ DC Telemetry Systems
● 1. Direct voltage telemetry system
● 2. Direct current telemetry system
▪ AC Telemetry Systems
● 1. Amplitude modulation (AM) telemetry system
● 2. Frequency modulation (FM) telemetry system
● Pulse Telemetry Systems
● 1. Pulse amplitude modulation (PAM) telemetry system
● 2. Pulse width modulation (PWM) telemetry system
● 3. Pulse phase modulation (PPM) telemetry system
● 4. Pulse frequency modulation (PFM) telemetry system
● 5. Pulse code modulation (PCM) telemetry system
51
Direct Current Telemetry
FM Radio Telemetry
53
Single Channel Bio Telemetry
54
Single Channel PWM Telemetry
55
Single Channel PCM Telemetry
56
Radio Telemetry Systems
• Radio transmission & reception of bio signals.
• Single channel and Multichannel telemetry.
• 100 kHz to 300MHz.
• FM or Pulse Modulation is used.
• Stray capacitance between the
electrode circuit and system.
• Two type of Measurement-
Active and Passive Measurement
• ECG, EMG & EEG- without
excitation ( Active)
• Blood pressure,
Temperature, Blood flow-
using Transducer and
excitation voltage(Passive).
• Tunnel diode FM transmitter,
Hartley Type FM transmitter and
Pulse Hartley oscillator.
• weight- 1.44gm, size
0.8x0.22cm2
Multiple channel Telemetry Systems
• Multiple
signal
transmission
• Scanning
frequency
Fn> 2 Fsmax
Thank you