Pulsed Shortwave Therapy Research Articles

Pulsed shortwave electromagnetic field therapy increases quality of life in canines with symptoms of osteoarthritics.

Joint stiffness, lameness and reduced activity levels are common inflammatory responses observed in canines and have significant impact on quality of life (QOL). The symptoms are often ascribed to osteoarthritis (OA), for which the standard treatment is systemic anti-inflammatories, but pharmacologic intervention can have significant short-term and long-term side effects. Test the efficacy of a Food and Drug Administration (FDA)-cleared pulsed shortwave therapy (PSWT) device as a means to modulate vagus nerve activity and initiate a systemic anti-inflammatory response to determine its ability to improve functionality and the QOL of canines with inflammatory symptoms commonly associated with OA. A randomized, double-blinded, placebo-controlled 14-day study of 60 dogs with a presumptive prior diagnosis of OA in at least one limb joint. Two outcomes assessing changes in the dog's QOL and functionality were measured: subjectively determined changes in eight behaviours associated with discomfort and objectively determined changes in passive range of motion (PROM). The device was secured near the cervico-thoracic region of the dog's spine. PROM measures were taken at baseline and at the end of study. Behavioural measures were taken daily. Forty-nine animals completed the study. No negative side effects were reported. Average subjective discomfort scores for the treatment group (N=26) were reduced from 3.74 to 2.10 (44%), compared to no improvement in the placebo group (N=23) over the study period (p=0.0001). Average PROM scores increased by 5.51 (4.59-6.23) degrees relative to the placebo group (p<0.01). Ninety-six per cent of the treatment group showed either increased PROM or improved behavioural changes or both, compared to 4% for the placebo group (p<0.01). Most changes occurred within the first 8 days of treatment. PSWT applied at the level of the cervico-thoracic spine to target the vagus nerve may have the potential to improve QOL in dogs manifesting behaviours commonly associated with OA.

Efficacy of Pulsed Short Wave Therapy in Symptomatic TMD Patients

Context: Temporomandibular joint (TMJ) is a ginglymoarthroidal joint of synovial variety. The joint's pathology includes those predominantly of musculoskeletal origin, which poses a complex problem in the clinical scenario. The management of temporomandibular joint disorders (TMD) remains a challenge due to the intricate anatomy of the joint and the multipart etiologies associated with it. Aims: This study aimed to compare the effectiveness of pulsed short wave therapy (PSWT) with pharmacotherapy in symptomatic TMD patients. Methods and Material: A total of 62 patients were included in this randomized control trial and were randomly allotted into two groups. Patients in Group I received PSWTand Group II received a combination of a muscle relaxant and a nonsteroidal anti-inflammatory drug (NSAID) for 5 consecutive days. Visual analog scale (VAS) scores were recorded during the follow-up. Statistical Analysis Used: The statistical analysis was performed using Stata/SE 17.0 statistical software. Results: There was a statistically significant difference in the groups for different periods. Kaplan–Meier function and extended survivor function tests showed better pain alleviation in the short wave therapy group. Conclusion: The current study shows that PSWT decreased pain without adverse effects. Therefore, it could be considered a safe and potentially effective adjuvant therapeutic modality for TMD.

Noninvasive, Wearable, Pulsed Shortwave (Radiofrequency) Therapy for Analgesia following Knee and Hip Arthroplasty: A Case Series

Background: Minimizing pain and opioid requirements following major orthopedic surgery can be challenging. Nonthermal, pulsed, shortwave (radiofrequency) therapy is a noninvasive treatment described previously as a possible analgesic modality following minor surgical procedures. The devices may be applied in a few minutes or less, are simply taped in place over the area of pain, are less expensive than a large bottle of acetaminophen, function for 30 days without any required intervention, may be applied to any part of the body, and produce no side effects-patients cannot detect any sensations from the devices-or substantial risks. Here we present a case series to explore the use of pulsed shortwave therapy for major joint arthroplasty.

Myofascial Induction Therapy Improves the Sequelae of Medical Treatment in Head and Neck Cancer Survivors: A Single-Blind, Placebo-Controlled, Randomized Cross-Over Study.

Head and neck cancer (HNC) is the sixth most common cancer worldwide. Yet, less than 60% of HNC survivors receive adequate therapy for treatment-related sequelae. The objective of this study was to determine the efficacy of myofascial induction therapy (MIT) in improving cervical and shoulder pain and range of motion, maximal mouth opening, and cervical muscle function in HNC survivors. This crossover, blinded, placebo-controlled study involved 22 HNC survivors (average age 56.55 ± 12.71) of which 13 were males (59.1%) who received, in a crossover fashion, both a single 30-min session of MIT in the form of manual unwinding and simulated pulsed shortwave therapy (placebo), with a 4-week washout interval between the two. Cervical and shoulder pain (visual analogue scale) and range of motion (cervical range of motion device and goniometer), maximum mouth opening (digital caliper), and cervical muscle function (deep cervical flexor endurance test) were measured before and after the treatment and placebo sessions. A single session of MIT improved cervical and affected side shoulder pain, cervical range of motion, maximum mouth opening, and cervical muscle function. The associated effect sizes ranged from moderate to large. The present study suggests that MIT, in the form of manual unwinding, improves cervical (−3.91 ± 2.77) and affected-side shoulder (−3.64 ± 3.1) pain, cervical range of motion (flexion: 8.41 ± 8.26 deg; extension: 12.23 ± 6.55; affected-side rotation: 14.27 ± 11.05; unaffected-side rotation: 11.73 ± 8.65; affected-side lateroflexion: 7.95 ± 5.1; unaffected-side lateroflexion: 9.55 ± 6.6), maximum mouth opening (3.36 ± 3.4 mm), and cervical muscle function (8.09 ± 6.96 s) in HNC survivors.

Pulsed Shortwave Therapy in Cervical Osteoarthritis: an NSAID- Controlled, Randomized Clinical Trial

Assess treatment superiority of pulsed shortwave therapy (PSWT) against COX-2 NSAID therapy, in reducing disability and pain due to cervical osteoarthritis. Two hundred chronic pain suffers (average pain duration about 2 years) diagnosed with cervical osteoarthritis by radiological imaging were randomized into one of two treatment arms: COX-2 NSAID treatment; etoricoxib 60 mg/day for 4 weeks; or PSWT treatment worn 24 h/day for 4 weeks. The primary outcome measure was the 4-week score on the Neck Disability Index (NDI), a 10-question assessment on a 50-point scale. Secondary outcome measures included pain (at rest and during activity) measured on a visual analog scale (VAS) of 0–100 mm, dose count of rescue pain medication (paracetamol) use, and a treatment satisfaction rating. These 4-week scores were compared across the two arms to assess superiority. After 4 weeks of treatment, subjects in both study arms reported statistically significant (p < 0.0001) reductions in NDI, with final scores of 11.24-NSAID and 9.34-PSWT, VASrest, with final scores of 30.08-NSAID; 22.76-PSWT, and VASactivity, with final scores of 36.40-NSAID; 27.42-PSWT. The absolute reduction from baseline in NDI was significantly greater in the PSWT arm than NSAID arm (3.66 points; 95% CI 2.3 to 5.02; p < 0.0001). Similarly, the reductions from baseline in VASrest and VASactivity were significantly greater in the PSWT arm than NSAID arm (10.89 mm; 95% CI 6.90 to 14.87; p < 0.0001; and 12.05 mm; 95% CI 7.76 to 16.33; p < 0.0001, respectively). The PSWT arm used 50% less rescue pain medication. Eleven adverse effects were reported in the NSAID arm and zero in the PSWT arm. Both NSAID and PSWT treatments resulted in statistically significant improvements in quality of life (NDI) and reduction in pain (VAS) resulting from cervical osteoarthritis. However, the PSWT intervention showed superior improvements in all outcome measures when compared to the NSAID arm with no adverse effects. Clinicaltrials.gov (NCT03542955).

Pulsed short waves in the remineralization of alveolar bone structures of the jaw in patients with diabetes mellitus – a series of cases

This clinical study included three patients aged between 50 and 78 years who had chronic marginal periodontitis and type 2 diabetes mellitus, diseases that are frequently associated due to changes occurring in polymorphonuclear cells, as well as to alterations of microcirculation. No bone augmentation therapies were performed. Bone regeneration was strictly influenced by conventional periodontal therapy, supplemented with ten pulsed short wave sessions applied to the lower face shortly after closed periodontal curettage. The allocated time was ten minutes for the first two sessions, and 15 minutes for the following 8 sessions. Clinical and radiological evaluations were performed at the time of presentation, as well as after initiation of pulsed short wave therapy: in the first case, three weeks after initiation of therapy and three years after the end of complex oral rehabilitation; in the second case, eight weeks after the onset of pulsed short wave therapy and in the third case, five weeks after the onset of pulsed short wave therapy. The results were significant in all three cases, demonstrated radiologically by the same type of radiological examination at identical scales. Bone remineralization was obvious in the alveolar processes of the jaw. Although further studies in this direction are necessary, the results are both clinically and radiologically significant. Key words: pulsed short waves, alveolar bone resorption, periodontal disease, diabetes,

A Prospective Six-Month Study of Chronic Pain Sufferers: A Novel OTC Neuromodulation Therapy.

Objective To assess the durability of treatment over various chronic pain conditions of an emerging, nonprescription electromagnetic neuromodulation device that uses pulsed shortwave therapy. Methods A 6-month prospective study, involving 240 chronic pain sufferers, 94% of whom reported using pain pills and 98% reported using pain therapies prior to entering the study. Their average baseline pain was 8.2 VAS points before treatment; they had a pain duration of 6.5 years, and they were positive responders to pulsed shortwave therapy in an initial 7-day trial. Prospective assessments were obtained at intervals of 3, 4, and 6 months following a retrospective 7-day assessment. Longitudinal analyses were conducted to determine pain relief trends after the initial 7-day device use. Results Seven days after initial treatment, the average pain was reduced to 2.9, a 65% pain reduction for the study subjects. At the 6-month measurement, the average pain was 3.3, a 60% pain reduction from baseline. Only 17% of the subjects saw their pain level increase although this new level was still lower than baseline pain. Pain relief translated into improved quality of life and reduced medication use for the majority of the subjects. There were no significant adverse side effects reported over the 6 months of use. Conclusion Ninety-seven percent of the recruited subjects, all of whom had previously reported clinically significant pain relief using the 7-day PSWT device, sustained this relief for 6 months by using the device on an as-needed basis.

Chronic pain intervention using pulsed shortwave therapy: the relationship between pain demographics and central sensitization inventory.

Aim: The central sensitization inventory (CSI) is a validated, patient-reported questionnaire that quantifies symptoms of hypersensitivity disorders such as chronic pain, for which central sensitization (CS) may be the etiology. Objective: To investigate the analgesic effectiveness of ActiPatch and analyze the relationship between baseline CSI scores and demographics of chronic pain sufferers. Methods: Upon completing a 7-day ActiPatch trial, baseline CSI scores along with other assessment measures were obtained via e-mail from 174 chronic pain sufferers. Conclusion: CSI scores were positively correlated with gender (higher for women), baseline visual analog scale scores and pain duration. ActiPatch was found to be effective in reducing baseline pain for all subjects by an average of 4.3 visual analog scale points.

KOMBINASI PULSED SHORTWAVE THERAPY DAN NEURODYNAMIC MOBILIZATION LEBIH EFEKTIF MENURUNKAN DISABILITAS PUNGGUNG DIBANDINGKAN KOMBINASI PULSED SHORTWAVE THERAPY DAN LUMBAR SPINE STABILIZATION EXERCISE PADA PASIEN HERNIA NUKLEUS PULPOSUS LUMBOSAKRAL

ABTSRACT Introduction: Herniated Nucleus Pulposus (HNP) is a pathological condition in which there is protrusion of the annulus fibrosus and nucleus pulposus into the lumen of the vertebral canal. Objective: The goal of this study is to determine the effectiveness of combination of pulsed shortwave therapy and lumbar spine stabilization exercise with combination of pulsed shortwave therapy and neurodynamic mobilization in decreasing low back disability in lumbosacral herniated nucleus pulposus patients at Denpasar and Badung Physiotherapy Clinic. Methods: The study used was an experimental method. Pre-test and post-test control group design is the design of this study. This study used 28 subjects were divided into two groups. The control group consist of 14 subjects received a combination of pulsed shortwave therapy and lumbar spine stabilization exercise while the treatment group consist of 14 subjects received a combination of pulsed shortwave therapy and neurodynamic mobilization. Intervention is given 2 times a week for 4 weeks. Sampling methods used in this study was simple random sampling. The low back disability is measured by a modified oswestry disability index. Result: The normality test of the data was tested using Saphiro-Wilk Test and homogeneity test of the data was tested with Levene's Test. Wilcoxon sign rank test results obtained significant differences in the control group with the value of p = 0.001, as well as in the treatment group found a significant difference with the value of p = 0.001. Post-test results with mann-whitney u-test showed a significant difference between the control group and the treatment group where p = 0.044 with the percentage of 48.53% in the control group and 54.88% in the treatment group. Conclusion: Based on the results of this study it can be concluded that the combination of pulsed shortwave therapy and neurodynamic mobilization is more effective than the combination of pulsed shortwave therapy and lumbar spine stabilization exercise in reducing low back disability in patients with lumbosacral herniated nucleus pulposus at the Denpasar and Badung Physiotherapy Clinic.Keywords: lumbosacral herniated nucleus pulposus, low back disability, pulsed shortwave therapy, neurodynamic mobilization, lumbar spine stabilization exercise

Skin thermophysiological effects of 448 kHz capacitive resistive monopolar radiofrequency in healthy adults: A randomised crossover study and comparison with pulsed shortwave therapy

ABSTRACTRadiofrequency-based electrophysical agents (EPA) have been used in therapy practice over several decades (e.g., shortwave therapies). Currently, there is insufficient evidence supporting such devices operating below shortwave frequencies. This laboratory-based study investigated the skin physiological effects of 448 kHz capacitive resistive monopolar radiofrequency (CRMRF) and compared them to pulsed shortwave therapy (PSWT). In a randomised crossover study, seventeen healthy volunteers received four treatment conditions – High, Low and Placebo dose conditions receiving 15-min CRMRF treatment and a Control condition receiving no intervention. Fifteen participants also received high dose PSWT for comparison. Treatment was applied to the right lower medial thigh. Pre, post and 20-min follow-up measurements of skin temperature (SKT), skin blood flow (SBF) and nerve conduction velocity (NCV) were obtained using Biopac MP150 system. Group data were compared using the ANOVA model. Statistical significance was set at p ≤ 0.05 (0.8P, 95%CI). Significant increase and sustenance of SKT with both high and low dose CRMRF was demonstrated over the other groups (p < 0.001). PSWT increased SKT significantly (p < 0.001) but failed to sustain it over the follow-up. However, among the five conditions, only high dose CRMRF significantly increased and sustained SBF (p < 0.001). Overall, the CRMRF physiological responses were significantly more pronounced than that of PSWT. No significant changes in NCV were noted for any condition. Physiological changes associated with CRMRF were more pronounced when compared to PSWT, placebo or control. Any potential stronger therapeutic benefits of CRMRF need to be confirmed by comparative clinical studies.

Pulsed shortwave therapy (PSWT) for acute bleed management in people with haemophilia. Semi-structured interviews to explore patient's views

Purpose: The overall aim was to investigate the role of pulsed shortwave therapy (PSWT) in the physiotherapeutic management of acute bleeds in persons with haemophilia (PWH) an umbrella term, including various clotting disorders.

Pulsed shortwave therapy for patients with haemophilia – a systematic review of the literature and national survey of physiotherapy departments

Pulsed shortwave therapy for patients with haemophilia – a systematic review of the literature and national survey of physiotherapy departments

Continuous-mode 448 kHz capacitive resistive monopolar radiofrequency induces greater deep blood flow changes compared to pulsed mode shortwave: a crossover study in healthy adults

Aims: Radiofrequency-based electrophysical agents (EPAs) have been used in therapy practice over several decades (e.g. shortwave therapies). Currently, there is insufficient evidence supporting such EPAs operating below shortwave frequencies. This laboratory-based study investigated the deep physiological effects of 448 kHz capacitive resistive monopolar radiofrequency (CRMRF) and compared them to pulsed shortwave therapy (PSWT).Methods: In a randomized crossover study, 17 healthy volunteers initially received four treatment conditions: high, low and placebo dose conditions receiving 15-min CRMRF treatment and a control condition receiving no intervention. Fifteen participants additionally received high-dose PSWT as fifth condition, for comparison. Pre- and post-treatment measurements of deep blood flow and tissue extensibility were obtained using Doppler ultrasound and sonoelastography. Group data were compared using analysis of variance model. Statistical significance was set at p ≤ .05, 0.8 power, and 95% confidence interval.Results: Significant increases in volume and intensity of deep blood flow were obtained with CRMRF over placebo, control (p = .003) and PSWT (p < .001). No significant changes in blood flow velocity or tissue extensibility were noted for any condition.Conclusions: Deep blood flow changes with CRMRF were more pronounced than that with PSWT, placebo or control. Potential greater therapeutic benefits need to be confirmed with comparative clinical studies.

Myofascial Induction Effects on Neck-Shoulder Pain in Breast Cancer Survivors: Randomized, Single-Blind, Placebo-Controlled Crossover Design

ObjectivesTo (1) investigate the immediate effects of myofascial induction (MI), with placebo electrotherapy as a control, on perceived pain, cervical/shoulder range of motion (ROM), and mood state in breast cancer survivors (BCSs) with shoulder/arm morbidity; and (2) examine the relationships between pain modifications and cervical/shoulder ROM on the side affected by breast cancer. DesignRandomized, single-blind, placebo-controlled crossover study. SettingPhysical therapy laboratory. ParticipantsBCSs (N=21) who had a diagnosis of stage I–IIIA breast cancer and had completed adjuvant therapy (except hormonal treatment). InterventionDuring each session, the BCSs received either an MI (fascial unwinding) intervention focused on the upper limb area following the Pilat approach or placebo pulsed shortwave therapy (control group). Each session lasted 30 minutes, and an adequate washout period of 4 weeks between sessions was established. Main Outcome MeasuresThe visual analog scale (VAS) for pain and anxiety, shoulder-cervical goniometry for ROM, the Profile of Mood States for psychological distress, and the Attitudes Towards Massage Scale were used. ResultsAn analysis of covariance (ANCOVA) revealed significant time × group interactions for VAS affected arm (P=.031) but not for VAS cervical (P=.332), VAS nonaffected arm (P=.698), or VAS anxiety (P=.266). The ANCOVA also revealed significant interactions for affected shoulder flexion (P<.001), abduction (P<.001), external rotation (P=.004), and internal rotation (P=.001). Significant interactions for affected cervical rotation (P=.022) and affected cervical lateral flexion (P=.038) were also found. A significant negative correlation was found between changes in VAS affected arm and shoulder/arm internal rotation ROM (r=−.46; P=.03). ConclusionsA single MI session decreases pain intensity and improves neck-shoulder ROM to a greater degree than placebo electrotherapy for BCSs experiencing pain.

A UK Registry Study of the Effectiveness of a New Over-The-Counter Chronic Pain Therapy

The ActiPatch(®) (BioElectronics Corporation, MD, USA) pulsed shortwave therapy device has been shown to be clinically effective in three double-blind randomized controlled pain studies. However, the effectiveness of this device in a broader population of chronic musculoskeletal pain sufferers, affected by a variety of etiologies in different regions of the body, has not been studied. The objective of this registry study was to assess the effectiveness and satisfaction of the ActiPatch device in the general population of chronic pain sufferers. A total of 44,000 subjects completed the trial, with 5000 assessments of the device collected. The ActiPatch device appears to provide a clinically meaningful reduction of chronic musculoskeletal pain affecting different locations of the body caused by a variety of etiologies.

Radiofrequency-based treatment in therapy-related clinical practice – a narrative review. Part I: acute conditions

Background:Radiofrequency electromagnetic field (RFEMF or simply RF)-based electrophysical agents (EPAs) have been employed in therapy-related clinical practice for several decades. They are used to reduce pain and inflammation and enhance tissue healing. Although these agents have generally become less popular in contemporary therapy practice, surveys have shown that some of these modalities are still reasonably widely used.Objective:To review the evidence for the use of non-invasive low frequency RFs (30 kHz–30 MHz) in therapy-related clinical practice.Major findings:All peer reviewed therapy-related clinical studies published in English and concerning low frequency RF were sought. Identified literature was divided into acute and chronic segments based on their clinical area and analysed to assess the volume and scope of current evidence. The studies on acute conditions were reviewed in detail for this paper. One hundred twenty clinical studies were identified, of which 30 related to acute conditions. The majority of studies employed Pulsed Shortwave Therapy (PSWT). Twenty-two studies out of 30 were related to conditions of pain and inflammation, seven to tissue healing and one to acute pneumothorax. No studies were identified on frequencies other than shortwave.Conclusions:Evidence for and against RF-based therapy is available. There is reasonable evidence in support of PSWT to alleviate postoperative pain and promote postoperative wound healing. Evidence for other acute conditions is sparse and conflicting. A general lack of research emphasis in the non-shortwave RF band is evident, with studies on acute conditions almost non-existent. Further and wider research in this area is warranted.

The thermal and nonthermal effects of high and low doses of pulsed short wave therapy (PSWT)

The study aimed to investigate the thermal and non-thermal effects of pulsed short wave therapy (PSWT) using high and low dose of PSWT together with placebo and control conditions in healthy subjects. A single-blind, crossover design was employed with 31 subjects who all participated in three conditions: High PSWT (PD 200 μsec, PRR 800 Hz, MP 24 W, 10 minutes), Low PSWT (PD 100 μsec, PRR 200 Hz, MP 3 W, 10 minutes), and Placebo PSWT (PD 20 μsec, PRR 50 Hz, MP 0.05 W, 10 minutes). Fourteen subjects additionally participated in a Control condition (no treatment, 10 minutes). Measurements of skin temperature, blood flow, heart rate, and core temperature were taken before, during, and after the application of PSWT. Data were analyzed using a repeated measures analysis of variance (ANOVA) model with a Bonferroni post-hoc comparison. A significant increase in blood volume and skin temperature with both the high- and low-dose applications during the treatment period was demonstrated. There were significant differences between time periods and between treated and untreated limbs compared with the control condition. The blood flow changes during the low-dose application were not significantly different from placebo. Some subjects were unable to detect significant changes in skin temperature. Significant physiological changes associated with the application of PSWT have been demonstrated, challenging the notion of a lack of effect of this therapy. The study also demonstrated a measurable increase in skin temperature, which was not associated with thermal sensory perception; thus, skin sensation may not be clinically reliable for detecting real changes in temperature. Subjects with a wide age range of ages were deliberately recruited; however, these results may not extrapolate to a patient population who could react differently to the same intervention. Further studies in the clinical environment are therefore needed.

An audit of patient records into the nature of pulsed shortwave therapy use

This evaluative audit aimed to investigate the nature of pulsed shortwave therapy (PSWT) use in outpatients clinics in England through the analysis of patient records. Eight randomly selected hospitals were chosen to reflect variations in practice across the country. Information concerning the total number of patients seen in these departments, the proportion of patients treated with PSWT, the mode of treatment (duration of exposure, PSWT parameters, treatment frequency and outcome) and the conditions treated were collected and analysed. A total of 1750 sets of physiotherapy patient notes were evaluated of which, 192 patients were treated with PSWT, averaging 11% of all treatments. The treatment records were found to be of generally poor quality. None of the files examined fulfilled the Chartered Society of Physiotherapy standards of documentation. Eighty eight percent of the files did not have reproducible treatment plans in terms of dose parameters. The issues raised by this evaluative audit are considered in the context of therapy treatment notes and in relation to PSWT.

A placebo controlled double blind trial to evaluate the effectiveness of pulsed short wave therapy for osteoarthritic hip and knee pain

The aim of this study was to investigate the effectiveness of pulsed short wave (PSW) in the relief of pain in osteoarthritis of the hip and knee. Ninety-two patients, mean age 63 years, (34 men and 58 women) were randomly allocated to one of three groups: (1) Active PSW, using the dosage found in a pilot study to be non-significantly most effective, (2) Placebo PSW, (3) No treatment control group. Nine sessions of treatment were provided over a 3-week period, each application lasting for 15 min. The machine was modified by the manufacturers so that the therapist was able to administer the treatment and carry out assessments without being aware of the treatment allocation. Outcome measures included sensory and affective pain diary reports averaged over days and weeks, self-reported benefit and the General Health Questionnaire. Analysis of variance with repeated measures over time was used to find out if the active treatment had a specific effect, incremental to the placebo effect. There were no significant differences between the active and placebo groups over time. According to the pain diary reports, both active and placebo groups tended to improve slightly during treatment, but worsened after its withdrawal. Patients who were given the placebo application tended to report more benefit than those who had the active treatment, although this did not quite reach statistical significance ( P < 0.06). Patients who were not on a waiting list for surgery did significantly better over time than those who were ( P < 0.03). There were no significant differences between the groups over time for the other outcome variables. Any treatment effect on this patient population appears to have been largely placebo-mediated. No evidence was found therefore for the specific effectiveness of PSW for treatment of osteoarthritic hip or knee pain.

The thermal effects of pulsed shortwave therapy

Although the thermal effects of pulsed shortwave diathermy (PSWD) have been previously reported, the modality is often regarded as a non-thermal treatment. This article explores the relationship between PSWD treatment parameters and the perception of heat in non-injured subjects. It is the initial report of an experimental programme to determine the relationship between PSWD treatment parameters and their physiological effects.