Hoobler, TR; University of Alabama at Birmingham, Birmingham, AL. Hooblert@uab.edu.

PURPOSE: To review the literature relative to the use of Shortwave Diathermy in a multidiagnostic population to determine if the evidence for use is supported by the literature. BACKGROUND: Sackett and others have described Evidence Based Medicine principles of evaluating clinical interventions. The use of the "evidence pyramid" is an accepted method of evaluating published research. SUBJECTS: Fifty-six articles from 1959 to 2001 were reviewed and the results of the search are presented. METHODS: Articles were evaluated using the hierarchical evidence pyramid. Study type and medical diagnosis are presented with the investigator’s conclusion as to benefit / non-benefit / risk of shortwave in each diagnosis. RESULTS: Four identified randomized controlled trials found only one beneficial effect with 2 negative effects and one no harm in the human immune system. Twenty-one controlled clinical studies found 10 positive effects with 11 of no benefit or negative effects. Twenty-three non-controlled clinical studies found 20 positive effects and 3 of no benefit or negative effects. Two meta-analyses found no evidence for continuous wave SWD but positive results for Diapulse. Two systematic reviews found either minor short-term effects or were inconclusive. Three case studies found positive effects using Pulsed SWD in Pelvic Inflammatory Disease and Soft tissue lesions with no harm involving pregnancy. One animal study found positive effects on tissue healing in dogs. Diagnoses reported were as follows: Chronic PID, Chronic pain, Post surgical pain and wound healing, Graft healing, Various musculoskeletal and soft tissue injuries, Herpes, Myofascial pain dysfunction, Osteoarthritis, Pressure ulcers, Post-op dental symptoms, Post traumatic algoneurodystrophies, Pregnancy, Subdeltoid calcific bursitis, TMJ disorders, and Whiplash. CONCLUSIONS: Only two of the randomized controlled trials had acceptable controls, with a small n in one of the two. A beneficial effect was noted in an RCT in which the investigators selected treatments to be applied based on the diagnosis. In both controlled and non-controlled clinical studies there was a wide discrepancy between beneficial and potentially harmful effects. The use of a pulsed wave (i.e. Diapulse) is the only treatment, which is supported or has shown potential positive effects in posttraumatic, post surgical and wound healing diagnoses. FUNDING SOURCE: none.

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