I tend to assume that if a growthplate is still in
situ then it has the potential to be active at that
time and even if it were fully dormant would
electrotharpy stimulate it? - whether that stimulation
would be adverse or not!
In terms of using electrotherapy "as long as the
growth plate is not in the line of fire" ... as I
understand things shortwave-type modalities have a
huge radius of 'fire' - the wavelength is 30 - 3
metres (Low and Reed, 1990), and although the further
the part is from the source of radiation the less the
intensity of radiation there is still the potential of
irradiating the whole body (!) to a certain extent -
all be it very small especially if low doses and
pulsed applications are used.
The other side of the argument is that these
modalities have been used for many years now and
hopefully if there were drastic effects they would
have shown up etc. This said, I personally don't think
we know enough about risks and future risks. So I
explain to any children, adolescents or their parents
that the full story isn't yet clear and that
electrotherapy to a potentially still growing area/
person is not a techniques that I am prepared to do.
All of my patients thus far have been perfectly happy
with this explanation.
I think we should use our own professional judgement
until more concrete evidence is there to guide us.
Listen to the thoughts/ opinions of others but then
digest them individually ourselves and don't be afraid
to question those thoughts and come to your own
rational conclusions and open-ended conclusions.
Wendy Johnson
--- Lisa Woolley <[log in to unmask]> wrote:
> An electrotherapy tutor advised me not to use
> electrotherapy when the
> individual growth plate is at it's most active
> stage, but when is that?
> Also it is safe to use as long as a growth plate is
> not in the line of
> 'fire'.
>
> Lisa
>
>
> >From: Wendy Johnson <[log in to unmask]>
> >Reply-To: [log in to unmask]
> >To: [log in to unmask]
> >Subject: Re: Electrotherapy use on Children
> >Date: Tue, 29 Feb 2000 14:12:33 -0800 (PST)
> >
> >I totally agree with the comments from Nick - but
> at
> >what age should one start electrotherapy if
> indicated
> >... Grays anatomy states the ages at each growth
> plate
> >ossifies - e.g. the SIJ may only fully ossify at
> >25years old! Personally I still go on the safety
> side,
> >but without further research I don't suppose we'll
> >have solid guidelines.
> >
> >Wendy Johnson
> >
> >--- nick bent <[log in to unmask]> wrote:
> > > Dear Andy,
> > >
> > > I did a bit of a mini-literature search on this
> > > myself
> > > recently and there is not much out there. The
> > > trouble
> > > is that it would probably be unethical to expose
> > > kid's
> > > growth plates to electrotherapy in the long-term
> and
> > > then see what happens.
> > > However,
> > >
> > > Witlink et al (1995) exposed developing
> metatarsal
> > > rudiments of rats to ultrasound in vitro. After
> 4
> > > days
> > > of pulsed rather than continuous ultrasound,
> > > longitudinal growth was significantly increased.
> > >
> > > Doyle and Smart (1963) demonstrated that
> repeated
> > > exposure of the growing epiphysis of the femur
> of
> > > rats
> > > to Shortwave diathermy increased the rate of
> growth
> > > compared to the untreated legs.
> > >
> > > Doyle and Smart (1963) Stimulation of bone
> growth
> > > by
> > > shortwave diathermy. Journal of Bone and Joint
> > > Surgery. Vol. 45, No. A1, p15-23.
> > >
> > > Witlink et al (1995) Effect of therapeutic
> > > ultrasound
> > > on endochondral ossification. Ultrasound Med
> Biol.
> > > Vol. 21, No. 1, p121-7.
> > >
> > > Personally, I think that the fact that there is
> some
> > > evidence to suggest alteration of bony growth
> with
> > > electrotherapy, weighed against the possible
> > > benefits
> > > of administering such treatments in youngsters
> who
> > > should not need to be rushed back to action,
> means
> > > that it is sensible to go on the side of safety.
> > >
> > >
> > > Nick
> > >
> > >
> > > --- Andy Thomas <[log in to unmask]> wrote:
> > > >
> > > > Is anybody aware of any research articles
> related
> > > to
> > > > the specific use of any
> > > > electrotherapy modality on Children
> particularly
> > > > related to the growth
> > > > plate.
> > > >
> > > > Many Thanks
> > > >
> > > >
> > > > Andy Thomas
> > > >
> > > >
> > > >
> > >
>
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