Efficacy of ReBound Diathermy as a Thermal Heating Agent: A Critically Appraised Topic.

Clinical Scenario: ReBound (ReGear Life Sciences, Inc, Pittsburgh, PA) is a portable shortwave diathermy unit (SWD) used to heat tissues using the same principle as induction drum SWD. It is unclear if ReBound can vigorously (4°C) heat intramuscular tissue as efficiently as other thermal agents.

CLINICAL QUESTION: In adults (P), is ReBound diathermy (I) compared to other thermal agents (C) effective at increasing intramuscular tissue temperature by 4°C (O)? Summary of Key Findings: Three studies were included for review, all randomized crossover studies. All studies agreed ReBound does not achieve vigorous (4°C) heating effects during a 30-minute treatment to the triceps surae muscle (depth=1 and 3-cm). Studies agreed the heat generated via ReBound dissipates slower than (p<.001) or similarly to PSWD at 3 cm and faster than moist hot packs (MHP, p<.001) at 1 cm. One study found intramuscular tissue temperatures increased more with ReBound (3.69°C±1.50°C) than MHP (2.82°C±.90°C) at superficial depths (1-cm, d=.70). Two studies compared ReBound to MegaPulse II PSWD at a 3-cm depth. One found the MegaPulse II increased intramuscular tissue temperature by 4.32°C±1.79°C compared to the ReBound's 2.31°C±.87°C increase (d=1.43). The final study reported the MegaPulse II increased triceps surae muscle temperature by 3.47°C±.92°C versus ReBound at 3.08°C±1.19°C (d=.37). The combined results are an increase of 3.81±1.38°C for the MegaPulse II and 2.77±1.12°C for ReBound (d=.83). Clinical Bottom Line: Results strongly indicate ReBound should not be used for vigorous (4°C) heating effects in the triceps surae muscle at 1 and 3-cm. Clinicians can use ReBound when traveling or instead of MHP for moderate (2-3°C) heating effects at deep and superficial levels (1 and 3-cm) for large treatment areas with subcutaneous fat thickness <15 mm. Strength of Recommendation: Consistent level B findings indicate ReBound does not achieve vigorous heating effects (4°C).