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DEEP OSCILLATION® - 'Making a difference to those living with Lymphoedema and Lipoedema'

Internationally Patented, Electrostatic Field Therapy. In contrast to externally applied, mechanical forms of therapy (e.g. vibration on the surface of the skin), the therapeutic effect of deep oscillation (also known as DEEP OSCILLATION® or HIVAMAT®) permeates a depth of 8 cm through skin, connective tissue, subcutaneous fat tissue, muscles, blood and lymphatic vessels, with a range of clinically proven effects. [1]

 

Deep Oscillation impacts the entire depth of tissue layers and intervenes in the connective tissue, setting it apart from conventional electrotherapy methods which act on the neuromuscular system.  In addition, there are more areas of application that deep oscillation can be used; see comparison of indications below.

 

 

Dr Jens Reinhold of Physiomed Elektromedizin AG, confirmed that ‘provided contraindications have been checked, deep oscillation can be applied in all age groups, from 0 years upwards’.

CONTRAINDICATIONS

  • acute infection
  • infectious skin disease
  • active tuberculosis
  • untreated thrombosis or vascular disorder
  • erysipelas or cellulitis
  • untreated malignant diseases - in the case of palliative care, patients and practitioners should refer to the patient’s consultant for further instruction
  • untreated heart complaints or disease 
  • cardiac pacemakers or other implanted stimulators
  • Pregnancy, sensitivity to electrostatic fields
  • vertebrobasilar insufficiency (VBI) 

NB As opposed to stimulation current therapy, metal implants are not a contraindication to deep oscillation therapy.

When treating a patient through gloved hands, contraindications refer to both patient and therapist. If a therapist becomes pregnant, they simply swap to treating their patient with the handheld applicators.  In terms of safety, there has not been any report of adverse effect since the original patent was granted in 1988.  Deep oscillation is also FDA approved and PhysioPod UK are approved NHS suppliers.

 

WHY IS DEEP OSCILLATION SO UNIQUE?

Deep oscillation is a particularly gentle and relaxing treatment and this is why it has become an unsurpassed treatment alternative for chronic oedema, lymphoedema, lipoedema and lipo-lymohoedema, fresh trauma, pre and post-operative care and for acute and chronic pain.

 

Bel Hardman, Director at Integral Workplace Wellness Ltd wrote recently..

"I love my personal Deep Oscillation unit. I've had it for nearly 1 year and it’s helped my Lipoedema by moving lymph flow, inflammation, pre-surgery preparation, pain relief and scar work. Not to mention my entire family use it on injuries. Highly recommended it!"

 

 

Sue Hansard, Lymphoedema Nurse Specialist of First Lymph Care confirmed:

 

“Deep Oscillation can be a great tool in the 'toolbox' for managing Lymphoedema, both in the clinical setting and for self -management. It can be well tolerated even when pain and hypersensitivity make even the lightest hand pressures intolerable”.

 

HOW CAN IT HELP YOUR PATIENT?

 

 

The a-thermal mechanical mode of action of deep oscillation can induce the following clinically documented effects in treated tissue:

  • Strong pain-alleviating potential. This applies to acute traumatic as well as to chronic pain conditions [2-11].
  • Anti-inflammatory effect [12, 13].
  • Prevention and reduction of secondary and primary lymphoedema, as well as reduction of oedema in lipoedema [2, 4, 6, 14-17].
  • Prevention of fibrotic remodelling processes, reduction of fibrosis [2, 14, 15, 18].
  • Muscle relaxation, mobilisation, functional improvement and improved ROM [4, 7, 18-20].
  • Support of wound healing processes [1, 21, 22].
  • Normalisation of haemodynamic parameters of the skin, correction of aesthetic-neurotic problems and influence on biological ageing through preventive effects on premature ageing [23].
  • Accelerated recovery after intensive physical workout [24, 25].
  • Decongestion and functional improvement in obstructive pulmonary conditions [26, 27].

 

OEDEMA REDUCTION

 

Teo I et al (2016) [16] demonstrated via high definition ultrasound scan (below) that Deep oscillation quickly leads to a visible reduction in oedema

 

 

FIBROSIS REDUCTION

 

Fibrotic areas can be treated effectively, quickly softening hardened tissue, especially in complex cases such as head and neck lymphoedema (HNL) and stubborn breast fibrosis.

 

PAIN REDUCTION

Significant pain reduction in Deep Oscillation was written about extensively in “Mechanism of Deep Oscillation” by Dr Jens Reinhold for the MLDUK The Journal, 2017 . Dr Reinhold also presented on Deep Oscillation and Pain at the MLDUK Conference in 2018.  You can watch this on vimeo here

 

  

FIELDS OF APPLICATION

Aesthetics (non-surgical), Bedsores (pressure ulcers, Burns, Chronic Regional Pain Syndrome (CRPS), Cording following breast cancer surgery/lymph node removal, Diabetic Neuropathy, Endoprosthesis (such as hip or knee joint implant), Fibromyalgia, Fibrosis, Fibrocystic Breast Disease, Lipoedema, Lymphoedema, Multiple Sclerosis, Osteoarthritis, Osteosynthesis (surgical connection of bones), Pain, Parkinson’s Disease, Postpartum, Raynaud’s Disease, Respiratory disorders, Scar Healing, Sports and Occupational Injury, Sports Recovery, Surgery Aftercare, Venous leg ulcers, Wound Healing.

 

VIDEO VERIFICATION OF DEEP OSCILLATION

 

Ultrasound Imaging (Medina L. F. 2015)

ICG Imaging Moving Lymph (Amore M., Del Rosario Pineda M. (2021)

 

In April 2015, a video report from Dr. MSc. Luis Felipe Medina C. Lic. TF concluded ‘Although this is an initial trial, resonance and kinetic movement of the connective tissue effected by an electrostatic field generated by DEEP OSCILLATION® can be evidenced and visualised. The illustrated test series visualises for the first time the impact on tissue of DEEP OSCILLATION® in real time. The method offers an interesting methodical approach for future studies’

In August 2021, in a special video research report, Dr. Miguel Amore and María Del Rosario Pineda proved lymph is driven (with ICG) by Deep Oscillation equipment (just with the oscillator applicator head moving gently over the surface of the skin).

 

SKIN HEALTH

In September 2021, International skin expert Marie Reynolds having used the therapy for several months wrote: "Deep Oscillation makes a huge difference to therapy - moving stagnant lymph is key to overall wellbeing and skin health". 

Actress Glynis Barber experiences Deep Oscillation Therapy with Marie in the video here from 8 minutes in. It is because Deep Oscillation is used medically that Marie Reynolds incorporates the therapy in to her treatments in London’s prestige Fortnum and Mason and Mayfair Clinic.

Boisnic S and Branchet MC (2013) proved in their study using an ex-vivo model of human skin maintained in survival condition, 'the Deep Oscillation® device was effective in reducing inflammation with a significant reduction of dilated capillaries and IL8, while lowering sensory receptor levels. Clinically, the device was successful in reducing both dark circles and bags by an average of 40%.'

 

INTENSIFYING MANUAL TREATMENTS

Deep oscillation is non-invasive and non-traumatic.  It intensifies and supplements all forms of manual treatment. The therapist simply adds a pair of light gloves which conduct the treatment or applicators are used. There are no new skills to learn, as these are already in the skilled therapists’ hands.

 

PRE AND POST OPERATIVE

 Due to the gentle therapeutic effect, deep oscillation is often used immediately after surgical procedures supporting rapid wound healing to take place.

 

Pre-operatively deep oscillation possesses anti-oedema, lymph drainage, anti-fibrosis and detoxifying properties, it prepares the tissue for aesthetic and general surgery and liposuction, also making liposuction more effective and durable and protecting against the adverse effects of the body sculpting procedure. 

Post-operatively deep oscillation can be used at a very early post-operative stage, the healing process is accelerated, scar quality is improved, and local inflammation is inhibited and stopped over a sustained period promoting earlier mobility and return to normal activity.  After liposuction, it helps with pain, swelling and bruising, smoothing tissue and making the results more durable. 

 

BURNS AND SKIN GRAFTS

Treatment with deep oscillation also enables accelerated and qualitatively improvement in the healing of burns and skin grafts. A special film is used to work around the edge of an open wound and encompassing a large area of surrounding tissue and after healing, directly over wound. Deep Oscillation is used in the UK at The Birmingham Women’s and Children’s NHS Foundation Trust for outpatient burn treatments and The Welsh Centre for Burns & Plastic Surgery.

 

WHAT HAPPENS IN TREATMENT?

The extremely gentle vibrations experienced by both parties have a deep effect on all tissue components. The tissue layers are intermittently (as polarity changes), attracted and released back to the gloved hands of the therapist or the applicator (between 5 and 250 times a second) depending on the pre-programmed or individually programmed frequency.

 

A three-way connection is required for therapy to commence

 

 

  • Patient holds a small titanium bar loosely in the palm of their hand or it is placed between their toes (if appropriate) and this lead is connected to the device.
  • Therapist adheres electrode to their forearm or ankle, the electrode is connected via a lead to the device. If worn on the ankle, an extension lead enables the therapist to have freer movement around the couch.
  • When the hands of the therapist start to massage the skin, the therapy comes through the hands in the form of a relaxing vibration sensation. A small dusting of powder is applied to help the therapy to glide over the skin. Skin should be cool for treatment to be successful.
  • There are several other ways to apply the therapy and these are all covered in PhysioPod Training Notes and in Zoom Training. In self-treatment, different sized applicators are used depending on the area to be treated, you cannot treat yourself with gloves, as is often thought, as a three-way connection is needed. For those with mobility issues, PhysioPod can supply bespoke extender handles to enable lower limb and ankle treatment.

 

WHAT IS THE EXPERIENCE FOR THE THERAPIST AND PATIENT?

The very pleasant, intermittent vibrations, permeate the tissue layers without the need to apply external mechanical force, thus protecting the therapists’ hands from unnecessary wear and tear.

The intermittent impulses are relaxing, for both the therapist applying and the patient receiving. A feeling of enhanced wellbeing is often the feedback from the patient.  Therapists often remark that they “get in to their zone” when applying, they “love it” and wouldn’t want to be without it!

 

WHO IS USING DEEP OSCILLATION?

Chartered Physiotherapists, Osteopaths, Chiropractors, NHS Burns units, Lymphoedema Clinics, Private MLD Practitioners, Lymphoedema and Lipoedema Patients, Physiotherapists, Sports Therapists, Sports and Complementary Massage Therapists, Aesthetic and Scar Therapists, Equine and Canine Therapists.

 

TRAINING

Training takes 1-2 hours (included in the price of the unit) and it is carried out via zoom with Julie Soroczyn, Managing Director of PhysioPod UK and certified UK/Ireland trainers. Following zoom training with Julie Soroczyn, training questions and statements are completed by the therapist which enable a training certificate to be issued together with accompanying information for insurance underwriters should the therapy not yet be a treatment covered in policies.

 

PHYSIOPOD UK THERAPIST MAP

A free listing is included on the deep oscillation therapist map https://www.physiopod.co.uk/therapist-map.shtml following completion of a questionnaire by the therapist and help is provided with social media images and wording.

 

PRODUCTS AVAILABLE

 

 

 

References

 

  1. Hernández Tápanes, S., Suárez, A., Bravo Acosta, T., Wilson Rojas, R., Fernández Prieto, B., Cabrera Morales, M. Valor de la Terapia con oscilaciones profundas en la cicatrización de las quemaduras AB. Rev Cub Med Física y Rehab [revista en Internet] 2010.
  2. Schönfelder, G., Berg, D., Nebenwirkungen nach brusterhaltender Therapie des Mammakarzinoms. Erste Ergebnisse mit Hivamat. Gynäkol. Prax, 1991. 15: p. 109-122.
  3. Johanning-Csik, F., Behandlung postpartaler Brustschmerzen und -spannungen mit dem Intensivierungssystem Hivamat. 1994, FAU Erlangen - Nürnberg
  4. Jahr, S., Schoppe, B., Reisshauer, A., Effect of treatment with low-intensity and extremely low-frequency electrostatic fields (Deep Oscillation) on breast tissue and pain in patients with secondary breast lymphoedema. J Rehabil Med, 2008. 40(8): p. 645-50.
  5. Aliyev, R., Clinical effects of the therapy method deep oscillation in treatment of sports injuries. Sportverletz Sportschaden, 2009. 23(1): p. 31-4.
  6. Fistetto, G., Iannitti, T., Capone, S., Torricelli, F., Palmieri, B., Deep Oscillation: therapeutic-rehabilitative experiences with a new electrostatic device. Minerva Med, 2011. 102(4): p. 277-88.
  7. Hernández Tápanes, S., Terapia con oscilaciones profundas. Experiencias en cervicalgias, lumbalgias y epicondilitis., ed. EdiReh-Latina. 2012, San José.
  8. Kraft, K., Kanter, S., Janik, H., Safety and effectiveness of vibration massage by deep oscillations: a prospective observational study. Evid Based Complement Alternat Med, 2013. 2013: p. 679248.
  9. Reinhold, J., Deeva, I., Korkina, L., Schaper, K., Krummenauer, F., Randomised Pilot Study for Quantification of Benefit from the Patient's Point of View of Deep Oscillation Treatment in Primary Wound Healing. Z Orthop Unfall, 2014. 152(3): p. 260-4.
  10. O Brien, C.P., Watson, A, Deep Oscillation® Therapy in the Treatment of Lateral Epicondylalgia: A Pilot Randomized Control Trial. J Sports Med Doping Stud, 2016. 6(3).
  11. Zehtindjieva, M.A., Ioshinov, B.R., Andonov, D.R., Ilkov, V.S., Deep Oscliiation - A modern additional physical modality for anagesia in patients with back pain. Praemedicus, 2013. 29: p. 85-90.
  12. Boisnic, S., Branchet, M. C., Anti-inflammatory and draining effect of the Deep Oscillation(R) device tested clinically and on a model of human skin maintained in survival condition. Eur J Dermatol, 2013. 23(1): p. 59-63.
  13. Mikhalchik E., T.S., Anurov. M., Suprun M., Ivanova A., Trakhtman I., Reinhold, J., Effects on blood parameters of Deep Oscillation, in 1st. International Conference on Skin and Environment. 2005: Moscow- St. Petersburg. p. 59.
  14. Korkina, L., Reinhold, J., Rota, L., Primavera, G., Raskovic, D. , Treatment of Gynoid Lipodystrophy (Cellulite) with Deep Oscillation®: A Pilot Clinical Study, in 29th. Annual Meeting of The Bioelectromagnetics Society. 2007: Kanazawa. p. 2.
  15. Gasbarro, V., Bartoletti, R., Tsolaki, E., Sileno, S., Agnati, M., Coen, M., Conti, M., Bertaccini, C. , Ruolo dell´oscillazione profonda (Hivamat® 200) nel trattamento fisico del linfedema degli arti. La medicina estetica 2006. 30(4 ): p. 373-478.
  16. Teo, I., A. Coulborn, and D. Munnoch, Use of the HIVAMAT® 200 with manual lymphatic drainage in the management of lower-limb lymphoedema and lipoedema. Journal of Lymphoedema, 2016. 11(1): p. 49-53.
  17. Nourollahi, S., Mondry, T.E., Herbst, K.L. , Bucher´s Broom and Selenium Improve Lipedema: A Retrospective Case Study. Altern Integ Med, 2013. 2(3).
  18. Gao, Y.C., Peng, C.C., Peng, R., A long term chronic fibrotic adhesion of elbow muscles alleviated by applying hivamat 200 deep oscillation therapy. IJMRD, 2015. 2(1): p. 286-289.
  19. Aliyev, R., Mikus E.W.S., Reinhold, J.G., Hochsignifikante Therapieerfolge mit DEEP OSCILLATION® in der orthopädischen Rehabilitation. Orthopädische Praxis 2008. 44: p. 448-453.
  20. Hinman, M.R.L., R., Perry, E., Robbins, K., Viertel, L. , Comparative Effect of Ultrasound and Deep Oscillation on the Extensibility of Hamstring Muscles. Journal of Athletic Medicine, 2013. 1(1): p. 45-55.
  21. Mikhalchik E., T.S., Anurov. M., Suprun M., Ivanova A., Trakhtman I., Reinhold, J. , Wound Healing Effects of Deep Oscillation, in 1st. International Conference on Skin and Environment,. 2005: Moscow- St. Petersburg. p. 71.
  22. Trybulsky, R., Using Deep Oscillation system in the treatment of wounds. Rehabilitacja w Praktyce, 2008. 1: p. 28-33.
  23. Turova, E.A., Konchugova, T. V., Balaban, E. I., Fadeeva, N. I., Golovach, A. V., Teniaeva, E. A., The application of a pulsed low-frequency electrostatic field for the prevention of premature ageing. Vopr Kurortol Fizioter Lech Fiz Kult, 2012(6): p. 9-11.
  24. Trybulski, R., Zebrowska, A., Marcol, W., Roczniok, R., Kepa, K., Kiljanski, M., Application of Deep Oscillation and Electric Stimulation in Smooth Muscles to Minimize the Selected Parameters of Muscular fatigue. fizjoterapia polska, 2016. 2(16): p. 14-30.
  25. Von Stengel, S., Deep oscillation self-treatment leads to accelerated regeneration after intensive exercise load in football 2017, publication in progress.
  26. Yashkov, A.V., Gazdieva, E.M., Badyanova, I.S., Efficacy of Intermittant Low-Frequency Field in the Sanatorium-based Complex Treatment of Patients with Chronic Obstructive Pulmonary Disease. Kurortniye Vedmosti 2007. 3(42): p. 62-63.
  27. Verster, J., Deep Oscillation Case Study. Pneumonia: total consolidation in right upper lope. 2014, J Verster Physiotherapist, Ninapark, South Africa.

 

Study references, articles, books, guidelines and presentations: https://www.physiopod.co.uk/references.shtml

 

 

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