Therapeutic effect
relaxation of muscle spams, muscle strengthening improve ROM
Therapeutic effect
facilitate wound healing, decrease edema
Therapeutic effect
eliminate disuse atrophy, muscle re-education
Therapeutic effect
increase local circulation
Therapeutic effect
facilitate bone repair, decrease pain
Electrotherapy indications
muscle spasms, muscle weakness, pain
Electrotherapy indications
decreased ROM, idiopathic scoliosis, fracture
Electrotherapy indications
joint effusion, facial neuropathy, muscle atrophy
Electrotherapy indications
open wound/ulcer
Electrotherapy indications
Bell's palsy
Electrotherapy indications
use with labor and delivery
Electrotherapy indications
Stress incontinence
Electrotherapy indications
shoulder subluxation
Electrotherapy contraindications
cardiac pacemaker
Electrotherapy contraindications
patient with a bladder stimulator
Electrotherapy contraindications
use over carotid sinus
Electrotherapy contraindications
seizures disorders
Electrotherapy contraindications
phlebitis (swelling (inflammation) of a vein caused by ablood clot)
Electrotherapy contraindications
malignancy
Electrotherapy contraindications
use over a pregnant uterus
Electrotherapy contraindications
cardiac arrhythmia
Electrotherapy contraindications
osteomyelitis
Monopolar technique
stimulating or active electrode is placed over the target areaa second dispersive electrode is placed at another site away from the target area
Monopolar technique
typically the active electrode is smaller than the dispersive electrode (active electrode = small, dispersive electrode = larger)
Monopolar technique
this technique is used with wounds, iontophoresis, and in the treatment of edema
Bipolar technique
two active electrodes are placed over the target area
Bipolar technique
typically the electrodes are equal in size
Bipolar technique
this technique is used for muscle weakness, neuromuscular facilitation, spasms, and ROM
Quadripolar technique
two electrodes from two separate stimulating circuits are positioned so that the individual currents intersect with each other
Quadripolar technique
this technique is used with interferential current
small electrode size
increased current density => patient may be more susceptible to pain and potential tissue damage
small electrode size
increased impedance
small electrode size
decreased current flow
large electrode size
decreased current density
large electrode size
decrease impedance
large electrode size
increased current flow
direct current
constant flow of electrons from anode to cathode for a period > 1 sec without interruption.
direct current
polarity remains constant and is determined by therapist based on treatment goal
direct current
iontophoresis uses direct current
alternating current
polarity changes from positive to negative with the change in direction of current flow
alternating current
can be biphasic, symmetrical or asymmetrical and its waveform is sinusoidal in shape
alternating current
can be used in muscle retraining, spasticity and stimulation of denervated nerves
interferential current
combines two high frequency alternating waveforms that are biphasic. this is used for deep muscle stimulation
interferential current
attempts to reach deeper tissues using the higher frequencies of each waveform along with the overall shorter pulse widths
interferential current for pain management
frequency of 50 - 120 pulses/sec and pulse width 50 - 150 microseconds
interferential current for muscle contraction
frequency of 20 - 50 pulses/sec and pulse width 100 - 200 microseconds
Russian current
medium frequency polyphasic waveform (alternating current)
Russian current
intensity: 50 burst/sec interval with a pulse width rage of 50 - 200 microseconds, and interburst interval of 10 milliseconds
Russian current
primary indication: to strengthen the muscle groups of otherwise healthy individuals and athletes
Russian current contraindication
over abdominal and pelvic area of a pregnant woman
Russian current contraindication
over an area of hemorrhage
Russian current contraindication
malignancy
Russian current contraindication
over the anterior cervical area and over electronic implants
Russian current
electrode orientation should be placed parallel to the muscle fibers along the line of pull of the muscle group
Russian current
electrode placement can be monopolar, bipolar, quadripolar or multipolar
Russian current
stimulation has an average peak current amplitude of 100mA, 50 burst/sec with and on/off ratio of 10/50
Russian current
training protocol 10 evoked contraction with a 10 second contraction and a 50 second rest period between each of the ten contractions
TENS
widely used for acute and chronic pain management
TENS
areas of use include: obstetrics, temporomandibular joint pain, and post-operative pain
TENS
the main therapeutic effects include pain relief through the gate control theory or the endogenous opiate pain control theory
TENS
indicated for bone fractures, during labor and delivery, bone fractures, trigeminal neuralgia, phantom pain
TENS
indicated for antiemetic effects (against vomiting), improved blood flow
Conventional TENS
Frequency : 50 - 50HZDuration: 20 - 100 microsecondsAmplitude: 10 - 30 mA
Acupuncture-like TENS (AL)
Frequency: 1 - 4 HZDuration: 20 - 100 microsecondsAmplitude: 30 - 80 mA
Pulse burst
Frequency: 70 - 100Hz/burstDuration: 40 - 75 microsecondsAmplitude: 30 - 60 mA
Brief intense (high intensity)
Frequency: 70 - 100 Hz/burstDuration: 150 - 200 microsecondsAmplitude: 30 - 60mA
TENS
waveform used are monophasic pulsatile current or biphasic pulsatile current with a spiked square, rectangular or sine wave form
TENS
electrode placement may based on sites of nerve roots, trigger points, acupuncture sites or key points of pain and sensitivity
TENS
net polarity is normally zero, if waveform is unbalanced, there will be accumulation of charges that will lead to skin irritation under the electrodes
High-voltage pulsed Current
HVPC aka high voltage pulsed galvanic current, is a twin-peak (pair of monophasic spike waveforms) monophasic pulsed current
HVPC
phase duration of 5 - 20 microseconds (fixed in most machines)short pulse duration (includes both spikes and the interspike interval) 100 - 200 microsecondsvoltage > 150 V to max of 500 V
HVPC
there is one large dispersive along with one, two or four active electrodes. Active electrode can be (+) or (-) based on tx goals
HVPC indications
wound management, pain management, soft tissue edema
HVPC indications
levator ani syndrome, muscle spasms, muscle weakness
HVPC indications
Bell's palsy (facial paralysis)
HVPC contraindications
cardiac pacemakers (relative contraindication), over heavy scarring tissues
HVPC contraindications
malignancy, over lower abdomen/uterus during pregnancy
HVPC contraindications
over the anterior transcervical area, over osteomyelitis, and anterior cervical region
HVPC wound tx
place electrode over the wound (using a warm sterile gauze and sponge) and the other over healthy skin a minimum of 5 cm from the wound itself
HVPC wound tx
polarity should be in reversal mode: 50 % of treatment with (-) polarity and the other 50% with (+) polarity
HVPC wound tx
Frequency: 30 - 200 pulse/secAmplitude: 1 - 500 VDuration of tx: 10 - 60 minutes/session
HVPC wound tx
dermal wounds should be treated 5 - 7 days/week for best results