Intro of electrotherapy in physiotherapy by Dr. Mumux

Intro of electrotherapy in physiotherapy ppt by Dr. Mumux

1. Introduction of Electrotherapy Dr. Mumux Mirani BPT, MPT Sports, PhD Scholar Asst. Professor SPB Physiotherapy College, Surat.

2. What do you think about electrotherapy?

3. Or this?

4. Essential and basic subject of Physiotherapy which includes various forms of therapeutic applications. Electro means using electricity or electrical current which is primary source of energy. Therapy means non surgical treatment approach.

5. Definition: It is a non surgical treatment approach characterized by the treatment of various diseases and disorders with the help of electricity or electrical means.

6. What is included in electrotherapy? Low frequency currents Medium frequecy currents High frequecy currents Phototherapy Electro diagnosis Biofeedback

7. What is common ? Frequency: it is a number of occurrences of any event per unit time . Or Impulses of current commence and cease at regular interval . Or No. of time these impulses comes in a particular unit time (second). It is usually cycles/sec, Htz , KiloHtz , MHtz …. Current: is a flow of electrons.

8. Low frequency currents: Frequecy ranges from 0 to 100 cycles per second. Used for stimulation of nerve and muscle. Direct current, interrupted direct current, sinusoidal current, didynamic current, micro amperage electrical nerve stimulation, trans-cutaneous electrical nerve stimulation….

9. Medium frequency currents: Frequency is in the range of 100 t0 10000 cycles per seconds. Used to stimulate deeply situated muscles and nerves. Clinically used to re educate muscle, to retard the rate of muscle atrophy, drainage of edema and for pain relief. Russian current. Interferential current….

10. High frequency currents: Frequency is more than 10000 cycles per second. Used to produce the deep heat inside the tissues. SWD. MWD. Long wave diathermy, therapeutic US.

11. Phototherapy: Light is the source of treatment Used for pain relief by heat and acceleration of healing through elevation of temperature, counter irritation and photochemical effects. Infrared rays, ultraviolet rays, laser…

12. Electro diagnosis: It means the detection of the diseases and disorders by the use of electrotherapeutic currents or EMG Electric current can be used for the diagnostic purpose Electrodiagnostic tests are rheobase , chronaxie , strength duration curve, pulse ratio, myasthenic reaction, galvanic- tetanic ratio, nerve conduction test, faradic-galvanic test

13. Electromyography is the study of electrical activity of the muscle by means of surface electrodes place over the skin or needle electrodes inserted in the muscle itself. EMG is for study of motor unit potential, motor nerve conduction velocity, sensory nerve conduction velocity….

14. Biofeedback: Process of providing information to an individual about the body function so as to get some voluntary control over it. EMG Biofeedback

15. Classification of currents: On the basis of direction of flow: Therapeutic current classified as alternating current and unidirectional current. Unidirectional current flows in one direction only are Direct current and interrupted direct current. Alternating current flows in both direction are sinusoidal current and interferential current.

16. On the basis of frequency: Therapeutic current classified as low, medium and high frequency currents.

17. On the basis of voltage: Therapeutic current classified as low and high voltage currents. Low voltage are with a voltage of less than 1oo volts High voltage is of several hundred volts.

18. On the basis of amperage: Therapeutic current classified as low and high amperage currents. Low amperage current ranges from 1 to 30 miliampears and same as of low voltage current. High amperage current is ranging from 500 to 2000 miliampears and of high tension.

19. On the basis of biophysical effects: Therapeutic current classified as having effect which causing ionic changes and thermal changes.

20. Cold therapy, paraffin wax bath, hot pack, contrast bath, fluidotherapy … are often included in electrotherapy. Physiotherapy modalities which work on electricity may not be necessarily called as electrotherapeutic modalities but are electro physical agents (EPA). CPM and traction work on electricity but should not be called as electrotherapeutic modalities.

21. Any form of physical energy applied to the body exerts significant primary as well as secondary physiological effects. There is a need of accurate measurement of dose in the application of all physical agents as used in medication. There is need to determine when to discontinue the procedures.

22. Safety precautions: Physiotherapist working in a hospital or clinical set up frequently uses modalities which are electrically operated. Therefore there is a great need for physiotherapist to be aware of the potential electrical hazards to patients as well as therapist.

23. Causes and types of hazards Worn-out power cords Broken plugs Faulty lamp sockets Incorrect wire outlets Leakage of current Breakage of power cord Absence of earthling Defective electrical sockets

24. Hazards are Electric shock, fire, thermal burns, electrochemical burns, scalds etc....

25. Physiological effects of shock are imperceptible with 0-1 milliampere. With 1-15 ma produces tingling sensation and muscle contraction. With 15-100 ma produces painful electrical shock. With 100-200 ma produces cardiac and respiratory arrest. More than 200 ma produces instant tissue burning and destruction.

26. Safety precautions Equipment purchase: Do not buy cheaper equipment as they may be most expensive to operate. Read the instruction manual before operating Check the instrument at the time of delivery If any defect is there exchange the unit Ask for working and safety check

27. Earthing and stabilizer: There should be proper earthing connected to all electrotherapy equipments working on electricity.. Ground fault interrupter circuit should be used. Voltage stabilizer should be either separate or central for the department to avoid voltage surge and thereby discomfort to the patient. It avoids damage to the equipments. Fuse is there on live wire so that if a large current passes than the fuse blows and stop the current flow.

28. Maintenance Yearly maintenance contract through biomedical engineer with your manufacturer after the warranty period. Routine maintenance checkup should be performed on all electrical equipments. Physiotherapist should not use the electrical equipment nearer objects or environment that draw the current . Usage of equipment may interfere with pacemakers and hearing aids.

29. Principles of treatment Patient After completion of assessment and selection of modality discuss the options with patient Advice and explanations, warnings, positioning, instructions, examination, and testing of the area to be treated. Aim to ensure valid consent is obtained and all risks are identifying prior to treatment. Preparation of area to be treated such as cleaning of the part, testing cutaneous sensation or blood flow. Keep privacy of a patient.

30. Preparation and testing of apparatus and examination Collect and assemble the parts of equipment needed. Check all electrodes, leads, cables, plugs, power outlets, switches, controls, indicator lights and dials. Output of the machine should be checked. Set the equipment to minimize risk and promote patient comfort during treatment and to minimize the exposure of the operator to the output of the modality.

31. Application Depending on the modality, checking throughout an application is required to ensure safety.

32. Termination of treatment On termination the area treated should be examined to identify expected effects such as superficial vasodilatation and unexpected effects like burn. Explain effect of treatment after application, instruction regarding future treatment and in between.

33. Recording Accurate record of all the parameters of treatment including area to be treated, technique, dosage and resultant effect must be made each time. Details of the advice and warnings given prior to treatment should be recorded.

34. Thank you