Low frequency stimulation specialized techniques

Low frequency stimulation, Faradic Foot Bath, Faradism Under Pressure, Faradism Under Tension, stimulation to Pelvic Floor Muscles, physiotherapy

1. Low Frequency Stimulation

2. Faradic Foot Bath

3. Bath Method

+ Application of faradic current to the body parts in a
tub, tray or tank containing water is termed as bath
method of application

+ Depending upon the placement of electrodes bath
can be

- Bipolar : both electrodes are kept in the water

+ Unipolar : one electrode kept in the water while
the other electrode kept at any convenient part of
the body

4. Bath Method

Advantage of bath method are:

+ Skin resistance is lowered considerably by
prolonged soaking in water

+ Water makes perfect contact with the tissues
+ Wash of electrolytes formed under the electrodes

Disadvantages are:
+ Current can not be localized

+ Superficial muscles contract more than deep
muscles due to the presence of water

+ Chances of electric shock is higher

5. Faradic Foot Bath

+ ES by faradic current may be applied in
baths.

+ Can be used to stimulate
- Lumbricals
- Plantar interrossei
+ Abductor hallucis

6. Faradic Foot Bath

+ Position the patient in high sitting with back well
supported

« Position the feet on a stool covered with a
plastic sheet

+ Place the foot in a bath containing enough
warm water to cover the toes

Sreeraj SR

7. Faradic Foot Bath

To stimulate the
lumbricals place two
electrodes transversely,

* one under the heel

and the other

+ under the metatarsal
heads

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8. Faradic Foot Bath

To stimulate the
plantar interrossei
place one electrode

on each side of the
foot at the level of
metatarsal shafts

9. Faradic Foot Bath

For Abductor hallucis
place

* one electrode
under the heel and

+ stimulate the
muscle through the
motor point using
a pen electrode

Sreeraj SR

10. Faradic Foot Bath
- A surged faradic current is used for this
+ Surge duration 1 sec.

+ Surge interval 3 sec.

+ Intensity : enough to produce a visible
contraction of the muscles.

- Treatment time: 15 — 30 minutes

Sreeraj SR

11. Faradic Foot Bath

+ Rectangular metal or carbon rubber electrodes of
3 X 7 cm can be used

+ No lint pad or coupling medium required

« Encourage the patient to contract the muscle
voluntarily with the current

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12. Faradism Under Pressure

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13. Faradism Under Pressure

+ ES of muscle combined with compression and
elevation of the limb can be used to increase
venous and lymphatic drainage and so to
relieve edema.

+ This technique is known as Faradism Under
Pressure

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14. Faradism Under Pressure

« Patient in supine position

+ The limb is elevated above the heart level using
pillows

+ The pressure bandage is applied over the electrode,
with maximum pressure distal to proximal

+ The skin must be cleaned before treatment

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15. Faradism Under Pressure

Placement of electrode for lower limb:

- Active electrode place over the belly of the calf
muscle

« Passive electrode is placed over the sole of the foot

Placement of electrode for upper limb:
- Active electrode over the flexor aspect of forearm at
the junction of proximal 1/3 and distal 2/3 of the
muscle belly

+ The passive electrode over the palm or cubital

fossa Sreeraj SR

16. Faradism Under Pressure

A surged faradic current is used for this
Surge duration 3 sec.
Surge interval 9 sec.

Intensity : enough to produce a visible contraction
of the muscles i.e. clenching of toes or fingers.

Treatment time: 15 — 30 minutes

Sreeraj SR

17. Faradism Under Pressure

+ Rectangular metal or carbon rubber electrodes of
3 X 5 cm. can be used

+ Encourage the patient to do active movement

along with the current and relax during surge
interval

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18. Faradism Under Tension

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19. Faradism Under Tension

+ Shortening of contractile soft tissues like muscles can
be treated with Faradism.

+ Such contractures develop in major muscle groups like
quadriceps or elbow flexor group

+ This is mostly after prolonged immobilization

+ These conditions are passively mobilized which can be
very painful.

+ Titanic contraction by the surged current gradually pulls
apart the shortened myofibrils with less pain.

+ So this can be an effective adjunctive with passively
mobilization.

Sreeraj SR

20. Faradism Under Tension

+ A surged faradic current is used for this
+ Surge duration 3 sec.
+ Surge interval 9 sec.

Intensity : enough to produce a visible contraction of the
muscles.

+ Treatment time: 15 — 30 minutes

Sreeraj SR

21. Faradism Under Tension

+ Rectangular metal or carbon rubber electrodes of
5 X 10 cm can be used.

« Encourage the patient to do actively contract the

muscle along with the current and relax during
surge interval

Sreeraj SR

22. Faradism Under Tension

For quadriceps contracture:

+ Patient is positioned on a plinth.

+ Aroll el towel or pillow is placed below the knee to give

a stretc

+ Passive electrode is placed over proximal 1/3 of the
quadriceps

+ Active electrode is placed on the junction of proximal 2/3
and distal 1/3 of the belly of the muscle

Sreeraj SR

24. Faradism Under Tension

For elbow flexor contracture:
+ Patient is positioned on a plinth.
+ Aroll is placed under the elbow just proximal to the joint.

+ Passive electrode is placed over proximal 1/3 of the
elbow flexor

+ Active electrode is placed on distal 1/3 of the belly of the
muscle

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25. ES to Pelvic Floor Muscles

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26. ES to Pelvic Floor Muscles

+ ES can be used for reeducating these muscles.

+ Indications are;
« Early cases of prolapse of pelvic organs
+ Stress incontinence

+ Incontinence following prostatectomy

Sreeraj SR

27. ES to Pelvic Floor Muscles

+ Position the patient in side lying

+ Keep a pillow between the lower legs

+ Place a plastic sheet under the patient

+ The indifferent electrode to the lumbosacral region
Insert the Active vaginal or rectal electrode

+ Sterilized lubrication jelly should be applied on vaginal
or rectal electrode

+ A large button electrode can also be used over the
perinea region

28. ES to Pelvic Floor Muscles

+ A surged faradic current is used.

+ Surge duration 1 sec.

+ Surge interval 3 sec.
The muscles of pelvic floor fatigue fast, so surge
duration should be short
Intensity : enough to produce a visible contraction of the
muscles.

+ Treatment time: 15 — 30 minutes

+ Encourage the patient to actively contract the muscles

along with the current and relax during surge interval
Sreeraj SR

29. References

Foster A, Palastanga N. Clayton’s Electroptherapy Theory and
Practice. 9" edition. WB Saunders. 2006;pp 70 - 79

Mitra PK. Handbook of Practical Electrotherapy. Jaypee. 2006;
pp44 — 49

Khatri S. Basics of Electrotherapy. Jaypee. 2003. pp 28 - 30

Sreeraj SR

30. THANK YOU