Physical agents and electrotherapy 2 in dpt

About electrotherapy

1. SHS.305: PHYSICAL AGENTS &
ELECTROTHERAPY
Lecture 10
RESOURCE PERSON:
RABIAMAJEED
REFERENCE TEXT:
P.M.SCOTT
SEMESTER: FALL 2023

2. REVIEW
•Therapeutic effects and uses of faradic current
•Technique with faradic and sinusoidal current treatments
•Preparation of patient
•Preparation of apparatus
•Application of electrodes
•Application of current

3. INTRODUCTION
•Methods of application
•Summary of faradic current
•Introduction to galvanic current
•Strength duration curve

4. METHODS OF APPLICATION
•Stimulation of motor points
•Stimulation of muscle groups
•Labile treatment
•Nerve conduction
•Bath treatment
•Faradism or sinusoidal under pressure
•Faradism to muscle of pelvic floor

5. Stimulation of Motor points
•Each muscle performs its own individual action
•Disadvantage –if there are many muscles to be stimulated, it is
impossible to produce large number of contractions

6. Stimulation of Muscle groups
•Twofixedelectrodeareused
•One–nervetrunkororiginofmuscle
•Second–coverthemotorpointsorlowerendoffleshybellyof
muscle

7. Stimulation of Muscle groups
•All muscles of group work together
•Satisfactory method of re-educating the action of muscles
•For those who work as a group
•Muscles of foot
•Quadriceps

8. LABILE METHOD
•Indifferent electrode –stimulation of motor points
•Second electrode –moved over the area to be treated
•As the electrode approaches over the muscle –it contracts and relaxes
•Used for large muscles with multiple nerve supply
•Longitudinal back muscles

10. NERVE CONDUCTION
•If motor nerve trunk is stimulated –contractions of all muscles will be obtained
to which it supplies beyond the point of stimulation
•Indifferent electrode –any convenient area
•Active electrode –nerve trunk is superficial
•Most satisfactory method of stimulation
•Muscle of facial expression

11. NERVE CONDUCTION
•Behind the lateral corner of eye
•In front of ear
•Just above angle of jaw

12. Behind the lateral corner of eye
In front of ear
Just above angle of jaw

13. BATH TREATMENT
•Both faradic and sinusoidal current may be applied
•Advantage –water makes perfect contact with muscles
•Prolong soaking reduces the resistance of skin
•Blood supply to the area
•Disadvantage –treatment cannot be localized
•All muscles cannot contract to the same degree

14. BATH TREATMENT
•Limb will be in dependent position
•Gravity opposes the drainage
•Danger of electric shock is there
•Not used when localized effect Is required

17. BATH TREATMENT
•Controls should be turned up slowly
•Breaks in the skin must be protected
•Metal objects removed
•Water in the bath should be comfortably warm
•Salt should not be added to water

19. METHODS OF BATH TREATMENT
•Bipolar method
•Monopolar method

20. FARADISM UNDER PRESSURE
•Treatment with faradiccurrentalso known as faradism.
•Used to increase the lymphatic or venous drainage from edematous area
•Nerve conduction method or stimulation of muscle group method may be used
•The main nerve trunk supplying the limb are stimulated above the edematous
area
•Limb is supported in elevation

22. FARADISM UNDER PRESSURE
•Limb is supported in elevation
•Gravity assist the lymphatic and venous return
•Limb is encased in an elastic bandage
•Bandage increases the pressure on the vessel when the muscle
contracts.

24. FARADISM TO MUSCLES OF PELVIC FLOOR
•Re-education of muscles in cases of early prolapse
•Stress incontinence
•C-section
•Good contraction can be achieved by vaginal electrode
•Voluntary contraction must be attempted at the same time as stimulation
•Male patients following proctectomy –rectal electrode is used

25. COSMETIC FARADISM
•Cosmetic electrotherapyis a range ofbeauty treatmentsthat uses
lowelectric currentspassed through theskin
•Produce several therapeutic effectssuch asmuscle toningin the
bodyand micro-liftingof the face

26. COSMETIC FARADISM
•The treatment tones the muscles by repeatedly contracting them with the
electric current
•Resulting in their firming and toning
•And an increase in muscular metabolismaims to remove waste products
more readily

29. Contraindications Of faradic Current
•Increased cellular metabolism
•a) Neoplasm-tumor b) Tuberculosis c) Infection
•Senile or confused patients (Mentally retarded, Mentally confused or
Elderly patients)
•Loss of skin sensations & Open wounds, cuts or skin lesions

30. SUMMARY TO FARADIC CURRENT
•Low Frequency current
•Faradic current
•Nerve impulse
•Method of application
•Physiological effects
•Therapeutic effects

31. DIRECT CURRENT
•Also referred as constant galvanism or galvanic current
•Unidirectional flow of current towards positive pole
•Main therapeutic use of this current is introduction of medication into the
body tissue -Iontophoresis

32. I.D.C.
•Most usual modification of direct current
•The flow of current commencing and ceasing at regular intervals
•Duration of 100 milliseconds commonly used
•Average frequency –30 per minute
If duration is increased –frequency must be reduced

33. LOW FREQUENCY –LONG DURATION
CURRENT
IDC is used for two purposes in physiotherapy department
1-Strength duration curve
2-Stimulation of denervated muscles

34. STRENGTH DURATION CURVE
•Thestrength-duration curveis a plot of the threshold current versus pulseduration
required to stimulate excitable tissue.
•To test electric reactions
•For this, duration of impulses must be accurate
•100, 30, 10, 3, 1, 0.3, 0.1, 0.03, 0.01 milliseconds
•Rectangular form

35. STIMULATION OF DENERVATED MUSCLES
•Long duration impulses are required
•100, 300, 600 milliseconds
•Although 10, 30, 1000, 2000 may also be provided
•Rectangular impulses
•Depolarization is desirable

36. STRENGTH DURATION CURVE
•Shows relationship between magnitude of change of
stimulus(current) and duration of stimulus
•Valuable information regarding the state of excitability of nerve lesion
•Should be done only after 21 days following injury

37. STRENGTH DURATION CURVE
•Wallerian degeneration –Wallerian degenerationis an active process
ofdegenerationthat results when a nerve fiber is cut or crushed and
the part of the axon distal to the injury (i.e. farther from the neuron's
cell body) degenerates.
•Nerve degenerates proximally to nearest Node Of Ranvier
•Distally –throughout whole length
•Debris is cleared by macrophagic activity

38. NERVE REGENERATION
•Regeneration of axon send out many branches, one of which become
myelinated and continues to grow
•Growth rate approximately 1mm per day

39. FACTORS INFLUENCING RATE OF
REGENERATION
•Age of patient –faster in younger age group
•Site of lesion –faster when lesion is more proximal to spinal cord
•Nature of lesion –faster following spontaneous regeneration then
following nerve suture

40. SUMMARY
•Methods of application
•Summary of faradic current
•Introduction to galvanic current
•Strength duration curve