Presentation (1) (1).pptx electrotherapy

Electrotherapy

1. Electr o stimulation

2. Electrotherapy is one of the oldest modalities used in physical therapy for the management of a wide range of musculoskeletal and neurological problems

3. Direct (galvanic) Current (DC) unidirectional Constant electron flow from the negative to the positive electrode with no alterations (with constant polarity). Alternating Current (AC) that rhythmically flows between anode & cathode. An electric current that rise to maximum in one direction and full back to zero and the rise to maximum in opposite direction and then repeat . When the alternating phases are smooth and equal in energy, they are often referred to as sine waves. Currents

4. Physiology

5. Skeletal muscles action potential

6. Chronaxie is the minimum time required for an electric current double the strength of the rheobase to stimulate a muscle or a neuron. Rheobase is the lowest intensity with indefinite pulse duration which just stimulated muscles or nerves

7. Galvanic current

8. High voltage pulsed galvanic current

9. Faradic current

10. :

11. Burst AC C reated by flow of current for a few milliseconds and then stop to flow (inter burst interval or pause period) and repeat cycle again. The clinical example of burst modulation is Russian Current.

12. Interrupted AC D one when the current flow for few seconds then stop to flow for 1 second or more. This interrupted AC is differ from burst AC because the inter-pulse interval is longer than the inter burst interval and this is an advantage for the interrupted AC because it permits relaxation from muscle contraction. The most common example of amplitude modulated AC is to mix two AC current with different frequency , and known as interferential current (IFC).

13. Tissue response to electrostimulation

14. Chemical Effects: Ion migration, where ions move through tissue in response to continuous DC current (iontophoresis) Magnetic Effects: electrical current flows in a conductor causing a magnetic field

15. Kinetic Effects (include sensation & muscle contraction): Moderate-amplitude, high frequency pulsed or AC stimulation that facilitates wound healing (twin pulse), edema reduction (twin pulse), and pain reduction (interferential).
Twitch contraction, followed by relaxation from low freq, moderate amp AC facilitates muscle re-education (biphasic, Russian) and tendinitis treatments (twin pulse, biphasic, & Russian).
Tetanic contraction from high amp, high freq AC (>20-30 pps) helps strength development and spasm reduction (biphasic, Russian )

16. Indications

17. Galvanic current

18. Faradic current

19. FES (Functional Electro-Stimulation). Is electrical stimulation of muscle deprived of normal control to prouduce a functional useful contraction FES serve to provoke contraction of paralyzed muscle and to affect sensory pathway contributing to the normalization of basic reflex motor activity In this technique, the application of the electrical stimulus is combined with act i vty on the part of patient

20. Precautions Burning of the skin
Electrical discharges (sparks) may occur
Do not use in the presence of inflammable anesthetics
Do not apply over an area where the hair has been shaved in the past 24 hours.
Known skin allergie

21. Treatment procedures

22. Preparation of The patient The skin in the area of electrode placement should be cleaned thoroughly.
Special gels, sprays or water is applied to the skin as a condition medium for better stimulation.
Electrodes should be fixed in position, using mending tapes to maintain good contact throughout the treatment period.

23. Securing the device

24. These devices are needed to prevent movement of the electrodes during treatment. They have to be of an insulating material coverage to prevent current conduction on their surfaces.
-Soft-rubber sandbags. - Lightweight sandbags.
-Adhesive tapes. - Velcro bands.
-Adhesive gels.

25. Electrodes types

26. Electrodes placement

27. Unipolar The unipolar technique is usually termed motor point stimulation, The motor point is the point where the motor nerve enters the muscle. This is usually found at the junction of the proximal third with the distal two-thirds of the muscle bellyv or either end of the muscle belly, in which the active (stimulating) electrode is placed on the target muscle, while the indifferent one is placed elsewhere.

28. Bipolar: In such a technique, two electrodes are placed on the target muscle, close to origin / insertion. Bilateral unipolar: The electrodes are placed on each of two separate muscles or muscle groups. Reciprocal: In which an active electrode is placed on each of two separate muscles or muscle groups, either agonist / antagonist or bilaterally, with the indifferent electrode placed elsewhere as in uniploar technique.

29. Trans-arthral: The electrodes are placed on both sides of the target joint. It should be clear in mind that the current does not pass across the joint, but instead flows around the joint between electrodes

30. Motor points for electrodes placement