Russian current

RUSSIAN CURRENT

1. RUSSIAN CURRENT NITHIN NAIR (MPT- 1) UNDER GUIDANCE OF Dr. POTHIRAJ .P (PT)

2. LECTURE OUTLINE

3. LEARNING OBJECTIVES After this session, the students will be able to:

4. INTRODUCTION 1977 Yakov Kots ( Russian physiologist) It is basically a medium-frequency current It is an intermittent alternating sinusoidal current with a carrier frequency of 2500 Hz. Russian Current is a sinusoidal waveform, delivered in bursts or series of pulses. Hence, it is known as medium frequency, burst alternating current.

5. CHARACTERISTICS Carrier Frequency Waveform Current Amplitude Bursts Frequency Burst Duration On / Off Ratio Duty Cycle Ramp Up & Down Training protocol Duration & Frequency of Treatment Electrode Placement Time Delay switch

6. CHARACTERISTICS Carrier Frequency : 2500Hz ( 2.5 KHz ). Waveform : Polyphasic sinusoidal waveform . Current Amplitude : The maximum current amplitude is 100mA . Clinical used at 70mA. Bursts Frequency : 50 Hz. Burst Duration : 10ms

7. CHARACTERISTICS On/Off Ratio : The on : off ratio is defined as the ratio of the time during which there is stimulation (contraction) to the time during which there is no stimulation (no contraction). Set as 10ms:10ms Duty cycle : Duty cycle is the proportion of on time to the summation of both the on and off time expressed as percentages. For example 10:10 sets up a duty cycle of =10/ (10+10)x 100= 50%. Russian current produced with duty cycle of 50%. Ramp-Up and Down : Setting the ramp time is very important to evoked contraction similar to muscle contraction. As the ramp allows gradual increase of intensity with associated gradually increase of muscle contraction. Set for 1-2 seconds

8. CHARACTERISTICS Training protocol with Russian current : The widely and most popular clinical protocol used with Russian current is (10/50/10) , which is 10 =Muscle contractions, lasting for 10 seconds 50= off time (no contraction) for 50 seconds 10=cycle repeated for 10 times Duration and frequency of treatment : The recommended duration of treatment is 10 minutes , once daily per week for several weeks (3-6months) Electrode placement : Arranged parallel to the direction of muscle fibers so that it is at the estimated line of pull of the muscle. Time delay switch : Synchronous mode (both channels triggered simultaneously- achieved by not setting time delay.). Reciprocal mode (channel 1 is on then channel 2 is off – achieved by setting time delay equal to time of channel 1.). Overlapping mode (channel 2 overlaps with on time and off time of channel 1- achieved by setting time delay more than 1 sec but less than on time of channel 1.)

9. PHYSIOLOGICAL EFFECTS The net physiologic effects depends on The total number of bursts delivered per second. Russian current has a capacity to depolarized : Sensory nerve fibers Moderate prickling sensation , Motor nerve fibers Tetanic Muscle contraction This contraction is Painless due to sensory nerve blocked of pain gate Allow use of high amplitude Contraction Stronger than those generated by voluntary control (Voluntary contraction – motor units recruited asynchronously while in electrically evoked muscle contraction – motor units fire synchronously.)

10. PHYSIOLOGICAL EFFECTS

11. Therapeutic effects / Protocol TO IMPROVE MUSCLE STRENGTH Amplitude: Tetanic muscle contraction. Pulse rate (Burst freq ): 50-70 Hz Pulse duration : 150 -200 µs Apply current during volitional activity – isometrics in different ROM, slow speed isokinetic and short arc isotonic movements ( 10/50/10 – rule applied) TO REDUCE MUSCLE SPASM Amplitude: tetanic muscle contraction up to patients tolerance. Pulse rate (Burst freq ): 50-70 Hz Pulse duration: 50 -175 µs Stimulation is applied to provide brief isometric contractions (on time – 5-12 secs and off – 8-15 secs) TO REDUCE OEDEMA (DUE TO LACK OF MUSCLE CONTRACTION) Amplitude : small visible muscle contraction. Pulse rate (Burst freq ): 35-50 Hz Pulse duration: around 400 µs On:Off Time : An on time of 1-2 secs and an off time of 1-2 secs – promote muscle pumping Treatment time: 10-15 mins/session (can be used more than once a day)

12. INDICATIONS & CONTRAINDICATIONS INDICATIONS The only indication for use of Russian current as introduced by Kots in 1977 , is to strengthening the muscular system of healthy and athletic persons Post-knee ligaments surgery Post arthroscopic knee surgery Following ligament sprain ( ↑ quads force during immobilization) Post casting Muscle spasm CONTRAINDICATIONS Over the anterior cervical area Over the lumbar or abdominal area during pregnant Over hemorrhagic area Over neoplastic area Over metallic and electronic implant Over area of impaired skin sensation

13. SUMMARIZE 2500 Hz evenly alternating Medium Frequency current Applied as a series of burst . Physiological effects & Therapeutic effects Indications & Contraindications CURRENT AMPLITUDE: ? ON-OFF RATIO: ? TRAINING PROTOCOL: ? BURST FREQUENCY: ? DUTY CYCLE: ? DURATION & FREQUENCY: ? BURST DURATION: ? RAMP UP-DOWN: ? ELECTRODE PLACEMENT: ?

14. CURRENT AMPLITUDE: 70 mA ON-OFF RATIO: 10ms : 10ms TRAINING PROTOCOL: 10 /50 /10 BURST FREQUENCY: 50 Hz DUTY CYCLE: 50% DURATION & FREQUENCY: 10 mins daily (3-6 months) BURST DURATION: 10 ms RAMP UP-DOWN: 1-2 sec ELECTRODE PLACEMENT: Parallel to muscle fibre

15. References Electrotherapy explained – Low & Reed (4 th ed ) Electrotherapy Simplified – Nanda (1 st ed ) Physical agents in Rehabilitation – Cameron (4 th ed ) Textbook of Electrotherapy – Jagmohan Singh (2 nd ed ) Physical agents in PT (Biophysics & Therapeutic electricity) - Solomen (1 st ed ) Handbook of practical electrotherapy – Mitra (1 st ed ) Clinical electrophysiology - Andrew Robinson (3 rd ed ) Russian current and Burst mode alternating current – Tim Watson ( Electrotherapy on the web.) www.scribd.com