Electro therapy

• What is electrotherapy?

  Electrotherapy is a branch of physical treatment using direct and pulsed currents for medicinal purposes.
• What historical principles is electrotherapy based on?

  Electrotherapy is based on principles developed in the nineteenth and twentieth centuries following Luigi Galvani's demonstration of "animal electricity".
• What are the types of electrotherapy mentioned?

  • Transcutaneous Electrical Nerve Stimulation (TENS)
  • High Voltage Pulsed Current (HVPC)
  • Diadynamic Currents
  • Interference Current
  • Neuromuscular Electrical Stimulation (NMES)
  • Electrical Stimulation of Denervated Muscle

  
• What is Transcutaneous Electrical Nerve Stimulation (TENS)?

  TENS is the application of electrical stimulation to the skin via surface electrodes to stimulate nerve fibers for pain relief.

  
• What are the types of TENS?

  • Conventional TENS
  • Acupuncture like TENS
  • Burst train TENS
  • Brief – intense TENS
• What is Conventional TENS?

  Conventional TENS is a high frequency, low intensity mode of electrostimulation that stimulates A beta afferents.

  
• What sensation is experienced with Conventional TENS?

  The sensation experienced is paraesthesia with no muscle contractions, unless higher stimulation intensities are used.
• How does Conventional TENS achieve analgesia?

  It achieves analgesia primarily by spinal segmental mechanisms when A beta fibers are stimulated.
• How long does the analgesia from Conventional TENS typically last?

  The analgesia typically lasts only for up to a few hours post treatment.
• What are the modes available for TENS?

  • Low intensity
  • High frequency (typically above 100 Hz)
  • Short pulse duration (50 - 80 µs)

  
• What is Acupuncture like TENS?

  Acupuncture like TENS is a low frequency, high intensity mode that primarily stimulates A delta and C nociceptive fibers.

  
• What sensations are experienced with Acupuncture like TENS?

  Patients experience paraesthesia and muscle contractions with this mode.
• How does the analgesia duration of Acupuncture like TENS compare to Conventional TENS?

  The analgesia lasts longer with Acupuncture like TENS than with Conventional TENS.
• What are the modes available for Acupuncture like TENS?

  • Low frequency (1 - 4 Hz)
  • High intensity (to produce visible muscle contractions)
  • Long pulse duration (200 µs)

  
• What is Burst Train TENS?

  Burst Train TENS is a high frequency train of pulses delivered at low frequency, developed from experiences with Chinese electroacupuncture.
• How does Burst Train TENS combine different TENS modes?

  It combines a baseline low frequency current with high frequency trains.
• Why do patients tolerate Burst Train TENS better than single impulses?

  Patients tolerate the stimulus intensity required for strong muscle twitches much better than single impulses.
• What are the modes available for Burst Train TENS?

  • Low frequency of trains (1 - 4 Hz)
  • High internal frequency of the trains (100 Hz)
  • Pulse duration (100 - 200 µs)
• What is Brief - Intense TENS?

  Brief - Intense TENS is a high frequency mode with long pulse duration used for painful procedures.

  
• What are the modes available for Brief - Intense TENS?

  • High frequency (100 - 150 Hz)
  • Long duration pulse (150 - 250 µs)

  
• What are the indications for TENS?

  • Pain relief after peripheral nerve damage
  • Pain after amputation
  • Nerve pain after shingles
  • Phantom pain
  • Peripheral neuropathies from metabolic disorders
  • Pain-related causes of central nervous system damage
• What are the parameters of High Voltage Pulsed Current (HVPC)?

  HVPC has very short phase durations (5 - 65 µs), high peak current amplitude (2000 to 2500 mA), and high driving voltage (up to 500 V).
• What is the total current delivered to the tissue per second in HVPC?

  The total current delivered does not exceed 1.2 to 1.5 mA.
• What are the indications and advantages of HVPC?

  Indications:

  • Soft tissue wounds (bedsores, ulcers, burns)
  • Edema
  • Pain conditions (e.g., muscle pain)

  
  

  Advantages:

  • Deeper penetration into tissue
  • Minimal risk of pain during application
  • Minor risk of skin damage
• What are Diadynamic Currents?

  Diadynamic Currents were first described in 1950 by Bernard and consist of direct current and alternating sinusoidal current.
• How are Diadynamic Currents delivered?

  They are delivered transcutaneously through anode and cathode as monophasic, half-wave, or full-wave pulses.
• What are the forms of Diadynamic Currents?

  • MF current
  • DF current
  • CP current
  • LP current
  • RS current
  • MM current
• What is the preferred current for pain modulation among Diadynamic Currents?

  Diphase Fixe (DF) is the preferred current for pain modulation.
• What sensation does DF produce?

  DF produces a vibrating, prickling sensation that subsides gradually.
• For what conditions is DF especially recommended?

  DF is especially recommended for pain conditions of sympathetic origin.
• What does Monophase Fixe (MF) produce?

  MF produces a strong vibratory sensation with slower sensory accommodation due to the 10 ms delay between successive pulses.
• What are the recommendations for Courtes Periods (CP)?

  • Combines MF and DF currents
  • Alternates at intervals of 1 s to prevent sensory accommodation
  • Recommended for treatment of pain states associated with sprains, strains, contusions
• What are the recommendations for Longues Periods (LP)?

  • Combines MF and DF current modes
  • Occurs together but out of phase
  • Recommended for longer-lasting pain relief in acute pain conditions
• What is the influence of Diadynamic currents on the human body?

  • Analgesic effects (DF, LP, CP)
  • Congestion effects (LP, CP, MF)
  • Muscle relaxation (DF, LP, CP)
  • Muscle tension (MF)
• What is Interference Current?

  Interference Current is the current of medium frequency arising from the interference of two alternating sinusoidal currents.
• What frequencies are used for Interference Current?

  Frequencies around 4000 Hz, such as 3900 Hz and 4000 Hz, are used.
• How is interference achieved in Interference Current?

  Interference is achieved using two independent circuits with two pairs of electrodes placed to create interference in the deep tissues.
• What are the advantages of Interference Current?

  • Weaker effects
  • Deeper tissue penetration
  • Reduced pain during application
• What are the effects of diadynamic currents on the human body?

  Analgesic effect, congestion relief, muscle relaxation, and muscle tension management
• What is interference current?

  It is the current of medium frequency resulting from the interference of two alternating sinusoidal currents