Handbook of Practical Electrotherapy Pushpal Kumar Mitra
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1Handbook of Practical Electrotherapy2
3Handbook of Practical Electrotherapy
Pushpal Kumar Mitra Lecturer in Physiotherapy NIOH, Kolkata
4Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
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Handbook of Practical Electrotherapy
© 2006, Pushpal Kumar Mitra
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
First Edition : 2006
9788180616204
Typeset at JPBMP typesetting unit
Printed at Gopsons Papers Ltd., A 14, Sector 60, Noida
5
To My dear departed Mother, in her memory6
7Preface
The scientific art of Physiotherapy has grown by leaps & bounds over the last few decades, gaining credibility as an established drug-less discipline of modern medicine. The public at large, especially in India, has become wary of the indiscriminate use of potentially harmful drugs for even trivial complaints. More and more people are being drawn towards physiotherapy, recognising it as an effective alternative to conventional drug based treatment. Though the discipline of physiotherapy has been in practice for over half a century, physicians, particularly in India, had been traditionally recommending physiotherapy, only as a supplementary measure to the drug based regime of disease management.
Of late, due to wide coverage given by the media to such issues like the free availability of over the counter drugs and the dangers of unmonitored use of such potentially harmful agents, have created awareness among the population regarding the dangers of excessive dependence on drugs. Physicians have of late begun to realize that physiotherapy can be extremely effective for the treatment of many disorders, as a complementary force-multiplier to their own efforts.
The role of physiotherapy in diverse areas of patient care, such as rheumatology, orthopaedics, sports medicine, paediatrics, neonatology, geriatrics, neurology, gynaecology, obstetrics, pulmonology, cardiology, etc. is now established beyond doubt and is accepted by the medical fraternity worldwide. So much so, it has led to a change in the definition of physiotherapy by the World Health Organisation.
This acceptance has led to a boom in physiotherapy education in India. Physiotherapy has come of age as a viable career option, either as a self employed professional or as a part of healthcare infrastructure, in India or abroad, drawing the best and the brightest students in India. Major universities all over the nation are now offering physiotherapy as speciality training, at undergraduate and postgraduate level.
In my capacity as a teacher and examiner spanning over two decades, I have had the opportunity to interact closely with a wide spectrum of student community. The feedback given by these students regarding problems that they face in pursuing a course curriculum in Physiotherapy unanimously boils down to the lack of precise volumes that cover relevant details of the subject, highlighting the applied aspect of the science in a format and language that can be easily understood by them. This problem is easy to understand, since most of the publications available on the subject are by foreign authors. Though very well researched and descriptive, contents of these volumes are usually expressed in an English that is far beyond the comprehension of the average Indian student, particularly if he/ she have had his/her basic education in vernacular medium.
The genesis of this hand book on practical aspect of electrotherapy owes its origin to the need among students for simple volumes, oriented to the practical application of the science, 8with adequate text, backed up with plenty of illustrations, in easily understood format and language. Happily enough, several young authors, involved with undergraduate teaching in India, being actively encouraged by publishers with the vision, like the J.P.Brothers, are now coming forward with excellent volumes that will go a long way to encourage many teachers like me to do their bit for this noble cause. This is volume is a humble attempt to bridge the gap between the text and the applied aspect of Electrotherapy. With no pretence of being a magnum opus, it may provide an easy updater for the student or practitioner working in a clinical setting.
The entire gamut of electrotherapeutics has been divided into three major sections, i.e. therapeutic electrical stimulation, thermo therapy and actino therapy. Each section commences with a review of the relevant biophysics. The applied aspects of the modalities considered under each section have been listed under the headings of Points to Ponder,' for quick review of the essential information. This will be useful for bus stop revisions at exam time. The text in this volume has been deliberately kept simple and short, with liberal use of illustrations to project a word picture of the essentials in electrotherapy. Every effort has been made to make the contents of this volume easy to understand and framed to stimulate the reader to try using the techniques in a step-by-step manner during practice/clinical sessions. It is also expected to help fledgling teachers of Physiotherapy, to impart basic training in electrotherapy, with confidence, projecting the fundamentals firmly in front of their pupil, without too much technical jargon, which often tends to confuse the teacher and the taught alike.
Among many unique features presented in this volume, I would like to highlight the sections on precise dosing parameters for each modality. This can be an excellent guide for the beginner in clinical practice. Each section concludes with a comprehensive chart that details all aspects of practical application for individual modalities. Placement of electrodes, optimum dosage, equipment settings, patient position, etc. has been detailed for each region of the body or for specific clinical condition. Several advanced applications of electrotherapy, yet to be mainstreamed in clinical practice in India, such as functional electrical stimulation or the combination therapy, have been presented for the appraisal of the reader. The volume also contains a section on frequently asked questions during the viva examinations, along with short and to the point answers. The students can use this section as a means of complete revision at exam time, since each modality has been explored separately through short question and answers.
My effort has been directed towards de-mystifying the science and makes it user friendly for the budding professionals in physiotherapy. I have made every effort to make the volume as free of factual errors as possible. However, I realise that there is still a lot of scope for improvement in this volume. I shall be indebted to the reader for any valuable input to make the further editions more useful.
Pushpal Kumar Mitra
9Acknowledgements
This volume would not have seen the light of the day without active participation of my students in this project. My students, past and present, have been the friend, philosopher and guide in this maiden venture. Their feedback, advice and quality assessment, though not always flattering, have been the prime mover behind this effort. In this context I would like to convey my sincere thanks to Ms. Bani Laha, my erstwhile pupil and present assistant, for the motivation, backup support and secretarial assistance. I would also like to put on record my appreciation for Mr. Devidutt Pathak, Mr. Ravishankar, Ms. Richa Kashyap and Mr. Prosenjit Patra and Mr. Sapan Kumar, all Internees of physiotherapy at NIOH, for literature review proof reading and research, to make this volume as foolproof as possible. Special mention must be made for Ms. Divya and Ms. Suravi, visiting internees from GNDU, Amritsar for organising the photo shoots. Finally I wish to convey my appreciation and thanks to my teachers, colleagues and patients for their inspiration.