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Basics of Electrotherapy
Subhash M Khatri
1:
WHAT IS ELECTROTHERAPY?
DEFINITION AND AREAS OF STUDY
Low Frequency Currents
Medium Frequency Currents
High Frequency Currents
Phototherapy
Electrodiagnosis
Biofeedback
CLASSIFICATION OF CURRENTS
On the Basis of Direction
On the Basis of Frequency
On the Basis of Voltage
On the Basis of Amperage
On the Basis of Biophysical Effects
ACTIVE AND PASSIVE MODALITIES
APPROACHES TO ELECTROTHERAPY
SUMMARY
2:
HISTORY OF ELECTROTHERAPY
MUSCLE-NERVE STIMULATION
IONTOPHORESIS
HIGH FREQUENCY CURRENTS
PHOTOTHERAPY
MEDICAL USE OF ELECTRICITY
SUMMARY
3:
MUSCLE AND NERVE STIMULATING CURRENTS
DIRECT CURRENT
Production
Polarity
Physiological Effects
Stimulation of Sensory Nerves
Stimulation of Motor Nerves
Accommodation
Chemical Production
Effect on Body Proteins
Therapeutic Indications
Galvanism
Medical Galvanism
Anodal Galvanism
Cathodal Galvanism
Surgical Galvanism or Electrolysis
Iontophoresis
Principle
Effectiveness
Method of Application
Uses of Iontophoresis
Contraindications and Dangers
FARADIC CURRENT
Original Faradic Current
Faradic Type Current
Production
Interruption and Surging
Physiological Effects
Stimulation of Sensory Nerves
Stimulation of Motor Nerves
Chemical Effect
Effect on Denervated Muscle
Effect of Muscle Contraction
Therapeutic Indications
Facilitation of Muscle
Muscle Re-education
New Muscle Action
Motor Nerve Neurapraxia
Blood Supply
Effect on Edema
Uses of Faradic Current
Methods of Application
Motor Point Stimulation
Labile Method
Nerve Conduction Method
Bath Method
Faradism Under Pressure
Faradism to Pelvic Floor Muscles
INTERRUPTED DIRECT CURRENT
Production
Physiological and Therapeutic Effects
Sensory Nerve Stimulation
Motor Nerve Stimulation
Effect on Denervated Muscle
Chemical Effect
Pole Used for Stimulation
Neuromuscular Electrical Stimulation
Uses and Methods of Application
Location of Motor Points
Face
Forearm and Hand
Leg and Foot Muscles
Physiotherapy for Peripheral Nerve Injuries
Electrical Stimulation
Passive Movements
Splints/Orthoses
Counseling
Reassurance
Classification of Nerve Injuries
Seddon's Classification
Sunderland's Classification
Schaumburg, Spencer and Thomas Classification
TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS)
Historical Aspects
Characteristics
Frequency
Modulation of TENS
Classification of TENS
Mechanism of Analgesia
Endorphin Theory
Gate Control Theory
Indications
Contraindications and Precautions
Electrode Placement in TENS
Dosimetry
Benefits of TENS
H-wave Therapy
INTERFERENTIAL CURRENT
Overview
Characteristics
Currents
Beat Frequency
Area of Interference
Therapeutic Effects
Pain Relief
Relief of Muscle Spasm
Stimulation of Innervated Muscles
Effect on Edema
Increased Blood Circulation
Electrodes
Vacuum Electrode
Labile Electrodes
Dosimetry
Indications
Contraindications and Precautions
Methods of Application
Advantages of Interferential Current
RUSSIAN CURRENT
SINUSOIDAL CURRENT
HIGH VOLTAGE PULSED GALVANIC CURRENT
MICROAMPERAGE ELECTRICAL NERVE STIMULATION
DIADYNAMIC CURRENT
PROCEDURE OUTLINE FOR LOW FREQUENCY CURRENT (LFC) AND MEDIUM FREQUENCY CURRENT (MFC) APPLICATION
SUMMARY
4:
DIAGNOSTIC ELECTROTHERAPY
RHEOBASE AND CHRONAXIE
Rheobase
Chronaxie
STRENGTH-DURATION CURVES
Definition
Apparatus and Other Requirements
Procedure
Preparation of Patient
Application of Electrodes
Application of Current and Recording
Drawing the Curve
Characteristics
Normal Innervation
Complete Denervation
Partial Denervation
Variations
Advantages
Disadvantages
PULSE RATIO
FARADIC INTERRUPTED DIRECT CURRENT (IDC) TEST
NERVE CONDUCTIVITY TEST
NERVE DISTRIBUTION TEST
NEUROTIZATION TIME
GALVANIC-TETANUS RATIO
DERMO OHMOMETRY
POLAR FORMULA
MYOTONIC REACTION
REACTION OF DEGENERATION
Complete Reaction
Partial Reaction
Absolute Reaction
ELECTROMYOGRAPHY
Definition
Uses
Contraindications
Equipment
Electrodes
Preamplifier
Amplifier
Cathode Ray Tube Display
Ancillary Equipment
Loudspeaker
MOTOR UNIT POTENTIALS
Normal Motor Unit Potential
Total Duration
Polyphasic Potential
Fibrillation Potential
Positive Sharp Wave
Nerve Potential
Myotonic Potentials
Fasciculation Potentials
Giant Potential
Bizarre High Frequency Discharge
Nascent Potential
Myopathic Potentials
ELECTROPHYSIOLOGICAL TESTS WITH ELECTROMYOGRAPHY
Nerve Conduction Velocity
Blink Reflex Test
Central Evoked Potentials
H-Reflex Test
F-Wave Test
SUMMARY
5:
THERMOTHERAPY
SHORT-WAVE DIATHERMY
Production
Principle
Circuit
Working
Electrodes and Arrangement of Electrodes
Physiological Effects
Temperature
Metabolism
Blood Supply
Effect on Nerves
Muscle Relaxation
Tissue Damage
Blood Pressure
Sweating
Therapeutic Effects and Uses
Pain Relief
Muscle Spasm
Joint Stiffness
Inflammation
Musculoskeletal Trauma
Indications and Contraindications
Indications
Contraindications
Precautions
Dosages of Short-wave Diathermy
Advantages of Short-wave Diathermy
Pulsed Short-wave Diathermy
MICROWAVE DIATHERMY
Production
Principle
Functional Parts
Physiological and Therapeutic Effects
Uses and Contraindications
Dosages
OUDIN CURRENT
PARAFFIN WAX BATH THERAPY
Paraffin Bath Unit
Clinical Effects and Uses of Paraffin Wax Bath Therapy
Contraindications
Methods of Application
Dip Method
Immersion Method
Brush Method
Bandage Method
Technique of Application
Maintenance of Paraffin Wax Bath Unit
HOT PACKS
Physiological and Therapeutic Effects
Local Temperature
Circulation
Pain Relief
Muscle Spasm
Connective Tissue Extensibility
Types of Hot Packs
Hydrocollator Packs
Hot Water Bag
Kenny Packs
Chemical Hot Packs
ELECTRICAL HEATING PADS
PROCEDURE OUTLINE FOR HIGH FREQUENCY CURRENT APPLICATION
Preparation of Apparatus
Testing of Apparatus
Preparation of Patient
Application of Treatment
Termination of Treatment
SUMMARY
6:
THERAPEUTIC ULTRASOUND
ULTRASOUND AS A THERAPEUTIC MODALITY
Introduction
Production
Principle of Production
Functional Parts
Parameters
Working
Physiological Effects
Thermal Effects
Mechanical Effects
Chemical Effects
Therapeutic Effects
Pain Relief
Inflammation
Effect on Healing/Repair
Therapeutic Uses
Contraindications
Dangers and Precautions
Methods of Application
Contact Cream Method
Insonation by Bath Method
Bag Method of Insonation
Testing of Ultrasound Machine
Water Drops Method
Container Method
Thenar Eminence
Dosages
PULSED ULTRASOUND
PHONOPHORESIS
COMBINATION THERAPY
EXTRACORPOREAL SHOCKWAVE THERAPY (ESWT)
Mechanism of Action
Indications
Contraindications
SUMMARY
7:
CRYOTHERAPY
CRYOTHERAPY (HYPOTHERMY)
Physiological Effects
Body Temperature
Circulatory Effect
Metabolism
Behavioral Changes
Therapeutic Effects
Pain Relief
Muscle Spasm
Inflammation
Swelling
Connective Tissue Extensibility
Trauma
Muscle Tone
Muscle Strength and Endurance
Agility
Indications
Contraindications and Precautions
Methods of Application
Vapocoolant Sprays
Ice Massage
Cold Packs
Ice Packs
Ice Towels
Cold Immersion
Compressive Cryotherapy
Chemical Cold Packs
SUMMARY
8:
PHOTOTHERAPY
THERAPEUTIC LASER
Historical Aspects
Characteristics
Monochromaticity
Coherence
Collimation
Classification Based on Intensity
Lasers Features
Classification Based on Risk of Eye Injury
Types of Laser Based on Source and Medium
Production of Laser
Principle of Production
Functional Parts
Working
Effects of Laser
Pain Relief
Tissue Healing
Indications
Contraindications
Dosages and Frequency
Sites of Application
INFRARED RAYS
Classification
Production
Non-luminous Generators
Luminous Generator
Depth of Penetration
Laws Regulating the Absorption of Radiation
Grothus Law
Law of Inverse Square
Cosine Law
Beer-Lambert Law
Kirchhoff's Law
Wien's Law
Stefan-Boltzman Law
Arndt- Schultz Principle
Physiological Effects
Therapeutic Effects
Uses
Contraindications
Dosages of Infrared Rays
Hazards of Infrared Irradiation
ULTRAVIOLET RAYS
Physiological Effects of Ultraviolet Rays
Erythema Reaction
Thickening of the Epidermis
Desquamation
Pigmentation
Esophylactic Effect
Bactericidal Effect
Vitamin D Formation
General Tonic Effect
Therapeutic Effects of Ultraviolet Rays
Counter-irritation
Increased Blood Supply
Destruction of Bacteria
Tissue Destruction
Desquamation
Indications and Contraindications
Hazards and Precautions
PUVA and Ionozone Therapy
SUMMARY
9:
SAFETY PRECAUTIONS OF ELECTROTHERAPY
IMPORTANCE OF SAFETY PRECAUTIONS
CAUSES AND TYPES OF HAZARDS
SAFETY PRECAUTIONS TO BE FOLLOWED
Equipment Purchase
Earthing and Stabilizer
Maintenance
Physiotherapist's Role in Safety
SUMMARY
10:
CLINICAL DECISION-MAKING IN ELECTROTHERAPY
WHAT IS CLINICAL DECISION-MAKING?
SUGGESTIONS FOR CLINICAL DECISION-MAKING
Evidence
Physiotherapist's Previous Experience
Patient's Previous Experience
Irritability
Underlying Pathology
Contraindications
Medical Condition of the Patient
Special Request
Comfort of the Patient
Treatment Time
Area to be Treated
Depth of Penetration
Equipment Availability
Reliability of Equipment
Familiarity
Proved Outcome
Professional Suggestions
Patient's Response
SUMMARY
11:
BIOFEEDBACK
BIOFEEDBACK AS A CLINICAL TOOL
TYPES OF BIOFEEDBACK
Myoelectric Feedback
Postural Biofeedback
Feedback Goniometers
Pressure or Force Biofeedback
Orofacial Control Devices
Toilet Training Devices
Stress-related Devices
Cardiovascular Biofeedback
Electroencephalograph Biofeedback
Feedback Thermometer
Hemoencephalography Biofeedback
Pneumograph Biofeedback
Capnometer Biofeedback
TREATMENT DURATION
ADVANTAGES AND DISADVANTAGES
Advantages
Disadvantages
SUMMARY
GLOSSARY
SUGGESTED READING
INDEX
TOC
Index
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