ELECTROTHERAPY NOTES Covered ALL the topics according to the SYLLABUS of Physiotherapy AFFORDABLE & NON - REGRETFUL NOTES Swipe LEFT @™ to see ALL THE TOPICS DM NOW... FOR OFFER IN EASY T0 UNDERSTANDABLE LANGUAGE Swipe LEFT 4 to see SAMPLES as wellELECTROTHERAPY NOTES - TOPICS Sn TOPIC SUB HEADINGS i BASICS ¢ Electrotherapy Introduction e Introduction to Therapeutic Currents - SINUSOIDAL and DIADYNAMIC CURRENTS @ Pain (Pain Gate Mechanism] Nerve & Nerve Injury 2 | PARAFFIN WAX BATH THERAPY Introduction Principle Paraffin Wax Unit Methods Techniques of Application Effects and Uses Physiological Effects Indications Contraindications Advantages Disadvantages After Treatment Maintenance Of PWB Unit Introduction Technique of Application Physiological effects Indications Contraindications Advantages Disadvantages 3. | HYDROCOLLATOR/ HOT PACKS 4. CONTRAST BATH IntroductionTHERAPY Principle Technique Procedure Physiological effects Indications Contraindications Maintenance Of CB Unit FLUIDOTHERAPY Introduction Method of Application Advantages Disadvantages Indications Contraindications CRYOTHERAPY / COLD THERAPY Introduction Physical Principle Bio Physics Bio Physical Principle of tissue Healing Physiological effects Therapeutic Effects / Indications Technique / Procedure Methods of Application Contraindications RADIATION THERAPY INFRA RED RADIATIONS ULTRA VIOLET RADIATIONS MUSCLE STIMULATOR A. FARADIC CURRENT Introduction Modified Faradic Current Surging of Current Physiological Effects Indications Contraindications Technique of treatmentB. GALVANIC CURRENT C. STIMULATION OF MUSCLE GROUP. Nerves And their Motor Points Introduction Modified Direct Current Physiological Effects Indications Contraindications Technique of treatment Quadriceps Faradic Foot Bath Faradism Under Pressure Pelvic Floor Muscles Re-education Functional Electrical Stimulation ELECTRODIAGNOSTIC TEST SD Curve Faradic Galvanic Test Nerve Conduction Velocity Test Nerve Conduction Test EMG Biofeedback 10 TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION Definition Parameters Electrodes Principles Mechanism of pain relief Types Electrodes positioning Arrangement Indications Contraindications Dosage Dangers Application 11 IONTOPHORESIS Introduction Principle Advantages DisadvantagesMechanism lonic Movement Physiological Effects Electrochemical Changes Continuous Direct Current Technique Procedure Indications Contraindications Commonly lons Used Precautions Dangers 12 MEDIUM FREQUENCY CURRENTS REBOX Current RUSSIAN Current 13 INTERFERENTIAL THERAPY/CURRENT (IFT/IFC) Introduction Principle Beat frequency Types of beat Frequency Direction of maximum static interference effect Direction of maximum interference effect or scanning effect Types Of Interfernce Terms Related To IFT Machine Physiological effects Methods of application Technique Of Application Procedure of treatment Precaution Advantages Indications Contraindications Adverse Effects Dosage14 ULTRASOUND Basics Introduction Frequency Production Transmission Principles Parameters Attenuation Ultrasonic Field (BNR ratio] Coupling Media Thermal & Non - Thermal Effects Uses Indications Contraindications Testing Methods Technique of application Dosage Danger PHONOPHORESIS 15 DIATHERMIES SWD (Short Wave Diathermy) MWD (Micro Wave Diathermy) LWM (Long Wave Diathermy) 16 LASER Introduction Physical Principle Production Active Medium Resonant Cavity Characteristics of LASER Types of LASER Properties Effects on tissues Therapeutic Use Principle Of Application Indications Contraindications Dosage© Precautions 17 TRACTION ¢ BASICSBASICS A.INTRODUCTION to ELECTROTHERAY Introduction > Physiotherapy is the means of treating disorders by physical means. Electrotherapy is an integral part of physiotherapy. > The use of electricity for therapeutic purposes has grown up in recent years and now includes a wide variety of apparatus and equipments. > Alarge number of therapeutic modalities for treating several disorders are now inuse > Duchenne was considered as the inventor of muscle nerve electricity or “localised faradizations” and considered as father of modern Electrotherapy > Electrotherapy is the use of electrical energy as a medical treatment. > Electrotherapy modalities administer thermal, mechanical, electrical, or light energy to the patient to provide physiological effects and therapeutic effects. sth lities: 4. Management and reduction of pain (acute pain, chronic pain, post-traumatic pain, and post-surgical pain). 2. Improved local blood circulation and flow. 3. Reduction and rehabilitation of muscles. 4. Maintain and improve ROM (range of motion). 5. Relaxation of muscle spasms. 6. Facilitation of wound healing. 7. Prevention and cessation of muscular atrophy due to disuse. 8. Prevention of post-surgery deep vein thrombosis. 9. Increase effectiveness in delivering prescription drugs. Physiological effects: 1. Increased ROM. 2. Muscle group contraction. 3. Retards muscle atrophy. 4, Increased muscle strength 5. Increase circulation 6. Decrease muscle spasmIntroduction eoeeeeereeee PA TH Form of superficial heat therapy. White or colorless soft solid wax Most convenient way Melting point of wax - 54°c 54°c is too for therapeutic use. If molten wax at 54°c poured on the body parts, it can cause burn. So to lower its melting point,impurity added to it. We add liquid paraffin / mineral oil to it. Ratio b/w solid wax and liquid paraffin / mineral oil is 7:1 Sometimes, petroleum jelly is also used for moistening the skin. Composition of solid wax:: liquid paraffin : petroleum jelly is 7:3:1 This compositions enhance patient's ability to tolerate heat from wax better than the water of same temperature Mode of transmission of heat from paraffin to patients skin is through conduction Provide pain relief to joints and muscles Temperature Latent heat of vaporization (Temperature remains constant as hquid turns to gas) Latent heat constant as si tums to liquid)HOT PACKS/ MOIST PACK /HYDROCOLLATOR PACKS Introduction Hot packs are the packs which are immersed in apparatus called hydrocollator They are commonly used as moist heat for superficial heating They provide superficial moist heat to the part where applied externally to an injured body part to relieve inflammation or directly on exposed area that needs treatment Transmission is through conduction ¢ Depth of penetration is between 2 to 10mm. The target tissue would be skin, subcutaneous fat and relative superficial tendons as in the hands and feets The superficial heating increases the blood flow to the tissues ¢ Hot packs contain hydrophilic substance such a silica or bentonite enchased in the channelled canvas covers. They are stored in thermostatically control units which are filled with water at temperature range of 71 to 79 degree centigrade Hot packs should be checked for rupture in canvas because these can lead to leakage © Silica gel is good absorbent and can hold water for long period so as the treatment can be done for long time. Prior to application to the patient, the hot packs should be cover with 6 to 8 layers of towelling that insulate the packs from heat loss and protect the patient from potential burns. Maximum skin temperature is achieved within the first 10 minute of hot packs application and maintain for approximately an additional 10 minutes. Treatment time 20 minutesCONTRAST BATH Introducti is method of combined heat and cold application with results in increase in blood flow and to decrease joint stiffness. © part is immersed alternatively in hot and in cold water tanks © When body part exposed to alternate hot and cold temperatures, it results in alternate vasodilation and vasoconstriction which results in pumping effect to facilitates or removal of edema. e Itcanbe used for painstiffness and edema. *® Vasodilation followed by vasoconstriction © principle of contrast bath therapy is to combine the effects of both hot as well as cold bath together ® Ahot bath produces vasodilation of blood vessels and increase blood flow © Cold produces vasoconstriction which will constrict the blood vessels, resulting in decreased blood flow.FLUIDOTHERAPY Introduction Fluidotherapy is a dry heating agent The fluidotherapy system uses air fluidized solids as the heat transfer media Transmission is through convection method that is the transfer of heat fromone place to another by the actual motion of hot fluidized material © When air is uniformly circulated ina container to the bottom of bed of finely divided cellulose particles. © Then these solid particles become suspended, when the stream of air is forced through them and making fluidized bed. Itbehaves and demonstrate the properties similar to those of liquid therefore it is known as fluidotherapy The viscosity of the air fluidised system is low, allowing a patient to submerged body parts into the fluid bed and suspending this part similar to being in a fluid thus permitting exercise with relative ease. Fluidotherapy units are available in different sizes. Treatment canbe given to distal extremity as well as proximal parts by large units * For treatment of back, larger models are used which are quite expensive.CRYOTHERAPY OR COLD THERAPY lucti ‘Cryo’ means cold and ‘therapy’ means treatment. Application of cold for various therapeutic purposes is called cryotherapy. ‘Commonly used in the treatment of acute trauma and subacute injury. The temperature of the body tissue is reduced and the heat is transferred from the body tissue to the cold medium. Magnitude of cooling depends upon the - area of the body tissue exposed - temperature of the cooling agent - duration of exposure. © [tis anold age remedy for pain relief, fever re-education and control of bleeding © Recently, it has been applied to prevent or reduce edema from traumatic origin, inflammation, decrease muscle spasm and temporary reduce spasticity for exercise. * Use world widely because of its effectiveness, convenience, low cost and easy transport. ® Common agents or techniques used for cold are :- 1. Cold orice packs 2. Ice cube massage 3. Vapocoolants spray Or evaporative cooling. 4. Cald Whirlpool or Immersion in cold 5. Controlled cold compression unitRadiation therapy also called as ACTINOTHERAPY i. means of radiations Itincludes - . INFRARED RADIATION 2. ULTRAVIOLET RADIATION the treatment done by the p INFRARED RADIATION Introduction Radiations lie beyond the red boundary of the visible spectrum in Electromagnetic Spectrum are called infrared radiations. © Itis superficial thermal agent, discovered by Hershel. © Among any hot object or body, can emit infrared radiations. For example, Sun, coal fire, gas fire, etc. <—— nrcreasing energy INWY PL P\ PNP NS NS. Increasing wavelength > 0.0001 nm 0.01 mn 100m 1000%m O.01em Tem 1m 100m Gommo rays Xray | Uli} norod Radio waves AM 400 am 500 om 600 nm 700 nmULTRAVIOLET RADIATION Introduction © Ultraviolet Radiation is electromagnetic radiation which is invisible to human have wavelength between 10 nm and 400 nm e Ultraviolet Radiation lies between visible right and X-ray in electromagnetic radiation. Ultraviolet radiations can cause sunburn and tanning on exposure to the sunlight. Ultraviolet radiations transmit much more energy than the visible radiations << hrcreasing energy IW. PD, PPS N SN. Increasing wavelength, — > 0.0001 nm 0.01 nm 10mm 1000nm O.0lcm = lcm Tm 100m 1 ! L i 1 Gomme roys Keays | Ullo-|—_Infrored Radio waves violet Radar TV FM AM Fordescriptive purposes, the therapeutic part of the ultraviolet spectrum may be divided into:jirect current Introduction e Flow of charge particles in one direction © It's direction of polarity is constant and passing continuously in one direction, so termed as.constant current © Because of its unidirectional property, when applied on muscle, muscle tends to contract and remain in that position till its intensity brought to zero which seems to be very painful * Torelieve this, relaxation period is advised so current is applied in a form of short duration with regular pulse interval between two consecutive phase. ® This paused constant current is termed as interrupted direct current or interrupted galvanic current Direct Current (DC) Alternating Current (AC) + + votare Voltage Time Time FA IC CURR Introducti Itis named given on inventor michael faraday © Faradic current is a short duration interrupted direct current with the pulse duration ranging from 0.1 ms to 1 milli seconds and a frequency of 50 to 100 hertz Faradic current produces muscle contraction via motor nerve. ® Used to stimulate innervated muscle fiber.E DIA Th I. STR RA URVE S-D Testing is mainly done for the motor point or nerve assessment ® Itindicates the strength to produce contraction in a muscle © The purpose of S -D curve plotting is to know whether the stimulated muscle is innervated, denervated or partially denervated. ® Itindicate proportion of denervation. . simple and reliable method e Provide information about the nerve lesions . . Also known as Intensity Duration Curve. Strength duration/Intensity duration curve shows the relationship between the magnitude of the change of stimulus and the duration of the stimulus. ® The curve provides valuable information regarding the state of excitability of nerve lesion. © Itshould be done only after 21 days following nerve injury. ‘On! days? e Nerve degenerates proximally to nearest node of Ranvier and distally throughout the whole length. Debris is cleared by macrophagic activity. Process takes up to 21 days to complete and is a preparation for regeneration. This phenomenon of degeneration is known as Wallerian Degeneration. So for accurate result whether denervation have occured or not, we have to wait for 21days Nerve regenerationT A ECT! R' LATI ENS Definition ® TENS is an application of rectangular waveform of pulses to the patient's skin via surface electrode Parameters 1. Pulse Width or pulse duration = 100 microsecond to 500 microsecond 2. Frequency = 2Hzto 600 hertz (for therapeutic purpose up to 150 hertz) 3. Waveform or pulse shape = rectangular 4, Intensity = 2to 60 millisecondsIONTOPHORESIS Introduction e lontophoresis isa therapeutic technique *® lon transfer or lontophoresis is a introduction of topically applied, physiologically active ions into the epidermis and mucous membrane of the body by the use of Continuous Direct Current. Constant current source @ This technique is also known as ‘technique of ion transfer’ into the body tissues by using electrical current as a driving force. Principle @ Negative ions placed under the cathode (negative) and positive ions placed under anode (positive), so that they will repelled and introduced the ions into the circulation by attracting towards opposite pole. © Active electrode is the electrode under which ions are presentMEDIUM FREQUENCY CURRENTS * Medium frequency currents are the currents whose frequency falls between the range of 1000 to 10000 Hz. © They are being used therapeutically due to their advantage of greater penetration and with a higher tolerance and comfort over the low frequency current. © Init, we will study about - 1. REBOX Current 2. RUSSIAN Current 3. INTERFERENTIAL Current A. Rebox Current Introduction Rebox-type currents are derived from a device called Rebox. Reboxis a device that was developed in czechoslovakiain 1970's The name rebox derived from “Rehabilitation Box” There is a hand held dispersive and current is delivered by a point type electrode Point electrode is made up of negative pole The current used unipolar, rectangular pulse of between 50 microseconds to 200 microsecond and at the frequency of 3000 hertz (between 2000 to 4000 hertz) with current intensity between 100 to 200 milli ampere * The circuit also contain some micrometer and a earphone and can be linked toa small computer and printer to display a graph of current and other parameters eeeveee Po oyINTERFERENTIAL THERAPY/CURRENT (IFT/IFC) Introduction IFTs principles was first introduced by HANS NEMECIN in the early 1950s, so it is also known as NEMEC current He wanted to overcome the problems of discomfort caused by the low frequency currents while maintaining their therapeutic effect. In this, 2 medium frequency currents are used to produce a low frequency current. Since direct application of faradic current results in pain due to high impedance of tissues, so to have a low frequency effect two medium frequency currents are used. In this, medium frequency are used to minimize the impedance generated by the tissue against the low frequency current. Out of these two medium frequency currents one current is always of 4000 Hz because there is minimum impedance generated by the tissues against this frequency current. The other current can be varied accordingly. — «ULTRASOUND Basics In the medical community, ultrasound is the modality that is used for anumber of purposes including diagnosis, destruction of tissues and therapy. Diagnostic ultrasound is used for imaging the fetus during pregnancy. Destructive ultrasound is used to produce extreme tissue hyperthermia which has been demonstrated to have tumoricidal effects in cancer patients. Therapeutic ultrasound is most widely used modalities in physiotherapy department. It has been used as a valuable tool in rehabilitation of many different injuries, to stimulate the repair of soft tissue injuries and to relieve pain. It has been traditionally classified as a deep heating modality and used primarily to elevate tissue temperature. IntroductionDiather' rodu e Diathermy isa Greek word meaning through heating. ® Diathermies are of following types: 11. Short wave diathermy 2. Microwave diathermy 3. Long wave diathermy A.SHORT WAVE DIATHERMY Introduction ® Short wave diathermy is the use of high frequency electromagnetic waves of the frequency between 10’ and 10° Hz, and a wavelength between 30 and 3mto generate heat in the body tissues. * It provides the deepest form of heat available to the physiotherapist.LASER Introduction e Light Amplification By Stimulated Emission Of Radiation e Itrefers to the production of a beam of arradiation which differs from the ordinary light in several ways The principle for LASER was put forward by Albert Einstein and Theodore Maiman and produced first LASER. ical Princi if LASER ® When an energy particle of light (photon) is directed at an atom and if it is absorb, the energy in the orbital electron is increased © One or more electron undergoes to positional changes from inner orbit to amore peripheral orbit.TRACTION Introduction Traction is the act of drawing or pulling and relates to forces applied to the body ‘to stretch a given part or to separate two or more parts. * Traction is used effectively in treatment of fractures. Beppe Traction is often limited to the cervical or lumbar spine with the goal of relieving pain in, or originating from those areas. Since the days of hippocrates, correction of scoliosis has also involved attraction Various methods of tractions have been performed that include :- . Skin aur skeletal traction Applying pulling force manually with free weight and a pulley or manual traction . Inversion techniques |. An overhead traction