This document provides an overview of low frequency currents used in electrotherapy. It discusses the history of electrotherapy including contributions from Galvani, Faraday, and others. It describes the main types of currents - direct current, alternating current, and pulsed current. Specific low frequency currents are explained such as faradic current, interrupted direct current, and TENS. The physiological effects and therapeutic indications of low frequency currents are outlined. Contraindications and precautions for electrotherapy are also reviewed.
The high voltage pulsed galvanic stimulator (HVPGS) delivers a high voltage, low amperage, short duration electrical current as a twin-peak monophasic waveform up to 300 volts to produce both mechanical muscle contractions and chemical changes in the body. It has been used clinically for over 45 years to treat various musculoskeletal conditions through analgesia, muscle stimulation, and wound healing. The high voltage allows for deep tissue penetration without risk of tissue damage due to its low total current. Typical treatments last 30-40 minutes, 3 times per day.
This document discusses high frequency currents and their production and use in diathermy. It describes how high frequency currents are produced using thermionic valves like diodes and triodes to generate oscillations above 500,000 cycles per second. It then discusses how different types of diathermy, like shortwave and microwave, are produced using oscillators, resonator circuits, and for microwaves, a magnetron. The therapeutic effects of diathermy include increased blood flow and tissue heating, as well as its indications for pain relief and soft tissue injuries and contraindications.
1. A hydro-collator pack is a fabric envelope containing silica gel or bentonite crystal packs that are heated in a hydro-collator unit to provide moist heat therapy.
2. The hydro-collator unit maintains water at 70-80°C to heat the packs for 30-40 minutes of moist heat application.
3. When applied with adequate toweling insulation, hydro-collator packs provide penetrating heat therapy above 75°C without raising skin temperature excessively, helping to reduce pain, muscle spasm, and inflammation.
1) Galvanic current is a steady direct current that can have pulse durations between 1-300 ms, though 100 ms is most common, and requires 30 pulses per minute.
2) There are two types - constant galvanic current which moves in one direction at a constant strength, and modified galvanic current which is interrupted direct current.
3) Galvanic current can cause muscle contraction, stimulate sensory and motor nerves, and increase blood flow and skin redness. It is also used in cosmetics for skin cleansing and nourishing through iontophoresis.
Sinusoidal current produces a sine wave alternating current of 50 Hz, giving 100 pulses per second with durations of 10ms each, alternating direction 50 times in each direction. It is produced from mains power by reducing the voltage to 60-80v using a step down transformer. When passed through the body, sinusoidal current causes changes in ion concentrations at cell membranes, producing muscle contraction in nerves and ionic movement in other tissues. It is commonly used to cause rhythmic muscle contractions and relieve pain and reduce swelling by alternately changing cell membrane permeability. Indications include pain and pain/swelling, while contraindications include skin lesions, infections, and impaired sensation.
This document discusses interferential therapy (IFT), a type of electrical stimulation treatment. IFT involves applying two medium frequency currents to generate a low frequency interference current in the tissues for therapeutic effects. It provides pain relief and motor stimulation while avoiding skin irritation experienced with other currents. IFT is indicated for various painful conditions and edema and uses specific frequencies for different treatments, like 1-10Hz rhythmic mode for reducing swelling. Precautions include avoiding direct electrode contact and proper placement to ensure current passes through tissues as intended.
Russian current is a medium-frequency current delivered in bursts at 2500 Hz. It produces strong muscle contractions through synchronous motor nerve depolarization. Key characteristics include a carrier frequency of 2500 Hz, burst frequency of 50 Hz, burst duration of 10 ms, and a 10/50/10 training protocol. Russian current is indicated for muscle strengthening, reducing muscle spasm and edema, such as following knee ligament injuries or surgery.
Rebox electrotherapeutic method is based on non-invasive transcutaneous application of specific electric currents to a living tissue. Main indications for using the Rebox include treatment of acute and chronic pain, immobility, musculoskeletal and neurological disorders and oedema.
Contrast bath therapy involves soaking an injured area in alternating hot and cold water baths to increase blood flow and decrease stiffness and pain. The physiological mechanism is that it induces vasodilation and vasoconstriction through changes in water temperature, pumping edema from the injured area. The procedure involves soaking in warm water for 10 minutes, cold water for 1 minute, repeating warm water for 4 minutes and cold water for 1 minute, ending in warm water for 4 minutes for a total time of 25 minutes. Contrast baths can treat injuries like sprains, strains and bruises by removing edema through changes in blood flow. Certain precautions should be taken for conditions like open wounds, pregnancy and impaired sensation.
Dr. Shweta Panchbudhe provides a lesson on iontophoresis. The key points are:
1. Iontophoresis is the transfer of ions through the skin using direct current. Positively charged ions migrate to the negative electrode and vice versa.
2. Different ions can be used to treat various conditions like salicylate for pain, chlorine for softening scars, and acetic acid for calcium deposits.
3. Proper application involves cleaning the skin, placing moistened electrodes on the treatment area and indifferent site, and applying a mild current for 15 minutes.
Modified galvanic current, or interrupted direct current, is a type of electrical stimulation where a direct current is pulsed on and off at regular intervals. The document discusses how this current is produced using a source, transistors, and a timer circuit. It describes the physiological effects of interrupted direct current such as sensory stimulation, hyperemia, electrotonus, pain relief, and accelerated healing. The document also provides guidelines for administering interrupted direct current and lists contraindications.
Galvanic current is a low frequency, interrupted direct current with pulse durations over 1ms up to 300ms and frequencies under 50Hz. It was discovered in the 1780s by Luigi Galvani and can cause contraction of denervated muscles through sluggish contractions, stimulation of sensory nerves resulting in pain sensations, and stimulation of motor nerves at high intensities. Therapeutically, galvanic current is used to retard muscle atrophy and substitute for normal muscle contraction in denervated muscles by slowing structural and functional changes like loss of activity and fibrosis through electrical stimulation. It can also be used facially to reduce dullness, fine lines, wrinkles, and improve elasticity and oxygen supply.
Ultraviolet radiation covers a small part of the electromagnetic spectrum between visible light and X-rays. It is divided into UVA, UVB, and UVC based on wavelength. UV is produced by mercury vapor lamps and fluorescent lamps and can cause both immediate and long term effects on skin like erythema, pigmentation, vitamin D production, and skin cancer. The dosage of UV exposure depends on the lamp output, distance from the skin, exposure time, and individual skin sensitivity. UV therapy is used to treat conditions like psoriasis, acne, and eczema.
This document provides information about faradic current, including its nature, therapeutic and physiological effects, techniques of application, indications, contraindications, and clinical applications. It describes faradic current as an asymmetrical alternating current with a pulse duration of 0.1-1 ms and frequency of 30-100 Hz. The document discusses the effects of faradic current such as stimulation of sensory and motor nerves and reduction of swelling and pain. It outlines various methods and techniques of faradic current application for diagnostic and therapeutic purposes, as well as precautions and potential dangers of its use.
The document discusses strength duration curves, which plot the electrical stimuli needed to elicit a muscle contraction over a range of stimulus durations. It describes how to perform the test and interpret the results, including details on:
- Plotting S-D curves after 20 days post-injury to assess innervation status
- The typical shape of normal, denervated, and partially denervated curves
- Additional metrics that can be measured from S-D curves like rheobase and chronaxie
- Factors that can influence the curves and what different curve patterns indicate
This document discusses whirlpool bath therapy. It describes how whirlpool baths combine water temperature and mechanical stimulation from jets of water or air to provide therapeutic benefits. Different types of whirlpool baths are used for specific body parts or full immersion. Benefits include pain relief, relaxation of muscles, improved circulation, and preparation for other treatments. Proper technique and monitoring for safety is important when using whirlpool baths.
This document discusses T.E.N.S. (Transcutaneous Electrical Nerve Stimulation), a non-invasive pain management technique. It stimulates nerves under the skin to reduce pain signals according to the gate control theory. T.E.N.S. has efficacy rates of 50-80% for controlling chronic and acute pain, such as post-surgical or injury pain. Different T.E.N.S. techniques like high frequency, low frequency, and brief intense stimulation are described along with their parameters and applications. Placement of electrodes and contraindications are also covered.
Interrupted direct current (IDC) involves delivering unidirectional current pulses separated by intervals of no current. The pulses can have different durations, frequencies, rise/fall times, and waveforms (rectangular, trapezoidal, triangular, sawtooth). IDC is used therapeutically for sensory stimulation, pain relief, accelerating healing, and muscle stimulation. It works on nerves and muscles depending on pulse duration and intensity. Techniques like labile and group stimulation are used to target all muscle fibers. IDC has physiological effects like hyperaemia and contraindications like metal implants or risk of injury.
The document discusses electrotherapy and faradic current. Faradic current is a type of pulsed current used in electrotherapy, with pulse durations between 0.1-1 msec and frequencies of 50-100 Hz. It stimulates motor nerves, causing contraction of muscles supplied by the nerve. Faradic current is used to facilitate muscle contraction inhibited by pain, for muscle re-education after injury or disuse, and to prevent or loosen adhesions after injury. The document outlines the physiological effects and proper application of faradic current, including identifying motor points and using small electrodes over muscles.
This document discusses the basic physics and parameters of electrical currents used in electrotherapy. It explains that electrical currents are carried by the movement of electrons and ions through conductive materials. The key parameters that determine a current's physiological effects are its waveform, amplitude, pulse duration, frequency, and modulation. Sinusoidal, rectangular, and triangular waveforms are described. Currents can cause muscle contraction, alter tissue healing, and relieve pain by interacting with nerves and tissue on the segmental, systemic and cellular levels. The type of response depends on the current parameters and tissue stimulated.
Electric muscle stimulation physiotherapy.pptxRexSenior
Electrical muscle stimulation (EMS) uses electrical currents to cause muscle contractions and strengthen weak muscles. Different types of currents such as faradic and galvanic are used depending on if the muscle is innervated or denervated. A strength duration curve shows the relationship between stimulus magnitude and duration, and can indicate the state of a nerve lesion by its shape. Parameters like frequency, pulse duration, and amplitude must be set properly for safe and effective EMS treatment.
Diadynamic currents, High Voltage Galvanic Stimulation, Micro current, Träber...Sreeraj S R
This document discusses several types of low-frequency electrical stimulation techniques including diadynamic currents, high voltage pulsed galvanic stimulation, microcurrent, and Trabert current. It provides details on the waveform characteristics, physiological effects, indications, contraindications and application parameters for each technique. Diadynamic currents have five classic types that use rectified alternating current to produce monophasic pulses. High voltage galvanic stimulation uses twin peak monophasic pulses of short duration and low duty cycle. Microcurrent uses even lower intensities in the microampere range to stimulate tissue healing. Trabert current is a direct current with a 2 ms pulse and 5 ms interval, producing a frequency of around 143 Hz.
Faradic current is a short duration, interrupted electrical current used for muscle stimulation. It produces asymmetrical, biphasic waveforms. Faradic currents are surged to produce near-normal tetanic muscle contractions and relaxations. They are produced via a circuit consisting of two parallel triode valves. Faradic currents stimulate motor nerves to cause muscle contraction if the intensity is high enough. They are used diagnostically and therapeutically for conditions like muscle weakness and nerve damage. Proper application and parameters are important to achieve benefits while avoiding dangers like burns.
- The strength-duration curve is a graph that plots the electrical stimulus intensity against the time needed to elicit a muscle contraction. It can determine if a muscle is innervated, denervated, or partially denervated.
- The curve is generated by applying electrical stimuli of varying durations (0.01-300ms) to a muscle and recording the intensity needed to produce a minimal contraction. The shape of the curve indicates the muscle's innervation status.
- A normal curve will have all longer duration stimuli producing a response at the same intensity, while shorter durations require more intensity. Complete denervation results in a steeply rising curve requiring more intensity for all shorter durations. Partial denervation produces
Low frequency stimulation advanced applicationsSreeraj S R
Some of the advanced low-frequency currents like Diadynamic currents, Träbert Current, High Voltage Galvanic Stimulation, Microcurrent are discussed here.
Different types of low frequency currents.pdfeyobkaseye
Electrotherapy uses low-frequency electric currents to stimulate the peripheral nervous system and control pain or cause muscle contraction. There are three main types of currents used: direct current, alternating current, and pulsed current. Direct current flows in one direction, alternating current changes direction continuously, and pulsed current consists of short bursts of current separated by intervals. The effects of electric currents depend on their characteristics like amplitude, frequency, pulse width, and rate of rise. Lower amplitudes preferentially stimulate sensory nerves while higher amplitudes can recruit motor nerves and cause muscle contraction or pain. Short pulse widths allow selective stimulation of motor and sensory fibers.
Interferential therapy (IFT) is a transcutaneous electrical nerve stimulation technique developed in the 1950s. It involves applying two medium frequency alternating currents (usually around 4000 Hz) through the skin that interfere with each other to generate a low frequency amplitude modulated current for therapeutic purposes. This provides deeper penetration than a single current while being more comfortable than low frequency currents. The interference produces a rotating vector that varies the stimulation frequency, preventing nerve accommodation. IFT is used to relieve pain, stimulate muscles, increase local blood flow, and reduce edema.
Electrotherapy uses electricity as the primary energy source to treat various diseases and disorders through non-surgical means. It involves applying electrical forces to the body to produce physiological changes for therapeutic purposes. Electrotherapy includes low, medium, and high frequency currents, as well as phototherapy, electrodiagnosis, and biofeedback. Low frequency currents below 1000 cycles per second are primarily used to stimulate nerves and muscles, while medium frequencies between 1000-10,000 cycles per second deeply stimulate muscles and nerves for muscle re-education. High frequencies above 10,000 cycles per second produce deep heat in tissues.
The document discusses various electrical stimulation modalities used for pain relief including TENS, interferential current, NMES, and iontophoresis. It describes the principles, physiological effects, indications, contraindications, and application parameters for each modality. Commonly used waveforms such as monophasic, biphasic, and Russian are also explained.
The document discusses shockwave therapy for musculoskeletal injuries in horses. It provides an overview of shockwave therapy including the mechanism of action, various generators used, and clinical applications for conditions like tendonitis, osteoarthritis, and fractures. Several research studies on shockwave therapy are also summarized that showed improvements in lameness, range of motion, and force plate measurements for conditions like stifle lameness and hip osteoarthritis in dogs receiving shockwave therapy.
Introduction to Electrotherapy in Physiotherapy ProfessionPriyanka Pundir
Electrotherapy uses electrical energy for therapeutic purposes and can be classified in several ways. It includes low-frequency currents used to stimulate nerves and muscles, medium-frequency currents used for muscle re-education and pain relief, and high-frequency currents used to produce deep heat in tissues. Other areas of study are phototherapy for pain relief and healing using light, electrodiagnosis for studying electrical muscle and nerve reactions diagnostically, and biofeedback to provide voluntary control over bodily functions. Electrotherapy is an important treatment approach in physiotherapy using various electrical modalities.
This document discusses interferential therapy (IFT), including its history, principles, instrumentation, applications, effects, and precautions. Some key points:
- IFT was developed in the 1950s and involves applying two medium frequency alternating currents slightly out of phase to produce a low frequency effect for therapeutic purposes.
- The interference of the currents produces an amplitude-modulated frequency that can stimulate tissues in a manner similar to low frequency electrotherapy.
- IFT is used for pain relief, muscle stimulation, increasing blood flow, and reducing edema through its physiological effects on tissues from 10-150 Hz.
- Proper electrode placement and current parameters are important to achieve the intended effects while avoiding contraindic
This study was carried out to determine whether EMG noise causes an error in heart rate measurement when using a household heart rate monitor. The Sportline S7 heart rate monitor watch was the device used to determine the effects. Our null hypothesis is that the EMG noise will not cause a significant difference in the heart rate measurements. Our alternative hypothesis is that the EMG noise will significantly increase the heart rate measurements.
1) Interferential therapy involves applying two alternating medium-frequency currents that intersect in the body tissue to produce an interference beat frequency current for therapeutic purposes.
2) The beat frequency current can stimulate different tissues at different frequencies - nerves at 1-150Hz, muscles at 1-100Hz, increasing blood flow at 10-25Hz, and reducing edema at 1-10Hz.
3) Indications for interferential therapy include relief of chronic pain, absorption of exudates, and stress incontinence. General contraindications include pacemakers, malignancy, and infections. Local contraindications include open wounds and metal in the skin.
This document discusses different types of wave forms used in electrical stimulation. It describes wave forms as the graphical representation of direction, shape, amplitude, and pulse of a current. It discusses different characteristics of wave forms including whether they are mono- or bi-phasic, their shape (such as sine, rectangular, triangular), amplitude, frequency, duration, and different methods of current modulation (continuous, interrupted, burst, ramping). The document also classifies currents based on direction of flow, frequency, voltage, and amperage. It provides details on specific types of currents including interrupted direct current, faradic type currents, and modified faradic currents.
This document provides a history of electrical stimulation and its applications from 420 BC to present day. It discusses key developments in electrical stimulation including the discovery of motor points in 1850 and the first use of functional electrical stimulation to restore movement in 1961. It also summarizes different types of electrical stimulators, how electrical stimulation works at a cellular level, and its various clinical applications for conditions like pain, edema, muscle strengthening and more. Application parameters are provided for different treatment types. Risks, contraindications and other considerations for safe electrical stimulation are also outlined.
Physiotherapy in Wound Healing; Role of ElectrotherapySreeraj S R
1. The document discusses wound healing and the normal phases of wound repair including hemostasis, inflammatory, proliferation and maturation phases. It also discusses factors that can affect wound healing such as infection, poor hygiene, and smoking.
2. Various high frequency modalities used to promote wound healing are discussed including ultrasound, which can stimulate fibroblasts and accelerate wound contraction, and pulsed shortwave therapy. Electrical stimulation modalities and their effects on wound healing through mechanisms like increased blood flow and angiogenesis are also covered.
3. Guidelines for application and dosimetry of different modalities like ultrasound, pulsed shortwave therapy and high voltage pulsed current are provided. Electrotaxis, the directional movement of cells in
Russian Current / Burst Mode Alternating Current (BMAC)Sreeraj S R
Russian current is a type of alternating current that is burst modulated at low frequencies to stimulate nerves and cause muscle contraction. It consists of 2.5 kHz sinusoidal AC applied in 10 ms bursts separated by 10 ms intervals, modulated at 50 Hz. This causes tetanic muscle contraction through depolarization of fast motor neurons. Russian current is used to strengthen muscles in healthy athletes and patients, reduce edema, and decrease muscle spasm through once daily 10 minute treatments over weeks or months. Care must be taken with pregnant individuals or those with implants or impaired sensation.
Therapeutic Heat: Contraindications and PrecautionsSreeraj S R
This document outlines various contraindications for the use of heat therapy. It discusses conditions where heat therapy should be avoided such as impaired sensation, acute injury/inflammation, hemorrhagic conditions, impaired circulation, malignancy, infection, DVT, pregnancy, skin diseases, cardiac failure, metal implants, recently radiated tissues, reproductive organs, eyes, obesity, improper positioning, heat intolerance, certain medications, and provides tips for safe practice. Absolute contraindications are where heat could cause severe damage, while relative contraindications mean caution is needed if benefits outweigh risks.
Therapeutic Heat: Physiological & Therapeutic EffectsSreeraj S R
Therapeutic heat can be delivered superficially using modalities like hot packs, paraffin wax baths, heating pads, fluidotherapy, hydrotherapy, and contrast baths. Deeper heating is achieved through ultrasound, shortwave diathermy, and microwave diathermy. Physiological effects of heat include vasodilation, increased tissue extensibility, reduced muscle spasm and strength initially, and increased metabolic rate and oxygen availability. Precautions must be taken with certain conditions like ischemia, impaired sensation, malignancy, or acute trauma/inflammation.
Morality and Ethics in Physiotherapy ProfessionSreeraj S R
As health care is considered divine and moral activity, physiotherapy professionals too are held to moral standards with expectations of ethical conduct.
Introduction to Physiotherapy and ElectrotherapySreeraj S R
Physiotherapy involves treating and preventing disease through physical means like exercise, heat, electricity and massage rather than drugs or surgery. Physiotherapists examine patients to diagnose issues, develop treatment plans, and provide independent or team-based care. They are subject to ethical guidelines like respecting patient rights and providing competent services. Electrotherapy is a type of physiotherapy that uses electrical currents, including techniques like TENS, IFT and Russian stimulation to treat patients.
Ultraviolet radiation has wavelengths between 400-100 nm. It can be divided into UVA, UVB, and UVC. UV is produced by mercury vapor lamps and fluorescent lamps and can cause both acute and chronic physiological effects. It is used therapeutically to treat conditions like psoriasis, acne, eczema, and vitiligo. Precise dosages must be calculated and increased gradually based on the individual's skin type and response to avoid overexposure and potential negative effects of UV radiation.
1. A hydro-collator pack is a fabric envelope containing silica gel or bentonite crystal packs that are heated in a hydro-collator unit between 70-80°C and provide moist heat for 30-40 minutes.
2. The packs come in various sizes and shapes and are wrapped in towels or blankets before being applied to patients to provide insulation and prevent skin burns.
3. Hydro-collator packs are easy to apply and provide uniform moist heat therapy, but risks include skin burns or rashes if not properly applied or monitored.
Thermal Agents PHYSICAL PRINCIPLES_SRS.pptSreeraj S R
This document discusses physical thermal agents and the principles of heat transfer. It covers the following key points in 3 sentences:
Matter can exist in solid, liquid, or gas states depending on the balance between cohesive and kinetic forces. Heat is transferred between materials via conduction, convection, conversion, radiation, or evaporation. The rate of heat transfer and temperature change depends on factors like an object's specific heat, thermal conductivity, circulation of transferring medium, radiation intensity, and distance from the heat source.
This document provides an overview of assessing the elbow, including:
1) Descriptions of the elbow joint anatomy and common injuries or complaints.
2) Details on subjective and objective examination techniques like inspection, palpation, range of motion testing, special tests, and neurological assessment.
3) Explanations of specific tests for common conditions like tennis elbow, golfer's elbow, ulnar nerve entrapment, and ligament injuries.
Musculoskeletal Physiotherapy Management in PoliomyelitisSreeraj S R
This document discusses the physiotherapy management of poliomyelitis. It begins by describing the virus, pathology, and stages of the disease. It then details the examination and treatment approaches for each stage. Treatment involves relieving pain, preventing contractures through proper positioning, assisted exercises, and splinting as needed. The goal is to aid recovery and minimize residual paralysis through ongoing physiotherapy.
Orthopedic Surgeries and Physiotherapy in Cerebral PalsySreeraj S R
This document discusses orthopaedic surgeries and physiotherapy for cerebral palsy, focusing on spine/scoliosis, hips, knees, and lower legs. For scoliosis, conservative treatments include bracing and physical therapy while surgical treatment is posterior spinal fusion. For hips, soft tissue releases and osteotomies are used to treat subluxation/dislocation, while contractures may be treated with botulinum toxin or soft tissue lengthening. Knee flexion contractures are treated first with stretching and bracing but may require hamstring lengthening, capsulotomy, or femoral osteotomy. Post-operative rehabilitation focuses on range of motion, stretching, strengthening, and functional training.
Physiotherapy Management in Cerebral PalsySreeraj S R
Cerebral palsy is a group of disorders that affect movement and posture, caused by damage to the developing brain either before, during, or after birth. Common causes include infections, trauma, prematurity, or genetic disorders. Cerebral palsy is classified based on the type of movement impairment (spastic, dyskinetic, ataxic, or mixed) and severity (mild, moderate, severe). Treatment focuses on managing symptoms like spasticity and contractures through medications, physical therapy, orthotics, and surgery. The goal is to improve mobility and function while preventing further complications.
Professional Practice and Ethics for PhysiotherapistsSreeraj S R
The document discusses professional practice and ethics for physiotherapists in India. It outlines key laws and regulations related to physiotherapy, including the Clinical Establishment Act, POSCO Act on child sexual abuse, rules on biomedical waste management, and laws on sexual harassment and consumer protection. The document also discusses ethical responsibilities of physiotherapists, principles of ethics in research and teaching, and important professional bodies like the World Physiotherapy organization.
Roles and Characteristics of PhysiotherapistsSreeraj S R
This document outlines the various roles and responsibilities of physical therapists. It discusses that physical therapists should have skills in communication, teamwork, problem-solving, and establishing relationships with patients. The primary role of a physical therapist is to provide direct patient care to improve movement and function through treatment, rehabilitation, and health promotion. Physical therapists work at various levels of care from primary to tertiary and employ a patient management model involving examination, evaluation, diagnosis, intervention, and outcomes assessment. They may also take on roles as consultants, educators, administrators, managers, and critical inquirers applying scientific research to practice.
Bone tumours can be benign or malignant. Benign tumours include osteoid osteoma, osteoma, and haemangioma which typically have well-defined borders and do not metastasize. Malignant tumours such as multiple myeloma, Ewing sarcoma and osteosarcoma are poorly defined, invasive and can metastasize. Treatment depends on the type and severity of the tumour and may include surgery, chemotherapy, radiation therapy or palliative care. Physiotherapy can aid in pain relief, improving function and mobility, and maintaining quality of life for patients with bone tumours.
Physiotherapy Management in Peripheral nerve & Plexus injuriesSreeraj S R
1. The document discusses various aspects of peripheral nerve anatomy and injury. It describes the formation and branches of the major plexuses from spinal nerves and classifies peripheral nerve injuries.
2. Mechanisms of nerve injury including compression, ischemia, traction and friction are outlined. The process of nerve degeneration and regeneration after injury is explained.
3. Methods for assessing peripheral nerve injuries are provided, including history taking, physical examination techniques, and electrodiagnostic studies. Specific peripheral nerves like the radial and ulnar nerves are used as examples.
Physiotherapy for ankle & foot deformitiesSreeraj S R
This document provides information about various foot conditions including pes cavus, pes planus, and their treatment. It defines pes cavus as a foot with an abnormally high arch. Pes planus is defined as flat foot where the arch is lost. Flexible flat foot has an arch when not weight bearing but it disappears with weight bearing. Rigid flat foot lacks an arch with or without weight bearing. Conservative treatments for flexible pes planus include orthotics and exercises while rigid pes planus may require surgery if causing symptoms. Surgical options are also discussed for treatment of pes cavus and rigid pes planus.
Musculoskeletal physiotherapy management in poliomyelitisSreeraj S R
This document discusses the physiotherapy management of poliomyelitis. It begins by describing the stages and symptoms of polio. It then outlines the treatment approaches, including relief of pain and spasms during the acute phase, prevention of contractures, exercises to improve strength, and use of braces. Surgery may be needed to address deformities, followed by postsurgical physiotherapy focusing on range of motion, strengthening, and retraining movements. The overall goal of physiotherapy is to aid recovery and maximize function for people affected by polio.
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Exploring Alternatives- Why Laparoscopy Isn't Always Best for Hydrosalpinx.pptxFFragrant
Not all women with hydrosalpinx should choose laparoscopy. Natural medicine Fuyan Pill can also be a nice option for patients, especially when they have fertility needs.
Hemodialysis: Chapter 8, Complications During Hemodialysis, Part 3 - Dr.GawadNephroTube - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/pCU7Plqbo-E
- Video recording of this lecture in Arabic language: https://youtu.be/kbDs1uaeyyo
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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JMML is a rare cancer of blood that affects young children. There is a sustained abnormal and excessive production of myeloid progenitors and monocytes.
Causes Of Tooth Loss
PERIODONTAL PROBLEMS ( PERIODONTITIS, GINIGIVITIS)
Systemic Causes Of Tooth Loss
1. Diabetes Mellitus
2. Female Sexual Hormones Condition
3. Hyperpituitarism
4. Hyperthyroidism
5. Primary Hyperparathyroidism
6. Osteoporosis
7. Hypophosphatasia
8. Hypophosphatemia
Causes Of Tooth Loss
CARIES/ TOOTH DECAY
Causes Of Tooth Loss
CAUSES OF TOOTH LOSS
Consequence of tooth loss
Anatomic
Loss of ridge volume both height and width
Bone loss :
mandible > maxilla
Posteriorly > anteriorly
Anatomic consequences
Broader mandibular arch with constricting maxilary arch
Attached gingiva is replaced with less keratinised oral mucosa which is more readily traumatized.
Anatomic consequences
Tipping of the adjacent teeth
Supraeruption of the teeth
Traumatic occlusion
Premature occlusal contact
Anatomic Consequences
Anatomic Consequences
Physiologic consequences
Physiologic Consequences
Decreased lip support
Decreased lower facial height
Physiologic Consequences
Physiologic consequences
Education of Patient
Diagnosis, Treatment Planning, Design, Treatment, Sequencing, and Mouth Preparation
Support for Distal Extension Denture Bases
Establishment and Verification of Occlusal Relations and Tooth Arrangements
Initial Placement Procedures
Periodic Recall
Education of Patient
Informing a patient about a health matter to
secure informed consent.
Patient education should begin at the initial
contact with the patient and should continue throughout treatment.
The dentist and the patient share responsibility for the ultimate success of a removable partial denture.
This educational procedure is especially important when the treatment plan and prognosis are discussed with the patient.
Diagnosis, Treatment Planning, Design, Treatment, Sequencing, and Mouth Preparation
Begin with thorough medical and dental histories.
The complete oral examination must include both clinical and radiographic interpretation of:
caries
the condition of existing restorations
periodontal conditions
responses of teeth (especially abutment teeth) and residual ridges to previous stress
The vitality of remaining teeth
Continued…..
Occlusal plan evaluation
Arch form
Evaluation of Occlusal relationship through mounting the diagnostic cast
The dental cast surveyor is an absolute necessity in which patients are being treated with removable partial dentures.
Mouth preparations, in the appropriate sequence, should be oriented toward the goal of
providing adequate support, stability,
retention, and
a harmonious occlusion for the partial denture.
Support for Distal Extension Denture Bases
A base made to fit the anatomic ridge form does not provide adequate support under occlusal loading.
The base may be made to fit the form of the ridge when under function.
Support for Distal Extension Denture Bases
This provides support
Case presentation of a 14-year-old female presenting as unilateral breast enlargement and found to have a giant breast lipoma. The tumour was successfully excised with the result that the presumed unilateral breast enlargement reverting back to normal. A review of management including a photo of the removed Giant Lipoma is presented.
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Sfaturi practice pentru o alimentație sănătoasă:
Rețete delicioase și ușor de preparat: Bucură-te de preparate gustoase și nutritive, perfecte pentru zilele călduroase de vară.
Recomandări pentru o alimentație echilibrată: Asigură-ți aportul necesar de nutrienți esențiali pentru un organism sănătos și plin de vitalitate.
Sfaturi pentru alegeri alimentare inteligente: Învață cum să faci cumpărături sănătoase și să eviți tentațiile nesănătoase.
Trucuri pentru un stil de viață activ:
Rutine de exerciții fizice adaptate nevoilor tale: Găsește antrenamente potrivite pentru a te menține în formă și energic pe tot parcursul verii.
Idei de activități în aer liber: Descoperă modalități distractive de a te bucura de vremea frumoasă și de a petrece timp de calitate cu cei dragi.
Sfaturi pentru un somn odihnitor: Asigură-ți un somn profund și reparator pentru a te trezi revigorat și pregătit pentru o nouă zi.
Sfaturi pentru o stare de bine mentală:
Tehnici de relaxare și gestionare a stresului: Învață cum să te relaxezi și să faci față provocărilor zilnice cu mai multă ușurință.
Sfaturi pentru cultivarea optimismului și a gândirii pozitive: Descoperă cum să abordezi viața cu o perspectivă optimistă și să atragi mai multă bucurie în ea.
Recomandări pentru a te conecta cu natura: Bucură-te de beneficiile naturii asupra stării tale mentale și emoționale.
Bonus:
Oferte exclusive la produsele Life Care: Beneficiază de reduceri și promoții speciale la o gamă largă de produse pentru o viață sănătoasă.
Concursuri și premii: Participă la concursuri distractive și câștigă premii valoroase.
Jurnalul Fericirii Life Care - Iulie 2024 este mai mult decât o simplă revistă. Este un ghid complet și personalizat pentru a te ajuta să obții o viață mai sănătoasă, mai fericită și mai plină de satisfacții.
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POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptxsouravpaul769171
Theoretically, gene therapy is the permanent solution for genetic diseases. But it has several complexities. At its current stage, it is not accessible to most people due to its huge cost. A breakthrough may come anytime and a day may come when almost every disease will have a gene therapy Gene therapy have the potential to revolutionize the practice of medicine.
Coronary Circulation and Ischemic Heart Disease_AntiCopy.pdfMedicoseAcademics
In this lecture, we delve into the intricate anatomy and physiology of the coronary blood supply, a crucial aspect of cardiac function. We begin by examining the physiological anatomy of the coronary arteries, which lie on the heart's surface and penetrate the cardiac muscle mass to supply essential nutrients. Notably, only the innermost layer of the endocardial surface receives direct nourishment from the blood within the cardiac chambers.
We then explore the specifics of coronary circulation, including the dynamics of blood flow at rest and during strenuous activity. The impact of cardiac muscle compression on coronary blood flow, particularly during systole and diastole, is discussed, highlighting why this phenomenon is more pronounced in the left ventricle than the right.
Regulation of coronary circulation is a complex process influenced by autonomic and local metabolic factors. We discuss the roles of sympathetic and parasympathetic nerves, emphasizing the dominance of local metabolic factors such as hypoxia and adenosine in coronary vasodilation. Concepts like autoregulation, active hyperemia, and reactive hyperemia are explained to illustrate how the heart adjusts blood flow to meet varying oxygen demands.
Ischemic heart disease is a major focus, with an exploration of acute coronary artery occlusion, myocardial infarction, and subsequent physiological changes. The lecture covers the progression from acute occlusion to infarction, the body's compensatory mechanisms, and the potential complications leading to death, such as cardiac failure, pulmonary edema, fibrillation, and cardiac rupture.
We also examine coronary steal syndrome, a condition where increased cardiac activity diverts blood flow away from ischemic areas, exacerbating the condition. The long-term impact of myocardial infarction on cardiac reserve is discussed, showing how the heart's capacity to handle increased workloads is significantly reduced.
Angina pectoris, a common manifestation of ischemic heart disease, is analyzed in terms of its causes, presentation, and referred pain patterns. We identify factors that exacerbate anginal pain and discuss both medical and surgical treatment options.
Finally, the lecture includes a case study to apply theoretical knowledge to a practical scenario, helping students understand the real-world implications of coronary circulation and ischemic heart disease. The role of biochemical factors in cardiac pain and the interpretation of ECG changes in myocardial infarction are also covered.
Hemodialysis: Chapter 8, Complications During Hemodialysis, Part 2 - Dr.GawadNephroTube - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/FHV_jNJUt3Y
- Video recording of this lecture in Arabic language: https://youtu.be/D5kYfTMFA8E
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Hepatocarcinoma today between guidelines and medical therapy. The role of sur...Gian Luca Grazi
Today more than ever, hepatocellular carcinoma therapy is experiencing profound and substantial changes.
The association atezolizumab (ATEZO) plus bevacizumab (BEVA) has demonstrated its effectiveness in the post-operative treatment of patients, improving the results that can be achieved with liver resections. This after the failure of the use of sorafenib in the already historic STORM study.
On the other hand, the prognostic classification of BCLC is now widely questioned. It is now well recognized that the indications for surgery for patients with hepatocellular carcinoma are certainly narrow in BCLC and no longer reflect what is common everyday clinical practice.
Today, the concept of multiparametric therapeutic hierarchy, which makes the management of patients with hepatocellular carcinoma much more flexible and allows the best therapy for the individual patient to be identified based on their clinical characteristics, is gaining more and more importance.
The presentation traces these profound changes that are taking place in recent years and offers a modern vision of the management of patients with hepatocellular carcinoma.
EXPERIMENTAL STUDY DESIGN- RANDOMIZED CONTROLLED TRIALRishank Shahi
Randomized controlled clinical trial is a prospective experimental study.
It essentially involves comparing the outcomes in two groups of patients treated with a test treatment and a control treatment, both groups are followed over the same period of time. Prepare a plan of study or protocol
a. Define clear objectives
b. State the inclusion and exclusion criteria of case
c. Determine the sample size, place and period of study
d. Design of trial (single blind, double blind and triple blind method)
2. Define study population: Most often the patients are chosen from hospital or from the community. For example, for a study for comparison of home and sanatorium treatment, open cases of tuberculosis may be chosen.
3. Selection of participants by defined criteria as per plan:
Selection of participants should be done with precision and should be precisely stated in writing so that it can be replicated by others. For example, out of open cases of tuberculosis those who fulfill criteria for inclusion may be selected (age groups, severity of disease and treatment taken or not, etc.)
Randomization ensures that participants have an equal chance to be assigned to one of two or more groups:
One group gets the most widely accepted treatment (standard treatment/ gold standard)
The other gets the new treatment being tested, which researchers hope and have reason to believe will be better than the standard treatment
Subject variation: First, there may be bias on the part of the participants, who may subjectively feel better or report improvement if they knew they were receiving a new form of treatment.
Observer bias: The investigator measuring the outcome of a therapeutic trial may be influenced if he knows beforehand the particular procedure or therapy to which the patient has been subjected.
Evaluation bias: There may be bias in evaluation - that is, the investigator(Analyzer) may subconsciously give a favorable report of the outcome of the trial.
Co-intervention:
participants use other therapy or change behavior
Study staff, medical providers, family or friends treat participants differently.
Biased outcome ascertainment:
participants may report symptoms or outcomes differently or physicians
Investigators may elicit symptoms or outcomes differently
A technique used to prevent selection bias by concealing the allocation sequence from those assigning participants to intervention groups, until the moment of assignment.
Allocation concealment prevents researchers from influencing which participants are assigned to a given intervention group.
All clinical trials must be approved by Institutional Ethics Committee before initiation
It is mandatory to register clinical trials with Clinical Trials Registry of India
Informed consent from all study participants is mandatory.
A preclinical trial is a stage of research that begins before clinical trials, and during which important feasibility and drug safety data are collected.
Following points high.
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What is electrotherapy?
Medical therapy using electric currents. Also
called electrotherapeutics1.
Electrotherapy, also electro physical agents (EPA) are any
forms of treatment or assessment conducted using an electro
physical agent which can be applied externally to the human
body2.
http://www.thefreedictionary.com/electrotherapy
Robertson V, Ward A, Low J, Reed A. Electrotherapy Explained. 4th edition. Elsevier; 2006. p. 2
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History
Electric fish for the treatment of gout in Greek and Roman times.
By 1780, Luigi Galvani, an obstetrician and anatomist, University
of Bologna, first observed the quick twitching of the muscle,
produced by electricity in a nerve muscle preparation of the frog’s
leg.
As this type of electricity seemed quite distinct from electrostatic
currents derived from frictional machines it was called Galvanic
current.
In honour of Luigi Galvani, the use of direct current in medicine is
called Galvanism.
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Johann G Kruger, professor of Medicine at Halle, Germany,
published first book on medical electricity in 1743 entitled
‘Thoughts about the Electricity’.
Christian G Kratzenstein published in 1745, was the first to use
‘Medical Electricity’ in its title.
Richard Lovett of England, in 1756 treated numerous conditions
with static shocks and published treatise recommending
electrotherapy.
John Wesley, inspired by Richard Lovett published his own
experiences on the subject in 1759, in the book entitled ‘The
Desideratum’.
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History
In the early 1800s, Michael Faraday laid the groundwork for the
creation of alternating current (AC).
The medical use of such current is called Faradism.
The current was initially used for tightening and toning the
muscles.
In1965 Ronald Melzack and Patrick David Wall published their
paper “Pain Mechanism: A New Theory” which revealed the
benefits of electricity used as pain therapy to the people of
today.
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Types of Currents
Mainly three types of currents used therapeutically:
Direct current
Alternating current
Pulsed current.
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Direct Current
“Galvanic” can be used to
describe DC
Uninterrupted unidirectional
flow of electrons
Electrons travel from the
cathode to the anode
Example: Flashlight
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Alternating current
Bidirectional flow of electrons –
direction & magnitude of flow
reverses
magnitude may not be equal on both
sides of the baseline.
AC possesses no true positive or
negative pole.
Electrons shuffle back & forth between
the two electrodes as they take turn
being + ve & - ve.
Household electricity uses AC.
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Alternating Current
Amplitude: (peak value) – the maximal
distance to which the wave rises above
or below the baseline (only one side of
the baseline)
Peak-to-Peak Value: measured from
the peak on the (+) side of the line to
the peak on the (-) side of the line.
Cycle Duration: measured from the
originating point on the baseline to its
terminating point; the amount of time
required to complete one full cycle
Hertz: number of cycles per second (1
MHz = 1 million cycles/second)
Pattern – Sine Wave
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Pulsed Current
• Unidirectional or bi-directional
flow
• Usually 3 or more pulses grouped
together
• Pulses are interrupted
• 3 Types of Waveforms
• Monophasic
• Biphasic
• Polyphasic
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Pulse Attributes
A
B
C D
F
E
B
E
A : Amplitude
B : Phase Duration
C : Pulse Duration
D : Interpulse Interval
E : Pulse Period
F : Intrapulse Interval
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Wave forms
Rise and decay time
Rise time is the time taken by
pulse to reach maximum
amplitude in each phase.
Decay time is the time taken by
pulse to return to neutral
They are generally from ns to ms
The more rapid the rise in
amplitude the greater the nerve
tissue excitability.
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Types of LF Currents
Pure faradic current
Direct current:
Constant direct current
Interrupted direct current
Faradic Type of current
TENS
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Faradic Current
From Smart Bristow faradic coil
Sinusoidal current
First long duration low amplitude
High intensity short duration
waves
Not used now
Original
Modern
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Faradic type Current
Short duration interrupted direct current
Pulse duration 0.1 – 1 ms
Frequencies 50 – 100 Hz
Shorter duration used for stimulating innervated muscle
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Modified Faradic Current
Faradic currents are surged for
treatment purposes.
To produce a near normal tetanic
type of contraction and relaxation
The surges can be of various
Duration
Frequencies
Wave forms
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Modified Faradic Current
The intensity of the successive
impulses increases gradually.
Surges can be adjusted from 2 to
5-second surge, continuously or
by regularly selecting frequencies
from 6 to 30 surges / minute.
Rest period (pause duration)
should be at least 2 to 3 times that
of the pulse to give the muscle
enough time to recover its normal
state.
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Interrupted Direct Current
Interruption of unidirectional
currents
Frequency of up to 5 Hz.
The equipment commonly
provide duration of 0.01, 0.03,
0.1, 0.3, 1, 3, 10, 30, 100, 300
ms.
Longer duration used for
stimulating denervated muscle
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Physiological Effects
Effects on body tissues
Stimulation of sensory nerves
Stimulation of motor nerves
Increasing metabolism
Removal of waste products
Stimulation of denervated muscle
Chemical effects
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Physiological Effects
Effects on body tissues:
Tissues contain fluid, thus ions so are good conductors. ex. muscles
Epidermis has high resistance, thus is a bad conductor.
So some media like water or conductive gel used to lower resistance
Washing the area with soap and water lower resistance to some
extend.
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Physiological Effects
Stimulation of sensory nerves
Faradic current produces mild prickling sensation.
IDC results in a stabbing or burning sensation
ES produces slight erythema due to reflex vasodilatation.
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Physiological Effects
Stimulation of motor nerves
Faradic current produces a tetanic contraction because of higher
frequency rate.
So they are surged to avoid muscle fatigue.
Galvanic current produces a muscle twitch followed by
relaxation.
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Physiological Effects
Increasing metabolism and Removal of waste products
The contraction and relaxation of muscle causes pumping
action on blood vessels.
This results in increased supply of oxygen and nutrients
Also aids in lymphatic and venous drainage.
So removal of waste products
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Physiological Effects
Stimulation of denervated muscle
Impulses of more than 1 ms required for this.
Faradic current of more than 1 ms is not tolerable for the
patient.
IDC of sufficient intensity and duration is used for this.
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Physiological Effects
Chemical effects
Chemical effects are produced at the electrode site resulting in
chemical burns
This risk is more in DC
Using AC, depolarized DC and pulsing avoid this danger.
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Accommodation
When a constant current flows nerve adapts itself to the current.
Consequently the nerve no longer respond to the stimulus
This is accommodation.
A current rises or fall suddenly is more effective
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Effects of nerve stimulation
When a sensory nerve is stimulated
Downward impulse has no effect
Upward impulses appreciated when it reaches CNS.
Long duration impulses produce uncomfortable stabbing sensation
Short duration gives milder sensations
When motor nerve stimulated
Upward impulses do not pass
Downward impulses cause muscle contraction
Motor point causes maximum muscle stimulation
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Effects of frequency of stimulation
Increasing the frequency of stimuli shortens the period of
relaxation
Frequencies exceeding 20 Hz causes partial tetani,
Frequencies exceeding 60 Hz causes tetanic contraction
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Strength of contraction
Depends on :
The number of motor units activated
Intensity of current
Rate of change of current; slow rising currents causes
accommodation
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Indications
Facilitation of muscle contraction inhibited by pain
Muscle re-education
Training a new muscle action
Improvement of venous and lymphatic drainage
Prevention and loosening of adhesions
Nerve injury
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Indications
Facilitation of muscle contraction inhibited by pain
Pain has an inhibitory effect on anterior horn cells.
ES
1. reduces this inhibition
2. Facilitate transmission of voluntary impulses to the muscle and
3. Induce relaxation of its antagonists
The procedure should be pain free,
Otherwise this would inhibit the discharge from the AHC.
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Indications
Muscle re-education
Inability to contract a muscle can be due to:
Prolonged disuse
Incorrect use
Faradic stimulation may be used to restore the sense of
movement.
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Indications
Training a new muscle action
This could be in:
Tendon transplant
Reconstructive surgeries
Faradic type current is used for this
The patient is expected to assist with voluntary contraction
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Indications
Improvement of venous and lymphatic drainage
The contraction and relaxation of muscle causes pumping
action on blood vessels.
A faradism under pressure is used to treat edema
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Indications
Prevention and loosening of adhesions
Adhesions can be formed due to :
Long standing effusions.
improper muscle actions
Faradic stimulation and adequate exercise loosens, stretches
and prevent the adhesions.
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Indications
Nerve injury
Seddon’s Classification:
Neuropraxia: faradic current used to maintain the properties of
muscle
Axonotmesis: Short or Long duration current according to
diagnostic responce
Neurotmesis: start with faradic, but IDC after degeneration
Wallerian degeneration
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Contraindication
Someone with a pacemaker
Someone with a heart condition
On head or neck of someone with epilepsy
Someone with venous or arterial thrombosis or thrombophlebitis
Cardiac pacemakers.
Superficial metals.
Near operating diathermy device
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Contraindication
On the eyes
Using electrodes on infected skin
Electrodes across the chest of a patient with cardiac disease
Electrodes should not be placed near carotid artery in the anterolateral
region of the neck. There is a potential risk that stimulation at this site
might cause heart block by exciting the vagus nerve.
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Precautions
Areas of skin irritation, damage or lesions
Areas with impaired sensation
Over abdominal, lumbosacral or pelvic regions during pregnancy other
than for labor/delivery
Tissues vulnerable to hemorrhage or hematoma
Extreme caution is needed with patients taking narcotic medication or
who are known to have hyposensitive areas.
Incompetent patients may not be able to manage the device and it must
be kept out of reach of children.
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Recommended Textbooks
1. Electrotherapy explained, 4th edition, Low & Reed
2. Clayton’s Electotherapy, Theory and Practice. Angela Forster. 9th Ed.
3. Clayton’s electrotherapy, 10th edition, Sheila Kitchen
4. Textbook of Electrotherapy, Jagmohan Singh.
5. Physical Agents in Rehabilitation, From Research to Practice, Michelle H.
Cameron
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Recommended Reference Books
1. Biophysical Basis of Electrotherapy, Alex J Ward
2. Handbook of practical electrotherapy, Pushpal Kumar Mitra,
3. Electrotherapy : Evidence Based Practice, Tim Watson
4. Principles and Practice of Electrotherapy. Joseph Kahn.
5. Thermal Agents in Rehabilitation. Susan L. Michlovitz.
6. Therapeutic modalities for physical therapists by William E Prentice
7. Clinical Electrotherapy by Roger Nelson, Dean Currier
8. Modalities for Therapeutic Intervention: Contemporary Perspectives in
Rehabilitation by Susan Michlovitz, Thomas Nolan