Low frequency stimulation specialized techniques
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Transcript of Low frequency stimulation specialized techniques
Sreeraj S R
Low Frequency Stimulation
Specialized Techniques
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Faradic Foot Bath
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Bath Method
● Application of faradic current to the body parts in a
tub, tray or tank containing water is termed as bath
method of application
● Depending upon the placement of electrodes bath can be
● Bipolar : both electrodes are kept in the water
● Unipolar : one electrode kept in the water while the other electrode kept at any convenient part of the body
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Bath Method
Advantage of bath method are:● Skin resistance is lowered considerably by
prolonged soaking in water● Water makes perfect contact with the tissues● Wash of electrolytes formed under the electrodes
Disadvantages are: ● Current can not be localized● Superficial muscles contract more than deep
muscles due to the presence of water● Chances of electric shock is higher
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Faradic Foot Bath
● ES by faradic current may be applied in
baths.
● Can be used to stimulate
● Lumbricals
● Plantar interrossei
● Abductor hallucis
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Faradic Foot Bath
● Position the patient in high sitting with back well
supported
● Position the feet on a stool covered with a
plastic sheet
● Place the foot in a bath containing enough
warm water to cover the toes
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Faradic Foot Bath
To stimulate the
lumbricals place two
electrodes transversely,
● one under the heel
and the other
● under the metatarsal heads
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Faradic Foot Bath
To stimulate the
plantar interrossei
place one electrode
on each side of the
foot at the level of
metatarsal shafts
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Faradic Foot Bath
For Abductor hallucis
place ● one electrode under the heel and
● stimulate the muscle through the motor point using a pen electrode
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Faradic Foot Bath
● A surged faradic current is used for this
● Surge duration 1 sec.
● Surge interval 3 sec.
● Intensity : enough to produce a visible contraction of the muscles.
● Treatment time: 15 – 30 minutes
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Faradic Foot Bath
● Rectangular metal or carbon rubber electrodes of 3 X 7 cm can be used
● No lint pad or coupling medium required
● Encourage the patient to contract the muscle voluntarily with the current
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Faradism Under Pressure
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Faradism Under Pressure
● ES of muscle combined with compression and
elevation of the limb can be used to increase
venous and lymphatic drainage and so to
relieve edema.
● This technique is known as Faradism Under
Pressure
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Faradism Under Pressure
● Patient in supine position
● The limb is elevated above the heart level using
pillows
● The pressure bandage is applied over the electrode,
with maximum pressure distal to proximal
● The skin must be cleaned before treatment
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Faradism Under Pressure
Placement of electrode for lower limb:
● Active electrode place over the belly of the calf
muscle
● Passive electrode is placed over the sole of the foot
Placement of electrode for upper limb:
● Active electrode over the flexor aspect of forearm at
the junction of proximal 1/3 and distal 2/3 of the
muscle belly
● The passive electrode over the palm or cubital
fossa
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Faradism Under Pressure
● A surged faradic current is used for this
● Surge duration 3 sec.
● Surge interval 9 sec.
● Intensity : enough to produce a visible contraction of the muscles i.e. clenching of toes or fingers.
● Treatment time: 15 – 30 minutes
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Faradism Under Pressure
● Rectangular metal or carbon rubber electrodes of 3 X 5 cm. can be used
● Encourage the patient to do active movement along with the current and relax during surge interval
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Faradism Under Tension
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Faradism Under Tension
● Shortening of contractile soft tissues like muscles can
be treated with Faradism.
● Such contractures develop in major muscle groups like
quadriceps or elbow flexor group
● This is mostly after prolonged immobilization
● These conditions are passively mobilized which can be
very painful.
● Titanic contraction by the surged current gradually pulls
apart the shortened myofibrils with less pain.
● So this can be an effective adjunctive with passively
mobilization.
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Faradism Under Tension
● A surged faradic current is used for this
● Surge duration 3 sec.
● Surge interval 9 sec.
● Intensity : enough to produce a visible contraction of the
muscles.
● Treatment time: 15 – 30 minutes
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Faradism Under Tension
● Rectangular metal or carbon rubber electrodes of 5 X 10 cm can be used.
● Encourage the patient to do actively contract the muscle along with the current and relax during surge interval
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Faradism Under Tension
For quadriceps contracture:
● Patient is positioned on a plinth.
● A roll of towel or pillow is placed below the knee to give a stretch
● Passive electrode is placed over proximal 1/3 of the quadriceps
● Active electrode is placed on the junction of proximal 2/3 and distal 1/3 of the belly of the muscle
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Faradism Under Tension
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Faradism Under Tension
For elbow flexor contracture:
● Patient is positioned on a plinth.
● A roll is placed under the elbow just proximal to the joint.
● Passive electrode is placed over proximal 1/3 of the elbow flexor
● Active electrode is placed on distal 1/3 of the belly of the muscle
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ES to Pelvic Floor Muscles
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ES to Pelvic Floor Muscles
● ES can be used for reeducating these muscles.
● Indications are;
● Early cases of prolapse of pelvic organs
● Stress incontinence
● Incontinence following prostatectomy
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ES to Pelvic Floor Muscles
● Position the patient in side lying
● Keep a pillow between the lower legs
● Place a plastic sheet under the patient
● The indifferent electrode to the lumbosacral region
● Insert the Active vaginal or rectal electrode
● Sterilized lubrication jelly should be applied on vaginal
or rectal electrode
● A large button electrode can also be used over the
perinea region
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ES to Pelvic Floor Muscles
● A surged faradic current is used.
● Surge duration 1 sec.
● Surge interval 3 sec.
● The muscles of pelvic floor fatigue fast, so surge
duration should be short
● Intensity : enough to produce a visible contraction of the
muscles.
● Treatment time: 15 – 30 minutes
● Encourage the patient to actively contract the muscles
along with the current and relax during surge interval
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References
1. Foster A, Palastanga N. Clayton’s Electroptherapy Theory and
Practice. 9th edition. W B Saunders. 2006;pp 70 – 79
2. Mitra PK. Handbook of Practical Electrotherapy. Jaypee. 2006;
pp44 – 49
3. Khatri S. Basics of Electrotherapy. Jaypee. 2003. pp 28 - 30
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THANK YOU