4. Classification of frequencies
• Low frequency – 1 to 1000 Hz
When successive impulses are applied of
low frequency Range, large diameter myelinated
fibers respond by depolarizing at the same rate of
stimulus Frequency k/a Stimulus-synchronous
depolarization.
6.10-6.11 IFT 4
5. • Medium frequency – 1001 to 10,000 Hz
• Medium frequency currents cannot stimulate nerves and muscles in
its own frequency ,as the frequency is high and successive pulse
falls within the refractory period the nerve initiates AP at its own
rate. So, known as stimulus –asynchronous depolarization
6.10-6.11 IFT 5
6. • High frequency - more than 10,000
• Produces perceptible warming of the skin.
6.10-6.11 IFT 6
7. Skin Resistance
• Ohmic resistance –
• Related to electrode surface Area, dryness and thickness of skin,
skin oil and hair present.
• Reduced by washing the skin and increasing the electrode
surface area
• It doesn’t depend on frequency of current
6.10-6.11 IFT 7
8. • Capacitive resistance
• When electrical currents are applied to body ,ions accumulate at
surface
• This electrolytic polarization causes a potential difference between
the electrode and the tissue
• This counter voltage is known as Capacitive resistance
6.10-6.11 IFT 8
9. Z = f c/2
Where,Z= Capacitive resistance, f=frequency
c=capacitance
Frequency of current inc. – capacitive resistance dec.
6.10-6.11 IFT 9
10. NEED FOR IFC
• Difficulty with low frequency
• More intensity is needed which is not
tolerated by patient
• To overcome skin resistance
• To stimulate deeper tissue
6.10-6.11 IFT 10
11. •Benefits of medium frequency
current:
• Easy to overcome skin resistance
• Capacitive resistance is also reduced due to high frequency
6.10-6.11 IFT 11
12. • BUT……..
• Because of high number of cycles , the next pulse falls
within the refractory period of nerve impulse.
• So, it cannot stimulate the nerve at its own frequency.
6.10-6.11 IFT 12
13. WEDENSKY INHIBITION
• Every cycle of medium frequency current will not result in
depolarization of nerve as in low frequency current
• Continuous application of medium frequency current will
lead to inhibition of depolarization of nerve.
• EXPLAINATION-Long repolarisation & long relaxation.
No. stimuli are more so it will fall in successive period of
refractory period.
6.10-6.11 IFT 13
14. • Shows only in medium frequency not in low frequency.
• E.g Aβ fibers has max. Conduction velocity 120m/sec.
impulse delivered at 4000Hz – now there is no time for
nerve to depolarize—cause no sensation no numbness–
continuous application cause loss of excitation with
constant amplitude greater than 1000hz called as
wedensky inhibition.
6.10-6.11 IFT 14
15. GLIDEMEISTER’S EFFECT
• With medium frequency current ,the depolarization
frequency of nerve neither coincides with the frequency of
current nor with the depolarizing frequency of the other
nerve fibers in the nerve bundle .
6.10-6.11 IFT 15
16. • Depolarizing freq. – 150 Hz,, stimulus applied at 4000hz–
due to continuous application of current delayed
depolarization .
• So there will be no response on stimulus also surrounding
fibers will respond after sometime.
6.10-6.11 IFT 16
17. • 3.Need For Interference :
• By superimposing two
medium frequency currents,
we can produce a resultant
current in which the amplitude
varies in a rhythm.
6.10-6.11 IFT 17
18. • This rhythmical variation is
of low frequency in nature
and called BIO-ELECTRIC
RHYTHM which can
stimulate tissues.
• Both waves are same –
constructive interference &
different waves 0 or
destructive interference.
6.10-6.11 IFT 18
20. SUPERPOSITION THEORY
• “When two or more waves travel through the same
medium each wave acts on the every particle of the
medium as if the other wave is not existing, the resultant
displacement is obtained by adding vectorially the
displacement due to the individual waves”
• _ amplitudes of both waves add together
vectorially.
6.10-6.11 IFT 20
21. • The medium will have a displacement, that is the
sum of displacement of individual waves
• Ǿ1=displacement of wave 1
• Ǿ2=displacement of wave 2,
Total displacement will be Ǿ =Ǿ1 +Ǿ2
6.10-6.11 IFT 21
22. INTERFERENCE OF WAVES
• Combining of two or more waves by superposition is k/a
INTERFERENCE
6.10-6.11 IFT 22
23. • When two or more sinusoidal waves originate
exactly in phase from separate circuits, are said
to be coherent with respect to frequency and
amplitude
6.10-6.11 IFT 23
24. • When the waves are superposition , crests of wave one
add to crests of wave two to produce a resultant
combined wave.
6.10-6.11 IFT 24
25. CONSTRUCTIVE INTERFERENCE
• Reinforcement of amplitude by summation of Two sine
waves that are exactly in phase is called As constructive
interference.
6.10-6.11 IFT 25
26. • Maximum constructive interference occurs
whenever two sine waves are exactly in phase
or when one of the two waves is one or more
wavelengths out of phase. There will be
constructive interference, when the
difference is any whole number of wavelength
6.10-6.11 IFT 26
28. 6.10-6.11 IFT 28
•DESTRUCTIVE INTERFERENCE
• The upward alteration of one wave cancels the
downward alteration of the other wave resulting in the
destructive Interference
• The sum of the wave amplitude is zero.
29. PRODUCTION OF IFC
Two oscillators are used to produce medium frequency
currents.
They are made to interfere within tissues and resultant
wave with beat frequency is set up endogenously.
6.10-6.11 IFT 29
30. 6.10-6.11 IFT 30
• One oscillator will produce static frequency known as
• The other oscillator will produce a frequency which
have a constant difference in relation to the first
oscillator which is known as
31. 6.10-6.11 IFT 31
• EXAMPLE :
Carrier frequency in one oscillator – 4000 Hz
Frequency in other oscillator-4100 Hz
Beat frequency- 100 Hz
32. INTERFERENTIAL CURRENT
• When two medium frequency currents ,which are slightly
out of phase to each other are made to interfere with one
another in a medium, a resultant current is set up.
• The amplitude of that current is not uniform.
6.10-6.11 IFT 32
33. • At any point, amplitude for that resultant is the sum of
amplitudes of two currents. There is a rise and fall of the
amplitude, which is known as
6.10-6.11 IFT 33
34. BEAT FREQUENCY
• As there is a constructive and destructive interference
occurs there is rise and fall of amplitude…and this
amplitude variation will occur in frequency k/a Beat
frequency
• It is low frequency in nature and its pulse can trigger a
nerve impulse.
6.10-6.11 IFT 34
36. • The exact frequency of the resultant beat
frequency can be controlled by the input
frequencies. If for example, one current
was at 4000Hz and its companion current
at 3900Hz, the resultant beat frequency
would be at 100Hz, carried on a medium
frequency 3950Hz amplitude modulated
current.
6.10-6.11 IFT 36
38. CONSTANT BEAT FREQUENCY
• In this carrier frequency and base frequency are fixed.
• So beat frequency=base frequency- carrier frequency.
• Different selective beat frequency can be selected in
between 0 to 100 Hz.
• IFT devices allow selection of any constant beat
frequency.
6.10-6.11 IFT 38
39. • Disadvantage –
• 1)not desire for treatment – different excitable tissues has
different exciting frequency e.g ligament, tendon, fascia.
• 2) Accommodation.
6.10-6.11 IFT 39
40. VARIABLE BEAT FREQUENCY
• In this the second oscillator will produce a medium
frequency current which varies rhythmically between base
frequency and above the base frequency
• This results in a RHYTHMICAL VARIATION from the
base frequency to the highest frequency, known as
6.10-6.11 IFT 40
41. • Advantages of frequency modulation or sweep
1. Reduces habituation of treated tissues
2. Types of nerves of various size of diameter can be
treated
6.10-6.11 IFT 41
42. • The principle of using the sweep is that the
machine is set to automatically vary the
effective stimulation frequency using either
pre-set or user set sweep ranges.
• The sweep range employed should be
appropriate to the desired physiological
effects.
6.10-6.11 IFT 42
43. • The pattern of the sweep makes a
significant difference to the stimulation
received by the patient.
6.10-6.11 IFT 43
44. TYPES OF FREQUENCY MODULATION-
SWEEP
• Oscillations are maintained at the preset base
frequency for 1s and immediately it switches over to
the sweep frequency and it is retained there for another
one second. Again it will come back to the base
frequency and the cycle is repeated.
6.10-6.11 IFT 44
45. • For vigorous treatment purpose
• Aggressive form of treatment
• Chronic conditions
6.10-6.11 IFT 45
46. • Maintains base frequency for 5 sec and take one second to
climb to the sweep frequency
• It retains the sweep frequency for 5 sec and again swing
back to the base frequency in 1 sec
• milder form
• Sub acute conditions
6.10-6.11 IFT 46
47. • It moves upwards from base frequency to sweep
frequency for 6 sec.
• After reaching the highest frequency it swings
• back immediately..
• Mildest form
• Acute forms
6.10-6.11 IFT 47
49. 6.10-6.11 IFT 49
The diagram (figure B) illustrates the effect of setting a
90 – 130Hz rectangular sweep.
50. AMPLITUDE MODULATION
• In medium frequency current, each pulse
will not result in to depolarization of nerve
fibers.
• but depolarization of nerve fiber is the
result of the summation principle.
6.10-6.11 IFT 51
51. • This will leads to the condition in which
nerve fiber stops to react to the current as
the motor end plate may get fatigue& fails
to transmit any impulse.
6.10-6.11 IFT 52
52. • To prevent this. It is necessary to interrupt
the current after each depolarization.
• It is achieved by rhythmically increasing &
decreasing the current amplitude.
• It is known as AMPLITUDE MODULATION
6.10-6.11 IFT 53
53. MODULATION DEPTH
• It is expressed in % .
• Varies between 0 - 100% .
6.10-6.11 IFT 54
55. • In the homogenous medium, greatest span
of stimulation by IFT occurs in the direction
of vector which bisect the intersecting
current line extending between the two
electrodes.
• shape of this area is clover leaf,
• so known as clover leaf pattern.
6.10-6.11 IFT 56
57. • The direction will be at 45 degree angle to
the flow of current in the two circuit.
• In this direction, depth of modulation is
100% .
6.10-6.11 IFT 58
58. • When IFT is applied to the excitable tissue
in the static mode, volume of tissue
stimulated by current remains constant &
depends on tetrapolar electrodes
placement.
• Under tetrapolar placement there is
unmodulation, max. modulation in current is
in direction of 45˚ i.e. clover leaf pattern.
6.10-6.11 IFT 59
59. VECTORSYSTEM
• Vector system allows entire area between
4 electrodes to be treated with much
uniformity.
• Whole area can be scanned by altering the
current path by 45degree in one direction &
45degree in other direction.
• Rotation of clover leaf pattern -- ↑ area
of stimulation & ↑depth of stimulation.
6.10-6.11 IFT 60
60. • Vector system is also called
- scanning
- rotatory vector system
- dynamic IF field system
• Dynamic IF field occurs when IF field is
rotated by 45 degree to change the position
of stimulation area.
6.10-6.11 IFT 61
61. • Reciprocal scanning of IFC through an arc
of 45 or 90 degree allows the current to
perfuse through greater volume of tissue
than that occurs with static mode.
• Full field scanning produce similar effects
by bursting current over 2 circuits.
6.10-6.11 IFT 62
62. • Scanning effects can be achieved by slowly
varying the current intensity in circuit 1
between 50% to 100% of max. preset
amperage, while maintaining intensity in
circuit 2 at 75% of max. current in circuit1.
6.10-6.11 IFT 63
63. • LINEAR STIMULATING EFFECTS :
Effects produce by bipolar circuit
• PLANIMATRIC STIMULAING EFFECTS :
effects produce by tetra polar circuit
6.10-6.11 IFT 64
64. • When 3 amplitude constant medium
frequency sinusoidal current of 5kHz are
super impose in homogenous medium,
a 3D IF field is created.
This 3D effect is known as
SPATIAL STIMULATING EFFECTS /
STEREO DYNAMIC EFFECTS
6.10-6.11 IFT 65
65. • Electrodes are placed in such a way that
current interfere with each other within
body.
• Principle :
tissue occupy 3 dimension space &
ions in excitable membrane & tissue
fluid move in 3 dimension.
6.10-6.11 IFT 66
70. •ABSOLUTE :
- loss of sensation
- UMN lesion
- pacemaker
6.10-6.11 IFT 71
71. • Relative contra indications :
- hyper sensitivity
- localised inflammation
- thrombosis
- pregnancy
- cardiac conditions
- metal on surface
6.10-6.11 IFT 72
72. Patients who do not comprehend the
physiotherapist’s instructions or are unable
to co-operate should not be treated
• Patients who are taking anticoagulation
therapy or have a history of pulmonary
embolism or deep vein thrombosis should
not be treated with the vacuum electrode
applications
• Similarly, patients whose skin may be
easily damaged or bruised
6.10-6.11 IFT 73
73. • Active or suspected malignancy
• eyes
• anterior aspect of the neck
• The carotid sinuses
• Patients with pacemakers
• Dermatological conditions e.g. dermatitis,
broken skin
6.10-6.11 IFT 74
74. • Danger of haemorrhage or current tissue
bleeding (e.g. recent soft tissue injury)
• Avoid active epiphyseal regions in children
• Transthoracic electrode application is
considered to be ‘risky’ by many authorities
6.10-6.11 IFT 75
75. Advantages
• safe application
• deep penetration
• large dosage can be applied
• metal implants are not contra indicated
• minimal skin resistance
6.10-6.11 IFT 76
76. ELECTROPHYSIOLOGICALEFFECTS
1) Maximum & minimum current intensity
2) Low freq. current & stimulus synchronous
depolarization
3) Medium freq. current & stimulus
asynchronous depolarization
4) Medium freq. current & Skin resistance
6.10-6.11 IFT 77
77. Maximum&minimumcurrentintensity
• Optimal IF effect is produce when
electrodes are arranged diagonally.
• line that bisect the area between two
electrodes receive max. stimulation.
• In this region, combined peak amplitude of
successive beats are greater than
amplitude of medium freq. applied to the
skin.
6.10-6.11 IFT 78
78. • Neither circuit, by itself provides sufficient
current amplitude or density to elicit nerve
response.
• Because each circuit delivers sub threshold
non modulated medium freq. current
6.10-6.11 IFT 79
79. • So sensory nerve fiber excitation below
electrode is minimal.
• In addition, each beat is amplitude
modulated, so stimulated nerve fiber do not
accommodate.
6.10-6.11 IFT 80
80. • advantage of IFT over other form of ES :
- current perfuse through greater depth
- it perfuse over a large volume of tissue
then with bipolar electrodes.
6.10-6.11 IFT 81
81. Lowfreq.current&stimulussynchronousdepolarization
• When volitional contraction occurs, all the
motor units fire asynchronously.
• So, each motor unit excite & relax by itself
at different rates.
• When weak volitional contraction occurs,
all motor units fire asynchronously between
5-15/sec.
6.10-6.11 IFT 82
82. • When max. volitional contraction occurs,
all motor units fire asynchronously between
25-50/sec.
• This results in smooth & graded muscle
contraction which requires less energy,
less likely to get fatigued.
6.10-6.11 IFT 83
83. • In a weak volitional contraction, small motor
units are recruited first , they are fatigue
resistant.
• when force of contraction is increased,
large motor units are also recruited.
• So, small motor units large motor units
6.10-6.11 IFT 84
84. • In electrical stimulation, there is tetanizing
contraction, in which large motor units are
recruited first & they are recruited in
synchronous pattern.
• Large motor units are easily fatiguable.
• In ES, small diameter MU are recruited only
when stimulus is sufficient.
6.10-6.11 IFT 85
85. • Thus, tetanic contraction by ES is more
fatigable than by volitional contraction.
• This is partly due to reversal in normal
pattern of MU recruitment & partly due to
synchronous firing of MU.
6.10-6.11 IFT 86
86. • In volitional contraction, neural discharge
rate is 5 - 50/sec & depends on the
intensity of contraction.
• This causes periodic release of
neurotransmitters at neuromuscular
junction.
6.10-6.11 IFT 87
87. • In ES, same nerve fibers are rapidly
depolarized to produce tetanic contraction.
• Frequency is 50/sec. so, nerve fibers are
stimulated at higher rate.
• So there may be decrease release of
neurotransmitters at NM junction
• So, rapid fatigue.
6.10-6.11 IFT 88
89. Wedensky Inhibition
• A Beta Fibers have a maximum conduction
velocity of about 120 m/sec
• Impulses are being delivered at a rate of
over 4000 Hz
• There is no time for the nerve to re-polarize
which results in NO sensation = numbness
6.10-6.11 IFT 90
90. GLIDEMEISTER’S EFFECT
• With medium frequency current ,the
depolarization frequency of nerve neither
coincides with the frequency of current nor
with the depolarizing frequency of the other
nerve fibers in the nerve bundle .
6.10-6.11 IFT 91
92. • Capacitive resistance :
- it is present when monophasic or biphasic
pulse current is applied to the skin.
- it is inversely related to the frequency
of pulse.
- this occurs in living tissue which are
comparable to capacitor.
6.10-6.11 IFT 93
93. • Polarisingcapcitance of tissue is denoted
by constant current which depends on
electrode surface area.
• As the frequency of current increases,
capacitive resistance decreases.
• Z = __ 1__
2𝜋fc
6.10-6.11 IFT 94
94. • The skin impedance at 50 Hz is
approximately 3200 ohms, while at 4000
Hz it is reduced to approximately 40 ohms.
• The result of applying this latter frequency
is that it will pass more easily through the
skin, requiring less electrical energy input
to the deeper tissues, giving rise to less
discomfort.
6.10-6.11 IFT 95
95. • Physiological effects of IFT depends on
- frequency
- constant or rhythmic freq. swing
- intensity
- accuracy of electrode placement
- patency of circulation & neurological
function.
6.10-6.11 IFT 97
97. High AMF :
- mainly excite sensory nerves
- used in acute conditions
low AMF :
- mainly excite motor nerves
- chronic & sub acute cases
- feel more rough & deeper
6.10-6.11 IFT 99
98. PHYSIOLOGICALEFFECTOFDIFFERENTFREQUENCY
100 Hz constant :( sweep-0, base-100)
- It causes fine oscillation & vibration of ions
without producing heat.
- Fine vibration on sensory nerve endings
are having analgesic effects.
- Mild tingling sensation that interfere with
perception of pain.
6.10-6.11 IFT 100
99. • 10-15min stimulation produce pain relief for
an hour.
• IFC with 100Hz constant freq. inhibit
sympathetic nervous system.
• IFC through stellate ganglion will relieve
causalgia or pain in RSD.
6.10-6.11 IFT 101
100. 1-10Hz constant : (sweep-0)
- More specific effects on motor nerves
cause muscle contraction & tissue ion
motion.
- Less sensory stimulation, great depth of
contraction& pleasant to feel.
- Stimulate only innervated muscle fibers.
6.10-6.11 IFT 102
101. 1-10 Hz rhythmic :( sweep-add)
- Automatic frequency change.
- stimulating effects on motor nerves &
tissue.
- it has vasodilatory effect
- it Has vigrous pumping effect, so facilitate
fluid re-absorption.
6.10-6.11 IFT 103
102. • Mainly use for muscle re-education.
• Also use to break the adhesions.
• Facilitate healing process.
6.10-6.11 IFT 104
103. 1-100Hz constant :
- Produce fine vibration movement of ions &
facilitate ion movement in cell.
- Alternate rhythmic excitation & relaxation of
tissue, producing more active hyperaemia
& increase cellular activity.
6.10-6.11 IFT 105
104. • Automatic frequency change.
• Alteration in vascular permeability.
• Increase venous & lymphatic flow.
• Increase tone of tissue in vessels.
• Relieve edema & facilitate healing.
6.10-6.11 IFT 106
105. 90-100Hz rhythmic :
- Automatic frequency change.
- Analgesic effect.
- Vasodilatory effect on tissue.
- Less adaptation & habituation than 100Hz
constant.
6.10-6.11 IFT 107
106. • Decrease activity of sympathetic system
• Pain gate mechanism
• Used in recent injuries, severe pain &
hypersensitivity.
• Decreased pain without heat.
6.10-6.11 IFT 108
107. 25-50Hz rhythmic :
- Produce tetanic contraction of muscles.
50-100Hz rhythmic :
- Sedative & spasmolytic effects in
sub-acute stage.
6.10-6.11 IFT 109
108. • Acute only sensory fibers base ↑ & sweep-↓
• Subacute base ↓ & sweep- ↑
• Less than 50hz stimulation of motor nerve
• For chronic condition --- sensory & motor nerves stimulate
to strength particular muscle.
6.10-6.11 IFT 110
109. Usesofinterferentialtherapy:
• 1. Relief and management of acute and
chronic pain:
• acute and chronic pain of different origins,
especially post traumatic pain and
sympathetically-maintained pain as in
shoulder hand syndrome and Raynaud’s
disease (spasm of the digital arteries
producing pallor or cyanosis of fingers or
toes).
6.10-6.11 IFT 111
110. Mechanisms of pain control:
• Stimulation with the higher frequencies of
about 100 Hz at the sensory level
intensities stimulates pain gate
mechanisms, there by mask the pain
symptoms.
6.10-6.11 IFT 112
111. • Stimulation with lower frequencies up to 10
Hz at motor level intensities can be used to
activate the opioid mechanism, providing a
degree of relief.
• Decreased activity of the sympathetic
ganglion and sympathetic nerves in cases
of sympathetically-maintained pain.
6.10-6.11 IFT 113
112. • Stimulation with the higher frequencies of
about 50 Hz cause a temporary
physiological block in both A delta &
C fibers.
6.10-6.11 IFT 114
113. 2) Muscle stimulation :
Stimulation of the motor nerves to induce
contraction of muscle can be achieved with
a wide range of frequencies (10 – 50 Hz).
stimulation at low frequency (1 – 10 Hz)
will result in a series of twitches, whilst
stimulation at 50 Hz will result in a tetanic
contraction.
6.10-6.11 IFT 115
114. • The choice of treatment parameters will
depend on the desired effect.
• contraction brought about by IFT is no
‘better’ than would be achieved by active
exercise
6.10-6.11 IFT 116
115. If IFC is used as neuromuscular stimulation,
it can be used for:
• - Relaxation of muscle spasm.
• - Prevention and retardation of disuse
atrophy.
• - Muscle re-education.
• - Maintenance of range of motion.
6.10-6.11 IFT 117
116. • 3. Increase blood flow:
• Increased vasodilatation is noticed
following interferential stimulation due to its
effect on the parasympathetic nerve fibers
for increased blood flow.
• So, interferential stimulation is used in
treatment of circulatory disorders .
6.10-6.11 IFT 118
117. • Moreover, depressing the activity of certain
cervical and lumbo-sacral sympathetic
ganglia in patients with increased arterial
constrictor tone, increases circulation as in
Raynaud's disease.
6.10-6.11 IFT 119
118. 4. Reduction of edema:
• Used to reduce Chronic post-traumatic
edema.
• The beat frequency is of approximately 15
Hz or a sweep of 10-25 Hz is often used.
6.10-6.11 IFT 120
119. • use the IFT to bring about local muscle
contraction(s) which combined with the
local vascular changes that could be
effective in encouraging the reabsorption of
tissue fluid.
• The use of suction electrodes may be
beneficial
6.10-6.11 IFT 121
120. • 5. Stimulation of soft tissue healing and
repair:
• The interferential current accelerates
ossification, so may be used to enhance
fracture healing.
• it may be used also to accelerate wound
healing by improving the cellular function
and increasing cell proliferation.
6.10-6.11 IFT 122
122. Pad electrodes
• standard method of application
• metal plate electrode is used with water
soaked lint pad.
• they should be of same size.
• available in various size & shapes.
• secured with strap or bandage with mild
pressure.
6.10-6.11 IFT 124
123. CARBON RUBBER ELECTRODE
• made up of carbon , used along with
conductive medium.
• Coupling medium may be an electrolytic
paste, gel, cream, or liquid.
6.10-6.11 IFT 125
124. • provide long-term, repeated use and will
generally maintain their conductive
properties for many months.
• Some commercially available electrodes
are coated with a self-adhesive conductive
polymer that serves as the coupling agent.
6.10-6.11 IFT 126
125. SUCTION ELECTRODES
• It contains flexible rubber cups, are
connected by tubes to a pump which
provide negative pressure.
• Pressure may be continuous or variable.
• It should not be continuous as it is
uncomfortable & may produce bruising.
6.10-6.11 IFT 127
126. • -ve pressure vary rhythmically to decrease
viscosity in membrane.
• metal electrodes are mounted inside the
cups & connected to IF source through
wires in tubes.
• Contact is made by water soak sponge
between metal plate & skin.
6.10-6.11 IFT 128
127. Advantages :
- Mild massaging effect on skin stimulating
cutaneous nerves result in reflex
vasodilatation.
- Easy to apply, no straps are used
- Facilitate the movement of fluid from cell to
the vessels, enhance venous return.
6.10-6.11 IFT 129
128. Disadvantage :
- Not possible to apply over irregular areas.
- On hairy area air tight seal is not possible.
- Bruising is common in Thin fragile skin of
elderly patient.
- Used carefully in pt taking steroids for long
time.
6.10-6.11 IFT 130
129. QUADRIPOLAR PROBE ELECTRODE
• 4 small electrodes are laminated in one
plastic cylinder which has diameter of 2cm.
• It can be applied as a one pad.
• 4 electrode cylinder may be moved across
skin to the poorly localized area or may
kept stationary as in trigger points.
6.10-6.11 IFT 131
130. LABILE ELECTRODE
• It is a plate electrode insulated on one side
& attach to operator’s hand by means of
velcro straps or gloves.
• 2 electrodes are used
• One is fixed & other electrode is moved
over treatment area
6.10-6.11 IFT 132
132. APPLICATION
PATIENT PREPARATION :
• Pt must be in comfortable position
• part must be supported & exposed.
• check for neural integrity
• check for the contra indications
6.10-6.11 IFT 134
133. • Inspect the body part for any cut, abrasion
or lacerations.
• Insulate this area with vaseline , but do not
place electrodes over this area.
• Wash the part to be treated to decrease the
skin resistance.
• Explain the sensation to be felt.
6.10-6.11 IFT 135
134. Preparation of apparatus :
- collect necessary equipments
- connect the leads to machine
& electrodes
- turn intensity dial to zero
- check the machine.
6.10-6.11 IFT 136
135. Application :
- select the electrodes
- types
- location
- size
- number
- attachments
6.10-6.11 IFT 137
137. Two pole method :
• Two medium freq. currents are
superimposed inside the machine, resultant
interference occurs through out the region
between the electrodes.
• Signal leaving the machine is modulated.
6.10-6.11 IFT 139
138. • This method is also known as
ELECTRO KINESY.
• Electrodes are placed opposite to each
other, so treatment area lies between the
electrodes.
6.10-6.11 IFT 140
139. • As the modulation occurs through the area,
there tends to be more sensory stimulation
than four electrode method.
• Depth of modulation in tissue is same in all
directions.
• Modulation depth is always 100 %.
6.10-6.11 IFT 141
140. - select the parameters
- turn on the device
- gradually increase the intensity
until the pt experiences strong
but comfortable paresthesia
6.10-6.11 IFT 142
141. Instruction to the patient :
- No heat or burning sensation
- No intense uncomfortable sensation
- No movements to disturb the electrodes
6.10-6.11 IFT 143
142. Termination :
- gradually decrease the intensity
until the pt experiences no
tingling sensation
- turn off the device
- remove the electrodes & clean the
part, check the skin condition.
6.10-6.11 IFT 144
143. TREATMENTOFSPECIFICDISEASE
1 ) Recent injury :
- Treatment of choice for recent injuries
- No danger of increase bleeding or bruising
- Treatment may be given even with the
breakage of skin.
6.10-6.11 IFT 145
144. • Bruise area may be painful
• Four electrode method is used
• Electrodes are applied above & below the
area.
AIM : - reduce pain
- reduce swelling
- promote healing
- restore function
6.10-6.11 IFT 146
145. Pain relief :
- Pain – swelling – pain cycle
- When reduce pain & swelling, support the
part with bandage or strapping
- Four electrodes method :
- Two electrodes above & below the area
6.10-6.11 IFT 147
146. • Beat freq. : 90 -130 Hz constant
130Hz is most effective.
• Intensity : as tolerated
• Time : 10-15 minutes
6.10-6.11 IFT 148
147. • If single point of tenderness, stronger dose
is given to anesthetize the part by passing
the maximum current the patient an tolerate
for 3 minutes.
• Treatment produce numbness, so strapping
is applied immediately.
6.10-6.11 IFT 149
148. • Prolonged exercises must be avoided for at
least 1 hour.
• Longer the rest period between IFT &
exercises, longer will be the pain relief.
• Later on, Re-education & exercises should
be given before IFT.
6.10-6.11 IFT 150
149. • In subsequent treatment, electrodes are
placed above & below the strapping.
• No need to remove the strapping,
to prevent un-necessary discomfort,
wearing & tearing of skin.
• If pain & spasm is reduced,
100-130 Hz with sweep of 10Hz
10 -15 min
6.10-6.11 IFT 151
150. • Gradually increase the sweep until patient
receives 10-100Hz sweep.
• If increase in sweep is increasing the pain,
then treatment is given in analgesic
frequency range.
6.10-6.11 IFT 152
151. • When there is no tenderness, two electrode
method may be used.
• It is less comfortable.
• Small electrode over injured area & large
opposite to that.
6.10-6.11 IFT 153
152. Reduce bruising & swelling :
• It is very imp. Because organization of
exudates leads to adhesion formation &
functional impairments
• There is no passive congestion following
IFT, it can be applied after injury.
6.10-6.11 IFT 154
153. • Start with 100- 130 Hz constant then
introduce sweep.
• Gradually increase sweep up to 10–150HZ
• This will stimulate blood flow &facilitate the
resolution.
• Contraction of the muscles at low freq, will
also assist the resolution.
6.10-6.11 IFT 155
154. • Colour of bruising changes from the first
treatment.
• deep & extensive bruising may take several
weeks to disperse.
• It is commonly used for bruising over thigh.
6.10-6.11 IFT 156
155. Promote healing :
• Alter electrical state of cell
• Increase the circulation
• Facilitate the healing
6.10-6.11 IFT 157
156. Restoration of function :
- Muscle wasting : sweep of 5-50Hz
to stimulate the muscle fibers
- Electrodes are placed so that muscle belly
remains in the path of IFC,not the injured
area.
- In many case it is convenient to stimulate
the muscle with faradic current rather than
IFT.
6.10-6.11 IFT 158
157. 2) CERVICAL SPONDYLOSIS :
- Electrodes are placed on the sides of
occiput or any vertebra.
- Bandaging is difficult.
- If the Patient is in half lying position ,
electrodes are kept in place with towel
around neck & pillow.
6.10-6.11 IFT 159
158. 3) BACK PAIN :
LOCALISED BACK PAIN
4 electrodes over back
90-130Hz sweep
6.10-6.11 IFT 160
159. RADIATING PAIN :
- two electrodes over foot & two over
buttocks or back.
- so current traverses whole length of nerve
- 100-130Hz is used for 15min
6.10-6.11 IFT 161
160. 4) Urinary incontinence :
• Most distressing & troublesome condition
• Aim of treatment is to increase efficiency of
sphincter by stimulating unstriped muscles
with low freq. & also by influencing
autonomic supply.
6.10-6.11 IFT 162
161. • IFT is more effective than faradism &
exercises, which can only influence the
sphincter indirectly through association with
striped pelvic floor muscles.
• Sphincter control is entirely unconscious,
so it must be treated through involuntary
muscles & ANS.
6.10-6.11 IFT 163
162. • Treatment is effective even when patient is
not willing to perform exercises.
• Passage of current through pelvic floor
muscle also accelerate the repair of tissue
damaged during delivery.
• Following the child birth, treatment should
be started as any difficulty is experienced.
6.10-6.11 IFT 164
163. • Position of patient :
• Stride sitting or crook stride lying.
• Two electrodes are on lower abdomen just
above the outer half of inguinal ligaments
• Other two electrodes are on upper & inner
aspect of thigh near adductor origin.
6.10-6.11 IFT 165
164. • They must be placed sufficiently far back to
direct the current through pelvic floor &
crossing point at urethral sphincter.
• 10×4 cm size electrodes are more suitable.
6.10-6.11 IFT 166
165. • Sweep of 0-100Hz is used
• Lowest freq stimulate unstriped muscles
directly
• 10-15Hz stimulate voluntary pelvic floor
muscles
• 5-100Hz stimulate autonomic nerves.
• Intensity is to produce perceptible muscle
contraction.
6.10-6.11 IFT 167
166. • Current never produce tetanic contraction.
• 1st treatment lasts 8minutes & time is
increased by 1min each session up to
15mins
• Less current is required with subsequent
session.
6.10-6.11 IFT 168
167. • 2-3 session /week
• Total 12 weeks
• Chronic case requires two full course with
2-4 weeks rest in between.
6.10-6.11 IFT 169
168. 5) RHEUMATOID ARTHRITIS:
- Used in both acute & chronic stage
AIM : - pain relief
- reduce inflammation
- increase ROM
6.10-6.11 IFT 170
169. ACUTE PHASE :
- To relive pain & swelling
- Four electrodes method
- Two electrodes above & below the part
- 100-130 Hz constant, 10min
- It is also used in most acute phase of
disease when joints are red, shiny &
swollen
6.10-6.11 IFT 171
170. • Sub acute phase :
• Sweep is introduce gradually, starting with
sweep of 20-30Hz below analgesic range
• Eg.
if 130Hz is used in acute case then
100-120Hz is used for 3-4min.
6.10-6.11 IFT 172
171. • Gradually increase both range & duration of
sweep up to 10-100Hz for 10min.
Chronic phase :
• Frequency of analgesic range & those
influence blood vessels & muscles are
used.
6.10-6.11 IFT 173
172. • Treatment is also given in area of spine that
innervate the affected joint.
• Four electrode method
• 10-100Hz sweep, 5-7min
- increase blood flow
- absorb the exudates
- decrease tension in joint
6.10-6.11 IFT 174
173. 6) OA hip joint :
• Crook side lying on the good side with
affected leg supported on pillow
• Two electrodes on front & back of thigh just
below ischial tuberosity
• One electrode on ant aspect of abdomen
above the center of inguinal ligament
• Other on post. aspect
6.10-6.11 IFT 175
174. • 100-130 Hz constant,7minutes
Followed by 10-100Hz sweep, 7min
• With patient in same position. Electrodes
are changed to LS spine with sweep of
10-100Hz for 7min.
- No severe exercises at least for 1 hour
- 2-3sessions / week
- Total 12 sessions
6.10-6.11 IFT 176
175. 7) OA KNEE JOINT :
- change the position of electrodes from one
treatment to other, to treat all aspect of the
joint.
6.10-6.11 IFT 177
176. • First session :
- one treatment may be given with the
electrodes placed laterally.
two electrodes above & below the joint.
• In Next treatment, electrodes are placed
ant & post above & below the knee.
6.10-6.11 IFT 178
177. • Subsequent session :
• Two electrodes on side of knee joint
• One electrode over supra patellar pouch
• One electrode to the calf.
• As in treatment of cruciate ligament.
• Analgesic freq. range
• 10-15min
6.10-6.11 IFT 179
178. 8)ARTHRITIS AFFECTING HANDS :
• Used for single MCP / IP joints of thumb &
fingers.
• Small electrodes are wrapped around
finger.
• 100-130Hz
• 2-3 session is sufficient
6.10-6.11 IFT 180
179. 9) septic arthritis :
• Start with 90-130 HZ used 10min then
introduce sweep & progress slowly to
15min
• This treatment stretches & releases
scarring of skin
• Fibroid tissues within the joint become
pliable & ROM is increased.
6.10-6.11 IFT 181
180. 10 ) shoulder pain :
• Used for - PA shoulder
- rotator cuff injury
- bicipital tendinitis
- Four electrode method
- Small square electrodes
6.10-6.11 IFT 182
181. • 100-130Hz constant, 10min
• In sub acute phase, electrodes are Applied
over deltoid, trapezius & infraspinatus
muscles with freq. of 10-50Hz used.
• When generalized pain is decreased, but
local pain remains, strong dose is given to
this point.
6.10-6.11 IFT 183
182. • Initially 5session / week
• Then 3 session /week
• Then two session /week
Total 12 session
6.10-6.11 IFT 184
183. 11) ANKYLOSIS SPONDYLITIS :
- To relieve pain
- Wide field with large electrodes are used
for maximum penetration
- 100-130Hz for 10 min
- Gradually add sweep 10-100Hz
6.10-6.11 IFT 185
184. • 3times a week for one month
• Then rest for 3 weeks
• IFT is combined with extensor exercises
either before or some time after IFT
application.
6.10-6.11 IFT 186
185. Treatment of circulatory disease
• Used in many cases of impaired circulation
• Action is directly on vascular smooth
muscles & on parasympathetic nervous
system.
• Sympathetic stimulation must be avoided
as it causes vasoconstriction.
6.10-6.11 IFT 187
186. • Frequency of 0-5Hz must be avoided.
• If H/o thrombosis, then IFT is not given on
affected limb.
• If H/o coronary thrombosis then IFT is
contraindicated.
6.10-6.11 IFT 188
187. IMPROVE CIRCULATION :
• Two electrodes over lumbar spine, one
over dorsum & one over planter aspect of
foot.
• 10-100HZ sweep is used with intensity to
produce gentle muscle contraction.
• 3 times a week
6.10-6.11 IFT 189
188. For chronic chilblains :
• treatment is best given in autumn, just
before the cold weather starts as
preventive measure & repeated when
chilblains appears.
• Treatment is repeated for several years for
permanent effects.
6.10-6.11 IFT 190
189. • same treatment is used for chronic cold
feet.
• If the condition leads to ulceration. IFT is
not contra indicated.
• Electrodes are placed above & below the
ulcer.
• Facilitate the healing process.
6.10-6.11 IFT 191
190. INTERMITTENT CLAUDICATION :
• Not entirely satisfactory
• Condition partially under control
• With treatment, walking distance is
increased & foot remains warm.
6.10-6.11 IFT 192
191. • Two Electrodes on either side of calf just
below knee & two on side of ankle.
• Sweep 10-100Hz for 10min
• Increase by 2min/session to maximum
15min.
6.10-6.11 IFT 193
192. LYMPHOEDEMA :
• Sweep of 45-90Hz, greatest effect on
vascular smooth muscles
• Prickling sensation
• Start with 20min, progress up to 45min.
6.10-6.11 IFT 194
193. SUDECK’S ATROPHY :
• Two electrodes on forearm &two over
hands.
• 90-100HZ constant,10min
• 3 session/week
• 4-6 weeks
6.10-6.11 IFT 195
194. ASTHMA :
• Relieve spasm of bronchial smooth
muscles
• Position : sitting / upright chair
• Two EL over back of trapezius & two over
lower ribs anteriorly.
6.10-6.11 IFT 196
195. • If pt has difficulty in breathing while
treatment is in progress. . . .
• Position : sitting with leaning forward with
arms supported over table.
• Two EL over anterior upper chest & two
over posterior lower ribs.
6.10-6.11 IFT 197
196. • Sweep 10-100Hz for 10min
• Increase by 1-2min/session to maximum
20min.
• 3 session/week for 1 month
• Should not given to pt with cardiac disease
• Close supervision is required.
• Mild acute asthma attack is not contra
indicated.
6.10-6.11 IFT 198
