2. The method of application and dosage for most uses of electrical stimulation
depends upon the following
Electrode type, size, number and locations.
Number of contractions per session.
Sessions per day.
Number of days and weeks using electrical stimulation.
โข Purpose of electrode:
Completes the circuit
Interface between electron and ion flow.
Resistance to current
โข Type of electrode:
Metallic, Carbon rubber, Self adhesive
3. Electrode placement
โข To ensure even delivery of current, electrodes must lie smoothly against the skin
without wrinkles or gaps.
โข Self adhesive electrodes usually maintain good contact.
โข With other type of electrodes flexible bandaging is needed to maintain good
electrode to skin contact.
โข Electrodes should not be placed directly over bony prominences because of greater
resistance of bone and poor adhesion of electrodes to highly contoured surfaces
increases the risk of discomfort and burns.
4. Spacing of the Electrode
โข The distance or spacing between the electrode affects the depth and
course of the current.
โข The closer together the electrodes are placed the more superficially the
current travels.
โข The greater the distance between the electrodes more deeper the
current travels.
5. Methods of application
โข Stimulation of motor points:
In this method the stimulation of individual muscle motor point is done
Advantage:
each muscle performs its own individual action and that the optimum
contraction of each muscle can be obtained.
Disadvantage:
If there are many muscles to be stimulated it is impossible to produce a
large number of contractions of each.
6. โข Stimulation of muscle groups:
With this all the muscles of the group work together.
Two fixed electrodes are used, one placed over the nerve trunk or origin of the
muscles and the other electrode over the lower ends of fleshy belly of the muscle.
Advantage:
All the muscles of the group work together.
Re educating the action of muscles which normally work as a group. For eg:
quadriceps, small muscles of foot.
Permits many contractions to be elicited, from each muscle than individual
stimulation.
Can be used for large muscles with multiple nerve supply.
7. โข Liable treatment:
An indifferent electrode is applied, as for the stimulation of motor points, and the
second electrode moved over the area to be treated.
The active electrode may be the disc or the plate electrode.
Current is not surged, but as the electrode approaches and leaves the motor point of
the muscle, the muscle contracts and relaxes.
Advantage:
Sensory stimulation is more marked.
Used for treating large muscles with multiple nerve supply such as longitudinal back
muscles.
Disadvantage:
Difficult to gauge the required intensity of current than when electrode is applied
directly over the motor points.
8. โข Nerve conduction:
If a motor nerve trunk is stimulated, contractions are produced of all the muscles
that it supplies beyond the point of stimulation.
The indifferent electrode is applied to a convenient area and the active electrode to
some point at which the nerve trunk is superficial.
It is the most comfortable methods of stimulating the muscles of facial expression.
โข Bath treatments;
The water makes perfect contact with the tissues, that the prolonged soaking reduces
the resistance of the skin and that widespread effects are produced.
It is particularly valuable when the principal aim of treatment is to improve the
blood supply to the area.
Disadvantage:
The treatment cannot be localized, the muscles do not contract to the same degree,
Those which are strongest and most superficial responding more easily.
9. โข Faradism under pressure:
This method is used to increase the venous and the lymphatic drainage from an
edematous area.
The limb is supported in elevation so that gravity assists the venous and the
lymphatic return and is encased in an elastic bandage.
Contractions of many muscles are required, and are obtained by placing large pads
so that they cover the motor points of the main muscle groups.
The bandage increases the pressure on the vessels when the muscles contract and its
recoil on muscle exerts a further pumping action.
The treatment lasts for upto 20 minutes, but frequent rests must be given.
