Interferential therapy (IFT) is a transcutaneous electrical stimulation technique developed in the 1950s. It involves applying two medium frequency alternating currents intersecting in the tissues at a low frequency. This produces amplitude modulation and generates a low frequency current for therapeutic purposes. IFT uses higher frequencies than TENS which allows for a more comfortable and tolerable penetration through the skin. It works by modulating the amplitude of the medium frequency currents applied through static, dynamic or bipolar interference methods. The physiological effects include pain relief, muscle stimulation, increased blood flow and edema reduction. Precautions must be taken with certain medical conditions and electrode placement is important.

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3. DEFINITION
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⚫Developed by Dr. Hans Nemec of Vienna, Austria in the
early 1950’s
⚫It may be described as the transcutaneous application of
alternating medium frequency electrical currents,
amplitude modulated at low frequency for therapeutic
purposes.

4. Why IFT?..
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⚫MF currents associated with a lower skin resistance
(impedance),
⚫more comfortable than low frequency currents
⚫more tolerable penetration of current through the skin is possible

5. SKIN IMPEDANCE
⚫The word impedance comes from the Latin impedire meaning
to prevent, to stop from going on.
⚫Impedance signifies the resistance of a conductor when an
electric current passes.
⚫Conventionally speaking, the term resistance refers to the obstacle to
the direct current, and it is represented by the letter R.
⚫The terms impedance refers to the obstacle to the alternating current
• and it is represented by the letter Z.
⚫Impedance Z, as resistance R, is expressed in ohms.
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6. SKIN IMPEDANCE
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⚫SKIN IMPEDANCE is calculated as Z = ½ π f C Where,
⚫Z = skin resistance
⚫f = frequency in Hertz (Hz)
⚫C = capacitance of skin in microfarads
⚫From above formula, skin impedance is inversely proportional to
frequency and capacitance of the skin.
⚫Capacitance of the skin cannot be changed; hence by increasing the
frequency the skin impedance can be lowered.

7. SKIN IMPEDANCE
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⚫It is assumed that a capacitance of 1 microfarad (1 μF) i.e. equivalent
to 0.000001 (10 to the -6th power).
⚫For a 50-Hz alternating current we obtain:
Z = 1/2π x 50x 10-6 = 3200 Ω
⚫For a 4,000-Hz alternating current this means:
Z = 1/2π x 4000x 10-6 = 39.8 Ω

8. PRINCIPLE
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⚫The principle of IFT is to pass two Medium Frequency
Alternating Currents which
through the tissues, where
are slightly out of phase,
the currents intersect to
produce a low frequency effect.

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10. Principles of wave interference: Combined Effects
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⚫Constructive, Destructive, & Continuous
⚫Constructive interference: when two sinusoidal waves that are exactly
in phase or one, two or three wavelengths out of phase, the waves
supplement each other in constructive interference
+ =

11. Principles of wave interference: Combined
Effects
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⚫Destructive interference: when the two waves are different by 1/2 a
wavelength (of any multiple) the result is cancellation of both waves.
+ =

12. Principles of wave interference: Combined
Effects
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⚫Continuous Interference: Two waves slightly out of phase collide and
form a single wave with progressively increasing and decreasing
amplitude
=
+

13. WORKING
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⚫In the interferential therapy method, two medium-frequency alternating
currents that interact with each other are used.
⚫One of the alternating currents has a fixed frequency of 4,000 Hz while
the frequency of the other alternating current can be set between 4,000
to 4,250 Hz.
⚫The superimposition of one alternating current on the other is called
interference

14. Carrying Frequency
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⚫The frequency of the new medium-frequency alternating current can be
calculated as follows:
⚫f1 + f2 /2 where
⚫Example:
f1 = 4,000 Hz
f2 = 4,150Hz
Resultant Carrying Frequency = 4,000 + 4,150/2 = 4,075 Hz

15. Beat Frequency
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⚫The frequency with which the amplitude varies is referred to as the
Beat Frequency.
⚫In interferential therapy the AMF (treatment frequency) corresponds to
frequencies which are used in low-frequency electrotherapy.

16. Beat Frequency
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⚫The AMF has a value of f2 - f1
⚫Example:
f1 = 4,000 Hz
f2 = 4,150 Hz
f 2 - f 1 = 4,150 - 4,000 = 150 Hz (AMF or treatment frequency)

17. Beat Frequency
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4000 Hz
4150 Hz
150 Hz

18. 4000 Hz
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4100 Hz

19. Why Amplitude modulation?
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⚫Synchronous depolarization
⚫Asynchronous depolarization
⚫Gildemeister effect/summation principle
⚫Wedensky inhibition

20. SWEEP
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⚫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.
⚫Such sweep prevents accommodation of nerves.
Example:
⚫An AMF of 20 Hz is set and a 50 Hz spectrum is added.
⚫The current begins with an AMF of 20 Hz and passes successively
through all frequencies up to 70 Hz, after which it decreases gradually
to 20 Hz.
⚫This process is repeated automatically.

21. Triangular sweep pattern Rectangular Sweep Pattern
Trapezoidal Sweep Pattern Sreeraj S2
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1

22. Amplitude modulation
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23. APPLICATION
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⚫ Methods of applications are:
1. Static interference
2. Dynamic interference
3. Bipolar interference

24. STATIC INTERFERENCE
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⚫Here the area in which IFT
is set up remains
stationary.
⚫This area of static
interference gives an
appearance of ‘clover leaf
’.
⚫It lies to 45°angles to the
perpendicular lines from
each electrode.

25. DYNAMIC INTERFERENCE
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⚫This is moving the area of
interference current in a to and
fro manner through 45°.
⚫It is obtained by varying the
current intensity from 50 to
100%.
⚫The dynamic area of
interference is also called as
vector sweep, vector scan,
rotating vector, etc.
⚫Used to treat diffuse area

26. Vector Scan
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27. BIPOLAR INTERFERENCE
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⚫Here pre-modulated IFT are
applied through 2 surface
electrodes.
⚫IFT is generated inside the
equipment and is delivered
to the patient through 2
electrodes.
⚫Useful for smaller areas.

28. INSTRUMENTATION
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⚫AMF PARAMETER To choose the basic value of the LF modulation that is
desired.
⚫SPECTRUM/ SWEEP PARAMETER to set the range of variation in the AMF
value that is desired; for ex. AMF at 100Hz and spectrum at 50Hz will give an
AMF variation from 100hz up to 150Hz and back to 100Hz.
⚫ROTATION PARAMETER is applicable in case of vector currents only and
sets the rate of rotation and the direction change of the AMF field within the
tissues.

29. PHYSIOLOGICAL EFFECTS
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⚫ This depends upon:
1. Magnitude of current
2. Type of mode used i.e. Rhythmic or constant
3. The frequency range used
4. Accuracy of electrode positioning

30. PHYSIO.EFFECTS (CONT…)
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Main clinical applications are :
1. Pain relief
2. Muscle stimulation
3. Increased local blood flow
4. Reduction of edema

31. PAIN RELIEF
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⚫Higher frequencies of 90 - 130 Hz to stimulate the pain gate
mechanisms & thereby mask the pain symptoms.
⚫Lower frequencies of 2 – 5 Hz can be used to activate the
opioid mechanisms

32. Pain Gate

33. MUSCLE STIMULATION
⚫Stimulation at low frequency, for e.g. 1 Hz will result in a series of
twitches
⚫Stimulation at 50 Hz will result in a tetanic contraction.
⚫Most effective motor nerve stimulation range is between
• 10 - 25 Hz.
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voluntary
⚫For patients who can not generate useful
contraction, IFT may be beneficial.

34. BLOOD FLOW
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⚫ Experimentation demonstrated vascular changes at 10 -
25Hz.
⚫ Effects of blood flow is believed to be due to:
1. Effects of suction electrodes on tissues
2. Effects of muscle stimulation on circulation.
3. Possibility that the IFT is acting as an inhibitor for
sympathetic activity. (Sympathetic nervous system stimulation
causes vasoconstriction of most blood vessels.)

35. OEDEMA
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⚫A rhythmical pumping action at a frequency of 1-10 Hz
⚫The effects are associated with the effects on Muscle
Stimulation & Blood Flow.

36. CONTRAINDICATIONS
1. Cardiac pacemaker
2. Advanced cardiac disease
3. Hypertension
4. Thrombosis
5. Hemorrhage
6. Pregnancy
7. Neoplasm
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8. T B
9. Fever
10. Infections
11. The eyes
12. Skin disorders
13. Epiphyseal region in children

37. PRECAUTIONS
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⚫IFT apparatus must be at least 6 meters away from
SWD machine
⚫Patients with febrile conditions
⚫Epileptic patients
⚫Over anterior chest wall
⚫Position suction electrode below the level of damage or
discomfort.

38. Placement of electrodes
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39. Types of Electrodes
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⚫Plate
⚫Vacuum
⚫Pen

40. Plate Electrodes
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⚫Made of conducting rubber
which are comfortable and
long lasting
⚫larger plates electrodes give
more comfortable treatment
and deeper effect
⚫Smaller electrodes are used
for a localized effect, but this
effect is more superficial
⚫Attached to the patient by
means of straps to assure a
good contact and greater
tolerance of treatment

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42. Vacuum Electrodes
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⚫Excellent for treating flat
smooth areas for example
back or a plump knee
⚫Not indicated for treatment of
the hairy areas because can’t
get an airtight seal

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44. Electrode positioning
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45. ELBOW
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46. KNEE
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47. NECK
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48. SHOULDER
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49. LOWER BACK
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51. Overview
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⚫These are medium frequency alternating current in the low kHz
range, which is delivered in a pulsed (or burst or interrupted)
output.
⚫The pulsing or bursting is at a 'low' frequency, and as a result,
nerves will respond.
⚫It is primarily employed to generating a motor response.
⚫Burst Mode Alternating Current (BMAC).
⚫The credit for the early work in this field is ascribed to Dr Yakov Kots,
based in Russia, in the late 1970s.

52. ⚫The term 'Russian currents' refers to sinusoidal AC of frequency
2.5 kHz which is burst-modulated at 50 Hz.
⚫It consists of 10 ms bursts of AC separated by 10 ms 'off' periods.
The waveform repeats every 20 ms (1/50th sec) so the burst or
modulation frequency is 50 Hz.
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53. Characteristics
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⚫Carrier Frequency: 2500Hz.
⚫Waveform: Polyphasic sinusoidal
waveform.
⚫Bursts Frequency: 50 Hz.
⚫Burst Duration: 10 ms
⚫Interburst interval: 10 ms
⚫Phase Duration: 0.2 ms
⚫Current Amplitude: The
maximum current amplitude is
100mA. Clinical used at 70mA.
2.5 kHz sinusoidal AC, burst modulated
at 50 Hz i.e. 10 ms 'on' and 10 ms 'off'.

54. Dosing Parameters
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⚫Base Frequency : 2500Hz (2.5kHz)
⚫Burst @ 50Hz
⚫10 ms ON : 10 ms OFF (50% duty cycle)
⚫Stimulation delivered thus for 10 seconds
⚫Rest period of 50 seconds
⚫Repeated 10 minutes per session
⚫Maximum tolerable intensity
⚫Applied once daily over a period of
weeks

55. CHARACTERSTICS
On/Off Ratio:
• The on-off ratio is defined as the ratio of the time during which there is
stimulation (contraction) to the time during which there is no stimulation
(no contraction). Set as 10ms:10ms.
Duty cycle:
• The duty cycle is the proportion of on-time to the summation of both the on
and off time expressed as a percentage. For example 10:10 sets up a duty
cycle of =10/(10+10) ×100= 50%. Russian current produced with a duty
cycle of 50%.
Ramp-up and down:
• Setting the ramp time is very important to evoked contraction similar to
muscle contraction. As the ramp allows a gradual increase of intensity with
associated gradual increase of muscle contraction. Set for 1-2second.

56. PHYSIOLOGICAL EFFECT
Depends on the total number of bursts delivered per second.
Russian current can depolarized:
• Sensory nerve fibers- Moderate prickling sensation
• Motor nerve fibers- titanic muscle contraction.
• This contraction is-
• Painless due to sensory nerve blocked of pain gate
Allow use of high amplitude
• Contraction stronger than those generated by voluntary control(voluntary
contraction- motor units recruited asynchronously while in electrically evoked
muscle contraction- motor units fire synchronously).

57. INDICATION
• The only indication for using Russian currents as introduced by
knots in 1977s is to strengthen the muscular system of healthy
and athletic persons.
• Post-knee ligament surgery
• Post arthroscopic knee surgery
• Following ligament sprain
• Post casting
• Muscle spasm

58. CONTAINDICATION
• Over the anterior cervical area
• The lumbar or abdominal area during pregnant
• Hemorrhagic area
• Neoplastic area
• Metallic and electronic implant
• Impaired skin sensation

59. ThankYou
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