This document discusses electrotherapy, which uses electrical energy as a medical treatment. It describes various types of electrotherapy including ultrasound and transcutaneous nerve stimulation. Electrotherapy can effectively manage pain and dysfunction when combined with manual therapy and exercise. The document outlines different classifications of electrical currents based on direction, frequency, voltage, and amperage. It also explains various waveforms, pulse characteristics, and how to select appropriate currents and impulses to stimulate denervated muscles without activating nearby innervated muscles.

1. INTRODUCTION OF
ELECTROTHERAY
Dr Mahat ZAFAR (pt)
Riphahcollege of rehabilitationsciences

2. ELECTROTHERAPY
Electrotherapy is the use of electrical energy as a
medical treatment.
 In medicine, the term electrotherapy can apply to a
variety of treatments, including the use of electrical
devices such as Ultrasound, Transcutaneous nerve
stimulation

3. ROLE OF ELECTROTHERAPY
 Although electrotherapy has a well established role within
physiotherapy practice
 It is argued that there is a place for electro physical modalities in
contemporary practice, and several basic principles are considered
together with more specific information regarding two modalities
namely, ultrasound and interferential therapy.
 Electrophysical agents are utilized to bring about physiological
effects, and it is these changes which bring about the therapeutic
benefit rather than the modality itself.

4. The patient management programme which combines
manual therapy, exercise therapy and electrotherapy, based
on current evidence, should enable the most effective
management of a patients' dysfunction.
Effective for the reduction of acute pain management.

5. a. On the basis of direction of flow of current
• Alternating current: flow in both direction
• Direct current: flow in one direction
b. On the basis of frequency
• Low frequency: range of 50 to 100 Hz
• Medium frequency: range of 100 to 4000 Hz
• High frequency currents: frequency more than 1MHz

6. c. On the basis of voltage
• Low voltage currents: less than100 Volt
• High voltage currents: greater than 100 volt
d. On the basis of amperage
 low amperage currents: 1 to30 mAmp e.g.- high TENS
 high amperage currents: 500 to2000 mAmp

7. LOW FREQUENCY CURRENTS
 Faradic current
 Sinusoidal current
 Galvanic current
 Constant galvanic current
 Modified galvanic current
 Superimposed current
 Transcutaneous electrical nerve stimulation
 Dia-dynamic current

8. MEDIUM FREQUENCY CURRENT
 Interferential current
 Rebox type current
 Russian current
HIGH FREQUENCY CURRENT
 Microwave diathermy
 Shortwave diathermy
 Longwave diathermy

9. Different Wave Forms
 Wave form means
 Graphical representation of the direction, shape, amplitude, & pulse
 A pulse may contain either one or two phases
 It rise above or goes below the base line for some specific period of time
Direct current/mono phasic current
 Have only single phase
 Current flow in unidirectional
 Flow in same direction towards positive or negative

10. Alternating current/biphasic current
 Have two separate phases
 Current flow is bi directional
 Wave form may be symmetrical or asymmetrical

11. Wave form shape
Could be of any type like sine, rectangular or triangular
Depends on the capabilities of the generator

12. Pulse amplitude
 Magnitude of current
 The peak current is the maximum amplitude of the current
 Maximum amplitude of pulse can be shown by tip of highest point
of each phase

13. Pulse frequency
 Number of pulses per second
 As frequency of wave form is increased the amplitude tends to
increase & decrease more rapidly

14. Pulse duration
Length of time that current is flowing in one cycle

15. Surging of current
 The intensity of each successive pulse gradually increases
 Each impulse reaches to higher intensity than that of preceding one
 After the peak levels either falls suddenly or gradually

16. Shape of the pulsed waves
– Monophasic
• Rectangular pulses
• Trapezoidal pulses
• Triangular pulses
• Saw tooth pulses

17. Biphasic: risk of skin damage is less with balanced pulses
(chemical reactions taking place are reversed)
 Slow rising wave forms can be used because muscle has less ability
to accommodate than nerves

18. Rectangular pulses have sudden rise where as others like
trapezoidal, triangular & saw tooth have gradual rise
The impulses in which current rises gradually are often
termed “selective”
A contraction of denervated muscle can often produced
with an intensity of current that is sufficient to stimulate
motor nerves because accommodation occurs

19. Selection of impulses
Rectangular impulse is capable of producing muscle
contraction but selective impulse is always satisfactory
With rectangular impulses rise is sudden where as with
trapezoidal it is slow, with triangular even slower & with
saw tooth still slower
A low intensity & gradual rise is often best for
stimulation of denervated muscle as it brings about
satisfactory contraction with less sensory stimulation than
with rectangular impulses

20. Proper selection of current leads to eliminate unwanted
contraction of innervated muscles present in closes
proximity
In long standing denervation a muscle contraction may be
obtained with a slowly rising current when there is no
longer response to rectangular impulse.