Commonly abbreviated as SDC. It is one of the electrodiagnostic method used in physiotherapy to detect presence or absence of excitable nerve fibers in a muscle.
Russian current is a form of electrical stimulation using alternating current delivered in 2.5kHz bursts with a 50Hz burst frequency and 50% duty cycle. It was developed by Russian scientist Kots who found it improved strength in athletes. As a result, this stimulation pattern became known as Russian current. It is used clinically to contract and strengthen muscles, typically with 10 seconds on, 50 seconds off bursts to avoid fatigue. The main effects are increased muscle force through central nervous system adaptation and physical muscle growth.
The strength duration curve is a graph that plots the electrical stimulus intensities and durations needed to elicit muscle contraction. It can identify whether a muscle is innervated, denervated, or partially denervated. The curve is measured using a stimulator with varying impulse durations, and indicates the strength required to produce contraction at each duration. Characteristics of the curve reveal muscle innervation status, with denervated muscles requiring higher intensities and longer durations to contract. The curve can be used from 10-14 days after injury to assess nerve regeneration over time.
Electrical stimulation involves using a medium-frequency current to stimulate nerves and muscles. Specifically, it uses a 2500 Hz sinusoidal alternating current delivered in bursts at 50 Hz intervals of 10 ms on and 10 ms off. This Russian current protocol of 10 seconds on, 50 seconds rest, repeated for 10 cycles over 10 minutes was found to be effective for generating muscle fatigue. The stimulation aims to synchronously depolarize sensory and motor fibers, activate fast motor units, and strengthen muscles through electrically evoked contractions against an external load.
Sinusoidal current is an alternating current that produces smooth, rhythmic muscle contractions at 50 Hz. It is produced from mains electricity reduced to 60-80 volts using a step-down transformer. This current stimulates both motor and sensory nerves, causing tetanic muscle contraction and tingling sensation. It is often used over large areas to relieve pain through sensory stimulation and reduce edema through rhythmic muscle pumping. Sinusoidal current is similar to faradic current but provides deeper penetration and is less irritating, making it well-suited for nervous clients.
This document discusses galvanic current and its use in stimulating denervated muscles. It defines galvanic current as a direct, unidirectional current that can cause pain due to its unidirectional nature. Interrupted galvanic current is introduced to overcome this by providing regular pauses in stimulation. Stimulating denervated muscles with galvanic current can help limit atrophy and edema until reinnervation occurs. Precautions must be taken when applying galvanic current due to potential dangers like burns or electric shock.
The Faradic Galvanic (FG) test assesses lower motor neuron problems by stimulating muscles with different electric currents. A brief tetanic contraction indicates intact innervation, while a sluggish response suggests denervation. The test involves using faradic current to search for motor points and elicit fast contractions in innervated muscles. Galvanic current then produces slow contractions in denervated muscles. However, the FG test is inaccurate and unreliable, correctly interpreting muscle reactions in only 50% of cases.
This document provides an overview of neuromuscular electrical stimulation (NMES). It discusses how NMES works by sending electrical impulses to nerves that cause muscle contraction. NMES can increase strength, range of motion, and offset disuse effects. The document outlines different electrical waveforms, stimulus parameters, and applications of NMES for conditions like stroke, spinal cord injury, and more. Precautions and contraindications are also reviewed.
Russian current is a form of electrical stimulation using alternating current delivered in 2.5kHz bursts with a 50Hz burst frequency and 50% duty cycle. It was developed by Russian scientist Kots who found it improved strength in athletes. As a result, this stimulation pattern became known as Russian current. It is used clinically to contract and strengthen muscles, typically with 10 seconds on, 50 seconds off bursts to avoid fatigue. The main effects are increased muscle force through central nervous system adaptation and physical muscle growth.
The strength duration curve is a graph that plots the electrical stimulus intensities and durations needed to elicit muscle contraction. It can identify whether a muscle is innervated, denervated, or partially denervated. The curve is measured using a stimulator with varying impulse durations, and indicates the strength required to produce contraction at each duration. Characteristics of the curve reveal muscle innervation status, with denervated muscles requiring higher intensities and longer durations to contract. The curve can be used from 10-14 days after injury to assess nerve regeneration over time.
Electrical stimulation involves using a medium-frequency current to stimulate nerves and muscles. Specifically, it uses a 2500 Hz sinusoidal alternating current delivered in bursts at 50 Hz intervals of 10 ms on and 10 ms off. This Russian current protocol of 10 seconds on, 50 seconds rest, repeated for 10 cycles over 10 minutes was found to be effective for generating muscle fatigue. The stimulation aims to synchronously depolarize sensory and motor fibers, activate fast motor units, and strengthen muscles through electrically evoked contractions against an external load.
Sinusoidal current is an alternating current that produces smooth, rhythmic muscle contractions at 50 Hz. It is produced from mains electricity reduced to 60-80 volts using a step-down transformer. This current stimulates both motor and sensory nerves, causing tetanic muscle contraction and tingling sensation. It is often used over large areas to relieve pain through sensory stimulation and reduce edema through rhythmic muscle pumping. Sinusoidal current is similar to faradic current but provides deeper penetration and is less irritating, making it well-suited for nervous clients.
This document discusses galvanic current and its use in stimulating denervated muscles. It defines galvanic current as a direct, unidirectional current that can cause pain due to its unidirectional nature. Interrupted galvanic current is introduced to overcome this by providing regular pauses in stimulation. Stimulating denervated muscles with galvanic current can help limit atrophy and edema until reinnervation occurs. Precautions must be taken when applying galvanic current due to potential dangers like burns or electric shock.
The Faradic Galvanic (FG) test assesses lower motor neuron problems by stimulating muscles with different electric currents. A brief tetanic contraction indicates intact innervation, while a sluggish response suggests denervation. The test involves using faradic current to search for motor points and elicit fast contractions in innervated muscles. Galvanic current then produces slow contractions in denervated muscles. However, the FG test is inaccurate and unreliable, correctly interpreting muscle reactions in only 50% of cases.
This document provides an overview of neuromuscular electrical stimulation (NMES). It discusses how NMES works by sending electrical impulses to nerves that cause muscle contraction. NMES can increase strength, range of motion, and offset disuse effects. The document outlines different electrical waveforms, stimulus parameters, and applications of NMES for conditions like stroke, spinal cord injury, and more. Precautions and contraindications are also reviewed.
A faradic current is a short duration interrupted direct current with a pulse duration of 0.1-1 ms and frequency of 50-100 Hz. It produces a biphasic, asymmetrical and spiked waveform. Faradic currents are used to produce near normal tetanic-like muscle contractions and relaxations. When applied to nerves and muscles, it causes sensory stimulation, muscle contraction, reduced swelling and pain, and increased metabolism. Faradic current is indicated for muscle reeducation, maintaining range of motion, loosening adhesions, and replacing orthosis. It involves placing electrodes on muscles or nerve trunks and gradually increasing and decreasing intensity to cause contraction and relaxation.
IFT which stands for Interferential Therapy is one of the types of electrotherapy used for the management of pain. The principle of interferential therapy is to cause two medium frequency currents of slightly different frequencies to interfere with one another. For example, if circuit A carries a current with the frequency of 4000Hz and Circuit B carry a current with a frequency of 3980 Hz, then the low frequency produced will be 20 Hz and this frequency is very useful in pain modulation. A new low-frequency current known as the beat frequency is equal to the difference in frequencies between the two medium frequency currents produced in the tissues at the point where the two currents cross.
It is basically used for the treatment of Chronic, Post Traumatic, and Post-surgical pains. The basic principle involves the utilization of effects of low frequencies (<250pps) without painful or unpleasant side effects. The major advantage of IFT is that it produces effects in the tissue, exactly where required without unnecessary and uncomfortable skin stimulation. This technique is widely used to elicit muscle contraction, promote healing and reduce edema.
Vector effect: The interference field is rotated to an angle of 450 in each direction, the field thus covers a wider area. This is useful in diffuse pathology or if the site of the lesion cannot be accurately localized.
Frequency swing: Some equipment allows a variation in the speed of the frequency swing. A rhythmic mode may be a continuous swing from 0 to 100 Hz in 5-10s and back in similar time or it may hold for 1-6s at one frequency followed by 1-6s at another frequency with a variable time to swing between the two.
Constant frequency: Some treatments may be carried out with the interference fixed at a certain frequency. Rhythmic frequency is useful if several types of tissues are to be treated at once. A variation in the frequency also overcomes the problem of tissue accommodation where the response of a particular tissue decreases with time.
WORKING PRINCIPLE: Interferential current therapy works by sending small amounts of electrical stimulation to damaged tissues in the body. The therapy is meant to boost the body's natural process of responding to pain, by increasing circulation thus produces hormones that promote healing. IFT delivers intermittent pulses to stimulate surface nerves and block the pain signal, by delivering continuous deep stimulation into the affected tissue. IFT relieves pain, increases circulation, decreases edema, and stimulates the muscles. A frequency of 100Hz may stimulate the large diameter A-beta fibers, which have an effect on the pain gate, and inhibit the transmission of small-diameter nociceptive traffic ( C and A-delta fiber), which effectively closes the gait to painful impulses. Interferential current Increases the circulation of blood thus reduces swelling.
Interrupted direct current (IDC) involves delivering unidirectional current pulses separated by intervals of no current. The pulses can have different durations, frequencies, rise/fall times, and waveforms (rectangular, trapezoidal, triangular, sawtooth). IDC is used therapeutically for sensory stimulation, pain relief, accelerating healing, and muscle stimulation. It works on nerves and muscles depending on pulse duration and intensity. Techniques like labile and group stimulation are used to target all muscle fibers. IDC has physiological effects like hyperaemia and contraindications like metal implants or risk of injury.
Therapeutic Ultrasound for Physiotherapy studentsSaurab Sharma
This lecture intends to provide general outline about the uses, parameters, precautions and contraindications of therapeutic ultrasound for undergraduate physiotherapy students at Kathmandu University School of Medical Sciences, Nepal. After the lecture, students will explore the evidences about current practices of therapeutic ultrasound in various musculoskeletal pain conditions, critically appraise them and present the evidences to the class.
This document discusses interrupted direct current (IDC), which describes continuous unidirectional current that is interrupted to create pulses of varying duration, shape, or frequency. There are two main types of IDC pulses: rectangular wave pulses and accommodation pulses. Rectangular pulses have sudden rises and falls, while accommodation pulses gradually rise and fall in shapes like triangular, trapezoid, or sawtooth. IDC can stimulate nerves and muscles. Short pulses preferentially stimulate nerves, while longer pulses are needed to stimulate muscles at tolerable intensities. The document discusses electrotonus effects from IDC and considerations for selecting appropriate pulse durations and intensities. It concludes with indications for using electrical stimulation to produce muscle contraction without excessive fatigue.
Microwave diathermy (MWD) uses electromagnetic radiation in the microwave frequency range to generate heat in tissue. MWD uses a magnetron to produce microwaves with frequencies commonly between 300 MHz to 300 GHz. These short wavelength microwaves generate strong electrical fields that cause heating through ionic movements and molecular distortion within tissues. MWD provides superficial heating that is more localized than shortwave diathermy and penetrates deeper than infrared radiation. Key uses of MWD include reducing pain, swelling and muscle spasm in inflammatory conditions like tendinitis as well as accelerating healing for injuries and infections.
The document provides information on the biophysical basics of electrotherapy. It defines electric current as the flow of electric charges from cathode to anode. The three main types of currents are direct current, alternating current, and pulsed current. It describes cathodal and anodal events that occur during current flow and discusses electrolysis, electrolytic dissociation, amplitude, voltage, resistance, waveform, phase, frequency, electrode placement and size. The objective is to explain the underlying biophysical principles of electrotherapy.
This document discusses pulsed shortwave therapy (PSWT), which delivers pulsed electromagnetic energy in short pulses with time gaps between. PSWT uses a similar 27.12MHz frequency as traditional shortwave diathermy but with lower mean power of 2-5W. It results in non-thermal tissue heating through effects on cell membranes and ion transport. PSWT is shown to increase healing factors like white blood cells in wounds and reduce edema and inflammation. Treatment doses and contraindications are provided. PSWT is compared to traditional shortwave diathermy, with PSWT having non-thermal rather than thermal effects.
Diadynamic currents are a variation of sinusoidal currents that are produced by rectifying alternating current into monophasic pulses. There are two main types - half wave rectification produces pulses with a duration equal to the interpulse interval at the original frequency, while full wave rectification produces continuous pulses at twice the original frequency. The pulses from diadynamic currents have a duration of 10ms, causing sensations from vibration to pain depending on intensity. Different current types like MF, DF, CP and LP are used for pain relief, muscle stimulation, and preventing accommodation effects. Precautions must be taken due to the electrochemical changes and potential skin damage from the currents.
Galvanic current is a low frequency, interrupted direct current with pulse durations over 1ms up to 300ms and frequencies under 50Hz. It was discovered in the 1780s by Luigi Galvani and can cause contraction of denervated muscles through sluggish contractions, stimulation of sensory nerves resulting in pain sensations, and stimulation of motor nerves at high intensities. Therapeutically, galvanic current is used to retard muscle atrophy and substitute for normal muscle contraction in denervated muscles by slowing structural and functional changes like loss of activity and fibrosis through electrical stimulation. It can also be used facially to reduce dullness, fine lines, wrinkles, and improve elasticity and oxygen supply.
Presentation slides from our recent workshop on Myofascial Release. This workshop was delivered from our St John Street Clinic in Manchester on Saturday 17th March.
This document provides information about faradic current, including its nature, therapeutic and physiological effects, techniques of application, indications, contraindications, and clinical applications. It describes faradic current as an asymmetrical alternating current with a pulse duration of 0.1-1 ms and frequency of 30-100 Hz. The document discusses the effects of faradic current such as stimulation of sensory and motor nerves and reduction of swelling and pain. It outlines various methods and techniques of faradic current application for diagnostic and therapeutic purposes, as well as precautions and potential dangers of its use.
This document discusses interferential therapy (IFT), including its history, principles, instrumentation, applications, effects, and precautions. Some key points:
- IFT was developed in the 1950s and involves applying two medium frequency alternating currents slightly out of phase to produce a low frequency effect for therapeutic purposes.
- The interference of the currents produces an amplitude-modulated frequency that can stimulate tissues in a manner similar to low frequency electrotherapy.
- IFT is used for pain relief, muscle stimulation, increasing blood flow, and reducing edema through its physiological effects on tissues from 10-150 Hz.
- Proper electrode placement and current parameters are important to achieve the intended effects while avoiding contraindic
This document discusses interferential therapy (IFT), a type of electrical stimulation treatment. IFT involves applying two medium frequency currents to generate a low frequency interference current in the tissues for therapeutic effects. It provides pain relief and motor stimulation while avoiding skin irritation experienced with other currents. IFT is indicated for various painful conditions and edema and uses specific frequencies for different treatments, like 1-10Hz rhythmic mode for reducing swelling. Precautions include avoiding direct electrode contact and proper placement to ensure current passes through tissues as intended.
Short wave diathermy (s.w.d) electro therapyÂbhìšhék Singh
Electrotherapy topic shot wave diathermy ppt (physics)
Bachelor of physiotherapy topic swd . Swd introduction, and range of swd , indications and contraindications of swd
This document discusses high volt pulsed galvanic stimulation (HVPGS), a type of neuromuscular electrical stimulation. It delivers a monophasic twin peak waveform with a high voltage up to 500 volts and short pulse duration to stimulate nerves and tissues. HVPGS can be used to promote wound healing, reduce edema, manage pain, and stimulate muscle. It provides physiological effects like increasing range of motion and blood flow. Treatment duration is typically 15-30 minutes per session and can be repeated daily.
Modified galvanic current, or interrupted direct current, is a type of electrical stimulation where a direct current is pulsed on and off at regular intervals. The document discusses how this current is produced using a source, transistors, and a timer circuit. It describes the physiological effects of interrupted direct current such as sensory stimulation, hyperemia, electrotonus, pain relief, and accelerated healing. The document also provides guidelines for administering interrupted direct current and lists contraindications.
This document discusses trick movements, or unnatural movements that occur when a muscle is paralyzed or inhibited. It defines trick movements and describes several types: direct/indirect substitution where another muscle takes over the action of the paralyzed prime mover; accessory insertion where a muscle's insertion allows it to assist a weak muscle's movement; tendon action where shortening of a tendon produces movement; rebound where relaxation of an antagonist muscle causes apparent agonist contraction; and gravity assistance where body positioning uses gravity to assist weak muscles. Examples are provided for each type of trick movement.
Contrast baths involve alternating immersion of an area in hot and cold water to increase blood flow and decrease joint stiffness. The alternating temperatures cause vasodilation and vasoconstriction, pumping blood and removing edema. This treatment alleviates pain, stiffness, and edema by improving circulation, increasing immune cells, and suppressing pain. Contrast baths are used for injuries like sprains and arthritis of the hands, wrists, feet, ankles, elbows, and knees. The procedure involves soaking in warm water for periods, then cold water for shorter periods, totaling around 25 minutes.
- The strength-duration curve is a graph that plots the electrical stimulus intensity against the time needed to elicit a muscle contraction. It can determine if a muscle is innervated, denervated, or partially denervated.
- The curve is generated by applying electrical stimuli of varying durations (0.01-300ms) to a muscle and recording the intensity needed to produce a minimal contraction. The shape of the curve indicates the muscle's innervation status.
- A normal curve will have all longer duration stimuli producing a response at the same intensity, while shorter durations require more intensity. Complete denervation results in a steeply rising curve requiring more intensity for all shorter durations. Partial denervation produces
The document discusses strength duration curves, which plot the electrical stimuli needed to elicit a muscle contraction over a range of stimulus durations. It describes how to perform the test and interpret the results, including details on:
- Plotting S-D curves after 20 days post-injury to assess innervation status
- The typical shape of normal, denervated, and partially denervated curves
- Additional metrics that can be measured from S-D curves like rheobase and chronaxie
- Factors that can influence the curves and what different curve patterns indicate
A faradic current is a short duration interrupted direct current with a pulse duration of 0.1-1 ms and frequency of 50-100 Hz. It produces a biphasic, asymmetrical and spiked waveform. Faradic currents are used to produce near normal tetanic-like muscle contractions and relaxations. When applied to nerves and muscles, it causes sensory stimulation, muscle contraction, reduced swelling and pain, and increased metabolism. Faradic current is indicated for muscle reeducation, maintaining range of motion, loosening adhesions, and replacing orthosis. It involves placing electrodes on muscles or nerve trunks and gradually increasing and decreasing intensity to cause contraction and relaxation.
IFT which stands for Interferential Therapy is one of the types of electrotherapy used for the management of pain. The principle of interferential therapy is to cause two medium frequency currents of slightly different frequencies to interfere with one another. For example, if circuit A carries a current with the frequency of 4000Hz and Circuit B carry a current with a frequency of 3980 Hz, then the low frequency produced will be 20 Hz and this frequency is very useful in pain modulation. A new low-frequency current known as the beat frequency is equal to the difference in frequencies between the two medium frequency currents produced in the tissues at the point where the two currents cross.
It is basically used for the treatment of Chronic, Post Traumatic, and Post-surgical pains. The basic principle involves the utilization of effects of low frequencies (<250pps) without painful or unpleasant side effects. The major advantage of IFT is that it produces effects in the tissue, exactly where required without unnecessary and uncomfortable skin stimulation. This technique is widely used to elicit muscle contraction, promote healing and reduce edema.
Vector effect: The interference field is rotated to an angle of 450 in each direction, the field thus covers a wider area. This is useful in diffuse pathology or if the site of the lesion cannot be accurately localized.
Frequency swing: Some equipment allows a variation in the speed of the frequency swing. A rhythmic mode may be a continuous swing from 0 to 100 Hz in 5-10s and back in similar time or it may hold for 1-6s at one frequency followed by 1-6s at another frequency with a variable time to swing between the two.
Constant frequency: Some treatments may be carried out with the interference fixed at a certain frequency. Rhythmic frequency is useful if several types of tissues are to be treated at once. A variation in the frequency also overcomes the problem of tissue accommodation where the response of a particular tissue decreases with time.
WORKING PRINCIPLE: Interferential current therapy works by sending small amounts of electrical stimulation to damaged tissues in the body. The therapy is meant to boost the body's natural process of responding to pain, by increasing circulation thus produces hormones that promote healing. IFT delivers intermittent pulses to stimulate surface nerves and block the pain signal, by delivering continuous deep stimulation into the affected tissue. IFT relieves pain, increases circulation, decreases edema, and stimulates the muscles. A frequency of 100Hz may stimulate the large diameter A-beta fibers, which have an effect on the pain gate, and inhibit the transmission of small-diameter nociceptive traffic ( C and A-delta fiber), which effectively closes the gait to painful impulses. Interferential current Increases the circulation of blood thus reduces swelling.
Interrupted direct current (IDC) involves delivering unidirectional current pulses separated by intervals of no current. The pulses can have different durations, frequencies, rise/fall times, and waveforms (rectangular, trapezoidal, triangular, sawtooth). IDC is used therapeutically for sensory stimulation, pain relief, accelerating healing, and muscle stimulation. It works on nerves and muscles depending on pulse duration and intensity. Techniques like labile and group stimulation are used to target all muscle fibers. IDC has physiological effects like hyperaemia and contraindications like metal implants or risk of injury.
Therapeutic Ultrasound for Physiotherapy studentsSaurab Sharma
This lecture intends to provide general outline about the uses, parameters, precautions and contraindications of therapeutic ultrasound for undergraduate physiotherapy students at Kathmandu University School of Medical Sciences, Nepal. After the lecture, students will explore the evidences about current practices of therapeutic ultrasound in various musculoskeletal pain conditions, critically appraise them and present the evidences to the class.
This document discusses interrupted direct current (IDC), which describes continuous unidirectional current that is interrupted to create pulses of varying duration, shape, or frequency. There are two main types of IDC pulses: rectangular wave pulses and accommodation pulses. Rectangular pulses have sudden rises and falls, while accommodation pulses gradually rise and fall in shapes like triangular, trapezoid, or sawtooth. IDC can stimulate nerves and muscles. Short pulses preferentially stimulate nerves, while longer pulses are needed to stimulate muscles at tolerable intensities. The document discusses electrotonus effects from IDC and considerations for selecting appropriate pulse durations and intensities. It concludes with indications for using electrical stimulation to produce muscle contraction without excessive fatigue.
Microwave diathermy (MWD) uses electromagnetic radiation in the microwave frequency range to generate heat in tissue. MWD uses a magnetron to produce microwaves with frequencies commonly between 300 MHz to 300 GHz. These short wavelength microwaves generate strong electrical fields that cause heating through ionic movements and molecular distortion within tissues. MWD provides superficial heating that is more localized than shortwave diathermy and penetrates deeper than infrared radiation. Key uses of MWD include reducing pain, swelling and muscle spasm in inflammatory conditions like tendinitis as well as accelerating healing for injuries and infections.
The document provides information on the biophysical basics of electrotherapy. It defines electric current as the flow of electric charges from cathode to anode. The three main types of currents are direct current, alternating current, and pulsed current. It describes cathodal and anodal events that occur during current flow and discusses electrolysis, electrolytic dissociation, amplitude, voltage, resistance, waveform, phase, frequency, electrode placement and size. The objective is to explain the underlying biophysical principles of electrotherapy.
This document discusses pulsed shortwave therapy (PSWT), which delivers pulsed electromagnetic energy in short pulses with time gaps between. PSWT uses a similar 27.12MHz frequency as traditional shortwave diathermy but with lower mean power of 2-5W. It results in non-thermal tissue heating through effects on cell membranes and ion transport. PSWT is shown to increase healing factors like white blood cells in wounds and reduce edema and inflammation. Treatment doses and contraindications are provided. PSWT is compared to traditional shortwave diathermy, with PSWT having non-thermal rather than thermal effects.
Diadynamic currents are a variation of sinusoidal currents that are produced by rectifying alternating current into monophasic pulses. There are two main types - half wave rectification produces pulses with a duration equal to the interpulse interval at the original frequency, while full wave rectification produces continuous pulses at twice the original frequency. The pulses from diadynamic currents have a duration of 10ms, causing sensations from vibration to pain depending on intensity. Different current types like MF, DF, CP and LP are used for pain relief, muscle stimulation, and preventing accommodation effects. Precautions must be taken due to the electrochemical changes and potential skin damage from the currents.
Galvanic current is a low frequency, interrupted direct current with pulse durations over 1ms up to 300ms and frequencies under 50Hz. It was discovered in the 1780s by Luigi Galvani and can cause contraction of denervated muscles through sluggish contractions, stimulation of sensory nerves resulting in pain sensations, and stimulation of motor nerves at high intensities. Therapeutically, galvanic current is used to retard muscle atrophy and substitute for normal muscle contraction in denervated muscles by slowing structural and functional changes like loss of activity and fibrosis through electrical stimulation. It can also be used facially to reduce dullness, fine lines, wrinkles, and improve elasticity and oxygen supply.
Presentation slides from our recent workshop on Myofascial Release. This workshop was delivered from our St John Street Clinic in Manchester on Saturday 17th March.
This document provides information about faradic current, including its nature, therapeutic and physiological effects, techniques of application, indications, contraindications, and clinical applications. It describes faradic current as an asymmetrical alternating current with a pulse duration of 0.1-1 ms and frequency of 30-100 Hz. The document discusses the effects of faradic current such as stimulation of sensory and motor nerves and reduction of swelling and pain. It outlines various methods and techniques of faradic current application for diagnostic and therapeutic purposes, as well as precautions and potential dangers of its use.
This document discusses interferential therapy (IFT), including its history, principles, instrumentation, applications, effects, and precautions. Some key points:
- IFT was developed in the 1950s and involves applying two medium frequency alternating currents slightly out of phase to produce a low frequency effect for therapeutic purposes.
- The interference of the currents produces an amplitude-modulated frequency that can stimulate tissues in a manner similar to low frequency electrotherapy.
- IFT is used for pain relief, muscle stimulation, increasing blood flow, and reducing edema through its physiological effects on tissues from 10-150 Hz.
- Proper electrode placement and current parameters are important to achieve the intended effects while avoiding contraindic
This document discusses interferential therapy (IFT), a type of electrical stimulation treatment. IFT involves applying two medium frequency currents to generate a low frequency interference current in the tissues for therapeutic effects. It provides pain relief and motor stimulation while avoiding skin irritation experienced with other currents. IFT is indicated for various painful conditions and edema and uses specific frequencies for different treatments, like 1-10Hz rhythmic mode for reducing swelling. Precautions include avoiding direct electrode contact and proper placement to ensure current passes through tissues as intended.
Short wave diathermy (s.w.d) electro therapyÂbhìšhék Singh
Electrotherapy topic shot wave diathermy ppt (physics)
Bachelor of physiotherapy topic swd . Swd introduction, and range of swd , indications and contraindications of swd
This document discusses high volt pulsed galvanic stimulation (HVPGS), a type of neuromuscular electrical stimulation. It delivers a monophasic twin peak waveform with a high voltage up to 500 volts and short pulse duration to stimulate nerves and tissues. HVPGS can be used to promote wound healing, reduce edema, manage pain, and stimulate muscle. It provides physiological effects like increasing range of motion and blood flow. Treatment duration is typically 15-30 minutes per session and can be repeated daily.
Modified galvanic current, or interrupted direct current, is a type of electrical stimulation where a direct current is pulsed on and off at regular intervals. The document discusses how this current is produced using a source, transistors, and a timer circuit. It describes the physiological effects of interrupted direct current such as sensory stimulation, hyperemia, electrotonus, pain relief, and accelerated healing. The document also provides guidelines for administering interrupted direct current and lists contraindications.
This document discusses trick movements, or unnatural movements that occur when a muscle is paralyzed or inhibited. It defines trick movements and describes several types: direct/indirect substitution where another muscle takes over the action of the paralyzed prime mover; accessory insertion where a muscle's insertion allows it to assist a weak muscle's movement; tendon action where shortening of a tendon produces movement; rebound where relaxation of an antagonist muscle causes apparent agonist contraction; and gravity assistance where body positioning uses gravity to assist weak muscles. Examples are provided for each type of trick movement.
Contrast baths involve alternating immersion of an area in hot and cold water to increase blood flow and decrease joint stiffness. The alternating temperatures cause vasodilation and vasoconstriction, pumping blood and removing edema. This treatment alleviates pain, stiffness, and edema by improving circulation, increasing immune cells, and suppressing pain. Contrast baths are used for injuries like sprains and arthritis of the hands, wrists, feet, ankles, elbows, and knees. The procedure involves soaking in warm water for periods, then cold water for shorter periods, totaling around 25 minutes.
- The strength-duration curve is a graph that plots the electrical stimulus intensity against the time needed to elicit a muscle contraction. It can determine if a muscle is innervated, denervated, or partially denervated.
- The curve is generated by applying electrical stimuli of varying durations (0.01-300ms) to a muscle and recording the intensity needed to produce a minimal contraction. The shape of the curve indicates the muscle's innervation status.
- A normal curve will have all longer duration stimuli producing a response at the same intensity, while shorter durations require more intensity. Complete denervation results in a steeply rising curve requiring more intensity for all shorter durations. Partial denervation produces
The document discusses strength duration curves, which plot the electrical stimuli needed to elicit a muscle contraction over a range of stimulus durations. It describes how to perform the test and interpret the results, including details on:
- Plotting S-D curves after 20 days post-injury to assess innervation status
- The typical shape of normal, denervated, and partially denervated curves
- Additional metrics that can be measured from S-D curves like rheobase and chronaxie
- Factors that can influence the curves and what different curve patterns indicate
a detailed description on theory behind Strength duration curve, along with procedure for plotting SD Curve and measuring the Rheobase and Chronaxie of the plotted graph.
Electromyography (EMG) and nerve conduction studies are used to evaluate nerve and muscle health. EMG records electrical activity in muscles at rest and during contraction. Abnormal findings include spontaneous activity in denervated muscles. Nerve conduction studies measure nerve impulse velocity, helping determine if a nerve injury is present and whether it is complete or partial. Strength-duration curves generated from EMG further characterize muscle health, with denervated muscles requiring longer or stronger stimulation. These electrodiagnostic studies aid in diagnosing and monitoring nerve injuries.
The strength-duration curve is a graphical representation of the relationship between the intensity of an electrical stimulus at the motor point of a muscleand the length of time taken to elicit a minimal contraction in that muscle.
Electrical stimulation is used both diagnostically and therapeutically for muscles and nerves. Diagnostic tests measure the rheobase, chronaxie, and create strength-duration curves to determine if a muscle is innervated, denervated, or partially denervated. Therapeutically, neuromuscular electrical stimulation is used to prevent muscle atrophy and decrease spasms by causing asynchronous muscle contractions, though it must be supplemented with voluntary strength training. The optimal stimulation parameters vary but generally include a pulse duration of 300-400 microseconds, frequency of 20-100 Hz, and a duty cycle sufficient to generate force without causing fatigue.
Electrical stimulation of nerve and muscles.pptxMaira Pervez
This document discusses electrical stimulation of nerves and muscles. It explains that a nerve impulse can be initiated by an electrical stimulus of adequate intensity and varying current. It describes the resting and activated states of nerves and how electrical stimulation works. It discusses factors that influence nerve and muscle stimulation like accommodation, stimulus duration and strength, and how this relates to normal, partial, and complete denervation. Strength-duration curves are used to characterize nerve and muscle responses. Chronaxie and rheobase can be determined from these curves. Direct muscle stimulation is also discussed.
Electric muscle stimulation physiotherapy.pptxRexSenior
Electrical muscle stimulation (EMS) uses electrical currents to cause muscle contractions and strengthen weak muscles. Different types of currents such as faradic and galvanic are used depending on if the muscle is innervated or denervated. A strength duration curve shows the relationship between stimulus magnitude and duration, and can indicate the state of a nerve lesion by its shape. Parameters like frequency, pulse duration, and amplitude must be set properly for safe and effective EMS treatment.
MSEE Defense: Digital Processor to Monitor the Muscular Energy Drop in Surfac...rff001
This document describes a digital processor to monitor muscular energy drop in surface electromyograms (EMGs). The processor aims to monitor fatigue in muscles undergoing neuromuscular electrical stimulation (NMES) rehabilitation. It analyzes EMG signals to extract spectral parameters that quantify fatigue, like root mean square, average rectified value, and mean and medium frequencies. These parameters are used in a proposed NMES control system to monitor energy decrease and prevent total muscle fatigue. A digital processing unit was developed using MATLAB to validate the technique.
Strength duration curve is a graph between electrical stimuli of different intensities and recording the time needed by each stimulus to start the response.
S-D curve should be plotted after 20th day of injury/lesion.
It indicates the strength of impulses of various durations required to produce muscle contraction by joining the points that graphically represent the threshold value along the ordinate for various duration.
After 21st/22nd day, regeneration of nerve will start, generally it take about 270 days to regenerate.
The purpose of S-D curve plotting is to know whether the stimulated muscle is innervated, denervated or partially denervated.
There are also other method for this purpose like EMG and NCV.
Strength duration curve
A motor point is a specific skin area where the targeted muscle is best stimulated with the smallest amount of current amplitude and the shortest pulse duration
Basics of peripheral nerve stimulator and ultrasoundhrishi bharali
This document provides an overview of peripheral nerve stimulation (PNS) and ultrasound guidance for nerve blocks. It discusses the history and components of PNS, including electrical stimulation parameters and techniques. It also covers ultrasound basics like machine parts, imaging modes, and resolution. Regarding nerve blocks, it describes imaging plane options, needle visualization techniques, and the steps of ultrasound-guided blocks including scanning the nerve and choosing an in-plane or out-of-plane needle approach. Overall, the document aims to educate about the principles and procedures of PNS and ultrasound guidance for regional anesthesia.
Dr. Yamini V S presented on the basics of peripheral nerve stimulation. Key points include:
1. Electrical nerve stimulation uses controlled electrical currents to locate nerves through eliciting motor responses or paraesthesia.
2. Modern nerve stimulators use constant current outputs to maintain stimulation strength despite tissue impedance changes.
3. Advances in stimulating needles, catheters, equipment, and techniques like transcutaneous nerve mapping have improved accuracy and reduced risk of nerve injury during peripheral nerve blocks.
4. Proper understanding of nerve physiology and anatomy remains essential for safe and effective use of peripheral nerve stimulation.
Electrotherapy involves the use of electric currents passed through the body to stimulate nerves and muscles, chiefly in the treatment of diseases. There are different types of electric currents including direct current (DC), alternating current (AC), and pulsed current. Currents are also classified by their frequency as low, medium, or high frequency currents, with each type used for specific therapeutic applications like muscle stimulation, pain relief, or inducing deep heat.
The document discusses various electrical stimulation modalities used for pain relief including TENS, interferential current, NMES, and iontophoresis. It describes the principles, physiological effects, indications, contraindications, and application parameters for each modality. Commonly used waveforms such as monophasic, biphasic, and Russian are also explained.
This document provides information about electromyography (EMG) and motor nerve conduction velocity testing. It discusses how EMG works by recording electrical muscle activity using needle or surface electrodes. Normal motor unit potentials are described. Motor nerve conduction velocity testing measures nerve conduction speed and can identify axonal or myelin abnormalities. The objectives are listed as learning how to perform the tests and analyze results in health and disease. The procedure for EMG and motor nerve conduction velocity testing is outlined, including instrument setup and electrode placement. Normal and abnormal EMG and nerve conduction findings are presented.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
2. OUTLINE
Definition
Advantages & disadvantages
of SD curve plotting
Optimum timing for SD
curve
Electrical parameters of SDC
Method of SD curve plotting
Characteristics of the curves
Rheobase, Chronaxie & Pulse
ratio
Rise time & Utilization time
Factors that affects the
accuracy of the SD curves
Practical uses of SD curve in
diagnosis
References
3. Definition
• “This curve indicates the strength of
impulses of various duration required
to produce contraction in a muscle, is
obtained by joining the points that
graphically represent the threshold
values along the ordinate, for the
various duration of stimulus
displayed along the abscissa.”
• The normal curve has a characteristic
shape, which shifts towards “right” in
denervation & shows a “kink” in case
of partial denervation.
100
50
20
15 14 13 13 13 13
0
20
40
60
80
100
120
0.01 0.03 0.1 0.3 1 3 10 30 100 300
Miliamp
Millisec
Constant current
stimulation
4. Advantages & Disadvantages of SD
curve plotting
• ADVANTAGES:
1. Simple
2. Reliable
3. Indicates the proportion of
denervation
• DISADVANTAGES:
1. In a large muscle only a
proportion of fibers may
respond, there for a full
picture is not obtained for
the whole muscle.
2. It also does not tell about
the site of lesion.
5. Optimum timing for SD curve
• The patients with peripheral nerve injuries can have their SD
curve done 10-14 days after the onset of the lesion, when the
motor end plate is no longer functioning & Wallerian
degeneration, if present would have occurred.
• For other lesions of the motor unit, if there is a paralysis/paresis,
present, following acute onset or slow insidious onset, then after
considering relevant pathology for prognosis, the SDC, may be
utilized to assess the extent of the lesion & monitor progress.
It is best done weekly under the same conditions until there is
recovery or decision has been reached on the final state of the
muscle.
Once recovery takes place, there will be changes expected in the
curve every fortnight or so.
6. Electrical parameters of SDC
• Rectangular, monophasic pulsed current.
• Frequency of 1 Hz.
• Pulse duration ranges from 0.01 to 300 ms.
• Constant current [CC] [more accurate] or constant voltage [CV] [more
comfortable] stimulator
• Cathode: at the motor point of the muscle.
• Anode: over the muscle few cm away from the motor point or other convenient
areas.
• Response: Minimally detectable (visible) twitch contraction.
Response of usually, two muscles supplied by the nerve distal to damaged area
are examined, one proximal & one distal usually starting 7-10 days after
injury.
Tests repeated every 2 weeks (depending on site of injury & muscle tested).
7. Method of SDC plotting
1. Patient is explained about the procedure & placed in comfortable
position.
2. The part to be tested is exposed & kept well supported.
3. The room should be well lighted.
4. Check contraindications if any.
5. Cover the abrasions, decrease the skin resistance by cleansing
the area with soap & water & moisten the part with warm 1%
saline. [use tap water in the absence of warm 1% saline]
6. Therapist should also be in a comfortable position with hand
stable throughout the procedure.
8. 7. Active electrode should be as small as possible to avoid spreading
of the current.
8. Set the parameters as described above with intensity on zero,
pulse duration at 300 ms & electrodes in position.
9. Stimulate with an active electrode at or around the motor point
area to get a minimal, visible contraction.
Find the best point & note the intensity of current needed.
Successively decrease the pulse durations, increase the intensity
for the particular pulse duration.
Repeat for all pulse durations up to 0.01 ms.
Method of SDC plotting
9. 10. Maintain the same position,
angle & pressure for the active
electrode.
11. Plot the graph of the strength of
the current [Y axis] versus the
pulse duration [X axis].
12. Note the name, age, gender, date
of injury & date of performing the
test along with the diagnosis &
interpretation.
Method of SDC plotting
100
50
20
15 14 13 13 13 13
0
20
40
60
80
100
120
0.01 0.03 0.1 0.3 1 3 10 30 100 300
Miliamp
Millisec
Constant current
stimulation
10. Characteristics of the curve
[1] Normal Innervations:
• When all the nerve fibers supplying the muscles are intact, the
curve obtained has a characteristic shape as seen in figure 1.
• The curve is of this typical shape because the same strength of
stimulus is required to produce a response with all the impulses of
longer duration.
• While those with a shorter duration require an increase in the
strength of stimulus each time the duration is reduced.
• The point of rise of the curve with a constant current stimulator is
around 1 ms, whereas that with the constant voltage stimulator is
at 0.1 ms.
12. [2] Complete denervation:
• When all the nerve fibers supplying a muscle have degenerated,
the SDC produced, is characteristic of complete denervation.
[figure 2]
• In this curve as the response is from the muscles which lacks
nerve continuity, only the long duration pulses will elicit the
response & there will be a need to increase the current intensity
from about 10 ms duration.
• The curve is no longer horizontal on the right hand side but is
converted into a distinctive steeply rising parabola, which is
displaced towards the right.
Characteristics of the curve
14. [3] Partial denervation:
• When some of the nerve fibers supplying a muscle have
degenerated, while the others are intact, the curve takes a
typical shape as shown in figure 3.
• The impulses of longer duration stimulate both the innervated &
denervated muscle fibers, so a contraction is obtained with a
stimulus of low intensity.
• As the impulses are shortened, the denervated fibers respond
less readily, so that a stronger stimulus is required to a produce
a perceptible contraction & the curve rises steeply, like that of
denervated muscle.
Characteristics of the curve
15. • With the impulses of shorter durations, the innervated fibers respond to a
weaker stimulus than that required for the denervated fibers, so a contraction
of the denervated fibers is not obtained & this part of the curve is similar to
that of innervated muscles.
• Thus, the right hand part of the curve resembles that of denervated muscle &
left hand part that of the innervated muscle & a “kink” is seen at the point
where the two sections meet.
• The appearance of a kink or discontinuity in the curve is a reliable early sign of
denervation & in progressive involvement of nerve lesions, it provides slightly
later evidence of denervation than electromyography.
• The extent of denervation can be picked up by the shape of the curve and kinks.
• If a larger part of the muscle is denervated, the greater part of the curve
resembles that of denervated curve with the kink but if only a part of the fibers
are denervated & the majority innervated, then the curve resembles a normal
curve with a kink in it.
Characteristics of the curve
18. Rheobase, chronaxie and pulse ratio
[1] Rheobase:
• It is the intensity of current required to produce a minimal perceptible &
palpable contraction using a pulse of infinite duration.
• Generally pulses of 100 or 300 ms duration are used to record rheobase.
• The shape of pulse is always rectangular.
• It is measured in milliampere or volt, depending upon whether a constant
current or constant voltage stimulator is used.
• Rheobase is usually measured by placing the cathode on the motor point of the
nerve.
• Normal values: 2-10 mA or 10-20 volts.
• In denervation, the value of rheobase may be less than that of the innervated
muscles & it often rises as re-innervations starts.
19. [2] Chronaxie:
• It is the duration of the shortest impulse, that will produce a response
with a current double that of the rheobase.
• It is the index of excitability & is the time in milliseconds, that is
necessary to induce minimal visible contraction, with a stimulus of twice
the strength of rheobase.
• Normal values: < 1 ms.
• In denervation, the value of chronaxie is more than that of innervated
muscles.
• The denervated muscle values for chronaxie are around 10 ms or more.
Rheobase, chronaxie and pulse ratio
20. [3] Pulse ratio:
• It is the ratio of intensity of the current needed to produce a
muscle contraction with 1 ms duration to that required if the
duration of the pulse is 100 ms.
• It is a crude test.
• A value greater than 2.2 indicates abnormality.
• The extent of partial denervation can not be assessed from this
test.
Rheobase, chronaxie and pulse ratio
21. Rise time & Utilization time
Rise time: it is the pulse duration at which one need to increase
the intensity of current more than the rheobase intensity.
• It is late in normal innervation & early in denervation.
Utilization time: it is the shortest pulse duration at which you
get a minimal stimulation with intensity of current equal to the
rheobase current.
22. Factors that affect the accuracy of
SDC:
1. Skin temperature: this alters the value of rheobase. An
increase in temperature lower the rheobase value, whereas a
decrease in temperature will raise the rheobase.
2. Humidity: high humidity decreases the value of rheobase.
3. Location of muscles: deeply placed muscles can not accurately
be located.
4. Oedema
5. Superficial fat: large amount of fat will cause increased
resistance to current flow, which leads to incorrect results.
23. 6. Ischaemia: causes a rise in the threshold values, therefore a
greater intensity of current will be required.
7. Electrode position: the electrode, if not positioned properly may
cover some of the fibers of the adjacent muscle, therefore gving
inaccurate results.
8. Pressure variations: the variations of pressure of the hand held
electrode during testing procedure will give faulty results.
Factors that affect the accuracy of
SDC:
24. Practical uses of SDC in diagnosis
1. To detect the presence or absence of the excitable nerve fibers in a
muscle.
2. It also assesses the extent of denervation/innervation.
3. It detects the signs of re-innervations in a muscle. [in most cases, the
onset of regeneration is evident well in advance of the clinical return
of the voluntary contraction]
4. It monitors the progress of the lesion & denotes whether the lesion is
recovering/regressing.
5. The values of rheobase & chronaxie which also indicate about the
status of innervation, is also measured from the SDC.
25. References
1. John Low and Ann Reed. Electrotherapy Explained. 4th
edition. Elsevier publications.
2. B Nanda. Electrotherapy simplified. 1st edition. Jaypee
publications.
3. N Vyas. Principles & practice of rehabilitation. 1st edition.
Jaypee publications.