good for UG students

1. A.THANGAMANI RAMALINGAM

3.  Electricity is an
element of PT
modalities most
frightening and least
understood.
 Understanding the
basis principles will
later aid you in
establishing treatment
protocols.

5. • Amplitude window
• Frequency window
• Acute window
• chronic window
• Energy based window
• Time based window
• Interval based window

6.  420B.C-hippocrates-in torpaedo fish
 46A.D-scribonius largus-gout/headache
 1700-luigi galvani & alessantro volta
 1745-leyden jar for ES
 1831-michael faraday
 1850s-duchene-motor points(father of ES)
 1909-rheo/chron-louis
 1916-SD curve-Adrian
 FES-1961-liberson
 1962-HVPC-robert becker

7.  Introduction
 Definition
 Physical characteristics
 Therapeutic uses
 Treatment regimes
 Practical application
 Contra-indications
 Dangers

8.  Widely used electrotherapy modality
 Used since the 1950s to utilise the therapeutic
aspects of low frequency currents without the
discomfort

10.  Two medium frequency currents of slightly
differing frequency are applied to the body
in such a manner to produce;
 an amplitude modulated medium frequency
current within the body.
 Amplitude modulation provides a beat
frequency that is within the biological
frequency range

11. PRODUCTION OF IFT

12. medium frequency A + medium frequency B = low (therapeutic) frequency C

14. 1.
Z=1/2Π fC
 ,Z = skin impedance
f = frequency in Hertz (Hz)
C = capacitance of skin in microfarads

15. Skin impedance is of two types
 ohmic resistance and
 capacitive resistance.

Capacitive resistance is developed deep in the tissues due to
electrolytic potential difference generated in the cell membrane

16.  2.Accomodation is delayed.
 3.Current can travel at the depth of the tissue.
 4.Alternating current can be used
 5. Stimulus asynchronous stimulation is applied for production of interferential
current so Wedensky inhibition doesn’t takes place and thereby there is no
accommodation phenomenon.
 Stimulus asynchronous produces Gilde-Meister effect.
(In low-frequency currents, stimulus synchronous is used which causes
Wedensky inhibition and thus nerve or muscle gets accommodated to that
current.
Inability of tissue to respond during the refractory period due to stimulus
synchronus current is known as Wedensky inhibition)

17. PlateElectrodes
Vacuum Electrodes
Combined Electrodes(probe electrode)
Quadripolar/bipolar method
Scannig/static
Constant/variable frequency

18. Suction electrodes
with moistened
sponges
Suction machine

19. Electrodes placed so that the
two circuits produce an interference
current and the patient experiences
the tingling sensation on and around
the site of their problem
Left knee

20. Electrodes placed above Thigh ,
Knee , Upper back & Lower back
Region

21.  4KHZ-pain relief
 2KHZ-muscle stimulation
 Pre modulated/4EL
 Able to penetrate tissues with little resistance
 No accomadation/gildemeister effect

22.  100Hz - pain relief
 50-60 Hz = muscle contraction
 1-50 Hz = increased circulation
 The higher the frequency (Hz) the more quickly
the muscle will fatigue
 1-4 Hz-beta endorphin
 40-100Hz-enkepalin,serotonin

23.  Interferential current is commonly used for pain
relief
 Relief of muscle spasm
 Promote tissue healing
 Relief from edema
 Re-education of deeply situated
Muscles.

24.  Facialnerve neuritis
 Orthopedic conditions
 Pain-LBP.jaw pain,OA pain,fibromyalgia
( same like tens)
 Gynecological problems-incontinence
 DOMS
 Edema
 Post surgical pain
 Bone healing

25.  Vasoconstrictive disease
 Venous insufficiency
 Delayed union
 Pseudo arthrosis
 Sudeck’s atrophy
 Muscle reeducation(PFM)

26. Relief of pain – pain gate theory
 80-140Hz (higher IFT frequencies)
 Stimulates Aβ fibres
 To inhibit impulse transmission in A∂ and C
fibres
 Used for both acute and chronic pain
 Temporary pain relief

27. Relief of pain – Ascending pain suppression,
2-30Hz (lower frequencies)
 Stimulates A∂ fibres:
 To inhibit C fibre transmission
 Via the release of encephalins and endorphins
 More longer lasting pain relief
 Only effective on chronic pain

28. Reduction of oedema 0-100 Hz
 Stimulates autonomic nerves to produce
vasodilatation
 Increases circulation

29. Motor stimulation
 0-25 Hz - twitch
 25-100 Hz - muscle contraction
 Can be used to treat incontinence or
muscle weakness secondary to trauma/
surgery (in conjunction with active
exercise).

30.  Acute sepsis - ↑ risk of spread of infection
 Tumours - ↑ risk of increased growth of activity
 Pregnancy – no treatment over uterus or its’
nerve supply
 Cardiac disease – no treatment over the heart,
cervical ganglia or vagus nerve

31.  Cardiac pacemakers
 Febrileconditions
 Large open wounds
 Menstruation - ↑ risk of bleeding or pain if treatin
abdominal of lumbar region
 Dermatological conditions-open wound,cuts or
eczema
 Thrombophlebitis – risk of embolus being
dislodged

32.  Severe ↑ or ↓ BP – avoid lower cervical
region – BP control via cervical ganglia
 Acute inflammation, oedema, haemorrhage
or haematoma when using suction cups
 Hypersensitivity or fear of electrical
treatment
 Patients who are unable to understand the
treatment or what is required of them

33.  Aesthenic individuals/children for rib cage
placements
 Acute trauma
 Near by SWD
 Senile and confused patients

34.  Burns – high intensity currents can cause sufficient
heating to cause a burn.
 Mains current shock – faulty equipment
 Electric shock – abrupt application of high intensity
current – turn current up/ down slowly
 General malaise
 Nausea
 Vomiting
 Dizziness / Faintness
 Migraine / Headache
 Neurological effects

35. Metal implants are not the
contraindications of
interferential therapy

36.  Pain
80-140 Hz 15 minutes
4 Hz constant 15 minutes
 Circulation
0-100Hz 20-30 minutes

37.  Musclestimulation
10-50 Hz 15 minutes
50Hz constant with surge
 Incontinence
Stress incontinence - 10-50Hz, surge
15 minutes.
Urge incontinence - 5-10Hz 10 minutes

38. Laser + Ultrasound + IFT Machine
performing
interferential therapy A patient receiving ICT
with suction pads to Tens Med Fit Mini 4 Pole Inferential Stimulator (IF)
(Interferential Current Therapy)
reduce swelling and
for pain in hand
alleviate pain.

39. Professional Interferential Unit With AC Adapte
Ultra IF - Interferential U
Electrode placement of interferential therapy in plantar fasciatis

40. Chronic Pain Suppressor CPS-2000
Interferential Current Therapy
JPM Interferential Therapy &
Vacuum

41. Vectorsonic Vu720 Combination Interferential
Interferential Current
Therapy Equipment Quattro 4-Channel Interfere

42.  Russian currents are alternating currents (AC)
at a frequency of 2.5 kHz that are burst
modulated at a frequency of 50 Hz with a 50%
duty cycle. The stimulus is applied for a 10-
second “on” period followed by a 50-second
“off” or rest period, with a recommended
treatment time of 10 minutes per stimulation
session.1 This stimulation regimen (called the
“10/50/10” regimen), applied once daily over a
period of weeks, has been claimed to result in
force gains, but many of the claims appear to be
anecdotal

43.  We believe some of the popularity of Russian
electrical stimulation stemmed from a talk
given by Russian scientist Dr Yakov Kots13 at
a conference in 1977. Kots is reported to have
advocated a stimulus regimen for increasing
muscle force that he claimed was able to
increase the maximum voluntary contraction
(MVC) of elite athletes by up to 40%.
Unfortunately, the only details of Kots'work
were brief conference notes, translated from
Russian and not readily accessible.13

44. A monophasic/unipolar current
 50to 250 micro seconds
 3000hz
 Czechoslovakia in1970

45. Frequency Analysis Method
 The external currents with different
frequencies are considered to cause different
effects in tissues. Thus we assume that tissue
reactions on different frequencies in different
states of the body will also differ from each other.
 Measuring the sensory, motor and pain thresholds
by stimulating the tissue with the interference
current may offer a diagnostic tool in
physiotherapy and rehabilitation

46.  Pain control treatment
 Can cause muscle contractions, but that is not why
it is used
 Decreases patient’s pain perception by decreasing
the conductivity & transmission of noxious
impulses from small pain fibers (effects large
diameter fibers)
 Moderate caffeine levels (200 mg, approx 2-3 c.
coffee) may decrease effectiveness of TENS

50. Introduce yourself to patient
Give assurance/confidence

51.  Go through the medical reports
 Find out diagnosis/general contra-indications/
previous physiotherapy treatment

52.  Hyper pyrexia
 Epilepsy
 Severe renal and cardiac problems
 Severe hypo/hypertension
 Cardiac pacemakers
 Infections
 Pregnant women
 Metal implants
 Mentally retarded/upset patients
 Malignancy
 Anterior aspect of neck/carotid sinus/eyes

53. Skin resistance Treatment tray
lowering/testing tray  Pillows
 Pillows  Towel
 Cotton  Bed sheet
 Soap  Cotton
 Towel  Adhesive tapes
 Mackintosh  Straps/goggles
 Petroleum jelly  Salt/Powder
 Test tubes ( hot &cold)  Scissor/ Inch tape
 U-pin (sharp &blunt)  Paper
 Clips  Graph paper
 Bowl of water  Pencil/scale/eraser
 IR lamp  Machine& accessories
 Hot &cold packs  Sand bags/crepe bandages

54.  Open wounds
 Scars
 Local skin infections
 Cuts
 Abrasions
 Eczema
 Local hemorrhagic spots
 Skin sensitivity (testing)

55.  Check the apparatus& accessories like
electrodes, leads, cables, plugs, power sockets,
switches, controls, dials and others

56.  Demonstration of the treatment
 Check the functioning of machine in front of the
patient
 Explanation of treatment

57.  Comfortable
 Relaxed
 appropriate

58.  Do skin resistance lowering
 Neatly &perfectly
 Use items required in an orderly manner

59.  Use proper technique of application

60.  Appropriate placement according to the
condition &patient
 Use adhesives &straps
 Apply gel evenly on electrode
 Maintain good contact with the skin
 No leads crossing each other
 Confirm connections &above all

61. Instructions Warnings
 Don’t move  Inform more
 Don’t sleep heating/uncomfort
 Don’t touch leads, able sensations
 Inform burning
apparatus, therapist
and any other metal sensation
near by you immediately

62.  Proper execution of treatment
 Appropriate intensity should be used
 Set duration of treatment acc. to condition
status
 Supervise the treatment through out the
session

63.  Put knobs to zero
 Remove electrodes
 Switch off the machine &mains
 Clean the area &inspect for adverse reactions
 Manage if anything &give instruction regarding
next coming
 Windup procedure

64. Accurate record of all parameters of
treatment including area treated , technique,
dosage and the outcomes

65.  Low J. and Reed A. (1992) Electrotherapy Explained: Principles and Practice.
Oxford
 Watson T. (2000) The role of electrotherapy in contemporary physiotherapy
practice. Manual Therapy Aug:5(3);132-41