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Galvanic Current
Avanianban Chakkarapani
Lecture 10
K 342
30.01.2015
11.00 am to 12.00 pm
Definition
› It is a direct current
› Unidirectional
› It is very painful to patients because it is unidirectional
› To ov...
› It is a direct Current used to activate muscle directly, without
activation of the peripheral nerve.
› Direct muscle sti...
Evidence for
› appropriate electrical stimulation can cause a denervated
muscle to contract
› contraction of a denervated ...
Evidence against
› contraction of the denervated muscle may disrupt
regenerating neuromuscular junctions and subsequently
...
Unipolar Vs Bipolar Motor PointStimulation
Unipolar Motor Point
Stimulation
Bipolar Motor Point
Stimulation
Electrodes Use...
Comparison of Electrical Excitability of Nerve
and Muscle
Stimulation of Innervated Vs Denervated Muscle
Innervated Denervated
Type of Contraction 1/sec- single brisk
contraction
2...
Uses:
1. Constant direct currents are used for iontophoresis
2. Modifide direct current are used to stimulate denervated
m...
Stimulating Denervated Muscle
› Electrical currents may be used to produce a
muscle contraction in denervated muscle
› Den...
Stimulating Denervated Muscle
› Muscle fibers experience a decrease in size,
diameter and weight of the individual muscle
...
Stimulating Denervated Muscle
› Degenerative changes progress until muscle is
re-innervated by axons regenerating across s...
Muscle stimulation with intermittent direct
current
› The term ‘muscle stimulation’ is used to refer to the production of ...
Application of Galvanic current
› Denervated muscles
› Facial muscle weakness secondary to Bell’s Palsy & Facial
palsy.
› ...
Why Galvanic over Faradic in facial
muscles?
Contraindications
› Placement of electrodes tangential to the heart
› Presence of a cardiac pacemaker
› Presence of malign...
Precautions
› Adequate precautions should be taken for patients with
heart problems.
› Placement of electrodes across the ...
Dangers
› Erythema
› Burns
› Electric Shock
› Hypovolemic shock
Galvanic current
Galvanic current
Galvanic current
Galvanic current
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Galvanic stimulation

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Galvanic current

  1. 1. Galvanic Current Avanianban Chakkarapani Lecture 10 K 342 30.01.2015 11.00 am to 12.00 pm
  2. 2. Definition › It is a direct current › Unidirectional › It is very painful to patients because it is unidirectional › To overcome this regular pause can be given between stimulation › Interrupted galvanic current(IGC) › Constant direct current is used for Iontophoresis › IGC is used for denervated muscle stimulation
  3. 3. › It is a direct Current used to activate muscle directly, without activation of the peripheral nerve. › Direct muscle stimulation requires pulse or phase durations of at least 1 milliseconds, and more often uses even longer durations. › Dosage: A regular 20-30 contractions with an average of 90- 200 contractions per muscle per day. Cease when motor point responds to faradic current.
  4. 4. Evidence for › appropriate electrical stimulation can cause a denervated muscle to contract › contraction of a denervated muscle may help limit edema and venous stasis within the muscle, and therefore delay muscle fiber degeneration and fibrosis › recovery time following denervation appears to be shortened with appropriate electrical stimulation
  5. 5. Evidence against › contraction of the denervated muscle may disrupt regenerating neuromuscular junctions and subsequently delay re-innervation › denervated muscle is more sensitive to trauma than innervated muscle, and electrical stimulation may further traumatize the denervated muscle › prolonged electrical stimulation until reinnervation occurs is not worth the financial and time costs involved
  6. 6. Unipolar Vs Bipolar Motor PointStimulation Unipolar Motor Point Stimulation Bipolar Motor Point Stimulation Electrodes Used One small activeelectrode and one largedispersive electrode Equal sized electrodes Site of Stimulation Motor point for stronger response Effect depends onplacement Description Same amount of current passes thru each electrode Smaller sized electrode will have higher current density, thus effects here is stronger (active electrode) Current density equal in both electrodes Convenient for stimulating mm groups or very large mm Equally small electrodes used for stimulating denervated mm
  7. 7. Comparison of Electrical Excitability of Nerve and Muscle
  8. 8. Stimulation of Innervated Vs Denervated Muscle Innervated Denervated Type of Contraction 1/sec- single brisk contraction 20/sec– partial tetany60/sec- full tetany Sluggish Rate of Change of Current Sudden increase in intensity Gradual rise in intensity Strength of Contraction Depends on number of motor units activated Depends on number of muscle fibers activated Intensity higher Lower Pulse duration Less 10 ms- short pulse duration More than 10 ms– longer pulse duration Chronaxie < 1 ms > 50 ms Ideal current Faradic or faradic type IDC
  9. 9. Uses: 1. Constant direct currents are used for iontophoresis 2. Modifide direct current are used to stimulate denervated muscles. 3. Maintain the properties of muscle. 4. Retards the denervation atrophy. 5. Helps the muscle to utilize all the substances and maintain nutrition. 6. Improves absorption and activates pumping function of muscle. 7. Prevents venous and lymphatic stasis. 8. Maintain the working hypertrophy of denervated muscles. 9. Maintain the extensibility of the muscles. 10.Improves local circulation. 11.Prevents contracture.
  10. 10. Stimulating Denervated Muscle › Electrical currents may be used to produce a muscle contraction in denervated muscle › Denervated muscle has lost its peripheral nerve supply › Purpose for electrically stimulating denervated muscle is to help minimize the extent of atrophy while the nerve is regenerating
  11. 11. Stimulating Denervated Muscle › Muscle fibers experience a decrease in size, diameter and weight of the individual muscle fibers › There is a decrease in amount of tension which can be generated and an increase in the time required for contraction
  12. 12. Stimulating Denervated Muscle › Degenerative changes progress until muscle is re-innervated by axons regenerating across site of lesion › If re-innervation does not occur within 2 years fibrous connective tissue replaces contractile elements and recovery of muscle function is not possible
  13. 13. Muscle stimulation with intermittent direct current › The term ‘muscle stimulation’ is used to refer to the production of a contraction in a muscle or muscle group by the application of an electrical stimulus. › The objective is to assess the response to electrical stimulation of the peripheral motor neurons and the muscle tissue. › Depending on the nature of the contraction that can be produced by means of direct current pulses, a distinction is made between single and multiple stimulation. › In single stimulation, a single contraction is produced. › Multiple stimulation leads to tetanic contraction. › With respect to the pulse type, only rectangular and triangular pulses are of interest in muscle stimulation.
  14. 14. Application of Galvanic current › Denervated muscles › Facial muscle weakness secondary to Bell’s Palsy & Facial palsy. › Iontophoresis
  15. 15. Why Galvanic over Faradic in facial muscles?
  16. 16. Contraindications › Placement of electrodes tangential to the heart › Presence of a cardiac pacemaker › Presence of malignancy › Placement of electrodes along regions of the phrenic nerve › Placement of electrodes over the carotid sinus or laryngeal musculature › Houghton et al. indicate that NMES is contraindicated “anywhere” on pregnant women; however, there appears to be no evidence for this
  17. 17. Precautions › Adequate precautions should be taken for patients with heart problems. › Placement of electrodes across the heart or trans- thoracically can cause an arrhythmia. › The device should not be used over skin eruptions or swollen, infected or inflamed areas. › Turn the unit off when applying or removing electrodes. › Do not use over the eyelids.
  18. 18. Dangers › Erythema › Burns › Electric Shock › Hypovolemic shock
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