Intro of electrotherapy in physiotherapy ppt by Dr. Mumux

1. Dr. Mumux Mirani
BPT, MPT Sports, PhD Scholar
Asst. Professor
SPB Physiotherapy College, Surat.

2. What do you think about electrotherapy?

3. Or this?

4.  Essential and basic subject of Physiotherapy
which includes various forms of therapeutic
applications.
 Electro means using electricity or electrical
current which is primary source of energy.
 Therapy means non surgical treatment approach.

5. Definition:
 It is a non surgical treatment approach
characterized by the treatment of various
diseases and disorders with the help of
electricity or electrical means.

6. What is included in electrotherapy?
Low frequency currents
Medium frequecy currents
High frequecy currents
Phototherapy
Electro diagnosis
Biofeedback

7. What is common ?
 Frequency: it is a number of occurrences of
any event per unit time.
Or
 Impulses of current commence and cease at
regular interval.
Or
 No. of time these impulses comes in a
particular unit time (second).
 It is usually cycles/sec, Htz, KiloHtz, MHtz….
 Current: is a flow of electrons.

8. Low frequency currents:
 Frequecy ranges from 0 to 100 cycles per
second.
 Used for stimulation of nerve and muscle.
 Direct current, interrupted direct current,
sinusoidal current, didynamic current,
micro amperage electrical nerve
stimulation, trans-cutaneous electrical
nerve stimulation….

9. Medium frequency currents:
 Frequency is in the range of 100 t0 10000 cycles
per seconds.
 Used to stimulate deeply situated muscles and
nerves.
 Clinically used to re educate muscle, to retard
the rate of muscle atrophy, drainage of edema
and for pain relief.
 Russian current. Interferential current….

10. High frequency currents:
 Frequency is more than 10000 cycles per second.
 Used to produce the deep heat inside the tissues.
 SWD. MWD. Long wave diathermy, therapeutic
US.

11. Phototherapy:
 Light is the source of treatment
 Used for pain relief by heat and acceleration
of healing through elevation of temperature,
counter irritation and photochemical effects.
 Infrared rays, ultraviolet rays, laser…

12. Electro diagnosis:
 It means the detection of the diseases and
disorders by the use of electrotherapeutic
currents or EMG
 Electric current can be used for the diagnostic
purpose
 Electrodiagnostic tests are rheobase, chronaxie,
strength duration curve, pulse ratio, myasthenic
reaction, galvanic-tetanic ratio, nerve conduction
test, faradic-galvanic test

13.  Electromyography is the study of electrical
activity of the muscle by means of surface
electrodes place over the skin or needle
electrodes inserted in the muscle itself.
 EMG is for study of motor unit potential, motor
nerve conduction velocity, sensory nerve
conduction velocity….

14. Biofeedback:
 Process of providing information to an
individual about the body function so as to
get some voluntary control over it.
 EMG Biofeedback

15. Classification of currents:
 On the basis of direction of flow:
 Therapeutic current classified as alternating
current and unidirectional current.
 Unidirectional current flows in one direction only
are Direct current and interrupted direct current.
 Alternating current flows in both direction are
sinusoidal current and interferential current.

16.  On the basis of frequency:
 Therapeutic current classified as low,
medium and high frequency currents.

17.  On the basis of voltage:
 Therapeutic current classified as low and high
voltage currents.
 Low voltage are with a voltage of less than 1oo
volts
 High voltage is of several hundred volts.

18.  On the basis of amperage:
 Therapeutic current classified as low and high
amperage currents.
 Low amperage current ranges from 1 to 30
miliampears and same as of low voltage current.
 High amperage current is ranging from 500 to
2000 miliampears and of high tension.

19.  On the basis of biophysical effects:
 Therapeutic current classified as having effect
which causing ionic changes and thermal changes.

20.  Cold therapy, paraffin wax bath, hot pack, contrast bath,
fluidotherapy… are often included in electrotherapy.
Physiotherapy modalities which work on electricity may
not be necessarily called as electrotherapeutic modalities
but are electro physical agents (EPA).
 CPM and traction work on electricity but should not be
called as electrotherapeutic modalities.

21.  Any form of physical energy applied to the body
exerts significant primary as well as secondary
physiological effects. There is a need of accurate
measurement of dose in the application of all
physical agents as used in medication. There is
need to determine when to discontinue the
procedures.

22. Safety precautions:
 Physiotherapist working in a hospital or clinical
set up frequently uses modalities which are
electrically operated.
 Therefore there is a great need for
physiotherapist to be aware of the potential
electrical hazards to patients as well as
therapist.

23. Causes and types of hazards
 Worn-out power cords
 Broken plugs
 Faulty lamp sockets
 Incorrect wire outlets
 Leakage of current
 Breakage of power cord
 Absence of earthling
 Defective electrical sockets

24. Hazards are
Electric shock, fire, thermal burns,
electrochemical burns, scalds etc....

25. Physiological effects of shock
 are imperceptible with 0-1 milliampere.
 With 1-15 ma produces tingling sensation and
muscle contraction.
 With 15-100 ma produces painful electrical shock.
 With 100-200 ma produces cardiac and respiratory
arrest.
 More than 200 ma produces instant tissue burning
and destruction.

26. Safety precautions
 Equipment purchase:
 Do not buy cheaper equipment as they may be
most expensive to operate.
 Read the instruction manual before operating
 Check the instrument at the time of delivery
 If any defect is there exchange the unit
 Ask for working and safety check

27. Earthing and stabilizer:
 There should be proper earthing connected to all
electrotherapy equipments working on
electricity.. Ground fault interrupter circuit
should be used.
 Voltage stabilizer should be either separate or
central for the department to avoid voltage surge
and thereby discomfort to the patient. It avoids
damage to the equipments.
 Fuse is there on live wire so that if a large current
passes than the fuse blows and stop the current
flow.

28. Maintenance
 Yearly maintenance contract through biomedical
engineer with your manufacturer after the warranty
period.
 Routine maintenance checkup should be performed
on all electrical equipments.
 Physiotherapist should not use the electrical
equipment nearer objects or environment that draw
the current .
 Usage of equipment may interfere with pacemakers
and hearing aids.

29. Principles of treatment
Patient
 After completion of assessment and selection of
modality discuss the options with patient
 Advice and explanations, warnings, positioning,
instructions, examination, and testing of the area to
be treated.
 Aim to ensure valid consent is obtained and all risks
are identifying prior to treatment.
 Preparation of area to be treated such as cleaning of
the part, testing cutaneous sensation or blood flow.
 Keep privacy of a patient.

30. Preparation and testing of apparatus and examination
 Collect and assemble the parts of equipment needed.
Check all electrodes, leads, cables, plugs, power
outlets, switches, controls, indicator lights and dials.
Output of the machine should be checked. Set the
equipment to minimize risk and promote patient
comfort during treatment and to minimize the
exposure of the operator to the output of the
modality.

31. Application
 Depending on the modality, checking
throughout an application is required to
ensure safety.

32. Termination of treatment
 On termination the area treated should be
examined to identify expected effects such as
superficial vasodilatation and unexpected effects
like burn.
 Explain effect of treatment after application,
instruction regarding future treatment and in
between.

33. Recording
 Accurate record of all the parameters of
treatment including area to be treated,
technique, dosage and resultant effect must be
made each time. Details of the advice and
warnings given prior to treatment should be
recorded.