low frequency stimulation specialized techniques

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Low Frequency Stimulation

Specialized Techniques

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Faradic Foot Bath

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Bath Method

● Application of faradic current to the body parts in a

tub, tray or tank containing water is termed as bath

method of application

● Depending upon the placement of electrodes bath can be

● Bipolar : both electrodes are kept in the water

● Unipolar : one electrode kept in the water while the other electrode kept at any convenient part of the body

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Bath Method

Advantage of bath method are:● Skin resistance is lowered considerably by

prolonged soaking in water● Water makes perfect contact with the tissues● Wash of electrolytes formed under the electrodes

Disadvantages are: ● Current can not be localized● Superficial muscles contract more than deep

muscles due to the presence of water● Chances of electric shock is higher

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Faradic Foot Bath

● ES by faradic current may be applied in

baths.

● Can be used to stimulate

● Lumbricals

● Plantar interrossei

● Abductor hallucis

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Faradic Foot Bath

● Position the patient in high sitting with back well

supported

● Position the feet on a stool covered with a

plastic sheet

● Place the foot in a bath containing enough

warm water to cover the toes

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Faradic Foot Bath

To stimulate the

lumbricals place two

electrodes transversely,

● one under the heel

and the other

● under the metatarsal heads

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Faradic Foot Bath

To stimulate the

plantar interrossei

place one electrode

on each side of the

foot at the level of

metatarsal shafts

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Faradic Foot Bath

For Abductor hallucis

place ● one electrode under the heel and

● stimulate the muscle through the motor point using a pen electrode

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Faradic Foot Bath

● A surged faradic current is used for this

● Surge duration 1 sec.

● Surge interval 3 sec.

● Intensity : enough to produce a visible contraction of the muscles.

● Treatment time: 15 – 30 minutes

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Faradic Foot Bath

● Rectangular metal or carbon rubber electrodes of 3 X 7 cm can be used

● No lint pad or coupling medium required

● Encourage the patient to contract the muscle voluntarily with the current

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Faradism Under Pressure

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● ES of muscle combined with compression and

elevation of the limb can be used to increase

venous and lymphatic drainage and so to

relieve edema.

● This technique is known as Faradism Under

Pressure

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● Patient in supine position

● The limb is elevated above the heart level using

pillows

● The pressure bandage is applied over the electrode,

with maximum pressure distal to proximal

● The skin must be cleaned before treatment

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Placement of electrode for lower limb:

● Active electrode place over the belly of the calf

muscle

● Passive electrode is placed over the sole of the foot

Placement of electrode for upper limb:

● Active electrode over the flexor aspect of forearm at

the junction of proximal 1/3 and distal 2/3 of the

muscle belly

● The passive electrode over the palm or cubital

fossa

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● Intensity : enough to produce a visible contraction of the muscles i.e. clenching of toes or fingers.


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● Rectangular metal or carbon rubber electrodes of 3 X 5 cm. can be used

● Encourage the patient to do active movement along with the current and relax during surge interval

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Faradism Under Tension

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● Shortening of contractile soft tissues like muscles can

be treated with Faradism.

● Such contractures develop in major muscle groups like

quadriceps or elbow flexor group

● This is mostly after prolonged immobilization

● These conditions are passively mobilized which can be

very painful.

● Titanic contraction by the surged current gradually pulls

apart the shortened myofibrils with less pain.

● So this can be an effective adjunctive with passively

mobilization.

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● Intensity : enough to produce a visible contraction of the

muscles.


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● Rectangular metal or carbon rubber electrodes of 5 X 10 cm can be used.

● Encourage the patient to do actively contract the muscle along with the current and relax during surge interval

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For quadriceps contracture:

● Patient is positioned on a plinth.

● A roll of towel or pillow is placed below the knee to give a stretch

● Passive electrode is placed over proximal 1/3 of the quadriceps

● Active electrode is placed on the junction of proximal 2/3 and distal 1/3 of the belly of the muscle

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For elbow flexor contracture:

● Patient is positioned on a plinth.

● A roll is placed under the elbow just proximal to the joint.

● Passive electrode is placed over proximal 1/3 of the elbow flexor

● Active electrode is placed on distal 1/3 of the belly of the muscle

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ES to Pelvic Floor Muscles

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● ES can be used for reeducating these muscles.

● Indications are;

● Early cases of prolapse of pelvic organs

● Stress incontinence

● Incontinence following prostatectomy

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● Position the patient in side lying

● Keep a pillow between the lower legs

● Place a plastic sheet under the patient

● The indifferent electrode to the lumbosacral region

● Insert the Active vaginal or rectal electrode

● Sterilized lubrication jelly should be applied on vaginal

or rectal electrode

● A large button electrode can also be used over the

perinea region

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● A surged faradic current is used.



● The muscles of pelvic floor fatigue fast, so surge

duration should be short

● Intensity : enough to produce a visible contraction of the

muscles.


● Encourage the patient to actively contract the muscles

along with the current and relax during surge interval

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References

1. Foster A, Palastanga N. Clayton’s Electroptherapy Theory and

Practice. 9th edition. W B Saunders. 2006;pp 70 – 79

2. Mitra PK. Handbook of Practical Electrotherapy. Jaypee. 2006;

pp44 – 49

3. Khatri S. Basics of Electrotherapy. Jaypee. 2003. pp 28 - 30

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