Electrotherapy Explained
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Electrotherapy is defined as the sum of therapeutic modalities of physical medicine capable to change the threshold of elicitation of nerve or muscle. Classification due to applied pulse frequencies, way of action of transcutaneous nerve stimulation (= TENS) and of iontophoresis is described. Pain syndromes, muscle atrophy by loss of activity and support of wound healing are named as accepted indications for electrotherapy. The difficulties of electrical stimulation of paretic muscles and the problem, whether different indications for certain forms of electrotherapy exist or not, is discussed.
Although electrotherapy, especially iontophoresis, appears to have particularly interesting applications in the field of postoperative orthopedic rehabilitation, relatively little scientifically based research has been conducted with regard to safety involving patients with orthopedic implants. A PubMed search given the keywords such as orthopaedic implant and electrotherapy resulted in only 21 hits, as of August 2015. Although a conference proceeding and a journal article discussed the use of neuromuscular electrical stimulation to reduce the incidence of deep vein thrombosis in postoperative total hip and knee arthroplasty patients, it simply reported metallic implant did not give rise to hypersensitivity judged by patient reports of comfort on a visual analogue scale.10 Few reports exist relating to the use of electrical currents as a sterilization procedure for both titanium and surgical stainless steel before implantation. However, no data with regard to modeling of the in vivo heating of implants in the presence of therapeutic levels of electrical currents were found.11,12
Electricity enables information to circulate in the body, electrotherapy manipulates a specific part of the information by pulsating electrical waves interfering with the transmission of pain signals.Our nervous system is composed of our brain and our spinal cord, which combine to form the central nervous system; and our sensory and motor nerves, which form the peripheral nervous system. Nerves send information about what is happening in our environment to the brain via the spinal cord. The brain then sends information back to our nerves, helping us to perform actions in response. By treating specific body areas and varying frequency, wavelength and intensity applied, electrotherapy devices can manipulate impulses and target actions to alleviate pain or they can disrupt pain signals.
University research centers, doctors, and physicians around the world have overseen treatments using electrotherapy with outstanding results in the reduction of pain for a wide range of acute and chronic conditions. The WellnessPro Plus is an effective complementary treatment modality for pain relief.
Interferential is a form of electrotherapy which uses two alternating medium frequency currents. The two currents form an area of wave interference where they cross. This results in a modulated frequency equal to the difference in frequency of the two waves.
Laser is used for the treatment of all kinds of musculoskeletal injuries to help reduce pain, muscle spasms, and inflammation and encourage cell reproduction. Research has however shown that Laser may not be as effective as other forms of electrotherapy.
Ultrasound has been used as an electrotherapy treatment modality by therapists over the last 50 years. It transmits high-frequency sound waves into tissues. It has a number of benefits and effects including heat and micro-massage effects.
Electrotherapy is the use of electrical energy as a medical treatment.[1] In medicine, the term electrotherapy can apply to a variety of treatments, including the use of electrical devices such as deep brain stimulators for neurological disease. The term has also been applied specifically to the use of electric current to speed wound healing. Additionally, the term "electrotherapy" or "electromagnetic therapy" has also been applied to a range of alternative medical devices and treatments.
In general, there is little evidence that electrotherapy is effective in the management of musculoskeletal conditions.[3]In particular, there is no evidence that electrotherapy is effective in the relief of pain arising from osteoarthritis,[4]and little to no evidence available to support electrotherapy for the management of fibromyalgia.[5]
A 2016 review found that, "in evidence of no effectiveness," clinicians should not offer electrotherapy for the treatment of neck pain or associated disorders.[6]Earlier reviews found that no conclusions could be drawn about the effectiveness of electrotherapy for neck pain,[7]and that electrotherapy has limited effect on neck pain as measured by clinical results.[8]
A 2014 Cochrane review found insufficient evidence to determine whether electrotherapy was better than exercise at treating adhesive capsulitis.[10]As of 2004, there is insufficient evidence to draw conclusions about any intervention for rotator cuff pathology, including electrotherapy;[11]furthermore, methodological problems precluded drawing conclusions about the efficacy of any rehabilitation method for impingement syndrome.[12]
A 2012 review found that "Small, single studies showed that some electrotherapy modalities may be beneficial" in rehabilitating ankle bone fractures.[14] However, a 2008 review found it to be ineffective in healing long-bone fractures.[15]
A 2004 Cochrane review found "weaker evidence" that pulsating electromagnetic fields could be effective in treating recurrent headaches.[17] A 2016 Cochrane review found that supporting evidence for electrotherapy as a treatment for complex regional pain syndrome is "absent or unclear."[18]
A 2015 review found that the evidence supporting the use of electrotherapy in healing pressure ulcers was of low quality,[19] and a 2015 Cochrane review found that no evidence that electromagnetic therapy, a subset of electrotherapy, was effective in healing pressure ulcers.[20] Earlier reviews found that, because of low-quality evidence, it was unclear whether electrotherapy increases healing rates of pressure ulcers.[21][22] By 2014 the evidence supported electrotherapy's efficacy for ulcer healing.[23]
The first recorded medical treatments with electricity in London were in 1767 at Middlesex Hospital in London using a special apparatus. The same apparatus was purchased for St. Bartholomew's Hospital ten years later. Guy's Hospital has a published list of cases from the early 19th century.[29] Golding Bird at Guy's brought electrotherapy into the mainstream in the mid-19th century.[30] In the second half of the 19th century the emphasis moved from delivering large shocks to the whole body to more measured doses, the minimum effective.[28]
Electrotherapy or electrical stimulation is the therapeutic application of electric current. Modern electrotherapy is primarily used to improve functions and activities. This is called functional electrical stimulation.
Modern electrical stimulation/electrotherapy is applied in a functional context (functional electrical stimulation), and thus aims to restore functions and motor learning in order to increase independence.
Medium-frequency currents are used in electrotherapy mainly for the treatment of pain and for motor stimulation. Electrotherapy includes high-frequency therapy, heat therapy (red light), and ultrasound therapy.
Ultrasound (US) is a form of mechanical energy (not electrical), and therefore, strictly speaking, not really electrotherapy at all, but does fall into the Electro Physical Agents grouping. Mechanical vibration at increasing frequencies is known as Sound Energy. The normal human sound range is from 16 Hz to something approaching 15-20,000 Hz (in children and young adults). Beyond this upper limit, the mechanical vibration is known as ultrasound. The frequencies used in therapy are typically between 1.0 and 3.0 MHz (1 MHz = 1 million cycles per second).
Electrotherapy is the use of electrical stimulation for therapeutic purposes. Specifically, electrotherapy uses energy waves that are part of the electromagnetic spectrum to produce desired physiological and chemical effects in the body.
Electrotherapy is used to manage both acute and chronic pain. In the gate model of pain, the neural fibers that carry the signal for pain and those that carry the signal for proprioception (body position) are mediated through the same central junction. Because signal transmission along pain fibers is slower than transmission along proprioception fibers, the gate model suggests that intense stimulation of proprioception fibers can block the slower-moving pain signals. Some forms of electrotherapy attempt to stimulate these proprioception fibers to reduce the sensation of pain. Other forms of electrotherapy alleviate pain by introducing analgesics and anti-inflammatory medications via electric current to the painful area.
Electrotherapy is also used to induce physiological and chemical changes. Some forms of electrotherapy induce these changes by introducing heat into the deep tissues; this deep heating increases blood flow to and from the problematic region and improves drainage. Other forms of electrotherapy are thought to stimulate the body's production of corticosteroids and vitamin D. Still others are believed to promote wound healing by stimulating intracellular activity.
Electrotherapy is used to stimulate the contraction of muscles during rehabilitation. This type of electrical stimulation is used to prevent muscle atrophy and to re-educate muscles after trauma or surgery. This form of electrotherapy can also be used to relieve muscle spasms.
Although each modality of electrotherapy has its specific set of contraindications, cardiac pacemakers are a general contraindication for electrotherapy. Electrical signals from electrotherapy devices can interact with the electrical signals from pacemakers and interfere with pacemaker functioning. Pacemaker disruption is particularly acute with modalities such as diathermy and electrical nerve stimulation. However, less interference may occur with radiation modalities of such as infrared, ultraviolet, and cold laser treatments (these modalities are discussed in detail below in the Description section). 59ce067264
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