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Interferential therapy is a form of electrical treatment in which two
medium-frequency currents are used to produce a low-frequency effect. Interferential
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current can be defined as the transcutaneous application of alternating medium-
frequency electrical currents, which are slightly out of phase through the tissues,
amplitude modulated at low frequency for therapeutic purposes such as relief of
pain, improve circulation and enhances healing process. Frequency used for
interferential therapy is 3500 Hz to 5000 Hz.
Z = 1 / 2Π f C
Where, Z = skin impedance or capacitive resistance or skin interface or reactance
4a resistance or skin resistance
f = frequency in Hertz (Hz)
C = capacitance of skin in microfarads
From above formula, skin impedance is inversely proportional to
frequency and capacitance of the skin. Capacitance of the skin cannot be changed;
hence by increasing the frequency the skin impedance can be lowered.
Skin impedance is of two types namely, ohmic resistance and capacitive
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resistance.
Ohmic resistance is developed due to skin and depends on following
factors:
y Ohmic resistance is inversely proportional to the size of the electrodes used.
y Ohmic resistance is directly proportional to the dryness of the skin.
y Ohmic resistance is directly proportional to the hairy and oily skin.
Capacitive resistance is developed deep in the tissues due to electrolytic
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currents, but still producing low-frequency effects within the tissues. They are used to
produce effects in deeper tissues of the body.
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INTERFERENTIAL THERAPY Sagar Naik, PT
The principle upon which interferential therapy is based is that which produces
the interference effect where two medium frequency currents cross in the
patient’s tissues.
Two medium frequency currents are used to produce the interferential current.
They are known as carrier waves as they do not produce muscle nerve
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stimulation and are just used to get the greater depth of penetration and to
produce the interferential current.
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channel 2
channel 1
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channel 2
interferential
current
channel 1
current.
Inability of tissue to respond during the refractory period due to stimulus
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INTERFERENTIAL THERAPY Sagar Naik, PT
The frequency of the resultant current will be equal to the mean of the two
original currents, and will vary in amplitude at a frequency equal to the
difference between these two currents. This later frequency is known as the
amplitude-modulated frequency (AMF) or beat frequency.
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It is also known as the beat frequency.
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AMF is defined as the difference between the frequencies of the two medium-
frequency currents, which is produced in the tissues at the point where the two
currents cross.
Amplitude of AMF is always higher than the amplitude of the two medium-
frequency currents.
Nerve or cell membrane does not coincide with the intensity of AMF of the
current, which we give to the tissues.
4a
AMF is a low-frequency current, which is produced deep inside the tissues.
For example, Circuit A
Circuit B
4000 Hz
3900 Hz
medium
frequency
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INTERFERENTIAL THERAPY Sagar Naik, PT
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Interferential currents are used to treat deeper tissues as amplitude-modulated
frequency is produced deep in the tissue.
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It relieves pain by the pain gate theory.
It can give sensory stimulation and motor stimulation.
There are minimum chances of electrolytic burns with the interferential currents
as the amplitude of the current keeps on varying continuously.
Interferential currents are used to treat larger area.
Ö Area of Interference:
4aIt is the area where interferential current is set-up. The pattern of the
interferential area may be static or dynamic.
channel 1
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channel 2 channel 2
clove leaf
channel 1 appearance
D Static Interference:
The area in which interferential current is set-up remains stationary is
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Ö Methods of Application:
D Quadripolar / Bipolar Application:
Interferential currents may be produced either by applying the two medium
frequency currents via four electrodes (quadripolar method) so that they
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intersect in the tissues, or alternatively by mixing the two currents in the
stimulator prior to application via two electrodes (premodulated or bipolar
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method).
A quadripolar application of interferential current produces modulated
current in a clove leaf pattern, with leaves set up at right angles to the two
medium frequency currents.
Quadripolar interferential current is produced deep inside the tissues (AMF
is produced endogenously); hence there is lowered skin impedance. Thus it
is used to treat larger areas.
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Bipolar interferential current will be distributed similarly to conventional
electrical stimulation, with maximal current intensities underneath the
electrodes, progressively decreasing with distance.
Bipolar interferential current is produced inside the machine (AMF is
produced exogenously); hence there is increased skin impedance. Thus it is
used to treat localized area or smaller areas.
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D Vaccum (Suction) / Rubber (Plate) electrodes:
Interferential current is often applied via electrodes that are held in place using
an intermittent suction unit. Alternatively, flat carbon rubber electrodes may
be used.
Suction electrodes have advantage of allowing application to large flat areas
or to patients who are relatively immobile.
The suction also stimulates cutaneous nerves and cause vasodilatation and
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other hand there may be anatomical areas that are less accessible and in these
cases the suction option may be advantageous.
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INTERFERENTIAL THERAPY Sagar Naik, PT
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If static type of interference is used than only smaller area of the body can
be treated.
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D 2 KHz / 4 KHz:
Mostly, 2 KHz frequency is used for the muscle stimulation and 4 KHz
frequency is used for pain relief.
Ö Selection of Pulse:
y Triangular – Acute cases
y Rectangular – Chronic cases
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y Trapezoidal – Subacute cases
Ö Intensity:
y Less than 8 mA – Sensory stimulation (4 to 8 mA)
y More than 8 mA – Motor stimulation (8 to 16 mA)
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INTERFERENTIAL THERAPY Sagar Naik, PT
D Motor Stimulation:
Normal innervated muscles will be made to contract if a constant frequency
between 1 to 10 Hz is used.
Muscle contraction can be achieved at higher current amplitude.
Strong muscle contractions can be achieved without ay significantly
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uncomfortable skin sensation.
Interferential current can stimulate deeply situated muscles, as it is like a
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low frequency current.
The contraction is produced with minimal sensory stimulation and can be
deeply placed muscles, e.g., those of the pelvic floor.
D Effect on venous & Lymphatic Returns:
This is accelerated by frequency of 1 – 10 Hz (rhythmic), as rhythmical
pumping action produced in muscle helps in improving the drainage of
blood and lymph.
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Thus, this effect of interferential current is used in the treatment of oedema.
D Relief of Muscle Spasm:
Interferential therapy can bring about relief of muscle spasm.
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results in further compression of the facial nerve.
Orthopedic conditions
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i) Osteotendinitis Eg:- Lateral epicondylitis
ii) Joint sprains
iii) Fracture complications like delayed union, non-union & retarded
callous formation
iv) Pseudus atrophy (dystrophy)
Gynecological Problems
i) Stress incontinence
ii)
i)
ii)
4a Urinary frequency
iii) Pelvic floor dysfunction
Pain (All types of musculoskeletal pains)
Low back pain
Brachial neuralgia
Severe pain in the course or distribution of a brachial nerve due to
irritation or damage to the brachial nerve is called brachial neuralgia.
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iii) Sciatica
Pain in the distribution of sciatic nerve due to lateral disc protrusion on L4
and/or L5 spinal nerve roots is called sciatica.
iv) Phantom limb pain
Pain felt as though arising in an amputated limb is called phantom limb
pain.
v) Myalgia
Pain in the muscles is known as myalgia.
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Spondylosis
A defect in the interarticular part of the vertebra is called spondylosis.
Frozen shoulder
A painful stiff shoulder secondary to periarthritis of the shoulder joint is
known as frozen shoulder.
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Chondromalacia
Softening of the cartilage is called chondromalacia.
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Nocturnal incontinence
Inability to control the passage of natural discharges or evacuations as
urine or faeces during night or sleep is known as nocturnal incontinence.
Myositis
Inflammation of the muscles is known as myositis.
Following immobilization
Bronchial asthma
4a
Bronchial asthma is a complex and heterogeneous syndrome
characterized by episodic intrathoracic airways obstruction, airways
inflammation resulting in occurrence of dyspnoea and wheezing which varies
widely over time either spontaneously or in response to treatment.
Bursitis
Inflammation of a bursa is called bursitis.
Tendinitis
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Painful inflammation of a tendon caused by injury, overuse or prolonged
pressure is called tendinitis.
Burns
Increased pain
General malaise
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Nausea
Vomiting
Dizziness / Faintness
Migraine / Headache
Neurological effects
D Contraindications:
Cardiac pacemakers
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INTERFERENTIAL THERAPY Sagar Naik, PT
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Pregnant women (Interferential therapy is contraindicated in abdominal,
lumbosacral, and pelvic area as it may lead to uterine contractions.)
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Increased cellular metabolism
i) Neoplasm
A tumour; an abnormal growth serving no function is called neoplasm.
ii) Tuberculosis
An infectious disease caused by Mycobacterium tuberculosis. Lungs form
the common site of the disease.
iii) Infection
4a
The invasion of the body by microorganisms that reproduce and multiply
causing disease is called infection.
Asthenic individuals (Children with small body mass should not be given
interferential current to rib cage.)
Trauma
Hyperpyrexia
Extremely high fever with a temperature above 41°C is known as
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hyperpyrexia.
Senile or confused patients (Mentally retarded, Mentally confused or Elderly
patients)
Loss of skin sensations
Open wounds, cuts or skin lesions
Nearby short wave diathermy (SWD) i.e., 15 feet.
The leads of interferential therapy may act as antenna and may collect
radio frequency energy from SWD and produce undesirable surging of
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D Aims:
To avoid dangers
To increase positive outcome of the treatment
To optimize patients complains
D Precautions:
Evaluate the sensations like touch, pain, and temperature.
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INTERFERENTIAL THERAPY Sagar Naik, PT
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denuded skin.
Use equal size electrodes.
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Apply even pressure during trapping.
Evenly moist the sponges.
Apply enough and comfortable vaccum during vaccum electrodes to prevent
haematoma or ecchymosis.
[Haematoma: A collection of blood inside the body, caused by bleeding from
an injured vessel is called haematoma.
Ecchymosis: A purplish discolouration from extravasated blood into the skin
or mucous membrane. It follows bleeding from a large vessel.]
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Optimal positioning of electrodes (Diagonal pattern).
Educate the patient about the interferential current.
Instruct the patient not to touch leads and apparatus during the treatment.
Ö Important Points of Interferential Current:
2 KHz – Muscle Stimulation
4 KHz – Pain Modulation
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High AMF (70 to 130 Hz) – Acute problems and pain
Low AMF (less than 50 Hz) – Chronic and Subacute problems where muscle
contraction is needed.
Metal implants are not the contraindications of interferential therapy.
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