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Modified Galvanic Current DR RIAZ AHMED PT LECTURER
Definition  Interruption is the most common modification of Direct current, the flow of current commencing and ceasing at regular intervals.
Production of Interrupted Direct Current  Production of interrupted direct current involves following:  Source of IDC  Transistors: a semiconductor device with three connections, capable of amplification in addition to rectification.  Potential divider  Timer circuit (Timer device)
Duration & Frequency of IDC  The duration and frequency of the impulses can be adjusted,  a duration of 100ms being commonly used, although it is often an advantage to increase this to 300 to 600ms  Frequency of the current reduces with increase in the pulse duration.  Pulse duration of 100ms will have frequency of 30 cycles/minute.  The interval between the impulses should never be shorter duration than the impulses themselves and is usually appreciably longer.
Types of IDC  Currents produced for therapeutic purposes may have sudden or gradual fall, hence depending on this there are several types, which are as follows:  1) Rectangular (sudden fall of intensity)  2)Trapezoidal (gradual)  3)Triangular(……………)  4)Saw-tooth (……………)  5)Depolarized : some equipment for low intensity reversed current between the impulses giving called depolarized impulses.
modifiedgalvaniccurrent-190713233302 (2).pdf
Physiological Effects of IDC  Following are the physiological effects of the interrupted direct current: 1. Sensory Stimulation 2. Hyperemia 3. Elecrotonous 4. Pain relief 5. Acceleration of healing
Sensory Stimulation  During the passage of direct currents the patient is aware of a mild tingling or prickling sensation, which may merge into a mild irritation or itching.
Hyperemia  If sufficient current has passed for long enough an erythema of the skin will be evident under both electrodes, and is more marked under the negative (cathode).  This erythema is confined to the area of the applied electrode.  Since this erythema is confined it indicates a capillary hyperemia.
Electrotonus  Sub threshold nerve stimuli do not cause an action potential but they do affect the membrane potential. This phenomenon is known as electro tonus. OR  the altered sensitivity of a nerve when a constant current of electricity passes through any part of it  catelectrotonus. : the local depolarization and increased irritability of a nerve in the region of the negative electrode or cathode on the passage of a current of electricity through it .  anelectrotonusThe condition of decreased irritability of a nerve in the region of the positive electrode or anode on the passage of a current of electricity through it.
Pain relief  Strong sensory stimulation blocks the pain transmission at the level of spinal cord by pain gate theory.  The hyperaemia occurring may help to remove the nociceptive substances and thus reducing pain.
Acceleration of healing  Electrical stimulation by direct current enhances healing process.  It leads to increase bone formation and accelerate healing when current is applied through implanted electrodes.  It has also got effects on healing of superficial and open wounds
Therapeutic Effect 1. Stimulation of Denervated Muscle 2. Sensory Stimulation 3. Hyperemia 4. Pain relief 5. Acceleration of healing
Stimulation of Denervated Muscle  Types of Denervated muscle fibers  Neurotmesis (complete denervation)  Axonotmesis (partial denervation)  Neurapraxia (compression of nerve)
Changes in Denervated Muscles  When the muscles are denervated the following changes will occur. Loss of voluntary contraction and reflex activities Atrophy: Resulting in fibrosis Fibrillization: Spontaneous contraction  There is marked wasting of the muscle fibers and if the degeneration is of long standing they tends to become fibrosed and to loss the properties of irritability, contracability, extensibility and elasticity.
Advantage  The purpose of such current is to maintain the muscles in as healthy state as possible to prevent the complication by electrically artificial contraction.  If some of the motor units (motor end plate + motor nerve + muscle fibers) are intact galvanic current is the choice of treatment.  Interrupted direct current is still recommended for the treatment of Axonotmesis and Neurotmesis nerve repair is to be taken.
Contraindications  Skin lesions  Impaired cognitive ability  Pregnancy (1st trimester)  Over Carotid sinus  Loss of sensation.  Cancer.  Cardiac pacemakers.  Superficial metals
Equipment preparation  No current leaking on to the casing •  Polarity is marked •  Duration of impulse and frequency of impulse controls are available desired •  Keep all control at zero •  Connect wire and electrode •  Select the appropriate probe if used •  Make appropriate size if indifferent electrode
METHODS OF TREATMENT  Patient preparation • Pt position is comfortable ,the part is adequately supported •  Explain the patient in simple words about the treatment (procedure and sensation) •  Explain Pt characteristics of muscle twitches •  Warn the patient not to touch the machine and not to manipulate any control(when both electrode are tried to Pt part • Report any other sensation
CONT;  Expose only that area to be treated cover the rest of the body. •  Test skin sensation for ‘’pin –prick’’ •  Inspect the skin , avoid stimulation when the skin has rashes •  Wash the area with soap and water then dry and then soak the area with warn saline for 5 mint •  Place the indifferent electrode to appropriate area and secure with bandage
TREATMENT  Inform Patient That You Are Going To Commence The Treatment Obtain Content •  Before Switching On The Mains And The Apparatus Check To See That All Controls Are At Zero •  Turn The Main Switch And Control Switch On. •  Increase The Intensity Very Slowly Till You Get The Desired Strength Of Muscle Contraction
Cont,…  note the sensation reported by the patient •  set the duration (time )of treatment •  remain with in the calling distance from the patient a call bell can be gives to patient •  At the end of the treatment time turn the intensity control slowly to zero then switch the apparatus and the mains off •  Remove terminals from the apparatus •  Undo bandage to remove electrodes • Inspect the skin and make a note of any reaction
modifiedgalvaniccurrent-190713233302 (2).pdf

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modifiedgalvaniccurrent-190713233302 (2).pdf

  • 1. Modified Galvanic Current DR RIAZ AHMED PT LECTURER
  • 2. Definition  Interruption is the most common modification of Direct current, the flow of current commencing and ceasing at regular intervals.
  • 3. Production of Interrupted Direct Current  Production of interrupted direct current involves following:  Source of IDC  Transistors: a semiconductor device with three connections, capable of amplification in addition to rectification.  Potential divider  Timer circuit (Timer device)
  • 4. Duration & Frequency of IDC  The duration and frequency of the impulses can be adjusted,  a duration of 100ms being commonly used, although it is often an advantage to increase this to 300 to 600ms  Frequency of the current reduces with increase in the pulse duration.  Pulse duration of 100ms will have frequency of 30 cycles/minute.  The interval between the impulses should never be shorter duration than the impulses themselves and is usually appreciably longer.
  • 5. Types of IDC  Currents produced for therapeutic purposes may have sudden or gradual fall, hence depending on this there are several types, which are as follows:  1) Rectangular (sudden fall of intensity)  2)Trapezoidal (gradual)  3)Triangular(……………)  4)Saw-tooth (……………)  5)Depolarized : some equipment for low intensity reversed current between the impulses giving called depolarized impulses.
  • 7. Physiological Effects of IDC  Following are the physiological effects of the interrupted direct current: 1. Sensory Stimulation 2. Hyperemia 3. Elecrotonous 4. Pain relief 5. Acceleration of healing
  • 8. Sensory Stimulation  During the passage of direct currents the patient is aware of a mild tingling or prickling sensation, which may merge into a mild irritation or itching.
  • 9. Hyperemia  If sufficient current has passed for long enough an erythema of the skin will be evident under both electrodes, and is more marked under the negative (cathode).  This erythema is confined to the area of the applied electrode.  Since this erythema is confined it indicates a capillary hyperemia.
  • 10. Electrotonus  Sub threshold nerve stimuli do not cause an action potential but they do affect the membrane potential. This phenomenon is known as electro tonus. OR  the altered sensitivity of a nerve when a constant current of electricity passes through any part of it  catelectrotonus. : the local depolarization and increased irritability of a nerve in the region of the negative electrode or cathode on the passage of a current of electricity through it .  anelectrotonusThe condition of decreased irritability of a nerve in the region of the positive electrode or anode on the passage of a current of electricity through it.
  • 11. Pain relief  Strong sensory stimulation blocks the pain transmission at the level of spinal cord by pain gate theory.  The hyperaemia occurring may help to remove the nociceptive substances and thus reducing pain.
  • 12. Acceleration of healing  Electrical stimulation by direct current enhances healing process.  It leads to increase bone formation and accelerate healing when current is applied through implanted electrodes.  It has also got effects on healing of superficial and open wounds
  • 13. Therapeutic Effect 1. Stimulation of Denervated Muscle 2. Sensory Stimulation 3. Hyperemia 4. Pain relief 5. Acceleration of healing
  • 14. Stimulation of Denervated Muscle  Types of Denervated muscle fibers  Neurotmesis (complete denervation)  Axonotmesis (partial denervation)  Neurapraxia (compression of nerve)
  • 15. Changes in Denervated Muscles  When the muscles are denervated the following changes will occur. Loss of voluntary contraction and reflex activities Atrophy: Resulting in fibrosis Fibrillization: Spontaneous contraction  There is marked wasting of the muscle fibers and if the degeneration is of long standing they tends to become fibrosed and to loss the properties of irritability, contracability, extensibility and elasticity.
  • 16. Advantage  The purpose of such current is to maintain the muscles in as healthy state as possible to prevent the complication by electrically artificial contraction.  If some of the motor units (motor end plate + motor nerve + muscle fibers) are intact galvanic current is the choice of treatment.  Interrupted direct current is still recommended for the treatment of Axonotmesis and Neurotmesis nerve repair is to be taken.
  • 17. Contraindications  Skin lesions  Impaired cognitive ability  Pregnancy (1st trimester)  Over Carotid sinus  Loss of sensation.  Cancer.  Cardiac pacemakers.  Superficial metals
  • 18. Equipment preparation  No current leaking on to the casing •  Polarity is marked •  Duration of impulse and frequency of impulse controls are available desired •  Keep all control at zero •  Connect wire and electrode •  Select the appropriate probe if used •  Make appropriate size if indifferent electrode
  • 19. METHODS OF TREATMENT  Patient preparation • Pt position is comfortable ,the part is adequately supported •  Explain the patient in simple words about the treatment (procedure and sensation) •  Explain Pt characteristics of muscle twitches •  Warn the patient not to touch the machine and not to manipulate any control(when both electrode are tried to Pt part • Report any other sensation
  • 20. CONT;  Expose only that area to be treated cover the rest of the body. •  Test skin sensation for ‘’pin –prick’’ •  Inspect the skin , avoid stimulation when the skin has rashes •  Wash the area with soap and water then dry and then soak the area with warn saline for 5 mint •  Place the indifferent electrode to appropriate area and secure with bandage
  • 21. TREATMENT  Inform Patient That You Are Going To Commence The Treatment Obtain Content •  Before Switching On The Mains And The Apparatus Check To See That All Controls Are At Zero •  Turn The Main Switch And Control Switch On. •  Increase The Intensity Very Slowly Till You Get The Desired Strength Of Muscle Contraction
  • 22. Cont,…  note the sensation reported by the patient •  set the duration (time )of treatment •  remain with in the calling distance from the patient a call bell can be gives to patient •  At the end of the treatment time turn the intensity control slowly to zero then switch the apparatus and the mains off •  Remove terminals from the apparatus •  Undo bandage to remove electrodes • Inspect the skin and make a note of any reaction