Electrotherapy is one of the large sections of physiotherapy, which is used for the treatment, prevention and recovery after illness. Electrotherapeutic methods are performed using electric currents and fields, which are produced by special electrotherapy devices.
In the section of electrotherapy, there are several areas, each of which has its own indications and contraindications and can be used as an independent type of physiotherapy procedures.
Types of procedures and their application
Electric methods of hardware treatment include low-frequency (galvanization), high-frequency (darsonvalization), fluctuation, pulsed electrotherapy (diadynamic therapy), electrical stimulation, electrophoresis, electrosleep, amplipulse therapy.
Low frequency electrotherapy
Galvanization is the effect on painful places by direct current of a small force (up to 50 mA) and low voltage (up to 80 V). Under the influence of such a current in tissues the ratio of potassium, magnesium, calcium and sodium ions inside and outside the cells changes. The amount of current during the procedure is selected depending on the place of application of the electrodes: on the nasal mucosa - 2-3 mA, on the skin of the face - 3-5 mA.
The ion concentration gradient has anti-inflammatory, draining, dehydrating, vasodilator, secretory and analgesic effects on tissue.
Indications for use: eye diseases, increased or reduced pressure, inflammation of the gastrointestinal tract (gastritis, pancreatitis, cholecystitis, colitis, hepatitis), nervous diseases (neuritis, plexitis, radiculitis, neuralgia), autonomic disorders, sleep disorders, dermatitis and other skin diseases, inflammation of the pelvic organs. The method is also used in cosmetology.
Contraindications to galvanization include: generalized and local purulent processes, skin hypersensitivity, inflammatory skin diseases at the site of application of electrodes.
Diadynamic Therapy Method
Diadynamic therapy is the effect on tissues of diadynamic currents with an amplitude of 2-20 mA. The procedure has myostimulating, neurostimulating, analgesic, regenerating, blood circulation improving action. For diadynamic therapy, 5 main types of currents and their two wave modulations are used. So that the tissues do not become accustomed to electrical effects, during each session the pulses alternate and change their combinations.
Diadynamic therapy is prescribed for injuries, sprains, bruises, rheumatoid arthritis, vascular diseases (inflammations of varicose veins, thrombophlebitis), gynecological pathologies, neurological diseases (radiculitis, neuritis, spinal cord injuries), inflammations of the digestive system (cholecystists, cravistists, and retinal descentists. diseases.
The procedure is contraindicated for unhealed fractures, stones in the kidneys and gall bladder, acute pain, multiple sclerosis.
The method of electrostimulation is based on the effect of pulsed currents on muscle tissue and skin on which internal organs are projected. Currents eliminate muscle weakness, improve metabolic processes, accelerate regeneration and excite nerve endings in muscles. The shape of the pulse currents, their strength, frequency and amplitude is regulated during the procedure itself. The signal of adequacy of exposure is the appearance of moderately painful rhythmic muscle contractions. For example, for facial muscles current is set to 3-5 mA, for leg muscles - 10-15 mA.
The indications for electrostimulation are atopic paralysis, skeletal muscle paresis, muscle atrophy after injuries and prolonged immobilization, atony of the smooth muscle of the internal organs, polio, plexitis, neuritis, radiculitis, radicular syndromes, enuresis.
The method is contraindicated in purulent processes, spastic paralysis and paresis, pathological muscle spasms, contractures and ankylosis of the joints, bone fractures prior to their accretion, varicose disease, hemorrhagic stroke.
The use of low-frequency electrical current to improve the penetration of drugs through intact skin is called electrophoresis. It is a combination of galvanization and local drug treatment. With the help of currents, blood circulation in the subcutaneous tissue and muscles is improved, thanks to which the drugs penetrate deep into the tissues.
The method of fluctuation therapy is similar to diadynamo and amplipulse therapy. When it used sinusoidal pulsed currents of low frequency (40-2000 Hz) and intensity (1-40 mA). The application of the technique does not allow the skin to become accustomed to electric action, since the fluctuation currents have special characteristics - asynchrony, randomness, aperiodicity.
Fluctuarization exhibits a pronounced analgesic, anti-inflammatory, anti-edema and myostimulating effect. Fluctuating currents facilitate the penetration of drugs into the tissues (fluctuophoresis).
The indications for the procedure include:
- dental inflammatory diseases (periodontitis, alveolitis, pain after filling, arthrosis-arthritis of the mandible joint);
- neuritis and neuralgia of the cranial nerves;
- back pains associated with neuralgia (lumbodynia, thoracalgia, cervicalgia);
- exacerbation of deforming arthrosis;
- chronic adnexitis in women.
The procedure is contraindicated in patients with metal objects in the body, pacemakers, a tendency to bleeding or thrombosis, decompensated diseases of the circulatory system and kidneys.
The effect of pulsed low-frequency currents (5-160 imp./sec.) On the hypnogenic brain structures is called electromotive. The current should not exceed 10 mA. Electrosleep has a sedative, hypnotic, antispasmodic, anticonvulsant and sedative effects.
It is used for insomnia, neurasthenia, psychogenic enuresis, bronchial asthma and asthma attacks, cardiovascular diseases (angina pectoris, coronary heart disease, atherosclerosis, hypertension), skin diseases (eczema, neurodermatitis), and peptic ulcer.
The method is contraindicated in severe heart defects, epilepsy, current intolerance, inflammation of the eyes.
Amplipulse Therapy Procedure
The amplipulse therapy method is based on the use of modulated (variable and constant) sinusoidal currents with a frequency of 5 kHz and an amplitude of up to 50 mA. These currents have anti-inflammatory, neuromiostimulating, vasodilating and regenerating actions.
Indications for its use are:
- peripheral nervous system diseases (neuralgia, lumbago, radiculitis);
- arterial hypertension;
- bronchitis, bronchial asthma;
- arthritis, arthrosis;
- inflammation of the gastrointestinal tract and the small pelvis;
The procedure is contraindicated in acute inflammation of internal organs, non-immobilized fractures, gallstone and urolithiasis.
Interferential Therapy Method
Sinusoidal variable (interference) sound frequency currents, which are used for interference therapy, have similar properties as amplipulse therapy. These currents are created due to the superposition of two or more currents of the same amplitude and close frequency.
The procedure improves lymphatic drainage and microcirculation in the tissues, increases the tone of skeletal muscles and smooth muscles of the walls of medium and large vessels, shows a massage and analgesic effect. As a result of these actions, regenerative processes in tissues are accelerated, their edema decreases.
Interference therapy is indicated for:
- neurological diseases and pathologies of the peripheral nervous system (neuralgia, myelopathies, Raynaud and Bechterew diseases, ganglionervitis, neuritis, vibration disease, polyneuropathy, phantom pains, after head and neck injuries);
- pathologies of the musculoskeletal system (arthritis, arthrosis, rupture of ligaments, contractures, after fractures and bruises);
- diseases of the digestive system (gastritis, colitis, biliary duct dyskinesia);
- diseases of the circulatory system (hypertension, venous insufficiency);
- inflammatory diseases of the female internal genital organs;
- skin diseases.
The procedure is prohibited if the patient has general contraindications.
Despite the many positive effects of electrotherapeutic methods of treatment, they still have a number of general contraindications. These include:
- acute mental illness, epilepsy, multiple sclerosis, Parkinson's disease;
- malignant and benign neoplasms;
- acute infections (viral, bacterial, fungal), tuberculosis with bacterial excretion;
- heart defects and ischemia, the presence of a pacemaker, cardiovascular failure in the stage of decompensation, severe and malignant arterial hypertension;
- bleeding, thrombosis;
- alcohol or drug intoxication;
- period of carrying a child;
- individual intolerance;
- urolithiasis or gallstone disease;
- febrile and acute surgical conditions, bouts of renal colic.
Skin inflammatory diseases are contraindicated for the application of electrodes at the site of inflammation.
Kinds of devices
Low frequency and medium frequency currents are most commonly used for electrotherapy. For certain types of electrotherapy mono-apparatuses are used:
- For galvanization and medicinal electrophoresis. One of the galvanic mono-apparatuses is the device "Flow".
- For diadynamic therapy. The classic diadynamic device is considered the device "Tonus".
- For amplipulse therapy. The most famous devices for creating sinusoidal currents are Amplipulse and Radius.
Modern devices are usually universal (complex), which to varying degrees combine in one building different types of electrical physiotherapy effects. Some devices can generate up to 40 different forms of current.
Additional (consumable) items and materials are attached to physiotherapeutic devices: electrodes, gaskets, cables, stands.
Electrotherapy devices in Europe are manufactured by three competing companies that produce medical devices and materials: the Dutch company Enraf Nonius (Sonoplus, Endomed, Curaplus, Radarmed, Vacotron, En-Stim, Myomed), the German company Phyziomed (Physiomed, Physisin, Physioson, Ionoson, Limfizifin, Vokostim) and the Czech-English company BTL (BTL Puls, Sono, Vac).
Electrotherapeutic devices are also produced in Russia (Amplipuls-7 and 8), Belarus (Radius-01), Ukraine (Potok-01M).
The Russian instrument-making plant Izmeritel currently produces three types of apparatus for electrotherapy of the type Amplipulse - Amplipulse-7, 7M and 8.
The device Amplipulse-7 is a multifunctional device for generating sinusoidal currents in alternating and unipolar mode. Amplipulse-7M differs from its predecessor in its compact size. Amplipulse-8 is an advanced electrotherapy device with 4-channel output.
All these devices are convenient to use in medical institutions and beauty salons, and at home. You can buy these devices in medical equipment stores and online stores at a price much lower than that of European manufacturers.
Radius-01 devices are produced in several modifications, depending on the currents generated by them: Radius-01, Radius-01 FT, Radius-01 Inter, Radius-01 Inter CM.
The basic equipment of the Radius-01 device generates low-frequency currents, therefore, it is used for the procedures of galvanization and medicinal electrophoresis, amplipulse therapy, diadynamic therapy.
Modification Radius-01 Inter CM is the most advanced and is intended for the treatment of low current (one channel) and medium frequency (two channels). Due to the ability to produce many types of currents, the device is used for electroplating (electrophoresis), diadynamic therapy, amplipulse therapy, electrostimulation, fluctuation, interferential therapy and electrosleep.
Before starting a course of electrotherapy, the patient should be fully examined in order to identify possible contraindications for the procedure. Electrotherapy should not be perceived by patients as the main therapeutic method: it is effective only as part of the complex therapy of the disease.