Electrotherapeutic Currents

Electrotherapeutic Currents

1. Direct current (DC)

   • has continuous (uninterrupted) unidirectional flow electrons toward the positive pole
   • monophasic current

2. alterating current (AC)

   • continous (uninterrupted) automatic reversal of polarity between positive and negative polse
     • ex: IFC continuous and Russian (pulsed)

3. Pulsed Current

   • monophasic, biphasic, polyphasic
   • pulsed currents that are the unidirectional (mono), bidirectional (biphasic) or polyphasic flow of electrons
     • are interrupted by discrete periods of non-current flow
   • might contain 3+ pulses grouped together (bursts/packets/envelopes)
   • ex: neuromuscular, TENS, HiVolt

4. Pain control

   • presynaptic inhibition (Hi TENS)
     • gate control mechanism
       • sensory stimulation of A-beta (pins and needles)
     • characteristics
       • high frequency (80-120 pps)
       • short phase duration (<100 microseconds)
       • low-moderate amplitude (tingly w/ no motor contraction)
   • endogenous opiate (low TENS/motor TENS)
     • beta-endorphin release
       • sensory stimulation of A-delta (twitching muscle contraction w/ pain)
       • high intensity stimulation and motor level stimulation
     • slowest onset, but longest lasting
     • characteristics
       • low-pulse frequency (2-4 pps)
         • activates muscle and A-deltas
       • phase duration (200-250 microseconds)
       • moderate amplitude (painful twitch muscle contraction)
         • grabby, squeezing muscle pain
   • descending inhibition (brief intense/noxious TENS)
     • central biasing from descending influences
       • sensory stimulation of C-fibers/A-deltas
       • high intensity stimulation
     • slower than gate control, but lasts longer
     • characteristics
       • high frequency (>100 pps)
         • equals more energy (usually 200 pps)
       • phase duration (>500 microseconds)
         • as high as possible on machine
       • moderate/high intensity (pain unlocalized w/ or w/o tetany)
         • doesn't feel comfortable