pt 158 physical agents ii diadynamic currents
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PT 158: Physical Agents II DIADYNAMIC CURRENTS

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PT 158: Physical Agents II DIADYNAMIC CURRENTS. Gilbert O. Madriaga , PTRP Department of Physical Therapy UP- College of Allied Medical Professions. Revised by: Mark David S. Basco, PTRP Department of Physical Therapy UP - College of Allied Medical Professions. Objectives.

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pt 158 physical agents ii diadynamic currents

PT 158: Physical Agents IIDIADYNAMIC CURRENTS

Gilbert O. Madriaga, PTRP

Department of Physical Therapy

UP- College of Allied Medical Professions

Revised by:

Mark David S. Basco, PTRP

Department of Physical Therapy

UP - College of Allied Medical Professions

objectives
Objectives
  • Describe diadynamic currents and its physical properties.
  • Discuss the physiologic effects of diadynamic currents on the body.
  • Identify the various indications, contra-indications and precautions with regards the use of diadynamic currents.
  • Enumerate the different methods of application of diadynamic currents for common clinical problems.
  • Prescribe correct dosage, intensity, duration and frequency of diadynamic currents on given problems.
  • Appreciate the value of evidence-based clinical practice in providing quality care to patients.
diadynamic currents
Diadynamic Currents
  • Monophasic pulsatile current
  • Usually a sine wave
  • F=100Hz
full wave rectification
Full wave rectification
  • reversal of the the direction of AC during alternate half-cycles. The current is unidirectional and pulsed.
half wave rectification
Half wave rectification
  • use of a rectifier to allow current to pass in one direction only, as the flow is blocked during alternate half-cycles of the AC. The current is pulsed direct current.
diadynamic currents1
Diadynamic Currents
  • Pulse rate
    • 50 pps for half wave rectified.
    • 100pps for full wave rectified
  • Pulse duration= 10 ms
diadynamic currents2
Diadynamic Currents
  • Provide excitatory responses but its long pulse duration is very uncomfortable
  • Effects are similar with DC because its flow is also unidirectional and it has short or no interpulse interval
fixed diphase df
Fixed Diphase(DF)
  • Full wave rectified AC
  • f = 50Hz
  • most effective in producing a masking effect
fixed monophase mf
Fixed Monophase (MF)
  • Half wave rectified AC
  • f = 50Hz
short periods cp
Short Periods (CP)
  • DF+MF
  • equal phases are attenuated without intervening pauses
long periods lp
Long Periods (LP)
  • 10 sec MF + 5 sec DF
  • peak intensity is varied and has a tendency to rise and fall
syncopal rhythm rs
Syncopal Rhythm (RS)
  • 1 sec MF + 1 sec rest period
slide15
Masking
  • sensory nerve excitability is altered

Vasomotor effects

  • ↑ vasodilation & hyperaemia

as result of release of histamine in tissues

slide16
Diadynamics affect only superficial tissues, but if by reflex activity it is possible to have effects on deeper structures

Muscle stimulation

    • For CP & LP currents muscle contraction is stimulated which increases blood flow to the muscles

Stimulation of vibration sense

indications
Indications
  • Soft tissue injury
    • Sprains
    • Contusions
    • Epicodylitis
indications1
Indications
  • Joint Disorders
    • Post-immobilization
    • Arthritis
indications2
Indications
  • Circulatory disorders
    • Raynaud’s disease
    • Migrane
indications3
Indications
  • Peripheral Nerve Disorders
    • Neuralgia
    • Neuritis
    • Herpes zoster
    • Radiculopathies
contraindications
Contraindications
  • Skin Lesions
    • To prevent burns, large cuts, abrasions or open areas
    • Eczema, psoriasis, acne, dermatitis can be exacerbated by electric currents
contraindications1
Contraindications
  • Infection
    • Can be aggravated by electric currents and it is possible to spread the infection
contraindications2
Contraindications
  • Impaired sensation
    • Must be checked first before any treatment
    • Density of current must be governed by the patient’s subjective feeling of current tolerance
pain spot application
Pain Spot Application
  • 2 electrodes using bipolar technique
  • Anode over painful site, cathode adjacent to it
  • Cathode may be applied proximally on the limb or over the nerve supplying the painful area (monopolar technique)
nerve trunk application
Nerve Trunk Application
  • Apply electrodes where the nerve is superficial
  • A tingling sensation will be felt in the area stimulated
paravertebral application
Paravertebral Application
  • Applied on both sides of the spine at the level of the nerve root supplying the painful area
  • If there are several nerve roots, apply alongside the spine at the highest and lowest nerve root levels
vasotropic application
Vasotropic Application
  • Electrodes are placed over the vascular paths affected in the circulatory system
myo energetic application
Myo-energetic Application
  • at each end of the muscle belly to produce stimulation
  • or monopolar technique with one electrode on the motor point of the muscle belly and the other proximal to it
transregional application
Transregional Application
  • To treat a joint, electrodes on opposite sides of joint
df fixed diphase
DF-fixed diphase
  • For initial treatment and before the application of any other current
  • For the treatment of circulatory disorders
  • Prickling sensation which subsides/ fine tremors
  • Muscle contraction occurs at high intensities
mf fixed monophase
MF-fixed monophase
  • Pain without muscle spasm after DF
  • Strong penetrating vibration which persist for longer than the sensation in DF
  • Muscle contraction occurs at lower intensities than with DF
cp short periods
CP-short periods
  • For traumatic pain
  • DF phase - Fine tremor rapidly diminishes
  • MF phase – strong constant vibration
  • Rhythmic contraction of muscle
lp long periods
LP-long periods
  • Long lasting analgesic effect particularly in the treatment of mylagias
  • Used in combination with CP for the treatment of neuralgia
  • Strong vibration
rs syncopal rhythm
RS-syncopal rhythm
  • For faradic-type stimulation
  • Test the excitability of nerves
intensity
Intensity
  • Gradually increased until a definite vibration or prickling is felt but without pain of burning sensation
  • Tetanic ms contraction should not occur
duration
Duration
  • Not more than 10-12 mins
  • 3 minutes for single applications
frequency
Frequency
  • 6-7 treatments given daily or every 2nd day
diadynamic currents3
Diadynamic Currents
  • The effects of diadynamic currents can be achieved by modern TENS with greater comfort and ease because of its microsecond pulses
what research tells us
What research tells us . . .

TITLE: Changes in pain by different types of diadynamic current in gonarthrosis and lumbar syndrome

  • No differences concerning the changes in pain can be demonstrated concerning the different types of current. Nor could any differences concerning changes in pain be found comparing the different weeks of therapy.

(Volklein & Callies, 1990)

we have just
We have just . . . .

. . . described diadynamic currents and its physical properties.

. . . discussed the physiologic effects of diadynamic currents on the body.

. . . identified the various indications, contra-indications and precautions with regards the use of diadynamic currents.

. . . Enumerated the different methods of application of diadynamic currents for common clinical problems.

. . . prescribed correct dosage, intensity, duration and frequency of diadynamic currents on given problems.

references
References
  • Clinical Electrotherapy by Roger M. Nelson & Dean P. Currier
  • Clayton’s Electrotherapy by Sheila Kitchen & Sarah Bazin
  • Principles and Practice of Electrotherapy by Joseph Kahn
  • Electrophysical Agents in Physiotherapy Therapeutic and Diagnostic Use by Hilary Wadsworth & A.P.P. Chanmugam
  • www.pedro.fhs.usyd.edu.au/ Physiotherapy Evidence Database (PEDro)h
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