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


Physical properties of diadynamic currents

PHYSICAL PROPERTIES OF DIADYNAMIC CURRENTS


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


Physiologic effects of diadynamic currents

PHYSIOLOGIC EFFECTS OFDIADYNAMIC CURRENTS


Masking

  • sensory nerve excitability is altered

    Vasomotor effects

  • ↑ vasodilation & hyperaemia

    as result of release of histamine in tissues


  • 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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