HIGH VOLTAGE GALVANIC STIMULATION
High voltage current with a high peak intensity but a low average current and a very short
duration pulse (50 and 100 micro seconds)
High peak intensity, usually produces a twin pulse to a maximum of 300 – 400 milliamperes
It is safe due to short pulse duration and can be maintained for longer periods of time
Have the advantage of penetrating deeper nerves and muscles
Permits selective stimulation of sensory and motor axons with little effect on the pain fibers
It will not produce contraction of denervated muscles
INDICATIONS
Same as low voltage stimulation except for denervated muscles
Pain reduction
a. by providing supra painful stimuli in a very narrow area using tiny electrodes closely packed
b. by minimizing pain fiber stimulation and providing for maximal sensory fiber stimulation using
larger electrodes
these methods thought to stimulate the release of endorphins which act to suppress pain
Increase Joint Mobility
Increase in peripheral circulation
Achieved by stimulating intermittent muscle contractions stimulating the muscle pump
effect on the venous circulation or may stimulate the sympathetic neurons directly
causing vasodilation
Healing of ulcers
a. a (+) electrical potential exists in the ulcer and by adding external (+) current the repair
process is accelerated; ES on the (-) pole will destroy the bacteria present
b. increase superficial circulation
Decreased muscle spasm
Strong muscle contraction produced may result in greater muscle relaxation, also the relief of
pain may reduce muscle spasm
Reduction of post-traumatic edema
CONTRAINDICATIONS
Same as low frequency currents, IDC in particular
DOSAGE
Intensity – patient’s tolerance
Should be high enough to produce a contraction
Pulse rate setting – 80 p/s
Switching Rate Setting (Surge) – continuous or surged
Electrodes
a. active electrode (anode) – large enough to cover the painful area or affected area
muscle spasm – 2 active electrodes; 1 at the belly and 1 at the musculo-tendinous jt
b. dispersive electrode (cathode) – positioned in the lumbar region
Treatement time - generally 20 mins
Oedema – 30 mins
It is recommended that the tx be preceded by hot pack in cases of pain, dec jt. Mob, and muscle spasm
followed by US, jt mob., mild stretching.
DIADYNAMIC CURRENTS
A variation of sinusoidal currents
Physical Properties
Fixed Diphase (DF) – a full wave rectified AC with a frequency of 50 hz
Fixed Monophase (MF) – half wave rectified AC with 50hz freq
Short Periods (CP) – equal phases of DF and MF are alternated without intervening pauses
Long Periods (LP) – 10 sec phase of MF followed by 5 sec phase of DF in which the peak intensity
is varied, with a general tendency to rise and fall
Syncopal Rhythm (RS) – 1 second phase of MF followed by a 1 sec rest
Physiological Effects
Relief of pain
Masking – DF is effective
Vasomotor effects – vasodilation and hyperemia as a result of the release of histamine in the
(primarily superficial) tissues
Muscle stimulation – CP and LP are used, muscle contraction is stimulated and results to
increase blood flow to the muscles
Stimulation of vibration sense – central masking of pain
Indications
Relief of pain for
Soft tissue injury – sprains, contusions, epicondylitis
Joint disorders – post- immobilization, arthritis
Circulatory disorders – Raynaud’s dse, migraine
Peripheral nerve disorders – neuralgia, neuritis, herpes zoster, radiculopathies
Contraindications
Same with LFC
Methods of Application
Should be based on the clinical problems presented
Pain spot application – anode on the pain spot and the cathode on the adjacent to it (bipolar)
- Cathode on the proximal limb or over the nerve root (monopolar)
Nerve trunk application – 2 electrodes along the superficial (peripheral) nerve. Tingling sensation is felt
Paravertebral application – applied on (B) sides of the spinal level of the painful (area) nerve root. It is
applied on the highest and the lowest (painful) nerve root level if several roots are involved.
Vasotropic application – along the vascular paths
Myo-energetic application – to produce muscle stimulation
Transregional application – electrodes are positioned on opposite sides of the joint
Electrodes – vary in sizes: metal plate, yoke, suction. The electrodes should be separated from the skin
by moist sponge pads.
Dosage
Current type
DF
o is primarily used for the initial treatment
o for the treatment of circulatory d/o
o px feels prickling sensation which subsides after a short time
o Muscle contraction occurs at high intensities
MF
o Treatment of pain w/o muscle spasm
o Penetrating vibration which persist for longer time than DF
o Muscle contraction at lower intensities
CP
o Treatment of traumatic pain
o DF phase,fine tremor which rapidly diminishes, MF phase, a strong constant vibration
o With sufficient intensity rhythmic contraction of muscle occurs
LP
o Long lasting analgesic effect, particularly in myalgia
o Also used in combination with CP in the treatment of Neuralgia
o Strong vibrational MF phase giving away to the prickling of the DF phase which rises and
falls slowly
RS
o Used for faradic-type stimulation of muscles and can be used to test the excitability of
motor nerves
Intensity
Should be increased slowly until a definite vibration or prickling sensation is felt, but
without any pain or burning sensation. Continuous (tetanic) contraction should not
occur
Duration
Total application should not exceed 10 -12 mins
Single applications are at 3 mins
Frequency
Generally 6-7 treatments, daily or every other day
