Current Types-Iontophorsis-

Galvanism
 Therapeutic currents

The currents used for the treatment purpose is called therapeutic

currents.

According to the difference in frequencies, the currents can be

divided into the following three types.
 Therapeutic currents

1. Low frequency currents

2. Medium frequency currents

3. High frequency currents

 Low frequency currents

• The current which has frequency ranging from 1 – 1000 Hz is called

low frequency current.

Examples:

• Diadynamic Current, TENS, Direct current, Faradic current , sinusoidal

current.
 Medium frequency currents

The currents which have frequency distribution ranging from 1000 –

10000 Hz are called medium frequency currents.
Examples:
Interferential therapy, Russian current
 High Frequency currents

The currents having frequency above 10000 Hz are called high

frequency currents.
Examples:
Short Wave Diathermy, Microwave Diathermy, Infrared Radiations,
Ultrasound.
Galvanic current
• Galvanic current is also known as direct current
which can be drawn directly from dry cell batteries.
Galvanic current can be used as a constant and
interrupted directed current.

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 Interrupted direct current
• Interrupted direct current is also known as modified
direct current or interrupted galvanic current.
• Interrupted direct current is commonly used for
stimulation of denervated muscles and for
electrodiagnostic purpose

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 Interrupted direct current

• It is modified type of direct current characterized by

cessation of the current flow at regular intervals. In
other words, it is current whose flow stops and starts at
regular intervals.

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Physiological effects
• Physiological effects of interrupted direct current are
stimulation of sensory nerves, effect of muscle
contraction, increased metabolism, effect on
denervated muscle .

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Direct Current

• Is an electric current that flows in one direction for about 1 seconds

or longer.
• DC is also referred to as a monophasic, unidirectional and constant
current.
• DC can be reversed, Interrupted and surged
 Direct Current

• Advantages
• Less danger of electric shock
• Disadvantages
• Heavy weight of cells
• Larger space occupies by cells
• costly
Electrotherapeutic Currents Types (cont.)
• Alternating Current (AC)
• Flow of electrons that rhythmically changes direction

• Two terminals of generator (source) alternatively change from positive to negative

• AC indicates that the energy travels in a positive and negative direction. The wave form which
occurs will be replicated on both sides of the isoelectric line
Wave Forms
–Monophasic, rectangular, pulsed

• Also called a modified square wave

• Similar to DC but modulated from AC input current
Wave Forms (cont.)
• Sinusoidal wave form
• Pure AC current
• Polyphasic, symmetrical, balanced, sinusoidal
Wave Forms (cont.)
• Faradic wave form
• Asymmetrical AC wave form
• Biphasic
• Positive portion: short duration, high amplitude, and spiked
• Negative portion: long duration, low amplitude, and curved
 Galvanic Stimulation
 Galvanism is a direct current with a low voltage and amperage

The electrochemical effects results in certain physiological alterations

to the tissues at the site of application
Galvanic Stimulation

The movement of molecules during the electrophoresis.

Physiological effects
•  the positive pole of the galvanic
current are somewhat analogous to
the effect of cold applications
•  the negative pole to hot
applications
 The polar effect of the galvanic current

Two unequally sized electrodes are required

The smaller electrode is the active pad
Half the size of the larger ‘dispersive’ electrode

The smaller pad will demonstrate stronger polar effects as compared

to the larger dispersive pad
Indications
Hyperhydrosis

Musculoskeletal complaints;
• Adhesions, joint pain, neuritis, myalgia, sprains, strains and arthritic
Safety & Contraindications

The galvanic current is relatively safe

Electrode pads should not be applied over broken skin

 Iontophoresis

• Ionto ion

• Phoresis transfer
Iontophoresis

Categorized as continuous direct electric current

The transfer of ions across the skin (transdermal) by use of
continuous direct current
• Delivers a low-volt; High-amp DC
• Local blood flow is increased for 1 hour post therapy
Iontophoresis
• Contraindications
• Indications
• Hypersensitivity to electrical currents
• Acute or Chronic Inflammation
• Contraindications to ions (allergy etc)
• Arthritis
• Pain of unknown origin
• Myositis
• Myofacial Pain Syndromes • Precautions
• Prescription
• Dosage
• Do not reuse electrode
• Burns if intensity to great**

** An alkaline reaction occurs under the cathode (negative electrode) which is

much more caustic to the skin than the acidic reaction occurring at the anode.
The cathode may be increased in size to attempt to decrease this caustic reaction
Iontophoresis
• Effects of treatment depends on the ion(s) delivered
• Tendonitis, bursitis (musculoskeletal inflammatory conditions)
• Using dexamethosone, sodium phosphate (decadron) and
Xylocaine
• Reduction of edema has been achieved by driving hyaluronidase
• Transitory (5min) local anesthesia has been produced by
delivering lidocaine to the tissues
• The anesthesia was better than that achieved by topical
application but less effective than infiltration of the area with
lidocaine
Selecting the Appropriate Ions
• Inflammation • Edema
Dexamethasone (-) Hyaluronidase(+)
Hydrocortisone (-) Salicylate (-)
Salicylate (-) Mecholyl (+)
• Spasm • Open Skin Lesions
Calcium (+) Zinc (+)
Magnesium (+) • Scar Tissue
• Analgesia Chlorine (-)
Lidocaine (+) Iodine (-)
Magnesium (+) Salicylate (-)
 Condition Ions Condition Ions
Scar Tissue Iodine(-) Plantar Faciitis Dex/lido. (-)
Inflamm. Disorders Dex(-)
Tendon Adhesion Iodine(-)
TMJ Dex & dex/lido(-)
Subdeltoid Bursa Magnesium(+) Epicondylitis Na+ Salicylate(-)
Carpal tunnel Dex(-)
Heel Pain Acetate(-)
Edema Hualuronidase(+)
Myositis Oss. Acetate/Acetic Acid
Myopathy Calcium(+)
Postsurgical hip Salicylate(-)
pain
Electrode Placement
• The pole that is driving ions into tissue is called the active electrode - Delivery
Electrode (drug electrode)
• placed over target tissue

The other pole is called the inactive electrode - dispersive electrode

• place 4-6 inches from drug electrode

• With iontophoresis…
• Positively charged ions are driven into tissues from positive pole
• Negatively charged ions are driven into tissues from negative pole
Current Intensity
Adjustable Timer
Treatment Time: ranges between 10-40 min.

Low amperage currents appear to be more effective as a driving force

than currents with higher intensities
Higher intensity currents tend to reduce effective penetration

Recommended current intensity: 2-5 mA

Dosage: 40 to 80 mA-min;
 Dosage Formula: amplitude X time = mA min.
Optimal Current Variables used in Iontophoresis
(after Rothstein et al, 1998)

Current Type DC

Current Amplitude 1.0 - 4.0 mA

Treatment Duration 20 - 40 minutes

Total Current delivered 40-80mA/min

Current Intensity
 If pain or a burning sensation occurs, intensity is too great and
should be decreased
 When terminating treatment, intensity should be slowly
decreased to zero before electrodes are disconnected
 Patient should be comfortable with no reported or visible
signs of pain or burning
 Check skin every 3-5 minutes for signs of skin irritation
 Decrease intensity during treatment to accommodate for
decrease in skin impedance (This avoids pain or burning)
Safe Current Density
 The current density means mA/cm2
 The current density of no more than 0.5mA/cm2 is applicable at the negative(cathode)
electrode
 1.0mA/cm2 at the positive(anodal) electrode
• If a current of 2mA is delivered using an electrode of 6cm2
• The current density will be 2(mA)/6(cm2) = 0.33mA/cm2

• Maximum Current (mA) = Maximum Safe Current Density (mA/cm2) x Electrode area (cm2)
• If the (active) electrode to be used is 6cm2
If the active electrode is to be made NEGATIVE (cathode)
The maximum safe current density is 0.5mA/cm2
The maximum current that can be safely applied is therefore = 0.5mA/cm2) x 6 (cm2) = 3mA