DIADYNAMIC CURRENTS

Assist. Prof. Baha Naci

2022-2023 Spring Semester
21.03.2023
SINUSOIDAL CURRENTS

◼ Low frequency currents alternating equally.

◼ Symmetrical bipolar alternating current.
◼ Its frequency is 50-100 Hz, current duration is 10ms.
◼ They do not have chemical effects as they constantly
change direction.
◼ Not used for heat purposes due to low intensity
SINUSOIDAL CURRENTS

Physiological effects:
◼ Sensory nerves: Prickling sensation, reflex vasodilation
and erythema (more than faradic current)
◼ Motor nerves: Muscle contraction through stimulation of
its motor nerve. Tetanic contractions are obtained with at
least 20 Hz
◼ Denervated muscles: Results in contraction of
denervated muscle but the patient can not tolerate
because of pain.
DIADYNAMIC CURRENTS

◼ Diadynamic current was discovered by Pierre Bernard

60 years ago
◼ Diadynamic currents are basically a variation of
sinusoidal current.
◼ They are monophasic sinusoidal currents (rectified
alternating current) with duration of 10 ms
◼ They are half or full wave rectified sinusoidal currents.
DIADYNAMIC CURRENTS

◼ Basic principle of diadynamic current is an electronic

modulation of symmetrical biphasic sinusoidal waveform,
with frequency of (50-60Hz).
◼ Pulse duration is extremely long, (6-10 ms) so it is more
painful
Half and Full Wave Rectification
◼ Half wave Rectification - When a sinusoidal current is
half wave rectified, half of the sinusoidal oscillation is
removed and the result is no longer AC but a series of
pulses.
◼ Full wave Rectification – includes reversing the polarity
of one phase of sinusoidal AC current so that current
flows in the same direction with each pulse
DIADYNAMIC CURRENTS
◼ Diadynamic currents are alternating sinusoidal
monophasic pulsed, galvano-faradic currents.
◼ There are two basic forms of diadynamic currents:
◼ Diphase Fixe (DF) or double phase, which is full-wave
rectified sinusoidal current.
◼ Monophase-Fixe or single phase current, known as half-
wave rectified sinusoidal current.
◼ Short Period (CP), Long Period (LP) and Rhythm
Syncope (RS) current types are obtained by
combinations of DF and MF.
Diadynamic Current Types

◼ Diphase fixe (DF)

◼ Monophase Fixe (MF)

◼ Courtes Period (CP)

◼ Long Period (LP)

◼ Rhythm Syncope (RS)

Diphase fixe (DF):
◼ Generally used for initial treatment and has analgesic effect
◼ Indication: Pain with muscle spasm
◼ DF is frequently used in cases of increased sympathetic tone
and peripheral circulatory disorders.
◼ Tickling and prickling sensations occur during the application.
◼ Muscle contraction occurs only at high intensities

◼ Frequency: 100Hz
◼ Impulse duration: 10 ms
◼ No rest between the impulses
Monophase Fixe (MF)
◼ MF is generally used for connective tissue
stimulation, and for pain without muscle
spasm
◼ The patient feels strong vibration sensation.
◼ MF current can result in muscle stimulation at
lower intensity than DF
◼ Fr: 50 Hz.
◼ Impulse duration: 10 ms
◼ Rest time: 10 ms
Courtes Period (KP)

◼ Consists of equal phases of consecutive DF and MF.

◼ The duration of each component is 1 second.
◼ No interval pause
◼ Rapid alternating feeling between DF and MF
◼ Fine tremors in MF phase (strong and constant vibration)
◼ It is used for trophic disorders, traumatic conditions and
non-spasm-related painful conditions.
◼ 1 s DF, 1 s MF passes sequentially.
Long Period (LP):

◼ 10 sec MF followed by 5 sec DF in which

intensity and frequency gradually rise then fall
◼ This type of current produces a long-lasting
analgesic effect.
◼ It is used for chronic painful conditions such as
neuralgia and myalgesia.
◼ Feeling: Strong vibration to pricking
Rhythm Syncope (RS):

◼ MF currents following each other intervally

◼ 1 second phase of MF, followed by a 1 second
rest phase
◼ Can be used for stimulation of muscles with
preserved innervation (faradic stimulation) and
as a test for motor nerve excitability.
◼ RS and MF are the same. Only passing
durations are different.
Parameters to consider
◼ Treatment can be started with direct current application.

◼ After direct current, DF is applied.

◼ Then MF, CP, LP or RS can be applied for 2-5 min.

◼ Intensity should be increased gradually until definite vibration or

prickling sensation occurs - within the pain threshold limit

◼ Frequency – 6-7 treatments given daily or every other day

Parameters to consider
◼ Total application time should not exceed 10-12 minutes
– electrochemical reactions – maximum 4-5 min.

◼ In acute painful cases, it is appropriate to apply the

treatment everyday and, if possible, 2 times in 24 hours.

◼ The interval between two treatment sessions should not

exceed 24 hours.
Electrodes:
◼ Metal plate or carbon rubber electrode / cup electrode /
Yoke electrode may be used.
◼ The electrodes should be separated from the skin by
moist sponge pads which are at least 1 cm-thick and
which absorb plenty of water.
Electrodes:

◼ Electrode may be of equal size or small electrode is

applied on the trigger site with a large electrode
proximal to it.
◼ Intensity will be gradually increased to produce muscle
contraction.
◼ To avoid tissue damage, current reversal during
treatment is followed
 CLINICAL APPLICATION OF DD CURRENT

◼ Pain spot: The two electrodes are applied as a bipolar

technique with the anode applied over pain spot and the
cathode adjacent to it. Cathode may be applied
proximally on the limb or over the nerve supplying the
painful area (monopolar technique)

◼ Nerve trunk: The two electrodes are placed along the

course of the peripheral nerve where the nerve is
superficial. A tingling sensation will be felt in the area
stimulated
 CLINICAL APPLICATION OF DD CURRENT

◼ Paravertebral or segmental application: The

electrodes may be applied on both sides of the spine at
the level of the nerve root supplying the painful area. If
several nerve roots are compromised, the electrodes
may be applied alongside the spine at the highest and
lowest nerve root levels.

◼ Vasotropic application: The electrodes are applied

along the vascular paths affected in the circulatory
disorders.
 CLINICAL APPLICATION OF DD CURRENT

◼ Myoenergetic application:
• The two electrodes at each end of the muscle belly to
produce stimulation
• Alternatively, monopolar technique with one electrode on
the motor point of the muscle belly and the other
proximal to it

◼ Transregional application (at painful spots on the

affected nerve) : to treat a joint, electrodes positioned
on opposite side of the joint.
Effects of DD current

◼ Similar to galvanic and faradic currents but DD is

superior in terms of producing hyperaemia and analgesia

◼ These strong effects are caused by the constant change

of the combined direct and alternating currents, and the
current shape.
Physiological Effects

◼ Sensory stimulation -prickling sensation

◼ Motor stimulation – Muscle contraction – intramuscular
blood flow
◼ Effects on blood flow – vasodilation & hyperaemia
◼ Altering the ionic distribution around the cell
◼ Tropic changes
Therapeutic Effects

1. Pain relief due to

• Direct mechanism - stimulation of sensory nerves

causing pain relief through stimulation of pain gate
mechanism
• Indirect mechanism - improving circulation through
pumping action of muscle contraction with subsequent
removal of irritant wastes.
Therapeutic Effects

2. Decrease inflammation and swelling – due to

increased local circulation and change of cell
membrane permeability

3. Muscle reeducation and strengthening – due to

stimulation of motor nerves
Therapeutic Effects

4. Increase of local circulation due to

• Release of H-like substance due to polar effect
• Changing autonomic activity – reduced sympathetic tone
causes vasodilation

5. Facilitation of tissue healing – due to local circulatory

changes and the polar effects resulting in increased cell
activity
Electrochemical Effects

◼ Skin damage due to electrochemical changes and

changes in the pH value of the skin.

◼ To minimize the risk of skin damage, treatment time

should be limited to 10 minutes.
Indications
1. Muscle and Joint Problems

◼ Sprain: 3-4 min CP (if there is pain, 1 min DF initially)

◼ Contusion: CP for painful spots
◼ Muscle injuries: 3-4 min CP
◼ Epicondylitis: 2-3 min LP
◼ Joint stiffness due to immobilization: 5 min CP
◼ Osteoarhritis: DF, CP, LP applications
◼ Humeroscapular periarthritis: 3-4 min CP, (LP is also applied if there
is muscle spasm.)
◼ Sudeck's atrophy
◼ Myositis
◼ Torticollis
Indications

2. Circulatory disorders

➢ Raynaud disease
➢ Buerger (thromboangiitis obliterans)
➢ Arteriosclerosis obliterans
➢ Migraine
➢ Varicosis
Indications

3. Neuralgia

➢ Trigeminal neuralgia
➢ Occipital neuralgia
➢ Sciatalgia
◼ Joint sprains: plaque or Yoke electrodes on
both sides of the joint

◼ DF 1 min
◼ CP 3-4 min
◼ RS 2 min
◼ Osteoarthritis: transarticular application

◼ DF 1 min
◼ LP 5 min
◼ (2-3 min MF)
◼ Migraine:
◼ DF is used
◼ one of the small cup electrodes is placed on
gg. cervicale sup, while the other one 2-3 cm
proximally - 3 min
◼ Then a. temporalis superficialis - 2-3 min
◼ Sciatalgia: starting from low back
- application through sciatic nerve

◼ DF 1 min
◼ CP 2-3 min
◼ LP 2-3 min
◼ Sudeck's Atrophy:

◼ (-) cup electrode is placed on stellar ganglion

◼ (+) electrode is placed behind SCM muscle
◼ DF application
◼ Torticollis:

◼ Paravertebral application
◼ DF 1 min
◼ LP 3 min
◼ Can be applied on painful spots of SCM
muscle
◼ Raynoud disease:

◼ Initially DF on stellar gg. with small cup

electrodes.
◼ Then CP (2 min) on dorsal and volar parts of
the hand with large plaque electrodes
Contradictions

◼ Acute inflammation
◼ Active bone, joint, and other organ tuberculosis
◼ Malignant tumor
◼ Transthoracic and transcranial regions
◼ Diseases that cause cachexia
◼ Decompensated heart condition
◼ Hemorrhage
◼ Metals in the tissue (after the injury, endoprosthetics,
osteosynthesisetc.)
◼ Dysesthesia
◼ Pregnancy
Summary

◼ DD current is particularly suitable for treating PAIN in small

joints. (e.g. finger joints & wrist joints).
◼ Segmental application of diadynamic current gives
outstanding results in REFLEX DYSTROPHY & in
SUPERFICIAL HYPERALGESIA
◼ MF – Good analgesic effect –treating painful conditions.
◼ DF –Strong analgesic effect –Connective tissue toning
◼ CP –Effective in oedema & hematoma & decreasing pain.
◼ LP –Strong & long lasting analgesic effect (Electroanalgesia)
–Painful syndromes & extra-articular rheumatism
Thank you..