HIGH VOLTAGE PULSED GALVANIC

STİMULATION

(HIGH VOLTAGE PULSED CURRENT=HVPC)

Assist. Prof. Baha NACI

2022-2023 Spring Semester
18.04.2023
 Originally developed by Haslip in 1940, and known as Dyne-wave
neuromuscular stimulation;

 Known as HVPC in 1970s

 High-voltage pulsed galvanic stimulation

 Pulsed= pulse indicates that the current is not direct galvanic.

 Twin-pulsed monopolar waveform includes a spike and
a slow descent.

 Twin pulse duration; 0.1-0.2ms

 Each peak lasts a few microseconds

 Current shape and duration are normally constant

 Twin pulse frequency ranges from 2-100Hz

Characteristics of the current shape;

 The HVPC stimulator is a device with a constant-

duration bi-peak monophasic waveform.

 Duration is set to 200µsec.

 The treatment voltage is above 100 volts (0-500V)

 Devices have constant voltage

 Frequency adjustable
Characteristics of HVPC

HVPC produces a
high-voltage current
with a high-peak
intensity of a
maximum of 300 to
400 mA but with a
low-frequency current
and a very short
duration.
Waveform characteristics of HVPC
Potential Advantages of HVPC (due to very short pulse
duration + long interpulse interval)

 Selectively stimulate motor rather than sensory nerves,

 No chemical effects – stimulation is safe and more comfortable
than faradic current – maintained for longer periods of time
(60 min)
 Due to less tissue resistance, HVPC penetrates deeper than
that of low voltage currents
 Direct stimulation of deep nerves and muscles can be effective.
 No stimulation of denervated muscles
 Partially or totally innervated muscle will respond well to HVPC
 In the presence of such short-duration peaks, very
high voltage is needed to stimulate nerve fibers.

 This kind of current;

a. Passes easily through tissues.
b. Used easily because they distinguish between
the nerves that carry the motor-sensory and pain
sensation.
Electrodes;

 In different sizes
 In the form of a flexible or rigid plaque
 Probe electrodes

 Can be applied with a large passive electrode; 1, 2 or

4 active electrodes; 1 pen electrode; or 1 anal
electrode. Gel, as a transition material, is used.
Clinical Application;

1. The physiotherapist should determine which

of the patient's problems is indicated for
neuromuscular electrical stimulation.
2. The physiotherapist should have the
necessary knowledge to use the HVPC
3. The physiotherapist should identify the
tissues through which the current passes.
4. The physiotherapist should observe the
current flow from the active electrode to
the passive electrode.
5. Appropriate documentation methods are
necessary to measure the effectiveness of
treatment
 Indications;

1. Wound healing – pressure ulcer, decupitus ulcer,

diabetic foot ulcer, burn wound
2. Pain elimination – chronic low back pain,
osteoarthritis
3. Muscle stimulation – innervated muscle stimulation
4. Edema reduction – posttraumatic edema
5. Muscle spasms
6. Increase of joint mobility
 Skin wound healing

 Pulse frequency: 30-200 pulse per second (pps)

 Continuous mode

 Voltage intensity: 1-500 V (with no discomfort)

 Treatment duration: 10-60 min.

 Pain therapy

 Pulse frequency: 1-200 pps

 Continuous mode
 Voltage intensity: 1-500 V (with no discomfort)
 Treatment duration: 10-20 min.

 Pain reduction is accomplished through decreasing pain by using

two small electrodes closely-spaced in a narrow area or through
decreasing pain fiber stimulation by using two widely-spaced
large electrodes.
 Edema, spasm, muscle weakness

 Pulse frequency: 30-60 pps

 Pulsed current form with an on:off ratio of 15:45 sec. This
ratio can be applied for 20 times.
 Voltage intensity: 1-500 V (with no discomfort)
 Treatment duration: 5-30 min.
Contraindications;

1. Circulatory Disorders
2. Anterior cervical region-Carotid sinus
3. Transthoracic region-Heart
4. Pregnancy-lumbar and abdominal regions
5. Transcranial region
6. Frequent epilepsy attacks
7. Neoplasmic lesions
8. Hemorrhagic area
9. Electronic implants (cardiac and other devices)
THANK YOU…