Interference Current (IFC)

Physical Principle
⚫ Interference of wave
1. When two sine waves are exactly in phase or when one of the two waves is one, two, three or more
wavelengths out of phase with the other → amplitude summation.
2. When one waves is any multiple of a half wavelength out of phase with another wave → amplitude
cancellation.

3. Interference of two different frequency of sine waves → amplitude-modulated beats (interference

beating effect).
⚫ Interference current
1. Two-circuit IFC
 Interference of two medium frequency (100 to 10000 Hz; carrier frequency) sinusoidal alternating
currents of slightly different frequencies.
 Perceived rhythmical sensory or motor pulsations, or both, depending on the maximum amplitude
of the beat modulation
 Beat frequency is the difference between the frequencies of the two alternating current.
→用中頻(carrier frequency)的波產生了低頻的波(beat frequency)來刺激
Constant- Versus Variable-Beat Frequencies
 Constant difference between the frequencies of the two circuits→ constant-beat frequency.
 The frequency between the two circuits varies within preselected ranges (one current is fixed, the
other is adjustable)→ variable-beat frequency.
 The variable-beat frequency has been claimed to reduce adaptation.
Two-Circuit Static Interference Field (static type)
  In a homogeneous medium, the maximum IFC amplitude modulation occurs in the direction of
vectors that are oriented 45˚ to perpendicular lines extending between the electrodes.
 The area of tissue stimulated by the current depends on the arrangements of the four electrodes
and current amplitude.
 More appropriately used when the target tissue is well defined or localized.
 The amplitude-modulated current occurs endogenously (內生的) in an unpredictable region
because of the nonhomogeneous composition of tissues.
Two-Circuit Scanning Interference Field (scanning type)
 Current amplitude varies in one circuit and is held constant in the other.
A. 可以利用向量的總和來思考
B. 當 current 1 的電流比較大時，所產生的最大 amplitude-modulation 會移往 current 1.
 The direction of amplitude-modulation results in rhythmical clockwise and counterclockwise
changes.
 The area of tissue stimulated is greater than that in the static mode.
 More preferred whenever difficult to identify the exact site of tissue involvement or the area of
symptoms is large.

2. Premodulated (one-circuit) IFC

 An alternative method of delivering IFC.
 Premodulate the current from the two circuits exogenously (體外) within the device and delivers
the premixed beats via only two electrodes. (兩個電流先在體外干擾好在輸入進體內)
 The only way to ensure 100% modulation and there is evidence that it may be more effective and
comfortable in muscle stimulation.
3. Three-Circuit IFC
 By adding a vector system, or claiming a 3D current flow by adding a third output to provide
greater spatial stimulation of tissues than two-circuit field.
 To date, no in vitro, experimental, or clinical data have been found to support these concepts.
Electrophysiological Effects
⚫ Cutaneous and subcutaneous stimulation- two-circuit IFC
1. Somewhere within the endogenous (subcutaneous) zone, nerve fibers receive higher amplitude
stimulation than the skin receives.
2. Stimulated subcutaneous nerve fibers cannot accommodate because each beat is amplitude
modulated.
⚫ Asynchronous recruitment of motor units with IFC (很接近自人生裡被徵招的狀態)
1. Every nerve fiber has a maximum depolarization frequency dictated by its refractory period
→ e.g. in A𝛼 nerve fibers the duration of the absolute refractory period is approximately 1 msec.
2. When a constant amplitude stimulus has a frequency greater than 1000 pps→ maintaining a
continuous refractory state → loss of excitation (Wedensky inhibition).
3. Nerve fibers respond to AC frequencies above 1000 pps at their own depolarization frequencies
(dictated by duration of refractory period) → stimulus-asynchronous depolarization (Gildemeister
effect).
⚫ IFC and skin impedance
1. The skin impedance decreases with increasing AC frequency → IFC does permeate soft tissues and
can penetrate to deep structures.
2. The decline in skin impedance results from the decreased pulse charge (shorter pulse duration)
generated at higher frequencies of AC (major effect).
Clinical Application: Indications and Contraindications
⚫ Indications and Theoretical Mechanisms
1. Pain control
 Classic pain gate theory.
 Elicit descending pain suppression (releasing inhibitory neurotransmitters at spinal level) through
stimulation of afferent Aδ and C fibers. →用於強度較高的電刺激時的解釋理論
 Stimulation of peripheral nociceptive fibers at rates above their maximum conduction frequency
may cause cessation of action potential propagation through increased thresholds and synaptic
fatigue.
2. Improve blood flow and reduce swelling
 Due to mild muscle contraction (muscle pumping).
 Action on the autonomic nervous system, decreasing blood vessel tone.
3. Facilitate bone and tissue healing
 IFC may alter activity of the ANS and cells, and alter production of important chemical mediators.
4. Muscle re-education
 Particularly advocated in the treatment of urinary incontinence.
⚫ Contraindications
1. Generally similar to those cited for most other types of therapeutic ES.
Treatment Parameters and Methods of Application
⚫ Treatment parameters
 1. Beat frequency (BF)
 The BF is traditionally considered to be the effective component of IFC, mimicking low-
frequency currents and creating differential stimulation of nerve and tissue types.
 However, recent studies illustrated IFC did not follow the very clear frequency-dependent effects.
 BF settings across a wide range between 1 and 130 Hz have been recommended in the literature
for the treatment of pain.
 Most participants appear to prefer higher (50-100 Hz) to lower BF settings (5Hz).
2. Current intensity
 For pain relief → ‘strong but comfortable’ sensation.
 If used for muscle stimulation, the aim should be to use an intensity that produces a comfortable
muscle contraction.
3. Treatment duration: often limit to 10-20 minutes in the clinical setting.
⚫ Type of electrode
1. Vacuum Electrode (Rubber Cup)
 The magnitude of the vacuum should be adjusted so the least amount of suction is used to keep
the electrodes on the skin.

 Advantages of vacuum electrode

A. Easy to apply.
B. Massage effect.
C. Increase conductivity. (真空負壓的體液，會把血液攜到皮膚的表層)
 Contraindications of vacuum electrode
A. There is a danger of hemorrhage, e.g., surface hematomas or bruising.
B. Varicose veins and areas of impaired capillary or venous function.
C. Fragile skin, open wound, just healed wound, or other skin hypersensitivity.
2. Rubber Pad

3. Probe (for muscle)

⚫ Methods of application
1. Quadripolar method: all electrodes on one surface or electrodes from both circuits on opposing
surfaces.

2. Bipolar method－ premodulated IFC

 It is easier to apply two electrodes with the bipolar method than four with the quadripolar method
except when a single four-electrode pad or vacuum electrode is used.
 The premodulated beats delivered to the skin with the bipolar method may be perceived as feeling
more intense than the unmodulated AC with the quadripolar method.
3. Hexipolar method