LAB.

FARADIC AND
INTERUPTED
DIRECT CURRENT
TEST
DR. TANVEER SIKANDER
PT
Learning objectives

 Brief
 Physiological effect
 Indication
 Method of application
What is interrupted direct current

 Low frequency impulses with a duration of more than 10msec (Long duration) are
termed as interrupted (modified) direct current and is used for stimulating
denervated muscles.

 The repetition rate is shorter, i.e. 30 per minute.

 Definition
• Interruption is the most common modification of
Direct current, the flow of current commencing and
ceasing at regular intervals.
• Impulses in which the current rises gradually are
termed selective
• Duration and frequency can be adjusted
When duration of impulses is 100ms the average
frequency is 30 per minute
 Duration & Frequency
of IDC
⚫ The duration and frequency of the impulses can be
adjusted,
⚫ a duration of 100ms being commonly used, although
it is often an advantage to increase this to 300 to 600ms
⚫ Frequency of the current reduces with increase in the
pulse
duration.
⚫ Pulse duration of 100ms will have frequency of
30 cycles/minute.
⚫ The interval between the impulses should never be
shorter duration than the impulses themselves and is
usually appreciably longer.
Types of IDC
⚫ Currents produced for therapeutic purposes may have
sudden or gradual fall, hence depending on this there are
several types, which are as follows:
⚫ 1) Rectangular (sudden fall of intensity)
⚫ 2)Trapezoidal (gradual)
⚫ 3)Triangular(slow rise slow fall)
⚫ 4)Saw-tooth (slow rise sudden fall)
⚫ 5)Depolarized : some equipment for low intensity
reversed current between the impulses giving called
depolarized impulses.
Physiological Effects of IDC

⚫ Following are the physiological effects of the

interrupted direct current:
1. Sensory Stimulation
2. Hyperemia (excess build up of blood in the
vascular system. Warm, red, swollen)
3. Elecrotonous (potential difference to create
depolarization)
4. Pain relief
5. Acceleration of healing
Sensory Stimulation

⚫ During the passage of direct currents the patient is

aware of a mild tingling or prickling sensation,
which may merge into a mild irritation or itching.
Hyperemia
⚫ If sufficient current has passed for long enough an
erythema of the skin will be evident under both
electrodes, and is more marked under the negative
(cathode).
⚫ This erythema is confined to the area of
the applied electrode.
⚫ Since this erythema is confined it indicates a
capillary hyperemia.
Electrotonus
⚫ Sub threshold nerve stimuli do not cause an action potential but they do
affect the membrane potential. This phenomenon is known as electro
tonus.
OR
⚫ The altered sensitivity of a nerve when a constant current of electricity
passes through any part of it

⚫ Catelectrotonus: the local depolarization and increased irritability of a

nerve in the region of the negative electrode or cathode on the passage of
a current of electricity through it .

⚫ Anelectrotonus: The condition of decreased irritability of a nerve in the

region of the positive electrode or anode on the passage of a current of
electricity through it.
Pain relief
⚫ Strong sensory stimulation
blocks the pain transmission
at the level of
spinal cord by pain gate
theory.
⚫ The hyperaemia occurring
may help to remove the
nociceptive substances and
thus reducing pain.
Acceleration of healing
⚫ Electrical stimulation by direct current
enhances healing process.
⚫ It leads to increase bone formation and
accelerate healing when current is applied
through implanted electrodes.
⚫ It has also got effects on healing of superficial
and open wounds
Stimulation of Denervated Muscle

⚫ Types of Denervated muscle fibers

⚫ Neurotmesis (complete
denervation)
⚫ Axonotmesis (partial denervation)
⚫ Neurapraxia (compression of nerve)
Changes in Denervated Muscles

⚫ When the muscles are denervated the following changes

will occur.

⚫ Loss of voluntary contraction and reflex activities

⚫ Atrophy: Resulting in fibrosis

⚫ Fibrillization: Spontaneous contraction

⚫ There is marked wasting of the muscle fibers and if the

degeneration is of long standing they tends to become fibrosed
and to loss the properties of irritability, contracability,
extensibility and elasticity.
Fibrosis
Advantage
⚫ The purpose of such current is to maintain the
muscles in as healthy state as possible to prevent
the complication by electrically artificial
contraction.
⚫ If some of the motor units (motor end plate + motor
nerve + muscle fibers) are intact galvanic current is
the choice of treatment.
⚫ Interrupted direct current is still recommended for
the treatment of Axonotmesis and Neurotmesis
nerve repair is to be taken.
Contraindications
⚫ Impaired cognitive
ability
⚫ Pregnancy (1st trimester)
⚫ Over Carotid sinus
⚫ Loss of sensation.
⚫ Cancer.
⚫ Cardiac pacemakers.
⚫ Superficial metals
Equipment preparation
⚫ No current leaking on to the casing
⚫ Polarity is marked
⚫ Duration of impulse and frequency of impulse
controls are available desired
⚫ Keep all control at zero
⚫ Connect wire and electrode
⚫ Select the appropriate probe if used
⚫ Make appropriate size if indifferent electrode
METHODS OF TREATMENT
⚫ Patient preparation
⚫ Pt position is comfortable ,the part is adequately supported
⚫ Explain the patient in simple words about the treatment
(procedure and sensation)
⚫ Explain Pt characteristics of muscle twitches
⚫ Warn the patient not to touch the machine and not to manipulate
any control(when both electrode are tried to Pt part
⚫ Report any other sensation
CONT…

⚫ Expose only that area to be treated cover the rest of the body.
⚫ Test skin sensation for ‘’pin –prick’’
⚫ Inspect the skin , avoid stimulation when the skin has
rashes
⚫ Wash the area with soap and water then dry and then soak
the area with warn saline for 5 mint.
⚫ Place the indifferent electrode to appropriate area and secure with
bandage
TREATMENT
Cont,
…
⚫ Note the sensation reported by the patient
⚫ Set the duration (time )of treatment
⚫ Remain with in the calling distance from the patient a call bell
can be gives to patient
⚫ At the end of the treatment time turn the intensity control
slowly to zero then switch the apparatus and the mains off
⚫ Remove terminals from the apparatus
⚫ Undo bandage to remove electrodes
⚫ Inspect the skin and make a note of any reaction
REFERENCE

 CLAYTON’S ELECTROTHERAPY