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Introduction
Therapists often use transcutaneous electrical stimulation to treat their patients. They can select
alternating current of various frequencies or direct
current applied continuously or as a train of pulses.
Each type of current has both advantages and
disadvantages when used therapeutically.
Direct current and low-frequency alternating currents (> 1 kHz) encounter a high electrical resistance
in the outer layers of the skin. This makes the
treatment of deep structures painful because a large
transcutaneous current must flow so that adequate
current passes deeply. Alternating currents of
medium (>lkHz to <lOkHz) or high frequency
(>lOkHz) meet little resistance (due to a marked
reduction in the effects of skin capacitance upon
current flow) and penetrate the tissues easily,
although such currents generally oscillate too rapidly
to stimulate the tissues directly A
These difficulties were overcome in the early 1950s
with the development of interferential current therapy. The equipment produces two alternating currents
of slightly differing medium frequency and is used
widely to induce analgesia, elicit muscle contraction,
modify the activity of the autonomic system, promote
healing, and reduce oedema5.
Use of interference effects in therapy
When two or more sinusoidal currents alternate at
the same frequency, rising and falling at exactly the
same time, they are said to be in phase. Waves
become out of phase when they are a half wavelength
out of step and the rising segment of one coincides
with the falling segment of the other. Waves in phase
interfere constructively to produce a resultant wave
with an amplitude greater than that of either of the
originals. Waves out of phase interact in a similar way
but interfere destructively to cancel each other out
(Figure 1).
Interference also occurs between waves of slightly
differing frequency. As one wave peak 'catches up'
with the other, constructive interference causes an
increase in the amplitude of the resultant wave,
modulation'.
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Techniques, contraindications and safety
texts2'4'5' 8-10
Stimulation of muscle
A neurone showing the reduced sensitivity associated with Wedensky inhibition will also have a rate
of firing independent of the frequency of the applied
stimulus. This rate is dictated instead by the duration
of the refractory period. Known as the Gildemeister
effect, rapid stimulation of a motor nerve with large
although comfortable interferential currents will
result in an asynchronous depolarization of indi-
incontinence
effects30 37.
elsewhere''.
References
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therapy5.
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Conclusion
Interferential current therapy is used widely to
stimulate tissues that lie deep within the body. The
effects can be local or more general depending upon
the configuration of the current applied to the skin.
Unlike other methods of low-frequency electrical
stimulation, these currents encounter a low electrical
resistance and can thus penetrate deeply without
causing undue discomfort.
Several physiological effects clearly occur during
interferential current therapy, although reliable clinical studies seeking to evaluate the claimed therapeutic benefits are reported infrequently.
Research suggests that interferential therapy can
effectively stimulate voluntary muscle, promote
peripheral blood flow, and accelerate bone healing.
Empirical observations support a case for using this
technique to reduce pain and control incontinence.
Interferential therapy would seem to represent a
valuable adjunct to the medical and physiotherapy
management of the pathologies seen frequently by
those specializing in sports medicine. As research
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