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Low Frequency Stimulation
Specialized Techniques

Sreeraj S R
Faradic Foot Bath

Sreeraj S R
Bath Method
●

Application of faradic current to the body parts in a
tub, tray or tank containing water is termed as bath
method of application

●

Depending upon the placement of electrodes bath
can be
●
●

Bipolar : both electrodes are kept in the water
Unipolar : one electrode kept in the water while
the other electrode kept at any convenient part of
the body
Sreeraj S R
Bath Method
Advantage of bath method are:
● Skin resistance is lowered considerably by
prolonged soaking in water
● Water makes perfect contact with the tissues
● Wash of electrolytes formed under the electrodes
Disadvantages are:
● Current can not be localized
● Superficial muscles contract more than deep
muscles due to the presence of water
● Chances of electric shock is higher
Sreeraj S R
Faradic Foot Bath
●

ES by faradic current may be applied in
baths.

●

Can be used to stimulate
● Lumbricals
● Plantar interrossei
● Abductor hallucis
Sreeraj S R
Faradic Foot Bath
●

Position the patient in high sitting with back well
supported

●

Position the feet on a stool covered with a
plastic sheet

●

Place the foot in a bath containing enough
warm water to cover the toes
Sreeraj S R
Faradic Foot Bath
To stimulate the
lumbricals place two
electrodes transversely,
●

one under the heel

and the other
●

under the metatarsal
heads
Sreeraj S R
Faradic Foot Bath
To stimulate the
plantar interrossei
place one electrode
on each side of the
foot at the level of
metatarsal shafts

Sreeraj S R
Faradic Foot Bath
For Abductor hallucis
place
● one electrode
under the heel and
●

stimulate the
muscle through the
motor point using
a pen electrode
Sreeraj S R
Faradic Foot Bath
●

A surged faradic current is used for this

●

Surge duration 1 sec.

●

Surge interval 3 sec.

●

Intensity : enough to produce a visible
contraction of the muscles.

●

Treatment time: 15 – 30 minutes
Sreeraj S R
Faradic Foot Bath
●

Rectangular metal or carbon rubber electrodes of
3 X 7 cm can be used

●

No lint pad or coupling medium required

●

Encourage the patient to contract the muscle
voluntarily with the current

Sreeraj S R
Faradism Under Pressure

Sreeraj S R
Faradism Under Pressure
●

ES of muscle combined with compression and
elevation of the limb can be used to increase
venous and lymphatic drainage and so to
relieve edema.

●

This technique is known as Faradism Under
Pressure

Sreeraj S R
Faradism Under Pressure
●

Patient in supine position

●

The limb is elevated above the heart level using
pillows

●

The pressure bandage is applied over the electrode,
with maximum pressure distal to proximal

●

The skin must be cleaned before treatment
Sreeraj S R
Faradism Under Pressure
Placement of electrode for lower limb:
● Active electrode place over the belly of the calf
muscle
● Passive electrode is placed over the sole of the foot
Placement of electrode for upper limb:
● Active electrode over the flexor aspect of forearm at
the junction of proximal 1/3 and distal 2/3 of the
muscle belly
● The passive electrode over the palm or cubital
fossa
Sreeraj S R
Faradism Under Pressure
●

A surged faradic current is used for this

●

Surge duration 3 sec.

●

Surge interval 9 sec.

●

Intensity : enough to produce a visible contraction
of the muscles i.e. clenching of toes or fingers.

●

Treatment time: 15 – 30 minutes
Sreeraj S R
Faradism Under Pressure
●

Rectangular metal or carbon rubber electrodes of
3 X 5 cm. can be used

●

Encourage the patient to do active movement
along with the current and relax during surge
interval

Sreeraj S R
Faradism Under Tension

Sreeraj S R
Faradism Under Tension
●

●

●
●

●

●

Shortening of contractile soft tissues like muscles can
be treated with Faradism.
Such contractures develop in major muscle groups like
quadriceps or elbow flexor group
This is mostly after prolonged immobilization
These conditions are passively mobilized which can be
very painful.
Titanic contraction by the surged current gradually pulls
apart the shortened myofibrils with less pain.
So this can be an effective adjunctive with passively
mobilization.
Sreeraj S R
Faradism Under Tension
●

A surged faradic current is used for this

●

Surge duration 3 sec.

●

Surge interval 9 sec.

●

Intensity : enough to produce a visible contraction of the
muscles.

●

Treatment time: 15 – 30 minutes
Sreeraj S R
Faradism Under Tension
●

Rectangular metal or carbon rubber electrodes of
5 X 10 cm can be used.

●

Encourage the patient to do actively contract the
muscle along with the current and relax during
surge interval

Sreeraj S R
Faradism Under Tension
For quadriceps contracture:
●

Patient is positioned on a plinth.

●

A roll of towel or pillow is placed below the knee to give
a stretch

●

Passive electrode is placed over proximal 1/3 of the
quadriceps

●

Active electrode is placed on the junction of proximal 2/3
and distal 1/3 of the belly of the muscle
Sreeraj S R
Faradism Under Tension

Sreeraj S R
Faradism Under Tension
For elbow flexor contracture:
●

Patient is positioned on a plinth.

●

A roll is placed under the elbow just proximal to the joint.

●

Passive electrode is placed over proximal 1/3 of the
elbow flexor

●

Active electrode is placed on distal 1/3 of the belly of the
muscle
Sreeraj S R
ES to Pelvic Floor Muscles

Sreeraj S R
ES to Pelvic Floor Muscles
●

ES can be used for reeducating these muscles.

●

Indications are;
●

Early cases of prolapse of pelvic organs

●

Stress incontinence

●

Incontinence following prostatectomy

Sreeraj S R
ES to Pelvic Floor Muscles
●

Position the patient in side lying

●

Keep a pillow between the lower legs

●

Place a plastic sheet under the patient

●

The indifferent electrode to the lumbosacral region

●

Insert the Active vaginal or rectal electrode

●

Sterilized lubrication jelly should be applied on vaginal
or rectal electrode

●

A large button electrode can also be used over the
perinea region
Sreeraj S R
ES to Pelvic Floor Muscles
●

A surged faradic current is used.

●

Surge duration 1 sec.

●

Surge interval 3 sec.

●

The muscles of pelvic floor fatigue fast, so surge
duration should be short

●

Intensity : enough to produce a visible contraction of the
muscles.

●

Treatment time: 15 – 30 minutes

●

Encourage the patient to actively contract the muscles
along with the current and relax during surge interval
Sreeraj S R
References
1.

Foster A, Palastanga N. Clayton’s Electroptherapy Theory and
Practice. 9th edition. W B Saunders. 2006;pp 70 – 79

2.

Mitra PK. Handbook of Practical Electrotherapy. Jaypee. 2006;
pp44 – 49

3.

Khatri S. Basics of Electrotherapy. Jaypee. 2003. pp 28 - 30

Sreeraj S R
THANK YOU

Sreeraj S R

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Low frequency stimulation specialized techniques

  • 1. Low Frequency Stimulation Specialized Techniques Sreeraj S R
  • 3. Bath Method ● Application of faradic current to the body parts in a tub, tray or tank containing water is termed as bath method of application ● Depending upon the placement of electrodes bath can be ● ● Bipolar : both electrodes are kept in the water Unipolar : one electrode kept in the water while the other electrode kept at any convenient part of the body Sreeraj S R
  • 4. Bath Method Advantage of bath method are: ● Skin resistance is lowered considerably by prolonged soaking in water ● Water makes perfect contact with the tissues ● Wash of electrolytes formed under the electrodes Disadvantages are: ● Current can not be localized ● Superficial muscles contract more than deep muscles due to the presence of water ● Chances of electric shock is higher Sreeraj S R
  • 5. Faradic Foot Bath ● ES by faradic current may be applied in baths. ● Can be used to stimulate ● Lumbricals ● Plantar interrossei ● Abductor hallucis Sreeraj S R
  • 6. Faradic Foot Bath ● Position the patient in high sitting with back well supported ● Position the feet on a stool covered with a plastic sheet ● Place the foot in a bath containing enough warm water to cover the toes Sreeraj S R
  • 7. Faradic Foot Bath To stimulate the lumbricals place two electrodes transversely, ● one under the heel and the other ● under the metatarsal heads Sreeraj S R
  • 8. Faradic Foot Bath To stimulate the plantar interrossei place one electrode on each side of the foot at the level of metatarsal shafts Sreeraj S R
  • 9. Faradic Foot Bath For Abductor hallucis place ● one electrode under the heel and ● stimulate the muscle through the motor point using a pen electrode Sreeraj S R
  • 10. Faradic Foot Bath ● A surged faradic current is used for this ● Surge duration 1 sec. ● Surge interval 3 sec. ● Intensity : enough to produce a visible contraction of the muscles. ● Treatment time: 15 – 30 minutes Sreeraj S R
  • 11. Faradic Foot Bath ● Rectangular metal or carbon rubber electrodes of 3 X 7 cm can be used ● No lint pad or coupling medium required ● Encourage the patient to contract the muscle voluntarily with the current Sreeraj S R
  • 13. Faradism Under Pressure ● ES of muscle combined with compression and elevation of the limb can be used to increase venous and lymphatic drainage and so to relieve edema. ● This technique is known as Faradism Under Pressure Sreeraj S R
  • 14. Faradism Under Pressure ● Patient in supine position ● The limb is elevated above the heart level using pillows ● The pressure bandage is applied over the electrode, with maximum pressure distal to proximal ● The skin must be cleaned before treatment Sreeraj S R
  • 15. Faradism Under Pressure Placement of electrode for lower limb: ● Active electrode place over the belly of the calf muscle ● Passive electrode is placed over the sole of the foot Placement of electrode for upper limb: ● Active electrode over the flexor aspect of forearm at the junction of proximal 1/3 and distal 2/3 of the muscle belly ● The passive electrode over the palm or cubital fossa Sreeraj S R
  • 16. Faradism Under Pressure ● A surged faradic current is used for this ● Surge duration 3 sec. ● Surge interval 9 sec. ● Intensity : enough to produce a visible contraction of the muscles i.e. clenching of toes or fingers. ● Treatment time: 15 – 30 minutes Sreeraj S R
  • 17. Faradism Under Pressure ● Rectangular metal or carbon rubber electrodes of 3 X 5 cm. can be used ● Encourage the patient to do active movement along with the current and relax during surge interval Sreeraj S R
  • 19. Faradism Under Tension ● ● ● ● ● ● Shortening of contractile soft tissues like muscles can be treated with Faradism. Such contractures develop in major muscle groups like quadriceps or elbow flexor group This is mostly after prolonged immobilization These conditions are passively mobilized which can be very painful. Titanic contraction by the surged current gradually pulls apart the shortened myofibrils with less pain. So this can be an effective adjunctive with passively mobilization. Sreeraj S R
  • 20. Faradism Under Tension ● A surged faradic current is used for this ● Surge duration 3 sec. ● Surge interval 9 sec. ● Intensity : enough to produce a visible contraction of the muscles. ● Treatment time: 15 – 30 minutes Sreeraj S R
  • 21. Faradism Under Tension ● Rectangular metal or carbon rubber electrodes of 5 X 10 cm can be used. ● Encourage the patient to do actively contract the muscle along with the current and relax during surge interval Sreeraj S R
  • 22. Faradism Under Tension For quadriceps contracture: ● Patient is positioned on a plinth. ● A roll of towel or pillow is placed below the knee to give a stretch ● Passive electrode is placed over proximal 1/3 of the quadriceps ● Active electrode is placed on the junction of proximal 2/3 and distal 1/3 of the belly of the muscle Sreeraj S R
  • 24. Faradism Under Tension For elbow flexor contracture: ● Patient is positioned on a plinth. ● A roll is placed under the elbow just proximal to the joint. ● Passive electrode is placed over proximal 1/3 of the elbow flexor ● Active electrode is placed on distal 1/3 of the belly of the muscle Sreeraj S R
  • 25. ES to Pelvic Floor Muscles Sreeraj S R
  • 26. ES to Pelvic Floor Muscles ● ES can be used for reeducating these muscles. ● Indications are; ● Early cases of prolapse of pelvic organs ● Stress incontinence ● Incontinence following prostatectomy Sreeraj S R
  • 27. ES to Pelvic Floor Muscles ● Position the patient in side lying ● Keep a pillow between the lower legs ● Place a plastic sheet under the patient ● The indifferent electrode to the lumbosacral region ● Insert the Active vaginal or rectal electrode ● Sterilized lubrication jelly should be applied on vaginal or rectal electrode ● A large button electrode can also be used over the perinea region Sreeraj S R
  • 28. ES to Pelvic Floor Muscles ● A surged faradic current is used. ● Surge duration 1 sec. ● Surge interval 3 sec. ● The muscles of pelvic floor fatigue fast, so surge duration should be short ● Intensity : enough to produce a visible contraction of the muscles. ● Treatment time: 15 – 30 minutes ● Encourage the patient to actively contract the muscles along with the current and relax during surge interval Sreeraj S R
  • 29. References 1. Foster A, Palastanga N. Clayton’s Electroptherapy Theory and Practice. 9th edition. W B Saunders. 2006;pp 70 – 79 2. Mitra PK. Handbook of Practical Electrotherapy. Jaypee. 2006; pp44 – 49 3. Khatri S. Basics of Electrotherapy. Jaypee. 2003. pp 28 - 30 Sreeraj S R