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Minerva Zaniebeth A. Gomez, PTRP Department of Physical Therapy College of Allied Medical Professions University of the Philippines-Manila All rights reserved.

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Presentation on theme: "Minerva Zaniebeth A. Gomez, PTRP Department of Physical Therapy College of Allied Medical Professions University of the Philippines-Manila All rights reserved."— Presentation transcript:

1 Minerva Zaniebeth A. Gomez, PTRP Department of Physical Therapy College of Allied Medical Professions University of the Philippines-Manila All rights reserved. Copyright by MZAG, Use exclusively for PT 158: Physical Agents iII. Approval and consent from Minerva Zaniebeth A. Gomez and University of the Philippines-Manila required before use for other purposes.

2 1.Describe Alternating Currents (AC) according to: Physical properties Classification –Uneven (Faradic currents) –Even (Sinusoidal currents) Learning Objectives:

3 2.Identify the physiological effects and therapeutic effects of: a. Uneven AC b. Even AC

4 3.Differentiate the precautions/ contraindications of: a. Uneven AC b. Even AC

5 4.Select appropriate treatment parameters for indicated cases/ conditions. a. Uneven AC b. Even AC

6 5.Describe Functional Electrical Stimulation and its therapeutic uses. 6.Select appropriate treatment parameters when using FES for different cases/ conditions.

7 7.Appreciate evidence on the use of FES

8 ALTERNATING CURRENT FARADIC Uneven AC SINUSOIDAL Even AC Cont.Interrupted Freq:50 Hz PD: 1 ms Freq: 50 Hz PD: 10 ms Cont.Interrupted

9 Alternating Current Periodic changes of the direction of electron flow in a rhythmic manner NO NET ion transfer Frequency used medically is 50 Hz

10 Alternating Current Not possible to cause burns, unless in high intensities Surged or unsurged

11 Uneven AC/ Faradic Two phases PD: 1 ms No polarity needed Surged Mild prickling sensation

12 NO chemical effects Similar to physiological effects of faradic type currents Indication and contraindication is the same with faradic-type currents/ SIDC Uneven AC/ Faradic

13 Even AC/ Sinusoidal Sine curve PD: 10 ms Surged or unsurged No polarity needed

14 Indication: Swelling and pain EXCEPT referred & psychosomatic type Contraindication: S kin lesion, I nfection, I mpaired sensation Indications and Contraindications

15 Sensory nerves: Marked prickling sensation longer duration Motor nerves: Tetanizes, with a sequence of contraction followed by relaxation NO chemical effects Physiological Effects

16 Swelling: Absorption of exudate Circulation: Superficial vasodilation via axon reflex (capillary vasodilation) hyperaemia Physiological Effects

17 Facilitate muscle contraction Re-educate muscle action Train new muscle action Exercise for paralyzed muscles Hypertrophy Increase strength Improve circulation Prevent and loosen adhesions Therapeutic Effects of Even and Uneven AC

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19 Functional Electrical Stimulation Functional NMES Used for: - disuse atrophy - impaired ROM - ms spasm - ms reeducation - spasticity - supplement to orthotic devices

20 FES for Shoulder Subluxation Waveform: Asymmetrical biphasic square Modulation: Interrupted

21 FES for DF Assist in Gait Training Waveform: Assymetrical biphasic square PD: µsec Modulation: interrupted by foot switch

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23 FES for Scoliosis Management Selection Criteria: –Curves measuring deg. (Cobb) –At least 1 year of spinal growth remaining –An idiopathic and progressive nature of the curve –Cooperative and psychologically stable –Compliant and tolerant to stimulation

24 Evidence in Practice Pomeroy V. M., King, L., Pollock, A., Baily-Hallam, A., and Langhorne, P. (2006). Electrostimulation for promoting recovery of movement or functional ability after stroke. Cochrane Database of Systematic Reviews 2006, Issue 2. Art. No.: CD DOI: / CD pub2. Can FES help improve UE motor recovery of a patient at acute- subacute phase post-stroke? Minerva Zaniebeth A. Gomez, PTRP, PT 158 faculty AY Ma. Liezel Bumanglag, Justine Charlotte Garcia, Marinelle Rabang, Michiko Alla

25 FES of hand extensors

26 Evidence in Practice There is significant change in upper extremity function with the use of electrical stimulation compared to no treatment. Low internal validity (single studies) low power

27 Evidence in Practice Wide confidence interval crosses zero point Heterogenous settings of parameters used FES loosely used term among PTs.

28 References: Gersh, M. R. (1992). Electrotherapy in Rehabilitation. USA: F.A. Davis Company. Hecox, B., Mehreteab, T. A., & Weisberg, J. (1994). Physical Agents: A Comprehensive Text for Physical Therapist. Appleton & Lange. Wadsworth, H., & Chanmugam, A. (1988). Electrophysical Agents in Physiotherapy. Singapore: Science Press. Revised ACDC lecture of Ms. Jazel Ann Atienza, PTRP


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