1. Jae Hyoung Lee Wonkwang Health Science College jhlee@wkhc.ac.kr http://etgr.wkhc.ac.kr Electro Therapy Research Laboratory for Tissue Growth & Repair ETRLab

2. SECTION 8. MEDICAL GALVANISM Course Objectives ( 학습목표 ) 1. 직류의 특성을 설명한다. (A) 2. 직류전류의 물리화학적 효과를 설명한다. (A) 3. 직류전류의 생리적 효과를 설명한다. (A) 4. 직류전류의 치료 효과를 설명한다. (A) 5. 의용평류치료의 적응증을 설명한다. (A) 6. 의용평류치료의 금기증을 설명한다. (A)

3. 1. Definition Medical galvanism ( 의용평류치료 ) : DC 를 사용하여 질병을 치료하는 전기치료 의 한 방법 Direct current (DC), Galvanic, Smooth current Amplitude - Constant Direction – One, Continuous 0 t I Fig. 1. Continuous direct current.

4. * 3 major divisions of Galvanism Electrotherapy Using DC Medical Galvanism ( 의용평류치료 ) Surgical Galvanism ( 외과적 평류치료 ) Iontophoresis ( 이온도입치료 ) ESTR (Electrical Stimulation for Tissue Repair) ( 조직치유전기자극 ) Wound healing (LIDC) Fracture healing, Nerve Regeneration

5. Surgical Galvanism ( 외과적 평류치료 ) Definition The use of the caustic effects of direct electrical current for the destruction of tissue electrocoagulation (electrodesiccation) Used primarily in the removal of unwanted hair (electrolysis) but not by PTs verrucae

6. 2. Physics 1. Direct Current (DC, Galvanic current, Smooth current) 의 특성 Direction : One Amplitude : Constant 2. Sources of DC ( 직류의 전원 ) 1) Electric cell (Battery, 전지 ) 2) AC Rectification ( 교류정류 ) Rectifier - 교류전류를 정류하여 직류전류로 변환시키는 장치 진공관식 정류기와 반도체 다이오드 정류기 3) DC Motor Generator ( 직류발전기 )

7. 그림 8-1. 진공관식 정류기를 통한 교류전류의 직류전류로의 변환. 1) 교류전류가 2) 반파장정류, 3) 완파장정류, 4) 부분여과 및 5) 완전여과되는 과정을 거쳐 직류전류로 전환되는 과정. 0 + - t 1) AC 2) Half Wave Rectified 3) Fulle Wave Rectified 4) Partial Filtered 5) Complete Filtered smooth DC

8. 3. 직류전류의 효과 (Effects of direct current) 1. 물리화학적 효과 (physicochemical effect) 생리학적 효과 표 8-1. 직류전류의 극성에 따른 물리화학학적, 생리학적 효과 양 극 음 극 물리학적 효과 염산과 산소 발생 수산화나트륨과 수소 발생 산성반응 알카리반응 금속 및 알카로이드 반발 산 및 산 라디클 반발 미열효과 미열효과 생리학적 효과 조직의 경화 조직의 연화 흥분성 감소 흥분성 증가 역치 증가 역치 감소 진정효과 자극효과 통증감소 통증유발 혈관수축 혈관확장 ( 혈관운동 증진 ) ( 혈관운동 증진 ) 국소빈혈 국소충혈 지혈효과 출혈효과

9. Physiological effect ( 생리적 효과 ) 2. Physiological effect ( 생리적 효과 ) 1) Vasomotor Stimulation ( 혈관운동자극 ) 및 Galvanic hyperemia ( 국소충혈 ) Direct Effect Cathode -Vasodilation) Anode - Vasoconstriction) Capillary circulation ↑ - Capillary hyperemia Indirect Effect 혈액의 전해질 변화 화학적 자극에 따라 모세혈관 운동 증진 피부 및 피하조직의 모세혈관 순환 증진 - 국소충혈 ( 음극 ) 전기자극 10 분 - 30 여분 고온욕 (hot bath) - intense hyperemia DC 자극 계속, 고강도, 다시 직류 통전 - 피하조직 국소충혈 0.8 mA/cm 2 stimulation- dermal capillary hyperemia - counter-irritant effect Pain Relief 2) Stimulation and Sedation ( 자극 및 진정 효과 )

10. 4. Therapeutic effects ( 치료 효과 ) Improvement of Local Circulation Improvement of Local Circulation 국소 순환증진 Increased Local Blood Flow 국소 혈류증진 Increased Nutrition 영양증진 Increased Cellular Metabolism 세포의 대사 항진 Facilitate Reabsorption of Inflammatory Products 염증산물 흡수 촉진 Stimulate Functional Activity of the parts Increased Excretion Activity of Glands 각종 선의 분비활동 촉진 Reflex Stimulation 반사 자극효과 Relief Pain (positive pole) 통증완화 효과 Softening scar tissue (negative pole)

11. . Application Method ( 적용기술 ) 5. Application Method ( 적용기술 ) 2 moist pad electrode ① Electrode Placement : 2 moist pad electrode Bipolar (same sized electrodes) Trans or Longitudinal application up to 30 mA ② Amplitude : 0.5-1 mA /in 2, up to 30 mA (depend on Electrode size) * Unpleasant burning sense : insufficient moistening excessive intensity 0.5-1 mA /in 2 * Tolerance of Normal skin surface : 0.5-1 mA /in 2 2.0-4 mA / 4 in 2 15-20 min ③ Treatment Duration : 15-20 min @ first, upto 20-40 min @ Later

12. . Application Method ( 적용기술 ) 5. Application Method ( 적용기술 ) Galvanic Bath ( 갈바니욕 ) Electrotherapy + hydrotherapy used Insulated bath entire surface of body as needed Diffused dispersion 92-100 ℉ improves local and general circulation multiple joint rheumatic problems circulation irregularities coping with stress cellulite treatment relaxation due to its regulatory effect

13. Indication ( 적응증 ) 6. Indication ( 적응증 ) 1. Trauma amd Acute Inflammatory Diseases Contusion, Sprain & Strain, Myositis, Fibrositis, Bursitis 2. Chronic Inflammatory Diseases Arthritis, Tenosynovitis, Neuritis 3. Pain Myalgia, Neuarlgia, Arthralgia 4. Vascular Diseases Raynaud disease 5. Hypersensitivity 6. Psychotherapy Neurosis, Hysteria etc. * Hyperhidrosis

14. Contraindication ( 금기증 ) 7. Contraindication ( 금기증 ) 1. Lack of skin sensation 2. Open wound Cut, abrasion 3. Metal plates, pins, oral fillings 4. Hypersensitive skin Rosacea, dermatitis, telangiectasis 5. Pustular acne 6. Highly nervous clients 7. Febrile disease, tuberculosis, cancer, active wasting diseases 8. Hemorrhagic tendency Cerebral hemorrhage (within 1-2 wk) Hemoptysis and hematemesis

15. Precautions ( 주의사항 ) 8. Dangers and Precautions ( 주의사항 ) 1. Burns Cathode Chemical burn @ Cathode – Current Intensity ↑- Burning sense or pain – Alkaline/Acid caustic Tissue Destruction Current Intensity : Low (less than 2 mA) Duration : Short Electrode : Move continually Evenly saturate Good even contact - don’t lying Thick pad Avoid too close Avoid metal under the electrode 직류전류를 열효과 목적으로 사용하지 않는 이유 음극 : 알카리 반응 - 조직 액화 양극 : 산성 반응 - 조직 응고

16. Dangers 2. Shock Check the stimulator Turn up or down : Slowly Electrode : Firm contact Connection : Tightly

17. 1.Purpose of Facial Galvanic Treatment @ Cathode ① General cleansing of greasy or combination skin to Remove sebum ② Deep cleansing (Disincrustation) ③ Stimulation of a sluggish skin ④ Soften the skin of face Remove keratinised cell GALVANIC TREATMENT

18. 1. Purpose of Facial Galvanic Treatment @ Anode ① Improve tone and texture of skin ② Refine a skin with large, open pores ③ Tighten the tissue, help to close the pores ④ Restore the acid mentle, improve the skin resistance to infection ⑤ Oxygen help to nourish and revitalise the tissue GALVANIC TREATMENT

19. 1. Purpose of Body Galvanic Treatment @ Cathode ① Soften areas of fat, cellulite and aid its absorption ② Improve skin and tissue condition stimulate the circulation of blood and lymph ③ Improve area of stasis ④ Soften areas of old, hard scar tissue

20. 2. Effects of Galvanic Treatment Effects of Cathode ① Alkaline Reaction, NaOH formation saponifies sebum softening the skin relax pores – releasing sebum drying effect on the skin break down the keratin in keratinised cell cleaning the skin alter the pH of the skin - destroying the acid mentle ② Hydration Fluid drawn towards cathode (-) will soften the skin GALVANIC TREATMENT

21. Effects of Cathode ③ Vasodilation, Galvanic Hyperemia Increase circulation increase oxygen, nourish supply, remove waste product Improve skin condition, colour Tripple response a. Histamine release dilation of the capillary etythema (reddening of the skin) b. Axon reflex relax arteriole wall muscle and dilation of arteriole c. Increase Permeability ④ Increase cell metabolism

22. 2. Effects of Galvanic Treatment Effects of Cathode ① Acid Reaction, HCl formation ② Tighten, harden the skin ③ Tissue fluid moves away from the anode (+) ④ Release oxygen, nourish Improve vitality of the cell ⑤ Acidic protection of the skin Restore the acid mentle GALVANIC TREATMENT

23. 2. Effects of Galvanic Treatment Interpolar Effects ① Increase Blood Circulation Vasodilation at Cathode (-) Vasoconstriction (+) ② Increase Lymphatic Circulation ③ Increase Cell Metabolism ④ Decrease Blood Pressure GALVANIC TREATMENT