It
is an interrupted direct current also called long duration current
having more than 1 ms up to 300 ms or 600 ms. But the commonly used
duration is 100 ms duration requires a frequency of 30 pulses/ min. If
the duration increases the frequency must be reduced. The interval
between the impulses should never be of shorter duration than the
impulses themselves.
Pulse duration ≤ Interval duration
t 1 ≤ t 2
Physiological effects:
Types of Denervated muscle fibers | ||
Neurotmesis (complete denervation)
|
Axonotmesis (partial denervation)
|
Neurapraxia (compression of nerve)
|
The
intensity and duration of impulses in galvanic current is adequate so
that it can cause a sluggish worm like contraction. When current is
applied it produces sensory stimulation resulting in the feeling
stabbing or burning sensation. It increases blood circulation causing
erythema (redness) of the skin. Stimulation of motor nerve with such
current produces contraction of the muscle supplied by that nerve.
Therapeutic effect and use:
There
has been confusion over the therapeutic use of electrical stimulation
for denervated muscles for the last many years. The purpose of such
current is to maintain the muscles in as healthy state as possible to
prevent the complication by electrically artificial contraction.
Skeletal muscles have greater power of regeneration. 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
are considerable literatures concerning the effects of electrics
stimulation. In 1987 Spieloloz concluded that it will retard the muscle
atrophy and degeneration but can not prevent it completely. In 1983
Devis provide evidences that all the denervated muscle fibers must be
activated to produce isometric contractions. And isometric contractions
are more effective than isotonic contractions and the regular
contraction should commence (start or begin or cause to start) as soon
as possible.
In
short value of electrical stimulation for denervated muscle is not
proven and its application to gain muscle power what may be small
benefits are obtain but not justified. 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.
Contra – indications:
- Cardiac pacemakers and Arrhythmias
- Hemorrhagic condition
- Thrombosis and thrombophlebitis (inflammation of wall of vein)
- Early tendon transfer and repair
- Pregnancy: On pelvic, low back and abdomen
- Unconscious patient
- Recent radiotherapy
- Carotid sinus
- Child with mental disturbance
- Malignancy
- Infected wound and skin lesion
Why to used galvanic current for face muscle stimulation????
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