Interferential
therapy was developed by Dr. Hans Nemec in 1950. It was suggested that
the use of two medium frequencies has the advantage of reducing skin
resistance.
Z = 1/2πfC
Where Z = Impedance
f = frequency
C = capacitance
When
the frequency increases the skin resistance decreases. So the
interferential therapy is used to treat the deep pain, idiopathic pain,
relieve edema, control stress incontinence (inability to control urine)
by stimulating pelvic floor muscles.
The
current is produced by mixing two medium frequency currents delivered
to skin through two sets of electrodes through separate channels in the
same stimulator. One current is normally of fixed frequency i.e. 5000 Hz
while the other frequency is variable i.e. 5200 Hz. The two alternating
currents interact with each other. When they are in the same phase
higher amplitude is produced and lower amplitude is produced when the
currents are in opposite phase. The interaction of two medium frequency
currents produce envelops of pulses known as beat frequency. Beat
frequency will be the subtraction of the two medium frequencies.
Physiological effects:
I. Pain relief:
The
increase in the blood circulation which may be produced by either
pumping effect of the stimulated muscles or the effect on the autonomic
nerves of blood vessels and therefore remove the chemicals from the area
which stimulates nociceptors. Low frequency currents with short
duration (at frequency of 100 Hz (5200 – 5100)) stimulate large diameter
nerve fibers which will have and affect on the pain gate and inhibition
of transmission of small diameter nociceptive traffic.
In
order to selectively activate the descending pain suppression system
with a frequency of 15 Hz (5200 – 5185) which stimulate small diameter
fibers eventually will cause the release of endogenous opiods.
II. Motor stimulation:
Normal
innervated muscle will be made to contract if the interferential
therapy is 1 – 100 Hz is used. The type of contraction depends upon the
frequency stimulation. At 1 – 5 Hz tickling (minimal contraction)
sensation is produced. Muscle twitch is produced at 5 – 20 Hz. Partial
tetanic contraction is produced from 20 Hz up to 30 Hz. And from 30 –
100 Hz complete tetanic contraction is produced.
The complete range of all contraction will be produced when rhythmical frequency between 1 – 100 Hz is used.
III. Removal of exudates:
Exudates
is accelerated by a frequency of 1 – 10 Hz with rhythmical pumping
action is produced by muscle contraction and therefore is possibly an
effect on autonomic nervous nerves which can affect the diameter of
blood vessels and therefore increased blood circulation. Both factors
help in the removal of exudate.
Indications of Interferential therapy:
1. Pain:
It
is useful in wide variety of painful conditions (Acute, Chronic, Deep,
Idiopathic, Subacute pains etc) AMF (Amplitude Modulating Frequency) 70 –
150 Hz is used for Acute Pain. Frequency below 50 Hz is used for
chronic pain and subacute pain where muscle contraction is required.
2. Oedema:
Frequency of 1 – 10 Hz is used for to reduce oedema i.e. oedema of hand and feet.
3. Stress incontinence:
Quadripolar technique:
Two
electrodes are placed on lower abdomen while the other two are placed
on inner upper thigh. This technique is used in stress incontinence.
Contra – indications:
- Pace maker
- Pregnancy
- On chest wall in cardiac patients
- Hemorrhage
- Malignancy
- Skin infection
- Deep vein thrombosis
Wonderful efforts by new young Physiotherapist Of MSP
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