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Electrotherapy

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Electrotherapy is the use of electrical energy in the treatment of impairments of health and a conditions of abnormal functioning.[1] In medicine, the term electrotherapy can apply to a variety of treatments, including the use of direct current in cardioversion and the use of electrical devices such as deep brain stimulators for neurological disease. The term has also been applied specifically to the use of electrical current to speed wound healing. Additionally, the term "electrotherapy" has also been applied to a range of alternative medical devices and treatments.

History

In 1855 Guillaume Duchenne, the father of electrotherapy, announced that alternating was superior to direct current for electrotherapeutic triggering of muscle contractions.[2] What he called the 'warming affect' of direct currents irritated the skin, since, at voltage strengths needed for muscle contractions, they cause the skin to blister {at the anode} and pit (at the cathode). Furthermore, with DC each contraction requiring the current to be stopped and restarted. Moreover alternating current could produce strong muscle contractions regardless of the condition of the muscle, whereas DC-induced contractions were strong if the muscle was strong, and weak if the muscle was weak.


Since that time almost all rehabilitation involving muscle contraction has been done with a symmetrical twin-phase wave. In the 1940s, however, the US War Department, investigating the application of electrical stimulation not just to retard and prevent atrophy but to restore muscle mass and strength, employed what was termed galvanic exercise on the atrophied hands of patients who had an ulnar nerve lesion from surgery upon a wound.[3] These Galvanic exercises employed a monophasic wave form, direct current - electrochemistry. The clinical findings were favorable, which made electrochemical therapy (ECT or EChT) an important subset of electrotherapy.

Current use

Electrotherapy includes a variety of stimulation types, protocols and uses. Most common are:

  • NMES (for Neuro-Muscular Electro-Stimulation) aka EMS (for Electro-Muscular Stimulation) for rehabilitation
  • TENS (Transcutaneous Electrical Nerve Stimulation) for pain therapy
  • Interferential currents; Russian currents (aka Kotz)
  • Microcurrents (aka MENS)
  • Galvanic currents for Iontophoresis.

Electrotherapy is used for relaxation of muscle spasms, prevention and retardation of disuse atrophy, increase of local blood circulation, muscle rehabilitation and re-education, maintaining and increasing range of motion, management of chronic and intractable pain, post-traumatic acute pain, post surgical acute pain, immediate post-surgical stimulation of muscles to prevent venous thrombosis, wound healing and drug delivery.

Reputable medical and therapy Journals have published peer-reviewed research articles that attest to the medical properties of the various electro therapies. Yet some of the treatment effectiveness mechanisms are little understood. Therefore effectiveness and best practices for their use in some instances are still anecdotal.

Electrotherapy devices have been studied in the treatment of chronic wounds and pressure ulcers. A 1999 meta-analysis of published trials found some evidence that electrotherapy could speed the healing of such wounds, though it was unclear which devices were most effective and which types of wounds were most likely to benefit.[4] However, a more detailed review by the Cochrane Library found no evidence that electromagnetic therapy, a subset of electrotherapy, was effective in healing pressure ulcers[5] or venous stasis ulcers.[6]

See also

References and notes

  1. ^ Institute of Electrical and Electronics Engineers, "The IEEE standard dictionary of electrical and electronics terms". 6th ed. New York, N.Y., Institute of Electrical and Electronics Engineers, c1997. IEEE Std 100-1996. ISBN 1-55937-833-6 [ed. Standards Coordinating Committee 10, Terms and Definitions; Jane Radatz, (chair)]
  2. ^ Licht, Sidney Herman., "History of Electrotherapy", in Therapeutic Electricity and Ultraviolet Radiation, 2nd ed., ed. Sidney Licht, New Haven: E. Licht, 1967, Pp. 1-70.
  3. ^ Licht, "History of Electrotherapy"
  4. ^ Gardner SE, Frantz RA, Schmidt FL (1999). "Effect of electrical stimulation on chronic wound healing: a meta-analysis". Wound Repair Regen. 7 (6): 495–503. doi:10.1046/j.1524-475X.1999.00495.x. PMID 10633009.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  5. ^ Olyaee Manesh A, Flemming K, Cullum NA, Ravaghi H (2006). "Electromagnetic therapy for treating pressure ulcers". Cochrane Database Syst Rev (2): CD002930. doi:10.1002/14651858.CD002930.pub3. PMID 16625564.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  6. ^ Ravaghi H, Flemming K, Cullum N, Olyaee Manesh A (2006). "Electromagnetic therapy for treating venous leg ulcers". Cochrane Database Syst Rev (2): CD002933. doi:10.1002/14651858.CD002933.pub3. PMID 16625565.{{cite journal}}: CS1 maint: multiple names: authors list (link)
Further readings
  • Singh, Jagmohan; "Textbook of Electrotherapy", Ed.1/2005, ISBN 81-8061-384-4; Pub: JAYPEE Brothers Medical Publishers, New Delhi; Cover type: Paperback
  • Nelson, Roger M.; Currier, Dean P.; "Clinical Electrotherapy"; 2nd ed., ISBN 0-8385-1334-4; 422 p. Appleton & Lange, a publishing division of Prentice Hall, c1991 c1987; 3rd ed., ISBN 083851491X;
  • Watkins, Arthur Lancaster, "A manual of electrotherapy.". 2d ed., thoroughly rev. Philadelphia : Lea & Febiger, c1962. 272 p.
  • Scott, Bryan O., "The principles and practice of electrotherapy and actinotherapy". Springfield, Ill., C.C. Thomas, c1959. 314 p. LCCN 60004533 /L
  • Neuroelectric Conference (1969 : San Francisco, Calif.), " Neuroelectric research; electroneuroprosthesis, electroanesthesia and nonconvulsive electrotherapy". Editor, David V. Reynolds and Anita E. Sjoberg. Springfield, Ill., Thomas, 1971. LCCN 75115389 (ed. Selected papers presented at the 1969 Neuroelectric Conference, the second annual conference of the Neuroelectric Society.)


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