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Electrotherapy Assignment: Topic: 1. Current and Its Types 2. Procedure of Stimulation of Biceps Brachii Muscle

The document discusses current and its types, then focuses on stimulating the biceps brachii muscle using electrotherapy. It defines current and classifies it as low, medium, or high frequency. Faradic current is described as a short-duration interrupted current. The procedure for finding the motor point of the biceps brachii muscle and stimulating it is outlined, including preparing the patient and equipment, setting parameters, and placing electrodes on the motor point to cause muscle contraction.

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768 views12 pages

Electrotherapy Assignment: Topic: 1. Current and Its Types 2. Procedure of Stimulation of Biceps Brachii Muscle

The document discusses current and its types, then focuses on stimulating the biceps brachii muscle using electrotherapy. It defines current and classifies it as low, medium, or high frequency. Faradic current is described as a short-duration interrupted current. The procedure for finding the motor point of the biceps brachii muscle and stimulating it is outlined, including preparing the patient and equipment, setting parameters, and placing electrodes on the motor point to cause muscle contraction.

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Apoorv
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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ELECTROTHERAPY

ASSIGNMENT
TOPIC: 1. CURRENT AND ITS TYPES
2. PROCEDURE OF STIMULATION OF BICEPS
BRACHII MUSCLE
BY: AMAN NEGI
ROLL NO. : 05
19TH BATCH
B. P. T. 2ND YEAR
SESSION: 2018-19
CURRENT:
Current is basically “the flow of charge in a conductor”. As per the classical
convention, current flows from positive to negative or in the direction reverse to
that of electrons. Electric current depends on several factors like the potential
difference between the 2 ends, and a conducting pathway between these ends.
Electrons will flow only for as long as the potential difference and the pathway
exist.
Electromotive force causes the electrons to move along a conductor connections
points of different potential. Whereas the resistance opposes the flow of the
electrons.
Electric current is measured in amperes.

CLASSIFICATION OF CURRENT:
1. LOW FREQUENCY CURRENT:
· Frequency range is between 1 to 1000 Hz
· Skin resistance- 3200 ohms
· Types of low frequency current:
1. Constant direct current: These are unidirectional current that
pass for more than 1 millisecond. These current are used in
iontophoresis.
2. Interrupted direct current: These currents are produced by
creating interruption in constant direct current. These are of
short duration IDC and long duration IDC. The short duration
IDC has pulse duration from 0.1 to 1 millisecond. Faradic,
TENS, HVPGS (high voltage pulse galvanic stimulation) are
included in short duration IDC. The long duration IDC have
pulse duration more than 1 millisecond and includes galvanic
current. The short IDC have spikey wave pulse while long IDC
have rectangular wave pulse.

3. Evenly AC: These currents are sinusoidal and di-dynamic


current. These can be ½ wave or full wave rectified current.

2. MEDIUM FREQUENCY CURRENT:


· These currents have frequency within the range of 1000 to 10,000 Hz
· These are further of 2 types:
o Time modulation or Russian current-
Frequency is 2.5 kHz delivered in rectangular bursts with burst
frequency 50 Hz.
· Amplitude Modulation or interferential current- These are 2
kHz alternating currents applied in a continuous train.
Advantage of interferential current is depth efficiency of
stimulation.

3. HIGH FREQUENCY CURRENT:


These are the currents of frequency more than 10,000 Hz. These currents
aren’t used for nerve and muscle stimulation because it produces heating
effect.
It includes:
· Short Wave diathermy
· Microwave diathermy
· Ultrasound
Faradic Current

Faradic current is a short-duration interrupted current, with a pulse duration


ranging from 0.1 and 1 millisecond and a frequency of 50 to 100 Hz. Faradic
currents are always surged for treatment purposes to produce a near normal tetanic-
like contraction and relaxation of muscle. Current surging means the gradual
increase and decrease of the peak intensity.
The pulse originally produced were asymmetric biphasic with a frequency of
between 30 and 70 Hz and pulse duration of 1 millisecond or less but usually
greater than 300 microseconds. Originally the faradic current was an alternating
current. Now the faradic current produced by electronic stimulators have same
physiological effect as original faradic current with difference only in the
waveform, with remaining the positive part of waveform only. The positive portion

is of short duration, high amplitude and is spiked.

Physiological effects of faradic current:


· Stimulation of sensory nerves- a mild prickling sensation is felt and stimuli
are of short duration
· Stimulation of motor nerves- faradic current stimulates motor nerves as well,
of intensity is sufficient then may cause contraction of the muscles which
these nerve supply.
· Stimulation of denervated muscle- faradic current not produces satisfactorily
effect because the intensity of current needed to depolarize the muscle
membrane is too great to be comfortably tolerated by the patient in the
absence of the nerve.
· Reduction of swelling and pain: It occurs due to alteration of the
permeability of the cell membrane, leading to acceleration of fluid
movement in the swollen tissue and arterial dilatation. Moreover, it leads to
increase metabolism and get red of waste products.
· Effect on muscle contraction: Electrical stimulation of motor nerves causes
muscle contraction and results in changes similar to those associated with
voluntary contraction. These contractions help in regaining the properties of
muscles as such and also helps in:
i. Increasing metabolism: The contraction and relaxation of muscles results
in pumping action on the blood vessels within the muscles and around it.
This pumping action provides more blood supply to the muscles and also
results in increased demand and supply of oxygen and nutrition.
ii. Removal of waste products: If the muscle contraction and relaxation is
sufficient enough to cause pumping effect on venous and lymphatic vessels
it results in removal of waste products.
· Chemical effects following stimulation: Chemical effects are produced at the
electrodes due to passing of direct current through the electrolyte. It results
in formation and accumulation of chemicals at the electrode site resulting in
chemical or electrolytic burn.
FINDING MOTOR POINT AND STIMULATION OF BICEPS
BRACHII MUSCLE

Motor point:
A small area on a muscle at which a minimal amount of electrical stimulation
will cause the muscle to contract. It is basically the point where the motor nerve
enters the muscle. In general case, motor point of a muscle is located
approximately at junction of lower ⅔ and upper ⅓ from the point of origin of
muscle.

Electrodes:
The appropriate selection of electrodes for nerve and muscle stimulation is
important. Electrodes could be of pad or plate type or pen type. Pad or plate
electrodes are kept in between the lint pads for even distribution of current. The
edges of plate electrode should be blunt. It should be smaller than the lint pad so
that it cannot come in contact with the skin. Pen electrode is used for smaller
muscles or for specific motor points.
Basically electrodes are of 2 types:
· One is passive electrode which is generally in red colour, have positive
polarity and larger than the other electrode. This electrode is placed the
point either where the nerve is most superficial or at the nerve trunk. This
electrode is used to complete the circuit for flow of current.

· Other electrode which is active; is black in colour, have negative polarity,


is smaller in size. This one is placed on the motor point of the muscle. This
electrode is used for stimulation of nerves and muscles and is held at 90°
to the skin surface for the proper transmission of current. For stimulation
purpose, instead of pad electrode, a pen electrode is used.
Technique of finding out motor point of biceps brachii muscle and thereby
stimulating the muscle:

· Preparation of apparatus:

The apparatus is tested prior to administration. Make sure that the


stimulator is properly functioning, each part of the stimulator like the
intensity knob, display; all must be properly working.

After thorough inspection, the electrodes are connected to their respective


terminals, i.e., black with black and red with red. The red electrode which
is passive and positive; is covered with wet electrode rubber strap. The
black electrode being active one; is connected with pen electrode. The tip
of pen electrode is covered with cotton plug to prevent any irritation on the
patient’s skin.

· Briefing to the patient:

The therapist explains the patient about the procedure, it’s effects on the
muscle during the treatment and post treatment.

· Checking the contraindications:

The therapist checks out all kind of contraindications before proceeding to


the treatment by asking history of patient or by getting the demographic
data.

· Preparation of the patient:

Clothing is removed from the arm till the axilla and patient is supported
well in a good light. Patient is asked to remove all kind of ornaments from
his body, as they only hinders the procedure.

The skin is washed with soap and water to remove the natural oils and
other kind of dirt to reduce the skin resistance for the electric current;
before the pads are applied. For the stimulation of biceps brachii muscle,
most comfortable position for the patient is high sitting; with supinated
forearm. With slight flexed elbow and support of pillow behind the back to
maintain proper posture. Id the patient is unable to sit, supine lying
position is preferred.

· Setting up of the parameters:

For both denervated and innervated biceps brachii, Interrupted galvanic


current is chosen. For innervated one, diagnosis treatment is selected, with
pulse duration of 30 milliseconds, on time is set on 2 seconds. After this,
therapist self tests the apparatus prior to application on the patient, by
increasing the intensity knob.

Interrupted galvanic is preferred over surged faradic because interrupted


galvanic current has pulse duration more than 1 millisecond, but surged
faradic has from 0.1 to 1 millisecond, so to achieve stimulation more
intensity of current will be required to produce the contraction of that
muscle and that intensity will become uncomfortable for patient.

· Finding the motor point of biceps brachii:

After setting up the parameters, the red electrode covered with wet strap is
placed at the cervical region of the neck or where there is
musculocutaneous nerve is superficial; to complete the circuit, and the
black which is an active pen electrode is used to locate the motor point.
Pen electrode is held at 90° to skin surface and moved gradually between
the lower ⅔ and ⅓ junction from the point of origin of muscle. Since the
biceps is a superficial muscle so it’s motor point lies in middle of arm and
slightly medial.
· Stimulating the biceps brachii muscle :

After finding the muscle motor point, stimulation is done for the muscle.

Contraindications:

· Infection

· Haemorrhage

· Deep vein thrombosis

· Fractures

· Open wounds

· Skin lesion such as eczema


· Neoplasm

· Absent sensation

· Stimulation of autonomic nerves may disturb cardiac rhythm

Indications:

· Facilitation of muscle contraction

· Re education of muscle action

· Training a new muscle action after tendon transplant or reconstructive


surgery

· Neurapraxia of motor nerve

· Improve venous and lymphatic drainage

· Prevention and loosening of adhesion

· Denervation

· Re education of recovering muscles in early stages of reinnervation


THANK YOU

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