Electrotherapy
Encyclopedia
Electrotherapy is the use of electrical energy as a medical treatment In medicine
, the term electrotherapy can apply to a variety of treatments, including the use of electrical devices such as deep brain stimulators
for neurological disease. The term has also been applied specifically to the use of electric current to speed wound healing. Additionally, the term "electrotherapy" or "electromagnetic therapy" has also been applied to a range of alternative medical
devices and treatments.
It has not been found to be effective in increasing bone healing.
, the developer of electrotherapy, announced that alternating
was superior to direct current
for electrotherapeutic triggering of muscle contractions. 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 required 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 rectangular biphasic waveform. During 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. These Galvanic exercises employed a monophasic wave form, direct current - electrochemistry.
The use of electrotherapy has been researched and accepted in the field of rehabilitation (electrical muscle stimulation
).
The American Physical Therapy Association
acknowledges the use of Electrotherapy for:
1. Pain management
2. Treatment of neuromuscular dysfunction
3. Improves range of joint mobility
4. Tissue repair
5. Acute and chronic edema
6. Peripheral blood flow
7. Iontophoresis
8. Urine and fecal incontinence
Electrotherapy is used for relaxation of muscle spasms, prevention and retardation of disuse atrophy, increase of local blood circulation, muscle rehabilitation and re-education electrical muscle stimulation
, 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.
Some of the treatment effectiveness mechanisms are little understood, with effectiveness and best practices for their use 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. 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 or venous stasis ulcers.
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
, the term electrotherapy can apply to a variety of treatments, including the use of electrical devices such as deep brain stimulators
Deep brain stimulation
Deep brain stimulation is a surgical treatment involving the implantation of a medical device called a brain pacemaker, which sends electrical impulses to specific parts of the brain...
for neurological disease. The term has also been applied specifically to the use of electric current to speed wound healing. Additionally, the term "electrotherapy" or "electromagnetic therapy" has also been applied to a range of alternative medical
Alternative medicine
Alternative medicine is any healing practice, "that does not fall within the realm of conventional medicine." It is based on historical or cultural traditions, rather than on scientific evidence....
devices and treatments.
It has not been found to be effective in increasing bone healing.
History
During 1855 Guillaume DuchenneGuillaume Duchenne
Guillaume-Benjamin-Amand Duchenne was a French neurologist who revived Galvani's research and greatly advanced the science of electrophysiology...
, the developer of electrotherapy, announced that alternating
Alternating current
In alternating current the movement of electric charge periodically reverses direction. In direct current , the flow of electric charge is only in one direction....
was superior to direct current
Direct current
Direct current is the unidirectional flow of electric charge. Direct current is produced by such sources as batteries, thermocouples, solar cells, and commutator-type electric machines of the dynamo type. Direct current may flow in a conductor such as a wire, but can also flow through...
for electrotherapeutic triggering of muscle contractions. 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
Anode
An anode is an electrode through which electric current flows into a polarized electrical device. Mnemonic: ACID ....
) and pit (at the cathode
Cathode
A cathode is an electrode through which electric current flows out of a polarized electrical device. Mnemonic: CCD .Cathode polarity is not always negative...
). Furthermore, with DC each contraction required 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 rectangular biphasic waveform. During 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. These Galvanic exercises employed a monophasic wave form, direct current - electrochemistry.
Current use
Although a 1999 meta-analysis found that electrotherapy could speed the healing of wounds, during 2000 the Dutch Medical Council found that although it was widely used, there was insufficient evidence for its benefits. Since that time, a few publications have emerged that seem to support its efficacy, but data is still scarce.The use of electrotherapy has been researched and accepted in the field of rehabilitation (electrical muscle stimulation
Electrical muscle stimulation
Electrical muscle stimulation , also known as neuromuscular electrical stimulation or electromyostimulation, is the elicitation of muscle contraction using electric impulses...
).
The American Physical Therapy Association
American Physical Therapy Association
A Historical PerspectivePhysical therapists formed their first professional association in 1921, called the American Women's Physical Therapeutic Association. Led by President Mary McMillan, an executive committee of elected officers governed the Association, which included 274 charter members...
acknowledges the use of Electrotherapy for:
1. Pain management
Pain management
Pain management is a branch of medicine employing an interdisciplinary approach for easing the suffering and improving the quality of life of those living with pain. The typical pain management team includes medical practitioners, clinical psychologists, physiotherapists, occupational therapists,...
- Improves range of joint movement
2. Treatment of neuromuscular dysfunction
- Improvement of strength
- Improvement of motor control
- Retards muscle atrophyMuscle atrophyMuscle atrophy, or disuse atrophy, is defined as a decrease in the mass of the muscle; it can be a partial or complete wasting away of muscle. When a muscle atrophies, this leads to muscle weakness, since the ability to exert force is related to mass...
- Improvement of local blood flow
3. Improves range of joint mobility
- Induces repeated stretching of contracted, shortened soft tissues
4. Tissue repair
- Enhances microcirculationMicrocirculationThe microcirculation is a term used to describe the small vessels in the vasculature which are embedded within organs and are responsible for the distribution of blood within tissues; as opposed to larger vessels in the macrocirculation which transport blood to and from the organs...
and protein synthesis to heal wounds - Restores integrity of connective and dermal tissues
5. Acute and chronic edema
Edema
Edema or oedema ; both words from the Greek , oídēma "swelling"), formerly known as dropsy or hydropsy, is an abnormal accumulation of fluid beneath the skin or in one or more cavities of the body that produces swelling...
- Accelerates absorption rate
- Affects blood vessel permeability
- Increases mobility of proteins, blood cells and lymphatic flow
6. Peripheral blood flow
- Induces arterial, venous and lymphatic flow
7. Iontophoresis
Iontophoresis
Iontophoresis is a technique using a small electric charge to deliver a medicine or other chemical through the skin. It is basically an injection without the needle...
- Delivery of pharmacologicalPharmacologyPharmacology is the branch of medicine and biology concerned with the study of drug action. More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function...
agents
8. Urine and fecal incontinence
Fecal incontinence
Fecal incontinence is the loss of regular control of the bowels. Involuntary excretion and leaking are common occurrences for those affected. Subjects relating to defecation are often socially unacceptable, thus those affected may be beset by feelings of shame and humiliation...
- Affects pelvic floorPelvic floorThe pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus, and associated connective tissue which span the area underneath the pelvis. The pelvic diaphragm is a muscular partition formed by the levatores ani and coccygei, with which may be included the...
musculature to reduce pelvic pain and strengthen musculature - Treatment may lead to complete continence
Electrotherapy is used for relaxation of muscle spasms, prevention and retardation of disuse atrophy, increase of local blood circulation, muscle rehabilitation and re-education electrical muscle stimulation
Electrical muscle stimulation
Electrical muscle stimulation , also known as neuromuscular electrical stimulation or electromyostimulation, is the elicitation of muscle contraction using electric impulses...
, 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.
Some of the treatment effectiveness mechanisms are little understood, with effectiveness and best practices for their use still anecdotal.
Electrotherapy devices have been studied in the treatment of chronic wounds and pressure ulcers. A 1999 meta-analysis
Meta-analysis
In statistics, a meta-analysis combines the results of several studies that address a set of related research hypotheses. In its simplest form, this is normally by identification of a common measure of effect size, for which a weighted average might be the output of a meta-analyses. Here the...
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. However, a more detailed review by the Cochrane Library
Cochrane Library
The Cochrane Library is a collection of databases in medicine and other healthcare specialties provided by the Cochrane Collaboration and other organisations. At its core is the collection of Cochrane Reviews, a database of systematic reviews and meta-analyses which summarize and interpret the...
found no evidence that electromagnetic therapy
Electromagnetic therapy
Electromagnetic therapy, is a form of alternative medicine which claims to treat disease by applying electromagnetic radiation or pulsed electromagnetic fields to the body....
, a subset of electrotherapy, was effective in healing pressure ulcers or venous stasis ulcers.
See also
- Electrical brain stimulationElectrical brain stimulationElectrical brain stimulation , also referred to as focal brain stimulation , is a form of electrotherapy and technique used in research and clinical neurobiology to stimulate a neuron or neural network in the brain through the direct or indirect excitation of its cell membrane by using an electric...
- Electrical muscle stimulationElectrical muscle stimulationElectrical muscle stimulation , also known as neuromuscular electrical stimulation or electromyostimulation, is the elicitation of muscle contraction using electric impulses...
- ElectroanalgesiaElectroanalgesiaElectroanalgesia is a form of analgesia, or pain relief, that uses electricity to ease pain. Electrical devices can be internal or external, at the site of pain or delocalized throughout the whole body...
- Electrotherapy (cosmetic)Electrotherapy (cosmetic)Cosmetic electrotherapy is a range of beauty treatments that uses low electric currents passed through the skin to produce several therapeutic effects, such as muscle toning in the body, and micro-lifting of the face...
- Galvanic bathGalvanic bathGalvanic bath is an alternative medical treatment based on the simultaneous use of water and electric current. The patient lies in a 34 degree Celsius bath, while gentle electric current is passed through his or her body....
- Neuromuscular diagnostics
- Deep brain stimulationDeep brain stimulationDeep brain stimulation is a surgical treatment involving the implantation of a medical device called a brain pacemaker, which sends electrical impulses to specific parts of the brain...
- Transcranial magnetic stimulationTranscranial magnetic stimulationTranscranial magnetic stimulation is a noninvasive method to cause depolarization or hyperpolarization in the neurons of the brain...
- Rebox electrotherapyRebox electrotherapyRebox electrotherapeutic method is based on non-invasive transcutaneous application of specific electric currents to a living tissue. Main indications for using the Rebox include treatment of acute and chronic pain, immobility, musculoskeletal and neurological disorders and oedema.- Method...
- Cranial electrotherapy stimulationCranial electrotherapy stimulationCranial Electrotherapy Stimulation is an experimental psychiatric treatment that applies a small, pulsed electric current across a patient's head. It has been claimed to have beneficial effects in conditions such as anxiety, depression, insomnia and stress...
- Electroconvulsive therapyElectroconvulsive therapyElectroconvulsive therapy , formerly known as electroshock, is a psychiatric treatment in which seizures are electrically induced in anesthetized patients for therapeutic effect. Its mode of action is unknown...
Further reading
- 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.)
External links
- Electrotherapy on the Web Tim Watson's website on electrotherapy, containing in-depth discussion and dose calculations.
- The Turn of The Century Electrotherapy Museum
- International Journal of Electrotherapy International Journal of Electrotherapy