HIGH-VOLTAGE PULSED GALVANIC

STIMULATION (HVPGS)

 recognized by many different names, including

high volt pulsed galvanic (HVPG),
high voltage stimulation (HVS) and
direct current stimulation (DC)

The high volt pulsed galvanic stimulator (HVPGS), a type

of neuromuscular stimulator is a short duration
(microsecond) microamperage current driven by a high
voltage current (up to 300 volts) that is delivered as a
twin-peak monophasic waveform of fixed duration (100
microseconds).

 Electrical currents are also used to produce

chemical effects.
Most biologic tissue contains negatively and
positively charged ions.
A direct current flow will cause migration of these
charged particles toward the pole of opposite
polarity.
At the positive pole the negatively charged
particles cause an acid reaction in which there is
coagulation of protein and hardening of the
tissues.
At the negative pole the positively charged
particles produce an alkaline reaction, liquefying
protein, and causing softening of the tissues.

 According to Robert Becker M.D. the current

of injury when the body is injured has a
negative charge.
Placing a negative electrode over the
injured body part perhaps creates a repelling
and movement of ions

General Indications For Use Of A Galvanic

Stimulator:
Pain Control
Edema Reduction
Wound Healing
Disuse Atrophy
Muscle Spasm
Post-Operative

Electrical Stimulation Characteristics of High

Voltage Pulsed Current
Wave form: paired monophasic with
instantaneous rise and exponential fall of
current.
Modulation: continuous, surged or
interrupted.

Physiological effects
Wound Healing
Higher Frequency (80 to 120 PPS)
Stimulates increases in numbers of fibroblasts. These are the cells
responsible for collagen (component of soft tissue responsible for
wound closure) synthesis.
Inhibition of bacterial growth (staph aureus)
Increased blood supply by blockade of sympathetic nervous system
activity. Increased blood supply results in increased oxygen and nutrient
delivery to the tissue.
Pain Reduction
Higher Frequency (80 to 120 PPS)
Causes blockade of pain nerve fiber conduction.
Causes the release of the bodys national pain reducing endorphins and
enkephalins.
Causes reduction/blockade of pain where the source of pain is an
inflamed nerve (Neuritis), the edema associated with the inflammatory
process and its subsequent exacerbation of the neuritis is blocked.

Edema Reduction
Higher Frequency (80 to 120 PPS)
Causes blockade of the microvascular permeability to fluids.
This is an event that occurs with tissue trauma. The subsequent
edema formed after an injury/surgery is secondary to
microvascular leakage of fluid from the blood vessels into the
surrounding tissues. Thus edema/swelling formation is reduced
result.
Lower Frequency (5 to 20 PPS)
This is produced with a muscular contraction that is promoted
by moving fluid away from the injured area by the pumping
action/muscle contraction stimulating the lymphatic system
resulting in fluid movement.
Disuse Atrophy/Muscle Strengthening
Lower Frequency (5 to 20 Hz)
The muscle contraction stimulation at this frequency allows for
the retardation of muscles weakening from disuse and/or
promotes/stimulates muscle strengthening/re-education by
stimulating muscle contraction.

Wound healing concept:

a. Intact skin surface negative with respect to
deeper epidermal layers.
b. Injury to skin develops positive potentials initially
and negative potentials during healing process.
c. Absent or insufficient positive potentials retard
tissue regeneration.
d. Addition of positive potentials, initially through
anode, may promote or accelerate healing.

Wound healing parameters.

a. Amplitude: comfortable tingling sensation,
paresthesia, no muscle response.
b. Pulse rate: 50-200 pps.
c. Pulse duration: 20-100 sec.
d. Duration of treatment: 20-60 min.

Wound healing procedures.

a. Inspect wound area.
b. Position patient and support treatment area.
c. Clean and debride wound site. Pack with sterile
saline soaked gauze.
d. Place active electrode over gauze.
e. For bactericidal effect, active electrode should
have negative polarity. For culture-free wound,
active electrode should be positive.
f. Turn the intensity up slowly to selected level.
g. At conclusion of treatment, turn intensity down
slowly to zero.