Electrical Stimulation

ELECTROMAGNETIC SPECTRUM
Array of electromagnetic waves in order

of length (frequency)
Longest wavelength

Electrical Stimulating Currents Lowest frequency Radio and Television Shortwave Diathermy Microwave Diathermy Infrared Visible Light Ultraviolet Ionizing Radiation

Shortest wavelength

Highest frequency

ELECTROMAGNETIC SPECTRUM
Characteristics of Electromagnetic Energy

Transmitted without a medium Travel in a straight line Reflected, Refracted, Absorbed, Transmitted

All EM waves have SAME VELOCITY but differ

in wavelength and frequency

C = wavelength (nm) x frequency (hertz) C = speed of light (300,000,000 m/sec)

Wavelength
Horizontal Distance between the crests

of any two adjacent waves

Wavelength

Frequency
Number of cycles which pass a point in a

unit of time

1 Second

Law of Grotthus-Draper
Energy must be absorbed to affect

matter and the effects are seen at the point of absorption If energy is not absorbed, it is reflected, refracted, or transmitted

Arndt-Schultz Principle
If the amount of energy absorbed is too small,

no significant reaction will take place.

If the amount of energy absorbed is adequate,

normal function will take place.

If the amount of energy absorbed is too great,

disruption and function cannot take place.

Electrical Principles
Passage of electrical current through

biological tissues results in following effects:

Thermal diathermies Physiochemical monophasic currents Physiological various types of muscle / nerve stimulation

Electrical Current
Flow of electrons between two points

Conductors allow easy flow of electrons, many free electrons Insulators difficult flow of electrons, few free electrons

Ampere
Unit of current

RATE which electrons pass a given point 1 ampere = 1 coulomb / second Coulomb is a unit of electrical charge
Indicate

the number of electrons

Measured in milliamperes (1/1000) microamperes (1/1,000,000)

Voltage
Electromotive force (EMF) or Electrical

Potential Difference

Greater the difference, greater potential for electron flow Potential difference necessary to move 1 amp of current in 1 sec against a resistance of 1 ohm

Measured in Volts (V)

High voltage = above 100 or 150 volts Low voltage = below 100 or 150 volts

Resistance
Opposition to the flow of electrons

Conductors = low resistance Insulators = high resistance

Material greater free electrons = less resistance Length longer = greater resistance Temperature warmer = greater resistance Cross-sectional area wider = less resistance

Factors that affect resistance:

Ohms Law
Amperes = Voltage

Resistance

Current Characteristics
Amplitude
Pulse Duration Frequency

Wave forms
Rise time Duty cycle

Waveforms
Monophasic (Galvanic, Direct)

Unidirectional flow of electrons High voltage units, low volt direct current units, neuroprobes Alternating / Sinusoidal currents Can be symmetrical or asymmetrical

Biphasic

Duration
Pulse duration time it takes to

complete one cycle

Phase duration time for a single phase

to complete its route

Monophasic currents: pulse = phase Biphasic currents: Neg phase + Pos phase

 Intrapulse interval

Period within a discrete pulse when the current is not flowing

Interpulse interval

Elapsed time between the conclusion of one pulse and start of next

Amplitude (Intensity)
The higher the amplitude of the current,

the greater the depth of penetration, therefore, greater number of fibers stimulated

Frequency
Stimulation frequency machine specific

Low: 1 1000 hertz Medium: 1,000 100,000 hertz (IFC, Russian) High: 100,000 hertz and higher (diathermy)

Pulse frequency adjustable output parameter

Low: 10 or less (individual muscle contraction, twitch) Medium: 10 50 (summation of contractions, tetany) High: 50 or higher (tonic contraction)

Strength / Duration Curve

Tissue Capacitance

Ability of a tissue to hold a charge before discharging Higher capacitance = longer pulse duration necessary to elicit a response

Law of Dubois Reymond

Effectiveness of a current to target

specific excitable tissues is dependent on 3 factors:

Adequate intensity to reach threshold Duration long enough to exceed capacitance Current onset is fast enough to reduce accomodation

Other terms
Accomodation

Decrease in a nerves action potential frequency over time when exposed to an unchanging depolarization stimulus

Rheobase

Minimum amplitude needed to depolarize a nerve fiber

Time required to depolarize a nerve fiber when the peak current is 2x rheobase

Chronaxie

Optimal Excitation of the nerve occurs between rheobase and chronaxie as plotted on the StrengthDuration Curve

Electrode Considerations
Monopolar

2 unequal sized electrodes

Active

(target site) Dispersive

Allows for polarity

 Bipolar

2 equal sized electrodes over treatment site Monophasic or Biphasic

Quadpolar

4 equal sized electrodes

Current Density
Smaller electrodes will have more

current density than larger electrodes

Electrode Proximity
Close

Superficial current flow Low number of parallel paths

As distance increases, current reaches

deeper and higher number of parallel paths (Decreased specificity)