Electrical Current

Medium frequency
Medium frequency
currents
 Medium-frequency currents have been a
golden standard in pain relief therapy as
well as in treatment of musculoskeletal
disorders for several years.
Interferential current
Definitions:
 Interferential therapy is the phenomenon

that occurs when two or more oscillations

simultaneously affect the same point or
series of points in a medium.
 When interferential therapy is applied in

electrotherapy, use is made of two medium-

frequency alternating currents that interact
with each other.
 One of these alternating currents has a
fixed frequency of 4000 Hz, while the
frequency of the other current can be
adjusted between 4000 and 4250 Hz. The
interference results from the
superimposition of these two currents.
• Electrical field is strongest near the center
• The strength of the electrical field gradually decreases
as it moves away from center
Principles
 To produce low frequency effects at sufficient
intensity and at sufficient depth, patients can
experience considerable discomfort in the
superficial tissues.
 This is due to the impedance of the skin being
inversely proportional to the frequency of the
stimulation.
 Lower the stimulation frequency, the greater the
impedance to the passage of the current. So,
more discomfort is experienced as the current is
‘pushed’ into the tissues against this barrier.
 For ex: The skin impedance at 50Hz is
approximately 3200 whilst at 4000Hz it is
reduced to approximately 40
Beat
 Beat: envelop of pulses.
 Beat frequency OR AMF: (higher

frequency – lower frequency)

Wave length
 Wavelength: which is equivalent to the
pulse duration of a pulsed waveform,
changes inversely with the carrier
frequency.
 If the carrier frequency is higher, the

wavelength is shorter, and if the carrier

frequency is lower, the wavelength is
longer.
Amplitude modulation (M)
 Amplitude modulation is also
characterized by the modulation depth (M).
 The modulation depth is expressed as a

percentage, and can lie between 0 and

100%.
Spectrum
 The set of range of variation in the AMF
value that desired.
Frequency
Interference frequencies come in automatic
pre selected modes with a desired intensity
at a constant/rhythmic level .
 Frequency scale:

1. 1 to 100Hz = Constant frequency

2. 1 to 10Hz = Rhythmic frequency
3. 90 to 100Hz Rhythmic frequency
Constant Beat Frequency

 Constant difference between the two

circuits and this results in a constant beat
frequency.
Sweep
Rhythmic Beat frequency
 It is obtained when one carrier frequency
remains fixed and the other keeps on
changing in frequency at regular interval
from lower to higher value and back down.
 It may take 10 seconds to go up and 5

seconds to come down, it is known as

Sweep , this sweep prevents
accommodations of the excitable tissue.
Sweep frequency
 Rhythmic progression through full range of
beat frequency.
 The principle of using the sweep is that the

machine is set to automatically vary the

effective stimulation frequency using either
pre-set or user set sweep ranges.
 Helps to prevent nerve accommodations.
Sweep frequency
Example:
 An AMF= 20Hz and 50 spectrum is added .
 The current begins at AMF 20 Hz and passes

successfully through all frequencies up to

70 Hz, and after it which decreased
gradually to 20 Hz.
 This process repeated automatically.
 Rectangular (sweep
pattern: This produces a
very different stimulation
Triangular sweep pattern in that the base
pattern: The machine and top frequencies are set
but the machine then “
gradually changes from
switches” between these
the base to the top two specific frequencies
frequency over 6 rather than gradually
seconds changing from one to other.
Sweep Time
 Is the time period for the AMF to change
from base to peak frequency.
 Faster sweep is used for less painful

stimulation and for strong muscle

contraction sweep must be slow, to ensure
aggressive stimulation.
 10 seconds to go up and 5 seconds to come

down
Continue
 Contour parameter: the rate of change of
the AMF from the base to peak frequency.
 Rotation: it is applicable in case of vector

current only sets the rate of rotation and

the direction change of the AMF field within
the tissue.
Methods of application
1. Bipolar interferential
2. Static interferential
3. Dynamic interferantial
1.Bipolar interferential
 Pre-modulated INF are
applied through 2
surfaces electrode.
 INF is generated
inside the machine
and is delivered to the
patient through 2
electrode.
 Useful for small area
like elbow, ankle, feet,
hand.
2. Static interferential
 Description: 4-poles INF
(quadripolar)/2channles/4electrode
s
 Production: Interference of two
medium frequency sinusoidal
current circuit, with another
Circuit), to introduce low frequency
current with beat frequency
 Modulation: Amplitude and
frequency modulated beats are
pre-mixed in the patient’s skin.
 Shape :Four-leaf clover
 Uses: for acute conditions
because of its mildness effect
3. Dynamic INF
 This is moving the area of
INF current in a to and from
manner through 45 degree.
 It is obtained by varying
the current intensity from
50-100%.
 Shape: circular.
 The dynamic area of INF
also called vector sweep,
vector scan, rotating
vector.
 Used: suited for large area
and diffuse pain as
shoulder, back, and thigh.
Advantages and
Disadvantage
 Advantages:
1. More comfortable than TENS: Medium-
frequency currents meet with less skin
resistance than low frequency currents; TENS
uses low frequency currents
2. Stimulates tissues deeper than a TENS unit
3. Larger coverage area than TENS

 Disadvantages
1. Eliminates pain; doesn't deal with cause of the
pain
2. Few portable units available
3. Expensive
Physiological effect
Depend on:

1. Current amplitude
2. Type of INF mode ( static or dynamic)
3. The frequency range used.
4. Accuracy of electrode position.
5. Underlying pathophysiology in relation to
desired effect.
6. Patency of circulation and neurological
function
Clinical applications
1. Pain relief
2. Muscles stimulation
3. Increased local blood flow
4. Reduction of edema
Pain control
 This may be achieved through:
1. Higher frequencies (90-130Hz) stimulate pain
gate mechanisms
2. Lower frequencies (2-10Hz) can be used to
activate the opioid system

IFT has marked analgesic effect on pain in

following conditions:
3. Reflex sympathetic dystrophy.
4. Stump pain
5. Herpes Zoster
6. Vascular insufficiency
7. Myofascial Pain Syndrome
Muscle stimulation
 No significant evidence that has
demonstrated a significant benefit of IFT
over active exercise.
 Note: Except for clinical circumstances

where assisted contraction is beneficial.

 Choice of parameters will depend on the

desired effect.
 Most effective motor nerve stimulation

range= 10 and 20, & 25 Hz

 1-10 Hz rhythmic frequency.
Effect of blood flow
Effect of blood flow is believed to be
due:
1. Effect of the suction electrode on tissue.
2. Effect on muscle stimulation on circulation.
3. Deep tissue penetration stimulates
parasympathetic nerve fibers for increase blood
flow

 vascular change at 10-25 Hz.

Edema control
Physiological effects :
1. Vibration of ions and facilitates ions movement
in the cells.
2. Alternative rhythmic excitation and relaxation
produce muscles pump
3. Alteration of cell membrane permeability
(electroporation)
4. Increase venous and lymphatic drainage
Edema control
 Acute Edema = 1-100Hz rhythmic
 Chronic edema = 100Hz consistent
Other clinical application
1. Urinary incontinence
2. Hematoma
Urinary incontinence
 Strong muscle contraction using
interferential therapy will be used to cause
muscle re-education for pelvic floor muscles

1. Program I 1-100Hz rhythmic
2. Program II 10-100Hz rhythmic
3. Program III 100Hz consistent
 Technique II:
Two electrodes are placed
symmetrically on the
abdomen above the inguinal
Technique I: ligament, 3 cm apart. - Two
One electrode placed under electrodes are placed on the
the ischial tubersity and inside of the thighs below
other placed inferior to the the inferior border of the
symphysis pubis femoral triangle
Hematoma

 Acute stage Using 100Hz constant current,

with ice application.

 Chronic stage: Using 100Hz constant

current with ultraso
INF Contraindication
1. Arterial disease
2. DVT
3. Infective conditions
4. Pregnant uterus
5. Hemorrhage
6. Malignant tumors
7. Artificial pacemakers
8. During menstruation
9. Eye
10. Fever
11. Large open wound
12. Dermatological or skin infection
13. TB
14. Advanced cardiac disease.
Precaution
1. Over anterior chest
2. Epileptic patients
3. Patient with febrile conditions
4. IFT must be at least 6 meters away from
SWD machine.
Side effect
Types of electrode

 Plate
 Vacuum
Plate electrode

 Smaller electrode are used for a localized

effect, but this effect is more superficial.

 Larger plate electrode gives more

comfortable treatment and deeper effect.

 Conducting rubber are comfortable and long

lasting
Vacuum
Electrode placement
Any Question???