Electrotherapy means application of physical agents for treatment purpose. It has been a major component of physiotherapy practice since the early days. As with every field electrotherapy has also undergone remarkable change overtime and is continuing to do so. Though the modalities used these days are quite dissimilar to those of early days but are based on same principles.
The application of electrotherapy needs to be more evidence based i.e. used at the right place, at the right time for the right reason. This makes electrotherapy more effective. The matter of concern is if a physiotherapist uses the electrotherapy modality unwisely, it will either do no good at all or possibly make matters worse – which is true for any other professional.
The physiotherapist should use his knowledge to judge the use of best possible modality to treat a condition and use the best possible evidence that supports his decision. There are few evidences supporting the use of single modality as the most effective treatment, while when used in combination with other physical agents, have strong evidences of effectively treating any condition.
The physiotherapist may have conflicts with use of different modalities in different condition, but, by large the terms that should dictates application of a modality, should be evidence based.
The physiotherapy modalities can be classified into 3 sub groups as mentioned below –
|Electrical Stimulation Agents / Modalities||Thermal Agents / Modalities||Non Thermal Agents / Modalities|
|Transcutaneous Electrical Nerve Stimulation (TENS)||Infra Red Irradiation (IRR)||[Pulsed] Ultrasound|
|Interferential Therapy (IFT)||Shortwave Diathermy (SWD)||Low Intensity Pulsed Ultrasound (LIPUS)|
|Neuromuscular Electrical Stimulation (NMES)||Microwave Diathermy (MWD)||[Pulsed] Shortwave Therapy (PSWT)|
|Functional Electrical Stimulation (FES)||Other RF Therapies||[Pulsed] Laser Therapy (LLLT / LILT)|
|Faradic Stimulation||Hydrocollator Packs||[Pulsed] Microwave Therapy|
|Iontophoresis||Wax Therapy||Low Intensity RF Applications|
|High Voltage Pulsed Galvanic Stimulation (HVPGS)||Balneotherapy ( inc spa/whirlpool)||Pulsed Electromagnetic Fields (PEMF’s)|
|Low Intensity Direct Current (LIDC) and Pulsed LIDC||Fluidotherapy||Microcurrent Therapies|
|Twin Peak Monophasic Stimulation||Therapeutic Ultrasound||Magnetic Therapies|
|Diadynamic Therapyn||Laser Therapy||Pulsed Magnetic Therapy|
|H Wave Therapy ; Action Potential System (APS)||Static Magnetic Therapy|
|Russian Stimulation : Medium Frequency Stimulation||Cryotherapy / Cold Therapy / Ice / Immersion Therapy||Microcurrent Therapy|
|Rebox Therapy; Scenar Therapy|
|Microcurrent Therapy (MCT)|
A simple clinical decision making model while applying a modality or modalities (shown in the diagram) should be utilized. All modalities introduce some physical energy into the human body. This energy brings about one or more physiological changes. This physiological change brings about the desired therapeutic effect of any electrotherapy treatment. A physiotherapist may think the other way round as well.
The most important aspect of electrotherapy treatment is selection of an appropriate dosage of a modality. If lesser dose is delivered into the body of a patient, the desired physiological changes may not happen, as a result the therapeutic effect is marginalized hence no benefit. Likewise a higher dose may cause damage or produce other non desirable physiological changes. In other words, it is not only very important to select the most appropriate modality based on the available evidences, but also to deliver it at the optimal dose.
So, if a physiotherapy practitioner selects the modality on the basis of best available evidences, uses different modalities in combination, decide an appropriate dosage according to the desired physiological changes, the treatment is no less effective than any manual or exercise therapy.
At PAIN FREE PHYSIOTHERAPY CLINIC, physiotherapists are well equipped in dealing with all the latest modalities. Dr. Roshan Jha (PT) keeps updated with latest researches in the field of electrotherapy and makes sure that any latest development in the application of modalities is discussed among the physiotherapist. The dosage is decided according to the severity of condition. We prefer combination of different therapeutic modalities which is superimposed with manual and exercise therapy to achieve desired result.
Discuss your query about electrotherapy or any treatment you are undergoing with our experts to understand the treatment better.