Assist. Prof.
Baha NACI
2022-2023 Spring Semester
14.03.2023
FARADIC CURRENT
Definition: It is a short-duration interrupted current, with a
pulse duration ranging from 0.1 and 1 ms and a frequency of 30 to
100 Hz.
Wave forms:
1. Induced asymmetrical alternating current.
2. Biphasic, Asymmetrical, Unbalanced, Spiked.
3. Positive portion- short duration, high amplitude and spiked.
4. Negative portion- long duration, low amplitude and curved
Modifications
➢ Faradic currents are always surged for treatment purposes
to produce a near normal tetanic-like contraction and
relaxation of muscle.
Forms of faradic current
Each represents one impulse:
* In surged currents, the intensity of the impulses increases
gradually, each impulse reaching a peak value greater than
the preceding one then falls suddenly or gradually.
* Rest period should be at least 2 to 3 times as long as that of
the pulse to give the muscle the sufficient time to recover.
Forms of faradic current
The most comfortable pulse is 0.1-msec pulse, with a
frequency of 70 Hz or 1-msec pulse with a frequency of 50
Hz.
For practically all skeletal muscles, tetanic contraction
requires a minimum frequency of 7 Hz.
The most comfortable tetanic contractions are obtained
with 40 to 80 Hz frequencies.
Effects of faradic currents
1. Stimulation of sensory nerves:
It is not very noticeable because of the short duration.
It causes reflex vasodilation of the superficial blood vessels
resulting in slight erythema.
Effects of faradic currents
2. Stimulation of the motor nerves:
It occurs if the current has sufficient intensity, resulting in
contraction of the muscles innervated by the nerve distal
to the point of stimulus.
A suitable faradic current applied to the muscle produces a
contraction of the muscle itself and may also spread to the
neighboring muscles.
Effects of faradic currents
2. Stimulation of the motor nerves:
The contraction is tetanic because the stimulus is repeated
50 times or more per second.
If this contraction type continues for more than a short
time, muscle fatigue occurs.
So, the current is commonly surged to allow for muscle
relaxation
Effects of faradic currents
3. Creating a change in the semi-permeability of the
cell membrane stimulates the nerve
This is achieved by altering the resting membrane
potential.
When it reaches a critical excitatory level, the muscle
supplied by this nerve is activated to contract.
Effects of faradic currents
6. Chemical changes:
The ions move one way during one phase of the current;
and in the reverse direction during the other phase of the
current if it is alternating.
If the two phases are equal, the chemicals formed during
one phase are neutralized during the next phase.
Application of faradic current
Muscle stimulation with faradic current; the muscle must
have a good general innervation.
The current may be applied for diagnostic and therapeutic
objectives.
Diagnostic objectives
Investigation of myasthenic reaction;
Investigation of myotonic reaction;
Localization of a neurapraxia(nerve compression) block.
Indications:
1. Facilitation of muscle contraction inhibited by pain:
Stimulation must be stopped when good voluntary contraction is obtained.
2. Muscle re-education:
Muscle contraction is needed to restore the sense of movement in cases of
prolonged disuse or incorrect use; and in muscle transplantation.
3. Training a new muscle action:
4. Nerve damage:
When a nerve is severed, degeneration of the axons occur
several days later.
So, for a few days after the injury, the muscle contraction
may be obtained with faradic current.
It should be used to exercise the muscle as long as a good
response is present but must be replaced by modified
direct current as soon as the response starts to weaken.
5. Improvement of venous and lymphatic drainage:
In oedema and gravitational ulcers, the venous and
lymphatic return should be improved by the pumping
action of the alternate muscle contraction and relaxation.
6. Prevention and loosening of adhesions:
After effusion, adhesions are prone to form. This can be
prevented by keeping structures moving with respect to each
other.
Adhesions may be stretched and loosened by muscle
contraction.
7. Painful knee syndromes:
After trauma, muscle contraction is inhibited, resulting in
muscle atrophy.
Contraindications:
Skin lesions
Loss of sensation
Certain dermatological conditions: psoriasis, eczema
Thrombosis
Acute infections and inflammations
Cancer
Cardiac pacemakers
Superficial metals
Methods of Application
Unipolar
Bipolar
Technique of Application
1. Group muscle stimulation
2. Motor Point stimulation.
3. Labile technique
4. Baths
5. Stimulating through the nerves
6. Faradism Under Pressure
7. Faradism Under Tension
1. Group Muscle Stimulation
It is used to stimulate muscle groups with same origin. There
are two plaque electrodes. One of the electrodes is placed on
the muscle belly and the other one on the place where the
nerve becomes superficial.
The active electrode is the electrode on the nerve. The
passive electrode is larger. Sometimes electrodes are placed
on the origin and insertion of the muscles.
2. Motor Point stimulation.
After finding the motor point of the paralyzed muscle,
muscle contraction is obtained with a surged faradic current
using a pen electrode. It is used in isolated muscles. This
method is preferred if a single muscle is performing a
movement.
Motor Points of Axiallary Nerve
Motor Points of Musculocutaneous Nerve
3. Labile Technique
In this technique, the active electrode is not fixed. It is
moved closer and further away from the motor point. The
pencil electrode cannot be used for surged currents.
4. Baths
Application of faradic current to the body parts in a tub,
tray or tank containing water is termed as bath method of
application
● Depending on the placement of electrodes bath can be:
1. Bipolar : both electrodes are in the water
2. Unipolar : one electrode is in the water while the
other one is kept at any convenient part of the body
Advantage of bath method are:
Skin resistance is lowered considerably by prolonged
soaking in water
Water makes perfect contact with the tissues
Wash of electrolytes formed under the electrodes
Disadvantages are:
Current can not be localized
Superficial muscles contract more than deep muscles due
to the presence of water
Electric shock risk is higher
Faradic Foot Bath
ES by faradic current may be applied in baths.
Can be used to stimulate
- Lumbricals
- Plantar interrossei
- Abductor hallucis
Lumbicals
Plantar Interrossei
Abductor hallucis
Faradic Foot Bath
Position the patient in high sitting with back supported
Position the feet on a stool covered with a plastic sheet
Place the foot in a bath containing enough warm water to
cover the toes
Faradic Foot Bath
To stimulate the
lumbricals place two
electrodes transversely,
one under the heel
and the other under the
metatarsal heads
Faradic Foot Bath
To stimulate the plantar
interossei place one
electrode on each side of
the foot at the level of
metatarsal shafts
Faradic Foot Bath
For Abductor hallucis
place
one electrode under the
heel and
stimulate the muscle
through the motor point
using a pen electrode
Faradic Foot Bath
A surged faradic current is used for this
Surge duration 1 sec.
Surge interval 3 sec.
Intensity : enough to produce a visible contraction of the
muscles.
Treatment time: 15 – 30 minutes
Faradic Foot Bath
Rectangular metal or carbon rubber electrodes of 3 X 7 cm
can be used
No lint pad or coupling medium required
Encourage the patient to contract the muscle voluntarily
with the current
5. Stimulating through the nerves
If the muscle to be stimulated is in plaster, nerve
stimulation can be done by opening a plaster window.
6. Faradism Under Pressure
ES of muscle combined with compression and elevation of
the limb can be used to increase venolymphatic drainage
and thus to improve edema.
This technique is known as Faradism Under Pressure
Faradism Under Pressure
Patient in supine position
The limb is elevated above the heart level using pillows
The pressure bandage is applied over the electrode, with
maximum pressure distal to proximal
The skin must be cleaned before treatment
Faradism Under Pressure
Placement of electrode for lower limb:
• Active electrode is over the belly of the calf muscle
• Passive electrode is over the sole of the foot
Placement of electrode for upper limb:
• Active electrode over the volar aspect of forearm at the
junction of proximal 1/3 and distal 2/3 of the muscle belly
• The passive electrode over the palm or cubital fossa
Faradism Under Pressure
A surged faradic current is used for this
Surge duration 3 sec.
Surge interval 9 sec.
Intensity : enough to produce a visible contraction of the
muscles i.e. clenching of toes or fingers.
Treatment time: 15 – 30 minutes
Faradism Under Pressure
Rectangular metal or carbon rubber electrodes of 3 X 5 cm.
can be used
Encourage the patient to do active movement along with
the current and relax during surge interval
7. Faradism Under Tension
Shortening of contractile soft tissues (muscles) can be
treated with Faradism.
Such contractures develop in major muscle groups like
quadriceps or elbow flexor group
This is mostly after prolonged immobilization
Passive mobilizations can be very painful.
Titanic contraction by the surged current gradually pulls
apart the shortened myofibrils with less pain.
Faradism Under Pressure
A surged faradic current is used for this
Surge duration 3 sec.
Surge interval 9 sec.
Intensity : enough to produce a visible contraction of the
muscles.
Treatment time: 15 – 30 minutes
Faradism Under Pressure
Rectangular metal or carbon rubber electrodes of 5 X 10 cm
can be used.
Encourage the patient to do actively contract the muscle
along with the current and relax during surge interval
Faradism Under Pressure
For quadriceps contracture:
Patient is positioned on a plinth.
A roll of towel or pillow is placed below the knee to give a
stretch
Passive electrode is placed over proximal 1/3 of the
quadriceps
Active electrode is placed on the junction of proximal 2/3
and distal 1/3 of the belly of the muscle
Faradism Under Pressure
For quadriceps contracture:
Patient is positioned on a plinth.
A roll of towel or pillow is placed
below the knee to give a stretch
Passive electrode is placed over
proximal 1/3 of the quadriceps
Active electrode is placed on the
junction of proximal 2/3 and
distal 1/3 of the belly of the
muscle
Faradism Under Pressure
For elbow flexor contracture:
Patient is positioned on a plinth.
A roll is placed under the elbow just proximal to the
joint.
Passive electrode is placed over proximal 1/3 of the elbow
flexor
Active electrode is placed on distal 1/3 of the belly of the
muscle
Precaution & Dangers
If the skin sensation is not normal, position the electrodes
at an alternative site ensuring effective circulation.
Avoid active epiphyseal regions in children.
Select stimulation parameters appropriate to the effect
desired.
Inappropriate stimulation may result in muscle damage,
reduction in blood flow through the muscle and muscle
fatigue.
Appropriate care should be taken to ensure that the level
of muscle contraction initiated does not compromise the
muscle and the joint(s) over which it acts.
Dangers
Burns
Electric shock
Hypovolemic shock
References
1. Low J & Reed A. Electrotherapy Explained: Principles and
Practice. 2nd ed. Butterworth-Heinemann. 2006
2. Foster A, Palastanga N. Clayton’s Electroptherapy Theory
and Practice. 9th edition. W B Saunders. 2006;pp 70 – 79
3. Mitra PK. Handbook of Practical Electrotherapy. Jaypee.
2006; pp 44–49
4. Khatri S. Basics of Electrotherapy. Jaypee. 2003. pp 28 –
30
Thank you..
