Write a note on interrupted direct current. Also explain its physiological effects, indications and techniques of treatment?

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 INTERRUPTED DIRECT CURRENT

Interrupted direct current is also known as Galvanic Current. The frequency of interrupted direct current is 30 Hz and Duration is 100 ms. The rise and fall in intensity may be sudden or gradual. 

Modified types of direct current includes : Rectangular, Trapezoidal, triangular, Saw-tooth and Depolarized.



Physiological Effects Of I.d.c :
                                                                    With the duration and intensity of current, a contraction of denervated muscle can be initiated. An impulse with a duration of 100 ms is the shortest that is generally considered satisfactory for the treatment of denervated muscle.
  1. Stimulation Of Sensory Nerves:   When an interrupted direct current is applied to the body, there is stimulation of sensory nerves. The impulses are of fairly long duration so the effect is rather marked, giving rise to a stabbing or burning sensation. There is a reflex dilatation of superficial blood vessels, and causes erythema of skin.
  2. Stimulation Of Motor Nerves:   In motor stimulation, a brisk muscle twitch followed by immediate relaxation is produced. There is a little beneficial effect on the muscle.
Indications For Interrupted Direct Current:
                                                                                                              The indications of i.d.c current are as follows:
  • The interrupted direct current is used to produce contractions of denervated muscles.
  • When muscle is deprived of nerve supply, changes in its structure and properties tend to occur and wasting of muscles occurs , then interrupted direct current is used to stimulate them. 
  • Electrical stimulation of the muscle fibres may slow down these changes and restore the degenerated muscle bulk. 
  • Three hundred contractions of each muscle are desirable at each treatment. Ninety is usually regarded, as the minimum no. of contractions for the treatment to be effective.
  • In early stages of re-innervation, electrical stimulation may be used for re-education.
Techniques Of Treatment:
There are two techniques of treatment: Labile technique, Stabile technique.
  1. Labile Technique: In this technique, One pad may be fixed over the origin of the muscle group and muscle stimulated in turn with the active electrode. The active electrode is a disc or small pad which is either held over the lower end of the fleshy belly of the muscle to be stimulated. Moving the electrode over the muscle ensures that current passes through maximum no. of muscles.
  2. Stabile technique: In this technique, two electrodes may be used, one placed over each end of the muscle to be stimulated. This method is used to stimulate deeply placed muscles. In it, two pads may be fixed, one over the origin and other over the lower end of the muscle group to be stimulated. 

Preparation Of Equipement:
The apparatus is tested. Make sure that the coverings of the disc electrodes and the pads consists of at least eight layers of lint. It is useful to avoid a chemical burn with a long-duration pulses. No metal should be allowed to come in contact with the patient's tissues.
Preparation Of The Patient:
  • The skin is prepared by washing and protecting abrasions as for electrical treatment. 
  • It is often an advantage to soak the part in a warm water before the treatment to lower the resistance of the skin and to warm the muscles.
  • Contractions are obtained more easily if the part is supported so that, the muscles to be stimulated are in a shortened position.
References:
Clayton's Electrotherapy ( Angela Forster, Nigel Palastanga )

About Author:
Tayyba Saleem ( PT )
Doctor of Physical Therapy.

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