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INTERFERENTIAL THERAPY, (OTHER CLINICAL APPLICATIONS) - Coggle Diagram

- - - - It is the transcutaneous application of alternating medium frequency electrical currents,
        amplitude modulated at low frequency
        for therapeutic purposes.
        
        The basic principle of Interferential Therapy (IFT) is to utilise the
        significant physiological effects of low frequency
        (=<250pps)
        electrical stimulation of nerves
        without the associated painful and
        somewhat unpleasant side effects
        sometimes associated with low frequency stimulation.
        
        To produce low frequency effects
        at sufficient intensity and
        at sufficient depth, patients can experience considerable
        discomfort in the superficial tissues (i.e. the skin).
        
        This is due to the impedance of the skin being inversely proportional
        to the frequency of the stimulation.
        
        image
        
        The skin impedance at
        50Hz is approximately 3200 whilst
        at 4000Hz it is reduced to approximately 40 .
        
        image
        
        Interferential therapy utilises
        2 of these medium frequency currents,
        passed through the tissues simultaneously,
        where they are set up
        so that their paths cross
        & they literally interfere with each other
        
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  - - - images
    - - It is rather a generic means of stimulation
        
        the machine can be set up to act more like a TENS type device
        
        or can be set up to behave more like a muscle stimulator
        
        by adjusting the stimulating (beat) frequency.
        
        It is often regarded (by patients) to be
        more acceptable as it
        generates less discomfort
        than some other forms of electrical stimulation
        
        The clinical application of IFT therapy is based on peripheral nerve stimulation (frequency) data,
        though it is important to
        note that much of this information has been generated from
        research with other modalities, and its transfer to IFT is
        assumed rather than proven.
        
        Selection of a wide frequency sweeps has been considered less efficient
        than
        a smaller selective range in that by treating
        with a frequency range of say 1-100Hz, the effective
        treatment frequencies can be covered,
        but only for a relatively small percentage
        of the total treatment time
      - Pain relief
        
        Logically one could use
        
        the higher frequencies (90-130Hz)
        
        to stimulate the pain gate mechanisms & thereby mask the pain symptoms.
        
        Alternatively,
        
        stimulation with lower frequencies (2-5Hz)
        can be used to
        
        activate the opioid mechanisms, again providing a degree of relief.
        
        100 Hz constant
        
        80-100 Hz rhythmic
        
        15 Hz
        
        MUSCLE STIMULATION
        
        Stimulation at low frequency (e.g. 1Hz)
        will result in a series of twitches,
        whist
        
        stimulation at 50Hz (30-100 Hz)
        will result in a
        tetanic contraction.
        
        5 to 20 Hz partial tetany.
        
        1-100 Hz rhythmical.
        
        There is limited evidence at present for the ‘strengthening’ effect.
        
        On the basis of the current evidence, the contraction brought about by IFT is no ‘better’ than would be achieved by
        active exercise
        
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        Blood Flow
        
        Based on current available evidence,
        the most likely option for IFT use
        as a means to increase local blood flow remains
        via the muscle stimulation mode,
        and thus the
        10-20 or 10- 25Hz frequency sweep options appears to be the most likely
        beneficial option.
        
        OEDEMA
        
        The evidence is very limited in this respect and the physiological
        mechanism by which is could be achieved as a direct effect of the IFT
        remains to be established.
        
        The preferable clinical option in the light of the available evidence is to
        
        use the IFT to bring about local muscle contraction(s)
        
        which combined with the local vascular changes that will result
        could be effective in
        encouraging the reabsorption of tissue fluid.
        
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      - Pain relief
        
        Muscle stimulation
        
        Increased local blood flow
        
        Reduction of oedem
- - - - Treatment time:
        
        In acute conditions, shorter treatment
        times of 5-10 minutes may be sufficient to achieve the effect.
        
        In other circumstances, it may be necessary to stimulate the tissues for 20-30 minutes
        
        Amplitude modulation parameter
        (beat frequency/base)-
        low frequency modulation required.
        
        Spectrum parameter- the range of variation in the AMF value desired.
        
        Sweep time parameter-time period for the AMF to change
        from base to peak frequency
        
        Contour parameter-the rate of change of the AMF from base to peak frequency.
        
        Rotation parameter-for vector currents; the rate of rotation and the direction of change of the AMF field within the tissues.
        
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    - - Classical 4 pole application
        
        IsoplanerVector Field
        
        Dipole Vector Field
        -Static vector mode
        -Dynamic vector mode
        
        Two pole
        
        image
      - Indications
        
        Pain
        
        Oedema
        
        Stress incontinence
        
        Improve circulation
        
        CONTRAINDICATIONS
        
        Patients who do not comprehend the physiotherapist’s instructions
        or are unable to co-operate should not be treated
        
        Patients with Pacemakers
        
        some pacemakers are relatively immune to interference from electrical stimulation
        whilst others can demonstrate serious adverse behaviour.
        
        It is suggested that as a
        general rule, if the patient has a pacemaker, it is best to avoid all electrical stimulation, but like TENS, if it is a treatment that is
        needed. The stimulation should be tried in a carefully controlled environment where appropriate equipment is available to correct
        any pacing problems should they arise
        
        Patients who are taking
        anticoagulation therapy or have a history
        of pulmonary embolism or
        deep vein thrombosis should not be
        treated with the vacuum electrode applications
        
        Similarly, patients whose skin may be easily damaged or bruised
        
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        PRECAUTIONS
        
        Care should be taken to maintain
        the suction at a level below that
        which causes damage / discomfort to the patient
        
        If there is abnormal skin sensation, electrodes should be positioned in a site other than this area to ensure effective stimulation
        
        Patients who have (marked)
        abnormal circulation
        
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        Dangers (Adverse effects)
        
        Electrical burn
        
        Increased pain
        
        General malaise
        
        Nausea
        
        Vomiting
        
        Dizziness/faintness
        
        Migraine/headache
        
        Neurological effects
        
        Short wave diathermy may interfere with the IFT, so operated well away from the SWD.
        
        INTERFERENTIAL TREATMENT RECORD
        
        Electrode number (2 pole, 4 pole) and positions
        
        Frequency applied
        
        Sweep settings employed (if applicable)
        
        Current intensity applied (or patient reported sensation)
        
        Treatment duration