Dr. Martin's notes

Tuesday Februrary 07, 2017

Sine Wave and Galvanic (incl. Iontophoresis)

Electrical Muscle Stimulation (EMS/Sine Wave)

The primary uses of electrical muscle stimulation (EMS), or neuromuscular stimulation, are to re-educate injured or impaired muscles, slow the effects of atrophy, and increase the strength of healthy muscles through electrical stimulation. The EMS machine consists of pads, wires, and the control unit. The pads are placed on the patient's skin at both ends of the muscle. Wires attached to these pads connect to the control unit, which is used to set the intensity and duration of the treatment. EMS should not be used over carotid arteries, cardiac pacemakers, high fluid areas, or a pregnant uterus. Duration of treatment is generally 10 to 20 minutes.

Galvanic Stimulation

This modality uses a high or low voltage galvanic (direct) current for therapeutic purposes. Galvanic stimulation is used in the treatment of contusions, sprains, strains, and acute edema. In this treatment, the patient is connected to the galvanic stimulator through the attachment of two positive pads and one negative pad that are connected to the machine by wires. The patient will experience a change in circulation to the body parts between the electrodes. Galvanic stimulation may also speed the elimination of cellular waste products. The contraindications are the same for EMS as noted above. This modality may also be used with heat packs or ice packs. Duration of treatment is generally 10 to 20 minutes.

The physiologic responses in the body, such as vasodilation, that result from galvanic stimulation depend on the polarity of the current, as listed below.

Iontophoresis

Similar to the way in which phonophoresis uses ultrasound to drive therapeutic agents into the skin, iontophoresis uses electricity to drive ionized medications, such as dexamethasone and hydrocortisone, through the skin and into superficial tissues. A painless treatment, iontophoresis uses an electrical current that passes from the positive electrode to the negative electrode to administer the ionized medications to the tissues. Pads and wires are used to connect the patient to the machine. One pad delivers the medication, and the other pad serves as a ground. This modality can be used for superficial tendonitis and bursitis to decrease edema, inflammation, and pain. Iontophoresis should not be used on pregnant women without a physician's approval, or over the eyes, carotid arteries, unhealed wounds, pacemakers, or new scar tissue. Treatment time ranges from 5 to 10 minutes, once per day, or as recommended by the manufacturer, physician, or therapist.