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Definition

Galvanic stimulation describes unidirectional electrical current between two electrodes place on the skin. It has been proposed as a treatment for various conditions, including inflammation, pain, and for denervated muscles. It is proposed to work by facilitating ion movement under the skin, promoting circulation near the negative electrode, while reducing circulation near the positive electrode. It is theorized that these changes in circulation promote wound healing, reduce edema and inflammation, and decrease pain.

Evidence for

  • appropriate electrical stimulation can cause a denervated muscle to contract
  • contraction of a denervated muscle may help limit edema and venous stasis within the muscle, and therefore delay muscle fiber degeneration and fibrosis
  • recovery time following denervation appears to be shortened with appropriate electrical stimulation

Evidence Against

  • contraction of the denervated muscle may disrupt regenerating neuromuscular junctions and subsequently delay re-innervation
  • denervated muscle is more sensitive to trauma than innervated muscle, and electrical stimulation may further traumatize the denervated muscle
  • prolonged electrical stimulation until reinnervation occurs is not worth the financial and time costs involved
Physiological Effects
  • Stimulation of sensory nerve
    • The stimulation gives a stabbing or burning
    • There is reflex dialatation of the superficial blood vessels and consequent erythema of the skin
  • Stimulation of motor nerve
    • Stimulation of motor nerves produces contraction of muscles
    • Produces a brisk muscle teitch followed  by  immediate
Applications
  1. Constant direct currents are used for iontophoresis
  2. Ability to contract denervated
  3. Maintain the properties of muscle (irritability, contractability, extensibility)
  4. Retards the denervation
  5. Helps the muscle to utilize all the substances and maintain
  6. Improves absorption and activates pumping function of muscle
  7. Prevents venous and lymphatic
  8. Maintain the working hypertrophy of denervated
  9. Maintain the extensibility of the muscles. Improves local circulation.
  10. Prevents Contracture
  11. Intensity must be strong enough to produce the contraction
  12. 300 contraction for each muscle is desirable
  13. 90 contraction is minimum
Contradictions
  1. Placement of electrodes tangential to the heart
  2. Presence of a cardiac pacemaker
  3. Metal ions
  4. Presence of malignancy
  5. Placement of   electrodes   along regions of the phrenic nerve- (Adversely affect a reflex center)
  6. Placement of   electrodes over the  carotid sinus  or laryngeal musculature
  7. Houghton et indicate that NMES is contraindicated “anywhere” on pregnant women; however, there appears to be no evidence for this
Precautions
  • Adequate precautions should be taken for patients with heart
  • Placement of electrodes across the heart or transthoracically can cause an
  • The device should not be used over skin eruptions or swollen, infected or inflamed
  • Turn the unit off when applying or removing

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