This articleneeds morereliable medical referencesforverificationor relies too heavily onprimary sources.(February 2009) |  |
Electrotherapyis the use ofelectrical energyas a medical treatment.[1]Inmedicine,the termelectrotherapycan apply to a variety of treatments, including the use of electrical devices such asdeep brain stimulatorsfor neurological disease. The term has also been applied specifically to the use of electric current to speed wound healing. The use of EMS is also very wide for managing muscular pain. Additionally, the term "electrotherapy" or "electromagnetic therapy" has also been applied to a range ofalternative medicaldevices and treatments. Evidence supporting the effectiveness of electrotherapy is limited.
| Electrotherapy | |
|---|---|
 SIS Super Inductive System electromagnetic therapy; used at a hospital inBudapest,Hungary | |
| MeSH | D004599 |
Medical uses
editElectrotherapy is primarily used in physical therapy for:
- relaxation ofmuscle spasms
- prevention and retardation of disuseatrophy
- increase of localblood circulation
- muscle rehabilitation and re-education
- electrical muscle stimulation
- maintaining and increasing range of motion
- management of chronic and intractable pain includingdiabetic neuropathy[2]
- acute post-traumatic and post-surgical pain
- post-surgical stimulation of muscles to preventvenous thrombosis
- wound healing[citation needed]
- drug delivery[citation needed]
There is limited evidence supporting electrotherapy.[3][4][5][6][7][8][9][10]Some of the treatment effectiveness mechanisms are little understood, with claims of their effectiveness and best practices for their use still anecdotal.
Musculoskeletal conditions
editIn general, there is little evidence that electrotherapy is effective in the management of musculoskeletal conditions.[3] In particular, there is no evidence that electrotherapy is effective in the relief of pain arising fromosteoarthritis,[4] and little to no evidence available to support electrotherapy for the management offibromyalgia.[5]
Neck and back pain
editA 2016 review found that, "in evidence of no effectiveness," clinicians should not offer electrotherapy for the treatment ofneck painor associated disorders.[6] Earlier reviews found that no conclusions could be drawn about the effectiveness of electrotherapy for neck pain,[11] and that electrotherapy has limited effect on neck pain as measured by clinical results.[12]
A 2015 review found that the evidence for electrotherapy in pregnancy-related lowerback painis "very limited".[7]
Shoulder disorders
editA 2014Cochrane reviewfound insufficient evidence to determine whether electrotherapy was better than exercise at treatingadhesive capsulitis.[8] As of 2004, there is insufficient evidence to draw conclusions about any intervention forrotator cuffpathology, including electrotherapy;[13] furthermore, methodological problems precluded drawing conclusions about the efficacy ofanyrehabilitation method forimpingement syndrome.[14]
Other musculoskeletal disorders
editThere is limited, low quality evidence for a slight benefit of noxious-level electrotherapy in the treatment ofepicondylitis. [15]
A 2012 review found that "Small, single studies showed that some electrotherapy modalities may be beneficial" in rehabilitating anklebone fractures. [9][needs update]However, a 2008 review found it to be ineffective in healing long-bone fractures.[16]
A 2012 review found that evidence that electrotherapy contributes to recovery from knee conditions is of "limited quality". [17]
Chronic pain
editA 2016 Cochrane review found that supporting evidence for electrotherapy as a treatment forcomplex regional pain syndromeis "absent or unclear."[18]
Chronic wounds
editA 2015 review found that the evidence supporting the use of electrotherapy in healingpressure ulcerswas of low quality,[19]and a 2015 Cochrane review found that no evidence that electromagnetic therapy, a subset of electrotherapy, was effective in healing pressure ulcers.[10]Earlier reviews found that, because of low-quality evidence, it was unclear whether electrotherapy increases healing rates of pressure ulcers.[20][21]By 2014 the evidence supported electrotherapy's efficacy for ulcer healing.[22]
Another 2015 Cochrane review found no evidence supporting the user of electrotherapy forvenous stasis ulcers.[23]
Mental health and mood disorders
editSince the 1950s, over 150 published articles have found a positive outcome in usingcranial electrostimulation(CES) to treat depression, anxiety, and insomnia.[24]
Contraindications
editElectrotherapy is contraindicated for people with:[25]
- medical implantsor stimulators like acardiac pacemaker
- certaincardiovascular diseases
- women who are pregnant
- deep vein thrombosis
- cognitive impairment
History
edit
The first recorded treatment of a patient by electricity was by Johann Gottlob Krüger in 1743.John Wesleypromoted electrical treatment as a universal panacea in 1747 but was rejected by mainstream medicine.Giovanni Aldinitreated insanity with static electricity 1823–1824.[26]
The first recorded medical treatments with electricity in London were in 1767 atMiddlesex Hospitalin London using a special apparatus. The same apparatus was purchased forSt. Bartholomew's Hospitalten years later.Guy's Hospitalhas a published list of cases from the early 19th century.[27]Golding Birdat Guy's brought electrotherapy into the mainstream in the mid-19th century.[28]In the second half of the 19th century the emphasis moved from delivering large shocks to the whole body to more measured doses, theminimum effective.[26]
Apparatus
edit
Electrotherapy equipment has historically included:
- Theelectric bathfor high-voltage static induction
- Oudin coil,a high-voltage induction coil, in use around 1900
- Faradic Battery,a device to provide localised electric stimulation
- Pulvermacher's chain,a wearable electrochemical device mostly used byquacks,in use second half of 19th century
- Leyden jars,an early form ofcapacitor,for storing electricity
- Electrostatic generatorsof various sorts
People
editSome important people in the history of electrotherapy include;
- Luigi Galvani,a pioneer of medical electricity
- Benjamin Franklin,an early proponent of electrotherapy who made it widely known, but mostly taken up by quacks and charlatans
- Golding Bird, mentioned above
- Charles Grafton Page
- Duchenne de Boulogne
- Jacques-Ar sắc ne d'Arsonval
- George Miller Beard
- Margaret Cleaves,a promoter ofozone therapy
- Many of theforms of electricityused in electrotherapy were named after scientists
Notable historic fringe practitioners
editMuscle stimulation
editIn 1856Guillaume Duchenneannounced thatalternatingwas superior todirect currentfor electrotherapeutic triggering of muscle contractions.[29]What he called the 'warming effect' of direct currents irritated the skin, since, at voltage strengths needed for muscle contractions, they cause the skin to blister (at theanode) and pit (at thecathode). Furthermore, with DC each contraction required the current to be stopped and restarted. Moreover, alternating current could produce strong muscle contractions regardless of the condition of the muscle, whereas DC-induced contractions were strong if the muscle was strong, and weak if the muscle was weak.
Since that time almost all rehabilitation involving muscle contraction has been done with a symmetrical rectangular biphasic waveform. During the 1940s, however, theU.S. War Department,investigating the application of electrical stimulation not just to retard and prevent atrophy but to restore muscle mass and strength, employed what was termedgalvanic exerciseon the atrophied hands of patients who had an ulnar nerve lesion from surgery upon a wound.[29]These galvanic exercises employed a monophasic (single-pulse) direct current waveform.
TheAmerican Physical Therapy Association,a professional organization representing physical therapists, accepts the use of electrotherapy in the field ofphysical therapy.[30][31]
See also
edit- Cranial electrotherapy stimulation
- Electrical brain stimulation
- Electroanalgesia
- Electroconvulsive therapy
- Electrotherapy (cosmetic)
- Galvanic bath
- Microcurrent electrical neuromuscular stimulator
- Neuromuscular diagnostics
- Pulsed electromagnetic field therapy
- Transcranial direct-current stimulation
- Transcranial magnetic stimulation
- Transcutaneous electrical nerve stimulation
- Vagus nerve stimulation
References
edit- ^Institute of Electrical and Electronics Engineers, "The IEEE standard dictionary of electrical and electronics terms".6th ed. New York, Institute of Electrical and Electronics Engineers, c1997. IEEE Std 100-1996.ISBN1-55937-833-6[ed.Standards Coordinating Committee 10, Terms and Definitions; Jane Radatz, (chair)]
- ^Pieber K, Herceg M, Paternostro-Sluga T (2010)."Electrotherapy for the treatment of painful diabetic peripheral neuropathy – a review".Journal of Rehabilitation Medicine.42(4): 289–295.doi:10.2340/16501977-0554.PMID20461329.
- ^abHurley MV, Bearne LM (2008)."Non-exercise physical therapies for musculoskeletal conditions".Best Practice & Research: Clinical Rheumatology.22(3): 419–433.doi:10.1016/j.berh.2008.01.001.PMID18519097.
- ^abSarzi-Puttini P, Cimmino MA, Scarpa R, Caporali R, Parazzini F, Zaninelli A, Atzeni F, Canesi B (2005). "Osteoarthritis: an overview of the disease and its treatment strategies".Seminars in Arthritis and Rheumatism.35(1 Suppl 1): 1–10.doi:10.1016/j.semarthrit.2005.01.013.PMID16084227.
- ^abSim J, Adams N (1999). "Physical and other non-pharmacological interventions for fibromyalgia".Baillière's Best Practice & Research: Clinical Rheumatology.13(3): 507–523.doi:10.1053/berh.1999.0041.PMID10562382.
- ^abCôté P, Wong JJ, Sutton D, Shearer HM, Mior S, Randhawa K, Ameis A, Carroll LJ, Nordin M, Yu H, Lindsay GM, Southerst D, Varatharajan S, Jacobs C, Stupar M, Taylor-Vaisey A, van der Velde G, Gross DP, Brison RJ, Paulden M, Ammendolia C, David Cassidy J, Loisel P, Marshall S, Bohay RN, Stapleton J, Lacerte M, Krahn M, Salhany R (2016). "Management of neck pain and associated disorders: A clinical practice guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration".European Spine Journal.25(7): 2000–2022.doi:10.1007/s00586-016-4467-7.PMID26984876.S2CID4417594.
- ^abGutke A, Betten C, Degerskär K, Pousette S, Olsén MF (2015)."Treatments for pregnancy-related lumbopelvic pain: a systematic review of physiotherapy modalities".Acta Obstetricia et Gynecologica Scandinavica.94(11): 1156–1167.doi:10.1111/aogs.12681.PMID26018758.
- ^abPage MJ, Green S, Kramer S, Johnston RV, McBain B, Buchbinder R (2014)."Electrotherapy modalities for adhesive capsulitis (frozen shoulder)".The Cochrane Database of Systematic Reviews.2014(10): CD011324.doi:10.1002/14651858.CD011324.PMC10898218.PMID25271097.
- ^abLin CW, Donkers NA, Refshauge KM, Beckenkamp PR, Khera K, Moseley AM (2012). Lin CW (ed.). "Rehabilitation for ankle fractures in adults".The Cochrane Database of Systematic Reviews.11:CD005595.doi:10.1002/14651858.CD005595.pub3.PMID23152232.
- ^abAziz Z, Flemming K (2015)."Electromagnetic therapy for treating pressure ulcers"(PDF).Cochrane Database Syst Rev.2015(9): CD002930.doi:10.1002/14651858.CD002930.pub6.PMC7138036.PMID26334539.
- ^Kroeling P, Gross A, Graham N, Burnie SJ, Szeto G, Goldsmith CH, Haines T, Forget M (2013)."Electrotherapy for neck pain".The Cochrane Database of Systematic Reviews.2013(8): CD004251.doi:10.1002/14651858.CD004251.pub5.PMC10696490.PMID23979926.
- ^Borenstein DG (2007). "Chronic neck pain: how to approach treatment".Current Pain and Headache Reports.11(6): 436–439.doi:10.1007/s11916-007-0230-4.PMID18173978.S2CID46620725.
- ^Grant HJ, Arthur A, Pichora DR (2004). "Evaluation of interventions for rotator cuff pathology: a systematic review".Journal of Hand Therapy.17(2): 274–99.doi:10.1197/j.jht.2004.02.013.PMID15162111.
- ^Michener LA, Walsworth MK, Burnet EN (2004). "Effectiveness of rehabilitation for patients with subacromial impingement syndrome: a systematic review".Journal of Hand Therapy.17(2): 152–164.doi:10.1197/j.jht.2004.02.004.PMID15162102.
- ^Dingemanse R, Randsdorp M, Koes BW, Huisstede BM (2014). "Evidence for the effectiveness of electrophysical modalities for treatment of medial and lateral epicondylitis: a systematic review".British Journal of Sports Medicine.48(12): 957–965.doi:10.1136/bjsports-2012-091513.PMID23335238.S2CID11549940.
- ^Mollon B, da Silva V, Busse JW, Einhorn TA, Bhandari M (November 2008). "Electrical stimulation for long-bone fracture-healing: a meta-analysis of randomized controlled trials".The Journal of Bone and Joint Surgery. American Volume.90(11): 2322–2330.doi:10.2106/JBJS.H.00111.PMID18978400.
- ^Button K, Iqbal AS, Letchford RH, van Deursen RW (2012). "Clinical effectiveness of knee rehabilitation techniques and implications for a self-care treatment model".Physiotherapy.98(4): 288–299.doi:10.1016/j.physio.2011.08.003.PMID23122433.
- ^Smart KM, Ferraro MC, Wand BM, O'Connell NE (2022-05-17)."Physiotherapy for pain and disability in adults with complex regional pain syndrome (CRPS) types I and II".The Cochrane Database of Systematic Reviews.5(8): CD010853.doi:10.1002/14651858.CD010853.pub3.ISSN1469-493X.PMC9112661.PMID35579382.
- ^Vélez-Díaz-Pallarés M, Lozano-Montoya I, Abraha I, Cherubini A, Soiza RL, O'Mahony D, Montero-Errasquín B, Cruz-Jentoft AJ (2015). "Nonpharmacologic interventions to heal pressure ulcers in older patients: an overview of systematic teviews (The SENATOR-ONTOP Series)".Journal of the American Medical Directors Association.16(6): 448–469.doi:10.1016/j.jamda.2015.01.083.PMID25737261.S2CID28533912.
- ^Reddy M (2011)."Pressure ulcers".BMJ Clinical Evidence.2011.PMC3217823.PMID21524319.
- ^Cullum N, Petherick E (2008)."Pressure ulcers".BMJ Clinical Evidence.2008.PMC2907959.PMID19450317.
- ^Barnes R, Shahin Y, Gohil R, Chetter I (April 2014). "Electrical stimulation vs. standard care for chronic ulcer healing: a systematic review and meta-analysis of randomised controlled trials".European Journal of Clinical Investigation.44(4): 429–440.doi:10.1111/eci.12244.PMID24456185.S2CID35060756.
- ^Aziz Z, Cullum N, Flemming K (2015)."Electromagnetic therapy for treating venous leg ulcers"(PDF).Cochrane Database of Systematic Reviews.2015(7): CD002933.doi:10.1002/14651858.CD002933.pub6.PMC6885063.PMID26134172.
- ^Cantor DS, Evans JR, eds. (2014).Clinical Neurotherapy.doi:10.1016/C2011-0-07624-X.ISBN978-0-12-396988-0.[page needed]
- ^Wu C (2018). "Physical Agent Modalities".Braddom's Rehabilitation Care: A Clinical Handbook.pp. 119–125.e11.doi:10.1016/B978-0-323-47904-2.00017-9.ISBN978-0-323-47904-2.
- ^abChalovich JM (23 January 2012).Franklinization: Early Therapeutic Use of Static Electricity.hdl:10342/3929.
- ^Steavenson, William Edward (1892).Medical electricity.Philadelphia: P. Blakiston, Son & Company. pp.3–4.
- ^Morus IR (1998).Frankenstein's Children: Electricity, Exhibition, and Experiment in Early-nineteenth-century London.Princeton University Press. pp. 234–237.ISBN978-0-691-05952-5.
- ^abLicht S (1967). "History of Electrotherapy".Therapeutic electricity and ultraviolet radiation.Waverly. pp. 1–70.OCLC901158561.
- ^Electrotherapeutic terminology in physical therapy.American Physical Therapy Association. 2001.ISBN978-1-887759-88-5.OCLC756896404.Archived fromthe originalon 2021-09-08.Retrieved2021-09-08.[page needed]
- ^Robinson AJ, Snyder-Mackler L (2008).Clinical electrophysiology: electrotherapy and electrophysiologic testing.Wolters Kluwer Health/Lippincott Williams & Wilkins. pp. 151–196, 198–237, 239–274.ISBN978-0-7817-4484-3.OCLC141177550.
External links
edit
- Irmak R (2020).Atlas of Electrotherapy -I: Waveforms and Electrode Placements for Cervical, Thoracic and Lumbosacral Regions.Rafet Irmak.ISBN978-605-89408-7-1.
- Tim Watson's site