Interferential current

Dr. Haitham Elessawy

Faculty of Physical Therapy

Electrotherapy 1 (PTBA 329)

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DEFINITION

• Non-invasive transcutaneous uses of two

alternating slightly out of phase medium
frequency (2000 to 5000Hz) sinusoidal current
to introduce low frequency (< 250Hz) current
used for therapeutic purposes.
PRINCIPLE

• the principle of IFT is to pass two Medium Frequency Alternating Currents

which are slightly out of phase, through the tissues, where the currents
intersect to produce a low frequency e ect.

• The superimposition of one alternating current on the other is called

interference

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Principles Of Wave Interference:

• Constructive interference: when two sinusoidal waves that

are exactly in phase or one, two or three wavelengths out of
phase, the waves supplement each other in constructive
interference

• Destructive interference : when the two waves are di erent

by 1/2 a wavelength (of any multiple) the result is
cancellation of both waves

• Continuous interference : Two waves slightly out of phase

collide and form a single wave with progressively increasing
and decreasing amplitude
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 Interferential Therapy Principle

Resistance of the skin is inversely proportional to the frequency of the stimulation.

The tissue impedance at

50Hz is 3200 Ώ
4000Hz is 40 Ώ

Why Interferential Therapy (IFT)

1. Associated with lower skin resistance
2. More comfortable & tolerable
3. Deep penetration For example, in muscles, tendons, nerves, bursae . Unlike galvanic,which has
more reaction in the skin and subcutaneous tissues, IFT is harmless

! Faradic and sinusoidal(low frequency currents) — very high skin impedanc

! Medium frequency currents ---- reduce skin impedanc

Working

• One of the alternating currents has a xed frequency of

4,000 Hz

• frequency of the other alternating current can be set

between 4,000 and 4,250 Hz or less than 4000 (varying
frequency).

• The frequency of the new medium-frequency alternating

current can be calculated as follows:

• Example:
• f1 = 4,000Hz f2 = 4,150 Hz
• f 1 - f2 = 4,000 - 4,150 = 150 Hz (AMF or treatment
frequency, beat freq)
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Amplitude modulated frequency
Current pathway pattern
Frequency Sweep

• Interference frequencies come in automatic pre selected modes with a

desired intensity at a constant/rhythmic level .

• Constant Beat Frequency :Constant difference between the two circuits and
this results in a constant beat frequency, If C1=4040Hz and C2=4000Hz,
BF=40Hz.

• Rhythmic Beat frequency: It is obtained when one carrier frequency

remains fixed and the other keeps on changing in frequency at regular
interval from lower to higher value and back down. It may take 10 seconds
to go up and 5 seconds to come down, it is known as Sweep , this sweep
prevents accommodations of the excitable tissue.
Sweep Principle :
• Rhythmical progression through full range of beat frequency
• automatically vary the effective stimulation frequency using either pre-set or
user set sweep ranges

• Such sweep prevents accommodation of nerves

• If rhythmical range of 0-100 Hz required, vary the freq of second circuit btw
3900-4000 Hz over a period of 5-10 second.
.

Physiological Effects This depends upon:

• 1) Magnitude of current
• 2) Type of mode used i.e. Rhythmic or constan
• 3) The frequency range used
• 4) Accuracy of electrode positioning

Physiological Effects Main clinical applications are

• 1. Pain relie
• 2. Muscle stimulation
• 3. Increased local blood o
• 4. Reduction of edema
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 Pain relief

• Local pumping effect

• Effect of autonomic nerves vasodilation
• 100 Hz or 80-100 Hz rhythmic large diameter ber
pain gait
• stimulation of the descending pain suppression system at
frequencies of 10-25 Hz
• or by blocking ‘c’ ber transmission AT > 50 Hz

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Muscle Stimulation

• For patients who can not generate useful voluntary contraction, IFT may be
bene cial.

• 1-100Hz commonly used Partial & complete tetany…??

• When employing IFT it is possible to continue to stimulate the muscle beyond
its point of fatigue. Some machines employ a ‘surged’ mode to overcome this.

• Most effective motor nerve stimulation range is between 10-25Hz

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Effects of blood flow

• Effects of blood ow is believed to be due to

1) Effects of suction electrodes on tissue
2) Effects of muscle stimulation on circulation.
3) Deep tissue penetration stimulates parasympathetic nerve bers
for increased blood ow. Experimentation demonstrated vascular
changes at 10-25Hz.
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EDEMA

• The use of suction electrodes may also be bene cial.

• Local muscle contraction combined with its local vascular
changes encourages the reabsorption of tissue uid
• 1-10Hz rhythmic

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Indications

• Pain
• Swelling
• Motor stimulation
• Stress incontinence

 CONTRAINDICATIONS
• 1. Cardiac pacemaker
• 2. Advanced cardiac disease
• 3. Hypertension
• 4. Thrombosis
• 5. Hemorrhag
• 6. Pregnancy
• 7. Neoplasm
• 8. Tb
• 9. Fever
• 10. Infections
• 11. The eyes
• 12. Skin disorders
• 13. Epiphyseal region in children

PRECAUTIONS

Burn May be due to:

1. Bar metal electrodes against skin

2. Increased intensity

3. Insu cient moisture pads

Hematoma May be due to: Suction force (negative pressure) may cause hematoma & ecchymosis

Poor results May be due to

1-Improper position of electrodes May be due to

2-Poor balanced circuit

3-Incorrect choice of frequency

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IFT Applications Parameters

• I-Stimulator types
1. Desk cabinet (lined –powered).

2. Portable (battery powered).

• II-Methods of delivery
1. Bipolar: for localized tissue
2. Quadripolar : for deeper tissue
3. Quadripolar with vector :for deeper tissue with enlarged area.

• III-Current modes
Constant current modes
Sweep current (rhythmic current modes)
Electrode types ( plate , Pen and vacuum)

Pad, rubber carbon-impregnated.

Large more comfortable /deep
Secure with straps/ Velcro
Flat smooth area
Not suitable for Irregular area

Vacuum or suction (rubber or metal ) electrodes.

Causing bruising of tissues
Secure
Flat smooth area
Irregular area
Not ideal for hairy area
IFT Applications Parameters
• Intensity of Current :use an intensity of current which produces a strong but comfortable prickling sensation without a muscular
contraction;

Steps to follow:

1) Increase current until the patient feels a de nite prickling, and leave for 1-5 minute for it to decrease.

2) Increase current again until the patient reports a slight muscular contraction, then decrease until contraction stops

• Duration of treatment:
•IFC usually applied for 10-20 minutes treatment at a normal intensity.

•Should not be given to one area for longer than 20 minutes

•If more than one area is to be treated a total time should not exceed 30 min.

• Frequency of Treatment
•In most cases, treatment every other day (i.e. 3/wk.) is ideal

•A course of 12-24 treatments is given(Use until IFT is no longer e ective)

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IFC advantages & disadvantages

• Advantages
1. More comfortable than TENS
a. Medium-frequency currents meet with less skin resistance than low frequency currents; TENS uses low
frequency currents
2. Stimulates tissues deeper than a TENS unit
3. Larger coverage area than TENS

• Disadvantages:
1-Eliminates pain; doesn't deal with cause of the pain
2. Few portable units available
3. Expensive
Placement of electrodes Position of electrode
Position of electrodes on knee
Quadripolar Method
Bipolar Method
Thank You

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