Low frequency stimulation, Faradic Foot Bath, Faradism Under Pressure, Faradism Under Tension, Stimulation to Pelvic Floor Muscles, Physiotherapy

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Low Frequency Stimulation
Specialized Techniques

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Faradic Foot Bath

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Bath Method
● Application of faradic current to the body parts in a tub,
tray or tank containing water is termed as bath method of
application
● Depending upon the placement of electrodes bath can be
● Bipolar : both electrodes are kept in the water
● Unipolar : one electrode kept in the water while the
other electrode kept at any convenient part of the body

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Bath Method
• Advantage of bath method are:
● Skin resistance is lowered considerably by prolonged soaking in
water
● Water makes perfect contact with the tissues
● Wash of electrolytes formed under the electrodes
• Disadvantages are:
● Current can not be localized
● Superficial muscles contract more than deep muscles due to the
presence of water
● Chances of electric shock is higher

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Faradic Foot Bath
● ES by faradic current may be applied in baths.
● Can be used to stimulate
● Lumbricals
● Plantar interrossei
● Abductor hallucis

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Lumbricals
Origin Medial borders of long flexor tendons
Insertion Proximal phalanges and extensor tendons of the 4 lateral toes
Nerve Supply medial and lateral plantar nerves (S3)
Actions Flexes metatarsophalangeal joints, extends interphalangeal joints
https://en.wikipedia.org/wiki/Lumbricals_of_the_foot

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Plantar interrossei
Origin Metatarsals, long plantar ligament
Insertion Medial side of Proximal phalanges of 3rd to 5th toe
Nerve Supply Lateral plantar nerve
Actions adduct toes
https://en.wikipedia.org/wiki/Plantar_interossei_muscles

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Abductor hallucis
Origin Medial process of calcaneal tuberosity, Plantar aponeurosis, Flexor
retinaculum
Insertion Medial aspect of base of 1st phalanx of hallux
Nerve Supply Medial plantar nerve
Actions Abducts hallux
https://www.kenhub.com/en/library/anatomy/abductor-hallucis-muscle

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Faradic Foot Bath
● Position the patient in high sitting with back well supported
● Position the feet on a stool covered with a plastic sheet
● Place the foot in a bath containing enough warm water to
cover the toes

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Faradic Foot Bath
To stimulate the lumbricals
place two electrodes
transversely,
• one under the heel
and the other
• under the metatarsal
heads

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Faradic Foot Bath
To stimulate the plantar
interossei place one electrode
on each side of the foot at the
level of metatarsal shafts

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Faradic Foot Bath
For Abductor hallucis
place
• one electrode under the
heel and
• stimulate the muscle
through the motor point
using a pen electrode

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Faradic Foot Bath
● A surged faradic current is used for this
● Surge duration 1 sec.
● Surge interval 3 sec.
● Intensity : enough to produce a visible contraction of the
muscles.
● Treatment time: 15 – 30 minutes

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Faradic Foot Bath
● Rectangular metal or carbon rubber electrodes of 3 X 7 cm
can be used
● No lint pad or coupling medium required
● Encourage the patient to contract the muscle voluntarily
with the current

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Faradism Under Pressure

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Faradism Under Pressure
● ES of muscle combined with compression and elevation of
the limb can be used to increase venous and lymphatic
drainage and so to relieve edema.
● This technique is known as Faradism Under Pressure
● "Increased venous and lymphatic return is brought about
by the pumping action of the alternate muscle contraction
and relaxation.“ (Clayton, 1959.)
● "The contraction causes an inward pressure on the tissue
spaces and veins and so propels fluid towards the heart.
(Savage,1960.)

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Faradism Under Pressure
● Patient in supine position
● The limb is elevated above the heart level using pillows
● The pressure bandage is applied over the electrode, with
maximum pressure distal to proximal
● The skin must be cleaned before treatment

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Faradism Under Pressure
• Placement of electrode for lower limb:
• Active electrode place over the belly of the calf muscle
• Passive electrode is placed over the sole of the foot
• Placement of electrode for upper limb:
• Active electrode over the flexor aspect of forearm at the
junction of proximal 1/3 and distal 2/3 of the muscle
belly
• The passive electrode over the palm or cubital fossa

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Faradism Under Pressure
• A surged faradic current is used for this
• Surge duration 3 sec.
• Surge interval 9 sec.
• Intensity : enough to produce a visible contraction of the
muscles i.e. clenching of toes or fingers.
• Treatment time: 15 – 30 minutes

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Faradism Under Pressure
● Rectangular metal or carbon rubber electrodes of 3 X 5
cm. can be used
● Encourage the patient to do active movement along with
the current and relax during surge interval

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Faradism Under Tension

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Faradism Under Tension
● Shortening of contractile soft tissues like muscles can be treated with
Faradism.
● Such contractures develop in major muscle groups like quadriceps
or elbow flexor group
● This is mostly after prolonged immobilization
● These conditions are passively mobilized which can be very painful.
● Titanic contraction by the surged current gradually pulls apart the
shortened myofibrils with less pain.
● So this can be an effective adjunctive with passively mobilization.

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● A surged faradic current is used for this
● Surge duration 3 sec.
● Surge interval 9 sec.
● Intensity : enough to produce a visible contraction of the
muscles.
● Treatment time: 15 – 30 minutes
Faradism Under Tension

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Faradism Under Tension
● Rectangular metal or carbon rubber electrodes of 5 X 10
cm can be used.
● Encourage the patient to do actively contract the muscle
along with the current and relax during surge interval

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Faradism Under Tension
• For quadriceps contracture:
• Patient is positioned on a plinth.
• A roll of towel or pillow is placed below the knee to give a
stretch
• Passive electrode is placed over proximal 1/3 of the
quadriceps
• Active electrode is placed on the junction of proximal 2/3
and distal 1/3 of the belly of the muscle

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Faradism Under Tension

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Faradism Under Tension
• For elbow flexor contracture:
• Patient is positioned on a plinth.
• A roll is placed under the elbow just proximal to the joint.
• Passive electrode is placed over proximal 1/3 of the elbow
flexor
• Active electrode is placed on distal 1/3 of the belly of the
muscle

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ES to Pelvic Floor Muscles

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ES to Pelvic Floor Muscles
● ES can be used for reeducating these muscles.
● Indications are;
● Early cases of prolapse of pelvic organs
● Stress incontinence
● Incontinence following prostatectomy

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ES to Pelvic Floor Muscles
● Position the patient in side lying
● Keep a pillow between the lower legs
● Place a plastic sheet under the patient
● The indifferent electrode to the lumbosacral region
● Insert the Active vaginal or rectal electrode
● Sterilized lubrication jelly should be applied on vaginal or rectal
electrode
● A large button electrode can also be used over the perinea region

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ES to Pelvic Floor Muscles
● A surged faradic current is used.
● Surge duration 1 sec.
● Surge interval 3 sec.
● The muscles of pelvic floor fatigue fast, so surge duration should be
short
● Intensity : enough to produce a visible contraction of the muscles.
● Treatment time: 15 – 30 minutes
● Encourage the patient to actively contract the muscles along with the
current and relax during surge interval

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References
1. Foster A, Palastanga N. Clayton’s Electroptherapy Theory and
Practice. 9th edition. W B Saunders. 2006;pp 70 – 79
2. Mitra PK. Handbook of Practical Electrotherapy. Jaypee. 2006; pp 44
– 49
3. Khatri S. Basics of Electrotherapy. Jaypee. 2003. pp 28 - 30

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