Electrotherapy is the use of electrical energy as a medical treatment. Electrotherapy (or Electro Physical Agents – EPA’s) comprise a wide variety of treatment methods for several indications and conditions like electrical currents, short- and microwave and ultrasound. In this "Electrotherapy" section we limit the scope to electrical currents for therapeutics purposes. that is:

• Interferential Currents
• Biphasic Pulsed Currents (TENS)
• Premodulated currents
• Russian Stimulation
• Micro Currents
• High Voltage
• Diadynamic Currents
• Galvanic Currents
• Faradic Currents

These current forms in Enraf-Nonius electrotherapy equipment are primarily designed for pain management, muscle stimulation and tissue regeneration.

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Indications Electrotherapy

All

• Pregnancy (do not apply anywhere over abdomen/pelvic region). Safety has not been established for the use of therapeutic electrical stimulation during pregnancy.

Pain Management

• Symptomatic relief of chronic, intractable pain. Management of pain associated with post-traumatic or postoperative conditions.

Muscle Stimulation

• Relaxation of muscle spasms
• Prevention or retardation of disuse atrophy
• Increasing local blood circulation
• Muscle re-education
• Immediate post-surgical stimulation of calf muscles to prevent venous thrombosis
• Maintaining or increasing range of motion
• Dysphagia

Contraindications Electrotherapy

Pain management

• This device should not be used for symptomatic pain relief unless etiology is established or unless a pain syndrome has been diagnosed.
• This device should not be used on patients with demand-type cardiac pacemakers.
• This device should not be used over cancerous lesions.
• Electrode placements that apply current to the carotid sinus region (anterior neck) must be avoided.
• Electrode placements that apply current trans cerebrally (through the head) must be avoided.
• Electrode placements that apply current trans thoracically (the introduction of electrical current into the heart may cause cardiac arrhythmias) must be avoided.

Muscle stimulation

• This device should not be used on patients with demand-type cardiac pacemakers
• This device should not be used over cancerous lesions
• Electrode placements that apply current to the sinus carotid region (anterior neck) must be avoided (*)
• Electrode placements that apply current trans cerebrally (through the head) must be avoided.
• Electrode placements that apply current trans thoracically (the introduction of electrical current into the heart may cause cardiac arrhythmias) must be avoided.

Note (*) However, the application area for the treatment of Dysphagia is distant enough from the sinus carotis area, when the therapist follows the guidelines as described in the therapy book "Dysphagia (by H.C.A. Bogaardt SLP, PhD)"

Precautions and warnings Electrotherapy

Pain management

• Benefits of TENS currents have not been established for pain of central origin.
• This device is to be used as a symptomatic treatment for pain and has no curative value. Patients should be cautioned and their activities regulated if pain that would otherwise serve as a protective mechanism is suppressed.
• The long-term effects of chronic electrical stimulation are unknown.
• Safety has not been established for the use of therapeutic electrical stimulation during pregnancy.
• Stimulation should not be applied over swollen, infected, or inflamed areas of skin eruptions e.g., phlebitis, thrombophlebitis, varicose veins, etc.
• Isolated cases of skin rash may occur at the site of electrode placement following long-term applications. The irritation may be reduced by use of an alternate conductive medium or an alternative electrode placement.
• Effectiveness of this treatment is dependent upon patient selection.
• See also chapter 9 for general warnings and precautions.

Muscle stimulation

• The long-term effects of chronic electrical stimulation are unknown.
• Safety has not been established for the use of therapeutic electrical stimulation during pregnancy.
• Stimulation should not be applied over swollen, infected, or inflamed areas of skin eruptions e.g., phlebitis, thrombophlebitis, varicose veins, etc.
• Adequate precautions should be taken when treating individuals with suspected or diagnosed heart problems, or epilepsy.
• Caution should be used when there is a tendency to hemorrhage following acute trauma or fracture.
• Caution should be used following recent surgical procedures when muscle contraction may disrupt the healing process.
• Caution should be used over the menstruating uterus.
• Caution should be used over areas of the skin which lack normal sensation.
• Some patients may experience skin irritation or hypersensitivity due to electrical stimulation or electrical conductive medium. The irritation can usually be reduced by using an alternative conductive medium, or alternate electrode placement.

Please consult the Instructions for Use for more information on indications and contra-indications and for warnings and recommendations.

The above indications and contra-indications originated from the 4-Series Operating Instructions EN 1498751-47.