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The information on these pages is provided in good faith and should be treated as such. If you make use of the information, please acknowledge its source.

The International Society for Electrophysical Agents in Physical Therapy (ISEAPT) is a formal subgroup of the World Congress Physical Therapy (WCPT) and is the leading International organisation concerned primarily with Electro Physical Agents

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The Electro Physical Agents and Diagnostic Ultrasound (EPADU) group is a Professional Networks of the Chartered Society of Physiotherapy based in the UK.

Contraindications

There has been on ongoing controversy over the various and diverse contraindication for electrotherapy modalities over recent years. Many of the widely held beliefs in this area have been challenged in that there appears to be little by way of 'concrete evidence' for many and a lot of anecdotal evidence and supposition about some of the others. If you look in a selection of the major texts, they tend to provide a 'sircular reference list' in that they all X refer to each other without getting to grips with the original work.

A group, under the auspices of the Chartered Society of Physiotherapy in the UK have spent some time working through as much of the original evidence as we could find in order to establish what actually is and what is not a contraindication for the most commonly employed modalities. A group in Australia have undertaken a similar exercise.

The Contraindication Grid is probably the most useful quick reference guide, and although I used to have it up on the web page, it seems like this new format really does not like large tables, so have given up trying to reproduce in full here for the moment. It is still available as a download file (.pdf - good for printing if you want a copy for the department / clinic).

The information below is a summary of the CSP group outcomes (Bazin, S.et al. (2006). Guidance for the Clinical use of Electrophysical Agents. London, Chartered Society of Physiotherapy, also reproduced as a chapter in Electrotherapy: Evidence Based Practice. (2008) T Watson, Elsevier) - contact the CSP (www.csp.org.uk) if you want a copy - which is fully referenced. For copyright reasons, I can't reproduce it in full here.

Additionally, there was a set of Guidelines published recently in a special edition of the Canadian Physiotherapy Journal. I am not permitted to reproduce them here (copyright) but well worth a look if you are able to gain access : Houghton PE, Nussbaum EL, Hoens AM: Electrophysical Agents: Contraindications and Precautions. Physiotherapy Canada 2010;62(5) The Canadian document appears to b openly accessible from HERE. There was a similar paper in the Australian Journal some while back (Robertson, V. J., L. S. Chipchase, et al. (2001). Guidelines for the use of Electrophysical Agents. Victoria, Australia, Australian Physiotherapy Association) and I gather they are currrently being revisited - will post an update when it appears.

Laakso and Young (Laakso, E.-L. and C. Young (2010). "Electrophysical agents (EPAs) for symptom control in cancer care–what is the evidence?" Physical Therapy Reviews 15(4): 334-343) provide an excellent narrative review of the controversy re the use of Electro Physical Agents in cancer care which you are strongly encouraged to access (looks like you can get if for FREE at:  http://bit.ly/1tyucTF)

I have a lot of additional material that I am trying to pull together to explain some of the commonly held misconceptions with regards the contraindications, precautions and dangers relating to electrophysical agents, but in the meantime, the grid that follows will provide a quick and easy summary about the key issues.

A version of the grid - in FRENCH - can be downloaded HERE. My thanks to Evan O'Neil. My French is pathetic, so I can not verify the translation, though I have no reason to doubt it.

 

Notes

Where there is no entry in a popup grid, it means that there is no known / demonstrated detrimental effect.

Where an entry relates to a 'LOCAL CI' in relates to whether the applied energy would reach the tissue in question.

The current issues regarding the use of TENS during pregnancy is dealt with in some considerable detail in a specific TENS During Pregnancy document which can be obtained from the download page.

Click on a title below to see its Contraindication popup grid.

Non Thermal Applications


Ultrasound (non thermal)

Laser Therapy

Pulsed Shortwave (Low dose, non thermal application)

Electrical Stimulation


TENS

Interferential

Other Low Frequency (e.g. muscule stim, diadynamics etc)

Heat


Infra Red

Wax

Shortwave (continuous, thermal)

Ultrasound (continuous / thermal)

Microwave

Hot Pack

Others


Biofeedback (with no adjunctive stim)

Cold Therapy

Ultraviolet Radiation

Resources

Courses

Courses

A wide range of Electrotherapy Courses are delivered throughout the UK, Europe and Worldwide with varying content, aims and duration.

Books

Books

Current books on Electrotherapy with brief descriptions and links to Amazon pages for purchase.

FAQs: Prof. Tim Watson

FAQs: Prof. Tim Watson

Some common answers to the most frequently asked questions on Electrotherapy, particularly in the area of Contraindications.