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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
The Electro Physical Agents and Diagnostic Ultrasound (EPADU) group is a Professional Networks of the Chartered Society of Physiotherapy based in the UK.
The use of diadynamic therapy - another form of electrical stimulation - varies widely between different countries. It is, for example, relatively rarely used in the UK, whilst in mainland Europe it has a stronger following.
Most people consider it to be consideraably more uncomfortable than other forms of electrical stimulation (like TENS) and this is attributed to the long duration of the 'pulses'.
It is a monophasic pulsed current that was developed in the 1950's, and attributed to Bernard (a French Dentist). The carrier frequency is a sine wave, operating at 50Hz (or 60Hz USA) which is then rectified (full wave or half wave). The resulting monophasic pulses have a duration of 10 msec (milliseconds). In the diagram below, MF is a half wave rectification which will deliver 50 pulses per second, delivering 10ms pulses with a 10ms interval. DF is full wave rectification providing 100 pulses per second, each of which will be the same duration (10ms) but with a zero interpulse interval.
The more complex patterns (CP and LP) are derived from some manipulation of these two basec waveforms.
Given the long pulse duration, uncomfortable nature of the stimulation and minimal specific research, it is difficult to determine the actual advantage over any other kind of electrical stimulation at equivalent pulse frequencies.
The abbreviations used for these different currents relate to the original French terms : MF = monophase fixe : DF = diphase fixe : CP = courtes periodes : LP = longues periodes.
The Can et al (2003) study compared TENS with Diadynamic therapy for a group of patients with patellofemoral pain, showing that both therapies were effective (in terms of pain management) but that there was not significant difference between the two.
Most standard electrotherapy texts cover this therapy in a very superficial way, and a considerable proportion of the literature is not easily available in English - no reason why it should be - but it means that I have difficulty accessing it!!! Some key reference materials are copied below for your information. The original Bernard reference and Belanger book chpater (the most useful one I can find) are at the end of the reference list.
Bolel, K., S. Hizmetli, et al. (2006). "Sympathetic skin responses in reflex sympathetic dystrophy." Rheumatol Int 26(9): 788-91.
Can, F., R. Tandoğan, et al. (2003). "Rehabilitation of patellofemoral pain syndrome: TENS versus diadynamic current therapy for pain relief." The Pain Clinic 15(1): 61-68.
de Carvalho, A. R., E. M. Fungueto, et al. (2005). "Bernard's diadynamic currents and iontophoresis in low back pain treatment [Portuguese]." Fisioterapia em Movimento 18(4): 11-9.
Hamalainen, O. and Kemppainen, P. (1990). Experimentally induced ischaemic pain and so called diaphase fix current. Scand J Rehab Medicine 22; 25-27
Iudel'son Ia, B. and N. P. Gribova (1994). "[The diagnosis and treatment of cervical radiculomyeloischemia]." Zh Nevropatol Psikhiatr Im S S Korsakova 94(2): 55-9.
Iudel'son, I. B. and N. P. Gribova (1994). "[The diagnosis and treatment of cervical radiculomyeloischemia]." Zh Nevropatol Psikhiatr Im S S Korsakova 94(2): 55-9.
Izakson Kh, A. and D. S. Gimmel'farb (1970). "[Experience in the use of diadynamic electrical current in combination with the administration of novocaine by this means in neurologic practice]." Vopr Kurortol Fizioter Lech Fiz Kult 35(4): 361-2.
Kiseleva, S. S. and V. V. Dvurechenskii (2002). "[Experience in using diadynamic currents in patients with acute rhinitis]." Vopr Kurortol Fizioter Lech Fiz Kult(1): 43.
Kroeling, P., A. Gross, et al. (2005). "Electrotherapy for neck disorders." Cochrane Database Syst Rev(2): CD004251.
Kroeling, P., A. R. Gross, et al. (2005). "A Cochrane review of electrotherapy for mechanical neck disorders." Spine 30(21): E641-8.
Romanenko, S. G., O. P. Tokarev, et al. (2001). "[Electrostimulation of laryngeal muscles with fluctuating currents in the treatment of patients with unilateral laryngeal paralysis]." Vestn Otorinolaringol(3): 52-4.
Sadil, V. and S. Sadil (1994). "[Electrotherapy]." Wien Med Wochenschr 144(20-21): 509-20.
Theron, E. Vermeulen, A, (1983). The utilisation of transcutaneous nerve stimulation in postoperative ileus. S Af Med J 63;971-972
Tonazzi, A., C. Bertolini, et al. (1981). "[The use of diadynamic currents in minor sports injuries]." Arch Putti Chir Organi Mov 31: 195-205.
Zytkowski, A. (1999). "[Ectodermal method of Ryodorak--an attempt at clinical measurement for evaluation of physiotherapy effects in patients with low back pain]." Neurol Neurochir Pol 32 Suppl 6: 207-15.
ORIGINAL TEXT: Bernard, P. (1950). La therapie diadynamique. Les Editions Naim. Paris
Useful Book Chapters: the most useful book chapter on this topic that I have seen is in: Evidence Based Guide to Therapeutic Physical Agents. Alain-Yvan Belanger.2003. Lippincott Williams Wilkins (details on the BOOK pages)
A wide range of Electrotherapy Courses are delivered throughout the UK, Europe and Worldwide with varying content, aims and duration.
Current books on Electrotherapy with brief descriptions and links to Amazon pages for purchase.
Some common answers to the most frequently asked questions on Electrotherapy, particularly in the area of Contraindications.