Current concepts in electrotherapy

Electrotherapy has an established role in the management of a wide range of musculoskeletal and neurological problems. Used in conjunction with other therapeutic interventions, it can make a positive contribution to patient care. The means by which a range of different exogenous energy forms can influence the physiological state of the tissue is well documented. Different therapeutic modalities achieve their effects in different tissues, and the clinical decision-making process should employ the available evidence in order to maximize the potential benefit for each patient. The applied energy essentially acts as a trigger that is responsible for stimulating, enhancing or activating particular physiological events, which in turn are utilized to achieve therapeutic benefit. There appear to be windows of opportunity related to the magnitude of the applied energy, the amplitude of the stimulus and the frequency of application. Tissues appear to vary in their responsiveness to these factors, and thus an appropriate modality applied in an inappropriate manner will fail to achieve the anticipated effect. This paper aims to review the current concepts of electrotherapy intervention, taking into account various theories which support the principles. Application of various energies in this way can result in significant benefit for the patient.

The role of electrotherapy in contemporary physiotherapy practice

Although electrotherapy has a well established role within physiotherapy practice, the current concepts that influence its application vary considerably from those proposed historically. It is argued that there is a place for electrophysical modalities in contemporary practice, and several basic principles are considered together with more specific information regarding two modalities namely, ultrasound and interferential therapy. Electrophysical agents are utilised to bring about physiological effects, and it is these changes which bring about the therapeutic benefit rather than the modality itself. Clinical decision protocols employing the available evidence should enable the most appropriate modality to be employed for a particular patient. Indiscriminate use of electrotherapy is unlikely to yield significant benefit, however used at the right time, it has the potential to achieve beneficial effect. The patient management programme which combines manual therapy, exercise therapy and electrotherapy, based on current evidence, should enable the most efficacious management of a patients' dysfunction. This paper aims to consider some of the current concepts in electrotherapy and to relate this to both general and specific treatments.