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Presentation Objectives
Review of HVPS parameters and uses
What current and past literature exists
Effects of this modality on swelling and pain
Identify protocols to use in clinical practice
Interpulse interval
Resulting in a short pulse duration up to 200 sec
Belanger, 2010
Edema Management
Pain Modulation
Muscle Re-education and Spasm Reduction
Wound Management
Textbook Protocols
Edema Management
Negative Polarity
120 pps
Pain Modulation
Negative/Positive
Polarity
1-150 pps
Under Water or
Large Surface
90% VMT
Sweep or Target
Specific Area
Sensory Tolerance/
No VMT
Target Specific
Area
Moderate Visible
Muscle Contract.
Wound Management
Negative/
Positive Polarity
100 pps
Active Electrode
Over Wound
Sensory
Human Models
Healthy
Injured
TIPS
Questions?
Does HVPS Work?
If so.
Clinical Questions
Is HVPS Effective in the Treatment of Edema?
Is HVPS Effective in the Treatment of Pain?
Human Studies - 2
Discussion
Positive polarity study may not have been carried out
long enough to determine a treatment effect
Parameters
Negative Polarity
120 pps
90% VMT
Discussion
Treatment not applied immediately
Longer rest time in between treatments
Conclusions
Not long enough treatment time
Treatment not applied immediately post injury as
seen in animal models.
Conclusions
Conclusions
Results different from other human studies because
frequency was lower, muscle contraction intensity muscle
pump contraction, electrodes were not over edema site
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Sensory information
coming from A fibers
is transmitted to higher
centers in brain
Pain message" carried
along A & C fibers is
not transmitted to
second-order neurons
and never reaches
sensory centers
(Prentice, 2003)
Dynorphin
released
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Voight. 1984
HVPGS application s/p ankle injury
# of txs not given, 20 to 30 min tx times;
elevate limb, or place in cold H20 emersion
HVPS(+) or (-) 60 to 80 pps or varied
Sub motor contraction or pt tolerance
Author believes this to be effective in swelling and
pain reduction. 3 other references used that were
in this presentations literature review.
IN CLOSING..
What we have presented: The Evidence/Facts
1 part of EBP
References
1. Belanger A. Therapeutic electrophysical agents; the evidence behind
practice. Philidelphia, PA. Lippincott Williams and Wilkins. 2010.
2. Knight KC, Draper DO. Therapeutic modalities: the art and science.
Baltimore, MD. Lippincott Williams and Wilkins. 2008.
3. Taylor K, Mendel F, Fish D, Hard R, Burton H. Effect of high-voltage pulsed
current and alternating current on macromolecular leakage in hamster cheek
pouch microcirculation. Phys Ther. 1997;77(12):1729-1740.
4. Reed B. Effect of high voltage pulsed electrical stimulation on microvascular
permeability to plasma proteins. A possible mechanism in minimizing edema.
PhysTher.1988;68(4):491-495.
5. Voight M. Reduction of post traumatic ankle edema with high voltage
pulsed galvanic stimulation. AthlTrain.1984;19(4):278-279.
6. Walker D, Currier D, Threlkeld A. Effects of high voltage pulsed electrical
stimulation on blood flow. PhysTher.1988;68(4):481-485.
7. Heath ME; Gibbs S. High-voltage pulsed galvanic stimulation: effects of
frequency of current on blood flow in the human calf muscle. Clin
Sci.1992;82(6):607-613.
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References
References
15. Lamboni P, Harris BA. The use of airsplints, and high voltage galvanic
stimulation in effusion reduction. Athl Train. 1983; 18:23.
16. Voight ML. Reduction of post traumatic ankle edema with high voltage
pulsed galvanic stimulation. Athl Train. 1984;4:278-311.
17. Prentice WE. Therapeutic Modalities in Sports Medicine and Athletic
Training. 5th ed. New York: McGraw Hill;2003.
18. Mohr T, Carlson B, Sulentic C, Landry R. Comparison of isometric exercise
and high volt galvanic stimulation on quadricepts femoris muscle strength.
Phys Ther. 1985;65(5):606-609.
19. Tanrijut a, Ozara N, Kaptan HA, Guven Z, Kayhan O. High voltage galvanic
stimulation in myofascial pain syndrome. J Musc Pain. 2003;11(2):11-15.
20. Nourbakhsh MR, Fearon FJ. An alternative approach to treating lateral
epicondylitis; a randomized, placebo-controlled, double-blinded study. Clin
Rehab. 2008;22:601-609.
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