High-voltage Pulsed Galvanic Stimulation Research Articles

A COMPARISON OF DIFFERENT QUADRICEPS FEMORIS ISOMETRIC STRENGTHENING METHODS IN HEALTHY YOUNG WOMEN

Purpose: This study was planned to compare the effectiveness of high voltage pulsed galvanic (HVPG) stimulation, Russian current and isometric exercise on quadriceps femoris (QF) isometric muscle strengthd in healthy young women. Methods: Forty-six healthy young women were included in the study. Before and after the training, the dominant side QF isometric muscle strength of participants was assessed with the isokinetic dynamometer. The peak torque and average torques of the participants were recorded after the test. The training was planned as HVPG current group (n=16), Russian current group (n=15) and isometric strengthening group (n=15). All treatments were performed under physiotherapist supervision for a total of 15 sessions for 3 days a week for 5 weeks. Results: No statistical difference was found between the groups when the peak torque and average torque delta values were compared (p> 0.05). Conclusion: The highest rate of change belongs to the HVPG group in terms of increasing the QF isometric muscle strength, therefore, we recommend that it is preferred in clinical practice.

Effect of High-Voltage Pulsed Galvanic Stimulation on Motor Development and Hamstring Spasticity in Diplegic Cerebral Palsy

Effect of High-Voltage Pulsed Galvanic Stimulation on Motor Development and Hamstring Spasticity in Diplegic Cerebral Palsy

Combination of Manipulation, Exercise, and Physical Therapy for the Treatment of a 57-Year-Old Woman With Lateral Epicondylitis

Objective This case report presents a simple systematic approach consisting of a 10-week specific sequential multimodal conservative management approach to chronic lateral epicondylitis. Clinical Features A 57-year-old female science teacher experiencing elbow pain for 5 months presented to our multidisciplinary clinic complaining of whole-arm pain extending to the wrist. Intervention and Outcome In the 10-week protocol, we used high-velocity and low-amplitude manipulation, high-voltage pulsed galvanic stimulation, a hard-padded elbow brace, ice, and exercise, along with restricted use of the affected elbow. The Patient-Rated Forearm Evaluation Questionnaire, currently named as the Patient-Rated Tennis Elbow Evaluation, was used for an outcome measurement. Overall, there was a systematic reduction of pain (92.86%), specific activity (100%), and usual activity (96.87%), and even after 3 weeks of follow-up, we did not notice significant changes in all of the data. Conclusions This case study showed the possible beneficial effects of the specific sequential multimodal treatment approach in a patient with resistant chronic lateral epicondylitis.

Short and Long-Term Results of Connective Tissue Manipulation and Combined Ultrasound Therapy in Patients with Fibromyalgia

Objective The aim of the study was to evaluate the short-term and 1-year follow-up results of connective tissue manipulation and combined ultrasound (US) therapy (US and high-voltage pulsed galvanic stimulation) in terms of pain, complaint of nonrestorative sleep, and impact on the functional activities in patients with fibromyalgia (FM). Methods This is an observational prospective cohort study of 20 female patients with FM. Intensity of pain, complaint of nonrestorative sleep, and impact of FM on functional activities were evaluated by visual analogue scales. All evaluations were performed before and after 20 sessions of treatment, which included connective tissue manipulation of the back daily, for a total of 20 sessions, and combined US therapy of the upper back region every other session. One-year follow-up evaluations were performed on 14 subjects. Friedman test was used to analyze time-dependent changes. Results Statistical analyses revealed that pain intensity, impact of FM on functional activities, and complaints of nonrestorative sleep improved after the treatment program ( P < .05). Conclusion Methods used in this study seemed to be helpful in improving pain intensity, complaints of nonrestorative sleep, and impact on functional activities in patients with FM.

Effect of high voltage pulsed galvanic stimulation on sacral transcutaneous oxygen tension levels in the spinal cord injured.

Evidence is mounting that spinal cord injured (SCI) persons may be at increased risk of pressure ulcers due to prolonged immobilization together with the injury-induced loss of sympathetic tone and decreased vascular resistance. With a view to developing a new method of preventing pressure ulcers, the objective of this study was to determine whether high voltage pulsed galvanic stimulation (HVPGS) could increase sacral transcutaneous oxygen tension (PtcO2) in SCI persons lying prone and supine. In experiment 1, HVPGS applied to the back at spinal level T6 led to a sustained, dose-related increase in sacral PtcO2 in 3 subjects lying prone. In experiment 2, carried out on 29 subjects lying supine on egg-crate mattresses, HVPGS (75 volts, 10 Hz) produced a 35% increase in sacral PtcO2, from a baseline level (Mean +/- SD) of 49 +/- 21 mmHg to 66 +/- 18 mmHg after 30 minutes of stimulation (F = 39.4, p < .00001). In experiment 3, simulated HVPGS was found to have no effect on sacral PtcO2 in 5 subjects lying supine. In experiment 4, HVPGS was repeated on 10 subjects and its effects found to be highly reproducible. It is hypothesized that HVPGS restores sympathetic tone and vascular resistance below the level of the spinal cord lesion, thereby increasing the perfusion pressure gradient in the capillary beds. Randomized controlled trials are now indicated to determine the efficacy of HVPGS for preventing pressure ulcers.

Electrical Stimulation in Clinical Practice.

In brief Four forms of electrical stimulation are clinically useful in the rehabilitation of injured athletes. These forms differ mainly in the way they combine the parameters of wave form, frequency, pulse width, and amplitude. Transcutaneous electrical nerve stimulation provides effective relief of both acute and chronic pain. High-voltage pulsed galvanic stimulation has several treatment indications, including pain, swelling, tissue injury, and infection. Interferential electrical stimulation is used for muscle relaxation, analgesia, and to promote soft-tissue healing. Minimal electrical noninvasive stimulation is purported to facilitate tissue healing. Electrical stimulation should be used In concert with other modalities for a complete rehabilitation program.

Electric stimulation of human fibroblasts causes an increase in Ca2+ influx and the exposure of additional insulin receptors.

Previously we reported that treating human fibroblasts in cell culture with high-voltage, pulsed galvanic stimulation (HVPGS) can significantly increase cellular protein and DNA synthesis (Bourguignon and Bourguignon: FASEB J., 1:398-402, 1987). In this study we have identified two of the early cellular events which occur following exposure to HVPGS: 1) an increase in Ca2+ uptake from the external medium and 2) an increase in the number of insulin receptors on the fibroblast cell surface. The increase in Ca2+ uptake begins within the first minute of electric stimulation while increased insulin binding is not detected until the second minute of stimulation. The HVPGS-induced increase in insulin binding can be inhibited by bepridil, a specific Ca2+ channel blocker, suggesting that the Ca2+ influx is required for the exposure of additional insulin receptors on the cell surface. Furthermore, we have determined that the addition of insulin to electrically stimulated cultures results in 1) an immediate, second increase in Ca2+ uptake and 2) significant increases in both protein and DNA synthesis compared to cells which were not stimulated. All three of these insulin-dependent effects are also inhibited by bepridil. Based on these results, we propose that HVPGS initially triggers the opening of voltage-sensitive calcium channels in the fibroblast plasma membrane. The increased level of intracellular Ca2+ then induces the exposure of additional insulin receptors, the fibroblasts will significantly increase both protein and DNA synthesis.

Accelerated Healing of Full-thickness Burns by the Use of High-voltage Pulsed Galvanic Stimulation in the Pig

An experimental study was designed using domestic pigs to evaluate the effect of high-voltage pulsed galvanic stimulation (HVPGS) on the rate of healing of full-thickness thermal burns. Twenty animals were used in the study; each one received two standardized burns over the paravertebral region. In half of the animals, HVPGS was performed daily for the study period. One of the burn wounds in each pig was used to evaluate wound contraction by measuring the wound surface weekly for four weeks. The second burn wound had weekly tissue biopsies to evaluate fibroblast population. The data showed a significantly faster rate of wound contraction (p less than 0.001) and a higher fibroblast response (p less than 0.001) in the HVPGS group when compared with controls.

Lymphocyte activation and capping of hormone receptors.

In this study both a ligand-dependent treatment [concanavalin A (Con A)] and a ligand-independent treatment [high-voltage pulsed galvanic stimulation (HVPGS)] have been used to initiate lymphocyte activation via a transmembrane signaling process. Our results show that both treatments cause the exposure of two different hormone [insulin and interleukin-2 (IL-2)] receptors within the first 5 min of stimulation. When either insulin or IL-2 is present in the culture medium, the stimulated lymphocytes undergo the following responses: (1) increased free intracellular Ca2+ activity; (2) aggregation of insulin or IL-2 receptors into patch/cap structures; (3) tyrosine-kinase-specific phosphorylation of a 32-kd membrane protein; and finally (4) induction of DNA synthesis. Further analysis indicates that hormone receptor capping is inhibited by (1) cytochalasin D, suggesting the involvement of microfilaments; (2) sodium azide, indicating a requirement for ATP production; and (3) W-5, W-7, and W-12 drugs, implying a need for Ca2+/calmodulin activity. Treatment with these metabolic or cytoskeletal inhibitors also prevents both the tyrosine-kinase-specific protein phosphorylation and DNA synthesis which normally follow hormone receptor capping. Double immunofluorescence staining shows that actomyosin, Ca2+/calmodulin, and myosin light-chain kinase are all closely associated with the insulin and IL-2 receptor cap structures. These findings strongly suggest that an actomyosin-mediated contractile system (regulated by Ca2+, calmodulin, and myosin light-chain kinase in an energy-dependent manner) is required not only for the collection of insulin and IL-2 receptors into patch and cap structures but also for the subsequent activation of tyrosine kinase and the initiation of DNA synthesis. We, therefore, propose that the exposure and subsequent patching/capping of at least one hormone receptor are required for the activation of mouse splenic T-lymphocytes.

Electric stimulation of protein and DNA synthesis in human fibroblasts.

Human fibroblast cell cultures were employed as a model system to rapidly examine several potentially important variables involved in the use of high-voltage, pulsed galvanic stimulation (HVPGS) to increase the healing rate of soft tissue injuries. Fibroblasts were grown on Millipore filters and exposed to HVPGS of various voltages and pulse rates for 20 min in a rectangular, plastic chamber filled with growth medium. Filters with attached cells were placed either in the center of the chamber or close to the positive or negative electrode. Protein synthesis and DNA synthesis were monitored after stimulation using the radioactively labeled precursors, [3H]proline and [3H]thymidine, respectively. The major results obtained in this study are as follows: 1) the rates of both protein and DNA synthesis can be significantly increased by specific combinations of HVPGS voltage and pulse rate; 2) maximum stimulation of protein and DNA synthesis was obtained at 50 and 75 V, respectively, with a pulse rate of 100 pulses/s and the cells located near the negative electrode; and 3) exposure to HVPGS intensities greater than 250 V (at all pulse rates and locations within the chamber) is inhibitory for both protein and DNA synthesis. In view of the results obtained in preliminary clinical studies on the use of HVPGS for the treatment of dermal ulcers, it appears that similar voltages, pulse rates, and relative electrode location may be required for maximum acceleration of human skin wound healing.

Skin pH following high voltage pulsed galvanic stimulation.

Prolonged electrotherapeutic treatment increases the probability of skin irritation beneath the electrodes. One probable cause is acid and base formation under the electrodes. It has been assumed that high voltage pulsed galvanic stimulators do not produce these chemical reactions. The validity of this hypothesis was tested on 40 healthy subjects. Three groups of subjects received stimulation with different high voltage pulsed galvanic units, and one group of subjects served as a control group. Pretreatment and posttreatment measures of skin pH revealed no chemical reaction under the electrodes.