HIGH VOLTAGE
PULSE GALVANIC
STIMULATION
Dr. Fzt. Süleyman KORKUSUZ
High voltage currents
■ In 1945, Haislip and colleagues developed the first high voltage
stimulator .
■ The first clinical study on high voltage stimulators was published in the
early 1950s.
■ Its most important advantage over low voltage-medium amperage
devices is that it can be easily tolerated by the patient regardless of the
degree and type of nervous system lesion .
High voltage
High Voltage Pulsed
Galvanic galvanic
stimulation stimulation
(HVPGS)
Properties of current
Properties of current
1. Waveform : It has a monophasic waveform with double peaks .
2. Phase and pulse duration : 100-200 μ sec This short phase duration allows for
easier stimulation ; better differentiation between sensory, motor and painful
stimulation ; reduced skin impedance; unchanged skin pH ; and elimination of
known side effects of electrical stimulation on chemical and thermal reactions.
3. Interpulse interval : This interval is very long in high voltage stimulators . The
very short phase duration and the very long interpulse interval allow the body's
own homeostatic mechanism to continue, thus eliminating chemical and thermal
side effects.
4. Pulse intensity : Peak intensity usually reaches 500 V in high voltage
stimulators . Total current intensity is 1.5-2 mA. does not pass. In this case, it is
used very safely. Higher peak current also leads to greater penetration into the
tissue. Thus, it causes excitation of deeper localized nerves .
5. Frequency : Generally between 0.1-200 Hz . The wide frequency range allows
the application of different frequencies in different clinical applications .
6. Treatment time : Duration in application is 30-60 minutes varies between.
7. Treatment session : In wound treatment, the application is usually made daily
and 5-7 days a week . In edema and muscle spasm, the frequency of the session
varies according to the pathology. In general, treatments are applied daily or 3
days a week.
Properties of current
■ Low voltage treatments, especially iontophoresis or long-term electrical
stimulation, can cause skin irritation and burns.
■ In high voltage intermittent galvanic current devices, due to the low
current intensity of up to 1.5 mA and the extremely short pulse
duration (5-100 μsec), acid or base formation under the electrodes is
not very high, electrochemical reactions are very few or not seen at all.
■ In all studies based on low voltage neuromuscular stimulation, the
maximum voltage output is less than 150 V, the pulse duration rarely
falls below 2500 μsec, is generally longer, and contains monophasic or
biphasic waveforms. In high voltage stimulators, the voltage output is
between 15-500 V, and the pulse duration is below 100 μsec.
■ All high voltage stimulators deliver only direct current to the patient,
while low voltage stimulators deliver alternating current or direct
current, or a combination of both types of current.
Differences from low
voltage stimulators
■ It stimulates motor nerves.
■ It does not stimulate denervated
muscles.
■ It does not cause a chemical
reaction.
■ Although it goes deep, the
patient does not feel discomfort
because it selectively stimulates
sensory, motor and pain fibers.
SHORT
PULSE
DURATIO LOW
N CURRENT
INTENSITY
Purposes of use
■ Strengthening atrophied muscles or minimizing disuse atrophy,
■ Facilitating muscle reeducation,
■ Reducing pain,
■ Reducing edema,
■ Wound healing
APPLICATION
VARIOUS APPLICATION
PARAMETERS IN DIFFERENT DISEASES
■ Current type: Continuous pulses
■ Pole: It doesn't matter.
■ Pulse frequency: 50-120 Hz
PAIN
■ Current intensity: Sensory stimulation
■ Electrode placement: Monopolar or bipolar
technique
■ Treatment duration: Initially several sessions of 10-
60 minutes
VARIOUS APPLICATION
PARAMETERS IN DIFFERENT
DISEASES
■ Current type: Continuous pulses
■ Pole: It doesn't matter.
ACUTE
■ Pulse frequency: 80-150 Hz EDEMA
■ Current intensity: Sensory stimulation
■ Electrode placement: Monopolar or bipolar
technique
■ Treatment time: 20-30 min
VARIOUS APPLICATION
PARAMETERS IN DIFFERENT
DISEASES
■ Current type: Continuous pulses
■ Pole: Positive pole to the wound area
WOUND
■ Pulse frequency: 80-100 Hz
HEALING
■ Current intensity: Sensory stimulation
■ Electrode placement: Monopolar or bipolar
technique
■ Treatment duration: 20-30 minutes or 1 hour per
day or every other day
VARIOUS APPLICATION
PARAMETERS IN DIFFERENT
DISEASES
■ Current type: Surge / intermittent
■ Transition time: 3/3 sec or 6/6 sec or 4/12 sec
■ Pole: It doesn't matter.
■ Pulse frequency: 40-50 Hz
MUSCLE
■ 10-15 Hz (if isolated contraction cannot be obtained) STIMULATION
■ Current intensity: Optimal motor stimulation
■ Electrode placement: Monopolar / Bipolar technique
■ Treatment duration: Initially 20-30 minutes
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