High Voltage Pulsed Current (HVPC)
- Overview. High Voltage Pulsed Current (HVPC) has been used in therapy for many years (machines have been available since the 1940's), yet while in many countries it is highly popular, ...
- HVPC Waveform and Stimulation Parameters. ...
- HVPC Effects and Clinical uses. ...
- Summary. ...
- References. ...
What does hvpc stand for?
Overview High Voltage Pulsed Current (HVPC) has been used in therapy for many years (machines have been available since the 1940's), yet while in many countries it is highly popular, in other countries its use is minimal.
Is hvpc an effective treatment?
Summary HVPC has a varied popularity around the world, with pockets of high activity, and areas of minimal or even absent use. It does have an evidenced efficacy, though at the present time, this is most strongly associated with wound healing activity.
What is the evidence for the effectiveness of hvpc?
HVPC has a varied popularity around the world, with pockets of high activity, and areas of minimal or even absent use. It does have an evidenced efficacy, though at the present time, this is most strongly associated with wound healing activity.
What are the parameters of an hvpc system?
A 'typical' HVPC set of parameters are illustrated in Figure 2 below. In this case the pulse duration is set at 200µs, the interpulse interval is set at 9800µs and therefore 1 cycle will take 10000µs to deliver (which is 10ms - milliseconds). If 1 cycle takes 10ms to deliver, the stimulation frequency will be 100Hz.
Does electrical stimulation help healing?
ELECTRICAL STIMULATION can help speed wound healing by increasing capillary density and perfusion, improving wound oxygenation, and encouraging granulation and fibroblast activity. Several manufacturers make the high-voltage pulsed current simulator used for this therapy.
What is HVPC used for?
The primary purpose for administration of HVPC is to accelerate the healing process for cutaneous wounds. It is also used for prevention of edema formation, muscle reeducation, muscle spasm reduc- tion, and pain modula- tion.
What is Hi Volt E Stim?
High voltage electrical stimulation is a type of electrical stimulation that your physical therapist may use to help decrease your pain or improve circulation. It is also occasionally used to help with wound healing.
What is Hvpgs?
High –Voltage galvanic stimulation produces a high voltage current with a high peak intensity of a maximum of 300 to 400 ma but with a low frequency, very short duration ranging from 50-100msec. HVPGS is considered to be efficient in treatment of pain syndromes, relieving oedema and promot- ing wound healing.
What is HVPC therapy?
HVPC uses a safe electrical current and a special silver dressing to conduct an electrical signal in the wound. This signal stimulates the growth of cells to heal and close a wound • HVPC is also called Electrical Stimulation Therapy (EST), E-Stim or ES.
What is HVPC in electrotherapy?
Recent Advances: HVPC is a monophasic pulsed electric current that consists of double-peaked impulses (5–200 μs), at very high peak-current amplitude (2–2.5 A), and high voltage (up to 500 V), at a frequency of 1–125 pulses per second.
Can electrical stimulation cause nerve damage?
Generally, greater intensity, higher frequency, and longer pulse width stimulation lead to more severe damage in nerve cells (McCreery et al., 2004). In addition, although short-term electrical stimulation is not damaging to nervous tissue, chronic electrical stimulation can damage nerve structure.
Does electrical stimulation help nerve damage?
All experimental results indicated that electrical stimulation facilitates regeneration of injured nerve; direct stimulation caused better recovery than TENS with respect to functional and morphological parameters during the six weeks of the experiment.
Why do chiropractors use electrical stimulation?
Electrical stimulation works by providing electrical impulses to nerve endings in an area of injury. The stimulation soothes the nerve endings, provides pain relief, and may also increase blood flow to speed up healing in injured tissues.
What is a fes machine?
Functional electrical stimulation (FES) uses small electrical impulses to activate specific muscles and nerves. These impulses trigger the desired function, such as contracting muscles to move a foot or lift an arm.
What is Faradic current physiotherapy?
Faradic current is a short duration interrupted direct current with a pulse duration ranging from 0.1 to 1 ms with a frequency of 50 to 100 Hz. Faradic current is surged to produce tetanic contraction and relaxation of the muscle. Treatment with faradic current also known as faradism.
What are Diadynamic currents?
Diadynamic currents are also called Bernard's currents based on a sine wave with a frequency of 50Hz. Due to the ease of generation of this current shape, they have been known almost from the beginning of electrotherapy, and their influence on the human body has been thoroughly studied.
How do you set up a high volt estim?
1:042:42How to prepare for High Voltage Pulsed Current (HVPC)? - YouTubeYouTubeStart of suggested clipEnd of suggested clipSo the active lead is the lead that I'll use and change the polarity to negative the swellingMoreSo the active lead is the lead that I'll use and change the polarity to negative the swelling typically is charged with a negative polarity.
What are the different types of estim?
Different Types of Electrical Stimulation – The Name GameElectrical muscle stimulation (EMS)Russian electrical stimulation.Neuromuscular electrical stimulation (NMES)Functional electrical stimulation (FES)Transcutaneous electrical nerve stimulation (TENS)and many more…
When do you use Premod and estim?
Traditional Interferential Current (IFC) or Premodulated (PREMOD) IFC for Pain Relief. IFC has been shown to be effective for treating multiple types of pain in locations throughout the body. Both traditional IFC and PREMOD IFC can be done at sensory and motor levels.
What is the meaning of electrical stimulation?
Electrostimulation is a strategy for modulating the nervous system by electrical stimulation. It takes advantage of the mechanism of neural signaling the electrical and chemical means by which actional potentials are propagated, neurotransmitters are released, and neurons or target organs (e.g., muscle) are activated.
What is HVPC used for?
There are several key areas in which HVPC is employed clinically. The main two of these are for WOUND HEALING and PAIN MANAGEMENT. Additionally there are applications which have been advocated (and researched to a limited extent) for OEDEMA MANAGEMENT and MUSCLE
What is a high voltage pulsed current?
High Voltage Pulsed Current (HVPC) has been used in therapy for many years (machines have been available since the 1940's), yet while in many countries it is highly popular, in other countries its use is minimal. It is sometimes called 'Twin Peak Monophasic' which is more like a description of the machine output, and some authors include it in the Microcurrent group on the basis that the average current flow is almost certainly in the microcurrent range. HVPC will be used here as the preferred term for this modality.
Is HVPC effective for pain management?
There is generally less evidence available relating to the use of HVPC as a pain management tool, though it is certainly practiced (i.e. supported by the anecdotal evidence). One of the few studies which concludes that it is not effective as a pain management intervention was pblished by Akarcali et al (2002) who evaluated its use for patellofemoral pain. Patients were managed with either exercise alone or exercise together with HVPC over a 6 week period. There was a significant advantage the the HVPC group in terms of pain management early in the treatment phase (at 3 weeks), but there were no significant differences by the 6 week (end of treatment) assessment point. There was a quads strength increase in both groups, but not significantly different by the end of the trial period. HVPC therefore makes a significant contribution to early pain relief in this patient group.
Does a multifunction device have an HVPC?
As with other electrical stimulation modalities, most multifunction devices (examples of which are illustrated below) will include an HVPC mode somewhere in their menu system. Additionally, there are dedicated (some small and portable, some mains powered) HVPC devices available from several manufacturers (examples illustrated below).
Does HVPC help with oedema?
There have been several studies looking at the potential for HVPC to influence oedema formation post trauma and also oedema management once it has formed. Several of the papers are based on animal experimentation, and thus may not be directly applicable in the clinical environment until transfer of effect has been verified. Stralka et al (1998) did employ HVPC as a means to resuce chronic hand oedema, using a wrist splint with HVPC or splint alone. Treatment for 20 minutes daily resulted in significantly reduced pain and reduced oedema in the HVPC group.
What is a VFC?
The Vaccines for Children (VFC) program helps families of eligible children who might not otherwise have access to vaccines. The program provides vaccines at no cost to children ages 18 years and younger who are uninsured, Medicaid-eligible, or American Indian/Alaska Native. To learn more, see VFC program.
When was the HPV shot first recommended?
Since HPV vaccination was first recommended in 2006, there has been a significant reduction in HPV infections. Fewer teens and young adults are getting genital warts. HPV vaccine has also reduced the number of cases of precancers of the cervix in young women.
Can you get HPV while pregnant?
People who are pregnant. HPV vaccines are safe for children who are mildly ill – for example, with a low-grade fever of less than 101 degrees, a cold, runny nose, or cough. People with a moderate or severe illness should wait until they are better.
Does HPV cause soreness?
Many people who get HPV vaccine have no side effects at all. Some people report having very mild side effects, like a sore arm from the shot. The most common side effects of HPV vaccine are usually mild and include: Pain, redness, or swelling in the arm where the shot was given. Fever.
Mechanism
- Essentially, this stimulation modality employs a monophasic pulsed current, the pulses being delivered in a doublet (hence the 'twin peak' term). Each pulse is of short duration (typically less than 200µs), but, as the name implies, at a high peak voltage (up to 500V, typically 150-500V). B…
Variations
- There are several variations on the specific waveform employed in machines from different manufacturers. Some machines allow very little control over the pulse parameters whilst others enable variation of several key parameters.
Example
- A 'typical' HVPC set of parameters are illustrated in Figure 2 below. In this case the pulse duration is set at 200µs, the interpulse interval is set at 9800µs and therefore 1 cycle will take 10000µs to deliver (which is 10ms - milliseconds). If 1 cycle takes 10ms to deliver, the stimulation frequency will be 100Hz. Figure 2 : Basic parameters with example settings for HVPC Figure 3 : Illustration …
Operation
- If the therapist has the option to adjust the pulse frequency, the machine will automatically adjust the Interpulse Interval to enable the right number of (twin) pulses to be delivered per second.
Pathophysiology
- It is argued (see figure 3 below, from www.nervestudy.com) that although the pulses are high voltage (typically 150-500V), they are of very short duration (microsec) and thus the actual (averaged) current flow through the tissues will be low - in the microcurrent range (microamps).
Applications
- There are several key areas in which HVPC is employed clinically. The main two of these are for Wound Healing and Pain Management. Additionally there are applications which have been advocated (and researched to a limited extent) for Oedema Management and Muscle Strengthening. Each is briefly summarised below with links to essential research and references.
Trial
- A trial concerning the effects of HVPC was reported by Kloth and Feedar (1988). A group of 16 patients with stage IV decubitus ulcers were recruited for the trial and all had lesions that had been unresponsive to previous treatment. Patients were allocated randomly to a treatment group (n=59) or sham treatment)group (n=57). The ES consisted of monophasic twin-pulse stimulatio…
Prognosis
- All patients in the treatment group achieved complete healing of their ulcers (on average over 7.3 weeks at a mean healing rate of 44.8% per week). The control group patients did less well, with an increase in mean wound size of almost 29% between the first and last treatments. A subgroup of patients who were in the control group went on to complete a course of ES following the main tri…
Treatment
- A more recent study by Houghton et al (2003) involved 27 patients with a total of 42 chronic leg ulcers of varying aetiology (diabetic, arterial, venous) and employed a placebo controlled RCT design. Following initial assessment, there was a stable (baseline) period during which only conventional therapy was employed, followed by a 4 week treatment phase with the patients divi…
Functions
- There are many trial like those reported above. There is little doubt that HVPC has the capacity to influence wound healing in the clinical environment. There are several other forms of electrical stimulation which have also been demonstrated to have such an effect, and whilst they are 'supportable' from the published evidence, what is lacking is the critical comparative trial which …
Uses
- There is generally less evidence available relating to the use of HVPC as a pain management tool, though it is certainly practiced (i.e. supported by the anecdotal evidence). One of the few studies which concludes that it is not effective as a pain management intervention was pblished by Akarcali et al (2002) who evaluated its use for patellofemoral pain. Patients were managed with …
Resources
- Holcomb, W. et al (2007). \"Effect of the simultaneous application of NMES and HVPC on knee extension torque.\" J Sport Rehabil 16(4): 307-318.
Selected publications
- Houghton, P. E. et al (2003). \"Effect of electrical stimulation on chronic leg ulcer size and appearance.\" Phys-Ther. 83(1): 17-28. Kincaid, C. B. (1989). \"Inhibition of bacterial growth in vitro following stimulation with high voltage, monophasic, pulsed current.\" Physical Therapy 69: 651-655.
Literature
- Kloth, L. C. (2005). \"Electrical stimulation for wound healing: a review of evidence from in vitro studies, animal experiments, and clinical trials.\" International Journal of Lower Extremity Wounds 4(1): 23-44.