High Volt Pulsed Current (HVPC)

- HVPC is used for

wound healing, edema reduction (acute & chronic)

- Polarity effects: cell attraction via galvanotaxis:

process in which cells with positive or negative charge are attracted to an electric field of opposite polarity.
Opposite charges attract
Like charges repel
Neutrophils, macrophages attracted to positive pole of stimulating electrode
Fibroblasts & epidermal cells attracted to negative pole of stimulating electrode

- Electrode setups:

monopolar:

(1 small, 1 larger electrode) used when focus of treatment is over a wide/long area: edema reduction/tissue healing; sensory-level

- Electrode setups:

bipolar:

(2 electrodes the same size)
used with motor-level edema reduction

- Acute edema protocols:

Intensity: sensory level (strong tingling)
Pulse Frequency: 100-120 pps
Pulse Duration: pre-set in unit (50-100 μsec)
Polarity: negative (-) over injured tissues
Duty Cycle: continuous
Pearl: initiate ASAP after onset of trauma for best success
Electrode Placement: *monopolar with dispersive electrode placed proximal 2 options for treatment electrode
1)immersion of hand in water
2)active electrode distal (red) lead wire; dispursive proximal (black)
Treatment Duration:
Four 30 min. treatments each followed by 30-60 min. rest
Goal is to use HVPC until edema decreases then discontinue

- chronic edema protocols

Intensity: strong, but comfortable muscle contraction (twitchy).
Avoid joint movement that is contraindicated
- Pulse Frequency:low 5-10 pps
- Pulse Duration: pre-set in unit (100-200 μsec)
- Polarity: negative
- Duty Cycle: 1:1 (i.e. on 10 sec./off 10 sec.)
- Electrode Placement:
Bipolar: proximal and distal ends of the major muscle
OR
proximal to the edematous area
- Pearl: apply Rest Ice Compression Elevation (RICE) with HVPC
Goal is to use HVPC until edema decreases then discontinue
- Clinical evidence and limitations (reimbursement)