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Patient And Professional Guide To Selection Of Electrotherapy Electrodes
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The article is specifically written as an aid to help patients and professionals select electrodes for use with electrotherapy units during TENS, IFC, and EMS/NMES therapy. A short discussion of each style electrode is provided along with common decision factors that influence their selection.

The selection of electrodes for use in electrotherapy such as TENS, IFC, and EMS/NMES have become somewhat of a random process by healthcare professionals. Many healthcare professionals will admit they have limited or no knowledge of electrode design and their purchase of electrodes for use in their clinics are made exclusively because they have utilized the same electrode brand for many years, are given and thus use what is available, or simple economics. Their patients typically fare worse, possessing less clinical knowledge of the various treatment options available.

The importance of design is discussed in the articles “Electrode Design for Electrotherapy Applications” and the impact of design criteria is further discussed in the article “Not All Electrodes Are Created Equally.” Both articles are short and will provide both the patient (user) and medical professional important information.

The many varieties of electrodes used in TENS, IFC, and EMS/NMES therapy are discussed below. Each electrode type has certain benefits which are discussed. Patients should always consult with a medical professional before selection or use of any treatment method and device.

Electrode Types


Reusable electrodes can be a cost effective solution, especially for in-home use by the chronically ill.

However, because their use requires messy conductive gels and may require straps to secure their position, their usage is generally limited to the home or healthcare clinic. The additional use of preparatory skin cleaners is recommended to remove contaminants that may interfere with current conduction.

For professional healthcare providers such as Physical Therapists and chiropractors, choose reusable electrodes only when able to provide appropriate infection control procedures, decontaminating the electrodes completely between patient uses. For patient in-home use, it is important to consult with a medical professional before the use of reusable electrodes to determine if they are appropriate and to demonstrate proper use.

Choose reusable electrode:

• For frequent, multiple session per day, in-home therapy

• For clinical use when adequate infection control procedures and equipment are available for decontamination

• For patients with hyper-sensitivity to electrode removal as no adhesive is used

Carbon-Film Economy Electrodes

Carbon-film economy electrodes, especially those for TENS therapy, are an economic solution for many. Though they require the least up-front purchase cost, they are seldom the most economical when considering long term use. Most carbon-film only electrodes provide for between 1 to 5 uses. For this reason, they are generally chosen when a limited number of treatment sessions is anticipated. Healthcare professionals will find this type of electrode the best selection for patients with limited or infrequent treatment sessions where long-term storage of higher quality electrodes may suffer degradation.

Choose carbon-film economy electrodes:

• When a small number (1-5) treatment sessions is anticipated

• For clinical use on patients with limited treatment sessions

Solid Silver Conductive Layer Electrodes

Premium electrotherapy electrodes that contain a solid silver dispersive layer are regarded as the highest quality. Their unique design that utilizes a solid highly conductive dispersive layer ensures nearly all the current produced by the TENS, IFC, and EMS/NMES units are delivered to the patient. The deeper muscular penetration of the current produced by interferential current electrotherapy units may make these type of electrodes the optimal choice for IFC patients. The premium quality associated with this construction design sometimes includes higher-quality adhesive layers with thicker hydrogels, thus improving useful lifespan (up to 15 uses), and sometimes making them the most economical (when considering cost/use).

Choose solid silver layer conductive electrodes when:

• Maximum potential therapeutic effect is required

• Using TENS and IFC electrotherapy units on deeper injuries

• Cost/use may be beneficial

• Therapeutic effect of treatment appears to be limited and the use of higher quality electrodes may be beneficial

Hybrid Electrodes

Hybrid electrodes include those with a silver matrix (non-solid silver layer) or alternate platinum matrix dispersive layer. They may also include some electrodes that are designed with a chemical marker that changes color when the pH level of the electrode changes, producing a decrease in performance. These electrodes can be an economical choice for some patients.

Choose hybrid electrodes when:

• Their previous use has proved therapeutic

• Their cost/use appears is beneficial

• Therapeutic treatment using other electrode designs has not produced optimal results

Blue Hydrogel

Elderly patients and those with sensitive skin will find blue hydrogel designed electrodes to be the most comfortable choice. Discomfort during removal of electrodes, especially those of the carbon-fiber variety utilizing thinner adhesive layers, is a common complaint of TENS, IFC, and EMS/NMES therapy patients. Blue hydrogel electrodes are designed using a less tacky, more “gooey” adhesive layer that allows for more comfortable removal. Blue hydrogels can be found in carbon-film, solid-silver layer, and hybrid electrode designs.

Choose blue hydrogel electrodes:

• For patients with sensitive skin

For electrotherapy to be effective, device components and treatment decisions must work in concert with one another. The best electrotherapy components will not produce favorable treatment outcomes if improper settings are used, or when electrodes are incorrectly positioned. For these reasons, patients should always consult with a medical professional before making any healthcare related decisions.

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