Summary

Aussie Current is a kHz frequency burst modulated alternating current (BMAC) defined by the parameters; 1-kHz AC, 50-Hz bursts of 4ms duration and a 20% duty cycle (Ward, Robertson & Ioannou, 2004). Aussie Current, developed by Australian Dr Alex Ward, is used as a method of muscle strengthening by electrical stimulation.  This neuromuscular electrical stimulation (NMES) modality was based on the principles of Russian Current, a form of NMES which gained interest in the western world during the 1970's (Ward, Oliver & Buccella, 2006).

Waveforms Of Electrophysical Stimulation.



Aussie is a BMAC as seen in waveform C. (Ward, 2009). Click to enlarge image.


 These parameters were developed through research examining the effectiveness of a range of low- and medium range frequencies and duty cycles, investigating torque production against perceived participant discomfort and hypoalgesic effects.  The review of the literature provided evidence that Aussie Current is as effective as true interferential current (Ozcan, Ward & Robertson, 2004) and more effective than Russian Current when providing maximum electrically induced torque (MEIT) in healthy muscle (Ward, Oliver & Buccella, 2006). Aussie Current also proved to create less discomfort than pulsed current (PC), such as transcutaneous nerve stimulation (TENS), during MEIT (Ward, Oliver & Bucella, 2006).  In addition, Aussie Current was found to be equally effective as TENS for pain relief (Ward & Oliver, 2007) and functional electrical stimulation (FES) for muscle rehabilitation (Ward & Robertson, 2000). 

Although we could not find any specific precautions for the application of Aussie Current, it is similar to other forms of electrical stimulation and therefore similar contraindications would apply.  For example: Transthoracic applications, use within 3m of operating short wave diathermy equipment, pregnancy in the vicinity of the uterus, placed in the vicinity of an inbuilt stimulator or pacemaker, an unreliable patient, or undiagnosed pain (Robertson, Chipchase, Laakso, Whelan, & McKenna, 2001).

From the data gathered by the research conducted thus far Aussie Current shows promising applications for muscle strengthening in healthy muscle, injury rehabilitation and pain relief (Ward & Lucas-Toumbourou, 2007).

References

Ozcan, J., Ward, A. R. & Robertston, V. J. (2004). A comparison of true and premodulated interferential currents. Arch Phys Med Rehabil. 85: 409-415.
http://download.journals.elsevierhealth.com/pdfs/journals/0003-9993/PIIS0003999303004787.pdf

Robertson,V.J. Chipchase,L.S. Laakso, E.L. Whelan, K.M & McKenna, L.J. (2001). Guidelines for the clinical use of electrophysical agents. Australian Physiotherapy Association                 

Ward, A. R. (2009). Electrical stimulation using kilohertz-frequency alternating current. Physical Therapy. 89(2): 181-190.
http://search.proquest.com.libraryproxy.griffith.edu.au/docview/223112446/fulltextPDF?accountid=14543

Ward, A. R., & Lucas-Toumbourou, S. (2007). Lowering of sensory, motor, and pain-tolerance thresholds with burst duration using kilohertz-frequency alternating current electric stimulation. Arch Phys Med Rehabil. 88: 1036-1041.
http://download.journals.elsevierhealth.com/pdfs/journals/0003-9993/PIIS0003999307002973.pdf

Ward, A. R. & Oliver, W. G. (2007). Comparison of the hypoalgesic efficacy of low-frequency and burst-modulated kilohertz frequency currents. Physical Therapy. 87(8): 1056-1063.

http://search.proquest.com.libraryproxy.griffith.edu.au/docview/223117543/fulltextPDF?accountid=14543

Special Precautions and Contraindications

We could not find any specific precautions for the application of Aussie Current, however as this is similar to other forms of electrical stimulation the general contraindications indicated for these would also apply.  These are outlined in the APA Guidelines for the use of electrophysical agents.

Contraindications to electrical stimulation include;

• Transthoracic applications (antero-posterior thorax, arm to arm, leg to arm).
• Use within 3m of operating short wave diathermy equipment.
• Pregnancy in the vicinity of the uterus.
• Placed in the vicinity of an inbuilt stimulator or pacemaker.
• Unreliable patient.
• Undiagnosed pain.



APA Guidelines for EPA
To view full guidelines.



 

Precautions should be made with;

• Circulatory insufficiency.
• Risk of dissemination.
• Exacerbation of existing conditions.
• Unable to communicate.
• Sensory loss.
• Avoid applications over broken skin.
• Repeated uses of self-adhesive electrodes, electrode sponges and covers   can reduce their conductivity and necessitate higher stimulus intensities.

(Robertson, Chipchase, Laakso, Whelan, & McKenna, 2001)

Electrodes

As Aussie Current is a MFAC small electrodes should not be used (Robertson et al, 2001). In the studies conducted by Ward and colleagues on wrist extensor torque conductive rubber electrodes were used measuring 44 x 40mm. The electrodes were place so as to efficiently stimulate the wrist extensors, ensuring that the cathode was the distal electrode (Ward et al, 2006).

Depending on the target muscle electrode size and placement will vary, but it is important to ensure general safety precautions are adhered to.

References

Robertson,V.J. Chipchase,L.S. Laakso, E.L. Whelan, K.M & McKenna, L.J. (2001). Guidelines for the clinical use of electrophysical agents. Australian Physiotherapy Accociation                 

Ward, A. Oliver, W. Buccella, D. (2006). Wrist Extensor Torque Production and Discomfort Associated With Low-Frequency and Burst-Modulated Kilohertz-Frequency Currents. Physical Therapy, 2006(86). 1360-1367 Doi:10.2522/ptj.20050300
http://search.proquest.com.libraryproxy.griffith.edu.au/docview/223108762/fulltextPDF?accountid=14543

 

The Literature Behind Aussie Current

Aussie Current is a relatively new development compared with its counterpart, Russian Current.  As such, there is limited literature available on the effects of the specific parameters that define Aussie Current.  During our literature search we found only 3 studies, which used Aussie Current explicitly, investigating torque production (Ward, Robertson & Ioannou, 2003; Ward, Oliver & Buccella, 2006) and hypoalgesic efficacy (Ward & Oliver, 2007).  However, from indirect research exploring the analgesic effects (Ward & Lucas-Toumbourou, 2007) and fatigue (Ward & Robertson, 2000) across a range of kHz frequency in conjunction with background information regarding electrical stimulation (Ozcan, Ward & Robertson, 2004; Ward, 2009) it is evident that Aussie Current has been developed with a sound theoretical basis.  This has resulted in current parameters that maximise torque production whilst minimising participant discomfort.

The positive outcomes thus far of the effectiveness of Aussie Current prompts the further exploration comparing it to other electrical stimulation modalities such as TENS and FES in a variety of conditions, such as analgesic and rehabilitation properties respectively.  To further strengthen the validity of the results would be aided by the reproduction of Ward’s research by a third party.  It will be interesting to see how Aussie Current’s journey as a electrophysical agent continues and how it can be used clinically in the future.

References 

Ozcan, J., Ward, A. R. & Robertston, V. J. (2004). A comparison of true and premodulated interferential currents. Arch Phys Med Rehabil. 85: 409-415.
http://download.journals.elsevierhealth.com/pdfs/journals/0003-9993/PIIS0003999303004787.pdf

Ward, A. R. (2009). Electrical stimulation using kilohertz-frequency alternating current. Physical Therapy. 89(2): 181-190.
http://search.proquest.com.libraryproxy.griffith.edu.au/docview/223112446/fulltextPDF?accountid=14543


Ward, A. R., & Lucas-Toumbourou, S. (2007). Lowering of sensory, motor, and pain-tolerance thresholds with burst duration using kilohertz-frequency alternating current electric stimulation. Arch Phys Med Rehabil. 88: 1036-1041.
http://download.journals.elsevierhealth.com/pdfs/journals/0003-9993/PIIS0003999307002973.pdf

Ward, A. R. & Oliver, W. G. (2007). Comparison of the hypoalgesic efficacy of low-frequency and burst-modulated kilohertz frequency currents. Physical Therapy. 87(8): 1056-1063.
http://search.proquest.com.libraryproxy.griffith.edu.au/docview/223117543/fulltextPDF?accountid=14543

Ward, A. R., Oliver, W. G. & Buccella, D. (2006) Wrist extensor torque production and discomfort associated with low-frequency and burst-modulated kilohertz-frequency currents. Physical Therapy. 86(10): 1360-1367.
http://search.proquest.com.libraryproxy.griffith.edu.au/docview/223108762/fulltextPDF?accountid=14543

Ward, A. R. & Robertson, V. (2000). The variation in fatigue rate with frequency using kHz frequency alternating current. Medical Engineering and Physics. 22: 637-646.
http://www.sciencedirect.com.libraryproxy.griffith.edu.au/science/article/pii/S1350453300000850

Ward, A. R., Robertson, V. & Ioannou, H. (2004). The effect of duty cycle and frequency on muscle torque production using kilohertz frequency range alternating current. Medical Engineering and Physics. 26: 569-579.
http://www.sciencedirect.com.libraryproxy.griffith.edu.au/science/article/pii/S1350453304000700