The transfer of current through skin and muscle during electrical stimulation with sine, square, Russian and interferential waveforms.

Electrical stimulation is a commonly used modality for both athletic training and physical therapy. However, there are limited objective data available to determine the waveform which provides the maximum muscle strength as well as minimizing pain. In the present investigation, two groups of subjects were examined. Group 1 was composed of six males and four females and group 2 was composed of three male and three female subjects. The first series of experiments investigated muscle strength with stimulation at currents of 20, 40 and 60 milliamps using sine, square, Russian and interferential waveforms evaluating strength production and pain as outcomes. The second phase of experiments compared the effect of the different waveforms on current dispersion in surface versus deep muscle electrodes with these same waveforms. The results of the experiments showed that sine wave stimulation produced significantly greater muscle strength and significantly less pain than square wave, Russian or interferential stimulation at that same current. The most painful stimulation was square wave. Strength production was greatest with sine wave and least with Russian and interferential. An explanation of these findings may be the filtering effect of the fat layer separating skin from muscle. The highly conductive muscle and skin dermal layers would form the plates of a capacitor separated by the subcutaneous fat layer providing an RC filter. This filtering effect, while allowing sine wave stimulation to pass to the muscle, reduced power transfer in square wave, Russian and interferential stimulation is observed.