Faradic stimulation for foot drop or Galvanic? A debate

One of my readers rightly asked me a question of “whether we should go for faradic stimulation or galvanic stimulation for foot drop and why”? This made me write this article on faradic stimulation for foot drop or galvanic? A debate.

After lots of brainstorming, searches and my personal knowledge and experience. Views expressed here are solely mine. It does not have any research data to back.

In one of our previous article “Foot Drop and its Physiotherapy management“, we have covered everything related to foot drop. We have discussed the different causes, its complications, and its management. We already know that electrical stimulation of foot dorsiflexor (tibialis anterior muscle) is an important part of the treatment.  

Let’s try to find out whether faradic or galvanic stimulation for foot drop.

Faradic and galvanic stimulation

Although both galvanic type current and faradic type current are used for the same purpose still there’s a difference between faradic and galvanic current. Galvanic current is interrupted direct current and is used for the treatment of denervated muscle.

Denervated muscle is the paralysis condition of muscle, where there is left no nerve connection to muscle. Faradic stimulation is given for muscle paresis conditions. In muscle paresis, there is partial nerve supply to the muscle. It is also called partially innervated muscle.

Denervated and partially innervated muscle

Denervation can be at CNS (central nervous system) level or PNS (peripheral nervous system)level. In severe brain damage is the perfect example of denervation at CNS level. In this case, the limbs may get totally paralysed. There will no sign of slightest of flickering movement.  

Denervation at a peripheral level may happen during fracture of the bone, or accidental injury during the surgery. I have seen a wrist drop case due to complete radial nerve injury at elbow due to fracture of the elbow joint.  

Same as the denervation, partial damage (partial innervation) of the nerve can happen both in CNS level and PNS level. But, there will be some movement or flickering movement in the limbs.

Faradic stimulation for foot drop or Galvanic

Foot drop also can happen due to CNS damage or PNS damage.   So before making any decision on giving faradic or galvanic stimulation, one should learn the full history of the patient. They should look for the sign of movement in the foot.  

In a hemiplegic or traumatic brain injury case, if you find that the foot does show any movement, then I suggest you go for galvanic stimulation or vice versa. As the treatment progresses, if you achieve minimal movement, then you should switch over to faradic stimulation.  

In peripheral nerve damage of peroneal nerve (can be due to fracture at the knee), look for whether it’s partial or complete nerve damage. Check the nerve investigation report, such as the NCV (nerve conduction velocity) test. Based on the finding, make you clinical decision.  

Final word

Though this has worked for me, not all severe foot drop case has shown improvement. It’s upon the reader to take an informed decision. So, what do you think? Please drop your opinion below.

Sunit. S. Ekka

Dr Sunit Sanjay Ekka is a physiotherapist in practice for the last 15 years. He has done his BPT from one of the premium Central Government physiotherapy colleges, ie, SVNIRTAR. The patient is his best teacher and whatever he gets to learn he loves to share it on his Youtube channel and blog.