Electrical currents play a varied role in physiotherapy, helping stimulate high brain centers, improve organism energy resources, accelerate metabolism, and positively affect other systems like the CNS and autonomic nervous systems . The main types of electrical currents used in physiotherapy include: 1. Direct current, used in galvanization and drug electrophoresis, beneficial for localized treatments and drug delivery . 2. Impulse current, advantageous for preventing adaptation and reaching deeper tissues through therapies like electrosleep and diadynamic therapy, suitable for pain relief and stimulating physiological functions . 3. Alternating high-voltage current, used in methods like diathermy and ultratonotherapy, provides heating effects and deeper penetration . These currents vary in their voltage, frequency, and application method, leading to different therapeutic benefits and allowing precise treatment adaptations to various conditions.

The main therapeutic phases that occur due to the absorption of physical factors in physiotherapy are the physical phase, the physico-chemical phase, and the biological phase. In the physical phase, energy from the acting factor is transferred to biological systems, tissues, and cells. This energy absorption results in selective energy uptake by different tissues, such as bones, adipose tissues, muscles, and blood . In the physico-chemical phase, the absorbed energy leads to cellular shifts and metabolic reactions, affecting tissues like cutaneous and subcutaneous tissues in localized ways . The biological phase involves direct and reflex changes in organs and tissues, contributing to local reactions like hyperaemia, increased metabolism, and anti-inflammatory actions, as well as general effects that involve various systems such as the CNS, endocrine, and cardiovascular systems .

Galvanization involves the use of a direct continuous current of low voltage connected to the patient via electrodes, which can be positioned in various configurations. It is often used for localized or segmental-reflex influence, and its benefits include local treatment without the need to saturate the whole organism, minimizing side effects . In contrast, impulse electrotherapy uses a modulated short pulse current that can reach deeper tissues and is less prone to adaptation due to a wide range of action parameters. It offers advantages in pain relief, cell depolarization, and is better tolerated by patients, especially those with cardiovascular conditions . While both methods use currents, the nature of the current and the application techniques differ significantly, affecting their specific clinical outcomes.

The universal mechanism of action refers to the observation that different physiotherapeutic methods can induce similar primary physico-chemical shifts, leading to unified therapeutic effects despite different initial stimuli. This is crucial because it allows flexibility and adaptability in treatment planning, ensuring that the selection of method can be tailored to patient-specific needs and pathological conditions while still achieving desired therapeutic outcomes . It enhances the efficacy of physiotherapy by permitting the use of various modalities to achieve metabolic stimulation, improve circulation, and modulate immune responses depending on patient tolerance and contraindications . The universal mechanism bolsters treatment consistency, allowing clinicians to adapt interventions based on patient-specific factors without compromising effectiveness.

Before applying any treatment modalities in physiotherapy, several contraindications must be considered to ensure patient safety. These include the presence of malignant neoplasms, systemic blood disorders, marked cachexia, circulatory decompensation, and active hemorrhage or its suspicion. Severe psychosis, fever, active tuberculosis, and individual intolerance to physiotherapy methods also necessitate caution. Additionally, specific contraindications may arise depending on the equipment used or the physiological condition of the patient, such as the presence of metal implants in the skull area or intolerance to electrical currents . Evaluating these factors helps prevent adverse reactions and enhances treatment efficacy.

Electrosleep therapy uses permanent impulse currents to induce a state of physiological sleep by stimulating the central nervous system. This method of neurotropic therapy leverages low-frequency, low-voltage impulses that correspond to the brain's chronaxia, producing inhibitory effects such as decreased physiological parameters like blood pressure and respiration rates . Once the current stops, the patient experiences a stimulating phase, feeling rejuvenated and in a better mood. Indications for electrosleep include conditions like neuroses, early stages of cerebral atherosclerosis, skull injuries and related complications, bronchial asthma, digestive tract diseases, and some ischemic cardiovascular conditions . These effects and indications highlight the therapy's dual role in offering relaxation and recovery.

Drug electrophoresis offers several advantages over traditional drug administration methods in physiotherapy. It enables the delivery of drugs to specific localized regions at high concentrations without systemic saturation, helping to minimize potential side effects. This method also supports the prolongation of drug action due to the localized concentration . It utilizes the ion form of drugs, which can be more effective than the molecular form, enhancing the therapeutic effect. Additionally, drug electrophoresis is painless and provides a complex integral action, aligning with patient's comfort and increasing compliance . All these factors make it a preferred choice in cases requiring localized drug delivery with minimal body-wide impact.

Amplipulse therapy involves the use of alternating sinusoidal modality current (SMC) to achieve therapeutic outcomes such as cell stimulation, pain relief, and spasmolytic effects . This method leverages low-voltage and low-frequency currents to promote depolarization and repolarisation processes in cells, which are critical for cell communication and function. The therapy's efficacy arises from its capability to induce deep tissue exposure, stimulating physiological and reparative processes while alleviating muscle spasms . By tailoring the frequency, amplitude, and duration of impulses, amplipulse therapy can specifically target nerve and muscle tissues, promoting quick pain reduction and enhancing overall rehabilitation efforts.

Achieving a local drug concentration in physiotherapy is significant as it allows targeted treatment of affected areas, minimizing systemic exposure and potential side effects. This localized approach ensures that a higher concentration of the therapeutic agent is delivered directly to the site of pathology, enhancing its effectiveness in treating the specific condition . It also supports sustained therapeutic action, as the drug affects the area of interest for a prolonged period without the need for frequent systemic administration. This approach maximizes treatment efficacy, increases safety by reducing generalized drug impact, and aligns with personalized medicine objectives, improving patient outcomes by focusing on precise pathological areas .

Skin receptors are crucial in mediating the therapeutic effects of electrical stimulation in physiotherapy. They increase excitability and conductivity of the peripheral nervous system, enhancing the reflexive and direct reactions of the organism to the stimulus provided by electrical currents . Through stimulation, these receptors modulate local biochemical processes, increasing the concentration of biological substances such as histamine and serotonin, and improving circulation and metabolism . This receptor activation not only supports the local therapeutic impact, such as anti-inflammatory and reparative effects, but also facilitates broader systemic responses, ranging from cardiovascular adjustments to improvements in immune functions . Thus, skin receptors serve as critical mediators that bridge external physical stimuli and internal physiological responses, optimizing therapeutic outcomes.