A Critical Evaluation of Iontophoresis as Used in Physiotherapy

Clijsen, Ron and Taeymans, Jan and Lambrecht, Renzo and Clarys, Peter and Barel, André Odilon (2005) A Critical Evaluation of Iontophoresis as Used in Physiotherapy. In: 10th Congress of the European College of Sport sciences, July 2005, Belgrade, Serbia & Montenegro.

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Introduction In this study we investigated the bioavailability of iontophoretically delivered diclofenac with the methylnicotinate (MN) test. The inhibition of an erythema provoked by MN is proportional with the bioavailability of diclofenac in the skin. It was our aim to use this procedure in the determination of the contribution of respectively the passive diffusion, the occlusion and the electrically assisted delivery during an iontophoretic procedure as used in physiotherapy. Methods A total of 6 application sites was marked on the volar forearm of each volunteer (n=12), for the following treatment and/or control modes: A= Cathodal iontophoresis of 12mg/cm² Voltaren Emulgel® (Diethylammonii diclofenac 1%) during 20 minutes; B=passive diffusion under occlusive sponge; C=passive diffusion without any covering; D=current alone; E=standard MN response and F=blanco site. Tristimulus surface colorimetry and Laser Doppler flowmetry were used to measure respectively the skin color and the perfusion of the microcirculation. Bioavailability was assessed by quantification of a MN induced erythema under the different conditions. Results A significant reduction of the MN induced erythema was observed with the Chromameter and Laser Doppler measurements for the following treatment modalities: (1) electrically assisted delivery: respectively 65 and 100%, (2) application under occlusive sponge: 66 and 97%, (3) passive diffusion without occlusion: 32 and 65%. A significant reduction was equally observed for the site treated with the current alone: 19 and 42%. There was no significant difference between the response after iontophoretic delivered diclofenac (Mode A) and application of diclofenac under occlusive sponge (Mode B). Conclusion The used procedure enabled us to evaluate the bioavailability of a non-steroidal anti inflammatory drug in the skin. Under the used conditions we did not found an increased bioavailability after electrically assisted delivery of diclofenac compared with the passive percutaneous penetration under occlusion. Reference Treffel P, Gabard C, Bieli E. (1993).Prediction of Percutaneous penetration, Vol 3B: 520-527

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