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physical agents 2 > application for NMES > Flashcards

application for NMES Flashcards

1
Q

NMES frequency

A

25-50 pps

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2
Q

NMES phase duration

A

200-300 ms

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3
Q

NMES cycle time

A

10 sec on, 10 sec off

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4
Q

NMES amplitude

A

enough to get a contraction

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5
Q

NMES ramp

A

patient preference, usually not more than 2 sec

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6
Q

NMEs total treatment time

A

couple sets of 6-12 reps

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7
Q

NMES progression

A

comes with amplitude or change of duty cycle

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8
Q

NMES strengthening principles

A
  • improve force output
  • apply overload principle
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9
Q

NMES strengthening contraction type

A

maximal tetanic isometric contraction (maximal voluntary isometric contraction (MVIC)

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10
Q

NMES strengthening position

A

fixed position is best

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11
Q

strengthening biphasic frequency

A

35 pps+ want good force, but low fatigue

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12
Q

strengthening biphasic phase duration

A

200-300+ usec - based on need for motor nerve recruitment

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13
Q

strengthening biphasic cycle time

A

6-10 sec on
30-50 sec off
generally, a 1:5 ratio

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14
Q

strengthening biphasic ramp

A
  • patient preference
  • size of muscle
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15
Q

strengthening biphasic treatment time

A

10-20 strong contractions

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16
Q

strengthening biphasic progression

A

primarily with amplitude

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17
Q

strengthening russian current contraction type and position

A

MVIC ~60%

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18
Q

strengthening russian current frequency

A

2500 Hz with 50 bps

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19
Q

strengthening russian current phase duration

A

200 usec - determined by bps

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20
Q

strengthening russian current cycle time

A

6-10 sec on
30-50 sec off
generally, a 1:5 ratio

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21
Q

strengthening russian current ramp

A
  • patient preference
  • sometimes longer than with PC
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22
Q

strengthening russian current treatment time

A

10-20 strong contractions

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23
Q

strengthening russian current progression

A

primarily with amplitude

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24
Q

endurance programs contraction type and position

A

submaximal tetanic

25
Q

endurance programs frequency

A

minimal tetanizing
< 50 pps

26
Q

endurance programs phase duration

A

200-300 ms

27
Q

endurance programs cycle time

A

begin 1:5 or 1:6 ratio > 1:1 ratio
overtime increase on cycle or decrease off cycle

28
Q

endurance programs amplitude

A

visible contraction against gravity

29
Q

endurance programs ramp

A

related to activity

30
Q

endurance programs treatment time

A

as much as possible; look at function

31
Q

endurance programs progression

A

look at amplitude but not as much; make cycle time smaller and more contractions in a shorter period of time, and more sessions per day

32
Q

motor control principles

A
  • increase number of motor units firing
  • increase rate of motor units firing
  • improve initiation of movement
33
Q

why improve motor control?

A

improve tactile and kinesthetic inputs using as much of the patients voluntary contraction as possible

34
Q

what are the 2 types of mechanisms for motor control?

A

motor and cutaneous

35
Q

motor control (motor) contraction type/position

A

visible contraction

36
Q

motor control (motor) frequency

A

non-fatiguing

37
Q

motor control (motor) phase duration

A

200-300 ms

38
Q

motor control (motor) cycle time

A

per function

39
Q

motor control (motor) amplitude

A

good contraction

40
Q

motor control (motor) ramp

A

patient preference

41
Q

motor control (motor) treatment time

A

frequent

42
Q

motor control (motor) progression

A

getting rid of unit

43
Q

motor control (cutaneous) contraction type/position

A

no contraction - sensory only

44
Q

motor control (cutaneous) frequency

A

non-fatiguing so high frequency

45
Q

motor control (cutaneous) phase duration

A

lower than 200 ms

46
Q

motor control (cutaneous) cycle time

A

per function - want tingling

47
Q

motor control (cutaneous) amplitude

A

sub-motor

48
Q

motor control (cutaneous) ramp

A

not usually used for this

49
Q

motor control (cutaneous) treatment time

A

based on function

50
Q

common applications of NMES

A

shoulder subluxation, orthotic use, spasticity reduction, pelvic floor re-education, improving ROM, edema reduction, and denervated muscle

51
Q

how does NMES reduce spasticity

A

through fatigue
do not use motor point for cutaneous usage

52
Q

what 2 things are needed for pelvic floor re-education?

A

strength and endurance

53
Q

how does NMES improve ROM?

A

with frequency, submaximal contraction, and doing it as often as possible

54
Q

how does NMES reduce edema?

A
  • primarily through the muscle pump
  • sub tetanic/barely motor contraction
  • fatigue parameters
55
Q

what cycle time is best to reduce edema?

A

1:1

56
Q

when muscle is denervated what is there an increase of?

A

chronaxy

57
Q

once atrophy sets in denervated muscle what should you do?

A

increase amplitude to excitation Ach sensitivity “vermicular” looking contraction

58
Q

purpose for NMES in denervated muscle

A

decrease atrophy and decrease CT replacement of muscle tissue

59
Q

denervated muscle current type

A
  • AC if long enough phase duration
  • DC often used
  • cathode active is DC
  • higher frequency if no problem with phase duration

physical agents 2 (4 decks)

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