BPA E-Stim Decision tree & Parameters

Question 1

Pain

What are the Parameters when a patient has an Acute pain and you want to focus on a small and superficial area; nerve pain with LVPC?

Answer 1

TENS
Mono-Bi-Polar or Quadripolar
- High Frequency (100 hz)
- Pulse width (100 us)

Comfortable amplitude

Question 2

Pain

What are the Parameters when a patient has an Chronic pain and you want to focus on a small and superficial area; nerve pain?

Answer 2

TENS
Mono-Bi-Polar or Quadripolar
- Low-Frequency (< 10 Hz)
- Pulse width (200 us)

Visable muscle twitches

Question 3

Pain

What are the Parameters when a patient has an Acute pain and you want to focus on Deep and large areas?

Answer 3

IFC
*Bipolar or Quadripolar *
- Carrier frequency: 4000 Hz
- Beat/Resultant Frequency: 100 Hz

Comfortable amplitude

Question 4

Pain

What are the Parameters when a patient has an Chronic pain and you want to focus on Deep and large areas?

Answer 4

IFC
Bipolar or Quadripolar
- Carrier frequency: 4000 Hz
- Beat/Resultant: 100 Hz (frequencies < 10 Hz are acceptable too)

Amplitude to visable muscle twitches

Question 5

Muscular Dysfunctions

What are the Parameters when a patient has Weakness and Atrophy with LVPC?

Answer 5

NMES - LVPC (symmetrical)
Muscle contraction - Bipolar or Quadripolar
- Pulse duration: 200 - 400 usec
- Pulse frequency: 50 Hz
- Ramp up: 1 - 5 sec
- Ramp down: 1 - 2 sec
- Amplitude: ≥ 50% MVC

Question 6

Muscular Dysfunctions

What are the Parameters when a patient has Weakness and Atrophy with Russian?

Answer 6

NMES - Russian
Muscle contraction - Bipolar or Quadripolar
- Pulse duration: 2500 usec
- Pulse frequency: Doesn’t apply
- Set Burst Frequency: 50 Hz
- Ramp up: 1 - 5 sec
- Ramp down: 1 - 2 sec
- Amplitude: ≥ 50% MVC

Question 7

Muscular Dysfunctions

What are the Parameters when a patient has Functional Deficits with LVPC?

Answer 7

FES - LVPC
Muscle contraction with Functional activities - Bipolar or Quadripolar
- Pulse Duration: 200 - 400 micorsec
- Pulse Frequency: 50 Hz
- Ramp up: 1 sec
- Ramp down: 1 sec
- Duty Cycle: According to activity

Question 8

Muscular Dysfunctions

What are the Parameters when a patient has Functional Deficits with Russian?

Answer 8

FES - Russian
Muscle contraction with Functional activities - Bipolar or Quadripolar
- Carrier Frequency: 2500 Hz
- Pulse Duration: Doesn’t apply
- Set Burst Frequency: 50 Hz
- Ramp up: 1 sec
- Ramp down: 1 sec
- Duty Cycle: According with the activity

Question 9

Muscular Dysfunctions

What are the Parameters when a patient needs to improve ROM with LVPC or Russian?

Answer 9

NMES - LVPC or Russian
- Pulse Duration: 200 - 300 usec
- Pulse Frequency: 30 Hz
- Ramp up: 3 sec
- Ramp down: 1 - 2 sec
- Duty Cycle: 1:1

Question 10

Muscular Dysfunctions

What are the Parameters when a patient has Spasticity with LVPC or Russian on Agonist Muslce?

Answer 10

• Pulse Duration: 200 - 400 usec
• Pulse Frequency: 100 Hz
• Duty Cycle: 1:1

Provoke Fatigue

Question 11

Muscular Dysfunctions

What are the Parameters when a patient has Spasticity with LVPC or Russian on Antagonist Muslce?

Answer 11

• Pulse Duration: 200 - 400 usec
• Pulse Frequency: 50 Hz
• Duty Cycle: 1:3

Reciprocal Inhibition

Question 12

What are the Ultrasound Parameters for Acute Conditions?

Answer 12

• If superficial: 3 MHz
• If deep: 1 MHz
• Mode: Pulsed (10-20%)
• Low Intensity up to 1 w/cm^2
• 5 to 10 min (2-4 times the effective radiating area)

Question 13

What are the Ultrasound Parameters for Subacute Conditions?

Answer 13

• If superficial: 3 MHz
• If deep: 1 MHz
• Mode: Pulsed (20-50%)
• Low Intensity up to 1 w/cm^2
• 5 to 10 min (2-4 times the effective radiating area)

Question 14

What are the Ultrasound Parameters for Chronic Conditions?

Answer 14

• If superficial: 3 MHz
• If deep: 1 MHz
• Mode: Continuous (100%)
• Low Intensity up to 1.5 w/cm^2
• 5 to 10 min (2-4 times the effective radiating area)