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Modalities > Chap 8 - E-STIM > Flashcards

Chap 8 - E-STIM Flashcards

1
Q

How can the application of electrical currents benefit the patient? What are the clinical uses.

A
  • Pain control
  • muscle strengthening and re-education
  • decrease muscle spasm
  • wound healing
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2
Q

explain the physiological effects of each physical agent #8

A

by depolarizing the nerve membranes and thereby producing action potentials, the message unit of the nervous system . Once that acton potential is propagated along eh axon, the human body responds to it in the same way as it does to action potentials that are initiated by physiological stimuli

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3
Q

what is action potential

A

The basic unit of nerve communication

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4
Q

what does IFC mean

A

interferential current

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5
Q

NMES

A

neuromuscular electrical stimulation

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6
Q

Inotophoresis

A

delivery of medication

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7
Q

What is gate control

A

stopping the pain at the spinal cord level. tricking the body to focus on the vibrations. Not treating the condition just blocking the pain.

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8
Q

Parameters for conventional TENS

A
  • PPS (pulse frequency) 100 to 150
  • PD (pulse width, duration) 50-80 us
  • C-continuous
  • produce tingling only -no muscle contraction
  • can be worn 24hrs but not recommended
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9
Q

Acupuncture-like TENS

A
  • uses the burst mode units of 10s
  • PPS=2-10
  • PD (pulse duration, width) 200-300
  • visible contraction
  • tx time 20-30 mins
  • release endorphins
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10
Q

Typically TENS is used for what type of pain

A

Chronic (more than six months)

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11
Q

Note when you are doing IFC use always use the same pulse frequency (rate) of….

A

PPS (pulse rate or frequency)
low beat is 100pps (hz)
high beat is 150pps(hz)

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12
Q

What sensation testing would you use for Electrical stimulation

A

Light touch is sufficient

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13
Q

placement of electrodes TENS

A
  • clean skin with alcohol pads
  • around the painful area
  • doesn’t matter crossed or parallel patterns
  • make sure setting are correct
  • explain the what they will be feeling (tingling)
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14
Q

If the patient accommodates to the continuous setting what can you do and why?

A

turn it to the modulation setting so it comes in waves and it will take them a longer time to accommodate to the tx.

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15
Q

Contra for ES

A

P- pace maker
C- Carotid sinus (don’t place over)
A- Arterial thrombosis or thrombophlebitis (blood clot cause embolism)
P- pregnant women’s abdomen or back

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16
Q

precaution for ES

A 
O- open wounds
M- malignant tumore 5-7 yrs (not benign)
I- impaired mentation
M
I- impaired sensation
C- Cardiac disease
S- skin irritation
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17
Q

Longer pulses and high current amplitudes are used for what type of stimulation?
200-400 us

A

Motor stimulation

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18
Q

Short pulses and low current amplitudes are used for what type of sensory?
100-300 us

A

Sensory stimulation

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19
Q

Ramp up time /Ramp down time

A

time it takes stimulator to go from no current to its maximum intensity

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20
Q

Acetate (bone spurs)- for ionto

A

source - Acetic acid
plarity- Negative
indications- calcium deposits
concentration-2.5-5

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21
Q

Dexamethasone phosphate- for ionto

A

-source- DexNa, PO3
-polarity-negative
-indications- inflammation
concentration-.4

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22
Q

Lidocaine

A
  • source- lidocaine with epinephrine
  • polarity-positive
  • indications- local anesthetic
  • concentration- 5
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23
Q

Pulse current

A

the period when current is flowing in any direction

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24
Q

A waveform produced by the interference of two medium frequency sinusoidal alternate currents of slightly different frequencies.
Mrs T notes
2 channel wave form produced by 2 medium frequency alternating currents to produce eats

A

interferential current

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25
Q

the frequency modulation of an interferential current

A

sweep

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26
Q

the time from the beginning of the first phase of a pulse to the end of the last phase of a pulse

A

Pulse duration

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27
Q

A continuous unidirectional flow of charged particles

A

Direct current (DC)

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28
Q

a continuous flow of charged particles without interruptions or breaks

A

Continuous current

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29
Q

the positive electrode

A

Anode

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30
Q

Cathode

A

the negative electrode (way to remember C is for Cat and if you don’t like cats that is negative)

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31
Q

TENS with short durations, low amplitude pulses used to control pain; also called high rate TENS

A

Conventional TENS

32
Q

TENS with long-duration, high-amplitude pulses used t control pain; also called low rate TENS

A

acupuncture-like TENS

33
Q

The movement or flow of charged particles through a conductor in response to an applied electrical field.

A

Electrical current

34
Q

a continuous bidirectional flow of charged particles

A

Alternating current

35
Q

the application of electrical current through the skin to modulate pain

A

Transcutaneous electrical nerve stimulation

36
Q

what are the types of electrical currents

A
  • Direct current
  • alternating current
  • pulsed current
  • interferential current
  • premodulated current
  • Russian Protocol
37
Q

An interrupted flow of charged particles where the current flows in a series of pulses separated by periods when no current flows

  • Mrs T notes Discontinued flow of current
    • monophasic
    • biphasic
A

pulsed current

38
Q

an alternating current with a medium frequency and sequentially increasing and decreasing current amplitude, produced with a single circuit and only two electrodes
Mrs. T notes
-1 channel wave form producing inferential effect.

A

premodulated current

39
Q

a waveform with specific parameters intended for quadriceps muscle strengthening.
Mrs Ts notes
Polyphasic alternating current waveform delivered at 50 bursts per second.

A

Russian protocol

40
Q

Effects of electrical currents

A
  • circulatory
  • metabolic
  • musculoskeletal
41
Q

mrs Ts notes

What does electrical currents do for the circulation?

A

It increase local cellular circulation

42
Q

mrs Ts notes

What does electrical currents do for metabolism?

A
  • promotes galvanotaxis

- increases antimicrobial activity

43
Q

mrs Ts notes

What does electrical currents do for musculoskeletal ?

A
  • Increases muscle contraction via creating action potentials
  • promotes pain modulation
44
Q

Mrs Ts notes (pg 216 tbl 8-1)
the change in the nerve membrane potential (via the electrical current) must be great enough to cause an action potential

A

Strength duration curve

45
Q

MVIC

A

Maximum voluntary isometric contraction

46
Q

This type of ES stimulates large diameter axons first then smaller diameter
-consider this for tx time and also for functional ES

A

NMES

47
Q

NMES -type I muscle fibers are

A

slow twitch muscle fibers

48
Q

NMES - type II muscle fibers are

A

fast twitch muscle fibers

49
Q

higher force contraction; more muscle strength gain

A

overload principal

50
Q

The place in a muscle where electrical stimulation will produce the greatest contraction with the least amount of electricity, generally located over the middle of the muscle belly

pg 419-421

A

Motor points

51
Q
  • Pulses per second (pps)

- Hz

A

Frequency

52
Q

a current that is made up of two phases; the first phase begins when current starts to flow in one direction and ends when the current starts to flow in the other direction, which is also the beginning of the second phase

A

biphasic pulse

53
Q

number of cycles per sec/ alternating current

A

Hz

54
Q

us

A

microsecond

55
Q

on/off cycle for sensory

A

constant

56
Q

on/off cycle for motor

A

not constant

57
Q

Why would you use IFC?

A

decrease pain
decrease inflammation
increase ROM
for the acute stage

58
Q

FYI- Large unit (vectra Genisys) and small unit

A

both can be set at low beat or high beat

59
Q

the process of a nerve gradually becoming less responsive to stimulation
-a transient increase in threshold to nerve excitation
Mrs T - increase in intensity

A

accommodation

60
Q

Any pattern of variation in one or more of the stimulation parameters.

Mrs T - to vary the current

A

modulation

61
Q

A series of pulses where the charged particles move only in one direction is known as?

A

monophasic

62
Q

what adjustments can be made to for a patient that begins to accommodate the tx?

A
  • Beat
  • Intensity
  • Electrodes
63
Q

These serve as interface between stimulator and patient and connects the leads to wires

A

Electrodes

64
Q

FYI

A

larger electrodes tend to feel more comfortable than smaller ones

65
Q

FYI

A

the smaller electrodes are better at targeting smaller muscle groups.

66
Q

What happens when you increase the distance between the electrodes

A

it increases the depth of penetration and decreases specificity

67
Q

Where should you not place electrodes .

A

Over bony prominences

carotid artery

68
Q

Adverse reactions to ES

A

burns
skin irritation
pain

69
Q

what is the recommended on and off time for an initial Russian E-Stim treatment if the goal is to improve muscle strength?

A

1:5 ratio initially

70
Q

What is the recommended on:off ratio to utilize when decreasing muscle spasm is the goal?

A

2:5 ratio

71
Q

What is the recommended on:off ratio when utilizing e-stim if the goal is to decrease edema?

A

2:5 ratio

72
Q

When utilizing e-stim with the goal of muscle strengthening (Russian), what are the recommended treatment parameters?

A

same as re-education
PPS 35-80
PD 150-200 small muscles
PD 200-350 large muscles

73
Q

When utilizing NMES (muscle re-education), what are the recommended treatment parameters?

A

same as strengthening
PPS 35-80
PD 150-200 small muscles
PD 200-350 large muscles

74
Q

What is important about electrode placement when utilizing IFC?

A

criss cross
centering around the point of pain
1 to 2 inches apart

75
Q

What is the purpose of Iontophoresis?

A

to use a low-amplitude direct current to facilitate transdermal drug delivery.

76
Q

FYI

A

“Ideal electrode placement should be documented, noting distance or approximation to bony landmarks or anatomical structures, so that follow up sessions can replicate the same placement. Diagrams are often helpful.

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