Clincal Application Flashcards
What are the 2 determining characteristics of high volt pulsed current (HVPC)?
- Must have twin peak monophasic current
- Must have be able to transmit a voltage of at least 150 V
What are the 5 things HVPC is used for?
- muscle reeducation
- nerve stimulation
- edema reduction
- pain control
- wound healing
The high peak and low average current of high-voltage stimulation provides what?
Deep penetration of a comfortable current
What is the pulse rate for HVPC?
1-120 pps depending on the desired clinical application
TENS utilizes a __phasic current to prevent net residual charge
biphasic
What characteristic of TENS specifically targets sensory, motor, and pain fibers?
The adjustable phase durations
What are the uses of TENS?
- Control of acute or chronic pain (typically LBP patients)
- Management of post-surgical pain
- Reduction of post-traumatic acute pain
What is low rate TENS?
TENS with long phase duration, high-amplitude pulses (low pulse frequency) used to control pain
What type of reactions are elicited with low rate TENS?
Repetitive muscle contractions or brief sharp pain
How long will low rate TENS usually control pain?
for 4 to 5 hours after a 20-30 minute treatment
Why do you not want to do a low rate TENS application for longer than 45 minutes?
Because prolonging the repetitive muscle contractions can result in DOMS
What is high rate TENS?
The most comfortable form of TENS application that utilizes short phase duration, low-amplitude pulses (high pulse frequency)
Because high rate or conventional TENS modulates pain through gating, how long should TENS treatments be?
They can be an all day treatment if necessary
When using high rate TENS long term what must you modulate?
Output must be modulated to reduce accommodation
What is brief-intense (burst) TENS?
TENS with long phase duration, high pulse frequency used to control pain
How does brief-intense (burst) TENS modulate pain?
It creates a negative feedback loop in the CNS by releasing opiates that inhibit the release of Substance P which blocks or reduces pain transmission
How long should brief-intense (burst) TENS be?
Very short treatment duration due to the noxious-level output
When should you not use TENS?
When you do not know the origin of the pain
What may reduce the effectiveness of TENS?
- Intake of 200 mg or more of caffeine
- Narcotics
What is interferential current (IFC)?
The waveform produced by the interference of two medium frequency sinusoidal ACs of slightly different frequencies
How are the waveforms of IFC delivered?
Through two sets of electrodes through separate channels in the same stimulator. The electrodes are configured on the skin so that the 2 ACs intersect
What happens when the two ACs of IFC intersect?
They interfere, producing a higher amplitude when both currents are in the same phase a lower amplitude when the two currents are in opposite phases. This produces envelopes of pulses known as beats
What does the beat frequency equal for IFC?
The difference between the frequencies of the 2 original ACs
When a carrier frequency of 5000 Hz interferes with a current with a frequency of 5100 Hz, what is the beat frequency?
100 Hz
Why is IFC more comfortable than other waveforms?
Because it allows low-amplitude current to be delivered through the skin easily
What can IFC be used for?
- Acute pain
- Chronic pain
- Muscle spasm
What is neuromuscular electrical stimulation (NMES)?
Application of an electrical current to motor nerves to produce contractions of the muscles they innervate
NMES tends to have a ___ phase duration
long
The biphasic and alternating currents associated with NMES decrease the possibility of what?
electrode irritation
6 uses of NMES
- Maintaining range of motion
- Muscle re-education
- Prevention of joint contractures
- Prevention of disuse atrophy
- Increasing local blood flow
- Decreasing muscle spasm
What are 2 of the effects of NMES?
It can produce substantial muscular tension which will lead to an increaase in the strength of muscles when the limb is immobilized.
What is the Russian current?
A waveform with specific parameters intended for quadriceps muscle strengthening.
Russian current uses a ____ frequency AC delivered in __ bursts/second, with each burst being __ ms long and separated from the next burst by a __ ms interburst interval
medium
50
10
10
What are the 3 claims of the Russian current?
- that it is painless and no sensory discomfort during maximum tetanic contraction
- that it can generate up to 30% more force than that generated during maximum voluntary effort or contraction
- that after a few weeks of using it could produce lasting gains in muscle strength
What is functional electrical stimulation (FES)?
a technique that uses electrical currents to activate nerves innervating extremities affected by paralysis resulting from spinal cord injury (SCI), head injury, stroke and other neurological disorders
How does FES assist those with spinal cord injuries?
FES may assist with locomotion, hand grasp, respiration, aerobic and cardiovascular conditioning, and bowel and bladder voiding
How does FES assist with stroke patients?
It can substitute for an AFO and it can also stimulate contraction of the wrist flexors and extensors, as well as thumb opposition
What are 3 other neurological conditions FES may useful for?
MS, TBI, CP
What is Microcurrent Electrical Neuromuscular Stimulators (MENS)?
a device used to send weak electrical signals into the body that can affect the function of healing tissues by normalizing the injured tissues’ electrical potential
What can MENS be used for?
- Acute and chronic pain
- Acute and chronic inflammation
- Reduction of edema
- Sprains
- Strains
- Contusions
- Temporomandibular joint dysfunction
- Carpal tunnel syndrome
- Superficial wound healing
- Scar tissue
- Neuropathies
