Clinical Use of E-Stim

Question 0

More A-Betas = ?

More C-Fibers = ?

Answer 0

A-Beta = pain relief, they try to close the gate (on)
C-Fibers = pain, they try to open the gate (off)

Question 1

What does sensory (biphasic) TENS do?

Answer 1

use in acute phase
Targets: Abeta
Pain reduced by gate theory
Avoid muscle contraction

Question 2

Sensory TENS

2 pads

Answer 2

phase duration = less than 100
pulse rate = 60 - 120 pps/Hz
Duty cycle = continuous

Question 3

Motor TENS

2 pads

Answer 3

Target: A-delta
Pulse rate/frequency: 2-7 pps
Phase duration: 200-300usec
contraction 
continuous duty cycle

Question 4

Noxious TENS 
(probe = active pad & 1 pad)

Answer 4

Target: C-Fibers
Phase Duration: 10-20ms
Pulse rate/frequency: High: 100-150 pps
Low: 2-7 pps

Question 5

Interferential Stim

2 currents, quadpolar set up (4 pads)

Answer 5

Phase Duration: 100-150 usec
Pulse rate/frequency: High: 80-150 pps
Low: 0-10 pps
Carrier frequency: 400-500 Hz
BEAT frequency: 1-150 beats per second
Used for pain control
this is the one we can use sweep and target

Question 6

What happens when the nerve does not have a refractory period and we feel numbness?

Answer 6

Wedenski’s inhibition

Question 7

Premod

2 pads

Answer 7

prevents accommodation
Phase duration: less than 100 usec
Pulse rate/ frequency: 60-120pps
Duty Cycle: continuous

Question 8

NMES

Answer 8

“wakes up the muscles”
over come muscle inhabitation after injury or surgery
Stimulates motor neurons

Question 9

Russian Stim for muscle reed

Answer 9

Pulse rate: 35-50pps
Phase duration:200usec
Carrier Frequency: 2500Hz
Duty Cycle: 1:5 10sec on 50 sec off
encourage manual contraction with machine contraction

Question 10

Biphasic for muscle reed

Answer 10

Phase duration: 250-300 usec
Pulse rate: 35-59 pps
Duty Cycle: 1:5
ramp for comfort

Question 11

Where do we put the pads on neuromuscular stim?

Answer 11

over motor points

Question 12

What is it called when you put a pad on a agonist and antagonist muscle?
ex: hammies & quads

Answer 12

Reciprocal stimulation

Question 13

High Volt

unequal stim pads 1 big 1 small

Answer 13

Phase duration: 50-120 usec
Pulse rate: preset
used for edema

Question 14

High Volt Negative Polarity encourages?

Answer 14

blood clots to dissolve and increases inflammation

Question 15

What encourages clot formation around granulation tissue of a wound?

Answer 15

High Volt postive polarity

Question 16

High Volt for Wound healing
negatively charged promotes:
positively charged promotes:

Answer 16

neg: getting infection to be culture free (typically 3-5 days)
pos: jump starts healing process

Question 17

High Volt for wound healing

2 pads over wound w/ gause

Answer 17

Frequency: 80-100pps
Duration: 20min to an hour

Question 18

Iontophoresis

Answer 18

like charges are repelled. 
use as direct current
if med negative, use negative polarity 
positive med- 80mA/min
negative med - 40 mA/min
Amp * min = mA/min
stims muscle directly

Question 19

UMN is?

LMN is?

Answer 19

brain or spinal chord trauma (can not regenerate)

spinal cord or below trauma (can regenerate)