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CP 2 > E-Stim Basics > Flashcards

E-Stim Basics Flashcards

1
Q

goals and indications for E-stim

A
  • pain modulation
  • decrease muscle spasm
  • improve ROM
  • muscle re-ed
  • improve muscle strength/reduce atrophy
  • wound healing
  • edema reduction
  • stimulate denervated muscle
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2
Q

contraindications (8)

A
  • pacemaker, insulin pump
  • over cartoid artery, thrombosis, eyes, phrenic nerve, pelvis and/or low back in pregnant women
  • transcerebrally
  • active bleeding/infxn
  • over superficial metal implants
  • over malignant tumors
  • over pharyngeal/laryngeal muscles
  • motor-level stimulation in conditions that prohibit motion
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3
Q

precautions (6)

A
  • cardiac disease
  • impaired mentation
  • impaired sensation
  • in areas of skin irritation or open wounds
  • in pt with uncontrolled hypotension or HTN
  • bleeding disorders
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4
Q

polarity

A

net charge of object

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5
Q

cathode

A

net negative

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6
Q

anode

A

net positive

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7
Q

voltage

A

driving force that move electrons

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8
Q

amerage/current

A

rate of flow of electrons (mA)

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9
Q

ohm’s law

A
  • more resistance, the greater the voltage needed to push the current through
  • I = V/R
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10
Q

resistance to current flow

A
  • skin
  • hair
  • fascia
  • ligament
  • callus
  • fat
  • bone
  • tendon
  • scar
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11
Q

if resistance increases…

A

more voltage will be required to overcome the resistance and produce the same current flow

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12
Q

if you have a large increase in voltage what could happen

A

discomfort, could lead to burns

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13
Q

how do you reduce skin-electrode resistance

A
  • minimize air-electrode interface
  • keep electrodes clean
  • use electrodes on clean skin, minimize hair, oils, abrasions if possible
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14
Q

what size electrode do you typically use

A
  • largest that you can to reduce discomfort
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15
Q

monophasic current

A
  • unidirectional flow of charged particles

- electrical stim moving from one pad to the other

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16
Q

biphasic

A
  • bidrectional flow of charged particles

- electrical stim bouncing back and forth btw 2 pads

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17
Q

direct current

A
  • uninterrupted unidirectional flow
  • one pad to the other
  • type of monophasic
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18
Q

alternating current

A
  • uninterrupted bidirectional flow
  • bouncing back and forth btw the two pads
  • biphasic
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19
Q

pulsed current

A

can either be unidirectional (monophasic) or bidirectional (biphasic) current that periodically ceases for very short period of time
- has additional parameters

20
Q

frequency

A

pf pulses per second or beats per second

21
Q

pulse duration

A
  • width
  • reported in microseconds
  • how long each individual pulse lasts
22
Q

amplitude

A
  • mA

- voltage of each individual pulse

23
Q

how does e-stim lead to an action potential

A
  • influx of Na+ which causes a reduction of resting membrane potential leading to depolarization which leads to action potential
24
Q

what must be great enough to cause an action potential

A

amplitude/intensity

25
Q

what must be long enough to produce depolarization of the cell

A

duration of the stimulus

26
Q

how is heat created with e-stim

A
  • friction and vibration of particles moving through the material
  • heat produced depends on intensity of current
27
Q

is it normal to have some redness under the electrodes?

A
  • yes bc some heat is produced
  • should go away after few hours
  • should not blister or break skin
28
Q

if intensity is too high….

A
  • may be at risk for burns

- important to remove resistance

29
Q

large electrode pad =

A

current dispersed over large area = small current density = more tolerated by pt

30
Q

small electrode pad =

A

current dispersed over small area = greater current density = less tolerated by pt

31
Q

how do you increase the current density

A
  • increase current of estim
  • decrease size of electrode
  • can cause skin burns
32
Q

how to avoid burns

A
  • remove resistance
  • listen to pt’s perception
  • use large electrodes when possible
  • always maintain good contact of estim pads
  • use appropriate coupling agent if appropriate
33
Q

monopolar

A
  • one small electrode over target area
  • one large electrode over remote area
  • polarity matters
34
Q

bipolar

A
  • both electrodes are of similar size and placed over target area
  • current bounce btw 2 pads
  • polarity doesn’t matter
35
Q

quadripolar

A
  • 2 electrodes from 2 seperate stimulating circuits are positioned so that the individual currents intersect with each other
36
Q

monopolar configuration

A
  • method when polarity is a concern
  • wound healing (attract to area)
  • edema control
  • iontophoresis (drive into body)
37
Q

with monopolar configuration, where are the electrodes placed

A
  • 1 small electrode is placed directly over target area (active/treatment electrode)
  • 2 larger electrode is placed away from target area (dispersive)
  • pads do not need to be on same muscle
38
Q

preferred use for bipolar configuration

A
  • disuse atrophy
  • neuromuscular facilitation
  • ROM
  • spasms
  • circulatory disorders
39
Q

where are electrodes for bipolar configuration

A
  • connected in same area with target treatment site btw two pads
  • same size
  • any wave form except direct current
40
Q

what influences the depth and course of the current

A

the distance btw the electrodes

41
Q

if the pads are farther apart….

A

deeper they go

42
Q

do you want the pads touching?

A

no, creates an arc

43
Q

if youre going for sensory stimulation, put the pads where?

A

over that sensory pathway

44
Q

if you’re going for motor point stimulation, put the pads where?

A
  • where the motor nerve is easily excited

- muscle belly or proximal 1/3 of the muscle

45
Q

common mistakes with muscle stimulation

A
  • placing 1 electrode over a muscle belly and the other over a distal area without much muscle
  • electrodes too close together when trying to stimulate a deep muscle

CP 2 (26 decks)

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