Electrical currents for tissue healing Flashcards
Attraction of cells to an electrical charge is
Galvanotaxis
Name 3 benefits of estim for tissue healing:
Decrease edema
Transdermal delivery of meds
Wound care
Estim aids in wound healing by
Decreases bacteria
Stimulates healing
Improves circulation
The most common waveform used for wound healing is
HVPC - High Volt Pulsed Current
Can not be used on wounds covered in eschar (scab)
With the direct method of electrode placement how are electrodes placed
Active electrode in wound and dispersive electrode a few inches away - must be larger than active electrode
Rules for periwound electrode placement
2 or more with dispersive being larger than sum of active
Polarity - when neg or pos over wound
neg over wound when inflamed or infected
pos over wound when not inflamed or infected
Parameters for HVPC for wound care: (Pulse, Freq, Amp, tx time)
Pulse - 40-100 micro seconds
Freq - 60-125 pps
Continuous
Amp - sufficient to produce comfortable sensation wo motor response
Tx time - at least 5 days per week for 45-60 min ea
Estim for edema control: polarity, freq, pulse duration, tx time, amplitude
neg 100-120 pps 40-100 microseconds 20-30 min enough to produce tingling
E-stim for edema control is usually; theory is
monophasic
theory is neg charge repels positively charged serum proteins
E-stim for Edema Reduction when edema caused by graviity and lack of muscle contraction: polarity does not matter - amp, freq, pulse duration, on-off times, tx time
biphasic enough amp to cause visible contractions freq - 35-50 pps pulse duration - 150-350 microseconds on:offf 1:1 for 2-5 ea up to 5 on 5 off tx time: 20-30 min
Iontophoresis is monopphasic, polarity matters, use of low amplitude DC with depth of delivery superficial 3-20mm
Dexamethasone is most common drug used and it is
negative so use neg electrode
iontophoresis with corticosteroid uses what polarity
corticosteroid is pos so use pos electrode
Ionto patches low voltage and low current: .1-.3mA for
1-24hrs
ionto patches increases drug retention because less increase in local
circulation
Hydrocortisone is an anti-inflammatory with a ___ polarity
positive
Dexamethasone is an anti-inflammatory with a ___polarity and able to peenetrate to
negative
8-10mm
Common uses for Dexamethasone
Epicondylitis
Tendinitis
Plantar fasciitis
Waveforms for pain control include:
TENS
IFC
Premod
Sharp pain transmitted along
A-delta
Dull pain transmitted along
C nerve fibers
These nerve fibers can inhibit transmission of A-delta and C nerve fibers
A-beta
When this activity is increased pain perception is decreased
A-beta activity
Half-life of endogenous opiods is
4.5 hrs
Most common types of TENS (Transcutaneous Electrical Nerve Stimulation)
Conventional
Acupuncture-like
Burst mode
TENS is always
on (no on-off times)
This type of TENS is most effective at activating A-beta nerves wo activating motor nerves
Conventional TENS
AKA Convential TENS
High rate TENS
Conventional TENS has _____ duration with ____ freq
short
high
Conventional TENS uses this theory to decrease pain perception
gate control theory
Conventional TENS has ____ microsecond duration and ____pps freq
50-80
100-150
Most common form of TENS used; faster onset of relief than other TENS forms, may be used for 24 hrs, generally only decrease pain while stim is active
Conventional
Acupuncture-like is aka
Low rate TENS
Acuupuncture-like uses this theory
endorphin release
Acupuncture-like does this
repetitive brief stimulation of motor nerves to produce muscle twitches and brief sharp pain which causes release of endogenous opiods
Acupuncture-like needs ____ amplitude and ___pulse durations than conventional TENS bc trying to _____motor and A-delta nerve fibers
higher
longer
depolarize
This type of TENS is better than conventional TENS for chronic pain
acupuncture-like
Acupuncture-like is better for_____pain than conventional TENS
Chronic
Acupuncture-like TENS controls pain for ____ after a ____minutes of tx
4-5hrs
20-30
More than a 45min tx can lead to ____ with acupuncture-like TENS
DOMS
Acupuncture uses ___pps freq; ___microsecond duration; ____ amplitude to produce visible muscle contraction: tx time ___ mins; can be used every___hrs
2-10 200-300 enough 20-30 2
Burst mode uses ____ theory; usually ____ comfortable than acupuncture-like; Freq____; duration_____; tx time____; can be used every __ hrs; ____ amplitude to produce visible muscle contractions
endorphin more 10 or fewer bursts - bursts of 100-150 pps (high burst rate) 100-300 microseconds 20-30 2 enuggh
Used for rapid onset but short term pain relief before procedures: deep friction massage, joint mob, passive stretch
Brief Intense TENS
Brief intense TENS ____amplitude; ____ pulse duration; ____freq; ____wearing time; ___ onset of relieff
strong 250-400 microseconds (widest) 110-200pps (Highest) 15 min max 1-2 minutes
Interferential current (IFC) if currents in same phase ___amp; if currents in dif phase ___amp; ____ freq is diif btwn carrier freeq and the other currents freq
higher
lower
beat
IFC ____ amplitude is delivered deeper and ___ amp is delivered through the skin (more comfortable)
higher
lower
IFC is mainly used for
pain relief
Able to cover larger area than TENS
IFC
IFC used mainly for pain relief at higher freq ____; can be used for muscle stim using ____ beats per second
100-150
35-50
IFC vector scan changes cloverleaf shape into a _____ shape by
circular
one circuit varying in amplitude
This is basically same as IFC except only need two electrodes
Premodulated Current
Waveform of ____ looks the same as IFC but doesn’t deliver ___amp to skin like IFC; doesn’t have as large ____ area as IFC
Premodulated Current
lower
stimulation
This is prohibited in FL
Electroacuppuncture - needles placed in skin then stim
MOST appropriate current for treating a pressure ulcer to enhance healing.
Monophasic pulsed current