Electrical Currents for Tissue Healing & Edema Control/Iontophoresis

Question 1

Define direct effects of electrical stimulation

Answer 1

• application of current to the wound

Question 2

Define indirect effects of electrical stimulation

Answer 2

• edema control or delivery of medications transdermally (iontophoresis)

Question 3

When are negative (black) electrodes indicated

Answer 3

• indicated for inflamed or infected wounds

Question 4

When are positive (red) electrodes indicated

Answer 4

• indicated for healing of non inflammatory or noninfectious wounds

Question 5

Define galvnotaxis

Answer 5

• natural movement of cells as a response to electrical current

Question 6

Precautions for electrical stimulation

Answer 6

• particular attention paid to wound care
• impaired sensation or mentation
• aggressive treatment is not indicated, low levels of stimulation is all that is required
• infection control

Question 7

What is attracted to the black/negative lead

Answer 7

• activated neutrophils
• lymphocytes
• platelets
• mast cells
• keratinocytes
• fibroblasts

Question 8

What is attracted to the red/positive lead

Answer 8

• inactive neutrophils
• macrophages
• epidermal cells

Question 9

parameters for the goal of treatment to be tissue healing in inflammatory phase/infection

Answer 9

Polarity: negative
Frequency: 60-125 pps
Duration: 40-100
Intensity: comfortable tingle
Treatment time: 45-60 minutes continuous 3-7 day/week

Question 10

Parameters for a treatment goal of tissue healing proliferation phase/clean

Answer 10

Polarity: positive
Frequency: 60-125 pps
Duration: 40-100
Intensity: comfortable tingle
Treatment time: 45-60 minutes continuous 3-7 days/week

Question 11

When is Estim best served for edema

Answer 11

• when it’s caused by inflammation or lack of motion

Question 12

When is Estim not recommended for edema

Answer 12

• not recommended in cases of systemic (bilateral) edema caused by disorders such as heart failure

Question 13

What kind of Estim can be beneficial for edema due to inflammation

Answer 13

• negative polarity shows that it can curb edema formation but can not get rid of already present edema

Question 14

What Estim can be beneficial for edema due to lack of muscle contraction

Answer 14

• motor level stimulation has been shown to decrease foot & ankle volume when combined with elevation & compression garment

Question 15

Parameters for a treatment goal for edema control for inflammation

Answer 15

Polarity: negative
Frequency: 100-120 pps
Duration: 40-100
Intensity: comfortable tingle
Treatment time: 20-30 minutes

Question 16

Parameters for a treatment goal for edema control associated with lack of motion

Answer 16

Frequency: 35-50 pps
On:Off time: 2-5 equal on:off times
Duration: 150-350
Intensity: visible contraction
Treatment time: 20-30 minutes

Question 17

Define cathode

Answer 17

• negative electrode that attracts positive ions

Question 18

Define anode

Answer 18

• positive electrode that attracts negative ions

Question 19

Contraindications for iontophoresis

Answer 19

• allergy to specific medication used

Question 20

Most commonly used medication for iontophoresis

Answer 20

• dexamethasone which is negative

Question 21

What proportionally determines the rate of penetration of medication for iontophoresis

Answer 21

• rate of penetration of the drug is proportional to the intensity

Question 22

Describe phonophoresis

Answer 22

• use of sound energy to drive medication into a patient’s skin
• done with ultrasound
• transports whole molecules into the skin

Question 23

Describe iontophoresis

Answer 23

• use of electrical energy to drive medication into a patient’s skin
• done with direct current
• transports ions into the skin

Question 24

Typical skin reactions due to direct current

Answer 24

• capillary dilation/erythema of the skin
• small fluid filled bumps caused by the release of histamine from dermal mast cells
• concern for chemical burns

Question 25

Parameters for iontophoresis

Answer 25

Waveform: direct current
Intensity: 1-4 mA as patient tolerates it
Dose: 40 mA-min - 80 mA-min
Treatment time: 40 minutes for 1 mA, 20 minutes for 2 mA, 13.3 minutes for 3 mA, & 10 minutes for 4 mA

Question 26

Tips for increases patient comfort

Answer 26

• place dispersive electrode over adipose/muscle
• avoid sensitive areas of skin
• ensure good contact
• ensure thorough hydration of electrode
• increase current slowly
• avoid additional modalities before iontophoresis
• do not shave area, clip hair with scissors
• do not tape, bind, or compress electrodes

Question 27

Hybresis patch intensity and treatment duration

Answer 27

• 3 minutes of mA current followed by mcirocurrent for 12 hours for 40 dose & 24 hours for 80 dose

Question 28

Micro-amplitude patch intensity and duration

Answer 28

• 0.1-0.3 dose for 24 hours

Question 29

What positive drug is recommended for iontophoresis use

Answer 29

• lidocaine

Question 30

Define dexamethasone

Answer 30

• negative polarity
• corticosteroid with anti-inflammatory effects & recommended for the treatment of inflammatory conditions such as tendinitis & bursitis

Question 31

Define lidocaine

Answer 31

• positive polarity
• local anesthetic used for venipuncture or venous cannulation (IV)