Electrical Stimulation Flashcards
Indications for e-stim
- Pain modulation
- Muscle spasms
- Improve ROM
- Muscle re-education
- Strength/prevent atrophy
- Edema reduction
- Wound healing
- Stimulate denervated muscle
E-stim precautions
- Cardiac disease
- Impaired mentation
- Impaired sensation
- Skin irritation/open wounds
- Controlled BP issues
- Bleeding disorders
e-stim contraindications
- Electronic medical device (PACEMAKER)
- Over carotid artery, thrombosis, eyes, phrenic nerve, pelvis +/- LB in pregnancy
- Active DVT
- Transcerebrally
- Active bleeding or infection
- Superficial metal implants
- pharyngeal or laryngeal muscles
- Motor-level stimulation in conditions that prohibit motion
Polarity
net charge of object
Voltage
driving force that moves electrons
Current
movement of ions or electrons in a conductor
Ohm’s Law
expresses the relationship between current, voltage, and resistance.
All of the following reduce resistance to ensure adequate current flow with e-stim, EXCEPT:
a. minimize the air-electrode resistance
b. using the smallest electrode that will illicit desired response.
c. ask the patient to shave and not wear lotion prior to PT
d. Keep the electrodes clean
b. using the smallest electrode that will illicit desired response.
- You would want to use the largest electrode to reduce discomfort and reduce risk of burns.
Direct current
unidirectional, uninterrupted flow of charged particles.
Common uses for direct current include all of the following except (select all that apply):
- pain modulation
- edema control
- wound care
- iontophoresis
- muscle re-education
pain modulation, edema control, muscle re-education (only used for wound care and iontophoresis)
Alternating current
uninterrupted bidirectional flow
Pulsed current
unidirectional or bidirectional current that periodically ceases for a very short time period.
Frequency
of pulses/sec
Pulse duration (width)
how long each individual pulse lasts
Amplitude
voltage of each individual pulse
If your goal is to elicit maximum muscle contraction - would pulse or direct current be more appropriate?
Pulsed as it allows for successive depolarization and repolarization
E-stim causes depolarization of _________ before the _______ critical threshold is reached.
nerve, muscle
T/F The amplitude (intensity) of a stimulus must be GREAT enough to lower the membrane potential to reach the critical threshold to induce depolarization.
True
What physical signs will be present to ensure you have set the e-stim to sufficient amplitude (intensity) for nervous tissue?
pt will report a tingling sensation
What physical signs will be present to ensure you have set the e-stim to sufficient amplitude (intensity) for muscle tissue?
active muscle twitch is visible
Heat from e-stim is created by _________ and __________ of particles moving through the material.
friction, vibration
Current density is affected by the current setting and the size of the electrode.
In general, the _________ the electrode the LESS current density.
The ________ current the LESS current density
larger electrode size, lower current
Monopolar electrode placement
one small electrode over target area and a large electrode place over a remote area.
If I am trying to attract negatively charge cells to an area - what terminal does the treatment electrode need to be plugged into?
Positive
Which waveform can NOT be used with bipolar?
direct
Your patient is having sciatica pain and you have determined you want to use e-stim to help with pain modulation. What placement considerations do you need to keep in mind?
a. place over the sciatica dermatomal pathway in a monopolar fashion.
b. place over the muscle belly or proximal 1/3 of the muscle in a monopolar fashion.
c. place over the sciatica dermatomal pathway and in a bipolar fashion
d. place over the muscle belly or proximal 1/3 of the muscle in a bipolar fashion
c. place over the sciatica dermatomal pathway and in a bipolar fashion
You asked a PTA to place your patient on e-stim over their soleus so you could get started with your next patient. The patient on e-stim calls you over and says it is really uncomfortable. When you check the electrode application - what would you observe that would INCREASE patient discomfort? (choose all that apply)
a. large electrode size relative to the muscle
b. small electrode size relative to the muscle.
c. Electrode A placed over the G/S complex region and electrode B placed over the bottom of the foot.
d. electrode A placed on the medial border of the G/S complex and electrode B placed on the lateral border
b. small electrode size relative to the muscle.
AND
c. Electrode A placed over the G/S complex region and electrode B placed over the bottom of the foot. (one electrode over a muscle belly and the other over a distal area w/o much muscle)
