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PMod > ELECTRICAL STIMULATION FOR INNERVATED MUSCLES > Flashcards

ELECTRICAL STIMULATION FOR INNERVATED MUSCLES Flashcards

1
Q

Intact peripheral nerves, including the motor
unit and neuromuscular junction

A

Innervated Muscles

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2
Q

Innervated Muscles Usually manifests as

A

disuse atrophy

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3
Q

Due to peripheral nerve injury

A

Denervated Muscles

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4
Q

Denervated Muscles Usually manifests

A

denervation atrophy

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5
Q

Use of ES to produce muscle contractions in
innervated muscles

A

Neuromuscular Electrical Stimulation
(NMES)

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6
Q

Orthotic Substitution

A

Functional Electrical Stimulation (FES)

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7
Q

Type of NMES that specifically enhances the
control of movement and posture

A

Functional Electrical Stimulation (FES)

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8
Q

NMES integrated to functional activities

A

Functional Electrical Stimulation (FES)

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9
Q

Volitional muscle contractions

A

Due to
command from upper
motor neurons

Recruits smaller to larger
motor units

Activates
first type I muscle
fibers

Asynchronous
recruitment of motor units

Slow onset of
muscle fatigue

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10
Q

Electrically induced muscle contraction

A

Due to applied
electricity stimuli

Recruits larger to smaller
motor units

Activates
first type II muscle
fibers

Synchronous
recruitment of motor units

Rapid onset of
muscle fatigue

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11
Q

Increase Muscle Strength

A

Overload principle
Specificity theory
Increased muscle size
Improved motor unit recruitment

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12
Q

Overload principle

A

↑ current, ↑ frequency, ↓ pulse duration 🡪
increase externally-applied resistance

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13
Q

Specificity theory

A

Targets type II muscle fibers which are reduced
after surgery, immobilization or any pathology

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14
Q

Increased muscle size

A

↑ muscle mass usually takes several weeks to
occur

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15
Q

Improved motor unit recruitment

A

Occur more rapidly
▪ Synchronized recruitment of more motor units

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16
Q

Promotes Muscle Re-education

A

Improvement of motor control
Stimulates brain plasticity

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17
Q

Therapeutic Effects of NMES& FES

A

Promotes Muscle Re-education
Inc Muscle strength
Prevents Disuse Atrophy
Reduces Muscle Spasm
Reduces Muscle Spasticity
Reduces Edema

18
Q

Prevents Disuse Atrophy

A

Provides externally-induced muscle
contraction to prevent muscle wasting
▪ With adequate muscle strength, it serves as a
biofeedback to promote muscle contraction

19
Q

Reduces Muscle Spasm

A

Over both agonist
▪ Fatigue the muscle 🡪 Relaxation

20
Q

Reduces Muscle Spasticity

A

Over the antagonist
▪ Reciprocal inhibition of agonist muscle

Over both agonist and antagonist
▪ Sequential stimulation of agonist then followed by
antagonist
▪ Closely mimics normal motor activity or typical
behavior of individuals without CNS dysfunction

21
Q

Reduces Edema

A

Through the muscle pumping effect

22
Q

During Gait Training
For Idiopathic Scoliosis
During Gripping
Activity
For Shoulder
Subluxation’
During Cycling

A

Functional Electrical
Stimulation (FES

23
Q

Commonly uses square, balanced, symmetrical,
biphasic PC; some use asymmetrical biphasic PC

A

Biphasic Pulsed Current

24
Q

Uses medium frequency AC with a frequency of 2500
Hz delivered in 50 bursts per second

A

Russian Current

25
Q

Alternating medium-frequency currents, which are
slightly out of phase and amplitude-modulated at low
frequency

A

Interferential Current

26
Q

Electrode Placement

A

Active electrode over the motor point and Dispersive electrode about 2-inch away on the same muscle following the orientation of themuscle fiber (preferred) [bipolar if on same
muscle; monopolar if on other area]

▪ Face and smaller muscles of the hand: motor point
stimulation using a probe/motor pen
▪ Motor point between the 2 electrodes [bipolar]
▪ 4 electrodes over targeted muscle [quadripolar]
▪ Wider spacing 🡪 deeper stimulation

27
Q

Strengthening Parameters

A
  • Overload principle
  • Selected recruitment

PD: 150-200 μsec (smaller muscles) and 200-350 μsec (larger muscles)
A: ≥50% MVIC; maximum
tolerated muscle contraction
Ramp Up/ Down:At least 2s
Freq:20 pps (smaller mms), 30
pps (larger mms), 35-50 pps
(smooth tetanic), 50-80 pps
(greater strengthening)
Treatment: 10-20min (10-20 reps)A
On:Off: 1:5 initially 🡪 1:3 🡪 1:1
Ratio: 10-sec on:50-sec off

28
Q

Muscle Endurance Parameters

A

↑ contraction time &
↓ rest intervals

PD:150-200 μsec (smaller muscles) and 200-350 μsec (larger muscles)
Amplitude: 25-50% MVIC
Ramp Up/Down: At least 2s
Frequency: 30-50 pps
TD: More Rep
On&Off: 1:1

29
Q

Motor level Spasticity

A

PD: 150-200 μsec (smaller
muscles)A
200-350 μsec (larger
muscles)
Amp: At motor threshold; to
visible contraction
Ramp Up& Down: 0.5-3 s
Freq:35-50 pps
TD: 10-60 min
Ratio: 1:1, 3:4

30
Q

Sensory Level Parameters

A

PD: 20-100 μsec
Amp:Below motor threshold
Freq: 80-100 pps
TD: 10-60 min

31
Q

Muscle Spasms
Motor

A

PD: 150-200 μsec (smaller muscles)
200-350 μsec (larger muscles
Amp: At motor threshold; to visible contraction
Ramp Up/Down: At least 1 sec
Freq: 35-50 pps
TD: 10-30 min
Ratio: 1:1
(2-5 sec on; 2-5 sec off)

32
Q

Edema Reduction (Muscle Pump)

A

PD: 150-200 μsec (smaller muscles)
200-350 μsec (larger muscles)
Amp: At motor threshold; to visible contraction
Ramp U&D:At least 1 sec
Freq: 35-50 pps
TD: 30 min
Ratio: 1:1 (2-5 sec on; 2-5 sec off)

33
Q

Duty Cycle

A

Duty Cycle = [ON ÷ (ON + OFF)] x 100

34
Q

Channels 1 & 2 produces ON and OFF times together

A

Synchronous (co-contraction)

35
Q

While channel 1 is ON, channel 2 is OFF

A

Reciprocal

36
Q

Muscle contraction solely relies on electricity

A

NMES

37
Q

Contraction produced by both the electrical
stimulator and the patient

A

NMES plus volition

38
Q

Electricity only serves as feedback for
contraction

A

NMES as biofeedback for motion

39
Q

Docu

A

NMES/FES using
To < affected muscle > x
< pulse frequency > x
< pulse duration > x
< duty cycle or On & Off
time > x < treatment
duration > to
< rationale >.

40
Q
A

PMod (10 decks)

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