Electrical stimulation (incl TENS, IFC, NMES, E-Stim)

Question 1

contraindications

Answer 1

pacemakers/ defibrillators 
unstable arrthymias
carotid sinus
thrombophlebitis
low back or abdominals during pregnancy

Question 2

precautions

Answer 2

cardiac disease
poor sensation
poor mentation 
malignancy
areas with skin irritation/ open wounds

Question 3

TENS high rate settings

Answer 3

Acute pain
50-80 pulse duration 
100-150pps high frequency
no muscle contraction 
Gate control theory "you get used to it" 
sensory effect

Question 4

TENS low rate settings

Answer 4

chronic pain 
150-300 pulse duration 
2-10 pps low freq
muslce contraction 
endogenous opiod system-stimulate endorphins to bind with opiate receptors (inhibitory) 
incr use may lead to DOMS

Question 5

IFC acute setting

Answer 5

LoHi
freq: 100-150Hz
Intensity: to sensory comfort
time: 15-20 mins (or 24hrs at home)

Question 6

IFC chronic settings

Answer 6

low setting
freq: 2-10Hz
Intensity: to visible muscle contraction 
Time: 15-20 mins in clinic
20-30 mins at home

Question 7

IFC edema/swelling settings

Answer 7

freq: 20-50 Hz
intensity: to visible muscle contraction “muscle pumping”
time: 15-20 mins

Question 8

IFC goals

Answer 8

pain control
decr swelling
incr ROM
longer lasting effects vs TENS

Question 9

TENS goals

Answer 9

pain control

modulation (altered pain signal pathway to CNS)

Question 10

NMES Freq

Answer 10

<30pps: separate twitch contraction
35-50pps: smooth tetanic contraction
50-80pps: incr strengthening, rapid fatigue, poss more comfy

Question 11

NMES pulse duration

Answer 11

small muscles: 125- 200 (shorter duration)

larger muscles: 200-350 (longer duration)

Question 12

NMES on:off

Answer 12

• to incr stength= 1:5 then 1:4 then 1:3 (6-10 sec ON/ 30-50 sec OFF)
• to decr edema or spasm= 1:1 (2-5 sec ON/OFF)

Question 13

NMES ramp time

Answer 13

1-4 seconds

Question 14

NMES amplitude (intensity)

Answer 14

weak muslce= 10% muscle contraction

strong muscle= 50% muslce contraction

Question 15

NMES time

Answer 15

10-20 mins or 10-20 contractions

Question 16

NMES pt edu

Answer 16

pt contracts when ON and relaxes when OFF
Soreness and fatigue expected
early use after sx, immobilization, or muscle weakness pathology can accelerate strength gains