Electrical Stimulation Parameters (competency)

Question 1

NMES - uses?

Answer 1

muscle strengthening, synchronous firing, and atrophy prevention

Question 2

NMES - pulse width/duration?

Answer 2

200 - 800 microseconds

Question 3

NMES - frequency?

Answer 3

30 - 100 pps

Question 4

NMES - on:off time?

Answer 4

will vary; avg = 10:50 for 10 reps (10 min)

Question 5

NMES - ramp?

Answer 5

1-5 sec up/down

Question 6

NMES - electrode placement?

Answer 6

bipolar; parallel to muscle fibers

Question 7

NMES - amplitude?

Answer 7

maximum contraction/tolerance

Question 8

What are the TWO biggest thing about performing NMES successfully?

Answer 8

1. ) you must see a muscle contraction

2. ) determine treatment based on number of contractions, not a length of time

Question 9

IFC - uses?

Answer 9

pain modulation, edema reduction, and sometimes muscle contraction

Question 10

IFC - wave form?

Answer 10

alternating current (polyphasic sinusoidal) amplitude modulated beats

Question 11

IFC - pulse width/duration?

Answer 11

200 - 400 microseconds

Question 12

IFC - frequency?

Answer 12

10 - 150 pps

Question 13

IFC - on:off time?

Answer 13

continuous for 10 - 30 min

Question 14

IFC - ramp?

Answer 14

n/a

Question 15

IFC - electrode placement?

Answer 15

in an X pattern with channels crossed so that the X is in the middle of the target treatment area

Question 16

IFC - amplitude?

Answer 16

strong but tolerable sensation

Question 17

Does the pt adapt easily to NMES?

Answer 17

not easily, because of the back and forth between constructive and destructive interference… but definitely may need to be turned up periodically if wearing for a long duration

Question 18

High Rate TENS - uses?

Answer 18

pain modulation through central inhibition (basically, gate control theory)

Question 19

High Rate TENS - wave form?

Answer 19

asymmetrical biphasic

Question 20

High Rate TENS - pulse width/duration?

Answer 20

50 - 100 microseconds

Question 21

High Rate TENS - frequency?

Answer 21

50 - 80 pps

Question 22

High Rate TENS - on:off time?

Answer 22

continuous, pulsatile, or burst for 10 min - hours

Question 23

High Rate TENS - amplitude?

Answer 23

comfortable tingling sensation; NO MUSCLE RESPONSE

Question 24

Explain how well pain relief occurs with High Rate TENS?

Answer 24

onset of relief is fast, but the duration of pain relief is temporary

Question 25

Low Rate TENS - uses?

Answer 25

pain modulation through descending pathways generating endogenous opiates

Question 26

Low Rate TENS - wave form?

Answer 26

asymmetrical biphasic

Question 27

Low Rate TENS - pulse width/duration?

Answer 27

150 - 300 microseconds

Question 28

Low Rate TENS - frequency?

Answer 28

1 - 5 pps

Question 29

Low Rate TENS - on:off time?

Answer 29

continuous for 20 - 40 min

Question 30

Low Rate TENS - amplitude?

Answer 30

strong but comfortable MUSCLE TWITCH

Question 31

Explain how well pain relief occurs with Low Rate TENS?

Answer 31

onset of relief = 20 - 40 min and it lasts more than an hour

Question 32

Contraindications for ES?

Answer 32

pacemaker on top of the carotid, eyes, pelvis or low back for pregnant women transcerebrally (on pt head) over a muscle that is being stimulated but it cannot move

Question 33

Precautions for ES?

Answer 33

``` cardiac disease impaired mental status open wound skin irritation uncontrolled HTN or hypoTN bleeding disorders ```

Question 34

Thermal Continuous US - uses?

Answer 34

improves tissue extensibility via heat and causes blood flow to increase in the area which can increase the healing properties going to that area

Question 35

Thermal Continuous US - duty cycle?

Answer 35

continuous thermal (heating) sensation

Question 36

Thermal Continuous US - frequency?

Answer 36

1mH = 5cm deep 3mH = 1-2cm deep SO, the deeper the tissue, the lower the frequency!

Question 37

Thermal Continuous US - output (intensity)?

Answer 37

1.6 W/cm2

Question 38

Non-Thermal (pulsed) US - uses?

Answer 38

pain modulation, increase CT extensibility, increase healing process

Question 39

Non-Thermal (pulsed) US - duty cycle?

Answer 39

20% on and 80% off (pulsed)

Question 40

Non-Thermal (pulsed) US - frequency?

Answer 40

either 1mH (deep tissues) or 3mH (superficial tissues)

Question 41

Non-Thermal (pulsed) US - output/intensity?

Answer 41

0.6 W/cm2

Question 42

Contraindications for US?

Answer 42

``` impaired circulation impaired cognition absent sensation cancers directly over plastic or metal over vital areas such as brain, eyes, heart, genitals pregnancy ```

Question 43

Precautions for US?

Answer 43

acute inflammation open epiphyseal plates healing fractures breast implants