Electrotherapeutic Concepts Flashcards

1
Q

Describe direct current

A

continuous or uninterrupted unidirectional flow of charged particles; direction determined by polarity chosen; no reversal of current

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2
Q

Iontophoresis is an example of _______ current.

A

direct

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3
Q

Describe alternating current

A

continuous or uninterruted bi-directional flow of charged particles; alternating polarity of electrodes; no net chemical run; expressed in HZ or cycles/second

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4
Q

Interferential, premodulated, and Russian protocol stimulation are examples of ________ current.

A

alternating

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5
Q

Describe pulsed current

A

can be DC or biphasic - bi-directional movement of charged particles that periodically ceases or is interrupted for a period of time

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6
Q

What is the most common current used in electrotherapy?

A

pulsed current

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7
Q

Unidirectional pulsed current is also known as

A

interrupted DC

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8
Q

Bi-directional pulsed current is also known as

A

interrupted biphasic

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9
Q

What is pulse cycle duration?

A

time of one pulse current

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10
Q

High Volt is a form of what kind of current?

A

monophasic pulsed current (appears as spike)

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11
Q

What are some clinical uses of NMES (neuromuscular electrical stimulation)?

A

increasing muscle contractility/strength, reducing muscle spasticity

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12
Q

What are some clinical uses of TENS (transcutaneous electrical nerve stimulation)?

A

pain suppression

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13
Q

NMES is used on _____ peripheral nerves.

A

intact

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14
Q

EMS, electrical muscle stimulation, is used on _____ peripheral nerves.

A

de-innervated

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15
Q

ESTR, electrical stimulation for tissue repair, is often used for

A

tissue repair

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16
Q

What type of e-stim applications are useful for tissue repair?

A

ESTR, HVPC, NMES

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17
Q

E-stim absolute contraindications (10)

A
  1. Implanted electrical pacing devices (cardiac demand pacemaker, bladder stimulator)
  2. over pregnant uterus
  3. over superficial metal implants
  4. when active motion is contraindicated - if stimulating for a muscle contraction (acute fracture)
  5. active bleeding in area being stimulated
  6. directly over malignancies
  7. phlebitis / circulation
  8. severely impaired sensation
  9. over transthoracic or anterior cervical area
  10. placement of electrodes over carotid sinus
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18
Q

E-stim precautions (5)

A
  1. open wounds or broken skin in treatment area
  2. extreme edema
  3. unreliable patients
  4. cardiac disease
  5. Malignant tumors
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19
Q

E-stim adverse effects (3)

A
  1. skin irritation or thermal; burns under electrodes
  2. allergy to gel, adhesive backing on electrodes, tape
  3. allergic reactions to medications used for iontophoresis
    pain
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20
Q

_____ allows for more comfortable contraction, slowly rising up/down current intensity.

A

Ramp

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21
Q

Describe the use of ratios in the parameters of electrotherapy.

A

1: 1 - fatigues quickly (e.g. 6 sec on /6 sec off)
1: 3 - common (e.g. 6 sec on/18 sec off)
1: 5 - early phase rehab often (e.g.6 sec on / 30 sec off)

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22
Q

Synchronous stimulation of 2 channels:

A

both channels on and off at same time

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23
Q

Reciprocal stimulation of 2 channels:

A

alternate stimulation between channels

24
Q

current density =

A

ratio of maximum current amplitude to electrode stimulation surface
(expressed in mA/cm2)

25
Q

________: small active electrode over motor point, a larger dispersive electrode

A

Monopolar technique

common in DC current application such as iontophoresis and in HVPC stimulation

26
Q

________: two electrodes of same size

A

Bipolar technique

common in biphasic PC applications but can use monopolar technique for small muscles or muscle groups

27
Q

________: 4 electrodes that can be parallel or crisscrossed

A

qaudripolar technique

28
Q

Electrode placement consideration:

A
  • over motor points for stimulation of muscles for contraction
  • over areas of pain, along dermatomes , referral patterns for electroanalgesia, transarthrally (across a joint)
29
Q

distance between electrodes affects depth of penetration such that closer =

A

more superficial penetration

30
Q

What is the minimum distance between electrodes

A

2 inches (5 cm)

31
Q

Orientation of the electrodes?

A

usually want parallel to muscle being stimulated

32
Q

muscular (motor) stimulation: may be __-__ minutes dependent on fatigue level and goals of treatment (strength vs. endurance)

A

5-20 minutes

33
Q

Amplitude (intensity) is the amount of current applied and is dependent on

A

dependent on goals; often limited by patient tolerance

34
Q

For motor stimulation, one electrode is placed on ______ and the other is placed elsewhere on the muscle so that the current flows _____ to the muscle fibers.

A
motor point (generally middle of muscle belly)
current flows parallel
35
Q

Indications for electroanalgesia?

A
  1. acute/chronic pain syndromes (musculoskel, neurological pain)
  2. post-operative pain
  3. labor and delivery pain
  4. prior to painful procedures
36
Q

motor-level TENS mechanism of action?

A

release of endogenous opiates (endorphins and enkephalins)

stimulates small un-myelinated A delta and C fibers plus motor efferents to stimulate muscles rhythmically

37
Q

Electroanalgesia contraindications (8):

A
  1. pacemakers/stimulating devices
  2. eyes
  3. carotid sinus
  4. over chest in presence of cardiac dysfxn
  5. with seizure disorders, avoid head/neck
  6. cognitive impairment
  7. over open wounds or compromised skin
  8. over areas where mvmnt is contraindicated if using a mode that requires visible contractions
38
Q

Sensory-level mode TENS synonyms:

A

high rate

conventional

39
Q

Motor-level mode TENS synonyms:

A

low rate

acupuncture-like

40
Q

Sensory-level mode TENS goal:

A

stimulates large A sensory (myelinated) afferents to “block” pain input

41
Q

Sensory-level mode parameters:

A

50-200 pps (usually 150-200)

20-100 microsec

42
Q

Sensory-level mode most appropriate for:

A

acute superficial musculoskeletal conditions (can be used for chronic conditions bc it is so well tolerated)

43
Q

Sensory-level mode effect:

A

analgesia only while unit is on (not long carry over)

44
Q

Quadipolar technique is uniquely used for:

A

biphasic NMES and IFC

45
Q

Interferential current is unique for:

A

beat frequency and vector scanning

46
Q

Motor-level mode is appropriate for:

A

deep, aching pain, chronic pain

47
Q

Motor-level modes goal:

A
  1. produce visible muscle contraction with 2-10pps frequency (do NOT want tetanic contraction)
    should not be uncomfortable
  2. high pulse duration (100-200 microsec)
48
Q

___________ create bursts of pulses at low repetitions (2 bursts per second)

A

burst modulated PC

49
Q

describe IFC (interferential current):

A

medium frequency current; specialized units which use sinusoidal polyphasic AC waveforms

50
Q

Describe quadripolar electrode technique:

A

4 crossed electrodes that create an interference in current

51
Q

describe Bipolar technique:

A

2 electrodes on one channel - the interference type current is generated in the machine (known as pre-modulated Interferential current)

52
Q

describe quadripolar with vector scan:

A

amplitude of current is varied which increases the field – can only be done with the quadripolar technique; current is felt to move among and between the electrodes

53
Q

What are the 2 types of beat frequency?

A

variable (sweep) and constant

54
Q

describe variable (sweep) beat frequency:

A

varies within a range (e.g. 1-15 bps, 80-150 bps)

55
Q

describe constant beat frequency:

A

set at one unchanging beat frequency

56
Q

What size area is pre-modulated indicated for?

A

smaller areas