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Electrotherapeutics Flashcards

1
Q

uses of electrical stimulation

A

pain control
muscle reeducation/facilitation
reduce edema / spasticity
wound healing
testing/evaluation

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1
Q

big dawgs of electrotherapy

A

PG - Scribonius Largus
SG - Luigi Galvani
SF - Alessandro Volta
PF - Guillame B. Duchenne
C - L. Erb
6MOTY - Polio Epidemic

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2
Q

general ways electrotherapeutics controls pain

A

gate control theory
breaking of pain-spasm cycle
introduce medication to body

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3
Q

types of current

A

direct
indirect current

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4
Q

constant unidirectional flow current

A

never crosses isoelectric

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5
Q

how does e-stim help edema

A

changing electrical gradient can change the cells that are attracted and repelled

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6
Q

how does e-stim reduce spasticity

A

applied to agonist - direct muscle fatigue
applied to antagonist - reciprocal inhibition of muscle experiencing spasticity

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7
Q

types of current

A

direct
alternating

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8
Q

direct current is described as

A

constant unidirectional flow

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9
Q

what is direct current used for

A

inducing chemical reactions

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10
Q

how is direct current related to isoelectric line

A

either above or below isoelectric line
never crosses isoelectric line

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11
Q

alternating current is described as

A

change in direction of flow periodically

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12
Q

what is alternating current also known as

A

biphasic
bidirectional

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13
Q

how does alternating current occur

A

electrodes change polarity in an alternating fashion

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14
Q

describe alternating current in relation to isoelectric line

A

crosses above and below isoelectric line

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15
Q

pulsatile current is described as

A

flow of charged particles that periodically cease before the next electrical event

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16
Q

time related to pulsatile current

A

cease of current that is <1 second

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17
Q

explain the forms of current found in pulsatile current

A

can be either AC or DC
–> as long as there is some sort of pause, it turns into pulsatile current

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18
Q

pulsatile current and chemical effect? why?

A

negligible chemical effect

a sustained current changes electrochemical gradient

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19
Q

what is the most common clinical use of electrical current

A

pulsatile current

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20
Q

what are the types of waveforms

A

monophasic
biphasic
polyphasic

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21
Q

types of biphasic waveforms

A

symmetrical
asymmetrical

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22
Q

types of asymmetric biphasic waveforms

A

balanced
unbalanced

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23
Q

explain monophasic waveforms

A

all waves are on one side of isoelectric line
one pulse at a time

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24
explain biphasic waveforms
waves cross isoelectric line one pulse above / one pulse below
25
explain polyphasic waveforms
groupings of biphasic waves
26
symmetrical vs asymmetrical waveforms are described as
equal intensity, duration, frequency waveforms or opposite of that can be either AC or DC
27
explain the difference between balanced and unbalanced waveforms
balanced = same amount of surface area beneath the wave unbalanced = different amount of surface area under the wave
28
what are the aspects of waveforms that can be modulated
peak amplitude pulse frequency phase duration
29
indication of symmetrical biphasic waves
nerves with minimal electric charge
30
indication of asymmetrical biphasic waves
activation of small muscles
31
indication of monophasic waves
wound healing
32
compare fatigue between polyphasic vs monophasic/biphasic waveforms
poly = more fatiguing mono/bi = less fatiguing poly = longer sustained contraction mono/bi = more rest time
33
how to calculate duty cycle
on time / (on + off time)
34
what has a direct effect on muscle fatigue
duty cycle
35
frequency is defined as
number of pulses delivered in one second
36
how is frequency of AC measured
Hz (cycles per second)
37
explain the levels of frequency and # of Hz associated with each
low = 1-1000 Hz medium = 1000-10k Hz high = >10k Hz
38
what has a direct effect of muscle response quality
frequency
39
explain how intensity is calculated
I = V/R I = current intensity V = voltage R = resistance
40
explain how voltage and resistance effect the intensity of current
> Voltage = >I > Resistance =
41
what is resistance measured in
Ohms
42
insulators - level of resistance - examples
high glass, rubber, paraffin, distilled H20
43
conductors - level of resistance - examples
low copper, silver, tap water
44
in series, what are good insulators
skin and fat
45
in parallel, what are good conductors
muscle and nerve
46
what current is resistance related to
direct current
47
what current is impedance related to
alternating current
48
impedance is defined as
hindrance to current flow in alternating current
49
relationship between tissue water content and impedance
higher water content = least impedance
50
explain the relationship between frequency and impedance
> frequency = < impedance
51
define excitation
generation of an action potential
52
define conduction
transmission/propagation of AP away from site of stuimulation
53
value associated with cellular resting potential
-60 to -90 mV
54
explain what an absolute refractory period is
if stimulus is applied during refractory period, it will not be able to overcome and begin repolarization
55
explain what a relative refractory period is
if a stimulus is applied during refractory period, at a certain level of external stimulus, repolarization can begin
56
explain the difference between orthodromic and antidromic conduction
ortho = from spinal cord out to peripheral motor units anti = goes from peripheral sites to spinal cord
57
what does effectiveness of electrical stimulation depend on
intensity (amplitude) duration rise time
58
rise time is defined as
amount of time it takes to get from isoelectric line to max intensity
59
what should the intensity be strong enough to do
create an action potential
60
explain temperature of tissue and effectiveness of e-stim
colder = slowed nerve conduction velocity, may decrease efficiency warmer = increased nerve conduction velocity, may increase efficiency
61
muscle response is described as
force rather than strength
62
PPS necessary for _________ contraction - twitch - summation - tetanus
twitch = 1-5 summation = 10-20 tetanus = 25-50
63
define decay time
amount of time it takes to go from peak intensity to isoelectric line
64
how are intensity and duration related
inversely
65
how is the strength duration curve calculated
plotting stimulus amplitude required to produce a minimally visible contraction as stimulus duration is varied
66
rheobase is defined as
minimal intensity necessary to create a contraction if the duration is considered endless
67
chronaxie is
intensity necessary to create two times rheobase
68
what is the strength duration curve used for
compare muscle groups bilaterally compare agonist/antagonist strength
69
chronaxie response of _____ in msec innervated muscle denervated muscle
innervated muscle = 0.03 denervated muscle = 10
70
levels of stimulation
subsensory sensory motor noxious/pain
71
define subsensory stimulation
no nerve fiber activation no sensory awareness
72
define sensory stimulation
nonpainful paresthesia stimulation of A-beta nerve fibers
73
define motor stimulation
strong paresthesia muscle contraction a-alpha nerve fiber activation
74
define noxious stimulation
strong, uncomfortable paresthesia maxed out muscle contraction A-delta and C-fiber activation
75
types of electrodes
metal plate carbon impregnated rubber self-adhering
76
what must be used for metal plate electrodes
sponge or item soaked in water
77
what must be used for carbon impregnated electrodes
electrode is to be wet and there must be a protective barrier
78
how to complete circuitry in e-stim
must have 2 leads with at least 2 electrodes secured to the body
79
electrode placement options
monopolar bipolar quadripolar
80
explain monopolar electrode indication/placement
for more specific treatment areas smaller electrode is placed in treatment area and larger one is placed on same limb/side of body slightly away from the treatment area
81
explain bipolar set up? how to modulate
placed in a parallel sort of fashion close = current in superficial tissue far = current in deeper tissues
82
what makes a quadripolar electrode placement
if diagonal connections exist between the four electrodes
83
explain the response related to bipolar electrode placement when closer/further to each other
closer = more superficial, sensory response further = more deep, motor response
84
in treatment of motor points, explain electrode placement
proximal 1/3 of a muscle
85
leads are defined as
intermediary between generator and electrodes effectively provides a conductive pathway for current flow
86
jack vs tips
jack = point of exit from machine tips = connected point on the electrodes
87
cleaning the skin will cause
impedance to decrease by 50%
88
contraindications of electric stimulation
demand type pacemakers around/distal to thrombotic/embolic sites pregnancy (in low back/abdominal area) cancer active TB active hemorrhage over carotid sinus through the chest implanted nerve stimulators
89
precautions of electrical stimulation
hyper/hypotension PVD decreased/absent sensation history of seizures obesity osteoporosis post MI - on anterior/lateral thoracic wall metal device in pathway of current
90
documentation of electrotherapeutics
patient position electrode placement type of e-stim duration treatment effects skin integrity before/after

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