electrotherapy Flashcards
indications
pain control
strengthening of muscles
promote tissue repair
deliver meds
urinary dysfunction
edema management
contraindications
pacemakers or implanted stimulators
over infections
metal implants
nerve sensitivity
epilepsy
thrombus/thrombophlebitis
over carotid sinus
electronic monitoring systems
precautions
pregnancy
cancerous lesions
altered mental status
abnormal sensation
irritated area
thoracic region
over reproductive organs
electrode placement
sensory –> close together
motor –> further apart
electrode size
small –> small areas
large –> large areas
what does using one small and one large electrode do
help intensify the stimulation under the small electrode
parameters
amplitude
pulse duration
frequency
duty cycle
ramp time
amplitude
the intensity
current flow delivered to electrodes measured in milliamps
pulse duration
time it takes one pulse to complete its cyccle
frequency
pulses per second or the pulse rate
duty cycle
used w/ NMES for motor response
refers to the pattern of on and off sequencing
can be equated by the percentage of time on divided by the sum on the one and off time
ramp time
period of time during which the amplitude of the stimulus is gradually increased (ramp up) or decreased (ramp down)
allows pt to accommodate to the increase in the intensity
ramp up
prevent a sudden violent contraction that would be painful and potentially damaging
ramp down
has little impact on comfort and no impact on treatment safety
types of contraction
DC
AC
DC current
characterized as steady, continuous, unidirectional flow of electrons
indications of DC
administer meds via iontophoresis
wound healing
stimulating denervated muscles
stimulation to denervated muscles –> DC
the muscle itself is being stimulated and the muscle membrane depolarizes
–> this requires posterization to depolarize the muscle of 10 milliseconds or longer
contractile properties of muscle are maintained while awaiting reinnervation which prevents atrophy
a combo does no occur
NMES for strengthening –> amplitude
strong motor within pts tolerance
NMES for strengthening –> pulse duration
continuous
but stim can be interrupted every 500 milliseconds
start w/ 500 and decrease 500, 100, 10
NMES for strengthening –> treatment duration
10-15 contractions
1-3x daily
start with few denervation is new
NMES for strengthening –> time
15 contractions
AC
continuous flow of electrons that changes direction
2 terminals alternatively change from positive to negative
AC indications
muscle strengthening of innervated muscles
pain modulation
edema control
AC characteristics
sinusiodal waveform
neurophysiological response AC
sensory response
motor response
sensory response –> AC
pain modulation
motor response –> AC
tetany for muscle strengthening via NMES
sub tetany for pain modulation and chronic edema
pulsatile
aka russian
inter pulse intervals resulting in noncontinuous current
monophasic
biphasic
polyphasic
pulsed monophasic
pulsed biphasic
pulsed polyphasic
pulsed monophasic
can be unidirectional
looks like DC but is shortter and duration has interruptions
less strength than DC
pulsed biphasic
two phase
bidirectional wave
has one negative and one positive phase
similar to AC and that the electrodes change polarity
polyphasic pulsed
bidirectional wave with 3 or more phases in bursts
NMES for strengthening parameters –> polyphasic pulsed
amplitude –> strong motor
burst duration –> 10 milliseconds, very high
burst frequency –> 50, high
duty cycle –> start at 1:5 and progress to 1:1 with on time up to 10 seconds
time: 10-15 contractions, 3-5 times a week
ramp time–> 3-5 seconds
strength duration curve
displays the amount of electrical current required to produce an action potential
motor need the most electrical current
nerves
the larger the fiber and the more superficial –> more easily it can be to stimulate
large sensory fibers are more excitable than motor fibers, which are more excitable than pain fibers
type A, B, C fibers
type a fibers
large diameter
conduct APs most rapidly
can be sensory and motor
type b fibers
medium diameter
autonomic motor nerves
type c fibers
smallest and slowest
sensory nerves
adaptation
nerve cell will not generate an AP after a period of time –> no longer responding to electrical current
in order to stop adaptation –> increase intensity or modulation
