Electrotherapy 2 Flashcards
Safety - you need to do what beforehand
Sensory testing
Cognitive testing
Proper electrical grounding
Inspect and maintain equipment
Pain modulation protocols
Sensory level
Motor level
Noxious level
Muscle re-education/strengthening protocols
Muscle re-ed Muscle strengthening Functional Estim Muscle spasm reduction Biofeedback
Sensory level pain modulation - current type
Alternating current
Sensory level pain modulation - target tissue
A Beta Fiber
Sensory level pain modulation - polarity
balanced
we do not want any polarity
Sensory level pain modulation - frequency
higher frequency = more comfort
80-150 Hz
Sensory level pain modulation - pulse duration
take the machine as low as possible
20-50 usec
Sensory level pain modulation - on/off time
continuous
we want to counter irritation
Sensory level pain modulation - intensity
pleasant tingling but no muscle contraction
Sensory level pain modulation - electrode placement
surround the dragon
bipolar or quadripolar
can use dermatome or acupressure points
Sensory level pain modulation - treatment duration
20-30 min
Sensory level pain modulation - effect theory
gate control theory
A beta to stimulate non painful input and compete with the painful signals
Sensory level pain modulation - length of effect
no residual effect
when machine is turned off, their pain will return
Sensory level pain modulation - use it when
Maybe to relieve pain while doing something else (ROM, adhesive capsulitis)
Maybe after session too, to reduce pain
Can also send patient home with it
Sensory level pain modulation - AKA
TENS
Motor level pain modulation - AKA
low frequency TENS
Motor level pain modulation - current type
Alternating
Motor level pain modulation - target tissue
alpha motor neuron
goal is muscle twitch
Motor level pain modulation - polarity
none
Motor level pain modulation - frequency
2-10 Hz
We just want a muscle twitch, not tetany
Motor level pain modulation - pulse duration
150 usec for small mm
300-400 usec for others
Motor level pain modulation - on/off time
continuous
Motor level pain modulation - intensity
tingling and then keep turning up until feel muscle twitch
Motor level pain modulation - electrode placement
bipolar or quadripolar
at muscle belly
motor points
Motor level pain modulation - treatment duration
30 - 45 min
Motor level pain modulation - effect theory
endogenous opioid
inc amount of circulating opioids
Motor level pain modulation - length of effect
several hours
Noxious TENS - current type
direct
Noxious TENS - target tissue
C fiber
Noxious TENS - polarity
present due to direct current
we aren’t using it though
Noxious TENS - pulse duration
1 msec to 1 sec
Noxious TENS - on/off time
none
you are treating one spot and moving on to another essentially
Noxious TENS - intensity
max tolerated, noxious
Noxious TENS - electrode placement
trigger points
painful points
often using an activator (or wand, probe) or point stimulator
Noxious TENS - treatment duration
vary depending on number of points treated
Noxious TENS - effect theory
endogenous opioids
Noxious TENS - length of effect
several hours
Interferential current (IFC) - current type
interferential current
need medium frequency generator machine
Interferential current (IFC) - target tissue
A beta
Interferential current (IFC) - polarity
none
Interferential current (IFC) - on/off time
continuous
Interferential current (IFC) - intensity
Max tolerated, pleasant tingling without a muscle twitch
Interferential current (IFC) - electrode placement
quadripolar is more often used with channels crossing
Interferential current (IFC) - treatment duration
20-30 minutes
Interferential current (IFC) - effect theory
gate control theory
Interferential current (IFC) - length of effect
no residual effect
Muscle re-education - current type
alternating
Muscle re-education - target tissue
alpha motor neuron
Muscle re-education - polarity
none
Muscle re-education - frequency
35-80 Hz
Muscle re-education - pulse duration
150 usec for small mm
300 - 400 usec for other
Muscle re-education - on/off time
1:3 ratio
Muscle re-education - intensity
sustained contraction
Muscle re-education - electrode placement
bipolar
quadripolar
parallel to muscle fiber
Muscle re-education - treatment duration
varies - until patient can volitionally contract the mm or the mm fatigues
Muscle re-education - what do we want
isometric contraction
best to position muscle in mid range (or position of function) and stabilze distal extremity
Muscle re-education - length of effect
NA
Muscle re-education - what do we want
isometric contraction
best to position muscle in mid range (or position of function) and stabilze distal extremity
Muscle strengthening - current type
alternating
Muscle strengthening - target tissue
alpha motor neuron
Muscle strengthening - polarity
none
Muscle strengthening - frequency
35-80 Hz
Muscle strengthening - pulse duration
150 usec small mm
300-400 for other
Muscle strengthening - on/off time
1:5 ratio
Muscle strengthening - intensity
maximum isometric contraction
Muscle strengthening - electrode placement
bipolar
quadripolar
parallel to the muscle bellies
Muscle strengthening - treatment duration
goal of 10-12 repititions
Muscle strengthening - what do we want
isometric contraction
best to position muscle in mid range (or position of function) and stabilze distal extremity
Functional Estim - current type
alternating
Functional Estim - target tissue
alpha motor neurons
Functional Estim - polarity
none
Functional Estim - frequency
35-80 Hz
Functional Estim - pulse duration
150 Hz for small mm
300-400 Hz for other
Functional Estim - on/off time
1:3
Functional Estim - intensity
sustained contraction
Functional Estim - doing what
Same as mm re-ed but having the patient perform a functional task while applying the estim
Functional Estim - treatment duration
Varies
until patient can volitionally contract the mm or the mm fatigues
Functional Estim - goal
to get the patient to perform a functional task while applying the estim
Russian - polarity
none
Russian - target tissue
alpha motor neuron
Russian - on/off time
1: 5 strengthening
1: 3 re-ed
Russian - intensity
Strengthening - stop at max isometric contraction
Re-ed - stop at isometric contraction
Russian - electrode placement
bipolar
quadripolar
Parallel to mm fibers
Russian - treatment duration
re-ed = until mm fatigues or volitional contraction strengthening = 10-12 reps
Spasm reduction - target tissue
alpha motor neuron
Spasm reduction - polarity
none
Spasm reduction - frequency
35-80 Hz
Spasm reduction - pulse duration
150 for small
300-400 usec for other
Spasm reduction on/off time
1:1 ratio
goal is muscle fatigue
(maybe 10 sec on and 10 off)
Spasm reduction - intensity
max isometric contraction
Spasm reduction - electrode placement
bipolar
quadripolar
parallel to mm fiber
Spasm reduction - treatment duration
until the muscle fatigues
When is interferential often used
sensory level pain modulation
Russian is often used for
muscle strength
muscle re-ed