Electrotherapy 3 Flashcards
Iontophoresis is what
Ions into the body with the assist of a direct current
Phonophoresis is what
use of sound waves to drive whole molecules through the skin
Iontophoresis uses ___ to ____
direct current to drive ions to tissues
Ions
positively or negatively charged particles
Like charges
repel
opposites attract
iontophoresis - Negative ions move away from ___ and toward ___
Away from the negative electrode (cathode) and toward the positive electrode (anode)
iontophoresis - Negative ion set up - leads to
an acidic reaction of pH in tissue
iontophoresis - Positive ions move away from ___ and toward ___
Away from the positive electrode and toward the negative electrode
iontophoresis - Positive ion set up leads to
alkaline reaction of pH in the tissue
iontophoresis - Active electrode
electrode used to deliver the ion
Has the medication on it
iontophoresis - Current density - recommended that
recommended that the negative electrode be larger
iontophoresis - Impedance - skin and fat
Skin and fat have high impedance
iontophoresis - Conductance - blood flow and sweat glands
sweat glands and blood flow to the area –>
this will inc conductance and dec impedance
As treatment progresses, what happens to impedance - iontophoresis
decreases as treatment progresses
Dosage (Iontophoresis) - expressed in
expressed in mA*min
Dosage ranges for iontophoresis
ranges from 0-80 with typical doses being 40 or 80 mA * min
iontophoresis - usually amplitude from 0-4 mA - so if overall goal for dosage is 40mA * min and get to 2 mA and patient says no more - how long will it take for patient to get their dose
20 minutes
iontophoresis - usually amplitude from 0-4 mA - so if overall goal for dosage is 80mA * min and get to 4 mA and patient says no more - how long will it take for patient to get their dose
20 minutes
Ion quantity - dosage - iontophoresis - what would get you an increased ion transfer
Higher intensity, longer duration = increased ion transfer
Ion quantity - dosage - iontophoresis - electrolyte concentrations up to
1-2%
Current intensity - iontophoresis
between 3-5 mA
Usually 0-4 is what machines allow
Current intensity - iontophoresis - what do you usually need to get channels open
3mA
What do you need to do iontophoresis
In iowa, need physician prescription or referral
Current intensity - iontophoresis - size of electrode determines
max intensity tolerated
Treatment duration - iontophoresis
depends on desired dosage and intensity
10-20 minutes
Treatment duration - iontophoresis - can leave the medicated electrode in place for how long
12-24 hours
some reason to do and some reason not to do this
some say get remaining ions will get out
Iontophoresis - electrodes and electrode placement - buffered
to protect against the acidic and alkaline reactions
Iontophoresis - electrodes and electrode placement - skin prep
use alcohol and light water to decrease impedence
Iontophoresis - electrode and electrode placement - active electrode where
over the are to be treated
Iontophoresis - electrode and electrode placement - dispersive electrode where
separated by at least diameter of the active electrode
typically on a meaty/fleshy area (just to be more comfortable)
Iontophoresis only works with drugs/substances that
can dissolve into ions
have relatively small ions
are in solution
are effective on a small treatment area
Iontophoresis - need to identify the drugs what
polarity and indication
Most common medications in clinical practice for iontophoresis
dexamethasone (steroid/antiinflammatory) phosphate lidocaine acetic acid salicylate
Acetate from acetic acid (vinegar) is what type and is used for what
negative solution
dissolves calcium deposits (used for bone spurs)
Dexamethazone is what type of solution and what can it be used for
negative
anti-inflammatory by reducing synthesis of prostaglandins
Anderson study - dexamethasone shows to have…
passive diffusion
10 min = 2mm into skin
6.5 hrs later = 12 mm into skin
Target tissue has to be pretty superficial
Hybresis by Empi - is what
patch applied with medication as in traditional iontophoresis
Hybresis - dose controller
Attached to patch for 3mA for 3 min to reduce impedance of skin and opens the channels for medication to pass through
If hybresis patch has 3 volt batteries that deliver 80 mA min for 2 hrs, what is the intensity
80mA min = ___ * 120 min
mA would be 0.66
Indications for iontophoresis
Inflammatory musculoskeletal conditions Pain Scar tissue modification Wound healing Edema Calcific deposits Hyperhidrosis
Contraindications/precautions for iontophoresis
Skin sensitivity
Allergy or sensitivity to the ion or electrolyte solution (this is key)
Pacemaker
Impaired cognition/sensation
Safety - iontophoresis
burns more likely from DC
More likely to burn under cathode
Normal skin after
Pink skin coloration
Biofeedback is what
Feedback provided by a device measuring real time biological data
EMG biofeedback
Uses electronic or electromechanical instruments to accurately measure, process, and feedback reinforcing information via auditory and visual signals
Amplitude of EMG biofeedback is effected by
Size of motor units under electrodes Number of motor units under electrodes Distance of muscle fibers from electrodes Size of recording area Interelectrode distance
Indication for use of EMG biofeedback
mm re-education Regaining neuromuscular control Inc isometric and isotonic strength Relaxation of mm spasm or tightness Psychological relaxation
