Electrotherapy 4 Flashcards

1
Q

Edema management - protocols

A

Muscle pump - edema control

High volt pulsed current - edema prevention

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2
Q

Muscle pump allows for

A

muscle contractions in the affected extremity while keeping the injured part protected

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3
Q

High volt uses

A

electrical field to induce movement of proteins into lymphatics

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4
Q

High volt facilitates

A

contraction of smooth muscle in lymphatics

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5
Q

High volt indirectly activates what

A

the autonomic nervous system

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6
Q

Effects of electrical stimulation on tissue healing

A

Inc microcirculation
Dec sympathetic tone
Inc regional blood flow through muscle contraction
Edema changes
Closure and bacteriostatic effect on wounds

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7
Q

Edema control - muscle pump - current type

A

alternating

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8
Q

Edema control - muscle pump - target tissue

A

alpha motor neuron

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9
Q

Edema control - muscle pump - polarity

A

no

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10
Q

Edema control - muscle pump - frequency

A

35-80 Hz

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11
Q

Edema control - muscle pump - pulse duration

A

300-400 usec

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12
Q

Edema control - muscle pump - on/off

A

1:1 ratio

more of a pumping action

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13
Q

Edema control - muscle pump - intensity

A

minimum to depolarize the alpha motor neuron

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14
Q

Edema control - muscle pump - electrode placement

A

bipolar or quadripolar

parallel to muscle fiber

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15
Q

Edema control - muscle pump - treatment duration

A

20-30 mintues

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16
Q

Edema control - muscle pump - effect theory

A

muscle pump will help to move edema out

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17
Q

Edema control - muscle pump - length of effect

A

variable - elevating the involved area if possible

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18
Q

Edema control - high volt - current type

A

high volt pulsed

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19
Q

Edema control - high volt - target tissue

A

smooth muscle, a beta fiber

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20
Q

Edema control - high volt - polarity

A

Yes - can choose either positive or negative - we will have it because it is monophasic
We arent using it though

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21
Q

Edema control - high volt - frequency

A

80-150 Hz

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22
Q

Edema control - high volt - intensity

A

pleasant tingling

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23
Q

Edema control - high volt - electrode placement

A

surround the dragon

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24
Q

Edema control - high volt - treatment duration

A

20-30 minutes

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25
Q

Edema control - high volt - effect theory

A

effect smooth muscle, autonomic nervous system

26
Q

Edema control - high volt - length of effect

A

4-5 hours

most effective within 24 hours of the injury

27
Q

E stim for wound healing - used when

A

Patients havent responded to other treatments
Multiple comorbidiites that predict a wound might need help healing
Treatment site has access and estim fits into model of care

28
Q

Estim for wound healing - medicare

A

covers treatment of chronic wounds (stage 3-4) - neuropathic, pressure ulcer, arterial insufficiency, venous insufficiency

29
Q

Wound - before use of estim

A

Wound must be nonchanging for 30 days before use of estim

30
Q

evidence for estim for wounds - most use polarity

A

alternating polarity (neg first) is more effective than keeping the same polarity

31
Q

Most effect - evidence for estim wounds - with what type

A

pressure ulcers

32
Q

Theoretical mechanisms by which e stim promotes tissue healing - current of injury theory

A

Negative polarity when injured and we want to return wound to positive polarity by treating with positive electrode
Very low intensity (1mA) 2 hours/2 times per day

33
Q

Theoretical mechanisms by which e stim promotes tissue healing - protein synthesis theory

A

Estim trigger Ca channel opening in fibroblast cell membrane
Inc intracellular Ca causes additional insulin receptors on cell surface
Insulin binds to receptors on fibroblast and ***stimulates fibroblasts to synthesize collagen and DNA

34
Q

Theoretical mechanisms by which e stim promotes tissue healing - Galvanotaxis

A

attraction of cells to electric polarity
Neg polarity initially to bring in neutrophils and leukocytes and then switch to positive to call in fibroblasts and epidermal cells
New or Infected wound - you want to use neg electrode
Without inflammation - use positive electrode

35
Q

Theoretical mechanisms by which e stim promotes tissue healing - inc antimicrobial activity

A

Neg polarity has bacteriocidal effect and will help clean the wound

36
Q

Theoretical mechanisms by which e stim promotes tissue healing - Angiogenesis

A

Production of new BVs in a wound

Inc cutaneous blood flow under the cathode

37
Q

Theoretical mechanisms by which e stim promotes tissue healing - Inc tissue oxygenation tension

A

Inc oxygen will promote healing and dec bacteria

HPVC has been shown to inc partial pressure of O2

38
Q

Protocol for wound healing

A

Make sure patient is candidate for estim

Determine biological phase of wound healing

39
Q

Estim for wounds - Other considerations beforehand

A

Infection control
Sometimes will need to do debridement before
Inspect the wound before and after tx
Conductive medium (esp if wound is dry)

40
Q

Types of wounds

A
pressure ulcers (most support)
Diabetic ulcers
Vascular ulcers
Traumatic and surgery wounds
Donor sites
Tissue flaps
Burns
41
Q

Estim for wounds - contraindications/precautions

A
CA
Osteomyelitis
Superficial metal or residue 
Pacemaker
Pregnancy
Thrombophlebitis
COnfused patient
Sensory impairment
Impaired circulation
Heart conduction problem
Wound care products composed of hypertonic salt solutions or metal ions (zinc, silver)
42
Q

Wound healing (uninfected, subacute/chronic) - current type

A

Monophasic

HVPC

43
Q

Wound healing (uninfected, subacute/chronic) - target tissue

A

wound bed

44
Q

Wound healing (uninfected, subacute/chronic) - polarity

A

Start with negative for 3 days and then switch to positive

45
Q

Wound healing (uninfected, subacute/chronic) - frequency

A

80-150 Hz

46
Q

Wound healing (uninfected, subacute/chronic) - on/off time

A

continuous

47
Q

Wound healing (uninfected, subacute/chronic) - intensity

A

Subsensory
1-5mA
Patient doesnt need to feel it

48
Q

Wound healing (uninfected, subacute/chronic) - electrode placement

A
Active = wound bed
Dispersive = proximal to active - out of wound though
49
Q

Wound healing (uninfected, subacute/chronic) - treatment duration

A

2-3 hours 2-3 times per day

50
Q

Wound healing (uninfected, subacute/chronic) - effect theory

A

stimulate proliferation

fibroblast activity

51
Q

Wound healing (infected wound) - current type

A

Monophasic

HVPC

52
Q

Wound healing (infected wound) - target tissue

A

wound bed

53
Q

Wound healing (infected wound) - polarity

A

Change to positive after infection is cleared

54
Q

Wound healing (infected wound) - frequency

A

80-150 Hz

55
Q

Wound healing (infected wound) - on/off time

A

continuous

56
Q

Wound healing (infected wound) - intensity

A

subsensory

57
Q

Wound healing (infected wound) - electrode placement

A

Active - wound bed

Dispersive - proximal to wound

58
Q

Wound healing (infected wound) - treatment duration

A

2-3 hours

59
Q

Wound healing (infected wound) - effect theory

A

negative pole will draw in neutrophils

60
Q

Wound healing (infected wound) - length of effect

A

if infected, until no longer infected