ES for innervated muscles Flashcards
what does an innervated muscle mean
intact peripheral nerves, motor unit and NMJ
manner of atrophy for an innervated muscle
DISUSE ATROPHY d/t post-op weakness, orthopedic conditions, CNS affectation
define NMES
use of ES to produce muscle contractions in innervated muscles
Neuromuscular Electrical Stimulation
define FES
type of NMES to enhance the control of movement and posture; integrated to functional activities
FES is aka
orthotic substitution
compare volitional and electrically induced in terms of cause of contraction
volitional - d/t command from upper motor neurons
electrically induced - d/t applied ES
compare volitional and electrically induced in terms of recruitment of motor units
volitional - recruits smaller to larger motor units
electrically induced - recruits larger to smaller motor units
compare volitional and electrically induced in terms of fiber activation
volitional - activates type 1 prior to 2
electrically induced - activates type 2 prior to 1
compare volitional and electrically induced in terms of recruitment of muscles
volitional - asynchronous recruitment
electrically induced - synchronous recruitment
compare volitional and electrically induced in terms of muscle fatigue
volitional - slow onset
electrically induced - rapid onset
how does ES inc muscle strength
d/t
overload principle
specificity theory
inc muscle size
improved motor unit recruitment
exp how overload principle inc muscle strength
inc current, inc frequency, inc pulse duration = increase externally-applied resistance
when is overload principle effective
can only inc if 2/5 or 3/5; ES alone not enough for 4 and above
exp how specificity theory inc muscle strength
since ES targets type 2 first na muscles for power or strength production
exp how inc muscle size d/t ES inc muscle strength
inc muscle mass = more power but takes several weeks or longer esp if vv weak
exp how improved motor unit recruitment d/t ES inc muscle strength
since recruit synchronously = more rapid contraction
exp how ES can promote muscle re-education
improves motor control - ES to contract until cues na lang
stims brain plasticity - capable to teach brain to contract again
exp how ES can prevent disuse atrophy
for rlly weak - provides externally induced contractions to prevent wasting
for adequate strength - biofeedback to promote contraction
exp how ES reduces muscle spasm over agonist
contracts until mag fatigue = relaxation
exp how ES reduces muscle spasm over antagonist
reciprocal inhibition of agonist
spastic biceps; so place on triceps para mag relax biceps
exp how ES reduces muscle spasm over agonist and antagonist
2 circuits - sequential stim of agonist tas antagonist
so if spastic biceps; contract muan biceps tas triceps; mimics the normal motor activity s CNS dysfunction
exp how ES reduces edema
muscle pumping effect
exp application of FES during gait training
initial contact - over tibialis anterior
during push-off - over gastrocsoleus
exp application of FES for idiopathic scoliosis
Over lateral flexors on convex side
exp application of FES during gripping
over wrist extensors
exp application of FES for shoulder sublaxation
Over supraspinatus and posterior deltoids
common waveform for BPC
square, balanced, symmetrical, biphasic PC
some p assym biphasic PC
common waveform for russian current
medium frequency AC c 2500 Hz in 50 bursts per second
common waveform for IFC
alternating MFC slightly out of phase that are amplitude-modulated at low frequency
frequency used for IFC
2 kHz since muscle contraction
discuss electrode placements
active - over the motor point
dispersive - 2 in. away on same muscle following fiber orientation
wider spacing of electrodes will cause _____
deeper stimulation
what would warrant a monopolar approach
face and hypo/thenar eminence of hand
exp how a pt would progress in NMES
contraction bcs of ES only - NMES and from patient - NMES as biofeedback only 100% contraction from pt
compare synchronous and reciprocal mode
synch - on and off times are together
reciprocal - 1 is on the 1 is off
