EStim

Question 1

What Estim is best for motor/noxious level pain?

Answer 1

TENS

IFC/Premod*

Question 2

What Estim is best for wound healing?

Answer 2

HVPC*

MENS (- then +)

Question 3

What Estim is best for Edema prevention?

Answer 3

HVPC (-) at sensory level

Question 4

What Estim is best for edema reduction?

Answer 4

Premod*
NMES
HVPC @ motor-level intensity

Question 5

What Estim is best for spasm/trigger point?

Answer 5

HVPS w/ probe (trigger pt)
Combo US-Estim (spasm)
Premod (motor twitch)

Question 6

What is the best Estim for muscle reeducation?

Answer 6

Russian

HVPC

Question 7

What is the best Estim for muscle strengthening?

Answer 7

Russian

Question 8

What are the disadvantages to using TENS?

Answer 8

Low total current limits tetany production

Cannot control duty cycle

Question 9

What are the goals with TENS units?

Answer 9

Motor/Noxious level pain control

Motor level edema/spasm reduction?

Question 10

What are the goals with HVPC?

Answer 10

Motor-level edema/spasm reduction
Probe option for trigger points
Neuromuscular reeducation

Question 11

What are the disadvantages of HVPC?

Answer 11

Lacks total current needed for maximum force production

Question 12

What are the motor level goals with IFC?

Answer 12

Pain control
Edema/spasm reduction
Combo (US/estim)

Question 13

What are the disadvantages with IFC?

Answer 13

Waveform may produce discomfort with patient before tetany can be reached
Typically no duty cycle control
No ramp option

Question 14

What are the motor goals with NMES?

Answer 14

Neuromuscular reeducation

Strength augmentation - tetany contraction w/ little sensory discomfort

Question 15

What is the best Estim for sensory pain reduction?

Answer 15

TENS
IFC/Premod*
HVPC (generally +)

Question 16

What are the parameters for Neuromuscular Reeducation?

Answer 16

Duty Cycle - 1:3 or 1:5
Ramping - dependent on patient comfort
Pulse frequency - 50-70Hz
Intensity - motor tetany
Frequency - 3 set 5-20 reps 3x/day

Question 17

What are the parameters for would healing with HVPC?

Answer 17

(reduce healing time by 1.5-2.5 times)
Pulse frequency - 100pps
Intensity - Sensory
(-) electrode till infection clears, then (+)

Question 18

What are the parameters for wound healing with MENS?

Answer 18

Pulse frequency - Max level
Intensity - subsensory
(-) electrode until infection clears then (+) electrode

Question 19

What are the parameters for Edema Prevention?

Answer 19

HVPC only
Intensity - sensory level (~10% less than needed for contraction)
Pulse Frequency - 120 pps
(-) polarity - facilitate permeability of BVs

Question 20

What are the parameters for Edema Reduction?

Answer 20

Any biphasic or HVPC (pulsed direct)
Intensity - motor twitch/tetany (strong but comfortable)
Duty cycle - 1:3
Pulse Frequency - 50 (te)
Frequency - 20-30 min 2-5x/day