estim and pain Flashcards

1
Q

Whats TENS voltage, carrying frequency and intensity

A

all low

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2
Q

Whats IFC voltage, carrying frequency and intensity

A

low
medium
medium

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3
Q

Whats HVPC voltage, carrying frequency and intensity

A

high
low
high peak but low average

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4
Q

is HVPC biphasic

A

no, monophasic

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5
Q

Physiological rationale for EPA’s

A

segmental mechanisms
extrasegmental mechanisms
Placebo

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6
Q

segmental mechanisms

A

ascending

GATING

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7
Q

gating

A

the gate control theory

inhibition of T cells by activating AB, Adelta or c fibres

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8
Q

hows gating best achieved

A

high frequency, low intensity

TENS

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9
Q

weaknesses of segmental mechanisms

A

doesn’t account for pain in small diameter nerve fibres being destroyed

doesn’t consider role of higher centres in pain perception

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10
Q

extrasegmental mechanisms

A

descending

Stim of A-delta may provoke impulses at midbrain down SC to inhibit nociceptors

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11
Q

A delta sim releases ____ to inhibit _____ activity similar to _____

A

enkephalins
C fibers
morphine like

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12
Q

motor level of stem releases ____

A

dynorphins

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13
Q

extra segmental effects best evoked by

A

low frequency
high intensity
(AL TENS)

over motor points with intensity /pulse duration enough for mm twitch

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14
Q

TENS activates __ and ___ receptors

A

opioid

serotonin

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15
Q

does high or low frequency TENS impact serotonin

A

no , low is just as good as high

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16
Q

how to treat persistent pain

A
exercise
manual Rx
education
self management 
EPA
17
Q

why can EPA help with pain

A

pt gets positive experience with movement in less pain to normalize it

18
Q

5 reasons estim/TENS is used clinically

A

relatively safe
evidence support physiological benefits
easy
PART of a treatment plan

19
Q

4 contraindications for TENS

A

impaired cog/comm
recent fracture/osteop
seizure/epilepsy
electronic implant

20
Q

HVPC TENS shared contraindications

A

recent fract / osteoporosis

impaired cog//comm

21
Q

should you use ice and stim

A

NEVVER

22
Q

adverse effects of stim

A
skin irrational (red)
skin burns
23
Q

reasons to change TENS settings

A

some work better in better areas of body

sensation can change

24
Q

if two different size electrodes where the greater current intensity

A

under the smaller one

25
Q

why is gel good

A

electrode specific and has higher salt

26
Q

CONVENTIONAL TENS settings

A

80-150 HZ
60 micro

comfortable tingle, modulated

27
Q

AL TENS settings

A

10Hz
200 microsexs

intensity to mm twitch at motor points

modulated

28
Q

should you apply TENS daily

A

no, theres an opiod tolerance

29
Q

outcome tests of TENS

A

VAS
NPRS
pain thermometer
disease specific scales

30
Q

other outcome measures for TENS

A

pain relief
distraction from pain
dec feeling mm tension/spasm

31
Q

indirect benefits of TENS

A

med reduced
enhanced function
psych benefits
ability to rest

32
Q

5 things to chart with stim

A
that you covered contraindications/prec
sensation test
parameters
response
changes of treatment
33
Q

t/f TENS inhibits cortical actives of various pain related areas

A

t

34
Q

is setting intensity to patients by saying let it be strong but comfortable reliable

A

no

35
Q

what mode of tens helps immediate pain

A

conventional

36
Q

which TENS reduces pain more than ice

A

AL Tens

37
Q

which TENS helps reduce long term pain

A

burst