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Therapeutic Modalities > EStim For Pain > Flashcards

EStim For Pain Flashcards

0
Q

What are the benefits of iontophoresis?

A

Delivers medicine without

  1. The need of a needle stick
  2. Risk of infection
  3. Systemic effects
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1
Q

What is iontophoresis?

A

Use of direct current to drive negatively or positively charged ions of a drug solution into the patients tissue

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2
Q

Limitations of iontophoresis?

A
  1. Little evidence related to the amount of medication that enters the tissue
  2. Reduce plantar fasciitis pain and inflammation
  3. Useful for acute epicondylitis
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3
Q

Set up of iontophoresis?

A

Mono polar arrangement. Active electrode has the medication. Dispersive electrode completes the circuit

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4
Q

Dosage of iontophoresis?

A

The amount of charge that is delivered.

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5
Q

Dexamethasone

A

Most widely used drug. Negatively charged. Reduces acute inflammation by inhibiting the response of inflammatory cells. Half life is 36-48 hours.

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6
Q

Types of transcutaneous electrical nerve stimulation

A
  1. High (Sensory)
  2. Low (Motor)
  3. Brief-intense (Noxious)
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7
Q

Sensory (high) TENS

A

Decreases the perception of pain by decreasing signals from A Delta and C fibers to the thalamus and cortex. The gate control theory comes in here (stimulating A beta)

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8
Q

Sensory TENS parameters

A 
Asymmetrical balances biphasic current. 
Frequency: 60-100pps
Pulse width: 60-100 msec
Onset of relief: 10 min
Lasting relief: minute to hours
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9
Q

Motor (low) TENS parameters

A 
Asymmetrical balanced biphasic current.
Amps: muscle twitch 
Frequency: 2-4pps
Pulse width: 150-250 msec
Duration: 30 min
Onset of relief: 20-40 min
Lasting relief: hours

*gate control and descending pathways
Best used for chronic pain

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10
Q

Brief-intense (noxious) TENS parameters

A 
Asymmetrical balanced biphasic current
Amps: painful
Frequency: >100pps
Pulse width: 300-1000 msec
Duration: 15-30min
Onset of relief: <30 min

*endogenous opiate mechanism

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11
Q

Interferential Current (IFC)

A

By crossing two frequencies alternating currents within a tissue, a third frequency current of greater intensity is created in deeper tissue

*the higher the frequency the lower the resistance

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12
Q

IFC parameters

A

Duration: 15-30 min
Intensity: tolerable sensory or muscle twitch

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13
Q

Why IFC?

A

The higher carrier (base) frequency passes through the skin and other tissues with ease… This is more comfortable for the patient

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14
Q

PreModulated Current

A

A single AC current that is mixed within the generator to provide a sine wave of varying amplitude
Feels similar to IFC for sensory level control, but you use two independent channels for stimulation
*smaller areas

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15
Q

Battery operated TENS over IFC… WHY?

A

Battery operated is more accessible

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16
Q

IFC over TENS.. Why?

A

IFC creates a third current for comfortability

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17
Q

When do you choose low TENS?

A

Chronic pain

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18
Q

When do you use high TENS?

A

On acute injuries for controlling pain

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19
Q

Micro current stimulation

A

Theory is that MENS will work at the cellular level to assist healing and pain reduction

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20
Q

MENS parameters

A

Current: monophasic, biphasic, direct, or alternating
Current flow:1-999 m amps
Frequency: .1-1000 msec
Duration: 30min to 2 hours
Used for acute and chronic pain, wound healing, scar tissue

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21
Q

Static electricity is..

A

Friction between two objects, one gains electrons and one loses electrons

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22
Q

Current electricity is..

A

A stream of loose electrons passing along a conductor

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23
Q

Current flows from…

A

The positive pole to the negative pole

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24
Conductors allow the ______ to pass through
Current
25
Insulators _____ the current flow
Block
26
Resistors let _____ flow through
Some
27
Watts =
Volts x amps
28
A watt is..
The amount of work that is done as amps are pushed by volts
29
Voltage is..
The potential to cause current; the amount of electrical pressure
30
Amperage is...
The volume of electricity that flows past a particular point in a given period of time
31
Electric current=
Quantity of charge
32
Volt
Unit of force required to push a current of 1 amp through the resistance of 1 Ohm
33
Ohms law
I=V/R
34
Closed circuit
Formed when a complete path is formed between two poles
35
Positive pole
Anode
36
Negative pole
Cathode
37
Non biologic insulators
``` Glass Rubber Oil Asphalt Diamond ```
38
Non biologic conductors
``` Silver Copper Iron Steel Dirty water ```
39
Blood and nerves have a ____ electron flow and a _____ electrical impedance
High; low
40
Muscle has a ____ electron flow and a _____ impedance
Medium; medium
41
Skin, adipose tissue, and bone have a ___ electron flow and a ___ impedance
Low; high
42
Lowering impedance for electrode application
Clean skin Avoid lotion Lubrication of electrodes Limit hair
43
The _____ the distance that an electron has to travel, the less resistance to current flow
Shorter
44
The ____ the cross sectional area of a path, the ____ resistance to current flow
Greater; less
45
Direct current
Uninterrupted, unidirectional flow of electrons traveling from cathode to anode Interrupts human pH (iontophoresis)
46
Amplitude is..
The maximum distance that the pulse rides above or below the isoelectric baseline
47
Pulse duration is..
The horizontal distance of the shape of the pulse; pulse width
48
Pulse charge is the..
Area within the waveform
49
Alternating current
Direction of current flow changes from positive to negative in a cyclical manner No true positive or negative pole "Sine wave"
50
Monophasic current (pulsed currents)
Unidirectional flow of electrons | One phase per pulse
51
Biphasic currents (pulsed currents)
Bidirectional flow of electrons marked by periods of non current flow Each pulse has 2 phases
52
Pulse duration is measured in...
Microseconds
53
Inter pulse interval
Time between the conclusion of one pulse and the start of the next
54
Pulse charge
Number of electrons contained within a pulse | Microcoulombs
55
Pulse frequency
The number of events per second
56
Pulse rise
The amount of time it takes for the pulse to reach its peak value
57
Pulse trains (bursts)
Individual flows of current that are regularly interrupted by periods of non current flow at regular intervals
58
Series circuit
Electrical current flows alone one set route; each component has the same amperage, but voltage varies
59
Parallel circuit
Electrons are provided with alternative paths to follow; electrons take the path of least resistance
60
Current density
The amount of current per unit area
61
Duty cycle
The amount of time the current is flowing as opposed to the time the current is not flowing
62
Smaller electrodes require ___ current to stimulate tissues than larger electrodes
Less
63
Stimulation points
Motor points, trigger points, acupuncture points
64
Motor point
An area where the muscle is most easily excited with the minimum amount of stimulatin
65
Trigger point
Hyperirritable areas of skeletal muscle associated with palpable nodules in taut bands of muscle fibers
66
Acupuncture point
Locations on the body that are the focus of acupuncture and acupressure treatments
67
Estim goals
Muscle control Pain control Edema reduction
68
Contraindications
``` Cardiac dysfunction Pregnancy Pacemakers Cancerous lesions Unstable fractures Infected tissue ```
69
Precautions
``` Menstruation Nerve sensitivity Communication impairments Severe obesity Electronic monitoring equipment ```

Therapeutic Modalities (5 decks)

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