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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
Q

Conductors allow the ______ to pass through

A

Current

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25
Q

Insulators _____ the current flow

A

Block

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26
Q

Resistors let _____ flow through

A

Some

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27
Q

Watts =

A

Volts x amps

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28
Q

A watt is..

A

The amount of work that is done as amps are pushed by volts

29
Q

Voltage is..

A

The potential to cause current; the amount of electrical pressure

30
Q

Amperage is…

A

The volume of electricity that flows past a particular point in a given period of time

31
Q

Electric current=

A

Quantity of charge

32
Q

Volt

A

Unit of force required to push a current of 1 amp through the resistance of 1 Ohm

33
Q

Ohms law

A

I=V/R

34
Q

Closed circuit

A

Formed when a complete path is formed between two poles

35
Q

Positive pole

A

Anode

36
Q

Negative pole

A

Cathode

37
Q

Non biologic insulators

A 
Glass
Rubber
Oil
Asphalt
Diamond
38
Q

Non biologic conductors

A 
Silver
Copper
Iron
Steel
Dirty water
39
Q

Blood and nerves have a ____ electron flow and a _____ electrical impedance

A

High; low

40
Q

Muscle has a ____ electron flow and a _____ impedance

A

Medium; medium

41
Q

Skin, adipose tissue, and bone have a ___ electron flow and a ___ impedance

A

Low; high

42
Q

Lowering impedance for electrode application

A

Clean skin
Avoid lotion
Lubrication of electrodes
Limit hair

43
Q

The _____ the distance that an electron has to travel, the less resistance to current flow

A

Shorter

44
Q

The ____ the cross sectional area of a path, the ____ resistance to current flow

A

Greater; less

45
Q

Direct current

A

Uninterrupted, unidirectional flow of electrons traveling from cathode to anode

Interrupts human pH (iontophoresis)

46
Q

Amplitude is..

A

The maximum distance that the pulse rides above or below the isoelectric baseline

47
Q

Pulse duration is..

A

The horizontal distance of the shape of the pulse; pulse width

48
Q

Pulse charge is the..

A

Area within the waveform

49
Q

Alternating current

A

Direction of current flow changes from positive to negative in a cyclical manner
No true positive or negative pole
“Sine wave”

50
Q

Monophasic current (pulsed currents)

A

Unidirectional flow of electrons

One phase per pulse

51
Q

Biphasic currents (pulsed currents)

A

Bidirectional flow of electrons marked by periods of non current flow
Each pulse has 2 phases

52
Q

Pulse duration is measured in…

A

Microseconds

53
Q

Inter pulse interval

A

Time between the conclusion of one pulse and the start of the next

54
Q

Pulse charge

A

Number of electrons contained within a pulse

Microcoulombs

55
Q

Pulse frequency

A

The number of events per second

56
Q

Pulse rise

A

The amount of time it takes for the pulse to reach its peak value

57
Q

Pulse trains (bursts)

A

Individual flows of current that are regularly interrupted by periods of non current flow at regular intervals

58
Q

Series circuit

A

Electrical current flows alone one set route; each component has the same amperage, but voltage varies

59
Q

Parallel circuit

A

Electrons are provided with alternative paths to follow; electrons take the path of least resistance

60
Q

Current density

A

The amount of current per unit area

61
Q

Duty cycle

A

The amount of time the current is flowing as opposed to the time the current is not flowing

62
Q

Smaller electrodes require ___ current to stimulate tissues than larger electrodes

A

Less

63
Q

Stimulation points

A

Motor points, trigger points, acupuncture points

64
Q

Motor point

A

An area where the muscle is most easily excited with the minimum amount of stimulatin

65
Q

Trigger point

A

Hyperirritable areas of skeletal muscle associated with palpable nodules in taut bands of muscle fibers

66
Q

Acupuncture point

A

Locations on the body that are the focus of acupuncture and acupressure treatments

67
Q

Estim goals

A

Muscle control
Pain control
Edema reduction

68
Q

Contraindications

A 
Cardiac dysfunction 
Pregnancy
Pacemakers
Cancerous lesions 
Unstable fractures 
Infected tissue
69
Q

Precautions

A 
Menstruation
Nerve sensitivity
Communication impairments
Severe obesity
Electronic monitoring equipment

Therapeutic Modalities (5 decks)

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