ESTIM/TENS for pain Flashcards
TES = ______ term
umbrella
______ = intensity in milliamp or microamp
amperage
Does TENS have high or low voltage?
Lows
______ = rate or pulses per second
frequency
Does TENS have a low or high frequency rate
low
Microcurrent:
- voltage?
- carrying frequency?
- intensity?
low; low; lowest (subsensory)
TENS:
- voltage?
- carrying frequency?
- intensity?
low; low; low
IFC:
- voltage?
- carrying frequency?
- intensity?
low; medium; medium
HVPC:
- voltage?
- carrying frequency?
- intensity?
high; low; high peak but low avg
segmental mechanisms = ascending gating; presynaptic inhibition of __ cells by activation of __ ____ fibres in preference to A delta or C fibers
T; A beta
Ascending gating is theoretically best achieved by using ___ frequency, ____ intensity
high; low (AKA conventional TENS!)
_______ _______ = descending gating
extrasegmental mechanisms
In descending gating, stimulation of __ ____ fibers may provoke impulses at the midbrain which travel down SC to inhibit nociceptors (release endorphins)
A delta
A delta stim releases ____ to inhibit C fiber activity (morphine like effect)
enkephalins
Motor level stimulation releases _____
dynorphins
Extrasegmental effects are theoretically best evoked by ___ frequency, ___ intensity pulses (aka AL-TENS)
low; high
TENS activate ____ and ______ receptors
opiod; serotonin
Low frequency TENS increases ______ concentration during and immediately after Rx, whereas high frequency does not
serotonin
Ion channels have a (long/short) lifespan
short
One type of ion channel can be replaced by another (T/F)
TRUE
EPA’s can be used to help enable ____ experience of movement with less pain in order to normalize movement
positive
4 reasons to use Estim/TENS to treat acute, sub acute and persistent pain?
- relatively safe with very limited side effects
- there is evidence to supports physiological effects
- evidence to support its effectiveness in many situations at specific parameters
- easy to apply
2 adverse reactions to estim?
- skin irritation
2. skin burns
Smaller electrodes = higher ____ _____
current density
The farther apart the electrodes the _____ the effect
deeper
Conventional TENS parameters?
~80-150Hz, ~ 60microsec, intensity to comfortable tingle; modulated
AL-TENS parameters?
~10Hz, ~200 microsec, intensity to muscle twitch, modulated
Is conventional or AL TENS Rx times longer?
AL
You should alternate high and low frequency (T/F).
TRUE
You should use TENS daily
FALSE (opiod tolerance)
4 outcome measures you could use with TENS?
- VAS
- NPRS
- Pain thermometer
- disease specific scales
What are 3 separate outcomes of TENS?
- pain relief
- distraction from pain
- reduction in sensations associated with muscle tension/spasm
Need to evaluated TENS using more than a ________ pain scale
unidimensional
TENS inhibits the _______ activities of various pain-related areas
cortical
TENS reduces acute pain more than placebo (T/F)
TRUE
Setting intensity based on subjective perception alone is _______ and requires objective standardization
unreliable
Adjusting pulse amplitude during Rx often used to prevent accommodation, but may not improve pain reduction (T/F)
TRUE
Different ____ of TENS appear to have different benefits
modes
Burst tens can reduce ___ ___ pain
long term
Is electrode location important ?
YES
