Exam III

Question 1

What is the use of sensory-level stimulation for edema control?

Answer 1

animal studies showed retarded edema formation if applied early
use (-) electrode over area with high frequency and low intensity
bull frog studies showed it prevented edema but didn’t decrease existing edema
usually used post-treatment

Question 2

What is the use of motor-level stimulation for edema control?

Answer 2

most common
rhythmical muscle contractions to reduce existing edema
minimal contraction
possible to increase venous return

Question 3

What is the use of sensory-level stimulation for increasing circulation?

Answer 3

low frequency to increase skin blood flow

won’t affect diseased blood vessels

Question 4

What is the use of motor-level stimulation for increasing circulation?

Answer 4

rhythmic muscle contraction to increase deeper arterial blood flow
(won’t affect diseased blood vessels)

Question 5

What are the common current types used to facilitate wound healing?

Answer 5

low-intensity direct current (LIDC)

high voltage pulsed current (HVPC)

Question 6

What is the history of electrical stimulation for wound healing?

Answer 6

LIDC was moved to HVPC
1950s the first studies were done, big increase in 80-90s
started out with studying bunnies, now lots of research on humans

Question 7

What are the effects or possible mechanisms of action for wound healing?

Answer 7

galvanotaxis (mvt of cells to oppositely charged poles)
promotion of granulation tissue
autolysis and phagocytosis (gobbling of bad tissue)
bactericidal effects (-) electrode
enhancing rate of epithelialization (need to fill with granulation first)
enhancing blood flow to wounds (-) or (+) electrodes

Question 8

What was the clinical application for electrical stimulation for wound healing?

Answer 8

HVPC stimulator
200 volts (sub-motor or sensory)
100 pps
1 hour per day for 20 consecutive days
polarity based on desired effects

Question 9

How is electrical stimulation for osteogenesis?

Answer 9

not done by PT
different types (both implanted, one implanted one outside, both external)
negative polarity is used

Question 10

What are the general effects of direct current under the cathode (-)?

Answer 10

alkaline reaction (d/t increased blow flow)
protein liquefaction (sclerolytic)
antibacterial effects
wound healing
depolarization (if interrupted)

Question 11

What are the general effects of direct current under the anode (+)?

Answer 11

acid reaction (weaker than alkaline)
protein coagulation (sclerotic)
antibacterial effects (some)
wound healing
hyperpolarization (anode block)

Question 12

What are the stimulation parameters for direct current?

Answer 12

current: direct or galvanic
intensity: less than or equal to 5 mA (less than one is microcurrent)
duration: minutes to hours (just on, no pulses)
dosage: intensity and duration= mA*mins
frequency: 0 (no pulses)
electrodes: special types for wound treatment and iontophoresis

Question 13

What are the clinical applications for direct current?

Answer 13

medical galvanism
galvanic bath/tap water galvanism
iontophoresis

Question 14

What are the stimulation parameters for medical galvanism?

Answer 14

vary depending on application and indication

Question 15

What are the indications for medical galvanism?

Answer 15

pain control

ESTR (wound healing without motor response)

Question 16

What are the stimulation parameters for a galvanic bath?

Answer 16

15 minutes of (-) and 15 minutes of (+)
12 mA
(alter between polarities)

Question 17

What is the indication for a galvanic bath?

Answer 17

hyperhidrosis

excessive sweating of palms and feet

Question 18

What is the most common form of direct current?

Answer 18

iontophoresis

Question 19

What is the description of iontophoresis?

Answer 19

use of electrical current to deliver medicinal solutions transcutaneously
meds must be water and lipid soluble and muse ionize to form charged particle solution

Question 20

What are the mechanisms of action for iontophoresis?

Answer 20

electromigration: ions are repulsed and driven into skin by similar charged electrodes
electroporation: increase in porosity of skin to facilitate movement of ions
electro-osmosis: movement of fluid caused by electrical field acting on ions in the fluid, bulk flow of fluids may carry drugs through hair follicles and sweat glands (an attempt to explain opposite charged medicine being driven)

Question 21

What are the application and selection of ions for iontophoresis?

Answer 21

anti-inflammatory effects: dexamethasone
anesthetic effects: lidocaine or any of the “caines”
other: acetic acid and iodine

Question 22

What is the electrode selection for iontophoresis?

Answer 22

standard (portable DC units)

patch (DC battery is built into electrode, can be used for longer treatments but doesn’t have much research for support)

Question 23

What is the electrode placement for iontophoresis?

Answer 23

active over target
inactive over meaty area
cathode for tissue damage

Question 24

What is the dosage for iontophoresis?

Answer 24

current * duration= mA * mins
20-80 mAmins
effective dosage: 70-80 mAmins

Question 25

What is the strength of evidence for iontophoresis?

Answer 25

weak to moderate

Question 26

What are the poor justifications for iontophoresis?

Answer 26

calcific tendinitis (also conflicting)

Question 27

What are the fair justifications for iontophoresis?

Answer 27

rheumatoid (dex and lido are opp)
epicondylitis
TMJ disorders

Question 28

What is the good justification for iontophoresis?

Answer 28

hyperhidrosis

Question 29

What are some considerations before treating with iontophoresis?

Answer 29

dispensing medications within pharmacy guidelines
insurance coverage and payment
skin damage