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DPT 608 > High Voltage Pulsed Current (HVPC) > Flashcards

High Voltage Pulsed Current (HVPC) Flashcards

1
Q

What is HVPC?

A

Twin peaked monophasic pulsed current with voltage up to 500 volts and very short pulse duration resulting in current with a relatively low average current yet high peak voltage

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2
Q

What is a characteristic of many HVPC devices?

A

A large dispersive electrode

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3
Q

What is the waveform of HVPC?

A

Twin peaked monophasic pulsed current

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4
Q

T/f: with HVPC, one electrode will accumulate negative charge (cathode) and the other will accumulate positive charge (anode)

A

True

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5
Q

Where do the electrodes go with HVPC?

A

One electrode is placed over the treatment area (active/treatment electrode) and one electrode is placed away from the treatment area (dispersive/reference electrode)

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6
Q

HVPC devices allow selection of _____ of the active electrode, and the dispersive electrode becomes the other ______

A

Polarity, polarity

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7
Q

The active electrode is _____and the dispersive electrode is _____

A

Small, large

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8
Q

What is the amplitude of HVPC?

A

Peak voltage reaching 150-500V

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9
Q

What is the pulse duration of HVPC?

A

Short
50-150usec
Instantaneous rise time, immediate exponential fall time

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10
Q
A
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11
Q

Is the interpulse interval for HVPC long or short?

A

Long

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12
Q

The short pulse duration and long interpulse interval of HVPC results in what?

A

Relatively low intrinsic duty cycle

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13
Q

Why is the long interpulse interval important in HVPC?

A

Bc it allows for the use of high peak voltages and overall low average treatment current

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14
Q

T/f: the higher voltage allows deeper penetration of energy in HVPC

A

True

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15
Q

The short phase duration in HVPC doesn’t allow for stimulation of what fibers?

A

A-delta and C fibers

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16
Q

T/f: bc the short phase duration of HVPC doesn’t allow for stimulation of A-delta and c-fibers, it tends to be more comfortable

A

True

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17
Q

What is the frequency of HVPC?

A

1-120 Hz

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18
Q

What are the modes of HVPC?

A

Continuous, reciprocating, and surge

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19
Q

What is continuous mode HVPC?

A

Continuous and uninterrupted flow of pulsatile current for the entire treatment session with no on/off time
Amplitude of each pulse is constant

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20
Q

What is reciprocating mode HVPC?

A

A mode that delivers current first to one of the active electrodes then to the other active electrode in an alternating/reciprocating manner

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21
Q

How many active electrodes are needed for reciprocating HVPC?

A

2 active electrodes

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22
Q

Can you select the time that the current flows for each electrode b4 switching with reciprocating HVPC?

A

Yes

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23
Q

T/f: the amplitude of ach pulse is constant unless the clinician adjusts it in reciprocating HVPC

A

True

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24
Q

What is balancing in HVPC?

A

When the clinician adjusts the amplitude of each pulse in reciprocating HVCP??? (I don’t really know)

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25
Q

What is the point of balancing with reciprocating HVPC?

A

It allows the peak intensity of the current to the active electrodes to be decreased by a selected % to accommodate for sensitive placement sites

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26
Q

What is surge HVPC?

A

Modulating the amplitude of the pulse train so that the amplitude of each successive pulse progressively increases to peak over the duration of pulse

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27
Q

T/f: surge HVPC is similar to ramp features

A

True

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28
Q

T/f: HVPC has significant electrophoretic effects

A

False, the electrophoretic effects of HVPC are negligible

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29
Q

Can ionto be performed with HVPC?

A

No

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30
Q

Describe the electrophoretic effects of HVPC

A

The net flow of ions across the membrane is minimal due to short phase duration and long interpulse interval
The membrane can neutralize any change in normal ion status

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31
Q

Can HVPC be used with appendage submersion (in water)?

A

Yes

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32
Q

What are the clinical uses of HVPC?

A

Pain modulation
Activation of skeletal muscle
Edema reduction
Tissue healing

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33
Q

How is HVPC used for pain modulation?

A

High frequency/sensory intensity provides electro-analgesia

By modifying the frequency and intensity of the HVPC it can yield a waveform similar to sensory/conventional TENS

OR

motor/AL TENS low frequency/motor intensity

35
Q

How can HVPC be used for activation of skeletal muscle?

A

Short phase/pulse duration requires high intensity stimulus perceived as painful for the pt

36
Q

T/f: other waveforms than HVPC are more suitable and effective for muscle re-education like Russian and biphasic

37
Q

What is edema?

A

Abnormal accumulation of interstitial fluid causing impairments, pain, and dysfunction

38
Q

T/f: if we can decrease edema we can increase functioning

39
Q

What is arthrogenic muscle inhibition (AMI)?

A

When muscles are inhibited from use following trauma/edema

40
Q

If we let edema continue on, what happens?

A

The protein content increases more and the tissue thickens and can even become fibrotic

41
Q

What 3 things can lead to edema?

A

Damage to vascular structures
Decreased muscle activity
Limb dependency

42
Q

What are the 2 approaches to edema management with HVPC?

A

Use of polarity
Use of muscle pumping

43
Q

The decision to use polarity or muscle pumping for edema management with HVPC is dependent upon what things?

A

The stage of injury and ability to generate a voluntary contraction

44
Q

How does use of polarity reduce edema with HVPC?

A

HVPC minimizes the leakage of plasma proteins and thus edema formation by limiting vascular permeability and repelling large negative charged plasma proteins from the interstitial spaces through the placement of a negatively charged electrode (cathode) over the site of injury

45
Q

How do we use muscle pumping to reduce edema with HVPC?

A

HVPC can decrease edema by increasing the rate of plasma protein uptake of accumulated fluids through the lymphatic system using muscle contractions

46
Q

An acute onset of edema occurs within how many hours?

A

24-72 hours

47
Q

What waveform of HVPC is used to reduce acute edema?

A

HVPC sensory level stimulation

48
Q

What is the polarity used with HVPC to reduce acute edema?

49
Q

What is the frequency of HVPC used to reduce acute edema?

A

100-125 pps

50
Q

What is the pulse duration of HVPC used to reduce acute edema?

A

100usec (preset by the unit)

51
Q

What is the amplitude of HVPC used to reduce acute edema?

A

mA to comfortable sensory perception (~10% below motor threshold)

52
Q

What is the treatment duration of HVPC used to reduce acute edema?

A

4-30 min applications, continuous applications of 3-4 hours is more effective

53
Q

What is the electrode configuration of HVPC used to reduce acute edema?

A

Monopolar electrode configuration
Bifurcated, smaller active electrodes over the treatment area
Larger dispersive electrode proximal to the treatment area

54
Q

What is the typical ankle electrode placement for acute edema reduction using HVPC?

A

Two smaller active bifurcated electrodes on either side of the ankle
Larger dispersive electrode over the GS

55
Q

What are the supplemental modalities we can use with acute edema reduction with HVPC?

A

Ice pack
Ice bath
Compression pump
Muscle pumping
Elevation

56
Q

T/f: there is limited evidence for the use of HVPC for subacute/chronic edema reduction

57
Q

What is theory behind using HVPC for subacute/chronic edema reduction?

A

Management is focused on clearing the swelling with NMES to create repetitive contractions of muscles to compress venous and lymphatic vessels to help reduce swelling while increasing venous and lymphatic return

Improve circulation by stimulating lymphatic flow

58
Q

What is the waveform used to reduce subacute/chronic edema using HVPC?

A

NMES, HVPC could be used but biphasic pulsed current or burst modulated AC (Russian) is more commonly used

59
Q

What is the frequency used with HVPC for subacute/chronic edema reduction?

60
Q

What is the pulse duration used with HVPC for subacute/chronic edema reduction?

A

100-600 usec if PC used

61
Q

What is the amplitude used with HVPC for subacute/chronic edema reduction?

A

Motor, mA to tetanic contractions

62
Q

What is the duty cycle used with HVPC for subacute/chronic edema reduction?

A

1:1
5-10” on, 5-10” off

63
Q

What is the treatment duration used with HVPC for subacute/chronic edema reduction?

64
Q

What is electrode placement used with HVPC for subacute/chronic edema reduction?

A

One electrode/channel on agonist muscle
One electrode/channel on antagonist muscle

OR

Over muscles located in the area of edema

65
Q

What is the goal of the electrode placement used with HVPC for subacute/chronic edema reduction?

A

Reciprocal contractions for muscle pumping action

66
Q

T/f: HVPC for tissue healing is well supported in peer reviewed literature

67
Q

The benefit of HVPC for tissue healing is greatest when?

A

With chronic, recalcitrant stage 3-4 ulcers

68
Q

How does HVPC promote tissue healing? (Long ass list)

A

Accelerated healing of pressure wounds
Reduced edema
Improved blood flow
Increased protein and DNA synthesis in human fibroblasts
Increased tensile strength
Antibacterial effect
Enhanced migration of cells
Increased receptor sites for certain growth factors
Improved organization for collagen tissue
Increased wound contraction rate and fibroblast response

69
Q

Is most bacteria positively or negatively charged?

A

Negatively charged

70
Q

What is the waveform used in HVPC for tissue healing?

A

HVPC monophasic twin peaked

71
Q

What is the frequency used in HVPC for tissue healing?

A

(-) 50Hz
(+) 80Hz

72
Q

What is the pulse duration used in HVPC for tissue healing?

A

2-100usec (fixed)

73
Q

What is the amplitude used in HVPC for tissue healing?

A

100-150 V
Sub threshold muscle contraction

74
Q

What is the treatment duration used in HVPC for tissue healing?

A

30-60 min 2-3x/day

75
Q

What polarity do we use for clean wounds?

A

Positive polarity

76
Q

What is effect of using positive polarity with HVPC for wound healing of clean wounds?

A

It facilitates cellular migration

77
Q

What polarity do we use for HVPC for tissue healing of infected wounds?

A

Start with negative then use positive

78
Q

Why do we start with negative and then use positive polarity with HVPC for wound healing of infected wounds?

A

The negative polarity will create an alkaline reaction to inhibit bacterial growth and increase blood flow
Then the positive polarity will create cell proliferation and promote migration of cells towards the center of the wound

79
Q

When do we use switching polarities in HVPC for wound healing?

A

After reaching the healing plateau to reactive the healing process

80
Q

What is the electrode placement used with HVPC for tissue healing?

A

Monopolar setup with the active a electrode in/on either side of the wound

81
Q

T/f: we often use custom made electrodes (aluminum foil) and saline soaked gauze to conform or fit inside wounds with HVPC for wound healing

82
Q

What infection protocols are important to use for infection control in HVPC for wound healing?

A

Universal precautions

DPT 608 (9 decks)

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