IF, NMES, Hi-Volt Flashcards
What are contraindications to Interferential Current?
anterior cervical area through the chest through the head pacemakers and implantable cardioverter-defibrilators (ICD Abdomen, pelvis, lumbar areas of pregnant women in their 1 trimester metal implants epilepsy areas of hemorrhage cancer confused and unreliable patients damaged skin unknown etiology
If any contraindications are present, What should you do?
do not perform the therapy, or proceed with caution as long as the contraindication is not in the area being treated
Is it ok to perform IFC on the ankle of a pregnant woman?
yes, but do not do it over her gravid uterus
What are the clinical goals of IFC?
for interferential current: decrease pain (strengthen the pelvic floor?)
What is the size of the area for IFC?
smaller area (use premod: 2 pads, 1 on each side of the pain) larger area (use IFC: 4 pads in a criss cross pattern)
What is the temporal presentation of IFC?
Acute (use 60-150Hz, or variations such as 80-120, 80-150, etc.)
Chronic (use 0-15Hz, or variations such as 0-10, 1-15Hz, etc.)
What nerve fibers are being targeted for IFC?
A-beta fibers (Acute, 60-150Hz, no muscle contraction)
A-delta fibers (Chronic, 1-15Hz, some muscle twitch)
For premod IFC (high), what is the treatment frequency, treatment area, clinical goal, electrode placement, intensity, treatment time, and target fiber?
treatment frequency: 80-150 treatment area: small area clinical goal: treats acute pain electrode placement: one electrode on either side of pain intensity: patient comfort- sensory only treatment time: 15-20 minutes tiber fiber: a-beta
For premod (high/low), what is the treatment frequency, treatment area, clinical goal, electrode placement, intensity, treatment time, and target fiber?
treatment frequency: 1-150
treatment area: small area
clinical goal: treats subacute pain
electrode placement: one electrode on either side of pain
intensity: patient comfort-sensory through muscle twitch
treatment time: 15- 20 minutes
target fiber: A-beta and A-delta
For premod IFC (low), what is treatment frequency, treatment, clinical goal, electrode placement, intensity, treatment time, and target fiber
treatment frequency: 0-15Hz treatment area: small area clinical goal: treats chronic pain electrode placement: one electrode on either side of pain intensity patient comfort- muscle twitch treatment time: 15-20 min target fiber: A-delta
For true interferential (high), what is the treatment frequency, treatment area, clinical goal, electrode placement, intensity, treatment time, and target fiber?
treatment frequency: 80-150Hz treatment area: large area (ex: LBP) clinical goal: treats acute pain electrode placement: crisscross/clover leaf around area of pain -4 pads and -2 channels intensity: patient comfort- sensory only treatment time:15-20min target fiber: A-beta
for true IFC (hi-lo), what is the treatment frequency, treatment area, clinical goal, electrode placement, intensity, treatment time, target fiber?
treatment frequency: 1-120Hz
treatment area: large area
clinical goal: treats subacute pain
electrode placement: crisscross/ clover leaf around area of pain -4 pads and -2 channels
intensity: patient comfort-sensory through muscle twitch
treatment time: 15-20 min
target fiber: A-beta and A-delta
for True IFC (low), what is the treatment frequency, treatment area, clinical goal, electrode placement, intensity, treatment time, and target fiber?
treatment frequency: 0-15 Hz
treatment area: large area
clinical goal: treat chronic pain
electrode placement: crissross/ cloverleaf around area of pain -4 pads -2 channels
intensity: patient comfort- muscle twitch
treatment time: 15-20 minutes
target fiber: a-delta
What are the indications of NMES?
muscle re-education, retard atrophy, muscle strengthening, and decrease muscle spasm through fatigue
What are the contraindications for NMES?
Exactly the same as IFC (ant cervical area, through chest and head, abdomen, pelvis, lumbar of pregnant women in 1st trimester, metal, epilepsy, hemorrhage, cancer, confused patients, damaged skin, or unknown)
What are the clinical goal of NMES?
fatigue of muscle spasm
re-educated a muscle after lack of use
What is the size of the area for NMES?
fatigue of a single muscle: 10/10 single muscle for 10 minutes
re-educate a single muscle: 10/50 single muscle for 10-15 minutes
fatigue bilateral muscle groups: 10/10 co-contract for 10 minutes
re-educate agonist/antagonist muscle pairs: use 10/50 reciprocal for 10-15 minutes
for 10/10 on NMES, what does each 10 stand for?
10 seconds of contraction followed by 10 seconds of relaxation
in NMES, what does 10/50 stand for?
10 seconds of contraction followed by 50 seconds of relaxation
Is Russian stimulation preformed to patient comfort or to patient tolerance?
patient comfort (turn up the amplitude slowly
What are the Indications of interferential current?
Pain reduction- acute and chronic
For russian current 10/10, what is the treatment area, clinical goal, electrode placement, intensity, ramp time, and ramp time for new patients?
Treatment area: single muscle
Clinical goal: fatigue muscle spasm
Electrode placement: one near origin and one near insertion
Intensity: patient tolerance
Ramp Time: 0.5-1 second
Ramp Time for new patients: 1.5-2 seconds
For Russian current 10/50, what is the treatment area, clinical goal, electrode placement, intensity, ramp time, and ramp time for new patients?
treatment area: single muscle
clinical goal: muscle re-education; recovery from/ prevent atrophy
electrode placement: one near origin and one near insertion
intensity: patient tolerance
ramp time: 0.5-1 second
ramp time for new patient: 1.5-2.0 seconds
For Russian current 10/10 co-contract, what is the treatment area, clinical goal, electrode placement, intensity, ramp time, and ramp time for new patients?
treatment area: bilateral muscle groups that work in unison (e.g. traps and erector spinae)
clinical goal: fatigue muscle spasm
electrode placement: one channel on one side, 2nd channel on other side
intensity: patient tolerance
ramp time: 0.5-1 second
ramp time for new patients: 1.5-2 seconds
For Russian 10/50 Reciprocate, what is the treatment area, clinical goal, electrode placement, intensity, ramp time, and ramp time for new patients?
treatment area: agonist/antagonist
clinical goal: muscle re-education; recovery from/ prevent atrophy
electrode placement: one channel on one muscle, 2nd channel on reciprocal muscle
intensity: patient tolerance
ramp time: b/w 0.5-1 second
ramp time for new patients: long 1.5-2.0 seconds/10 minutes
What are the indications for both Hi-Volt current and micro current therapy (ESTHR)?
stimulate healing
What are the indications for hi volt only?
reduce edema and decrease spasm/ guarding (pelvic floor muscles)
What are the contraindications for Hi-volt and micro current therapy?
Osteomyelitis (traps infection in the bone), cancer, electronic implants (pacemakers, ICDs, etc), anterior cervical area, through the chest, through the head, over metal implants, abdomen, pelvis, and lumbar areas of pregnant women in their first trimester, areas of hemorrhage, and unknown etiology
What are the current characteristics of ESTHR?
DC current (AKA galvanic) so each electrode has different polarity
Features twin pulse peaks
often used with two different sized electrodes (monopolar electrode placement)
Where does the active electrode go for ESTHR?
placed in the area of the injury
Where does the dispersal electrode go for ESTHR?
placed proximal to the active electrode
What are the four phases in the clinical goals of ESTHR?
Inflammatory phase (+), repair/remodeling phase (-), reduce edema (-), fight infection (+/-)
What is the inflammatory phase of ESTHR?
attracts neutrophils and macrophages
What happens in the repair/remodeling phase of ESTHR?
attracts fibroblasts, epidermal cells, and keratinocyts
What happens during the reduce edema phase in ESTHR?
repels short peptides and small proteins
What happens during the fight infection phase of ESTHR?
change polarity every 3 days
For Hi Volt +, what is the treatment frequency, treatment area, clinical goal, electrode placement, intensity, and treatment time?
treatment frequency: 1-200 Hz treatment area: wound clinical goal: healing electrode placement: over or around wound with dispersal pad proximal intensity: patient comfort treatment time: 30-90 min 1-3x/day
For High Volt -, what is the treatment frequency, treatment area, clinical goal, electrode placement, intensity, and treatment time?
treatment frequency: 1-200Hz
treatment area: wound
clinical goal: healing or edema reduction
electrode placement: over or around wound/ over edema with dispersal pad proximal
intensity: patient comfort
treatment time: 30-90min, 1-3x/day
For micro-current, what is the treatment frequency, treatment area, clinical goal, electrode placement, intensity?
treatment frequency: continuous treatment area: wound clinical goal: healing electrode placement: over or around wound intensity: subsensory ALSO called MENS
