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DPT 608 > Interferential, Biphasic Pulsed Currents, And Microcurrents > Flashcards

Interferential, Biphasic Pulsed Currents, And Microcurrents Flashcards

1
Q

Electrotherapy can help us with what things?

A

Pain modulation
Promoting tissue healing
Preventing/reducing edema
Increasing circulation
Muscle relaxation

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2
Q

T/f: ES can be used to increase blood flow in superficial and deep tissues

A

True

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3
Q

T/f: increased circulation can be accomplished using various different types of ES

A

True

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4
Q

Local (superficial) increase in blood flow occurs with _____ frequency TENS at a _____ level by vasodilation of _____ vessels

A

Low, sensory, cutaneous

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5
Q

Deeper arterial blood flow increases with _____ level stim, using rhythmic musc contractions

A

Motor

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6
Q

Does deep blood flow increase with sensory level stim?

A

No

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7
Q

Muscle contraction with ____ level creates a muscle pump for circulation

A

Motor

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8
Q

When wanting to increase blood flow, where should we put the electrodes for best efficiency?

A

Over the ganglions

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9
Q

When wanting to control pain, where should we put the electrode for best efficiency?

A

Over acupressure points

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10
Q

When is NMES with what is even more beneficial for increasing microcirculation and decreasing edema?

A

When with muscle contractions

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11
Q

T/f: a decrease in 6MWT time leads to an increase in function

A

True

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12
Q

What type of stim promotes local (superficial) blood flow?

A

Sensory level stim

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13
Q

What is the waveform used to promote superficial local blood flow?

A

Monophasic or biphasic pulsed

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14
Q

What is the frequency for promoting superficial local blood flow?

A

4-100 pps (lower 4 shown to be more effective than 100)

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15
Q

What is the pulse duration for promoting superficial local blood flow?

A

4-600 usec

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16
Q

What is the amplitude for promoting superficial local blood flow?

A

mA to comfortable sensory level

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17
Q

How long should we do ES to promote superficial local blood flow?

A

10-30min

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18
Q
A
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19
Q

What is the electrode placement to promote superficial local blood flow?

A

Over the tissue area where increased blood flow is desired, dermatomes, sympathetic ganglion

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20
Q

What type of stim is used to promote deeper arterial/venous blood flow?

A

Motor level stim (NMES)

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21
Q

What is the waveform used to promote deeper arterial/venous blood flow?

A

Biphasic pulsed current or burst modulation AC (Russian)

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22
Q

What is the frequency used to promote deeper arterial/venous blood flow?

A

35-80 pps

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23
Q

Why should we not use higher than 80 pps to promote deeper arterial/venous blood flow?

A

Bc it can create tetany and fatigue the muscle leading to no response

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24
Q

What is the pulse duration used to promote deeper arterial/venous blood flow?

A

100-600 usec

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25
Q

What is the amplitude used to promote deeper arterial/venous blood flow?

A

mA to robust tetanic contraction

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26
Q

What is the duty cycle used to promote deeper arterial/venous blood flow?

A

1:1 on/off

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27
Q

How long should ES be left on to promote deeper arterial/venous blood flow?

A

10-15 min

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28
Q

What is the electrode placement to promote deeper arterial/venous blood flow?

A

Over the muscle of the area desired (find motor units for quicker contractions)

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29
Q

What is interferential current (IFC)?

A

Interference or superimposition of 2 symmetrical but asynchronous, kilohertz frequency (really high frequency), AC, resulting in a single treatment or interference current with properties uniquely different than the 2 og currents

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30
Q

What type of ES has two waveforms coming out at different frequencies?

A

IFC

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31
Q

T/f: IFC is more comfortable bc the carrier frequency is high and can go deep in tissues

A

True

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32
Q

What is constructive interference?

A

In IFC when the amplitudes of the 2 currents summed together

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33
Q

What is destructive interference?

A

Equally periodic, currents out of phase, and amplitudes that negate each other

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34
Q

Why is IFC referred to as amplitude modulated AC?

A

Bc of the modulation of amplitude that occurs with the intersection of the two currents

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35
Q

What is the beat frequency of IFC?

A

The currents are maximally in/out of phase at a rate equal to the difference bw the frequencies of the currents interfered

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36
Q

If the two currents in IFC have frequencies of 4000Hz and 4100Hz, what is the beat frequency?

A

100Hz

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37
Q

What is the typical range of beat frequency?

A

1-250 Hz

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38
Q

T/f: amplitude of IFC will peak and fall at a frequency equal to the beat frequency

A

True

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39
Q

What is the carrier frequency in IFC?

A

The frequency of the lesser of the 2 interfered currents, typically 1000-10,000Hz

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40
Q

____ carrier frequency is perceived as more uncomfortable

A

Lower

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41
Q

T/f: there is evidence that higher carrier frequency is better than lower carrier frequency in IFC

A

False, there is no evidence to support selection of one carrier frequency over another

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42
Q

Does the beat frequency or carrier frequency affect the tissues in IFC?

A

The beat frequency

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43
Q

The ______ _______ reflects the therapeutic frequency

A

Beat frequency

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44
Q

The ____ _____ elicits the therapeutic effect of physiologic effects on IFC

A

Beat frequency

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45
Q

T/f: The higher the carrier frequency the better the depth of penetration but shorter the phase duration

A

True

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46
Q

What are the suggested advantages of IFC?

A

Reduction in skin impedance with medium to high frequency currents

More current is concentrated in deeper tissues due to amplitude magnification at the intersection of 2 independent waveforms

Pain modulation

Greater comfort since less intensity is needed to drive the current through the skin

Increased arterial and microcirculatory blood flow

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47
Q

_____ and _____ frequency currents can reduce skin impedance in IFC

A

Medium, high

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48
Q

Why does medium and high frequency currents reduce skin impedance in IFC?

A

Likely due to the short pulse duration resulting in deeper penetration

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49
Q

Is there more or less discomfort with medium and high frequency IFC than with low frequency

A

Less

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50
Q

You need to increase the ____ for greater depth of penetration with low frequency stimulators

51
Q

Why is more current concentrated in deeper tissues due with IFC?

A

Bc of the amplitude magnification at the intersection of 2 independent waveforms

52
Q

T/f: there is likely greater comfort with IFC due to the fact that less intensity is needed to drive the current through the skin

53
Q

T/f: IFC can provide “nerve block” through Wedensky inhibition

55
Q

What is Wedensky Inhibition in IFC?

A

When the nerve receives too much excitation and shuts down, creating a numbing effect

56
Q

What are the prosed physiologic mechanisms for IFC?

A

Gate control theory (SC level interneurons)
Increased circulation
Descending pain modulation (increased intensity)
Nerve block pain modulation
Placebo

57
Q

What is quadripolar IFC?

A

Using 4 electrodes positioned so that the 2 different frequency currents intersect each other perpendicularly within the tissue of the pt.

58
Q

What is the point of intersection and site of new interference current in quadripolar IFC.

A

The assumed geometric center of the electrodes

59
Q

T/f: the geometric center cannot be accurately determined bc of non-homogenous tissue resistances, so the current will take the path of least resistance, causing the path of one or both currents to be altered

60
Q

Does placement of electrodes matter with IFC?

61
Q

What is the vector scan IFC modulation?

A

A modulation of the amplitude of one or both input currents offered in some units

63
Q

What does the modification of amplitude of one or both input currents in some IFC units result in?

A

Rhythmic change in position of the interference pattern (feels like a little massage)

64
Q

What is the vector scan though to do in IFC?

A

Increase the effective treatment area

65
Q

What is the sweep modulation of IFC?

A

Modulation of the beat frequency causing an automatic and rhythmic increase and decrease in the carrier current

67
Q

What is the purpose of rhythmic mode (sweep modulation) on IFC?

A

To reduce accommodation

68
Q

How long should treatment be with sweep modulated IFC?

A

10-30 minutes

69
Q

Why should we not do more than 60 minutes of sweep modulated IFC?

A

NBC it is a lot of higher current going in and can pose a burns risk

70
Q

IFC can modulate _____ or ______ to prevent accommodation

A

Beat frequency, amplitude

71
Q

What is swing modulation on IFC?

A

Temporal characteristics of sweep pattern (changing the timing of the beats)

72
Q

What is the benefit of swing modulation in IFC?

A

To avoid accommodation

73
Q

What are the parameters for linear/continuous sweep modulation?

A

2-2 sweep 100-10Hz that will decrease continually over 2 sec then increase continuously over the next 2 seconds

74
Q

What is peak to peak sweep modulation?

A

2f2 sweep 100-10Hz
Beat frequency will remain at 100Hz for 2 sec b4 switching to 10Hz for 2 sec
For analgesic tolerance

75
Q

What is premodulated IFC?

A

Created by interference of 2 different medium frequency alternating current WITHIN THE STIMULATOR DEVICE with similar benefits to IFC

76
Q

What is the benefit of using preamodulated IFC over a quadripolar IFC?

A

It is easier to set up and can be used for smaller areas

77
Q

T/f: currents interfere within the tissues with premodulated IFC

A

False, they interfere within the device then come out as a single current

78
Q

What kind of IFC is only a single current delivered using 2 electrodes, not quadripolar?

A

Premodulated IFC

79
Q

What is a good option for IFC use on the elbow, wrist, or for CTS/radicular symptoms?

A

Premodulated IFC

80
Q

What are the indications for IFC?

A

Pain modulation
Neuromuscular ES
Increase circulation
Reduce edema

81
Q

Why is it significant that the use of IFC can reduce need for opioids?

A

Bc opioid use causes constipation, which poses a fall risk in geriatric patients, so if we can decrease their reliance on opioids, we can decrease their fall risk

82
Q

T/f: we can use IFC for pain modulation in compression fractures in geriatric populations with osteoporosis

83
Q

Does biphasic pulsed current use symmetrical or asymmetrical waveforms?

84
Q

Is asymmetrical or symmetrical biphasic pulsed current better?

A

There is no evidence that either one is better

85
Q

What can biphasic pulsed current be used for?

A

Improved circulation, NMES, FES, and pain modulation

86
Q

What do NMES and FES do?

A

Activate skeletal muscle

87
Q

What is the pulse duration for biphasic pulsed current?

A

200-800usec

88
Q

What is the frequency for biphasic pulsed current?

89
Q

What is the amplitude for biphasic pulsed current?

A

Strengthening to max contraction
FES to level needed for fxnal use

90
Q

What is the duty cycle for biphasic pulsed current?

A

10s on/50s off
10 contractions
Adjust based on treatment goals and pt tolerance (typical starting EDC)

91
Q

What is the ramp for biphasic pulsed current?

A

1-2s for NMES

92
Q

To strengthen muscles you need a _____ MVIC

93
Q

What is FES?

A

using NMES to get the muscle contraction to do something functional

94
Q

For FES, do you need a high MVIC?

A

No, just enough to reach the threshold for the contraction needed for the action

95
Q

What are biphasic pulsed current and Russian stim used for?

A

Muscle strengthening

96
Q

What is variable muscle stim (VMS)?

A

Symmetrical biphasic pulsed current with fixed interpulse interval to produce a greater phase charge than Russian

97
Q

What ES can produce pain modulation?

A

Sensory, motor, brief intense, burst, modulated, or noxious TENS

98
Q

What is microcurrent?

A

Low volt pulsed current

99
Q

What is the waveform of microcurrent?

A

DC or monophasic pulsed current

100
Q

If microcurrent is pulsed current, what is the pulse duration typically?

101
Q

What is the frequency of microcurrent?

102
Q

What is the treatment duration of microcurrent?

A

Minutes to hours

103
Q

What is the intensity of microcurrent?

A

Less than 1mA
Current insufficient to excite sensory or motor nerves

104
Q

What are the indications for microcurrent?

A

Inflammation
Post-op trauma
Soft tissue injury
Swelling
Fractures
Wound healing
Pain control (myofascial and neuropathic pain)

105
Q

How does microcurrent promote wound healing?

A

By having biological effects on cells and substrates of healing

106
Q

When would microcurrent be used for pain control?

A

When the or is unable to tolerate sensory feeling of stim

107
Q

What is the effect of microcurrent with currents from 50-1000uA?

A

Increased ATP levels

108
Q

What is the effect of microcurrent with currents >1000uA?

A

ATP concentrations are leveled

109
Q

What is the effect of microcurrent with currents >5000uA?

A

Decreased ATP concentrations

110
Q

What is the effect of microcurrent with currents at 500uA?

A

Increased protein synthesis

111
Q

What is the effect of microcurrent with currents >5000uA?

A

Suppressed protein synthesis

112
Q

With frequency specific microcurrent, what is the treatment time?

A

A few minutes at each frequency until a feeling of the tissue going “smoosh”

113
Q

T/f: FSM (frequency specific microcurrent) causes tissue softening and warming

114
Q

What is the effect of FSM of 0.3Hz?

115
Q

What is the effect of FSM of 3Hz?

A

Stimulating acupuncture points

116
Q

What is the effect of FSM of 30Hz?

A

Controlling pain

117
Q

What is the effect of FSM of 300Hz?

A

Reducing edema and stimulating lymphatic flow

118
Q

What does the evidence say about microcurrent?

A

That is is good for wound healing
Limited evidence to support its use for treating MSK injuries

119
Q

T/f: microcurrent ES can be applied to the skin to promote tissue healing

120
Q

How does microcurrent promote tissue healing?

A

The ES produces a current in the tissues that mimics the natural skin battery and stimulates the body’s mitochondria to increase production of ATP

121
Q

Studies support the use of LIDC (microcurrent) for what ulcers?

A

Venous ulcers
Ischemic ulcers
Non healing ulcer

122
Q

Does the theoretical basis underlying the application of microcurrent involve nerve fiber depolarization?

123
Q

T/f: microcurrent can be used to treat MSK injuries

DPT 608 (9 decks)

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