Interferential Current, NMES, ESTHR, HiVolt Flashcards
Indications for interferential current?
Pain reduction- acute or chronic
Contraindications for interferential current?
Anterior cervical area Through the chest Through the head Pacemakers and ICDs (implantable cardioverter defibrilators) Abdomen, pelvis, lumbar areas of pregnant women in FIRST tri Metal implants Epilepsy Areas of hemorrhage Cancer Confused and unreliable patients Damaged skin Unknown etiology
Is it ok to do IFC over a pregnant women’s ankle?
YES- just not over her uterus
Clinical goals of IFC?
Decrease pain
*strengthen pelvic floor
Size of treatment area for IFC?
Smaller area= use Premod: 2 pads, 1 each side of pain
Larger area= use IFC: 4 pads in crisscross cloverleaf pattern
What is the temporal presentation for IFC?
Acute (60-150hz, or variations like 60-120, 80-150)
Chronic (0-15hz, or variations like 0-10, 1-15)
Nerve fibers targeted during IFC?
A beta fibers (acute, 60-150, no muscle contraction)
A delta fibers (chronic, 1-15, some muscle twitch)
How many channels, leads, and electrodes are used for IFC?
1 channel/lead/2 electrodes (premod)
2 channels/leads/4 electrodes (true interferential)
Treatment time for IFC?
15-20 minutes
Intensity for IFC?
Patient comfort
What is the difference between using premod and true interferential?
Size of treatment area
Indications for neuromuscular electrical stimulation (NMES)?
Muscle re-education
Retard atrophy
Muscle strengthening
Decrease muscle spasm through fatigue
Contraindications for NMES?
Anterior cervical area Through chest Through head Pacemakers and ICDs Abdomen, pelvis, lumbar areas of pregnant women in their FIRST tri Metal implants Epilepsy Areas of hemorrhage Cancer Confused and unreliable patients Damaged skin Unknown etiology
Is it ok to perform Russian stim over a pregnant woman’s ankle?
YES- just not over her uterus
Clinical goals of NMES?
Fatigue of a muscle spasm
Re-educate a muscle after lack of use
Size of treatment area of NMES?
Fatigue of single muscle: 10/10 single muscle 10 min
Reeducate a single muscle: 10/50 single muscle 10-15 min
Fatigue bilateral muscle groups: 10/10 cocontract 10 min
Reeducate agonist/antagonist muscle pairs: 10/50 reciprocal for 10-15 min
Intensity/amplitude of NMES?
Patient tolerance (turn up slowly!)
How many channels for NMES?
Single muscle= 1 channel
Bilateral muscle groups/agonist antagonist muscles= 2 channels
What is the clinical goal of Russian current 10/10 normal?
Fatigue muscle spasm
Clinical goal of Russian current 10/50 normal?
Muscle reeducation, recovery from/prevent atrophy
Clinical goal of Russian current 10/10 co contract?
Fatigue muscle spasm
Clinical goal of Russian current 10/50 reciprocate?
Muscle reeducation, recovery from/prevent atrophy
NMES ramp time for patients?
New patient= 1.5-2 seconds/10 min
Old patient= 0.5-1 second
Indications for ESTHR (electrical stimulation for tissue healing and repair) and HiVolt pulsed current and microcurrent?
Stimulate healing
Indications for HiVolt ONLY?
Reduce edema
Decrease spasm/guarding (pelvic floor muscles)
Contraindications for ESTHR and HiVolt?
Osteomyelitis (traps infection in bone) Cancer Electronic implants (pacemakers, ICDS) Anterior cervical area Through chest Through head Over metal implants Abdomen, pelvis, lumbar areas of pregnant woman in FIRST tri Areas of hemorrhage Unknown etiology
Is it ok to perform HiVolt on a pregnant woman’s ankle?
YES- just not over uterus
What is another name for DC current? What is the purpose of it? Which modality does this pertain to?
Galvanic current, so each electrode has a different polarity
Pertains to HiVolt
Are different sized electrodes used with HiVolt? What are they called?
Yes, two different sizes are used Active electrode (larger) is placed in area of injury Dispersal electrode (smaller) placed proximal to active electrode
What are the clinical goals of HiVolt and what do the different polarities mean?
Inflammatory phase (+): attracts neutrophils and macrophages Repair/remodeling phases (-): attracts fibroblasts, epidermal cells, keratinocytes Reduce edema (-): repels short peptides and small proteins Fight infection (+/-): change polarity every 3 days
Which phases of healing require negative polarity?
Repair/remodeling phases
* also used to reduce edema
Treatment frequency of HiVolt + or -?
1-200 Hz
Treatment frequency of micro current?
Continuous
Clinical goal of HiVolt +?
Healing in acute phase
Clinical goal of HiVolt -?
Healing in repair phase or remodel phase, also edema reduction
Clincial goal of microcurrent?
Healing
Intensity of HiVolt and microcurrent?
HiVolt- Patient comfort
Microcurrent= subsensory
Treatment time for HiVolt + or -?
30-90 min, 1-3 times a day
Another name for microcurrent?
MENS
When do you use pulsed versus continuous HiVolt?
Pulsed for acute, continuous for chronic(?)
