Interferential Current, NMES, ESTHR, HiVolt

Question 1

Indications for interferential current?

Answer 1

Pain reduction- acute or chronic

Question 2

Contraindications for interferential current?

Answer 2

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

Question 3

Is it ok to do IFC over a pregnant women’s ankle?

Answer 3

YES- just not over her uterus

Question 4

Clinical goals of IFC?

Answer 4

Decrease pain

*strengthen pelvic floor

Question 5

Size of treatment area for IFC?

Answer 5

Smaller area= use Premod: 2 pads, 1 each side of pain

Larger area= use IFC: 4 pads in crisscross cloverleaf pattern

Question 6

What is the temporal presentation for IFC?

Answer 6

Acute (60-150hz, or variations like 60-120, 80-150)

Chronic (0-15hz, or variations like 0-10, 1-15)

Question 7

Nerve fibers targeted during IFC?

Answer 7

A beta fibers (acute, 60-150, no muscle contraction)

A delta fibers (chronic, 1-15, some muscle twitch)

Question 8

How many channels, leads, and electrodes are used for IFC?

Answer 8

1 channel/lead/2 electrodes (premod)

2 channels/leads/4 electrodes (true interferential)

Question 9

Treatment time for IFC?

Answer 9

15-20 minutes

Question 10

Intensity for IFC?

Answer 10

Patient comfort

Question 11

What is the difference between using premod and true interferential?

Answer 11

Size of treatment area

Question 12

Indications for neuromuscular electrical stimulation (NMES)?

Answer 12

Muscle re-education
Retard atrophy
Muscle strengthening
Decrease muscle spasm through fatigue

Question 13

Contraindications for NMES?

Answer 13

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

Question 14

Is it ok to perform Russian stim over a pregnant woman’s ankle?

Answer 14

YES- just not over her uterus

Question 15

Clinical goals of NMES?

Answer 15

Fatigue of a muscle spasm

Re-educate a muscle after lack of use

Question 16

Size of treatment area of NMES?

Answer 16

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

Question 17

Intensity/amplitude of NMES?

Answer 17

Patient tolerance (turn up slowly!)

Question 18

How many channels for NMES?

Answer 18

Single muscle= 1 channel

Bilateral muscle groups/agonist antagonist muscles= 2 channels

Question 19

What is the clinical goal of Russian current 10/10 normal?

Answer 19

Fatigue muscle spasm

Question 20

Clinical goal of Russian current 10/50 normal?

Answer 20

Muscle reeducation, recovery from/prevent atrophy

Question 21

Clinical goal of Russian current 10/10 co contract?

Answer 21

Fatigue muscle spasm

Question 22

Clinical goal of Russian current 10/50 reciprocate?

Answer 22

Muscle reeducation, recovery from/prevent atrophy

Question 23

NMES ramp time for patients?

Answer 23

New patient= 1.5-2 seconds/10 min

Old patient= 0.5-1 second

Question 24

Indications for ESTHR (electrical stimulation for tissue healing and repair) and HiVolt pulsed current and microcurrent?

Answer 24

Stimulate healing

Question 25

Indications for HiVolt ONLY?

Answer 25

Reduce edema | Decrease spasm/guarding (pelvic floor muscles)

Question 26

Contraindications for ESTHR and HiVolt?

Answer 26

``` 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 ```

Question 27

Is it ok to perform HiVolt on a pregnant woman's ankle?

Answer 27

YES- just not over uterus

Question 28

What is another name for DC current? What is the purpose of it? Which modality does this pertain to?

Answer 28

Galvanic current, so each electrode has a different polarity | Pertains to HiVolt

Question 29

Are different sized electrodes used with HiVolt? What are they called?

Answer 29

``` Yes, two different sizes are used Active electrode (larger) is placed in area of injury Dispersal electrode (smaller) placed proximal to active electrode ```

Question 30

What are the clinical goals of HiVolt and what do the different polarities mean?

Answer 30

``` 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 ```

Question 31

Which phases of healing require negative polarity?

Answer 31

Repair/remodeling phases | * also used to reduce edema

Question 32

Treatment frequency of HiVolt + or -?

Answer 32

1-200 Hz

Question 33

Treatment frequency of micro current?

Answer 33

Continuous

Question 34

Clinical goal of HiVolt +?

Answer 34

Healing in acute phase

Question 35

Clinical goal of HiVolt -?

Answer 35

Healing in repair phase or remodel phase, also edema reduction

Question 36

Clincial goal of microcurrent?

Answer 36

Healing

Question 37

Intensity of HiVolt and microcurrent?

Answer 37

HiVolt- Patient comfort | Microcurrent= subsensory

Question 38

Treatment time for HiVolt + or -?

Answer 38

30-90 min, 1-3 times a day

Question 39

Another name for microcurrent?

Answer 39

MENS

Question 40

When do you use pulsed versus continuous HiVolt?

Answer 40

Pulsed for acute, continuous for chronic(?)