Iontophoresis, E stim, Ultrasound Flashcards
Conventional Tens parameter
50-150 (prob closer to 100-150) pulse duration (50-80 usec)
For gait control, pain relief, Indicated in acute situations
Higher frequency for TENS vs Ultrasound
TENS - higher is deeper
Ultrasound - higher frequency is more superficial (e.g superfical tissues use 3 hz vs deeper is 1 hz)
Acupuncture TENS
Low frequency 2-10 and high pulse duration 100-300 usec
Muscle twitching response
For pain relief after estim (20-30 min treatment with 6-8 hr lasting effect, (muscle response), longer lasting effcets
Burst mode similar only paresthesia motor response
NMES
Frequency 35-60 pps for smooth tetanic contraction (higher means quicker fatigue)
High pulse duration 150-350 usec
On off time 1:5
Duty Cycle approx 20 percent
10-20 contractions takes 10-20 min
HVPC Estim Parameters
Inflammatory and infected tissue - Negative polarity overwound
60-125 pps
pulse duration 60-125 usec
amplitude to comfort
45-60 min treatment
Ultrasound in water…
Used underwater in plastic or rubber tub for distal extremities
with transducer head 0.5 to 0.3 cm away from skin (indirect)
Ultrasound parameters for thermal effect on superficial tissue e.g supraspinatus
100 % duty cycle
1-2 cm or so superficial
3 hz
0.5 for intensity
2xERA
Always 5-10 min start conservative
Ultrasound parameters for thermal effect on deep tissue
100 % duty cycle
3-5 cm deep
1 hz
1.5 for intensity
2xERA
Always 5-10 min start conservative
Ultrasound parameters for tissue healing/inflammation
Same rules of frequency apply
20% duty cycle b/c don’t want to overheat
0.5 to 1 for intensity
2xERA
Always 5-10 min start conservative
Phantom Limb estim
Quadripolar, continuous at 80 pps.. Utilizing four pads with a low frequency would be the most appropriate setting for modulating pain for a patient with phantom lower extremity limb pain and hyperalgesia.
Russian Estim
Quadripolar, polyphasic at 60 pps, with a 1:5 duty cycle.. These parameters fall within Russian current and a muscle strengthening protocol, not pain modulation.
TENS e.g
Bipolar, alternating current/burst at 100 pps. These parameters would be more appropriate if transcutaneous electrical stimulation (TENS) was being utilized. Additionally, the frequency is set too high for a patient with hyperalgesia
pulse 50-150, od 50-100
Sensory response amplitude
vary avg everything
Quadriceps NMES example
Frequency of 50 pps, duration of 250 microseconds
Noxious Stim
Low or high frequency with very hugh pulse duration and amplitude (highest they can tolerate) for trigger points to release endorphins,
Treatments only from seconds to a min
Brief intense tens
Used to get through ther act or man therapy in clinic,
High PD and freq
Strong paresthesisa or motor response for amplitude