Iontophoresis, E stim, Ultrasound

Question 1

Conventional Tens parameter

Answer 1

50-150 (prob closer to 100-150) pulse duration (50-80 usec)

For gait control, pain relief, Indicated in acute situations

Question 2

Higher frequency for TENS vs Ultrasound

Answer 2

TENS - higher is deeper
Ultrasound - higher frequency is more superficial (e.g superfical tissues use 3 hz vs deeper is 1 hz)

Question 3

Acupuncture TENS

Answer 3

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

Question 4

NMES

Answer 4

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

Question 5

HVPC Estim Parameters

Answer 5

Inflammatory and infected tissue - Negative polarity overwound

60-125 pps
pulse duration 60-125 usec
amplitude to comfort
45-60 min treatment

Question 6

Ultrasound in water…

Answer 6

Used underwater in plastic or rubber tub for distal extremities
with transducer head 0.5 to 0.3 cm away from skin (indirect)

Question 7

Ultrasound parameters for thermal effect on superficial tissue e.g supraspinatus

Answer 7

100 % duty cycle
1-2 cm or so superficial
3 hz
0.5 for intensity
2xERA
Always 5-10 min start conservative

Question 8

Ultrasound parameters for thermal effect on deep tissue

Answer 8

100 % duty cycle
3-5 cm deep
1 hz
1.5 for intensity
2xERA
Always 5-10 min start conservative

Question 9

Ultrasound parameters for tissue healing/inflammation

Answer 9

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

Question 10

Phantom Limb estim

Answer 10

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.

Question 11

Russian Estim

Answer 11

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.

Question 12

TENS e.g

Answer 12

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

Question 13

Quadriceps NMES example

Answer 13

Frequency of 50 pps, duration of 250 microseconds

Question 14

Noxious Stim

Answer 14

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

Question 15

Brief intense tens

Answer 15

Used to get through ther act or man therapy in clinic,

High PD and freq

only 15 min b/c would fatigue quick

Strong paresthesisa or motor response for amplitude

Question 16

Nerve fibers

Answer 16

Larger (fast twitch) fibers are activated first with E-stim

vs small (slow twitch) fibers are first with natural contraction

Question 17

Stretching with thermal heat at the same time is

Answer 17

More effective than seperating the two

Question 18

Hotpacks vs ultrasound

Answer 18

Ultrasound is deeper

Question 19

Iontophoresis using acetic acid, not dexamethasone, would be most appropriate to treat calcium deposits in tendon

Answer 19

Negative

Question 20

Dexmethasone

Answer 20

Negative
for inflammation

Question 21

Lidocaine

Answer 21

For pain, positive

Question 22

Calcium chloride

Answer 22

For muscle spasms and scar tissue, positive

Question 23

Copper

Answer 23

Positive for fungal infection

Question 24

Magnesium

Answer 24

positve for muscle spasm, ischemia

Question 25

Zinc oxide

Answer 25

positive for various wounda

Question 26

Iodine

Answer 26

scars, adhesive capsulitis
negative

Question 27

Salicylates

Answer 27

Negative, muscle and joint pain

Question 28

Negatives are

Answer 28

Iodine, acetic acid, dexamethasone, salicyclates

“I ate a dex salad, which was negative”

Question 29

If there is a sharp unwanted pain with ultrasound

Answer 29

decrease intensity first

Question 30

NMES example extensor lag

Answer 30

3. For strengthening with electrical stimulation the current intensity should be maximal, so 60% is the better answer when compared with 40% of maximal voluntary contraction. Also, the duty cycle should allow for the rest period to be 5 times as long as the hold cycle, so a 20% duty cycle is best. One treatment session should include at least 10 contractions, so a 10 minute treatment time is appropriate.

Question 31

Monopolar direct current

Answer 31

Ionophoresis - one direction

Question 32

Bipolar

Answer 32

Muscle, spasms, ROM

Question 33

Small electrodes

Answer 33

Increase current density
Increase impedance
Decreased current flow

and vice versa

Question 34

Monophasic vs biphasic

Answer 34

monophasic electrical stimulation is typically used primarily for wound healing due to its ability to promote tissue repair by delivering a directed current flow, while biphasic stimulation is preferred for muscle contractions and pain management

Question 35

Frequency must be at least 30pps

Answer 35

for NMES

Question 36

Ramp-up time is good for preventing

Answer 36

spasticity (b/c velocity dependent)

Question 37

Change US intensity fist i

Answer 37

if pain ful

Adding medium only increases sx

Question 38

IF current

Answer 38

must be quadripolar and criss cross (diagonal flow)

Question 39

Noxious tens

Answer 39

Highest that you can tolerate
done for 30-60 sec in each point
For specific pain points

Question 40

Pulsed monophasic

Answer 40

FOr wounds, edema