L10 NMES and FES

Question 1

NMES

Answer 1

can be done passively or actively
longer pulse frequency
higher amplitude

Question 2

FES

Answer 2

done during functional task such as walking, reaching, grasping
shorter pulse frequency
lower amplitude
can be a substitute for orthosis/external brace

Question 3

indications for FES and NMES

Answer 3

muscle activation pre and post ortho
neurologic conditions
incontinence
inhibition due to certain conditions
general de-conditioning

Question 4

Ohm’s law

Answer 4

charge, current, voltage and resistance relationship

Question 5

How do we reduce resistance to maximize current into underlying tissue?

Answer 5

water content and temp
low adiposity
clean skin
minimize or remove hair

Question 6

which electrode is the active one?

Answer 6

negative because it does depolarization

Question 7

Precautions of electricity

Answer 7

local circulatory insufficiency
older age
pregnancy
impaired cutaneous sensation
metal implants

Question 8

Contraindications of electricity

Answer 8

pregnancy
malignancy
active bleeding
epilepsy
active implants

Question 9

Effects of electricity

Answer 9

activates weak muscles
strengthening muscle
reduce guarding, spasticity
prevent atrophy
enhance ROM
muscle re-education
inhibit overactive muscles

Question 10

holy trinity of nmes

Answer 10

pulse duration
frequency
amplitude

Question 11

pulse duration of nmes

Answer 11

300 ms
shorter for smaller muscles
longer for larger muscles

opposite of amplitude; one should increase as the other decreases

Question 12

Dosage of NMES

Answer 12

5-20 minutes, 2-5x a week
less duration if fatigue setting in or pain increasing

Question 13

Frequency of NMES

Answer 13

typically 30-80
higher frequency allows for greater summation of force
lower frequency is better for smaller muscles

Question 14

Duty cycle of NMES

Answer 14

how long pulse is on and off
longer time off = stronger contraction
shorter off time = more reps in given time

start with larger ratio

Question 15

Duty cycle for edema or muscle spasms

Answer 15

2:5 ratio

Question 16

FES

Answer 16

pulse delivered when muscle should be activated
during a functional activity
most commonly used to assist DF during swing phase

Question 17

Macro pro

Answer 17

cheaper and more portable than clinical muscle stim units

Question 18

FES differs from standing NMES in which of the following parameters?

Answer 18

FES requires patient performing the functional activity

Question 19

Which of the following would most likely elicit a greater muscle contraction while still being somewhat comfortable for the patient needing to strengthen their quads?

Answer 19

High amplitude and high frequency

Question 20

Documentation of NMES

Answer 20

NMES applied to (area of body) for (duration) at (frequency, (duty cycle), while performing (exercise) at (beginning, end, middle) of appointment, to help with (…), patient reacted (…)