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PHTY2240 MSE > L14: EPAs Revision > Flashcards

L14: EPAs Revision Flashcards

1
Q

What are the 3 ES used for muscle stimulation?

A
  1. High voltage galvanic stimulation (HVGS)
  2. Functional Electrical Stimulation (FES)
  3. TENS
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2
Q

What are the 3 ES used for pain relief?

A
  1. TENS
  2. Interferential (IFT)
  3. Modulated medium frequency (2 pole ‘IF’)
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3
Q

What are 3 other modalities for pain relief (not ES)?

A
  1. Ice
  2. hot pack
  3. wax
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4
Q

What is the summary table for EPAs look like?

A
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5
Q

What curve does the FES have?

A

Square

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6
Q

What curve does the HVGS have?

A

Double peak

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7
Q

What is the electrode placement for EPAs look like?

A
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8
Q

When do you use ramping?

A

For motor nerves to stimulate activity

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9
Q

What is the timing for sensory (pain relief) ER application for pain gating?

A
  • 10‐20 mins
  • Pain relief short lived, only while treatment is on and for up to 1 hour after treatment
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10
Q

What is the timing for sensory (pain relief) ER application for descending inhibition/endorphin effect (endogenous)?

A
  • At least 20mins
  • 2‐3 hours relief (more useful than short term pain relief)
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11
Q

What are 4 things that must be considered for the timing of ES application?

A
  1. Consider effect trying to achieve:
    • Strengthening
    • Endurance
  2. Nb. Treatment time based on work/rest time + no. of reps
  3. But also need to consider:
    • Fatigue
    • Delayed onset muscle soreness (DOMS)
  4. Individual patient characteristics, aims of treatment
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12
Q

What is the 3 specific dosage for pain relief for the sensory application for pain gating in TENS?

A
  1. short duration pulses/narrow width : 60‐100μs
  2. fast/high pulse rate: 80‐200pps
  3. Intensity until ‘strong but comfortable’
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13
Q

What is the 2 specific dosage for pain relief for the sensory application for pain gating in IFT?

A
  1. Eg 80‐120Hz, 90‐100Hz, 100‐199Hz, constant 100Hz
  2. Larger sweep if you want an effect on swelling 0‐100Hz, 80‐ 150Hz
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14
Q

Why do you need a rnage of options for the dosage in ES application?

A

Need a range of options because every patient will respond differently and you need to be able to modify dosage for effective treatment

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15
Q

What is the 3 specific dosage for descending inhibition/endorphin effect (endogenous analgesia) for the sensory application for pain gating in TENS?

A
  1. Long duration/wide pulse width 150‐200μs
  2. Slow/low pulse rate 1‐5 pps
  3. Intensity as strong as patient can tolerate
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16
Q

What are the 2 specific dosage for descending inhibition/endorphin effect (endogenous analgesia) for the sensory application for pain gating in IFT?

A
  1. 10‐25Hz, 20‐25Hz, constant 10Hz
  2. Well below 30-35 where you might get muscle contraction (motor nerve stimulated)
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17
Q

What are the 5 specific dosage for retraining muscle activity for the motor application in HGVS?

A
  1. 30‐50Hz (can be higher if no response)
  2. Strength 4 sec hold, 12 sec rest
  3. Endurance longer hold times
  4. Progress by increasing rest time so patient can hold the contraction themselves
  5. Work out timing by adding hold and rest times together
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18
Q

When using HVGS, what patient position would you use to treat a patient who has a 10 degree quads lag due to Vastus medialis weakness?

A

Sitting with knee in extension (go against gravity) = long sitting

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19
Q

When using HVGS, what frequency would you use to treat a patient who has a 10 degree quads lag due to Vastus medialis weakness?

A

To get muscle contraction = 30-50Hz (start at 30Hz)

20
Q

When using HVGS, what intensity would you use to treat a patient who has a 10 degree quads lag due to Vastus medialis weakness?

A

Until muscle contraction

21
Q

When using HVGS, what pulse duration and pulse interval would you use to treat a patient who has a 10 degree quads lag due to Vastus medialis weakness?

A

Unable to be controlled in HVGS

22
Q

When using HVGS, should you use a surge to treat a patient who has a 10 degree quads lag due to Vastus medialis weakness?

A

Yes –> Trying to get normal contraction

23
Q

When using HVGS, what electrode side would you use to treat a patient who has a 10 degree quads lag due to Vastus medialis weakness?

A

Small and large (bipolar) –> active and dispersive

24
Q

When using HVGS, what electrode position would you use to treat a patient who has a 10 degree quads lag due to Vastus medialis weakness?

A

Active on muscle bulk; dispersive proximal (still over nerve supply)

25
Q

When using HVGS, what time/duration would you set to treat a patient who has a 10 degree quads lag due to Vastus medialis weakness?

A
  • 4 secs on and 6 secs off
  • For strength (not endurance)
  • Progression: 4 secs and 12 secs off (get them to hold contraction) 5 sets
26
Q

ADD Practice exam questions

A

ADD

27
Q

What are the 4 uses of EPAs?

A
  1. Reduce pain
  2. Reduce swelling
  3. Stimulate healing
  4. Re‐educate muscles Used in combination with other treatments
28
Q

EPAs are used in _____with other treatments. What is their purpose?

A

combination

Try to enhance other treatments

29
Q

What are 7 considerations for using EPAs?

A
  1. EPA passive treatment, use wisely
  2. Generally should be used as short term adjunct to management
  3. EPAs need to be part of a multimodal approach
  4. Can help encourage independence and reduce reliance on medication in some cases eg portable TENs
  5. Dosage settings are guidelines only
  6. There are considerable variations in individual patient characteristics so you have to be able to have a range of settings to try
  7. You need to understand what you are trying to achieve in a given situation and be able to defend your choice
30
Q

What are 5 parameters in therapeutic ultrasound?

A
  1. Mode
  2. Frequency
  3. Intensity
  4. Duration
  5. Treatment area size
31
Q

Can 1 mHz penetrate deep or superficial?

A

Deep

32
Q

Can 3 mHz penetrate deep or superficial?

A

Superficial

33
Q

What is the mode for ultrasound for chronic (heating), subacute and acute?

A
  • Heating – continuous (chronic)
  • Sub acute: 1:1
  • Immediately following injury 1:3, 1;4
34
Q

What is the rule for intensity for ultrasound?

A

lowest intensity and highest frequency to produce desired result

35
Q

What are the general intensity guidelines for acute conditions for US?

A

0 – 0.5 w/cm2

This is the dose at the target tissue.

36
Q

What are the general intensity guidelines for chronic conditions for US?

A

0.5 – 1 w/cm2

This is the dose at the target tissue.

37
Q

____ w/cm2 doses associated with adverse affect on tissue healing in US

A

1.5

38
Q

if doing US in water or through water bag – increase intensity by ____%

A

20

39
Q

What are is the time for US?

A

Usually calculated between 30sec ‐ 2 mins per effective radiating area (ERA)

40
Q

What is the time for US for acute conditions?

A

30 secs

41
Q

What is the time for US for chronic conditions?

A

2 mins

42
Q

In US, consider the ____ of the damaged tissue not the pain area

A

size

43
Q

What are 5 characteristics of hot packs?

A
  1. Wrapped so 1‐2 cm (6‐8 layers) of towelling between the pack and skin
  2. Takes 8 mins for skin temp to reach maximum
  3. CHECK patients response and skin colour about 10 mins after placing it
  4. Left on for 15‐20 mins
  5. Not through clothes and not have there leg held up (must be rested)
44
Q

What are the 8 steps in the procedure of wax application?

A
  1. Check for contra‐indications and temperature of wax
  2. Test patients sensation (thermal)
  3. Explanation/ warning
  4. Wash part (wipes), remove jewellery
  5. Check for open wounds and contra‐indications
  6. Immerse part to be treated
  7. Repeat 6‐8 times
  8. Wrap in greaseproof paper/ towel for 15‐20 mins
45
Q

What are 4 characteristics of cryotherapy?

A

Rest

Ice

Compression

Elevation

  • Timing: 10‐20mins
  • Longer time if larger limb, more adipose tissue
  • Reduce time on frail elderly patients

PHTY2240 MSE (17 decks)

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