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1
Q

Indication of TENS

A

Control/relieve pain

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2
Q

Secondary benefits of TENS

A
  • Reduce the amount of and dependency on pain medication
  • Provide the patient a more active role in their pain management
  • Increase functional movement and mobility with less discomfort
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3
Q

What is parameter for frequency of conventional TENS?

A

100-150 Hz (high frequency)

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4
Q

What is parameter for pulse duration of conventional TENS?

A

50-80 microseconds

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5
Q

What is parameter for amplitude of conventional TENS?

A

Strong but comfortable

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6
Q

What is parameter for treatment duration of conventional TENS?

A

20-30 mins, up to 24 hours

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7
Q

What is parameter for mechanism of action of conventional TENS?

A

Gate control

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8
Q

What is parameter for analgesia duration of conventional TENS?

A

Immediate relief with little residual effect

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9
Q

What is parameter for frequency of acupuncture TENS?

A

2-10 Hz (low frequency)

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10
Q

What is parameter for pulse duration of acupuncture TENS?

A

200-300 microseconds

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11
Q

What is parameter for amplitude of acupuncture TENS?

A

Strong, visible muscle contraction

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12
Q

What is parameter for treatment duration of acupuncture TENS?

A

20-30 mins

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13
Q

What is parameter for mechanism of action of acupuncture TENS?

A

Endogenous opiods release

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14
Q

What is parameter for analgesia duration of acupuncture TENS?

A

Up to 5 hours

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15
Q

How does TENS- acupuncture work?

A

Through brief sharp pain through repetitive muscle twitched and stimulation of A-delta fibers

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16
Q

Which fibers are sensory?

A

A-beta

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17
Q

Indication for IFC

A

Pain control

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18
Q

Secondary indication of IFC

A
  • Edema control (weak evidence)
  • Force production
  • Modulation
  • Treat larger region
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19
Q

Electrode placement for IFC is always ____

A

Criss-crossed

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20
Q

What are the electrode placements for TENS

A
  • Criss cross
  • Parallel
  • Bracket
  • Unilateral
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21
Q

Where should you avoid placing electrode for TENS?

A
  • Transcranial

- Over genitalia

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22
Q

What do you use a vector scan for in IFC?

A

For change in position of interference pattern (scan entire field)

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23
Q

What is the purpose of the sweep mode in IFC?

A

To decrease sensory habituation for longer treatment times

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24
Q

IFC provides pain relief over a _____ region with ____ body tissue involvement

A

IFC provides pain relief over a larger region with multiple body tissue involvement

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25
When should pre-modulated current be used?
In small/narrow regions where the 4 electrode placement used in IFC is not possible
26
How many channels and electrode pads should be used in pre-mod?
- 1 channel | - 2 large pads
27
How many channels and electrode pads should be used in IFC?
- 2 channels | - 4 small pads
28
HVPC is a ___ current
Direct current
29
What are the indications of HVPC?
- Wound healing (supportive evidence) | - Inflammation/edema (weak evidence)
30
Theoretical clinical use of HVPC
- Softening scar tissue | - Increased tissue density
31
What is a side effect from HVPC?
Increased aching in the area of the dispersive pad (larger electrode)
32
Position of limb when using HVPC for edema control
Leg elevated
33
What kind of polarity should be used when using HVPC to treat edema?
Negative polarity
34
What kind of polarity should be used when using HVPC to treat tissue healing?
Positive polarity
35
What color channel should be used at the treating/active pad?
Red channel
36
What color channel should be used at the dispersive pad?
Black channel
37
What is/are the indication(s) for russian?
Strengthening of muscle
38
What is/are the indication(s) for NMES?
- Stimulation of denervated muscles - Improve/retrain motor control - Strengthening - Muscle pump for edema control - Reduce spasticity by applying over the antagonist muscle (NMES)
39
Characteristic of a russian current
Burst modulation
40
Recommended parameter of a russian treatment?
- 50 bursts/ second - Burst duration is 10 microsecs - 10 secs contraction time - 50 secs off time - 10 repetitions
41
What are the precautions of HVPC?
- Cardiac disease - Impaired sensation - Malignant tumors - Skin irritation or open wounds
42
What are the contraindications of HVPC?
- Pacemakers, heart conditions (unstable arrythmias) - Over the carotid sinus - Venous or arterial thrombosis or thrombophlebitis - Pelvis, abdomen, trunk, and low back during pregnancy(1st trimester), can be used for pain control during delivery
43
What are the contraindications of HVPC, TENS, IFC?
- Pacemakers, heart conditions (unstable arrythmias) - Over the carotid sinus - Venous or arterial thrombosis or thrombophlebitis - Pelvis, abdomen, trunk, and low back during pregnancy(1st trimester), can be used for pain control during delivery
44
FES is like ____, except it i used for ___
FES is like *NMES*, except it i used for *foot drop*
45
What are the risk of TENS, HVPC, NMES, russian, and IFC
discomfort
46
For immediate increased ROM, which frequency of IFC should be used?
High frequency (80-150)
47
If patient has a fear of movement, and will be performing movement for a short period of time post treatment, which frequency of IFC should be used?
High frequency (80-150)
48
If patient has a fear of movement, and will be performing movement for a long/extended period of time post treatment, which frequency of IFC should be used?
Low frequency (2-10)
49
What frequency should for a patient getting E-stim for the first time?
80-150
50
What is difference the feeling from IFC/TENS under high and low frequency?
They both feel pins needles, but a high frequency is a strong but comfortable feeling, while a low frequency is at a higher intensity, and a deeper level. It is a strong but comfortable feeling with a muscle twitch
51
When should you come back to check on a patient?
In 5 mins
52
What is frequency called on a TENS unit?
Pulse rate
53
What is pulse duration called on a TENS unit?
Pulse width
54
Indications of an ultrasound
- Pain control - Dermal ulcers - Tendon and ligament injuries - Bone fractures - Carpal tunnel syndrome - Soft tissue inflammation - Tissue extensibility - Scar tissue remodeling - Tissue healing
55
The higher the frequency, the ____ the absorption, hence ____ depth of penetration
The higher the frequency, the *higher* the absorption, hence *less* depth of penetration
56
When looking to get a mechanical effect of US, ___ duty cycle should be used
Lower duty cycle (20%)
57
When looking to get a thermal effect of US ___ duty cycle should be used
Higher duty cycle (100%)
58
At what temperature does US start to increase metabolism and healing?
1 deg C
59
What temperature does US start to decrease pain and muscle spasms?
2-3
60
What temperature does US increase extensibility, and decrease joint stiffness
4 deg C or higher
61
What frequency will you use for a tissue depth of up to 5cm?
1 MHz
62
What frequency will you use for a tissue depth of 1-2 cm deep?
3 MHz
63
What intensity should be used at 1 MHz?
1.5-2 W/cm^2
64
What intensity should be used at 3 MHz?
0.5 W/cm^2
65
What intensities should be used if a non-thermal effect is desired?
0.5-1.0
66
How long should all US be done?
5-10 min/2 x ERA
67
How long should all US be done?
5-10 min/2 x ERA
68
What are the contraindications for US?
- Malignancy - Pregnancy - CNS tissue - Joint cement - Plastic - Pacemaker - Thrombophlebtis - Eyes and reproductive organs

Physical agents (7 decks)

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