Lect. 9 NMES Flashcards
What is important when you apply NMES on patients?
that the peripheral nerve is intact
precautions?
- Elderly for CV reasons – monitor
- Pregnancy
- *Superficial metal – staples
- Decreased skin sensation
Patients only get comfortable after how many minutes?
Why is Higher frequency needed ?
15 min
-for more comfort and tetany
Increase of amps (current) = increase in number of
motor units recruited
What is our BODY’S NMES build in PD (pulse duration=pulse width)?
300 u sec.
What PD (pulse duration) do most NMES have?
20- 500 u sec.
*Large suprerficial nerves with async firing is what type first?
Type 1 first
Another term for Duty cycle?
ex. how many seconds off vs on?
ratio of on:off
ex. 4 sec on and 12 sec off= 1:3
**What does off time allow muscle to do?
lets muscle recover for next contraction (linking molecules together)
Rise time on most NMES is….. for patient comfort ?
2 sec.
What is an important part of NMES other than applying current (stimulation) ?
What muscles/body parts for example are exercised?
exercise at the same time!!
- ACL
- quads
- hams
- ankle dorsiflexion (post CVA)
( What does Strength and Endurance have to do with ?)
nervous system
It is important to instruct the patient to ___ ____ at or just before the “on” time during NMES
(volitionally) voluntarily contract
NMES might
a)
b)
- fatigue muscle
- breaks pain spasm cycle
When patient has Edema you place NMES on muscle where?
Why is that?
in the area or slightly distal to edema
-to assist in moving the edema proximal
Endogenous Opiate Liberation: duration is ?
30-45 min
- leads to pain reduction
- Frequency: 1-5 Hz to generate TWITCH: to decrease pain
What are some electrode placements for EO (Endogenous Opiates)
motor points,
acupuncture points or trigger points, reflexology
(all overlap)
What are 6 Contraindications for E.O ?
- pacemakes
- carotid sinus
- over eyes
- epilepsy
- malignancy (malignant cancer)
- loss of sensation
What are 3 Precations for NMES?
- arrhythmias
- open wounds
- abdomen of pregnancy
What is MOTOR POINT? (electrode placement)
a location where peripheral nerves enter the muscle
What is a TRIGGER point?
What does pressure on trigger points lead to?
an area of increased excitability within a muscle
-referral of pain
Describe Low Rate in NMES
For CHRONIC pain
- twitch
- treatment time: 30-45 min
- low frequency (rate), high P.W.
- endogenous opiates
Describe High Rate in NMES:
For ACUTE pain
- More electrode placements
- More comfortable
- High frequency (rate), low P.W.
- Gating
- sensory analgesia
Indication of NMEs (how to work it)
> First feel: tingling
Then: visible contraction (HAVE ON Continuous! NOT on ON/OFF at first)
Start strengthening: cycle it’ll be on (full contraction) then off (rest)
