Modalities Flashcards
(22 cards)
Describe how TENS helps to block pain and affects guarded muscles?
Gate Control Theory
non noxious stimulus “noise”
goes up spinal cord to brain, blocks pain signals like a soccer goalie
gives an opportunity for muscles that are guarding to relax as well
usually pre-mod setting to provide current variability and prevent desensitization/ “getting used to it”
TENS Parameters for:
sensory-level pain relief
waveform pulse frequency pulse duration amplitude description treatment duration
mono/biphasic alternating PC
high frequency, low duration
30-150 Hz, higher
50-100 microseconds duration, lower
comfort sensory amplitude
duration varies
TENS Parameters for:
motor level/ acupuncture-like pain relief after stim
waveform pulse frequency pulse duration amplitude description treatment duration
biphasic PC
low freq 2-4 Hz, high duration 100-300 microseconds
muscle response amplitude
20-45 minutes
TENS Parameters for:
noxious level, longer lasting pain relief
waveform pulse frequency pulse duration amplitude description treatment duration
DC, mono/biphasic PC
high or low pulse frequency
long pulse duration, 250-1000 microseconds
highest tolerated amplitude
30-60 second treatment duration
Interfering biphasic currents at different frequencies that create a dissonance frequency when crossed together, resulting in broader, deeper coverage
IFC
NMES preferentially hits which muscle fiber type?
Type 2
which is why you’ll want a treatment with more rest breaks, bc these types of fibers have very high fatigability
when NMES is used during functgional activity:
FES
NMES is used for? waveform? pulse hz? pulse duration? amplitude? tx duration?
muscle strength/re-education
mono/biphasic PC OR medium frequency burst AC (Russian)
30-85 pulse hz
200-700 microseconds
muscular contraction amplitude
1:3-5 duty cycle
another name for Russian Stim?
frequency burst AC
monophasic pulsed current with double peaked pulses is aka
parameters
Hi-Volt PC
used for wound healing, 4-100 microseconds for 60 min at a comfy amplitude
Hi-Volt polarity for inflammation?
positive
Hi-Volt polarity for granulation, infection?
negative
Iontophoresis:
dexamethasone is used for? polarity?
anti inflammatory
-
Iontophoresis:
lidocaine is used for? polarity?
pain/inflammation
+
Iontophoresis:
acetic acid vinegar is used for? polarity?
calcific tendonitis
-
Iontophoresis:
iodine is used for? polarity?
adhesive capsulitis
-
Iontophoresis:
salicylates is used for? polarity?
muscular pain (-)
describe therapeutic ultrasound:
really fast mechanical sound waves that cause vibration; travels well through liquids/gel (coupling medium); our soft tissue also acts like a liquid
piezoelectric crystal vibrates creating electric current, high frequency goes from crystal to tissue
ideal beam non-uniformity ratio for therapeutic ultrasound? what is BNR?
1:1
peak intensity vs average intensity
6:1 is the FDA limitation of too high of a peak,
attenuation
decrease in sound energy due to absorption, reflection or refraction
why use ultrasound?
to increase temperature and blood flow
- scar tissue
- subacute inflammation
- facilitate healing through blood flow and microstreaming
temperature increase due to friction between molecules = local blood flow increase
microstreaming: pushing air bubbles through cell walls, cell wall permeability diffusion changes = increase in metabolism and healing that occurs at a cellular level
contraindication for ultrasound in kids?
don’t ultrasound over growth plates! it can cause them to seal over early
