neuromuscular electrical stim for strengthening

Question 1

purpose

Answer 1

strengthens normally innervated healthy muscle with strength deficits through muscle reeducation and prevention of disuse atrophy

decrease muscle spasm

decreases the demand through reciprocal contraction of agonist and antagonist creating a pumping effect

works by depolarizing alpha motor nerves via type 2 first and then type 1

depolarized skeletal muscles and denervated muscles via DC current

Question 2

electrode placement

Answer 2

muscle belly or motor point

–> motor point is where the never innervates the muscle

Question 3

parameters

Answer 3

high pulse duration, frequency, amplitude

high frequency will produce a titanic contraction which would be good for muscle spasms or trigger points

Question 4

instructions to pt

Answer 4

explain what is happening and what they will feel

the intensity and amplitude will gradually increase until a significant contraction is achieved by the machine alone

ensure the pt does not make any contractions until you’ve found the highest amplitude that will give you a strong contraction and that the pt can tolerate

once this is achieved the pt is instructed to contract the muscle

Question 5

functional electrical stimulation

Answer 5

when NMES is applied during the performance of a functional activity

commonly used in pts who have neurological diagnosis

used in urinary incontinence

uses a biphasic pulsatile current

Question 6

goals of functional electrical stim

Answer 6

help pt relearn movement pattern with the goal of discontinuing when pt can voluntary move

produce a more functional movement pattern for those who have permanently lose the ability to voluntarily produce a muscle contraction

Question 7

protocols –> shoulder subluxation w/ pt who had CVA –> electrode placement

Answer 7

over posterior deltoid and supraspinatus

Question 8

protocols –> shoulder subluxation w/ pt who had CVA –> goal

Answer 8

move humerus superiorly into glenoid fossa w/o creating ABD

Question 9

protocols –> shoulder subluxation w/ pt who had CVA –> amplitude

Answer 9

strong motor w/o shoulder hiking

Question 10

protocols –> shoulder subluxation w/ pt who had CVA –> cycle duration

Answer 10

200-350 usec

high

Question 11

protocols –> shoulder subluxation w/ pt who had CVA –> pulse frequency

Answer 11

30-40 pps

high

Question 12

protocols –> shoulder subluxation w/ pt who had CVA –> duty cycle

Answer 12

start w/ 1:5 but increase on time and decrease off time as endurance improves

Question 13

protocols –> shoulder subluxation w/ pt who had CVA –> time

Answer 13

30 min - 6 hours

5-7 days per week

Question 14

protocols –> dorsiflexion assist during gait –> amplitude

Answer 14

strong motor

Question 15

protocols –> shoulder subluxation w/ pt who had CVA –> pulls the ration

Answer 15

200-350 usec

high

Question 16

protocols –> shoulder subluxation w/ pt who had CVA –> pulse frequency

Answer 16

30-40 pps

high

Question 17

protocols –> shoulder subluxation w/ pt who had CVA –> duty cycle

Answer 17

start 1:5 and progress 1:1

Question 18

protocols –> shoulder subluxation w/ pt who had CVA –> consideration

Answer 18

make sure ankle does not invert or just get toe extension