NMES Flashcards
What is the rational behind using this treatment (Pain/Increase ROM/strengthen)?
increase muscle strength
promote continence (control of bladder)
improve ROM
increase blood supply to muscle as a warm up prior to exercise
lessen changes in muscle tone
prevent disuse atrophy e.g. RA
What are the physiological effects of the treatment?
increased muscle fibre recruitment and activation
NMES facilitates neuromuscular re-education, improving coordination, motor control, and functional movement patterns.
The release of neurotransmitters during NMES-induced muscle contractions contributes to pain relief by inhibiting pain transmission pathways and modulating pain perception.
prevent muscle atrophy
NMES can help improve joint flexibility and range of motion by stretching and lengthening muscles during controlled muscle contractions.
What structures are affected by the technique?
neuromuscular junction
skeletal muscles
blood circulation
What principles are used in carrying out the technique?
electrodes placed on the motor point of the muscle, or either end of the muscle belly
pt shouldn’t fight against the machine
Precautions and contraindications?
demand style pacemaker (only kicks in if ventricular contraction fails)
during pregnancy
undiagnosed pain
peripheral vascular disease
deep xray therapy
dont place over carotid sinus, over larynx, inside mouth
what are the conditions known to respond to arthritis?
urinary and rectal incontinence
chronic neurological conditions to decrease spasticity and strengthen the muscle
peripheral nerve lesions
arthritis for muscle atrophy and pain relief
What should you do if someone doesn’t like the feeling?
can increase the ramp
What should the settings be on the machine for a strengthening regime?
pulse duration- 300 microsecs
frequency- 40Hz (pps)
on off time- 15/50 seconds
treatment time for up to 15 minutes x4 daily
What is the application procedure for NMES?
identify area for application and ensure its clean
check for contraindications
perform pin prick test
place electrode over motor point (3rd of way down muscle belly) or either end of muscle belly
attach leads to machine
set the settings
turn up intensity until suitable muscle contraction occurs
start timer
turn machine off, remove electrodes and check sign for adverse reactions
pt may then have to be taught how to do it
Where should electrodes be applied to the deltoid muscle?
two electrodes places either end of muscle belly of deltoid
the other two places on upper attachments of the anterior and posterior fibres of deltoid
Where should electrodes be applied to the quadriceps muscle?
one on the motor point of vastus medialis and the other on the motor point of vastus lateralis
How to do muscle stimulator for foot drop?
one electrode placed over common peroneal nerve (head of fibula), other on the motor point of tibialis anterior
raising the heel off the switch activates stimulation of tibialis anterior and the foot is then able to clear the floor when taking a step.
What are the 3 stages of NMES?
Watch it
Work with it
And bridge the gap
What is the watch it stage?
ask patient to watch and pick up on sensory changes, watching and feeling how muscle contracts
What is the work with stage?
the relaxation phase is longer
when the the muscle is being contracted work with it and contract more
relax when machine relaxes
to progress-turn down intensity or make them work longer periods of time and reduce relaxation
