Nmes Flashcards
Indications for NMES
Retard or prevent disuse atrophy muscle reeducation maintain or increase joint mobility increased local blood circulation relax muscles spasms prevent Venus thrombosis in calf muscle immediately following surgery
What does NMES due to muscle fibers
Recruits large fast twitch fibers first with the smaller muscle fibers recruited later
What happens with recruited muscle fibers
Muscle fatigue more quickly
fine motor controls Limited
Powhatan kind of sensory input does nMES provide
Increased ability for the body to activate muscles
Kinesthetic info
proprioceptive info
Contraindications for nMES
Over thoracic region pacemakers bladder stimulator's carotid sinus high or hyposensitive pt cancer infection pregnant near diathermy devices unable to provide feedback area of pathology over superficial metal pins or hardware Where movt is contraindicated
What is an NMES
Muscle contraction through stimulation of intact or partially from nervous system
What does NMES act as a substitute for
Orthotics
For CVA what is best for NMES
Intact or partially intact PNS
What kind of benefit can those CVA get
Emotional and physical
How is it used for relaxation of muscles spasm
Fatigue the muscle usually used with shoulder
How is it used for spasticity
Interrupts the abnormal cycle through muscle fatigue
high frequency
stimulation of the antagonist muscle leads to inhibition of the agonist
What is not achieved
Long term muscle control
What can It do in regards to healing
Stimulate bone growth and help with wound healing
Enhance callus development
mineralization
How to prevent muscle fatigue during it
LowFrequency and high intensity
How to judge muscle fatigue
Tremors in the muscle during contraction
decreased overall strength of contraction
decreased quality of movement during contraction
What Should you combine with it
Functional activity
What is a smaller used for
Higher current density
What is a larger electrode used for
Lower current density
Monopolar electrode placement
Small electrode over motor point of muscle
dispersive electrode on the same side of body larger than active electrode
BiPolar electrode placement
Two electrodes that are the same size
place an electrode at each end of the muscle belly
Synchronous channel
Channel 1 and 2 deliver stimulation simultaneously
Asynchronous channel selection
Stimulation will alternate between channel 1 and two
Channel 2 delay
After a short delay stimulation from channel 2 occurs
What to use a symmetrical waveform for
Large muscle
To use asymmetrical waveform four
Small muscles
How to choose the electrode size
Largest electrode that works without causing overflow to other muscles
3 inch for trunk and upper legs
2 inch for extremities
What is active in a symmetrical wave form
Both electrodes
What is active in a asymmetrical wave form
Negative is more active (placed over motor point)
What pps is used to elicit mm fatigue
80
What is a 1 to 5 ratio used for
Strengthening
What is a 1:3 ratio for
Debilitated pt
What is a 1:2 ratio for
Average person
What is a 1:1 ratio used for
Athletes and conditioning
What might you need a longer ramp for
Prevent stretch reflex in pts with spasticity
What is accommodation
Increased stimulation is necessary to achieve result
What do you document
Goal Electrode place,net and size Tx time On off ratio Ramp Intensity Comments Response to tx
