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Boards - PT (Passive Care) > Passive Care - Electrical Stimulation Terminology > Flashcards

Passive Care - Electrical Stimulation Terminology Flashcards

1
Q

Physiologic Effects of Electrical Stimulation

A
  1. Decrease Pain: gate-control theory / endorphin release
  2. Decrease Muscle Spasm
  3. Reduce Edema
  4. Simulate exercise by muscle contraction: increase muscle fiber recruitment and retard atrophy
  5. Stimulate Healing
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2
Q

Capacitance

A

ability of a material to store a charge

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3
Q

Ohm’s Law

A

V (volts)
I (current)
R (resistance)

V= I * R
R= V/I
I= V/R
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4
Q

Types of Currents

A

Monophasic or Biphasic

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5
Q

Monophasic Current

A
  1. Current flow in 1 direction
  2. Unique positive and negative electrodes
  3. direct current (DC)
  4. aka: Galvanic
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6
Q

Biphasic Current

A
  1. Alternating Current (AC)
  2. Flow of electrons changes direction regularly (changes polarity)
  3. Wave form: symmetrical (same shape in both phases) / asymmetrical (different positive and negative)
  4. Net charge: balance - equal electrical charge in both phases / unbalanced - unequal charge
  5. Shape: sinusoidal, square, rectangular, triangular
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7
Q

Phase Duration

A
  1. Time it takes current to leave the isoelectric line to when it returns to this line
  2. Tissues respond to phase duration not pulse duration
  3. Must be long enough to overcome capacitance and cause an action potential - large diameter nerves have low capacitance and reach threshold quickly
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8
Q

Amplitude

A
  1. Intensity or Magnitude of the current
  2. Peak Current - maximum amplitude of the current regardless of duration
  3. Must be high enough to reach threshold of muscle or nerve - beta is close to skin and has lower threshold so will be stimulated first, give sensory response before motor
  4. High peak current is associated with greater depth of penetration
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9
Q

Average Current

A
  1. Amount of current supplied over a period of time
  2. Takes into consideration peak amplitude and the phase duration
  3. Higher average current needed for some physiologic responses
  4. Too high average current can cause tissue damage
  5. Depending on wave form, can have high peak but low average current
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10
Q

Root Mean Square (RMS)

A
  1. Measure of the effective current contained in the waveform
  2. Complex calculation
  3. Similar to average but more accurate
  4. Preferred over average
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11
Q

Strength Duration Curve

A
  1. Describes the relationship between amplitude (strength) of the electrical current and the duration (phase duration)
  2. If charge is sufficient to overcome the capacitance of a nerve fiber it will depolarize
  3. If charge does not exceed the capacitance then no depolarization will take place
  4. Likewise if the amplitude is too low no depolarization will occur no matter how long the duration
  5. Short duration requires a higher amplitude for the nerve response
  6. Longer duration allows a lower intensity for the same nerve response
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12
Q

Strength Duration Curves

A

Ab - tingle
Aa - muscle contraction
Ag - pain
C - a lot of pain

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13
Q

Rheobase

A
  1. Minimum amplitude needed to depolarize a nerve fiber when phase duration is infinite
  2. If peak amplitude fails to exceed rehabs the nerve will not depolarize regardless of phase duration
  3. Rheobase will never cause depolarization
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14
Q

Chronaxie

A
  1. The time (or phase duration) required to depolarize a nerve fiber when the peak current is twice rheobase
  2. When amplitude is twice rehabs and the phase duration is slightly greater than chronaxie the result will be greatest comfort for the patient
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15
Q

Frequency

A
  1. Number of pulses or cycles generated per seconds (pos or Hz)
  2. Affects the number of action potentials elicited during the stimulation
  3. Higher frequency leads to summation (motor neuron: tetany)
  4. The absolute refractory period is the rate-limiting factor of the number of impulses that can be generated by a nerve
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16
Q

Summation

A
  1. Single Twitch: contraction and then relaxation
  2. Summation: force from two twitches, no relaxation after first twitch
  3. unfused tetanus
  4. fused tetanus
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17
Q

Wedenski’s Inhibition

A
  1. Stimulation at high frequency near refractory period of the sensory nerve causes inhibition
  2. > 1000 Hz sensory nerves
  3. Action Potential Failure
  4. Results in anesthesia between the electrodes
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18
Q

Temporal Summation

A

35-50 pps / tetanic contraction

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19
Q

Low Frequency Generators

A 
up to 1,000 Hz
contraction (rehab muscle)
Produce action potential
1-10 Hz or 60-100 Hz are common treatment frequencies
TYPES:
EMS (electrical muscle stim)
HV (low frequency) / best contract
LVG (low volt galvanized - drug pusher)
Sine
Faradic (RD) (used with people who are paralyzed)
Interference (IF and RS) / best contract
TENS (milliamps) / help with pain
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20
Q

Medium Frequency Generators

A

1,000 - 100,000 Hz
Russian Stim: 2,500 Hz
IF: 4,000 - 5,000 Hz
Intrinsic duty cycle of 10ms on and 10ms off creates a burst frequency of 50 Hz
It gets in with Medium Frequency but treats with Low Frequency (one side 4,200 and the other side 4,300 - the difference is 100 so it gets in with the high number and treats with the difference (100).

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21
Q

High Frequency Generators

A

Greater than 100,00 Hz
used for chronic issues
Used for thermal (heat) purposes
Diathermy uses high frequency and creates minimal sensory effects

SUPERFICIAL HEAT:
IR (infrared) - mc
UV (skin and bones)

DEEP HEAT: (diathermy)
MWD (micro wave diathermy)
SWD (short wave diathermy)
US (1 MHz - 3 MHz) (continuous has heat / pulsed US removes heat and you can use for acute) / 1 MHz goes deep and 3MHz is superficial - opposite of normal electricity - increase electricity you increase the depth - opposite with US - increase electricity decrease depth / reverse piezoelectric effect

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22
Q

Electrodes are attached to the current generator by wires called?

A

leads

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23
Q

There must be how many leads to complete a circuit?

A

2

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24
Q

Leads can be split or

A

bifurcated

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25
Q

leads usually are wired into pairs that plug into a

A

single channel

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26
Q

Unequal size electrodes will

A

concentrate the current in the smaller electrode and it will give the perception of increased intensity

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27
Q

When sizes vary greatly one may not be able to perceive current under the larger electrode. This becomes the

A

dispersal electrode

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28
Q

If pads are placed close together the current is most concentrated in

A

superficial tissues

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29
Q

When pads are far apart the current has the potential to take a

A

deeper path through the nerve and blood vessels that have less resistance

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30
Q

When you use one big pad and one small pad

A

the focus/feeling will be on the small pad

the big pad is used for dispersement

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31
Q

Monopolar Electrode Configuration

A
  1. Two or more unequal sized electrodes are used
  2. Can be used with either biphasic (AC) or monophonic (DC) currents
  3. One is the active and one is the dispersive electrode
  4. Active at the target site and dispersive away from target site
  5. 3 reasons for this placement: (1) leads placed far apart - deeper penetration (2) greater comfort (3) to create an electrical field with specific polarity
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32
Q

Bipolar Electrode Configuration

A
  1. Can be used with either monophonic (DC) or biphasic (AC) currents
  2. Two equal sized electrodes are placed over the treatment site
  3. Most common for TENS
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33
Q

Quadripolar Configuration

A
  1. Often used with IF
  2. Two separate medium frequency currents are used with electrodes placed as cross currents
  3. Current is interfered with in the center of the two currents
  4. Can change this location of interference where ou feel the beat frequency
34
Q

CURRENT: AC or DC

AC =

A

Biphasic (no polarity)

35
Q

CURRENT: AC or DC

DC =

A

Monophasic (polarity)

36
Q

AC Current types

A

Sine
Faradic
Interferential

37
Q

DC Current types

A

Galvanic

High Volt

38
Q

Sine

A

AC - biphasic - no polarity

symmetrical / best contractor / no charge left in patient

39
Q

Faradic

A

AC - biphasic - no polarity

asymmetrical / sporadic

40
Q

Interferential

A

AC - biphasic - no polarity

two sine waves

41
Q

Galvanic

A

DC - monophasic - polarity

make and break

42
Q

High Volt

A

DC - monophasic - polarity

Twin Pulsed Peak

43
Q

Electrothermal

A

Heat
micro-vibration, electrically leads to heat
Joule’s Law

44
Q

Electrochemical

A

Iono and Opiods
Iontophoresis is DC current
Opiod frequency 1-10 (endorphins), 70-120 (enkephalins)

45
Q

Electrophysical

A

Kinetic

ions push other molecules around shifting Na+/K+ pump resulting in contraction

46
Q

Increase frequency = ______ penetration

A

deeper penetration

47
Q

Medium frequency = _______ skin impedance

A

decreased

best to use a bigger electrode and increased voltage

48
Q

Motor Point or Muscle Belly

A

isolates the muscle ( 1 pad)

49
Q

Either side of the Muscle Belly

A

if the muscle is especially weak (2 pads)

50
Q

Pad Rule

A

1 mA per square inch of pad size (3” square pad = 9mA)

51
Q

Monopolar

A

large area or trigger / acupuncture point
Dispersal aka Indifferent - large pad (ground)
Active Pad or Pads - small pad

52
Q

Bipolar

A

small muscle group

Dispersal and Active Pads are the equal size

53
Q

Quadripolar

A

Crisscross Pattern

54
Q

mA problem

A

If the dispersal pad is too small or active sites are too large ( too many) = tingle

55
Q

EMS: Continuous

A

Use: Pain

Duty Cycle: None

56
Q

EMS: Surge

A

Use: Exercise / Rehab

Duty Cycle: 1:3

57
Q

EMS: Pulsed / Tetanizing

A

Use: Fatigue / Spasm

Duty Cycle: 1:1

58
Q

EMS: Reciprocating

A

Use: contract agonist, then antagonist

Duty Cycle: none

59
Q

EMS: Modulation

A

Use: Avoids accommodation

Duty Cycle: none

60
Q

EMS: Burst / TENS

A

Use: Packages of stimulation

Duty Cycle: none

61
Q

Low Frequency: Pain

A

1-20 endorphins

70-150 enkephalin

62
Q

Low Frequency: Edema

A

3-5

63
Q

Low Frequency: Exercise

A

15-25

64
Q

Low Frequency: Fatigue

A

50

65
Q

Electricity: Increase mA (amps) =

A

Increased Muscle Contraction

66
Q

Electro-induction

A

charges lie up = electrical lines of force

one object produces electromagnetic property in another

67
Q

Coulomb

A

charge

68
Q

Waveform

A

pulse width
interpulse width
frequency

69
Q

Amplitude

A

magnitude depth

70
Q

Current (AMP)

A

electricity that flows

number of electrons

71
Q

Transformer

A

increase or decrease volts

72
Q

Capacitance (OHM)

A

stores up energy

73
Q

Resistance

A

property of substance to oppose current
measured in OHMs
decreased resistance = increased conduction
(shorter path, lower temp, increased diameter)

74
Q

EMF (electromagnetic force)

A

measured in Volts (force behind electrons)
difference between force in two objects (whether connected or not)
greater the charge = increase EMF
greater the distance = decrease EMF

75
Q

Impedance

A

slow it down (dampen)

increased by oily skin

76
Q

Strength Duration Curve

A

Chronaxie = the time necessary for contraction when the rehabs is doubled
Rheobase (threshold) = the minimum volts necessary to excite a nerve

77
Q

Reaction of Degeneration (RD Factor)

A

Innervated muscle responds different than denervated muscle

Galvanic & Faradic current are compared to determine extent of damage and prognosis

78
Q

EMG (electromyography)

A

used to test muscle best

79
Q

NCV (nerve conduction velocity)

A

used to test nerve best

80
Q

Arndt-Schultz Principle

A

energy of modality has to be absorbed by body to stimulate physiological response

81
Q

Law of Grotthus-Draper

A

inverse relationship between penetration and absorption of energy (US)

Boards - PT (Passive Care) (28 decks)

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