Practical

Question 1

Contraindications for NMES

Answer 1

1. ) Pregnancy
2. ) Malignancy
3. ) Pacemaker
4. ) Impaired sensation
5. ) Imparied mentation
6. ) Unstable arrhythmia
7. ) Over carotid sinus
8. ) DVT
9. ) Cardiovascular Disease
10. ) Open wound/skin irritation

Question 2

Contraindications for E-Stim for edema or muscle spasms

Answer 2

1. ) Pregnancy
2. ) Malignancy
3. ) Pacemaker
4. ) Impaired sensation
5. ) Imparied mentation
6. ) Unstable arrhythmia
7. ) Over carotid sinus
8. ) DVT
9. ) Cardiovascular disease
10. ) Open wound/skin irritation

Question 3

Contraindications for E-Stim for Pain

Answer 3

1. ) Pregnancy
2. ) Malignancy
3. ) Pacemaker
4. ) Impaired sensation
5. ) Imparied mentation
6. ) Unstable arrhythmia
7. ) Over carotid sinus
8. ) DVT
9. ) Cardiovascular disease
10. ) Open wound/skin irritation

Question 4

Treatment parameters for NMES

Answer 4

Frequency = 35-50 Hz
Pulse duration = 200 microseconds
Ramp up time = 5 sec
Contraction time = 5 sec
Rest time = 20 sec
Total treatment time = 10 min
Max tolerated intensity

Question 5

E-stim for edema or spasms =

Answer 5

Low TENS

Question 6

Treatment parameters for E-stim for edema or spasms

Answer 6

Frequency = 2 Hz
Pulse duration = 300 microseconds
Treatment duration = 10 min

Question 7

When to use low TENS

Answer 7

For edema or muscle spasms

Question 8

Treatment parameters for TENS for pain

Answer 8

Frequency = 100Hz
Pulse duration = 75 microseconds
Treatment duration = 30 min

Question 9

TENS for pain =

Answer 9

high TENS

Question 10

What is high TENS used for

Answer 10

decrease pain

Question 11

What would you tell a patient who is receiving TENS for pain control

Answer 11

You may feel a tingling sensation but should not be painful

Question 12

What would you tell a patient who is receiving TENS for edema?

Answer 12

We want you to have strong rhythmic contractions to pump the edema out

Question 13

Thermal US =

Answer 13

Continuous US

Question 14

What is thermal ultrasound used for

Answer 14

1. ) Increasing blood flow
2. ) Increasing collagen extensibility
3. ) Decrease spasms
4. ) Decrease pain

Question 15

Treatment parameters for Thermal Ultrasound

Answer 15

Dose = 1
Frequency = 1 MHz for deep structures and 3 MHz for superficial structures
Tx time = 8 min
Duty cycle = 100%

Question 16

Patient education for ultrasound (both thermal and non-thermal)

Answer 16

Should not feel anything except the head on the skin. Let me know if you feel a stinging sensation

Question 17

Non-thermal US =

Answer 17

Pulsed US

Question 18

What is Non-thermal US used for

Answer 18

decreasing subacute/chronic inflammation

Question 19

Treatment parameters for Non-thermal US

Answer 19

Dose = 1
Frequency = 3 Mhz
Duty Cycle = 50%
Tx time = 8 min

Question 20

What is Ice used for?

Answer 20

1. ) Acute pain
2. ) Swelling
3. ) Inflammation

Question 21

Treatment parameters for ice

Answer 21

Elevate area
Ice for 10-15 min until numb
Use 2 pillows to put ice pack in

Question 22

Patient education for Ice

Answer 22

Let them know the stages of Cold
-Cold
-Burning
-Aching
-Numb
Also educate them on how to use ice at home (15 min with 1/2 pillow cases around the ice pack)

Question 23

When to use heat?

Answer 23

1. ) Stiffness
2. ) Chronic Pain
3. ) Hypertonicity

Question 24

Treatment parameters for heat

Answer 24

Want 2-4 towels underneath
Treatment time = 10 min
Monitor to make sure it is not too hot and adjust number of towels if needed

Question 25

What should you do after heating an area

Answer 25

Stretch!

Question 26

What would you tell a patient who is receiving E-stim to reduce atrophy or improve muscle strength

Answer 26

You should feel a contraction of your muscle about once every 25 seconds for 5 seconds. When you feel this you should try to contract the muscle yourself. This may be uncomfortable but not painful. If it is painful, let me know