Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DPT 608 > TENS > Flashcards

TENS Flashcards

1
Q

What are the contraindications to TENS?

A

Treating pain of unknown or unidentified origin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is TENS (transcutaneous electrical stimulation) ?

A

All therapeutic stimulators that deliver electrical current at the electrode/skin interface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

T/f: TENS units are small portable stimulators for pain

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the different muscle stimulators?

A

NMES
FES
EMS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the most common use of electrotherapy?

A

Pain modulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

TENS units are _____ and ______ treatment

A

Complementary and adjunct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What should TENS be used as an adjunct to?

A

An exercise program and fxnal training

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

T/f: TENS is safe with relatively few contraindications

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

T/f: TENS is non-invasive

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Who can administer TENS?

A

PT, AT, patient once educated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why is self administration of TENS important?

A

Bc it empowers pts to take control of their pain management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

T/f: TENS provides relatively instantaneous pain relief

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the pulse duration for TENS flex it (EMSI)?

A

50-300us

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the frequency for TENS flex it (EMSI)?

A

2-150 Hz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the waveform for TENS flex it (EMSI)?

A

Biphasic (symmetrical/assymetrical)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the pulse amplitude (intensity) for TENS flex it (EMSI)?

A

0-54 mA, 0-27V at 500 ohms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What types of output can be used with the TENS flex it (EMSI)?

A

Normal, burst, MRW, SD, BiPulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are normal TENS parameters?

A

Fixed/adjustable frequency and duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is burst TENS?

A

Bursts of 7 pulses, 2/sec, 100Hz fixed, duration adjustable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is MRW TENS?

A

Modulated rate and width
Rate and width automatically varied 50%
R/W adjustable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is SD TENS?

A

Strength duration, modulates intensity and pulse duration
Amplitude increases, duration decreased, vice versa
Rate and width adjustable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is BiPulse TENS?

A

Channel 1 fixed 4 Hz
Channel 2 fixed 100 Hz
On 1 sec off 1 sec
Duration adjustable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

At least ____% MVIC needed for TENS to be effective

A

50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Where can electrodes be placed with TENS?

A

At the site of injury
Around or over the painful area
Over the course of the peripheral nerve
Spinal nerve roots of spinal nerve innervation the painful dermatitis of the involved region
Acupuncture/trigger points, motor points, on myotomes related to the painful area
CL mirror side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

When would we put the electrodes for TENS on the CL mirror side?

A

When treating phantom limb pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are different duration of TENS that can be effective for pain?

A

20 min TENS
40 min TENS
60 min TENS
60 min placebo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How often should TENS be done for optimal pain management of OA knee pain?

A

5x/week for at least 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What it the most optimal duration of TENS for OA of the knee?

A

40 min TENS for over 4 hours of relief

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Why do we often do 15 minutes of TENS in the clinic if longer works better?

A

Bc of time restraints and bc 15 minutes is a billable unit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

T/f: using TENS for pain can be just as effective as OTC NSAIDs without the GI side effects

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the 5 modes of TENS?

A

Conventional TENS (sensory)
Acupuncture like TENS (AL)
Burst train TENS
Brief intense TENS
Noxious TENS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What type of TENS is high frequency, low intensity TENS?

A

Conventional TENS (sensory)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the intensity of conventional (sensory) TENS?

A

Low intensity (sub motor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What fibers are stimulated by conventional (sensory) TENS?

A

A beta fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the sensation of conventional TENS (sensory)?

A

Tolerable paresthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the pulse duration of conventional (sensory TENS)?

A

50-100 us (low threshold)
Duration long as possible is ideal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the frequency of conventional (sensory) TENS?

A

High frequency
80-150 Hz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What duty cycle is conventional (sensory) TENS?

A

Continuous duty cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How long is the treatment time for conventional (sensory) TENS?

A

20-30 minutes or longer with activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

When is the onset of relief for conventional (sensory) TENS?

A

10-20 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

How long does pain relief last with conventional (sensory) TENS?

A

30 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the most common use of conventional (sensory) TENS?

A

Acute and post op pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is often the first mode of TENS trialed?

A

Conventional (sensory) TENS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What fibers are targeted by conventional (sensory) TENS?

A

A beta fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

How does conventional (sensory) TENS elicit pain relief?

A

By stimulating a beta fibers, it releases enkephalin into the DH for short duration pain relief

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

T/f: conventional (sensory) TENS provides pain relief when the ES is on and shortly after

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Bc a beta fibers accomodate quickly to stimulation, what do we need to do with conventional (sensory) TENS?

A

Adjust intensity as needed
Use modulated amplitude, rate, duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Acupuncture like (AL) TENS (rhythmical/motor TENS) is _____ frequency, _____ intensity TENS

A

Low, high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is the intensity of AL TENS?

A

High to produce strong, tolerable muscle contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Why do we want a high intensity with AL TENS?

A

To produce strong, tolerable muscle contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the pulse duration of AL TENS?

A

Long
200-400 us

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is the frequency of AL TENS?

A

Low frequency
<10Hz
Usually 1-4 Hz to mimic acupuncture needle turning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Why is AL TENS frequency so low?

A

To mimic the needle oscillation of acupuncture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Why is AL TENS frequency so low?

A

To mimic the needle oscillation of acupuncture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What is the duty cycle of AL TENS?

A

Continuous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

How long is the treatment time for AL TENS?

A

30 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

When does the onset of pain relief start with AL TENS?

A

Within 15-30 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is the duration of relief of AL TENS?

A

2-6 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is AL TENS used to treat?

A

Sub acute and chronic pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Where should the electrodes be placed with AL TENS?

A

At the trigger/acupuncture points
Myotomes related to their pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What fibers are targeted by AL TENS?

A

A alpha and A beta fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

How does AL TENS induce pain relief?

A

Stimulation of a beta and a alpha fibers releases endogenous opioids, inhibits pain through descending mechanisms and increases serotonin in the SC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What are some conditions that indicate use of AL TENS?

A

Non specific LBP
RA
DJD
peripheral neuropathy
Peripheral nerve injury
Phantom limb pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is burst train TENS?

A

A combo of conventional and acupunture like TENS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What level should the intensity reach in burst train TENS?

A

Motor level

66
Q

What is the frequency of burst train TENS?

A

High frequency trains (100 Hz) delivered at low frequency (1-4Hz)

67
Q

What is the pulse duration of burst train TENS?

A

Long
About 200us

68
Q

What form of TENS produces a more comfortable motor contraction than AL TENS?

A

Burst train TENS

69
Q

What is treated with burst train TENS?

A

Subacute pain and trigger points

70
Q

How is acute post op pain treated with TENS?

A

With conventional (sensory) TENS

71
Q

How can acute pain be treated with TENS?

A

With burst train TENS, or AL TENS

72
Q

How may chronic pain be treated with TENS?

73
Q

How may trigger points be treated with TENS?

A

With burst train TENS, Brief intense TENS (to numb), or with noxious TENS

74
Q

What does brief intense TENS do?

A

Causes short local hyperalgesia (nerve block)

75
Q

What is the intensity of brief intense TENS?

A

Highest tolerable by the patient

76
Q

What is the frequency for brief intense TENS?

A

High
100-150 Hz

77
Q

What is the pulse duration for brief intense TENS?

A

Longest pulse duration
150-300us

78
Q

How long is the treatment time for brief intense TENS?

A

5-10 minutes

79
Q

What is brief intense TENS used for?

A

Minor painful procedures: dressing changes, debridement, suture removal, painful TE, mobs, myofascial trigger point release

80
Q

What is type of TENS is difffuse noxious inhibitory control (DNIC)?

A

Noxious TENS

81
Q

What is the intensity of noxious TENS?

A

Max tolerable

82
Q

What is the phase duration for noxious TENS?

83
Q

What is the frequency of noxious TENS?

A

Low (2-7Hz) and high (100-150 Hz)

84
Q

What is a point stimulator in noxious TENS?

A

A small diameter probe with high current density

85
Q

What fibers are triggered in noxious TENS?

A

C fiber and sometimes A delta (harder to stimulate)

86
Q

How long is noxious TENS usually?

A

No more than 5 minutes

87
Q

What condition was shown in a case study to have 5 months of pain relief with noxious TENS?

A

Achilles tendinopathy

88
Q

What is noxious TENS used to treat?

A

Trigger points and acupuncture points

89
Q

What is the treatment time for noxious TENS?

A

30 sec, 8-10 points per treatment session

90
Q

Electrophysical agents modulate through ______ and ______ mechanisms

A

peripheral and central

91
Q

What are the peripheral mechanisms of TENS?

A

Decreased nociceptors mechanical sensitivity

Peripheral opioid receptors

92
Q

TENS effects are mediated via activation of peripheral _____ receptors

93
Q

What are the spinal level mechanisms of TENS?

A

Gate control theory

DH neurons

94
Q

How to TENS work through Gate control theory?

A

TENS stimulate large diameter afferent activity (a beta) that inhibits central nociceptive transmission, resulting in decreased pain

95
Q

How does TENS work on the DH neurons?

A

TENS decreases inflammation induced DH neuron sensitization
TENS alters level of NTs GABA and glycine, though to be involved in inhibition of nociceptive traffic

96
Q

What are the supraspinal mechanisms that TENS works through?

A

Endogenous analgesia
Placebo analgesia

97
Q

How does TENS create endogenous analgesia?

A

TENS stimulates descending inhibitory activity via the PAG and RVM has anti nociceptive effects mediated via opioidergic pathways

98
Q

T/f: TENS induced analgesia is blocked by opioids

99
Q

Is it possible that TENS induced analgesia could result from the therapeutic ritual of using the TENS unit?

100
Q

T/f: TENS is never used in the recovery room

A

False, it can be used within 48 hours in the recovery room

101
Q

When pain ______ appetite ______

A

Decreases, increases (or vice versa)

102
Q

T/f: TENS is not an effective analgesic to be used during birth

A

False, it has been shown to make severe pain less likely

103
Q

What is a particularly difficult to treat disease that TENS can help decrease pain and increase muscle power for?

A

RA of the hand

104
Q

Can we use TENS on cancer patients?

A

Yes, if they are cleared by the attending

105
Q

T/f: TENS can reduce pain that lasts 2 months and improve QOL in pts with cancer

106
Q

What are the benefits of TENS for phantom limb pain?

A

Decreased duration, degree, and area of pain
Increased appetite and sleep

107
Q

Can TENS be used for migraines

108
Q

What is analgesic tolerance?

A

A decrease in analgesic effectiveness with repeated use of a given therapeutic method

109
Q

Repeated stim of opioid receptors by repeated opioid drug or TENS can lead to what?

A

Analgesic tolerance

110
Q

What is cross tolerance?

A

Treatment backfires after prolonged use bc the system will become depleted of endorphins and serotonin

111
Q

If using TENS for weeks and no longer getting an effect, what should be done?

A

Take a break

112
Q

Low frequency TENS induced tolerance results in _______ ________ of Mu receptors in the SC

A

Cross tolerance

113
Q

High frequency induced analgesic tolerance results in ______ ______ at delta opioid receptors in the SC

A

Cross tolerance

114
Q

Opioid users are non-responders to _____ _____TENS

A

Low frequency

115
Q

Bc opioid users aren’t respondent to low frequency TENS, what do we have to do?

A

Use high/low mix

116
Q

T/f: non opioid users respond to both high and low frequency TENS

117
Q

Pts can develop tolerance to TENS within ____ days

118
Q

How can we prevent tolerance in TENS?

A

Simultaneous administrations of low and high frequency TENS in the same session
Alternating administrations of high and low frequency TENS on subsequent sessions
Increase intensity by 10% each day
By using mixed frequency motor intensities

119
Q

How does caffeine interact with TENS?

A

Caffeine is a competitive adensosine antagonist and may interfere with TENS effectiveness is over 100mg

120
Q

What is the best way to get a response with TENS?

A

High intensity (strong yet tolerable)

121
Q

The greatest analgesia is achieved with the _____ sensory dose

122
Q

T/f: doses at the sensory threshold or below will be ineffective

123
Q

When does TENS produce the greatest effect?

A

While the unit is on and immediately after treatment

124
Q

Is it better to use TENS with or without activity?

A

With activity bc it has minimal effects on resting pain

125
Q

How does TENS help with pain physiology?

A

By increasing central inhibition and reducing central excitability
By targeting people with altered pain processing

126
Q

How can TENS help fibromyalgia patients?

A

By increasing the pain threshold and restoring central inhibition

127
Q

What is the best stimulation intensity for TENS to be most effective?

A

Amplitude should be increased until the patient report strongest tolerable paresthesia

128
Q

Only _____ intensities promote significant hypoalgesia

129
Q

During treatment, we must ask patient about _____ ______ frequently to make sure paresthesia is felt

A

Sensory habituation

130
Q

If a patient is experiencing sensory habituation, what should we do?

A

Increase the amplitude until strong tolerable paresthesia is felt

131
Q

How can electrodes be placed for max effectiveness of conventional (sensory) TENS?

A

Around the site of pain (box it out)
If unsuccessful, try peripheral nerve, spinal root, CL, or dermatomal distribution

132
Q

How can electrodes be placed for max effectiveness of AL TENS?

A

Over the muscle belly at the site of pain
If unsuccessful, try motor units, trigger points at site of pain, CL positions, myotomal distribution

133
Q

How can electrodes be placed for max effectiveness of brief intense TENS?

A

Straddle the site of pain
If unsuccessful over the main nerve bundle

134
Q

Conventional TENS should be used for ____ minutes

A

> 30 minutes, 40-60 minutes

135
Q

How often should conventional (sensory) TENS be used?

A

As often as needed taking breaking every hour or so

136
Q

AL TENS should be used for ____ minutes

A

15-20 minutes initially and progress to 30 minutes

137
Q

How often should AL TENS be used?

A

30 minutes at a time as needed with rest period to avoid muscle fatigue

138
Q

Brief intense TENS should be used no more than ___ minutes initially and progress to ____ minutes

139
Q

What are common user problems with TENS?

A

Connectivity
Fitting
Visibility of the device
Availability
Sensation
Settings

140
Q

How long does it take to develop tolerance to TENS?

141
Q

How is typically the life time of uses we can get out of a set of electrode pads with TENS?

A

~10-12 applications

142
Q

How do we know we have used the correct intensity?

A

If the patient can still feel it after removing the TENS

143
Q

How can we prevent tolerance of TENS?

A

Simultaneous administration of low and
high frequency TENS in same session.

Alternating administration of high an low
frequency TENS on subsequent sessions.

Increasing intensity by just 10% per day.

Using mixed frequency with motor
intensities.

145
Q

What are normal TENS parameters?

A

Produces continuous train of impulses

No interruption in stimulus parameters

Frequency adjustable 2-150 Hz

Duration adjustable 50-300 us

146
Q

What are the burst TENS parameters?

A

Burst of seven pulses

There are two burst delivered per second continuously

Frequency fixed @ 100 Hz

Pulse Duration adjustable 50-300 us.

147
Q

What is modulated rate and width (MRW) TENS?

A

The pulse rate and width are automatically varied in a cycle

During the first 0.5 second period, the width decreases 50% of original setting, during the next 0.5 second period the rate decreases 50% of its original setting

Total cycle time one second

148
Q

What is MRW used for?

A

Pain modulation or when a pt has tried TENS before and it didn’t work

150
Q

What is modulated intensity and width (SD) TENS?

A

Alternately modulates intensity and pulse width
Intensity is always increasing while width decreasing and vice-versa

Intensity modulates 62.5% of max., width modulates 67%

Total cycle time 6 seconds

151
Q

What are the parameters for Bi-pulse TENS?

A

Channel one fixed 4 Hz
Channel 2 fixed 100 Hz
Duration fully adjustable 50-300 us
Stimulation is burst on for one second burst off one second.

153
Q

What is the frequency and duration used for high frequency normal TENS?

A

120 Hz
100usec

155
Q

What is the frequency and duration used for low frequency normal TENS?

A

2 Hz
300usec

156
Q

What is the frequency and duration used for burst TENS?

A

Frequency fixed at 100Hz
Duration 100-300usec

157
Q

What is the frequency and duration used for MRW TENS?

A

150Hz
300usec

158
Q

What is the frequency and duration used for high frequency SD TENS?

A

100 Hz
100usec

159
Q

What is the frequency and duration used for low frequency SD TENS?

A

4 Hz
300 usec

160
Q

What is the frequency and duration used for bi-pulse TENS?

A

200usec
Channel one frequency fixed at 4Hz
Channel two frequency fixed at 100Hz

DPT 608 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions