TENS & IFC Flashcards

1
Q

TENS and ICF

What might be a reason IFC (quadripolar) might be used over TENS?

A

larger surface areas

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2
Q

TENS and ICF

TENS Patients with rate responsive pacemakers or ICDs

A

no, contrainidicated

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3
Q

TENS and ICF

TENS Over metal implants?

A

no, contrainidicated, causes unnecessary pain due to electrical current-induced overheating of implants

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4
Q

TENS and ICF

What are the stimulation levels of TENS?

A
  • Sensory: large A-beta fibers. Gate system
  • Motor: Large Diameter afferents (A-beta) & efferent motor (alpha)
  • Noxius: Large Diameter afferents (A-beta) & efferent motor (alpha) & nociceptive (A- delta and C fibers)
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5
Q

TENS and ICF

Should you see muscle contractions when applying TENS on the burst mode?

A

yes, sensory and motor estimulation. A-delta, C and Alpha fibers

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6
Q

TENS and ICF

Can a pt use NMES or TENS if muscle contractions are contrainidicated?

A
  • No NMES
  • TENS only on the sensory threshold
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7
Q

TENS and ICF

TENS Over or around the lumbar, abdominal area and hips of pregnant women?

A

no, contraindicated, induces labor

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8
Q

TENS and ICF

Low frequency, amplitude modulated electrical current that interference between 2 (or 3) currents consisting of differing medium carrier frequencies (usually 3000-5000MHz).

A

ICF, interferencial current

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9
Q

TENS and ICF

Where does the interference of current occurs with a
quadripolar set up?

Where does the interference occurs with a
bipolar set up?

A
  • quadripolar set up: in the tissues
  • bipolar set up: in the machine
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10
Q

TENS and ICF

TENS over the anterior cervical area?

A

no, contrainidicated

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11
Q

TENS and ICF

TENS over cranial area?

A

no, contrainidicated

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12
Q

TENS and ICF

TENS over damaged skin?

A

no, contrainidicated

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13
Q

TENS and ICF

TENS stimulates what type of nerve fiber?

A
  • Sensory: Large A-Beta
  • Motor: A alpha
  • Nociceptive: Small A-delta & C fibers
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14
Q

TENS and ICF

TENS decreases pain via…

A

peripheral nerve depolarization.

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15
Q

TENS and ICF

Should you see muscle contractions when applying TENS on the brief intense mode? Why?

A

Yes, depolarization of all nerve fibers

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16
Q

TENS and ICF

TENS in presence of thrombophlebitis?

A

no, contrainidicated

17
Q

TENS and ICF

What ate the 5 types of TENS Modes:
nerve fibers affected?
mechanism for pain modulation?
threshold?

A
  1. —Conventional: large A-beta, gate system, sensory
  2. Acupuncture-like: A-delta, C and A-Aplha fibers, opiate, sensory/motor
  3. Brief Intense: A-delta and C fibers, opiate, noxius
  4. Burst: A-delta, C and A-Aplha fibers, Opiate, sensory motor
  5. Modulation: variable
18
Q

TENS and ICF

TENS over thoracic area?

A

no, contrainidicated, affects heart function

19
Q

TENS and ICF

Claimed main therapeutic effects of ICF:

A
  • Management of pain (via gate closing)
  • Management of urinary incontinence (via pelvic floor contraction)
  • Management of muscle weakness (via evoked tetanic muscle contraction)
20
Q

TENS and ICF

General Dangers and Precautions for Using Electrical Stimulation

A
  • Confused and unreliable patients
  • Muscle Damage: with repeated mechanical stress in same motor units during electrical
    stimulation
  • Near functioning shortwave diathermy devices
    • Keep all electrical stimulators at least 3 m (10 feet) away from any functioning SWD devices
  • Burns
  • Skin reaction to electrodes: try a different type of electrode
  • Pain: increase current slowly
21
Q

TENS and ICF

TENS over impaired sensation?

A

no, contrainidicated

22
Q

TENS and ICF

Types of TENS devices:

A
  • portable, battery-operated
  • cabinet, line-powered
23
Q

TENS and ICF

Should you see muscle contractions when applying TENS on the acupunture-like mode?

A

Yes, This mode implies the preferential and concomitant depolarization of afferent large-diameter A-beta and efferent alpha motor fibers innervating skeletal muscles.

24
Q

TENS and ICF

IFC Modes

A
  • The constant mode: Selection of a preset beat frequency, which is kept constant for the entire treatment duration
  • The sweep mode (helps to avoid habituation to current):—  Selection of a predetermined beat frequency range, e.g. 80 to 150 bps — 
    • The beat frequency automatically sweeps within the range

— No scientific evidence suggests that one mode is better than another for any given pathological condition

25
Q

TENS and ICF

Mechanisms for pain modulation:

associated fibers?

what is the duration of pain relief for each?

A
  1. Gate system: A-beta fibers; sensory threshold
    • <30 min
  2. Opiate system: A-delta (shrap/prick) and C fibers (dull/achy)
    • motor or noxius threshold
    • a few hours
26
Q

TENS and ICF

TENS

A

Transcutaneous Electrical Nerve Stimulation

27
Q

TENS and ICF

Indication for TENS:

A
  • Symptomatic pain only
28
Q

TENS and ICF

The most common TENS waveform is…

A

biphasic and symmetrical, thus balanced

29
Q

TENS and ICF

TENS over hemorrhagic area?

A

no, contrainidicated

30
Q

TENS and ICF

In selecting TENS mode, first you must decide what?

A

First decide if you want:

  • Immediate pain-relief onset/ short analgesic duration or — 
  • Slow pain-relief onset/ longer analgesic duration

—  To further select → Trial an Error → Based on patient response

31
Q

TENS and ICF

Prime physiological effect of ICF:

A

—  Depolarizes peripheral sensory and motor nerve fibers

32
Q

TENS and ICF

Should you see muscle contractions when applying TENS on the conventional mode? Why?

A

No, convectional mode stimulates A-beta fibers, gate system, in the sensory threshold

33
Q

TENS and ICF

TENS Electrode Placement
— 

A
  • On the painful area
  • Around the painful area
  • Along dermatomes corresponding to painful area
  • Over acupuncture points or trigger points
34
Q

TENS and ICF

Application of pulsed electrical current to induce “electroanalgesia”

A

TENS

35
Q

TENS and ICF

TENS electrode configuration and placement:

A

Much has been written and discussed about electrode configuration and placement relative to the treatment of pain using TENS therapy. The controversy still exists as to which configuration and placement are best to use for pain modulation. Evidence from the published literature indicates that bipolar, quadripolar, and multipolar electrode configurations are routinely used in clinics. Practically speaking, the larger the painful area, the greater the number of electrodes used for treatment. As far as electrode placement is concerned, the evidence suggests the following four options. First, electrode placement may be over, or on top of, the painful area. Second, placement may be around the painful area. Third, electrode placement may be along the dermatome(s) associated with the painful area. Fourth, placement may over acupuncture points and trigger points. There is still no evidence to show that one placement is better than the other. Until more evidence is provided, practitioners must continue to rely on trial and error when considering the best electrode placement with their patients.

36
Q

TENS and ICF

TENS over cancerous area?

A

no, contrainidicated

37
Q

TENS and ICF

true or false: technically all electrical current that goes through skin is “Transcutaneous electrical nerve stimulation”

A

true

38
Q

TENS and ICF

TENS with patients with epilepsy?

A

No, contrainidicated