TENS Test Flashcards
What are the precautions for Electrical simulation /NMES and TENS?
Unstable fracture Decrease sensation Impaired cognitive ability/dementia/non-compliant patients Pregnancy Heart problems (hyper/hypo tension E-stim placed in the thoracic region it could interfere with the heart- Never Place interferential across the chest Peripheral vascular disease Phrenic nerve Pathology of the nerve that includes the myelin sheath Neuromuscular Junction Epilepsy, cva, TIA Surgical procedure recent acute inflammation areas of infection
What are the contraindications for E-stim (NMES and TENS)
Epilepsy NOT intact skin over the carotid sinus (neck arteries) Cardiac arrhythmias Pacemakes Cancerous lesions Eyes, mouth, pharynx, genitals, internally or transcranial areas with prior adverse reactions to electricity Avoid crossing the spinal cord Either side of the spinal column is OK. Ducmented allergy/sensitivity to the prescribed medication Damaged skin
What are some things to know before applying the E-STIM or taking it off?
Avoid poor electrode contact with the skin
Clip don’t Shave
Assess skin for scars, excessively dry skin, hairy forearms
Avoid electrodes to touch/more painful if touching
After a hot pack it will feel stronger due to blood supply increase and moist area.
DO NOT pull out/push in the electrodes pins by the wires
What does TENS stand for ?
Transcutaneous Electrical Nerve Stimulation
Transcutaneous means?
Across the skin
TENS unit stimulates your nerves via?
electric current through your skin.
TENS is usually a rectangular biphasic (Symetrical or asymmetrical waveform) at frequencies is a range?
1 to 150Hz and pulse duration from 50 to 300ms.
TENS Pain relief Theories (Gate Control Theory)
Descending endogenous control on opioid receptors in the spinal cord
TENS SENSORY (SET UP)
High frequency 80-150 Hz; small pulse duration less then 100microseconds.
Use with ACUTE PAIN - BEST if used while patient is performing functional activities.
Places Electrodes over the painful area
Tingling sensation only - no muscle contracture
YOU CAN USE SENSORY TENS AS OFTEN AS YOU LIKE.
Usually for 30 to 60 minutes up to 4 times daily.
Gate Control Mechanism of Pain - some research supports good for opioid addiction pain relief bc it simulateds a different opioid receptor in spinal cord.
TENS MOTOR (SET-UP)
Low frequency 1-10Hz, Large pulse duration 200-300 Microseconds
Use with Subacute or Chronic Pain
Helps with pain control for 4 to 9 hours
Endogenous Pain descending control system
Needs muscle to contract - to activate the A-alpha and A-delta fibers
Dont use with a tissue that needs to be healed.
Chronic Pain
- 20 to 30 min around five times/wk to start
- 15-45 minutes with no limit per/wk to start
What is Interferential simulation ?
Is essentially a deeper form of electical stimulation.
Pain relieve that uses 2 different (AC) currents on 2 challenls - 4 electrodes, interacting with each other.
Tranvels deep into the tissue with one current at 4000-5000 hz and the other at 1-100hz
What is the purpose to treat with interferential stimulation ?
Acute pain/gate control, motor nerve excitability- sub acute/ chronic pain, endorphins and encephalin release.
What is Iontophoresis?
Use of electrical current and pH to deliver medication or chemicals substances transdermlly.
Once the medication is under the sink it is spread via passive diffusion.
What is the common medication used to Iontophoresis?
Dexamethasone (anti-inflammatory)
Direct Current ?
DC, Monophasic, “ Galvanic stim’
The current flows in one direction it gose from positive to negative and negative to positive.
Play in on/of and Ma
