The physiotherapist is right: Easter Edition (CH14) Flashcards
What is TENS?
Transcutaneous electrical nerve stimulation
How is TENS delivered?
Biphasic pulsed current
What is the clinical rationale for TENS?
Pain management
How would you describe TENS waveform?
Biphasic, rectangular, symmetric
What is the advantage of symmetric waveform?
It prevents accumulation of electrical charges reducing agitation
What is the nature of A-beta fibers?
Mechanosensitive
What is the nature of A-delta fibers?
Nociception
What is the nature of C fibers?
Nociception
How does the pain gate close?
When large fibers activate, inhibitory neurons activate in the substantia gelatinosa, they inhibit T-cells or pain transmitting cells.
What settings allow for targetting of certain fibers?
Amplitude and pulse duration
TENS targeted at large diameter sensory fibers is called:
Sensory-level stimulation
TENS targeted at larger fibers that can elicit painless muscle contraction is called:
Motor-level stimulation
TENS targeted at smaller fibers with even higher amplitude and longer pulse durations is called:
Noxious-level stimulation
What is the purpose of Noxious-level stimulation?
Activation of the opiate system
When endogenous opiates are secreted how does this affect T-cells (pain transmitting, not the immune ones)?
It starts a negative feed back loop that ends with inhibition of said T-cells
Conventional mode doses operate at what level, how long does analgesia last?
Sensory level, relatively short
A low frequency long duration mode, that targets A-beta and Alpha motor fibers, simulates what other type of therapy?
Acupuncture
Delivery of relatively long, high frequency and amplitude that targets all fibers is called?
Brief-Intense mode
How long does analgesia from brief-intense mode last?
Relatively long compared to other modes
Delivery of a burst of pulses aimed at a-beta and alpha motor fibers with low burst frequency describes what?
Burst mode
What is modulation mode?
A randomization of pulse duration, current amplitude, and frequency. This prevents habituation to electrical input
