Therapeutic Modalities: Electrical Agents Flashcards
The cell membrane is more permeable to ____ compared to _____ and ______.
More permeable to POTASSIUM
Less permeable to SODIUM and ANIONS
Describe 3 types of waveforms.
Monophonic = unidirectional flow of charged particles (either positive or negative charge)
Biphasic = bidirectional flow of charged particles (zero net charge if symmetrical)
Polyphasic = biphasic current that is modified to produce 3 or more phases in a single pulse (maybe used in Russian or IFC currents)
List 6 indications for using electrical stimulation.
- Pain modulation
- Decrease muscle spasm, spasticity and edema
- Increase or maintain ROM
- Muscle reeducation
- Wound healing
- Denervated muscle
The _____ is recommended with the use of a silver dressing over the wound if infected. If there is no infection, the _____ is recommended over the wound initially to promote healing.
Anode (+ pole) over an infected wound
Cathode (- pole) over a non-infected wound
List 8 contraindications to electrical stimulation.
- Pacemakers
- Unstable arrhythmia
- Epilepsy or seizure disorders
- Over the carotid sinus
- Over thrombosis or thrombophlebitis
- Over the abdomen or low back during pregnancy
- Superficial metal implants
- Active bleeding or infection
How big of a space should be left between electrodes?
The space between the electrodes should be at least the diameter of the electrodes being used
What is iontophoresis?
Application of a continuous direct current to transport medicinal agents through the skin or mucous membranes
Positive ions move towards the _____ and negative ions move towards the ____.
Positive ions move towards the cathode (-)
Negative ions move towards the anode (+)
What type of current and intensity are used with iontophoresis?
Direct current
Maximum intensity of 4-5 mA
List 6 indications for the use of iontophoresis.
- Analgesia
- Calcium deposits
- Dermal ulcers
- Fungal infections
- Muscle spasm
- Musculoskeletal inflammatory conditions
TENS is designed to provide ______ for pain management.
Afferent stimulation
_____ is the most common mode of TENS.
Conventional (high rate) TENS
Describe the amplitude and duration of pain relief associated with conventional TENS.
Amplitude: comfortable tingling sensation. No muscle response.
Duration of pain relief: Temporary
Describe the amplitude and duration of pain relief associated with acupuncture like TENS.
Amplitude: strong, but comfortable rhythmic muscle twitches
Duration of pain relief: long lasting
Describe the amplitude and duration of pain relief associated with brief intense TENS.
Amplitude: to patient’s tolerance
Duration of pain relief: temporary (30-60 minutes)
Describe the amplitude and duration of pain relief associated with burst mode TENS.
Amplitude: comfortable, intermittent paraesthesia
Duration of pain relief: long lasting (hours)
Describe the amplitude and duration of pain relief associated with hyper stimulation TENS.
Amplitude: strong, to patient’s tolerance
Duration of pain relief: long lasting
List 6 types of TENS and their purpose.
Conventional (high rate): acute or chronic pain
Acupuncture like (low rate): chronic pain
Brief intense: rapid onset, short term pain relief during painful procedures
Burst mode: combination of high and low rate tens
Hyper-stimulation: used to stimulate trigger points
Modulation mode: used to prevent perceptual habituation due to constant electrical stimulation
Describe the amplitude used with high voltage pulsed current (HVPC).
Amplitude: comfortable tingling sensation, no muscle response
High voltage pulsed current (HVPC) is primarily used for ______.
Wound healing
Describe the amplitude of Russian current.
Amplitude: tetanic muscle contraction
List 3 volitional activities in which Russian current is applied.
- Isometric exercise at several points through ROM
- Slow isokinetic exercise
- Short arc movement when ROM is restricted
Describe the electrode placement when using interferential current (IFC).
Bipolar (per modulated IFC): two electrodes are placed to affect desired structures
Quadripolar: Two sets of electrodes placed diagonally to one another over large area
List two indications for the use of functional electrical stimulation.
Shoulder subluxation
DF assist in gait training
Describe the electrode placement when using functional electrical stimulation for shoulder subluxation.
Bipolar
Electrodes on supraspinatus and posterior deltoid
How does functional electrical stimulation provide dorsiflexion assist during gait? (2)
Controls foot drop
Facilitates DF and evertors during swing phase
Describe the electrode placement when using functional electrical stimulation as a DF assist in gait training.
Bipolar
Peroneal nerve near head of fibula or anterior tibialis muscle
Describe the electrode application used for EMG biofeedback.
Active electrodes are placed on or near a motor point/targeted muscle group
Closer together for more precise signals
Farther apart to detect more than one muscle
List 4 criteria that must be met for a patient to participate in biofeedback training.
- Good vision, hearing and communication skills
- Good comprehension of simple commands, concentration
- Good motor planning skills
- No profound sensory or proprioceptive loss
