To Pass E-STIM and TENS Flashcards
applications/indications of E-STIM (8):
- pain control and modulation
- decrease muscle spasm/guarding
- reduce swelling and inflammation
- increases ROM
- muscle strengthening and muscle re-education
- wound healing
- fracture healing
- transdermal drug delivery (Iontophoresis)
How does E-STIM work?
Uses an electrical current to create a physiological change by targeting afferent nerve pathways to include:
- sensory fibers
- motor fibers
- pain fibers
How does E-STIM cause a change in the nerve fibers of the PNS?
Action potentials
Precautions (7):
- cardiac disease
- impaired cognition
- areas of impaired sensation, malignant tumors, skin irritation, wounds
- hypo/hypertension excessive adipose tissue, excessive edema
- bleeding disorders
- pregnancy
- skin irritation, allergies to adhesive
CONTRAS (5):
- pacemakers or unstable arrhythmias
- epilepsy or seizure disorders
- over carotid, thrombosis, eyes, phrenic nerve, bladder stimulators, pharyngeal/laryngeal mm, superficial metal implants, transcerebral/thoracic legions
- over low back or abdominal region during pregnancy
- active bleeding or infection
Possible adverse reactions (4):
- electrical burns
- skin irritation
- pain
- sensitivity
TENS stands for:
- Transcutaneous
- Electrical
- Nerve
- Stimulation
Indications for TENS
pain control and modulation
Therapeutic frequencies of E-STIM application:
- creates a tapping effect –> # to # pps/hz
- creates a smooth muscle contraction –> # to # pps/hz
- creates a sensory effect –> # to # pps/hz
- 1 to 10 pps/hz
- 35 to 50 pps/hz
- 80 to 150 pps/hz
When an unchanged, constant stimulus is applied, this leads to a decrease in nerve excitability with decreased perception of a sensation after a period of time with the same sensory input. In other words “you get used to it”
Accommodation Phenomenon
3 modes of TENS
- continuous
- burst
- modulated/modulation
frequency, pulse width and intensity stay as set without change
continuous mode
gradual increase in intensity which peaks, then decreases in intensity and cycles on/off
burst mode
any pattern variation of frequency, pulse width, intensity, randomly set by the unit
modulated mode
TENS Pad placement protocol (6):
- can use 2 or 4 pads (determined by size of treatment area)
- can place pads on or around an area of pain
- can place pads along a nerve to assist with desensitization
- can place pads on a “trigger point”
- can place pads along muscle fibers
- pads should be placed at least 1 inch apart
IFC pad placement protocol (4)
- 4 pads at all times
- pads must be crossed with the most painful area in the middle
- frequency must be slightly different
- always crisscrossed
IFC acute pain:
frequency -
intensity -
treatment time -
frequency: 80-150 pps
intensity: to sensory comfort
treatment time: 15-20 minutes in clinic can be worn up to 24 hours at home
IFC chronic pain:
frequency -
intensity -
treatment time -
frequency: 1-10 pps
intensity: to visible muscle contraction
treatment time: 15-20 minutes in clinic. 20-30 minutes for home use
IFC Edema/swelling:
frequency -
intensity -
treatment time -
frequency: 20-50 pps
intensity: to visible muscle contraction (muscle pumping)
treatment time: 15-20 minutes in clinic
TENS acute, conventional (hight rate):
amplitude: pulse rate: pulse duration: mode: treatment time: relief:
amplitude: comfortable, no mm response
pulse rate: 50-80pps
pulse duration: 50-100
mode: continuous
Tx time: 20-60 mins
relief: fast, short duration
TENS chronic, acupuncture-like (strong low rate):
amplitude: pulse rate: pulse duration: mode: Tx time: relief:
amplitude: strong but comfortable, rhythmic mm twitch
pulse rate: 1-5pps
pulse duration: 150-300
mode: continuous
Tx time: 30-40 min
relief: longer lasting
TENS physiological responses:
- use of electric current to create a physiological change by targeting afferent nerve pathways; including sensory fibers, motor fibers, pain fibers
- depolarizing the nerve membrane and creating an action potential strong enough to cause change
- gate control theory, stimulation of non-noxious fibers interferes with noxious (pain) transmission to the brain and decreases perception of pain
- endogenous opioid system (stimulation of endorphins bind with opiate receptors to cause an inhibitory response. occurs when motor nerve fibers are stimulated
