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Week 3 Flashcards

1
Q

What kind of wave form does a high-volt pulsed current use?

A

Monophasic twin peaks pulsed current

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2
Q

What is included in a monophasic twin peak pulsed current?

A
  • Dc current
  • Active electrode
  • Large pad
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3
Q

What kind of charge does an active electrode build up?

A

A positive charge

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4
Q

Large pad _____ current in the area being tested with a monophasic twin peak pulsed current

A

Large pad to decrease current in the area being tested with a monophasic twin peak pulsed current

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5
Q

What is the purpose of a monophasic twin peak pulsed current?

A
  • Edema control

- Soft tissue healing

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6
Q

When should E-stim be used to treat edema?

A

When the edema is caused by inflammation of lack of motion

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7
Q

When should E-stim not be used to treat edema?

A

When edema is caused by systemic causes like heart failure, liver failure, and kidney failure

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8
Q

What waveform should be used in the tissue healing: inflammatory/infected parameter setting/goal?

A

HVPC

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9
Q

What frequency(Hz) should be used in the tissue healing: inflammatory/infected parameter setting/goal?

A

60-125

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10
Q

What pulse duration should be used in the tissue healing: inflammatory/infected parameter setting/goal?

A

40-100 microseconds

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11
Q

What (I) should be used in the tissue healing: inflammatory/infected parameter setting/goal?

A

Tingling

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12
Q

What polarity should be used in the tissue healing: inflammatory/infected parameter setting/goal?

A

Negative

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13
Q

What treatment time should be used in the tissue healing: inflammatory/infected parameter setting/goal?

A

45-60 mins few times/day

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14
Q

What waveform should be used in the tissue healing/proliferation clean parameter setting/goal?

A

HVPC

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15
Q

What Hz should be used in the tissue healing/proliferation clean parameter setting/goal?

A

60-125

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16
Q

What pulse duration should be used in the tissue healing/proliferation clean parameter setting/goal?

A

40-100 microseconds

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17
Q

What (I) should be used in the tissue healing/proliferation clean parameter setting/goal?

A

Tingling

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18
Q

What polarity should be used in the tissue healing/proliferation clean parameter setting/goal?

A

Positive

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19
Q

What treatment time should be used in the tissue healing/proliferation clean parameter setting/goal?

A

45-60 mins few times/day

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20
Q

What waveform should be used in the edema control: acute parameter setting/goal?

A

HVPC

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21
Q

What Hz should be used in the edema control: acute parameter setting/goal?

A

100-120

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22
Q

What pulse duration should be used in the edema control: acute parameter setting/goal?

A

40-100 microseconds

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23
Q

What (I) should be used in the edema control: acute parameter setting/goal?

A

Tingling

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24
Q

What polarity should be used in the edema control: acute parameter setting/goal?

A

Negative

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25
What treatment time should be used in the edema control: acute parameter setting/goal?
20-30 mins
26
What waveform should be used in the edema control: chronic lack of motion parameter setting/goal
NMES/HVPC
27
What Hz should be used in the edema control: chronic lack of motion parameter setting/goal
35-50
28
What pulse duration should be used in the edema control: chronic lack of motion parameter setting/goal
150-350 microseconds
29
What (I) should be used in the edema control: chronic lack of motion parameter setting/goal
Visible motor response
30
What polarity should be used in the edema control: chronic lack of motion parameter setting/goal
N/A
31
What treatment time should be used in the edema control: chronic lack of motion parameter setting/goal
20-30 mins
32
Inflammatory phase use ____ electrode on affected area
Inflammatory phase use *negative electrode* on affected area
33
Proliferation phase use positive electrode to attract more _____ to the affected area
Proliferation phase use positive electrode to attract more *proteins* to the affected area
34
What should you do to an area during edema control?
Elevate the area
35
What are the precautions of HVPC?
- Cardiac disease - Impaired sensation - Malignant tumors - Skin irritation or open wounds
36
What are the contraindications of HVPC?
- Pacemakers, heart conditions (unstable arrythmias) - Over the carotid sinus - Venous or arterial thrombosis or thrombophlebitis - Pelvis, abdomen, trunk, and low back during pregnancy(1st trimester), can be used for pain control during delivery
37
What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in the muscle fiber type?
PIC: Slow twitch type 1 first ESC: fast twitch type 2 first
38
What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in the contraction force?
PIC: low ESC: high
39
What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in the speed of contraction?
PIC: slow ESC: fast
40
What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in fatigue?
PIC: fatigue resistance ESC: fatigues quickly
41
What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in atrophy?
PIC: atrophy resistant ESC: atrophies quickly
42
What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in recruitment?
PIC: asynchronous ESC: synchronous
43
What are the 2 ways that electrical stimulation strengthens muscles?
- Overload principle | - Specificity
44
What is the overload principle?
Increased pulse duration, amplitude, electrode size, external resistance leads to higher load leads to higher force contraction leads to greater strengthening
45
What is specificity?
* Contractions specifically strengthen fibers that contract * ES has more effect on type II muscle fibers than on type I * Disuse atrophy is primarily present with type II fibers
46
What are the clinical application of electrically stimulated muscle contractions?
- Orthopedic conditions: increased strength after surgery, nonsurgical management of knee conditions - Neurological disorders: stimulates intact peripheral nerves in patients with CNS damage, can integrate with performance of functional activities= functional electrical stimulation - Functional electric stimulation (FES)
47
What does electric stimulation do for spinal cord injury?
- Counteract disuse muscle atrophy - improve circulation - contract muscle to assist with locomotion - contract muscle to assist with hand grasp, respiration, conditioning, bowel and bladder voiding
48
What are requirements for ES for spinal cord injury?
* Sufficient force to carry out activity * Not painful * Can be controlled and repeated * Acceptable to the user
49
What is the lower extremity stimulation of ES for stroke?
* Improved gait * Increased ankle dorsiflexion torque * Reduced agonist-antagonist co-contraction * Increased probability of returning home
50
What happens in EMG-triggered NMES in ES for stroke?
* Antagonist contraction reduces agonist spasticity * Agonist contraction increases agonist strength and control * Improved joint stability (GHJ) * Post stroke patients
51
What are the advantages of adding NMES to strength training?
* Can enhance strength gains * May or may not enhance functional performance * Is not a substitute for sports-specific training
52
What are other conditions that ES can be used for?
o Dysphagia, urinary incontinence/pelvic floor dysfunction, promotes circulation/reduces risk of DVT formation
53
Where are the guides for electrode placement?
o Place electrodes over largest part of muscle belly o Apply electrodes at least 2 inches apart (ideally the distance apart should be greater than the size of electrode) o If possible: Place one electrode over motor point and place other electrode over stimulated muscle aligned parallel to muscle fiber direction
54
Where are the guides for patient positioning?
o Avoid closed-pack positioning o There should be no pain in healing/ injured tissues o Have patient perform voluntary isometric or isotonic contraction through safe ROM while machine is active o Can base initial positioning on amount of voluntary contraction if using isotonic contraction through movement
55
What is amplitude and what are its general guidelines?
- Maximally tolerated force of contraction is best | - Contraction ≥10% of MVIC in injured tissues, and > 50% MVIC in uninjured tissues (vs uninvolved limb)
56
_____ should determine the amplitude and duration of a contraction
Functional goal
57
In what way is NMES similar and different to TENS?
Similar: bi-phasic AC current Different: pulse duration, results in a muscle contraction instead of a tingling
58
What is the difference between NMES and russian ES?
Russian has a poly-phase AC current, hence it has a deeper penetration in tissue
59
What frequency should generally be used on smaller muscles during russian ES?
20-30 pps
60
What frequency should generally be used on larger muscles during russian ES?
35-50pps
61
What are the indications/clinical utility of TENS and IFC?
- Control/relieve pain - Reduce the amount of and dependency on pain medication - Provide the patient a more active role in their pain management - Increase functional movement and mobility with less discomfort

Physical agents (7 decks)

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