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Physical agents > Week 3 > Flashcards

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
Q

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

A

20-30 mins

26
Q

What waveform should be used in the edema control: chronic lack of motion parameter setting/goal

A

NMES/HVPC

27
Q

What Hz should be used in the edema control: chronic lack of motion parameter setting/goal

A

35-50

28
Q

What pulse duration should be used in the edema control: chronic lack of motion parameter setting/goal

A

150-350 microseconds

29
Q

What (I) should be used in the edema control: chronic lack of motion parameter setting/goal

A

Visible motor response

30
Q

What polarity should be used in the edema control: chronic lack of motion parameter setting/goal

A

N/A

31
Q

What treatment time should be used in the edema control: chronic lack of motion parameter setting/goal

A

20-30 mins

32
Q

Inflammatory phase use ____ electrode on affected area

A

Inflammatory phase use negative electrode on affected area

33
Q

Proliferation phase use positive electrode to attract more _____ to the affected area

A

Proliferation phase use positive electrode to attract more proteins to the affected area

34
Q

What should you do to an area during edema control?

A

Elevate the area

35
Q

What are the precautions of HVPC?

A
  • Cardiac disease
  • Impaired sensation
  • Malignant tumors
  • Skin irritation or open wounds
36
Q

What are the contraindications of HVPC?

A
  • 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
Q

What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in the muscle fiber type?

A

PIC: Slow twitch type 1 first
ESC: fast twitch type 2 first

38
Q

What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in the contraction force?

A

PIC: low
ESC: high

39
Q

What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in the speed of contraction?

A

PIC: slow
ESC: fast

40
Q

What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in fatigue?

A

PIC: fatigue resistance
ESC: fatigues quickly

41
Q

What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in atrophy?

A

PIC: atrophy resistant
ESC: atrophies quickly

42
Q

What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in recruitment?

A

PIC: asynchronous
ESC: synchronous

43
Q

What are the 2 ways that electrical stimulation strengthens muscles?

A
  • Overload principle

- Specificity

44
Q

What is the overload principle?

A

Increased pulse duration, amplitude, electrode size, external resistance leads to higher load leads to higher force contraction leads to greater strengthening

45
Q

What is specificity?

A
  • 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
Q

What are the clinical application of electrically stimulated muscle contractions?

A
  • 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
Q

What does electric stimulation do for spinal cord injury?

A
  • 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
Q

What are requirements for ES for spinal cord injury?

A
  • Sufficient force to carry out activity
  • Not painful
  • Can be controlled and repeated
  • Acceptable to the user
49
Q

What is the lower extremity stimulation of ES for stroke?

A
  • Improved gait
  • Increased ankle dorsiflexion torque
  • Reduced agonist-antagonist co-contraction
  • Increased probability of returning home
50
Q

What happens in EMG-triggered NMES in ES for stroke?

A
  • Antagonist contraction reduces agonist spasticity
  • Agonist contraction increases agonist strength and control
  • Improved joint stability (GHJ)
    * Post stroke patients
51
Q

What are the advantages of adding NMES to strength training?

A
  • Can enhance strength gains
  • May or may not enhance functional performance
  • Is not a substitute for sports-specific training
52
Q

What are other conditions that ES can be used for?

A

o Dysphagia, urinary incontinence/pelvic floor dysfunction, promotes circulation/reduces risk of DVT formation

53
Q

Where are the guides for electrode placement?

A

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
Q

Where are the guides for patient positioning?

A

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
Q

What is amplitude and what are its general guidelines?

A
  • Maximally tolerated force of contraction is best

- Contraction ≥10% of MVIC in injured tissues, and > 50% MVIC in uninjured tissues (vs uninvolved limb)

56
Q

_____ should determine the amplitude and duration of a contraction

A

Functional goal

57
Q

In what way is NMES similar and different to TENS?

A

Similar: bi-phasic AC current
Different: pulse duration, results in a muscle contraction instead of a tingling

58
Q

What is the difference between NMES and russian ES?

A

Russian has a poly-phase AC current, hence it has a deeper penetration in tissue

59
Q

What frequency should generally be used on smaller muscles during russian ES?

A

20-30 pps

60
Q

What frequency should generally be used on larger muscles during russian ES?

A

35-50pps

61
Q

What are the indications/clinical utility of TENS and IFC?

A
  • 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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