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e-stim revised
| Question | Answer |
|---|---|
| Acupuncture like TENS amplitude is? | visible contraction |
| Acupuncture like TENS on:off | continuous |
| Acupuncture like TENS pulse duration is? | 200-300 pps |
| Acupuncture like TENS releases what? | endorphins |
| Acupuncture like TENS treatment time is? | 20-30 min |
| Acupuncture like TENS frequency is? | 2-10 pps |
| Acidic reaction (+) | Hydrochloric acid forms under the positive electrode, less uncomfortable than alkaline reaction |
| acute edema (inflammation) amplitude is? | comfortable tingling sensation |
| Acute edema (inflammation) frequency is ? | 100-120 pps |
| acute edema(inflammation) on:off is | continuous |
| acute edema(inflammation) polarity is? | Negative |
| acute edema(inflammation) pulse duration is ? | 40-100us |
| acute edema (inflammation) treatment time is? | 20-30 min |
| Acute edema(inflammation) waveform is? | HVPC |
| Adverse effects to e-stim | electrical burns, skin reaction to the electrodes, pain |
| Alkaline reaction (-) | sodium hydroxide forms under the negative electrode. causes discomfort, skin irritation or chemical burns, reduced likelihood by increasing the size of the negative electrode |
| Alternating current | continuous and bidirectional flow of charged particles (+ and -) |
| Amplitude Modulation | usually referred to as scan |
| Amplitude | magnitude of the current or voltage |
| Anode | Positive pole |
| AP are all or none | increased amplitude or duration doesn't increase strength of the AP |
| What is an AP? | nerves communicate with one another through the production of action potentials(AP), created by depolarization and repolarization of nerves |
| Benefits of IFC | more comfortable as it has a low amplitude current when going through the skin, delivers higher current in deeper tissues--continuous AC with increase average amplitude, stimulates a larger area |
| Burst mode TENS is used to? | combines conventional and acupuncture TENS, stimulated endogenous opiates like low-rate TENS but may be tolerated better, provides pain relief similar to high rate TENS |
| Cathode | Negative pole |
| chronic edema (due to lack of motion) amplitude is? | visible contraction |
| chronic edema(due to lack of motion) frequency is? | 35-50 pps |
| chronic edema (due to lack of motion) on:off time? | 2-5 on, 2-5 off. 1:1 |
| chronic edema (due to lack of motion) pulse duration is? | 150-350= small muscles, 200-350= large muscles |
| chronic edema (due to lack of motion) ramp? | >1 sec |
| chronic edema (due to lack of motion) treatment time is? | 20-30 min |
| chronic edema (due to lack of motion)waveform is? | biphasic or IFC |
| common medication used in iontophoresis | Dexamethosone (0.4 % solution (-), corticosteroid that acts as an anti-inflammatory, useful with tendinitis or bursitis |
| Conventional or high rate TENS is used for ? | pain control |
| conventional TENS amplitude is? | tingling |
| conventional TENS frequency is? | 100-150pps |
| conventional TENS on; off is? | continuous |
| conventional TENS pulse duration is? | 50-80 us |
| conventional TENS time of treatment is? | up to 24 hrs a day |
| conventional TENS utilizes the gate theory of pain control where? | spinal cord level |
| Depolarize | Na+ channels open fast, Na+ rushes in to make inside more positively charged. |
| Frequency | Number of cycles or pulses per second |
| General parameters for low rate or acupuncture like TENS are? | longer pulse duration, higher amplitude (visible contraction), treatment must be less than 30 minutes to prevent DOMS. |
| General parameters of Conventional or High rate TENS are | short pulse duration, comfortable amplitude (strong but comfortable), can be used constantly |
| HVPC is used for? | Tissue healing (speed healing process) |
| IFC amplitude of current | higher amplitude current when both are in the same phase and a lower amplitude current when they are in opposite phases |
| IFC beat frequency = | difference between the frequencies of the original AC's (usually set by machine) |
| IFC Carrier frequency= | slower original AC (ex: 4100 Hz frequency interferes with 4000 Hz frequency |
| Gate Control Theory: | pain signals travel up A delta and C nerves. Messages from the brain via descending fibers or peripheral A beta fibers can block pain signals in a hypothetical "pain gate" in the spinal cord |
| Interpulse Interval | Time between pulses |
| Iontophoresis amplitude is? | Patient tolerance, no more than 4mA |
| Iontophoresis polarity is? | same as drug (drives drug into skin) |
| Iontophoresis time of treatment is? | depends on amplitude |
| iontophoresis total dose= | 40mA. min |
| Iontophoresis waveform is? | DC |
| motor nerves do what? | (Efferent) will always submit motor info to the muscles, higher amplitude and longer pulses are required to depolarize. |
| muscle contraction for denervated muscles | helps slow the process of muscle atrophy and tissue fibrosis formation, continuous DC with longer pulse duration can allow denervated muscles to contract; may slow nerve regeneration, so should not be used if this is the goal |
| muscle reeducation amplitude is? | functional activation of muscle |
| muscle reeducation frequency is? | 35-50 pps |
| muscle reeducation on:off time? | varies based on functional activity |
| muscle reeducation pulse duration is? | 150-200 =small muscles, and 200-350= large muscles |
| muscle reeducation ramp is? | > 2 sec |
| muscle reeducation time of treatment is? | depends on functional activity |
| muscle spasm amplitude? | visible contraction |
| muscle spasm frequency is? | 35-50 pps |
| muscle spasm on:off time | 2-5 sec on/2-5 sec off; 1 |
| muscle spasm pulse duration is? | 150-200= small muscles,200-350= large muscles |
| muscle spasm ramp? | > 1 sec |
| muscle spasm time of treatment | 10-30 min |
| muscle strengthening frequency is ? | 35-80pps |
| muscle strengthening pulse duration is? | 150-200= small muscle and 200-350=large muscles |
| muscle strengthening Ramp is | > 2 sec |
| muscle strengthening is treated how often ? | every 2-3 hours patient is awake |
| muscle strengthening amplitude is? | > 10% MVIC if injured, > 50% MVIC if uninjured, visible contraction |
| muscle strengthening on; off is? | 6-10 on; 50-120 off, 1:5 ratio initially |
| muscle strengthening time of treatment is? | 10-20 min (to produce 10-20 reps) |
| Galvanotaxis: | cells are attracted to electrical charge. |
| Negative electrode attracts | activated neutrophils ( present with infection or inflammation) lymphocytes, platelets and mast cells, fibroblast. Used for infected or inflamed wounds, acute stage of healing. |
| Positive electrodes attracts? | inactive neutrophils and macrophages, epidermal cells. Used with necrosis without inflammation and wounds in the proliferation stage; clean wounds. |
| Premodulated Current | Similar to IFC but uses only one channel; not as effective as IFC |
| principle of muscle strengthening overload principle | Greater load-->greater force production-->greater strength |
| Propagation speed is what? | depends on nerve diameter and myelination |
| Pulse duration | Time from the beginning of the first phase of a pulse to the end of the last phase of a pulse |
| Pulsed current | an interrupted flow of charged particles where the current flows in a series of pulses separated by periods when no current flows |
| Ramp up/Ramp down time | ramp up is the time it takes current amplitude to go from 0 to maximum amplitude for any one on time. Ramp down is the time it take for the current amplitude to decrease from its max amp during on time back to zero. |
| Repolarize= | Na+ channels close and K+ channels open to allow K+ out of the cell and the membrane repolarizes to resting state |
| Resting potential is | when a nerve is at rest, inside of cell is more negative than outside of cell (b/c most sodium ions outside, most potassium ions inside) |
| Rise Time/Decay Time | Rise Time is the time it takes current to go from 0 to peak during any one phase; Decay time is the time it takes current to decrease from peak to zero in any one phase |
| Russian Protocol | 2500Hz carrier AC frequency with 50 burst per second, each burst is 10 ms followed by a rest interval of 10 ms. |
| Sensory nerves do what? | (Afferent) will always submit sensory info to the brain,also low current amplitude and shorter pulse duration depolarize |
| tissue healing polarity is? | + for clean wound, --for infection |
| tissue healing amplitude is? | comfortable tingling sensation |
| Tissue healing frequency is? | 60-125 pps |
| Tissue healing occurs through? | attraction of cells for tissue healing (neutrophils, leukocytes,)reduction of edema, increased antimicrobial activity, promotion of circulation,increased synthesis of DNA and collagen most effective at healing pressure ulcers |
| tissue healing on:off is? | continuous |
| tissue healing pulse duration is? | 40-100us |
| tissue healing treatment time is? | 45-60 min |
| Tissue healing waveform is? | HVPC |
| Transdermal drug delivery (Iontophoresis) | use a low voltage DC to move charged ions across the dermis by increasing the permeability of th stratum corneum, penetration is likely 3-20 mm, current must be the least sufficient to overcome the resistance of th skin and electrode |
| Wavelength | Duration of one cycle of AC |
| What happens to an AP during Depolarization? | The neuron is rapidly depolarized by the opening of voltage-gated Na+ channels. Na+ is pulled into the cell by the negative charge inside and because of the larger concentration of Na+ outside the cell. |
| What happens to an AP during Repolarization? | The Na+ channel close and voltage-gated K+ channels open to repolarize nerve. K+ is pushed out of the cell because of the large concentration of K+ inside of the cell and because of the positive charge inside the cell. |
| What is absolute refractory period? | when the membrane is depolarized, it is not possible to create another AP |
| What is accommodation? | decreased response to same amplitude of nerve stimulation, must rise fast enough that nerve cannot acclimate to the current produced. |
| what is Beat frequency? | 4100Hz-4000Hz=100Hz |
| what is burst duration? | time from beginning to end of the burst |
| what is Burst mode? | series of pulsed delivered in an "packet" as a single pulse, frequency and duration preset |
| what is Chronaxie? | minimum duration to stimulate nerve at twice rheobase (measures time/duration) |
| What is decay time? | time it takes form peak to decrease to 0 during a phase |
| What is Duty cycle? | ration of on time to total cycle time, On 10 sec, off 50 sec=10;60 or 1;6 duty cycle |
| What is electric current (I)? | the flow or movement of charged particles |
| what is frequency modulation? | varying the number of pulses or cycles per second , usually referred to as sweep |
| what is interburst interval? | time between burst |
| what is interferential current (IFC)? | waveform produced by the interference of 2 medium frequency sinusoidal AC's of slightly different frequencies |
| What is Interphase interval? | time between phases of a pulse |
| what is modulation? | any variation, cyclic or random, of one or more of the stimulation parameters, limits adaptation of the neurons to current |
| what is On/Off Time? | On Time is the time when a train of pulses occurs; Off Time is the time between the train of pulses when no current flows. |
| What is Phase duration? | duration of one phase of the pulse |
| what is relative refractory period? | after depolarization occurs, a short hyperpolarization period occurs, a stronger than normal AP would be required to produce another AP |
| what is Rheobase? | minimum amplitude required with a long pulse duration to produce an AP (measures amplitude) |
| What is Saltatory conduction? | impulse jumps between spaces in myelin sheaths, known as nodes of Ranvier, this leads to greater speed of impulse conduction |
| What is Strength-duration curve? | minimum amount of electrical current (combination of amplitude and pulse duration) required to depolarize the nerve and produce an AP in a specific type of nerve. |
| Clinical applications of E-stim: | ("MR.PHET") Musc.strengthening, Re-education of musc., Pain, Healing, Edema, Transdermal drug delivery |
| Clinical effects of e-stim are result of the current stimulating: | action potentials |
| E-stim to anterior tibialis muscle to produce dorsiflexion during the swing phase of gait is an example of: | FES- functional electrical stimulation |
| Phase: | in a pulsed current, when starts to flow in one direction to when it stops or starts to flow in other direction |
| Pulse: | in a pulsed current, period when flows in any direction |
| Innervated muscle stimulation: | NMES-neuromuscular electrical stimulation (depolarization of nerve) |
| Denervated muscle stimulation: | EMS-electrical muscular stimulation (depolarization of muscle) |
| Motor Point: | the place where electrical stimulus will produce the greatest contraction with least amount of electricity. Most motor points are over the middle of the muscle belly. |
| Current Density: | amount of current delivered per unit area |
| Adaptation: | a decrease in frequency of AP's and subjective sensation of stimulation that occurs in response to electrical stimulation with unchanging characteristics |
| Monophasic: | a series of pulses where the charged particles move only in one direction |
| Biphasic: | a series of pulses where the charged particles move in one direction and then in the opposite direction |
| Electrodes should not be placed over: | bony prominences...(b/c the higher resistance of bone and poor adhesion of electrodes to highly contoured surfaces increases risk of discomfort and burns, and is less likely to produce therapeutic benefits. |
| Pt.position for muscle strengthening: | limb should be secured to prevent motion thru the range, with the joint that the stimulated muscles cross in midrange. |
| Effects of electrode spacing: | closer together=current travels more superficially; further apart=current goes deeper |
| Waveform used for muscle contraction: | pulsed biphasic or Russian |
| Waveform used for pain: | pulsed biphasic or IFC |
| Waveform used for healing: | monophasic or HVPC |
| Contraindications for E-stim: | ("PT CuP"--thx Joey!) Pacemaker or unstable arrythmias, Thrombosis/thrombophlebitis, Carotid sinus, Pregnancy—over abs/low back |
| Precautions for E-stim: | ("IC MIA") Impaired sensation/mentation, Cardiac disease, Malignant tumors, Ionto. After other PA's, Areas of skin irritation/open wounds |
Created by:
llacorte
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