Question | Answer |
What types of electricity emerged from early research? | 1)Electrodiagnosis-interpreting response of nerves and mm 2)Electromyography-records electrical activity of motor units 3)Electrotherapy-treats disease,facilitates contraction,pain management,retards mm atrophy,osteogenesis,meds thru skin,wound m |
What is EMS? | Electrical mm stimulation |
What is the meaning of EMS? | Stimulating denervated mm to maintain its viability of the motor unit |
What current is used in EMS? | D/C = Direct Current |
What is ESTR? | Electrical Stimulation Tissue Repair |
What is the meaning of ESTR? | electrical stimulation for edema reduction, enhancement of circulation, and wound management |
What is NMES? | Neuromuscular Electrical Stimulation |
What is the meaning of NMES? | stimulation of innervated mm to restore mm function and includes: 1)Strengthening 2)spasm reduction 3)atrophy prevention 4)mm re-education |
What is NMES used for? | 1)strengthening 2)spasm reduction 3)Atrophy prevention 4)mm re-education |
What is FES | Functional Electrical Stimulation |
How does FES work | It activates muscles with electrical stimulation to perform functional activities |
What is TENS? | Transcutaneous Electrical Nerve stimulation |
What does TENS mean? | Electrical stimulation for pain management |
Name the 3 currents used in Electrical Stimulation. | 1)D/C: Direct Current 2)A/C: Alternating Current 3)Pulsed or Pulsatile Current |
Name the 3 effects of E Stim. | 1)physiologic 2)Chemical 3)Thermal: US,Diathermy,Infared |
Electrical current in biologic tissue depends upon what 2 things? | 1)type of tissue and physiologic response characteristics 2)The parameters of the electrical current applied: Intensity,Duration,Waveform,Modulation,and Polarity |
Name the 5 different parameter of electrical current applied. | 1)Intensity 2)Duration 3)Waveform 4)Modulation 5)Polarity |
What are the 4 clinical uses of electrical therapy? | 1)Producing mm contraction by stim fo motor endplate 2)electrical field to drive meds into tissue 4)electrical field for wound healing |
What are conductors? Give 2 things in the human body and 1 non biological conductor. | have free moving and loosly bound electronsHuman Body Ex: Nerves and MMMetal is a non biological conductor |
What are Insulators? Give 3 examples in the human body | Electrons that are tightly bound 1)Skin 2)adipose tissue 3)bone |
What is D/C: Direct Current? Tell 5 things about it. | electrons flowing in one direction 1)one electrode is always (+) or always (-) 2)direction of current is adjusted by the PTA3)DC produces Chemical effects4)Only current able to stimulate denervated mm |
What is A/C: Alternating Current? Tell 4 things about it. | Electrons flowingt with periodic reversal 1)Uninterupted bidirectional flow of charged particles 2)can be delivered in interrupted bursts 3)elctrode becomes (+) for 1 phase of cycle then (-) for other 4)No chemical effects able to build up under either |
What is Pulsed/Pulsatile Current? Name 3 things about it. | Unidirectional or Bidirectional or chared particles ceasing for a period of <1 sec1)Comprised of individual pulses or short duration 2)electochemical reaction depends on current setting D/C or A/C (unidirectional vs alternating3)Most commonly current used |
What is the meaning of Charge? | # of electrons flowing. Represents the quantity of electricity |
What is the meaning of Current? | How fast the electrons flow. The rate measured in amps |
What is the meaning of Resistance? | Resistance determines the ease or difficulty of current moving through substance.Conductor = Low resistanceInsulator = High resistance |
Is Resistance used to describe opposition to D/C or A/C? | D/C |
What is the standard unit of measure for Resistance? | ohm |
Is Impedance used to describe opposition to D/C or A/C? | A/C It is a more accurate term for oppostion in the human body.Electrical current in the body takes the path of least resistance.It will go to the mm and nerve fibers First |
What is Tissue Impedance? | This varies in the body. It is how much good or poor conduction a body has |
Increased water content = 1)decreased / increased impedance 2)decreased / increased conductance, and easy flow of current | 1)decreased 2)increased |
70-75% water in nerves and mm = poor conduction / good conduction | good conduction |
20-30% water in bone, fat, tendons, and fascia = Poor conduction / good conduction | poor conduction |
What will help increase moisture to promote better conductivity? | Heat |
Why does impedance change with injury or disease? | 1)Impedance increases with edema, ischemia, atherosclerosis, scarring and denervation 2)Impedance is decreased with open wounds and abrasions |
What is a waveform? Tell 3 things about it. | visual representation of the pulse 1)shows amplitude and duration 2)classifies pulses as either monophasic,biphasic,or polyphasic 3)body responds to amplitude and time characteristice of waveform, not the shape |
Name the 3 types of waveforms. | 1)Monophasic 2)biphasic 3)polyphasic |
Does the body respond to the amplitude and time characteristics or the shape of the waveform? | amplitude and time characteristics of waveform |
What is Monophasic Waveform? name 4 things about it. | Only one phase 1)always unidirectional- polarity doesn't effect the magnitude of D/C because of pulsatile current flows for shorter time 2)Carries a (-) or (+) charge 3)Active (smaller dispersive) electrode over target area; other electrode away from tar |
What is the Monophasic waveform used for? | 1)wounds 2)iontophoresis 3)edema control |
The active / dispersive electrod for monophsic waveform is used in the target area. | active |
What is Biphasic Waveform? Tell 5 things about it. | It is bidirectional with 2 phases 1)two directions with one phase (+) the other (-) 2)waveforms mirror ea other (symmetrical) 3)No Chemical effect (no polarity effect) 4)two active electrodes over target area5)used for mm weakness, neuromuscular facil |
What is Biphasic waveform used for? | 1)mm weakness 2)neuromuscular facilitation 3)Spasms 4)ROM |
For biphasic how many active electrodes are placed in the target area? | two |
What is the Quadripolar waveform? | two electrodes from two separate stimulating circuits are positioned so that the individual currents intersect with each other- used for interferential current |
What type of current is used with the quadripolar waveform? | interferential current |
What is Polyphasic waveform? | It groups together a series (burst) of pulses and delivers them to the body as a single charge. It can be monophasic, biphasic, or polyphasic- machine gun vs single shot gun- burst is perceived as a single pulse |
Polyphasic can be classified as what other 2 types of waveforms besides polyphasic? | 1)monophasic 2)biphasic |
Should you use biphasic waveform for wound healing? | No |
What is the best way to select the best waveform to use? | Pt comfort |
What is Peak Amplitude/Peak Current? | The max current delivered in one phase or a pulse |
What is the meaning of Rise Time? | The time it takes for the amplitude to increase from 0 to peak amplitude. |
What is the meaning of Delayed Time? | The time it takes for the amplitude to go back down to 0 |
What is the meaning of Frequency | pulses per sceond (pps) The number of pulses delivered to the body in one second.-mm's change from twitch to tetany (very fast twitch as frequency increases (usually above 40 pps) |
What is Duty Cycle? | On vs Off times (%)-with longer off time = decreased fatigue |
What are the 3 safety precautions to always remember when using electrical stim? | 1)Use close to outlet (avoid tripping) 2)Wires should not cross pt 3)Always do skin inspection- look for edema, scars abrasions, lesions |
What 4 things are you looking for when doing a skin inspection? | 1)edema 2)Scars 3)Abrasions 4)Lesions |
Patient Factors: What 4 things should you inform your pt of before doing electrical stim? | 1)how it will feel (tingly, or asleep) 2)Don't play with the controls 3)Call if you need to chg positions and never lay on electrodes 4)How to shut off machine 5)Use call light when needed |
What 4 things should be considered when positioning your pt? | 1)comfort 2)Leave slack in lead wires to prevent disconnection 3)Leave call button 4)Inform pt how to shut off machine |
Name 9 things you should do before tx begins. | 1)Check machine wires and electrode 2)Pt Education 3)Plug in Machine and turn machine on 4)Postition Pt 5)Do skin inspection & sensation test 6)Position the machine 7)Wash skin and place the electrodes 8)Preset parameters 9)Make sure amplitude is on 0 |
During delivery what 6 things do you need to do? | 1)Increase amplitude to pts tolerance 2)Ask for feedback 3)Monitor for several min 4)Give pt call button 5)Check periodically 6)Tell pt that if it becomes painful to turn machine off and use call button. (getting a nerve) |
What 6 things should you do when tx is finished (Post Tx)? | 1)Turn amplitude to 0 2)Remove electrodes 3)Turn power off 4)Do skin inspection 5)Document (note variables) 6)Unplug machine |
When electrodes are closer together it is more superficial / deep? | superficial |
When electrodes are further apart it is moresuperficial / deep? | deep |
A decreased sized electrode will increase/decrease current density | increase current density |
A decreased sized electrode will increase/decrease impedance | increase impedance |
A decreased sized electrode will increase/decrease comfort | decrease comfort |
Name 3 electrode placement choices for placement. | 1)painful region 2)within dermatome3)to peripheral nerve supplying pain |
What is depolarization? | Action Potential |
When can electrical current begin to be felt? | When current density is great enough to reach the minimal threshold for depolarization of AB fibers |
What fiber is reached to get a mm contraction by reaching the threshold for depolarization? | A fibers |
If the current intensity is to high and causes pain what fiber is being reached? | C fibers |
What 3 things can be adjusted to get very different physiologic responses? | 1)current density 2)current duration 3)combination of both current density and duration |
What are the 4 physiological effects of Anode (+)? | 1)Attracts (-) ions (anions) 2)Solidification of proteins 3)Hardening of tissue 4)Hyperpolarization-resting(below -70mV) |
What are the 4 physiological effects of Cathode (-)? | 1)attracts (+) ions (cations) 2)Liquifies proteins 3)Hypopolarization (toward action potential) |
Describe voluntary mm contraction. | 1)It 1st recruits Type I mm fibers (slow twitch) 2)Then it recruits Type II fibers (fast twitch) 3)Primarily use oxygen for metabolism 4)It is fatigue resistant 5)activated asynchronously (constantly "turning on and off" making it very energy effecient an |
Describe an E-stim mm contraction. | reverse of voluntary mm contraction / 1st recruits Type II (fast twitch fibers)leading to gradual mm tension / Type II utilizes glycogen for metabolism and fatigues quickly / MM is turned on as long as E-stim unit is on also known as synchronous |