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140 Cards in this Set
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The flow of ions in tissue resulting in the passage of an electrical current |
Biological current |
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What must current have to flow |
Flowable item with a charge Driving force behind it |
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Unit of measure for electrical current |
Amphere |
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when do we need to worry about red positive black negative |
decreasing edema (using high pulse current) |
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with iontophoresis, dexa drug creates positive or negative charge |
negative |
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with iontophoresis and lidocane what charge are you wanting |
positive |
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what are the isulators/ resistors |
hair fat bone skin |
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what is an example of funcitonal estim |
the guy using for foot drop |
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when we talk about EMS and denervated muscle what is that |
its not there there is no message for contraction |
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what types of estim are for tissue repair (healing) |
HVPC and microcurrent |
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what are NMES for |
to restore function and get the muscle innervated to fire for strength, reduction of spasm, to decreae atrophy or increase ROM |
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What are FES for |
neural implantation for long term muscle activation to perfomr functional activities |
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what are TENS for |
portable superfiscial across skin for pain relief |
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What are ESTR for |
stimulation for edema reduciton, circulation, and wound managment |
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what are EMS for |
stimulating denervated muscle to maintain viability |
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These complete the circuit, interphase between ion flow and electron primary site of resistance to current |
electrode |
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materials of electrodes |
carbon rubber, metalic, silver, self adhesive |
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what does electrode size determine |
current density bigger the electrode the higher you have to turn it up |
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have equal current densitites; equal effects under each electrode (all other factors being equal) |
bipolar technique (2 electrodes used) |
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unequal current densities at least 4:1 difference effects concentrated under the smaller electrode (active) no effects under larger electrode (dispersive) |
monopolar technique |
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two bipolar electrode arrangments 2 independent channels common example is TENS |
quadripolar technique |
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if the electrodes are close together what does this do to the depth of trtmt |
more superfiscial spread out deeper |
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what ather the stim points |
motor trigger accupuncture and traumatized |
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areas of pain having decreased electrical resistance |
accupuncture points |
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localized hypersensitive muscle spasms |
trigger points |
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order of nerve depolarization |
SMPM sensory, motor, pain, muscle (fiber) |
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small and deep nerves fire first? |
no large and superfiscial |
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short phase what tissue |
sensory nerves |
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medium phase tissue effect |
motor nerves |
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what nerves long phase |
pain nerves |
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what nerves DC phase |
muscle fiber |
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what does electrical modulation of pain do in terms of fibers |
a beta help overtake a delta and c fibers |
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what is DEOS pain mechanism decending endogenous opioid system what does it do to the cortical system |
release of endorphins can close the gate distracts the patient |
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first site where nociceptive signals are integrated with input form other sites |
dorsal horn |
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signals ascend to the brain or inhibition gait theory |
fascillitation |
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these transmit the pain impulse to the dorsal root ganglia |
a delta and c afferent fibers |
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efferent fibers are activated to stimulate muscle fibers to move the body away from the stimulus |
reflex response |
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pain impulse crosses over and up to the brain |
spinal decussation |
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what type of fibers are a delta and c vs a beta |
pain not pain |
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what is important about when you reach the threshold for action potenial |
its all or nothing |
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what charge is the resting potential and how does estim change that |
negative; turns it positive |
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speed of action potential is based on what |
myelination/ type of fiber |
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0rder of recruitment for the body naturally and with estim |
small to large large to small |
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compare speed of conduction of a delta a beta and c fibers |
a beta large myelinated a delta small myelinated \c small unmyelinated |
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difference between physiological and electrical response to fatigue;smoothness |
fatigue Physi0-slow to fatigue estim- quick to fatigue
smoothness- Physio-smooth estim- twitch then smooth |
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difference between nerve depolarization between NMES and EMS |
NMES-nerve that innervates EMS- deinnervated muscle goes right to the muscle |
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what will paitent feel at the sensory level type of amp and pulse? fibers innervated |
tingles low amp short pulse a beta |
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what will patient feel at the motor level, what amp and pulse and fibers |
contraction high amp long pulse a beta and motor |
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what will patient feel at the noxious level what amp and pulse what happes at end |
tingling, contraction, then painful ( sharp burning dull thump) high amp and even longer pulse releases opioids eventually |
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what do you feel with subsensory |
nothing its microcurrent |
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what word is interchangable with pulse |
phase or duration |
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what does pulse duration mean |
how long it is on how long the pulse is |
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how is pulse duration labeled |
weird u and s (microseconds up to milliseconds) |
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x and y axis for strength duration curve |
amplitude and pulse duration |
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wny is the strength duration curve used |
determining specificity of the effect min combo of electrical current required to make an action potential |
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sensory pulse durations |
50 -100 |
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motor pulse durations |
150-350 |
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contraindications for estim |
demand pacemaker, implantable defibrillator, unstable arrythmia placement over carotid (neck pulse) areas where venous or arterioal thrombosis or thrombophlebitis is present low back or abdomen of pregnant people |
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etim precuations |
C ii M A cardiac disease, impaired mentation or sensation, malignant tumors, areas of skin irritation or open wounds |
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what needs to be documented for ESTIM |
area of body treated patient position parameters of stim electrode placement treatment duration patient’s response to treatment |
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what are the three types of waveforms PAD |
direct alternating pulsed |
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continuous stream of charged particles flowing in one direction used with iontopheresis or stimulating contractions in denervated mm |
direct |
wavelenth |
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continous sinusoidal bidirectional flow of charged particles used for pain control and muscle contraction |
alternating |
waveform |
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different ways AC can be |
symetrical or unsymetrical balanced or unbalanced |
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examples of ACs |
russian or IFC |
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asym or symetric more comfy |
asym |
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when is balanced or un symetric or un importatnt |
small muscles hands and face or kids |
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this type of current stays positive or negative (always unbalanced) |
monophasic pulsed |
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this current can be sym or asym always balanced charge is the same |
biphasic pulsed |
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period when electric current flows in one direction |
phase |
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how long a phase lasts |
phase duration |
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period when electric current flows in any direction may be made of one or more phases |
pulse |
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the time from the beginning of the first phase of the pulse to the last phase of the pulse |
pulse width/duration |
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amount of time inbetween pulses |
interpulse interval |
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is there a phase or pulse duration in DC |
no |
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magnitude of currnet flow strength intensity if possible expressed in amps or volts |
amplitude |
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number of cycles (AC) or pulses for (pc) that occur each second |
frequency |
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how is frequency expressed ? |
hz or pps |
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when do you adjust on off times |
trying to fatigue a muscle 10/30 for strength 5/5 for endurance example |
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low rate means what frequency high rate means what frequency |
low and high matching |
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what is the ramp |
warm up and cool down time usually a couple seconds so its not instant on instant off |
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when is burst mode used what ex |
russian or tens |
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when do you need to modulate |
getting used to it change the vibe |
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what do you change to modulate |
intensity, duration, or frequency |
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when is the gate closed |
when a beta fibers are stimulated or endorphins are released from brain |
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what does tens stand for what affect does it have |
transcutaneous electrical nerve stim \electroanalgesia |
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why use tens |
cheap can wear it alot for pain at home or clininc |
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electrical purpose of tens |
initiate action potential |
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period from the initiation of the action potential to immediately after the peak when another stimulus is given to the neuronNo action potential will be granted |
nerve refractory period |
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bigger the pulse width on tens the more |
painful |
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waveform for tens |
pulsed biphasic asymetrical and balanced making them able to wear all day |
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is current constant for tens why is that good |
yes, amp stays consistent for ease of patient |
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fdatpp for tens |
f 100-150 d 50-80 microseconds a TINGLE t up to 24 hr pain mech-gating patient sensation-pins and needles tingles |
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fdatpp for the ACCUPUNCTURE like tens (low rate |
f=2-10 d-200-300 microseconds a-contraction t-20-30 every 2 hrs p= endorphin release p- thump |
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FDATPP burst tens |
f=preset at 10 d-100-300 generally a-contraction t=20-30 mins for endorphin release |
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which tens for chronic |
low rate |
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finger hose analogy is for what |
current density with electrode size |
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what does electrode proximity affect |
depth |
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in cns when brain filters non meaningful repetitive info |
habituation |
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pns when depolarization threshold increases |
accomodation |
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order for practical of events |
equip prep pain rating conra pre explanation patient positioned skin check check wires for strays attach wires and apply set params slowly adjust intensity obserce skin check document |
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things to put in O |
type mode pulse duration amplitude electrode type number size and placement duration treatments per day response |
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areas of sensitivity for estim |
carotid esophagus larynx pharynx eyes temples upper thorax |
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extra stuff to check on estim with |
obese epilepsy menstruation over abd and low back exposed metal implants |
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low frequency current choices |
mono or biphasic pulsed |
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medium frequency choices |
IFC or Russian |
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high frequency choices |
diathermies |
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what are the different wave forms? |
mono bi iFC premodulated interferential russian tens micro |
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when is monophasic used and what CAN it be for |
tissue healing edema reduction pain |
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most current used in all waveforms is ______ ________ |
pulsed biphasic |
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what does this describe 2 channels at separate fq less skin resistance quadripolar electrode configuration |
Interferential current |
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what does this describe 2 channels at separate fq less skin resistance quadripolar electrode configuration |
Interferential current |
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what is ifc used for |
pain |
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what is four electrodes crossing |
quadripolar ifc |
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for quad ifc 2 fixed carrier fq for each channel when they cross there is a ______ _____ _______ ________ created in soft tissue and they mix |
carry over beat fq \ |
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fpatt for quad polar ifc |
f-100-150 hz p- 50-80 microseconds a- tingle strong but comfy t-10-30 frequency PRN |
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varies the intensity to reduce accomodation aka amplitude modulation |
scan |
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varies the fq to reduce accomodation frq modulation |
sweep |
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ratio of on and off itme deliver interrupted current |
duty cycle |
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mixing of currents inside the machine less penetration than ifc bipolar electrode config |
premodulated ifc |
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when use premodulated ifc |
targeted area mm strengthening(syrge) pain edema( with muscle pump) |
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premod ifc params ACUTE FDATM |
F-100-150 hz duration: 50-80 microseconds a strong ti ngle t-10-30 mech-gating |
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pdatm for chronic premod ifc |
p-2-10 hz d-200-300 a- contract t-20-30 endorphin release |
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pre mod ifc for strengthening f, pd, on.off, ramp, amp, tt, tf |
f-35-50 hz pulse duration- smaller muscles=120-200 large-200-350 o- 5:1 ramp 2 s a- contraction t- 10-20 every 2-3 hr when awake |
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premod ifc params for spasms fdoratt |
f=35-50 d-120-200 smaller larger 200-350 0- 5:5 r- at least 1 s a contraction t-10-30 every 2-3 hr |
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premod ifc for edema fdoratt |
f-35-50 d-120-200 small 200-350 larger 0- 5:5 r- at least one s contraction 30 minutes 2x a day |
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what is russian for |
strength endurance control posture |
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burst interval for russian |
10 millisec |
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fixed burst fq for russian |
50 bursts/ second |
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what is tetany |
involuntary contraction of muscles |
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what frequency produces tetany? |
50 pps. (30-60) |
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continuous or pulsed for smooth muscle contraction |
pulsed |
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what are the primary differences between biological contraction and elecretical |
electrical- goes from large to small, synchronous biological-small to large recruitment, asynchronous |
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params for russian amp, burst, on and off times/ duty cycle ramp up and down |
amp= contraction burst freq-50 bups 10 on 50 off 1-2 seconds |
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which is better, estim or estim with voliton |
equal volition is like russian where patient flexes |
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stimulation mode where more than one muscle in the same group or two or more muscle groups |
synchronous |
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stimulation mode where more than one muscle in the same group or two or more muscle groups |
synchronous |
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stimulation mode where its typically agonist antagonist |
reciprocal |
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stimluation mode where two different muscles in same or separate groups |
overlap co contraction |
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edema control parameters duration for biphasic duration for russian placment, fq, on off amp, treatment time |
150-300 for biphasic 400 US russian frequecny- 30-50 pps on off up to five seconds on amp- small visible contraction 20-30 minutes multiple times a day |
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