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44 Cards in this Set

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TENS sensory- Low parameters

Frequency: greater than 50-100 pps

Pulse duration: 2-50 ms

Time: 20-60 min

TENS sensory- Low effects and when to use

low level gating

Acute injuries

TENS sensory- Low electrode placement

Electrode placement on or around site of pain or use acupuncture sites

TENS sensory- High parameters

frequency: greater than 100-150 pps

pulse duration: 2-50 ms

time: 20-60 min

TENS sensory- High effects


TENS sensory alternative parameters

Intensity- high as tolerable w/o reaching motor level

Time: 10-15 min

TENS sensory alternative effects and when to use

quick analgesic effect

When you need to perform procedures that would otherwise be too painful (friction massage, wound debridement, etc)

TENS sensory alternative electrode placement

close placement

TENS motor- Low parameters

frequency: 2-4 pps

pulse duration: greater than 125-150

time: 45-60 min, 2-3x/day

TENS motor- Low effects and when to use

Beta release, mm pumping

Chronic pain, deep & throbbing, "acupunture-like"

TENS motor- Low electrode placement

Electrode placement away from site (mm contraction not well tolerated) – Prox. nn roots, acupuncture, nn points, CL side

TENS motor- High parameters

frequency: greater than 150 pps if tolerable

pulse duration: 125-150 ms

time: 15-20 min

TENS motor- high effects and when to use

mm fatigue, gating, beta release

for analgesia

TENS motor- high electrode placement

Electrode placement similar to sensory unless mm contraction in area is unwanted

TENS noxious parameters

Frequency: -Low – 1-5 pps High – 80-100 pps

*Note: both release endorphins, so it’s more about pt comfort

pulse duration: 1 mx -> 1 s

Time: 10-15 min

TENS noxious when to use

Stimulate opiate release (inhibition), if other methods aren't working

TENS noxious electrode placement

At painful site, TPs, MPs, acupuncture pts etc.

Sensory vs Motor TENS pain relief

• A betas block nn impulses = gating effect = frequency dependent (directly related)

• Sensory = Residual pain relief is brief (but faster onset)

• Motor = Residual pain relief lasts longer (but slower onset)

NMES strength type of current

biphasic or burst modulated AC (Russian)

NMES strength treatment time

Frequency: 1-100 pps (tetany at highest tolerated level - 60% of MVIT in quads)

Duration/On & off: 50-1000 ms, 10-15 on, 50-120 off

15 min -> 10-15 contractions at max intensity

3 sessions/week

NMES strength purpose

activate as many motor units as possible and fired as fast as possible (higher training volume)

better motor recruitment

NMES endurance type of current

Pulsed biphasic- w/ low-moderate amplitude submax

NMES endurance parameters

Frequency: 30-40 pps

Duration: 50-250 ms

NMES endurance purpose

want to selectively activate the S and FR fibers for prolonged periods

FES type of current

Amplitude can be sensory or motor level

FES parameters

frequency: 50-100 pps

duration/on & off: 5-10s on, 5-25 s off (ratio due to fatigue

Short- 15-20 min but frequent, 1-2x/day

FES purpose

may help increase recovery RATE but not necessarily level of recovery

Spasticity management type of current

Amp = enough to get mm contraction (antagonist- maybe only sensory)

spasticity management parameters

frequency: higher than tetany greater than 25-30 pps

Gradual ramp up/down to avoid stretch reflex

20-40 min, prior to fxnl activity & pt pre-positioned

Spasticity management purpose

fatigue spastic mm

effects are temporary (less than 24 hours)

Shoulder subluxation type of current

Amp = enough to move humerus

Shoulder subluxation parameters

10s on

50 s off & gradually increase endurance -> 120 s on, 10 s off

gradual ramp up & down

30 min for 4-7 hrs/day


6 weeks of tx

humerus subluxation electrode placement

supraspinatus and posterior delt

Wrist extension type of current

Amp = enough to promote wrist extension

wrist extension parameters

frequency: 20-100 pps (tetany needed)

200-300 ms, 5-10 s on, 5-25 s off, Gradual ramp up & down

10-20 min

2-3x/day3-5x/week2-4 wks of tx

scoliosis type of current

rectangular monophasic

amp = produce mm contraction that partially reverses curve

Scoliosis parameters

frequency: 25 pps

pulse duration: 200 ms

6s on

6 s off

8 hrs continuous stimulation

Cutaneous A betas: MR, low threshold characteristics

Part of barrage, but don't cause pain alone

Supressed by noxious stimuli (heat)

May have a role in inhibition - reduces nociceptive responses

Cutaneous A deltas: MR, high threshold characteristics

respond to intensities that produce skin damage

may explain hyperalgesia due to continuous vigorous discharge

Cutaneous A deltas: MT (heat nociceptive) characteristics

Critical for the judgement of heat induced pain

Account for FIRST pain felt with noxious heat (like touching stove

small receptive fields

Cutaneous C polymodal characteristics

Respond to thermal, mechanical, and chemical stimuli (variety)

Convey both nociceptive and non-nociceptive inf

Involved in MILD tissue damage (vs A deltas

Muscle A delta characteristics

Lightly myelinated

Activated by bradykinin/serotonin (chemicals)

May be ergoceptive (tell you are moving)

Muscle C fibers characteristics

primary pain neurons in mm that connect to ST tract- excitatory effect

optimally responsive to noxious stimuli

also activated by chemicals

primary afferent visceral characteristics

poorly localized and discriminated

often referred to region = tender (2ndary hyperalgesia)

often accompanied by autonomic and somatic reflexes

C polymodals = most organs

Especially prevalent in inflammation and certain diseases