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50 Cards in this Set
- Front
- Back
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High Volt
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Current Type: Monophasic twin peack wave
Amplitude: 0-500mA RMS Voltage: 0-500V Pulse Frequency: 1-120pps Pulse Duration: 13-100msec Phase Duration: 20-45msec |
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High Volt- Pain Control
OPIATE RELEASE |
Output Intensity: Motor Level
Pulse rate: 2-4pps Phase Duration: 150-250msec Mode: continuous Electrode arrangement: monopolar or bipolar Polarity: Acute: positive Cronic: negitive Elecrode Placement: over pain site, nerve root, trigger point |
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High Volt Pain Control
GATE CONTROL |
Intensity: Sensory level
Frequency: 60-100pps Duration: <100msec Mode: continuous Polarity: Acute: + Cronic: - Elecrode Arrangement: mono or biplolar Placement: over pain site |
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High Volt- Pain Control
Breif-Intense Protocol |
Intensity: Noxious
Frequency: >120pps Duration: 300-100msec Mode: Probe -15-60sec Elecrode: Monopolar Polarity Acute: + Cronic: - Probe Placement: Distal from the painful area to proximal to it. Gridding technique |
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High Volt- Edema Reduction
Conrol Edema Formation |
Intensity: sensory
Frequency: 120pps Pulse Duration: maximum allowed Mode: continuous Elecrode: Immersion Polarity: - electrodes placed over injured tissues Treatment duration: 4, 30min treatments, each followed w/30min rest periods Comments: -imidiate onset of trauma. -wrapped & elevated btw sessions |
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High Volt- Edema Reduction
Muscle-Milking Technique |
--Intensity: Strong/Comfortable contraction
--Pulse Frequency: low --Mode: Alternating --Placement: Bipolar-proximal and distal ends Monopolar-active electrodes follow the course of venous return system --Comment: Ice applied but could impede venous return |
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TENS- Transcutaneous Electrical Nerve Stimulation
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PAIN ONLY!!!!!!
---decreases patient's perception of pain by decreasing the conductivity and transmission of noxious impulses from the pain fibers to the CNS --------->High-frequency --------->Low-frequency --------->brief-intense |
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TENS- Hight Frequency
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Intensity: Sensory
Pulse Frequency: 60-100pps Pulse duration: 60-100msec Mode: modulated rate Treatment Duration: as needed Onset of Relief: <10min Duration of Relief: Min to Hrs Placement: direct, nerve root |
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TENS- Low-Frequency
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Intensity: Motor
Pulse Rate: 2-4pps Pulse duration: 150-250msec Mode: Modulated Burst (interupted / off time) Treatment Duration: 30min Onset of Relief: 20-40min Duration of Relief: hours Placement: stimulation points |
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TENS- Brief-Intense
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Intensity: noxious
Pulse Frequency: Variable >100pps Pulse duration: 300-1000msec Mode: modulated Amplitude (% is increased & decreased) Treatment Duration: 15-30min Onset of Relief: <15min Duration of Relief: <30min Placement: stimulation points |
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TENS-- Electrode Placement
Direct Placement |
--placed directly on site
--Electrical channels run parallel A<------>A B<------>B |
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TENS-- Electrode Placement
Contiguous Placement |
--Placed around painful site
--Electrical channels run parallell to each other --Currents can cross over target tissue A B B A |
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TENS---Set up
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1. Adjust output parameters
--Width (duration) --Rate (frequency) 2.select electrodes 3. Output Mode: mode and Duration of treatment 4. unit off ---intensity is zero 5. increase output intensity channel 1 then 2 7. balance channels home care instructions |
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Interferential Stimulation
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Pain control
2 AC currents on separate channels sine waves combined |
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Interferential Stimulation
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constructive interference:
---Combinatin of both Destructive interference: ---Cancle out ---wave of 0 Continuous interference: --combo of both |
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IRS- Pain control
Gate Control Mech |
--Output Intensity: strong sensory
--Carrier Frequency: patient confort --Burst Frequency: 80-150 Hz --Sweep: fast --Electrode Arrangement: Quadripolar --Electrode Placement: around target area --Treatment Duration: 20-30min |
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IRS Pain control
Opiate Release mech. |
--Output Intensity:mderate-strong sensory
--Carrier Frequency:patient confort --Burst Frequency: 1-10Hz --Sweep: slow --Electrode Arrangement: Quadripolar --Electrode Placement: arond periphery of target area --Treatment Duration: 20-30min |
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Premodulated/ Russian Stimulaiton
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Decrease Atrophy
2500- Hz sine wave with burst Less capacitive skin resistance---->allows more current to reach motor nerve |
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PremodulatedTreatment Setup
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--Output intensity: strong muscle contraction, discomfort
--Carrier Frequency: 2500Hz --Burst frequency: 30-60 bps --bust Duty Cycle: 10% --Cycle duration:400musec --On/Off Duty Cycle: 10:50 s --Ramp: 2s --Electrode placement: Bipolar, muscle ends --Treatment Duration: 10cycles or until fatigue |
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Neuromuscular Electrical Stimulation (NEMS)
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Muscle reeducation, decrease spasticity, delay atrophy, and muscle strengtheing
Bipolar electrode placement over muscle ends |
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NMES
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Smaller type 2 nerves fire first
reversed method vs VC |
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NMES settings
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-Intensity: strong, intense, comfortable contractions
-Frequency (rate): Individual contract- <15pps mod- tonic contrct >50pps -polarity: negative over primary motor point 4 monopolar -Duty Cycle: 20% -Electrode Placement: Bipolar-muscle ends, direct method Monopolar-motor points or muscle belly |
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High-Volt- muscle reeducation, strengthening
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-Intensity: strong, intense, comfortable contractions
-Frequency (rate): Individual contract- <15pps mod- tonic contrct >50pps -polarity: negative over primary motor point 4 monopolar -Duty Cycle: 20% -Electrode Placement: Bipolar-muscle ends, direct method Monopolar-motor points or muscle belly |
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Iontophoresis
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medication through the skin
low-volt, DC Med driven 6-20mm |
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Iontophoresis Mechanisms
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0-5mA
500ohms-100kilohms Meds used ---acetic acid ---dexamethansone & lidocaine ---lidocaine & epinephrin ---Dexamethasone |
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IontoPatch Extended Time-release Iontophoresis System
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low-intensity, long-duration treatment- 24hrs
inflammation of joint |
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Ultrasound
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modality stimulates repair of soft tissue and pain relief
Deep tissue heating |
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Ultrasound
Indications |
Acute conditions: more treatment over shorter period
Cronic conditions: fewer treatments over longer period |
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Ultrasound
Equipment |
Piezoelectric effect: current transformed into acoustic energy through the piezoelectric crystals
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Ultrasound
Frequency selection (1MHz) |
1.0MHz:
--fatty tissues, deep beneath the skin --3-5cm penetrates --half-value distance |
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Ultrasound-
Frequency Selection (3 MHz) |
superficial structures
half-value distance-1.5cm tissue 1-2cm below skin Ex: patellar tendon, MCL |
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Ultrasound-
Mode |
continuous- thermal and non-thermal
-extensibility in collagen -decrease joint stiffness -decreased spasm & pain -increase blood flow and nerve conduction pulsed-nonthermal -tissue regeneration -tissue & bone repain -increase bone flow -cell metabolism - pain releif |
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Ultrasound-
Intensity & Duration |
Acute Injuries-.5
Nonthermal-low intensity and short treatment, lowest Duty Cycle Superficial skin lesions- 3MHz, high intensity (0.1-0.5) W/cm), 20% duty cycle Duration: 5-10min |
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Ultrasound-
Intensity |
Low- 0.1-0.3 W/cm2
Med- 0.4-1.5 High- 1.5 - 3.0 |
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Ultrasound-
number of treatmetn |
limit at 14
stop after 3-4 if not + effects acute: daily treatment, 6-8days chronic:everyother day, 10-12 applications |
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Ultrasound- Techniques
Direct Skin |
---no greater than 15 degrees form skin
---coupling medium ---DO NOT EXCEED 2-2.5 TIMES THE SIZE OF SOUND HEAD |
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Ultrasound-Techniques
Underwater |
--Plastic container
--increase intensity by 20% --Brush air bubbles off skin |
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Ultrasound-Techniques
Blader Technique |
--when body part is irregular shape and cant be immersed in water
--ballon filled |
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Ultrasound-Techniques
Moving the Transducer |
--even distribution
--4cm/sec --maintain contact with skin circular/ stroking patterns |
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Ultrasound-
Indications |
-joint contractures
-muscle spasm -neuroma -scar tissue -Sympathetic nervous system disorders -warts -postacute reduction of myositis ossificans -inflammatory acute & chronic |
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Ultrasound
Contraidications |
-Acute conditions
-Ischemic areas -impaired circulation -Deep Vein Thrombosis -cancerous tumors -infection -prgnancy -fracture sites, osteoporosis -menstrating females |
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Intermittent Compression
Settings |
treatment: 1-2x daily for 20-30min
-Temp: 50-55 degrees F On:Off- 3:1 (45sec on, 15sec off) Pressure set BELOW diastolic blood pressure -upper extremity: 40-60 -lower extremity: 60-100 |
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Compression
Indications |
Edema: post traumatic & post surgery
PREVENTION of Deep Vein Thrombosis (DVT) |
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Compression
Contraidication |
injuries where pressure would increase problem
peripheral vascular disease Arteriosclerosis DVT--->known case could cause death if used |
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Continuous Passive Motion
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enhance nutrition
stimuates remodeling & regrowth accelerates healing |
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Traction
cervical |
set at 7% of patients body weight
Wall-mounted traction: |
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Mechanical Traction
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--Lumbar: 50% of lower extremity weight
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Massage
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encourages venous flow and mild streatching
Increases circulation, removal of metabolites,overcoming venostasis |
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Massage- Effleurage
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stroking
push toward heart gental suberfical |
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Massage- Petrissage
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kneading
pick up skin deep tissue |
