Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
30 Cards in this Set
- Front
- Back
|
Purpose of Tens |
To provide afferent stimulation for pain management Acute and Chronic pain management |
|
|
What are the two pain theories used by TENS |
Gate Theory Endogenous Opiate pain control theory |
|
|
Describe Gate Theory |
A-Delta - large, myelinated in subsatnia gelatinosa in dorsal horn (Lamina 2-3) inhibit smaller A-dela and C-fibers |
|
|
Describe Endogenous Opiate pain control theory |
Descending pathway generates endogenous opiates Noxious stimuli generates endorphin production and end. opiate rich nuclei in the CNS -Pituitary/PAG/Midbrain/Thalamus Travel down and limit release of substance P from pain fibers Pain fibers up, inhibiting down = wash |
|
|
Outcome tools for Tens use |
Oswestrys McGill pain drawings VAS Drug intake ADL Ability |
|
|
Characteristics of TENS |
Waveform: Asymetrical biphasic with a zero net direct current Modulation: Continuous or burst |
|
|
Parameters of TENS |
20-200msec duration 1-200hZ Fq 0.1-120 mA |
|
|
Indications for TENS |
Pain modulation Post op pain Labor Bone fractures Phantom pain Improve blood flow |
|
|
Contraindications for TENS |
Pacemakers Epilepsy Larynx, pharynx, neck, or head of CVA pt Over eyes First trimester Lower abdomen during pregnancy Anterior transcervical area |
|
|
Precautions for TENS |
Cardiac Disease Arrhythmias Open wounds Malignancy` |
|
|
Adverse reactions to TENS |
React iosn to Tape, Electrodes, or gel Skin irritation Electrode burns |
|
|
What are the 4 main types of tens |
Subsensory - MENS Sensory - Conventional TENS Motor - Burst Modulated TENS Noxious - Intense TENS |
|
|
What is Electroacupuncture |
Form of acupuncture where a small electric current is passed between pairs of acupuncture needles |
|
|
Conventtional TENS Parameters |
Amp: comfortable tingling sensation (10-30mA) Pulse rate: 50-80pps (50-100) Pulse duration: 50-100msec (20-50msec) TxTime: 20-60min Pain relief - temporary |
|
|
Acupuncture TENS Parameters |
Amp: Strong but comfortable motor (30-80) Pulse Rate: 1-5pps Pulse Duration: 150-300msec Tx Time: 30-40 Pain Relief - over 1 hour |
|
|
Brief Intense TENS Parameters |
Rapid onset but short term relief during procedures Amp: Pt tolerance (30-60) Pulse rate: 80-150 Pulse Duration: 50-250 Tx Time: 15min Pain relief: 30-60min |
|
|
Burst Mode TENS |
Amp: comfortable (10-60mA) Pulse rate: 50-100 pps in bursts of 1-4pps Pulse Duration: 50-200msec Tx Time: 20-30min Pain relief - hours (opiate system) |
|
|
Hyperstimulation TENS |
Amp: pt Tolerance (strong) Pulse rate: 1-5pps Pulse duration: 150-300msec Tx Time: 15-30s increments Pain relief - long lasting (probe to find tirgger points |
|
|
Modulation Mode TENS Purpose |
Preventing neural or perceptual adaptation due to constant ES |
|
|
What is the MoA for TENS |
Aims to excite (stimulate) the sensory nerves and activate specific natural pain relief mechanisms |
|
|
How does stimulating both types of nerves reduce pain |
The higher fq stimulation output (100hz) is interrupted (or burst) at the rate of about 2-3 bursts per second |
|
|
What should be considered for electrode placement |
Acupuncture site Dermatome distribution of involved nerve Over painful site Proximal or distal to pain site Segmentally related myotomes Trigger points |
|
|
Options on where to place electrode |
At nerve root for radiculopathies
Along dermatome Over or around painful site Over the myotome Over or around trigger point Along acupuncture meridians |
|
|
Best method for local and referred pain? |
2 channel application One channel for each component |
|
|
TENS frequencies |
High - sensory - 80-110 Low - motor - 2-10 |
|
|
Acute Pain and TENS |
High rate, low intensity - provides long term buzzing that doesnt fluctuate and the person doesnt seem to notice it
|
|
|
Chronic Pain and TENS |
Low rate, high intensity - provides a more motor like response that can induce endorphin-like properties |
|
|
How are the different versions of TENS applied? |
By varying the pulse rate/fq, pulse width/duration and intensity/amplitude. |
|
|
What can you change if one method of TENS is not working? |
Level Fq Placement Distribution |
|
|
Effectiveness of TENS |
No info on subsensory TENS Motor TENS most effective in RA, OA, tigger, and Diabetic Neuropathy High fq has success with LBP paints May be used in dysmenorrhea when medicatiosn do not work. |
