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52 Cards in this Set
- Front
- Back
TENS
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-current is applied across the skin to stimulate nerves
-peripheral NS must be intact |
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stimulators that are classified as TENS
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-high voltage
-interferential -micro-current stimulators (MENS) -low voltage -portable electrical stimulators |
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electrical stimulation
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-elicit or facilitate a desired therapeutic response
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purpose of TENS
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-pain relief
-stimulate large diameter sensory fibers, smaller pain fibers may be pre-synaptically inhibited -parameters may be altered to elicit the descending pain modulation |
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TENS indications
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-pain relief
-edema reduction -wound healing -increase circulation |
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types of TENS
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-sensory
-motor -noxious |
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sensory TENS
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-conventional
-modulation |
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motor TENS
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-acupuncture like
-burst mode |
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Noxious TENS
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-brief intense mode
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what nerve fibers are targeted in gate control theory
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-a-beta
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what pulse duration is used in gate control theory
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-short
-(up to 150) |
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what frequency is used in gate control theory
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-higher (more AP to override a-delta and C fibers)
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what is the total treatment time when targeting gate control theory
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-10-20min
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what is the neuromodulation of sensory TENS
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-dorsal horn gate control
-endorphin release |
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what fibers do sensory TENS target?
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a-beta
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what is the pulse duration of sensory TENS
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-50-150 microseconds
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what is the frequency of sensory TENS
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-60-150Hz
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what is the typical duration of sensory TENS
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-20-30 min
(can be worn all day but be aware of the accommodation effect) |
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what technique provides the fastest relief?
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-sensory TENS
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sensory TENS is often used when?
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-acute pain
-post-surgical |
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what type of fibers does the endogenous opiates theory target
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-a-delta
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is the pulse duration in the endogenous opiates theory higher or lower?
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-higher
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what type of frequency should be used in the endogenous opiates theroy
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-low; do not want to fatigue the muscle
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what is the neuromodulation of motor TENS
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-endorphin release moreso than gate control
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what fibers does motor TENS target
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-a-delta
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what should the pulse duration be during motor TENS
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-150-300 microseconds
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what should the frequency be during motor TENS
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-<20 Hz (looking for a twitching response)
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what is the duration of treatment when using motor TENS
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-20-45 min
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what are the indications for motor TENS
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-subacute pain (NOT used w/ acute)
-trigger points |
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how long can motor TENS provide relief for?
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1-5 hours
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What is the purpose of burst mode TENS
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-get a strong contraction at a lower intensity
-(body only perceives bursts, not the carrier frequency) |
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what is the pulse rate of burst mode TENS
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-70-100 pps modulated to 1-5 bursts per second
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-what is the intensity of burst mode TENS
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-strong, rhythmical contractions w/in tolerance
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what is noxious TENS used for?
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-descending control of pain (stimulates releases of endorphins)
-primarily used w/ point stimulators to direct the stimulation over motor or acupuncture points |
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what fibers are stimulated when using noxious TENS
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-C fibers
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what is the neuromodulation of noxious TENS
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-endorphin release
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what is the pulse duration of noxious TENS
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-150-1000 microseconds
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what is the frequency of noxious TENS
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-1-5 Hz or 100-150 Hz
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what is the duration of noxious TENS
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-30-60 seconds (8-10 points per session)
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what are possible electrode sites?
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-over painful sites
-over peripheral nerve (dermatome/myotome) -trigger/acupuncture points -spinal nerve roots |
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what are contraindications of E-Stim
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-cardiac pacemaker/any implanted electronic device
-placement of electrodes over carotid sinus -areas of venous or arterial thrombosis -pregnancy -directly over the eyes |
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what are precautions of E-stim
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-cardiac disease
-impaired mentation/sensation -malignancy -skin irritation/open wounds |
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what are the purposes of IFC
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-pain control
-increase circulation -muscle re-education |
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what type of current does interferential current utilize
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-alternating current
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how many generators does IFC use?
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-2 medium frequency generators w/ the lower frequency generator being the carrier
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what is the advantage of a higher frequency
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-shorter pulse duration which leads to greater comfort
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constructive interference
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-in phase
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destructive interference
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-out of phase
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beat frequency
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-difference b/t the 2 frequencies used
-makes a medium frequency a biologically lower frequency |
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sweep
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-modulation of beat frequency (one channel remains constant)
-prevents accomodation |
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vector scan
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-modulates input currents (switching stationary channel w/ the one that is changing)
-covers larger area |
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pre-mod
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-interference of the 2 currents takes place inside the unit
-only requires 2 electrodes (advantage) -electrical field is not necessarily generated in the location of the lesion (disadvantage) |