06-08: Russian Current

Question 1

Characteristics of Russian Current

Answer 1

• Alternating Current (AC)
• Medium Frequency (2,000-10,000 Hz) - Carrier Frequency
• Pulsatile (3 or more pulses)
• Polyphasic waveform (at least 3 phases)
• Type of NMES

Question 2

Why Russian Current?

Answer 2

• Less Pain
• Allows deeper motor nerve fibers to be stimulated
• Less painful to patient

Question 3

Primary Indication

Answer 3

• Muscle strengthening of healthy individuals
• Augments strengthening and allows pt to obtain stronger voluntary contraction than without E-Stim assistance
• Apply during activity - contract when machine on to elicit full contraction

Question 4

Contraindications

Answer 4

• Electronic implant devices
• Malignancy
• Over pregnant uterus
• Over anterior transcervical area
• Over areas of hemorrhage

Question 5

Single Channel Delivery

Answer 5

• Used for bipolar application for muscle re-education

- Ex: across quad fibers and get it to contract

Question 6

Co-Contraction Delivery

Answer 6

• Used to stabilize joint while performing functional activity or in order to be able to perform functional activity
• Ex: Quad/Ham contraction during stance phase

Question 7

Reciprocating Delivery

Answer 7

• During functional activities such as gait, when one muscle group contracts, then another
• Ex: Swing Phase - Alternate between different muscle groups

Question 8

Russian Parameters

Answer 8

• Amplitude: To max contraction tolerated - no pain
• Pulse Width: 50-200 microsec (pre-set)
• Frequency: 50 bursts/sec (modulation of medium frequency wave
• On/Off Ratio: 10/50 (10 sec contract/50 sec rest) - avoid fatigue
• Rx time: 10 min (can vary based on time of muscle to fatigue)

Question 9

Frequency

Answer 9

• 50 bursts/sec is variable - rate causes more of a twitch than contraction
• Gradually increasing the # of bursts causes muscle to contract (makes it more comfortable for pt)

Question 10

Duty Cycle

Answer 10

• “Relative” Duty cycle

- Due to burst duration of 50 bursts/sec being equal to inter-burst interval, machine has 50% duty cycle

Question 11

Electrode setup

Answer 11

• Parallel to muscle fibers, along line of pull of muscle group
• Monopolar, bipolar, quadripolar or multipolar depending on treatment area
• Usually bipolar; if co-contraction, then quadripolar

Question 12

Pt Set up

Answer 12

• Greeting; identify self, verify pt
• Provide call bell, make sure equipment off
• Skin integrity
• Sensation Test
• Palpate muscle to contract for any tenderness/pain
• Conduct MMT
• Clean Skin
• Place electrodes parallel to muscle fibers along line of pull of muscle group
• If motor points, apply coupling gel to treatment area of electrodes
• Set parameters
• If no response, reset to “0” and reposition electrode

Question 13

Documentation of Russian E-Stim

Answer 13

• Location (muscle group)
• How many electrodes used
• How many bursts? On-off ratio?
• Which muscle working
• Treatment time
• Single Channel, Co-Contraction, Reciprocal (Delivery)
• Why used Russian E-Stim
• Activity while machine on (SLR, gait, quad set, grip?)