application for NMES Flashcards by Ashley Carlson

NMES frequency

25-50 pps

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NMES phase duration

200-300 ms

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NMES cycle time

10 sec on, 10 sec off

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NMES amplitude

enough to get a contraction

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NMES ramp

patient preference, usually not more than 2 sec

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NMEs total treatment time

couple sets of 6-12 reps

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NMES progression

comes with amplitude or change of duty cycle

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NMES strengthening principles

improve force output
apply overload principle

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NMES strengthening contraction type

maximal tetanic isometric contraction (maximal voluntary isometric contraction (MVIC)

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NMES strengthening position

fixed position is best

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strengthening biphasic frequency

35 pps+ want good force, but low fatigue

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strengthening biphasic phase duration

200-300+ usec - based on need for motor nerve recruitment

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strengthening biphasic cycle time

6-10 sec on
30-50 sec off
generally, a 1:5 ratio

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strengthening biphasic ramp

patient preference
size of muscle

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strengthening biphasic treatment time

10-20 strong contractions

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strengthening biphasic progression

primarily with amplitude

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strengthening russian current contraction type and position

MVIC ~60%

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strengthening russian current frequency

2500 Hz with 50 bps

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strengthening russian current phase duration

200 usec - determined by bps

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strengthening russian current cycle time

6-10 sec on
30-50 sec off
generally, a 1:5 ratio

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strengthening russian current ramp

patient preference
sometimes longer than with PC

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strengthening russian current treatment time

10-20 strong contractions

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strengthening russian current progression

primarily with amplitude

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endurance programs contraction type and position

submaximal tetanic

endurance programs frequency

minimal tetanizing < 50 pps

endurance programs phase duration

200-300 ms

endurance programs cycle time

begin 1:5 or 1:6 ratio > 1:1 ratio overtime increase on cycle or decrease off cycle

endurance programs amplitude

visible contraction against gravity

endurance programs ramp

related to activity

endurance programs treatment time

as much as possible; look at function

endurance programs progression

look at amplitude but not as much; make cycle time smaller and more contractions in a shorter period of time, and more sessions per day

motor control principles

- increase number of motor units firing - increase rate of motor units firing - improve initiation of movement

why improve motor control?

improve tactile and kinesthetic inputs using as much of the patients voluntary contraction as possible

what are the 2 types of mechanisms for motor control?

motor and cutaneous

motor control (motor) contraction type/position

visible contraction

motor control (motor) frequency

non-fatiguing

motor control (motor) phase duration

200-300 ms

motor control (motor) cycle time

per function

motor control (motor) amplitude

good contraction

motor control (motor) ramp

patient preference

motor control (motor) treatment time

frequent

motor control (motor) progression

getting rid of unit

motor control (cutaneous) contraction type/position

no contraction - sensory only

motor control (cutaneous) frequency

non-fatiguing so high frequency

motor control (cutaneous) phase duration

lower than 200 ms

motor control (cutaneous) cycle time

per function - want tingling

motor control (cutaneous) amplitude

sub-motor

motor control (cutaneous) ramp

not usually used for this

motor control (cutaneous) treatment time

based on function

common applications of NMES

shoulder subluxation, orthotic use, spasticity reduction, pelvic floor re-education, improving ROM, edema reduction, and denervated muscle

how does NMES reduce spasticity

through fatigue do not use motor point for cutaneous usage

what 2 things are needed for pelvic floor re-education?

strength and endurance

how does NMES improve ROM?

with frequency, submaximal contraction, and doing it as often as possible

how does NMES reduce edema?

- primarily through the muscle pump - sub tetanic/barely motor contraction - fatigue parameters

what cycle time is best to reduce edema?

1:1

when muscle is denervated what is there an increase of?

chronaxy

once atrophy sets in denervated muscle what should you do?

increase amplitude to excitation Ach sensitivity "vermicular" looking contraction

purpose for NMES in denervated muscle

decrease atrophy and decrease CT replacement of muscle tissue

denervated muscle current type

- AC if long enough phase duration - DC often used - cathode active is DC - higher frequency if no problem with phase duration