E-stem

Question 1

What are the goals for NMES?

Answer 1

• atrophy treatment/prevention
• strengthening
• achieve synchronous firing/recruitment of motor units

Question 2

Parameters for NMES - pulse width/duration, pulse frequency, on:off time, ramp, amplitude

Answer 2

• Pulse width/Duration= 200-800 µsec
• Pulse Frequency= 30-100 pps
• On:Off time - Will vary on your use, 10 sec on:50 sec off is common for >10 reps
• Amplitude - max contraction/tolerance

Question 3

What type of e-stem is used as an alternative or supplement to orthotic devices or braces? What needs to be intact, but not functioning appropriately?

Answer 3

Functional Electrical Stimulation (FES) - peripheral nerve needs to be intact
- common uses are for shoulder subluxation after stroke and foot drop (tib anterior)

Question 4

What is the goal of IFC and what are the parameters (pulse width/duration, frequency, duration, amplitude)

Answer 4

• pain modulation - quadripolar set up
• pulse width/duration = 200-400 µsec
• Frequency= 10-150 pps
• Duration = 10-30 mins
• Amplitude: strong but tolerable sensation

Question 5

How does high rate TENS work? When can it be applied?

Answer 5

• gait control theory
• Pain modulation through activation of central inhibition of pain transmission
• can be applied during the acute or chronic phase of pain

Question 6

What are the parameters of high rate TENS (pulse rate, pulse duration, duration, amplitude)

Answer 6

• Pulse rate: 50-80pps
• Pulse duration: 50-100 µsec
• duration - 10 min - several hours
• amplitude - comfortable tingling sensation; no muscle response

Question 7

What is the goal of low rate TENS? What are the parameters (pulse rate, pulse duration, duration of treatment, amplitude)

Answer 7

• Pain modulation through descending pathways generating endogenous opiates
• Pulse rate: 1-5pps
• Pulse duration: 150-300 µsec
• Duration of treatment: 20-40 minutes
• Amplitude: strong, but comfortable rhythmic muscle twitch

Question 8

What is the goal of brief intense TENS?

Answer 8

Used to provide rapid-onset, short term pain relief during painful procedures (wound debridement, passive stretching, joint mobilizations)

Question 9

What is the goal of Burst-mode TENS?

Answer 9

• Combines characteristics of both high and low rate TENS. Stimulation of endogenous opiates, but current is more tolerable to patient than low rate TENS
• used for pain relief

Question 10

What type of e-stem uses noxious stimulus? What does it help relief?

Answer 10

• hyperstimulation

- used for trigger point or local area such as tendonitis

Question 11

How deep does 3.3 MHz ultrasound go? 1 MHz?

Answer 11

3 MHz - up to 2.5 cm (close to the surface of skin)

1 MHz - up to 5 cm (deep structures)

Question 12

Current is directly proportional to ______ and inversely proportional to _________.

Answer 12

voltage and resistance