E- stim

Question 0

3 wave forms of electrical current:

Answer 0

DC
AC
Pulsed

Question 1

E-stim is used in PT for these 5 reasons:

Answer 1

Pain
Weakness
Wound care
Functional deficits
Re-educate muscles

Question 2

IFC used mainly for____ and uses___ electrodes

Answer 2

Pain

4

Question 3

IFC machine does crossing in machine so instead of 4 electrodes we use

Answer 3

two

Question 4

Premodulated Current (Premod) does the same as IFC but only needs ___ electrodes and doesn’t deliver___amplitude to skin like IFC and doesn’t have as large_____ area as IFC

Answer 4

2
lower
stimulation

Question 5

Russian is medium frequency AC that gives bursts of AC __millisecond bursts___millisecond interburst interval ___burst per second

Answer 5

10
10
50

Question 6

Pulsed Current is

Answer 6

Interrupted flow of charged particles

Question 7

Three types of pulsed current

Answer 7

Monophasic
Biphasic
High voltage pulsed

Question 8

Three types of biphasic pulsed current are:

Answer 8

Biphasic Symmetrical
Biphasic Asymmetrical balanced
Biphasic Asymmetrical unbalanced

Question 9

This tends to be more comfortable when stimulating large muscles

Answer 9

Biphasic Symmetrical

Question 10

This tends to be more comfortable when stimulating smaller muscles

Answer 10

Biphasic asymmetrical

Question 11

Most of the asymmetrical we use is balanced/unbalanced

Answer 11

Balanced

Question 12

Three dependent parameters

Answer 12

Pulse duration (width)
Phase duration (cannot change)
Interpulse interval (cannot change)

Question 13

shorter pulse duration =

Answer 13

pain control

Question 14

longer pulse duration =

Answer 14

muscle contraction (this pulse duration also feels stronger to pt)

Question 15

name 4 other electrical current parameters

Answer 15

1 Amplitude
2 Frequency
3 On time and Off time
4 Ramp up and Ramp down time

Question 16

Pulse duration measured in

Answer 16

microseconds

Question 17

Units of Amplitude

Answer 17

mA milliamps or volts (V)

Question 18

Frequency measured in

Answer 18

Hz or pps (pulse per sec)

Question 19

On and Off time measured in:

Answer 19

10 seconds on 50 seconds off 1:5 or 10:50

Question 20

These are used to improve patient comfort

Answer 20

Ramp on & ramp off

Question 21

Effects of electrical currents (3):

Answer 21

Stimulation of action potentials
Direct muscle depolarization
Ionic effects of electrical currents

Question 22

Basic unit of nerve communication

Answer 22

Action Potentials

Question 23

Lower amplitudes and shorter pulse durations are required to depolarize ____nerves (_ beta nerve fibers))

Answer 23

sensory

A

Question 24

Higher amplitudes and longer pulse durations are required to depolarize ____- nerves

Answer 24

motor

Question 25

Even higher amplitudes and even longer pulse durations are required to depolarize ___ nerves

Answer 25

pain

Question 26

as you gradually increase amplitude and pulse duration

Answer 26

Sensation to Muscle contraction to Pain

Question 27

Shorter pulse durations are used for sensory stimulation - these are usually ____ microseconds

Answer 27

80

Question 28

Longer pulse durations are used for motor stimulation these are usually ____ microseconds

Answer 28

150-350 microseconds

Question 29

Longer pulse durations feel ___ and are less comfortable

Answer 29

stronger

Question 30

Pulse durations longer than 1 millisecond are required to stimulate __ nerve fibers

Answer 30

C

Question 31

Pulse durations longer than __ milliseconds are required to stimulate denervated muscle

Answer 31

10

Question 32

We normally stimulate the motor nerve that goes to the muscle but have to stimulate this type of muscle directly

Answer 32

denervated

Question 33

The longer pulse duration makes the stim feel stronger because

Answer 33

it grabs more muscle fibers bc it has more time to cause ap in more muscle

Question 34

What happens when the nerve ACCOMODATES to the stimulus

Answer 34

prevents depolarization

Question 35

If this is too long the nerve may accomodate

Answer 35

ramp time

Question 36

May need to change one of these three things if accomodation is met

Answer 36

amplitude frequency duration

Question 37

Negative electrode and attracts positive ions and repels negative ions

Answer 37

Cathode

Question 38

Positive electrode and attracts negative ions and repels positive ions

Answer 38

Anode

Question 39

When electrodes are farther apart current goes

Answer 39

deeper

Question 40

When electrodes are closer together current is more

Answer 40

superficial

Question 41

Contraindications

Answer 41

``` Cardiac pacemaker unstable arrhythmia over carotid sinus implanted electronic device over venoous/arterio thrombosis pregnancy ```

Question 42

Precautions

Answer 42

``` cardiac disease impaired sensation or mentation Malignancy skin irritation/open wound in area where muscle contraction could disrupt surgical repair ```

Question 43

Adverse effects (3):

Answer 43

Burns Skin irritation Pain

Question 44

Decrease pain by

Answer 44

using larger electrodes increasing intensity very slowly using shorter pulse durations

Question 45

Application:

Answer 45

``` turn machine on ensure intensity is off inspect wires place electrodes set parameters inform pt ```

Question 46

Ending tx

Answer 46

``` turn intensity to 0 remove electrodes turn machine of inspect area document ```

Question 47

Do not do this during ttx

Answer 47

plug or unplug machine | turn machine on or off while electrodes are on pt

Question 48

Document

Answer 48

area of the body pt position parameters duration pt response - skin inspection, decreased pain, etc Activities performed with stim if applicale

Question 49

Neuromuscular Electrical Stimulation is the application of electrical current to motor nerves to cause contractions of the muscles they innervate. Must have intact and functioning

Answer 49

peripheral nervous system

Question 50

NMES stimulated contractions can (5) things

Answer 50

``` strengthen muscle improve cardiovascular health retard or prevent muscle atrophy reduce spasticity restore function ```

Question 51

NMES recruit

Answer 51

type II muscle fibers before type I

Question 52

Parameters for NMES

Answer 52

Russian protocol or pulsed biphasic waveform normally used Electrode placement: one over motor pt of muscle and one on muscle aligned parallel to muscle fiber direction. Apply electrodes at least 2 inches apart Patient positioning

Question 53

Parameters for NMES pulse durations:

Answer 53

150-350 microseconds 150-200 ms for smaller muscles 200-350 ms for larger muscles

Question 54

Parameters for NMES Freq. & on:off time

Answer 54

35-50 pps 50-80 pps may increase strength but also increases fatigue on:off 1:5 initial with on time 6-10 seconds

Question 55

To reduce muscle spasm or to pump out edema 1:1 woth both on and off times of

Answer 55

2-5 seconds