E-Stim Basics & Pain Managment

Question 1

To have current there must be these 3 things

Answer 1

source, conductor, and driving force of electrons

Question 2

Define current

Answer 2

net movement of charged particles along conductor

Question 3

Define electromotive force

Answer 3

amount of electric potential in an electric field that drives charged particles

Question 4

Low voltage is?

Answer 4

<150V

Question 5

High voltage is?

Answer 5

> 500V

Question 6

Define inductance

Answer 6

opposition to electric flow created by eddy currents when current passes through a wire

Question 7

Define Capacitance

Answer 7

ability of a material to store electrical charge

Question 8

Define Impedance

Answer 8

resistance+inductance+capacitance

Question 9

Define Conductors

Answer 9

materials that offer little resistance

Question 10

Define Resistors

Answer 10

materials that offer high resistance

Question 11

Semiconductors

Answer 11

materials that offer neither low nor high resistance to current

Question 12

Define Power

Answer 12

WATTS

Volts x Amps

Question 13

Energy created by water flow depends on?

Answer 13

gallons/minute

pressure of the pipes

Question 14

Ohm’s Law

Answer 14

V=IR

if we increase resistance we must increase voltage to move current

Question 15

Define Parallel

Answer 15

when current flows through a circuit with multiple pathway to follow

Question 16

Define series

Answer 16

when current flows through every resistor

Question 17

List the 3 type of DC current

Answer 17

Continuous
Reversed DC current
Interrupted DC current

Question 18

Define Continuous DC current

Answer 18

unidirectional flow of electrical charge for at least 1s

Question 19

Define Reversed DC current

Answer 19

unidirectional flow of electrical charge for at least 1s and then changes polarity

Question 20

Define Interrupted DC current

Answer 20

unidirectional flow of electrical charge for at least 1s then stops for 1s then resumes

Question 21

Define AC current

Answer 21

a continuous bidirectional flow of electrical charge where each cycle lasts less than 1s

equal ion flow in each direction=no net charge

1cycle=1wavelength, wavelength inversely proportional to frequency

Question 22

DC current is generally for?

Answer 22

Iontophoresis, Wound healing, Stimulating denervated nerves

Question 23

AC current is generally for?

Answer 23

mm retraining, mm strengthening, pain modulation, functional training ie gait

Question 24

Define pulsed current

Answer 24

Monophasic or Biphasic

Question 25

Define the different types of Biphasic pulsed currents

Answer 25

symmetrical or asymmetrical asymmetrical is either balanced or unbalanced

Question 26

4 ways to describe WAVEFORMS

Answer 26

Number of phases symmetry balance shape of waveform

Question 27

4 ways to describe Amplitude

Answer 27

peak amp- max current reached for a single phase peak to peak- max current reached from 1st phase to 2nd phase RMS amp- for sine wave RMS, 0.707 of peak, 0.354 of peak to peak average amp- mean volt under sine wave

Question 28

8 ways to describe Time of current

Answer 28

Phase duration- beg of phase to end of phase Pulse duration- beg of pulse to end of pulse Rise time- beg of phase to peak of phase Decay time- peak of phase to end of phase Interpulse duration- end of pulse to beg of next pulse Intrapulse duration- end of phase to beg of next phase Period- time it takes to complete one pulse Frequency- 1/period

Question 29

4 ways to modify current

Answer 29

amp mods pulse duration mods frequency mods ramp mods

Question 30

Timing mods (Burst)

Answer 30

Burst duration Interburst interval Burst frequency

Question 31

Size of electrodes

Answer 31

smaller electrodes=denser

Question 32

Placement of electrodes

Answer 32

closer to each other=more superficial density | farther from each other=more deeper density

Question 33

Tap key electrode

Answer 33

to identify motor points | stimulate small muscles

Question 34

Define IFC

Answer 34

interferential currents of medium frequency (1,000-10,000) unmodulated sinusoidal waves that cross

Question 35

Define beat frequency

Answer 35

net of 2 different carrier frequencies

Question 36

Define constructive IFC

Answer 36

originate at same time and summate

Question 37

Define destructive IFC

Answer 37

originate at different time and cancel out

Question 38

Define heterodyne

Answer 38

blending of waves constituting and destructively

Question 39

Define constant bipolar

Answer 39

both carriers are fixed

Question 40

Define quadripolar

Answer 40

one is fixed other has varied frequency=sweep frequency to minimize accommodation

Question 41

Define scanning quad vector

Answer 41

move entire petal of stim to cover more treatment area

Question 42

Define stereodynamic

Answer 42

3 distinct circuits that blend and create a distinct wave

Question 43

Define High Volt Pulsed current

Answer 43

twin peak monophasic pulsed current that rises instantly and declines exponentially

Question 44

What is the typical pulse duration and frequency of HVPC

Answer 44

pulse duration=100-200 | frequency=1-200pps

Question 45

Strength duration curve relationship between voltage and pulse duration

Answer 45

increase volt, decreased pulse duration

Question 46

Tissue impedance and HVPC

Answer 46

HVPC=low capacitance=low impedance=more comfortable

Question 47

Typical Parameters of Russian Currents

Answer 47

``` frequency=2,500 burst duration=10ms interburst interval=10ms burst frequency=50/s On:Off=10/50 Duty cycle start from 100% and move down with pt. comfort ```

Question 48

Russian currents characteristics

Answer 48

painless involuntary contraction training increase current amp for deeper motor neurons can painlessly stim larger pools of type II motor units for voluntary max mm. force

Question 49

Strength-duration curve between amp, pulse duration, and motor/sensory neurons

Answer 49

low current amp, low pulse duration to stim A Beta, A delta high current amp, high pulse duration to stim A Alpha, A gamma higher yet current, longer pulse duration to stim pain transmitting C-fibers

Question 50

Define Rheobase

Answer 50

minimal current (with long pulse duration) needed to AP

Question 51

Define Chronxaie

Answer 51

minimal duration to stimulate tissue at 2x of rheobase

Question 52

Current and pulse duration controlling superficial and deep fibers in mixed nerves

Answer 52

current and pulse duration just enough to reach threshold large superficial fibers medium superficial fibers, large deeper fibers small superficial fibers, medium deeper fibers

Question 53

TENS Conventional

Answer 53

high frequency, low pulse duration, lower current just enough to feel tingling only when unit is on, can be effective 24 hours 100-150pps 50-80 microseconds

Question 54

Low rate TENS

Answer 54

low frequency, high pulse duration, higher current just enough to feel muscle contraction effective for 4-4/12 hours, after 20 minutes 2-10pps 100-200 microseconds

Question 55

Noxious TENS

Answer 55

can use high or low frequency opiod,seratonin,muscarinic mediated 5pps or 80 pps up to 1,000 microseconds or 1s amp: 2x motor threshold

Question 56

IFC parameters for pain management

Answer 56

to stim sensory 50-120pps to stim motor 30-50pps 1pps to acustim pain relief

Question 57

IFC Indications

Answer 57

pain of known origin | muscle relaxation to increase blood flow and decrease edema

Question 58

IFC effect

Answer 58

inc pain threshold mm contraction mm pump

Question 59

Burst TENS parameters

Answer 59

10pps | 200-300 microseconds

Question 60

HVPC parameters for pain management

Answer 60

to stim sensory 80-120pps to stim motor 30-60microseconds 2-4 for motorpain