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Flashcards in Electrotherapeutic Concepts Deck (56):
1

Describe direct current

continuous or uninterrupted unidirectional flow of charged particles; direction determined by polarity chosen; no reversal of current

2

Iontophoresis is an example of _______ current.

direct

3

Describe alternating current

continuous or uninterruted bi-directional flow of charged particles; alternating polarity of electrodes; no net chemical run; expressed in HZ or cycles/second

4

Interferential, premodulated, and Russian protocol stimulation are examples of ________ current.

alternating

5

Describe pulsed current

can be DC or biphasic - bi-directional movement of charged particles that periodically ceases or is interrupted for a period of time

6

What is the most common current used in electrotherapy?

pulsed current

7

Unidirectional pulsed current is also known as

interrupted DC

8

Bi-directional pulsed current is also known as

interrupted biphasic

9

What is pulse cycle duration?

time of one pulse current

10

High Volt is a form of what kind of current?

monophasic pulsed current (appears as spike)

11

What are some clinical uses of NMES (neuromuscular electrical stimulation)?

increasing muscle contractility/strength, reducing muscle spasticity

12

What are some clinical uses of TENS (transcutaneous electrical nerve stimulation)?

pain suppression

13

NMES is used on _____ peripheral nerves.

intact

14

EMS, electrical muscle stimulation, is used on _____ peripheral nerves.

de-innervated

15

ESTR, electrical stimulation for tissue repair, is often used for

tissue repair

16

What type of e-stim applications are useful for tissue repair?

ESTR, HVPC, NMES

17

E-stim absolute contraindications (10)

1. Implanted electrical pacing devices (cardiac demand pacemaker, bladder stimulator)
2. over pregnant uterus
3. over superficial metal implants
4. when active motion is contraindicated - if stimulating for a muscle contraction (acute fracture)
5. active bleeding in area being stimulated
6. directly over malignancies
7. phlebitis / circulation
8. severely impaired sensation
9. over transthoracic or anterior cervical area
10. placement of electrodes over carotid sinus

18

E-stim precautions (5)

1. open wounds or broken skin in treatment area
2. extreme edema
3. unreliable patients
4. cardiac disease
5. Malignant tumors

19

E-stim adverse effects (3)

1. skin irritation or thermal; burns under electrodes
2. allergy to gel, adhesive backing on electrodes, tape
3. allergic reactions to medications used for iontophoresis
pain

20

_____ allows for more comfortable contraction, slowly rising up/down current intensity.

Ramp

21

Describe the use of ratios in the parameters of electrotherapy.

1:1 - fatigues quickly (e.g. 6 sec on /6 sec off)
1:3 - common (e.g. 6 sec on/18 sec off)
1:5 - early phase rehab often (e.g.6 sec on / 30 sec off)

22

Synchronous stimulation of 2 channels:

both channels on and off at same time

23

Reciprocal stimulation of 2 channels:

alternate stimulation between channels

24

current density =

ratio of maximum current amplitude to electrode stimulation surface
(expressed in mA/cm2)

25

________: small active electrode over motor point, a larger dispersive electrode

Monopolar technique
(common in DC current application such as iontophoresis and in HVPC stimulation)

26

________: two electrodes of same size

Bipolar technique
(common in biphasic PC applications but can use monopolar technique for small muscles or muscle groups)

27

________: 4 electrodes that can be parallel or crisscrossed

qaudripolar technique

28

Electrode placement consideration:

- over motor points for stimulation of muscles for contraction
- over areas of pain, along dermatomes , referral patterns for electroanalgesia, transarthrally (across a joint)

29

distance between electrodes affects depth of penetration such that closer =

more superficial penetration

30

What is the minimum distance between electrodes

2 inches (5 cm)

31

Orientation of the electrodes?

usually want parallel to muscle being stimulated

32

muscular (motor) stimulation: may be __-__ minutes dependent on fatigue level and goals of treatment (strength vs. endurance)

5-20 minutes

33

Amplitude (intensity) is the amount of current applied and is dependent on

dependent on goals; often limited by patient tolerance

34

For motor stimulation, one electrode is placed on ______ and the other is placed elsewhere on the muscle so that the current flows _____ to the muscle fibers.

motor point (generally middle of muscle belly)
current flows parallel

35

Indications for electroanalgesia?

1. acute/chronic pain syndromes (musculoskel, neurological pain)
2. post-operative pain
3. labor and delivery pain
4. prior to painful procedures

36

motor-level TENS mechanism of action?

release of endogenous opiates (endorphins and enkephalins)
stimulates small un-myelinated A delta and C fibers plus motor efferents to stimulate muscles rhythmically

37

Electroanalgesia contraindications (8):

1. pacemakers/stimulating devices
2. eyes
3. carotid sinus
4. over chest in presence of cardiac dysfxn
5. with seizure disorders, avoid head/neck
6. cognitive impairment
7. over open wounds or compromised skin
8. over areas where mvmnt is contraindicated if using a mode that requires visible contractions

38

Sensory-level mode TENS synonyms:

high rate
conventional

39

Motor-level mode TENS synonyms:

low rate
acupuncture-like

40

Sensory-level mode TENS goal:

stimulates large A sensory (myelinated) afferents to "block" pain input

41

Sensory-level mode parameters:

50-200 pps (usually 150-200)
20-100 microsec

42

Sensory-level mode most appropriate for:

acute superficial musculoskeletal conditions (can be used for chronic conditions bc it is so well tolerated)

43

Sensory-level mode effect:

analgesia only while unit is on (not long carry over)

44

Quadipolar technique is uniquely used for:

biphasic NMES and IFC

45

Interferential current is unique for:

beat frequency and vector scanning

46

Motor-level mode is appropriate for:

deep, aching pain, chronic pain

47

Motor-level modes goal:

1. produce visible muscle contraction with 2-10pps frequency (do NOT want tetanic contraction)
should not be uncomfortable
2. high pulse duration (100-200 microsec)

48

___________ create bursts of pulses at low repetitions (2 bursts per second)

burst modulated PC

49

describe IFC (interferential current):

medium frequency current; specialized units which use sinusoidal polyphasic AC waveforms

50

Describe quadripolar electrode technique:

4 crossed electrodes that create an interference in current

51

describe Bipolar technique:

2 electrodes on one channel - the interference type current is generated in the machine (known as pre-modulated Interferential current)

52

describe quadripolar with vector scan:

amplitude of current is varied which increases the field – can only be done with the quadripolar technique; current is felt to move among and between the electrodes

53

What are the 2 types of beat frequency?

variable (sweep) and constant

54

describe variable (sweep) beat frequency:

varies within a range (e.g. 1-15 bps, 80-150 bps)

55

describe constant beat frequency:

set at one unchanging beat frequency

56

What size area is pre-modulated indicated for?

smaller areas