estem

Question 1

what are the indications for e stem?

Answer 1

pain
edema
loss of function
ROM
tissue healing (of skin)
augmentation of blood flow

Question 2

what are the contraindications of stem

Answer 2

*Cardiac arrythmia
*Pacemakers
*Pregnancy
*Menstruation *
Cancer
*Open wounds (except when treating the wound)
*Hardware (exposed)
*Carotid Sinus
*Eplilepsy
*Across spine

Question 3

what are the one indications in the CPG to perform ESTEM because it has grade A level evidence

Answer 3

knee stability and movement coordination impairments: knee ligament sprain revision

6-8 weeks to do muscle strengthening after ACL reconstruction to increase quadriceps.

Question 4

what are the three types of currents?

Answer 4

direct current
alternating current
pulsed current

Question 5

what are the types of direct current E-stem?

Answer 5

conventional DC
reversed DC
Reversed-interruption DC

Question 6

what are the parameters for direct current?

Answer 6

polarity
intensity

Question 7

what are the parameters for E-stem?

Answer 7

Monophasic and biphasic

Question 8

what are the parameters for monophonic?

Answer 8

polarity
frequency
pulse duration
intensity
ramps

Question 9

what are the two types of biphasic currents?

Answer 9

symmetrical and asymmetrical

Question 10

what is are the parameters for asymmetrical biphasic?

Answer 10

balanced and unbalanced

Question 11

what are the parameters for unbalanced alternating currents?

Answer 11

polarity
frequency
intensity

Question 12

Describe what a DC current is?

Answer 12

continuous unidirectional flow of electrons or ions for 1 second. flows between a + and - or - to +.

Question 13

Describe what a interrupted DC current flow looks like?

Answer 13

After flowing in one direction for a sec the current will stop and kick back in to flow for another sec in the same direction.

Question 14

describe a reverse DC current flow?

Answer 14

The current will flow in one direction for a sec and flip to flow int he opposite direction for a sec.

Question 15

describe what a interrupted reversed current will look like?

Answer 15

combination of both interrupted pausing pattern and the flipping of directions seen in reverse flows.

Question 16

From the book:
what is the most common use of DC current in the clinic?

Answer 16

most commonly used for iontophoresis or wound care.

Question 17

How does iontophoresis work?

Answer 17

The process in which ions are transferred through intact skin via electrical potential

Via negatively charged ions being placed under the cathode (-) which are replied or pushed into the tissue away from them negative cathode.

Question 18

what is iontophoresis used for and what are the precautions?

Answer 18

administer aqueous solutions of FDA approved medications prescribed by physician

used as alternative to injections

Precautions: Skin irritation (erythema, pruritis, increased temperature), burns (especially at cathode)

Residual skin break down (long term treatments)

Question 19

What is a AC current and how does the flow of current work?

Answer 19

uninterrupted bidirectional flow off currents.

ions must flow and change directions at least one time per second.

Sinusoidal wave form.

Question 20

from the book: What is the most common use of AC currents clinically?

Answer 20

most commonly modulated AC currents are used in Russian or IFC.

Question 21

AC must change direction at least one time per second. If it does not, then what type of current would it be?

Answer 21

DC

Question 22

what does pulsed currents flow look like?

Answer 22

pulsatile current, is the unior
bidirectional flow of ions or electrons that periodically
ceases for a period of time before the next electrical event.

Question 23

Describe the difference between monophonic and biphasic currents?

Answer 23

monophonic: pulse deviates in one direction from baseline. Pulse phase is followed by a interpulse interval.

Biphasic: current flow switches between directions with a interpulse interval.

Question 24

what are the three things you will primarily modulate?

Answer 24

frequency
phase duration
amplitude and intensity

Question 25

Do you want a short, fat wave, a tall skinny wave, or something in between?

Question 26

Describe the strength duration curve theory?

Question 27

For a A α nerve fiber what is the size/ myleination? what is the diameter? what is the conduction velocity? what receptor does it use? what stimulus does it use?

Answer 27

size/ myleination: large/high diameter: 12-20um conduction velocity: 70-120m/s Receptor: Proprioceptive mechanoreceptor Stimulus: Muscle veocity & length changes, reflex?

Question 28

For a A β nerve fiber what is the size/ myleination? what is the diameter? what is the conduction velocity? what receptor does it use? what stimulus does it use?

Answer 28

size/ myleination: medium/high diameter: 6-12 um conduction velocity: 36-72 m/s Receptor: Proprioceptive mechanoreceptor Stimulus: Muscle length, SENSORY, TOUCH, Hair receptors

Question 29

For a A δ nerve fiber what is the size/ myleination? what is the diameter? what is the conduction velocity? what receptor does it use? what stimulus does it use?

Answer 29

size/ myleination: Smaller/Less diameter: 1-4 μm conduction velocity: 5-15 m/s Receptor: Pain, crude touch, pressure, temperature Stimulus: Thermal change

Question 30

For a C nerve fiber what is the size/ myleination? what is the diameter? what is the conduction velocity? what receptor does it use? what stimulus does it use?

Answer 30

size/ myleination: Smallest/Un-myelinated diameter: 0.1-1 μm conduction velocity: 0.2-2 m/s Receptor:Pain, pressure, touch, SLOW Stimulus: Noxious, mechanicalTemp

Question 31

what are the settings for gate control theory application?

Answer 31

* Target nerve: A Beta * Frequency: 80-150 Hz * Phase Duration: 50-100 μs * Intensity: Strong, sub motor tingle * Pain relief: Gate theory * Duration of effect: As long as current is on

Question 32

what are the levels for motor level pain modulation

Answer 32

Motor Level Pain Modulation (Beta Endorphin) * Target nerve: A Delta (alpha motor too) * Frequency: 1-10 Hz (usually 2-4) * Phase Duration: >150 μs * Intensity: Strong, visible contractions * Pain relief: Beta endorphins * Duration of effect: possibly hours

Question 33

what are the settings for descending pain modulation?

Answer 33

Hyperstimulation Analgesia or Noxious Level Pain Mod) ◦ Target nerve: C Fiber ◦ Frequency: 100-150 Hz OR 2-7pps* ◦ Phase Duration: >1 millisecond ◦ Intensity: As high as tolerable (PAIN!) ◦ Pain relief: Descending serotonergic path Beta Endorphins, Dynorphins ◦ Duration of effect: Several hours