estim and pain

Question 1

Whats TENS voltage, carrying frequency and intensity

Answer 1

all low

Question 2

Whats IFC voltage, carrying frequency and intensity

Answer 2

low
medium
medium

Question 3

Whats HVPC voltage, carrying frequency and intensity

Answer 3

high
low
high peak but low average

Question 4

is HVPC biphasic

Answer 4

no, monophasic

Question 5

Physiological rationale for EPA’s

Answer 5

segmental mechanisms
extrasegmental mechanisms
Placebo

Question 6

segmental mechanisms

Answer 6

ascending

GATING

Question 7

gating

Answer 7

the gate control theory

inhibition of T cells by activating AB, Adelta or c fibres

Question 8

hows gating best achieved

Answer 8

high frequency, low intensity

TENS

Question 9

weaknesses of segmental mechanisms

Answer 9

doesn’t account for pain in small diameter nerve fibres being destroyed

doesn’t consider role of higher centres in pain perception

Question 10

extrasegmental mechanisms

Answer 10

descending

Stim of A-delta may provoke impulses at midbrain down SC to inhibit nociceptors

Question 11

A delta sim releases ____ to inhibit _____ activity similar to _____

Answer 11

enkephalins
C fibers
morphine like

Question 12

motor level of stem releases ____

Answer 12

dynorphins

Question 13

extra segmental effects best evoked by

Answer 13

low frequency
high intensity
(AL TENS)

over motor points with intensity /pulse duration enough for mm twitch

Question 14

TENS activates __ and ___ receptors

Answer 14

opioid

serotonin

Question 15

does high or low frequency TENS impact serotonin

Answer 15

no , low is just as good as high

Question 16

how to treat persistent pain

Answer 16

exercise
manual Rx
education
self management 
EPA

Question 17

why can EPA help with pain

Answer 17

pt gets positive experience with movement in less pain to normalize it

Question 18

5 reasons estim/TENS is used clinically

Answer 18

relatively safe
evidence support physiological benefits
easy
PART of a treatment plan

Question 19

4 contraindications for TENS

Answer 19

impaired cog/comm
recent fracture/osteop
seizure/epilepsy
electronic implant

Question 20

HVPC TENS shared contraindications

Answer 20

recent fract / osteoporosis

impaired cog//comm

Question 21

should you use ice and stim

Answer 21

NEVVER

Question 22

adverse effects of stim

Answer 22

skin irrational (red)
skin burns

Question 23

reasons to change TENS settings

Answer 23

some work better in better areas of body

sensation can change

Question 24

if two different size electrodes where the greater current intensity

Answer 24

under the smaller one

Question 25

why is gel good

Answer 25

electrode specific and has higher salt

Question 26

CONVENTIONAL TENS settings

Answer 26

80-150 HZ 60 micro comfortable tingle, modulated

Question 27

AL TENS settings

Answer 27

10Hz 200 microsexs intensity to mm twitch at motor points modulated

Question 28

should you apply TENS daily

Answer 28

no, theres an opiod tolerance

Question 29

outcome tests of TENS

Answer 29

VAS NPRS pain thermometer disease specific scales

Question 30

other outcome measures for TENS

Answer 30

pain relief distraction from pain dec feeling mm tension/spasm

Question 31

indirect benefits of TENS

Answer 31

med reduced enhanced function psych benefits ability to rest

Question 32

5 things to chart with stim

Answer 32

``` that you covered contraindications/prec sensation test parameters response changes of treatment ```

Question 33

t/f TENS inhibits cortical actives of various pain related areas

Answer 33

t

Question 34

is setting intensity to patients by saying let it be strong but comfortable reliable

Answer 34

no

Question 35

what mode of tens helps immediate pain

Answer 35

conventional

Question 36

which TENS reduces pain more than ice

Answer 36

AL Tens

Question 37

which TENS helps reduce long term pain

Answer 37

burst