Exam III Flashcards
(29 cards)
What is the use of sensory-level stimulation for edema control?
animal studies showed retarded edema formation if applied early
use (-) electrode over area with high frequency and low intensity
bull frog studies showed it prevented edema but didn’t decrease existing edema
usually used post-treatment
What is the use of motor-level stimulation for edema control?
most common
rhythmical muscle contractions to reduce existing edema
minimal contraction
possible to increase venous return
What is the use of sensory-level stimulation for increasing circulation?
low frequency to increase skin blood flow
won’t affect diseased blood vessels
What is the use of motor-level stimulation for increasing circulation?
rhythmic muscle contraction to increase deeper arterial blood flow
(won’t affect diseased blood vessels)
What are the common current types used to facilitate wound healing?
low-intensity direct current (LIDC)
high voltage pulsed current (HVPC)
What is the history of electrical stimulation for wound healing?
LIDC was moved to HVPC
1950s the first studies were done, big increase in 80-90s
started out with studying bunnies, now lots of research on humans
What are the effects or possible mechanisms of action for wound healing?
galvanotaxis (mvt of cells to oppositely charged poles)
promotion of granulation tissue
autolysis and phagocytosis (gobbling of bad tissue)
bactericidal effects (-) electrode
enhancing rate of epithelialization (need to fill with granulation first)
enhancing blood flow to wounds (-) or (+) electrodes
What was the clinical application for electrical stimulation for wound healing?
HVPC stimulator 200 volts (sub-motor or sensory) 100 pps 1 hour per day for 20 consecutive days polarity based on desired effects
How is electrical stimulation for osteogenesis?
not done by PT different types (both implanted, one implanted one outside, both external) negative polarity is used
What are the general effects of direct current under the cathode (-)?
alkaline reaction (d/t increased blow flow) protein liquefaction (sclerolytic) antibacterial effects wound healing depolarization (if interrupted)
What are the general effects of direct current under the anode (+)?
acid reaction (weaker than alkaline) protein coagulation (sclerotic) antibacterial effects (some) wound healing hyperpolarization (anode block)
What are the stimulation parameters for direct current?
current: direct or galvanic
intensity: less than or equal to 5 mA (less than one is microcurrent)
duration: minutes to hours (just on, no pulses)
dosage: intensity and duration= mA*mins
frequency: 0 (no pulses)
electrodes: special types for wound treatment and iontophoresis
What are the clinical applications for direct current?
medical galvanism
galvanic bath/tap water galvanism
iontophoresis
What are the stimulation parameters for medical galvanism?
vary depending on application and indication
What are the indications for medical galvanism?
pain control
ESTR (wound healing without motor response)
What are the stimulation parameters for a galvanic bath?
15 minutes of (-) and 15 minutes of (+)
12 mA
(alter between polarities)
What is the indication for a galvanic bath?
hyperhidrosis
excessive sweating of palms and feet
What is the most common form of direct current?
iontophoresis
What is the description of iontophoresis?
use of electrical current to deliver medicinal solutions transcutaneously
meds must be water and lipid soluble and muse ionize to form charged particle solution
What are the mechanisms of action for iontophoresis?
electromigration: ions are repulsed and driven into skin by similar charged electrodes
electroporation: increase in porosity of skin to facilitate movement of ions
electro-osmosis: movement of fluid caused by electrical field acting on ions in the fluid, bulk flow of fluids may carry drugs through hair follicles and sweat glands (an attempt to explain opposite charged medicine being driven)
What are the application and selection of ions for iontophoresis?
anti-inflammatory effects: dexamethasone
anesthetic effects: lidocaine or any of the “caines”
other: acetic acid and iodine
What is the electrode selection for iontophoresis?
standard (portable DC units)
patch (DC battery is built into electrode, can be used for longer treatments but doesn’t have much research for support)
What is the electrode placement for iontophoresis?
active over target
inactive over meaty area
cathode for tissue damage
What is the dosage for iontophoresis?
current * duration= mA * mins
20-80 mAmins
effective dosage: 70-80 mAmins
