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DPT 608 > High Voltage Pulsed Current (HVPC) > Flashcards

High Voltage Pulsed Current (HVPC) Flashcards

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1
Q

What is HVPC?

A

Twin peaked monophasic pulsed current with voltage up to 500 volts and very short pulse duration resulting in current with a relatively low average current yet high peak voltage

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2
Q

What is a characteristic of many HVPC devices?

A

A large dispersive electrode

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3
Q

What is the waveform of HVPC?

A

Twin peaked monophasic pulsed current

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4
Q

T/f: with HVPC, one electrode will accumulate negative charge (cathode) and the other will accumulate positive charge (anode)

A

True

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5
Q

Where do the electrodes go with HVPC?

A

One electrode is placed over the treatment area (active/treatment electrode) and one electrode is placed away from the treatment area (dispersive/reference electrode)

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6
Q

HVPC devices allow selection of _____ of the active electrode, and the dispersive electrode becomes the other ______

A

Polarity, polarity

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7
Q

The active electrode is _____and the dispersive electrode is _____

A

Small, large

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8
Q

What is the amplitude of HVPC?

A

Peak voltage reaching 150-500V

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9
Q

What is the pulse duration of HVPC?

A

Short
50-150usec
Instantaneous rise time, immediate exponential fall time

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10
Q
A
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11
Q

Is the interpulse interval for HVPC long or short?

A

Long

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12
Q

The short pulse duration and long interpulse interval of HVPC results in what?

A

Relatively low intrinsic duty cycle

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13
Q

Why is the long interpulse interval important in HVPC?

A

Bc it allows for the use of high peak voltages and overall low average treatment current

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14
Q

T/f: the higher voltage allows deeper penetration of energy in HVPC

A

True

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15
Q

The short phase duration in HVPC doesn’t allow for stimulation of what fibers?

A

A-delta and C fibers

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16
Q

T/f: bc the short phase duration of HVPC doesn’t allow for stimulation of A-delta and c-fibers, it tends to be more comfortable

A

True

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17
Q

What is the frequency of HVPC?

A

1-120 Hz

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18
Q

What are the modes of HVPC?

A

Continuous, reciprocating, and surge

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19
Q

What is continuous mode HVPC?

A

Continuous and uninterrupted flow of pulsatile current for the entire treatment session with no on/off time
Amplitude of each pulse is constant

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20
Q

What is reciprocating mode HVPC?

A

A mode that delivers current first to one of the active electrodes then to the other active electrode in an alternating/reciprocating manner

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21
Q

How many active electrodes are needed for reciprocating HVPC?

A

2 active electrodes

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22
Q

Can you select the time that the current flows for each electrode b4 switching with reciprocating HVPC?

A

Yes

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23
Q

T/f: the amplitude of each pulse is constant unless the clinician adjusts it in reciprocating HVPC

A

True

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24
Q

What is balancing in HVPC?

A

When the clinician adjusts the amplitude of each pulse in reciprocating HVCP??? (I don’t really know)

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25
What is the point of balancing with reciprocating HVPC?
It allows the peak intensity of the current to the active electrodes to be decreased by a selected % to accommodate for sensitive placement sites
26
What is surge HVPC?
Modulating the amplitude of the pulse train so that the amplitude of each successive pulse progressively increases to peak over the duration of pulse
27
T/f: surge HVPC is similar to ramp features
True
28
T/f: HVPC has significant electrophoretic effects
False, the electrophoretic effects of HVPC are negligible
29
Can ionto be performed with HVPC?
No
30
Describe the electrophoretic effects of HVPC
The net flow of ions across the membrane is minimal due to short phase duration and long interpulse interval The membrane can neutralize any change in normal ion status
31
Can HVPC be used with appendage submersion (in water)?
Yes
32
What are the clinical uses of HVPC?
Pain modulation Activation of skeletal muscle Edema reduction Tissue healing
33
How is HVPC used for pain modulation?
High frequency/sensory intensity provides electro-analgesia By modifying the frequency and intensity of the HVPC it can yield a waveform similar to sensory/conventional TENS OR motor/AL TENS low frequency/motor intensity
34
35
How can HVPC be used for activation of skeletal muscle?
Short phase/pulse duration requires high intensity stimulus perceived as painful for the pt
36
T/f: other waveforms than HVPC are more suitable and effective for muscle re-education like Russian and biphasic
True
37
What is edema?
Abnormal accumulation of interstitial fluid causing impairments, pain, and dysfunction
38
T/f: if we can decrease edema we can increase functioning
True
39
What is arthrogenic muscle inhibition (AMI)?
When muscles are inhibited from use following trauma/edema
40
If we let edema continue on, what happens?
The protein content increases more and the tissue thickens and can even become fibrotic
41
What 3 things can lead to edema?
Damage to vascular structures Decreased muscle activity Limb dependency
42
What are the 2 approaches to edema management with HVPC?
Use of polarity Use of muscle pumping
43
The decision to use polarity or muscle pumping for edema management with HVPC is dependent upon what things?
The stage of injury and ability to generate a voluntary contraction
44
How does use of polarity reduce edema with HVPC?
HVPC minimizes the leakage of plasma proteins and thus edema formation by limiting vascular permeability and repelling large negative charged plasma proteins from the interstitial spaces through the placement of a negatively charged electrode (cathode) over the site of injury
45
How do we use muscle pumping to reduce edema with HVPC?
HVPC can decrease edema by increasing the rate of plasma protein uptake of accumulated fluids through the lymphatic system using muscle contractions
46
An acute onset of edema occurs within how many hours?
24-72 hours
47
What waveform of HVPC is used to reduce acute edema?
HVPC sensory level stimulation
48
What is the polarity used with HVPC to reduce acute edema?
Negative
49
What is the frequency of HVPC used to reduce acute edema?
100-125 pps
50
What is the pulse duration of HVPC used to reduce acute edema?
100usec (preset by the unit)
51
What is the amplitude of HVPC used to reduce acute edema?
mA to comfortable sensory perception (~10% below motor threshold)
52
What is the treatment duration of HVPC used to reduce acute edema?
4-30 min applications, continuous applications of 3-4 hours is more effective
53
What is the electrode configuration of HVPC used to reduce acute edema?
Monopolar electrode configuration Bifurcated, smaller active electrodes over the treatment area Larger dispersive electrode proximal to the treatment area
54
What is the typical ankle electrode placement for acute edema reduction using HVPC?
Two smaller active bifurcated electrodes on either side of the ankle Larger dispersive electrode over the GS
55
What are the supplemental modalities we can use with acute edema reduction with HVPC?
Ice pack Ice bath Compression pump Muscle pumping Elevation
56
T/f: there is limited evidence for the use of HVPC for subacute/chronic edema reduction
True
57
What is theory behind using HVPC for subacute/chronic edema reduction?
Management is focused on clearing the swelling with NMES to create repetitive contractions of muscles to compress venous and lymphatic vessels to help reduce swelling while increasing venous and lymphatic return Improve circulation by stimulating lymphatic flow
58
What is the waveform used to reduce subacute/chronic edema using HVPC?
NMES, HVPC could be used but biphasic pulsed current or burst modulated AC (Russian) is more commonly used
59
What is the frequency used with HVPC for subacute/chronic edema reduction?
35-80 pps
60
What is the pulse duration used with HVPC for subacute/chronic edema reduction?
100-600 usec if PC used
61
What is the amplitude used with HVPC for subacute/chronic edema reduction?
Motor, mA to tetanic contractions
62
What is the duty cycle used with HVPC for subacute/chronic edema reduction?
1:1 5-10” on, 5-10” off
63
What is the treatment duration used with HVPC for subacute/chronic edema reduction?
10-20 min
64
What is electrode placement used with HVPC for subacute/chronic edema reduction?
One electrode/channel on agonist muscle One electrode/channel on antagonist muscle OR Over muscles located in the area of edema
65
What is the goal of the electrode placement used with HVPC for subacute/chronic edema reduction?
Reciprocal contractions for muscle pumping action
66
T/f: HVPC for tissue healing is well supported in peer reviewed literature
True
67
The benefit of HVPC for tissue healing is greatest when?
With chronic, recalcitrant stage 3-4 ulcers
68
How does HVPC promote tissue healing? (Long ass list)
Accelerated healing of pressure wounds Reduced edema Improved blood flow Increased protein and DNA synthesis in human fibroblasts Increased tensile strength Antibacterial effect Enhanced migration of cells Increased receptor sites for certain growth factors Improved organization for collagen tissue Increased wound contraction rate and fibroblast response
69
Is most bacteria positively or negatively charged?
Negatively charged
70
What is the waveform used in HVPC for tissue healing?
HVPC monophasic twin peaked
71
What is the frequency used in HVPC for tissue healing?
(-) 50Hz (+) 80Hz
72
What is the pulse duration used in HVPC for tissue healing?
2-100usec (fixed)
73
What is the amplitude used in HVPC for tissue healing?
100-150 V Sub threshold muscle contraction
74
What is the treatment duration used in HVPC for tissue healing?
30-60 min 2-3x/day
75
What polarity do we use for clean wounds?
Positive polarity
76
What is the effect of using positive polarity with HVPC for wound healing of clean wounds?
It facilitates cellular migration
77
What polarity do we use for HVPC for tissue healing of infected wounds?
Start with negative then use positive
78
Why do we start with negative and then use positive polarity with HVPC for wound healing of infected wounds?
The negative polarity will create an alkaline reaction to inhibit bacterial growth and increase blood flow Then the positive polarity will create cell proliferation and promote migration of cells towards the center of the wound
79
When do we use switching polarities in HVPC for wound healing?
After reaching the healing plateau to reactivate the healing process
80
What is the electrode placement used with HVPC for tissue healing?
Monopolar setup with the active a electrode in/on either side of the wound
81
T/f: we often use custom made electrodes (aluminum foil) and saline soaked gauze to conform or fit inside wounds with HVPC for wound healing
True
82
What infection protocols are important to use for infection control in HVPC for wound healing?
Universal precautions

DPT 608 (20 decks)

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