Physics Test Tuesday March 20th Flashcards Preview

Physics SUM Second Semester > Physics Test Tuesday March 20th > Flashcards

Flashcards in Physics Test Tuesday March 20th Deck (44):
1

Electrotherapy

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the use of electric currents passed through the body to stimulate nerves and muscles, chiefly in the treatment of various forms of paralysis. (Google)

is a branch of the physical treatment, in which direct current and pulsed currents of low and medium frequencies are used for medicinal purposes. (slides)

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Electrotherapy Tests

  • (TENS) Transcutaneous electrical nerve stimulation
  • (HVPC) High Voltage Pulsed Current
  • Diadynamic Currents
  • Interference Current
  • (NMES) Neuromuscular Electrical Stimulation
  • Electrical Stimulation of Denervated Muscle

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(TENS) Transcutaneous electrical nerve stimulation

-Transcutaneous electrical nerve stimulation is the use of electric current produced by a device to stimulate the nerves for therapeutic purposes. (Google)

-The application of electrical stimulation to the skin via surface electrodes to stimulate nerve fibers primarily for pain relief. (slides)

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Types of TENS

  • conventional TENS
  • acupuncture like TENS
  • burst train TENS
  • brief-intense TENS

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Conventional TENS

(High Frequency, Low Intensity)

  • most commonly used mode of electrostimulation
  • combination of parameters stimulates A beta afferents

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Convetional TENS Effects

  • When A Beta fibers are stimulated, the conventional TENS mode achieves analgesia, primarily by spinal segmental mechanisms
    • ​Analgesia tends to be relatively short, lasting up to a few hours post-treatment
      • Analgesia is the inability to feel pain.

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Conventional TENS Modes

  • low intensity
  • high frequency, over 100 Hz
  • pulse duration is usually short, (50-80µs)

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Acupuncture like TENS

(Low Frequency, High Intensity)

  • Primarily stimulates A delta and C nociceptive fibers and small motor fibers
  • Electrodes should be positioned to produce visible muscle contrations, over a myotome related to the painful area

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Acupuncture Like TENS Modes

  • Low frequency, (1-4 Hz)
  • High Intensity, (enough to produce visible muscle contractions)
  • long pulse duration, (200µs)

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Acupuncture like TENS Effects

  • patient will experience paraesthesia and muscle contrations with this mode
  • the analgesia lasts longer than with conventional TENS
  • paraesthesia is an abnormal sensation, typically tingling or pricking (‘pins and needles’), caused chiefly by pressure on or damage to peripheral nerves.

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Burst Train TENS

(High Frequency trains of pulses delivered at Low Frequency)

  • this is a mixture of conventional and acupuncture like TENS, and comprises a baseline low frequency current together with high frequency trains
  • Patients must tolerate the stimulus intensity required to produce the desired strong muscle twitches, which are much better than single impulses
  • This type was developed by Eriksson and Sjolund in 1976 as a result of their experiences with chinese electroacupuncture

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Burst Train TENS Modes

  • Low frequency of trains(1-4 Hz)
  • High Internal Frequency of Trains(100 Hz)
  • pulse duration(100-200 µs)

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Brief-Intense TENS

(High Frequency, Long Pulse Duration)

  • this mode can be used for painful procedures such as skin debridement, suture removal, etc.

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Brief-Intense TENS Modes

  • High Frequency(100-150 Hz)
  • Long duration pulse(150-250 µs)

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(Not important)

Postions of Electrode Placement

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TENS Indications

TENS is useful for:

TENS is useful for:

  • Pain relief after amputation
  • Nerve pain after shingles
  • phantom pain
  • peripheral neuropathies caused by metabolic disorders
  • pain-related cause of CNS damage

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(HVPC) High Voltage Pulsed Current

Parameters

  • very short phase durations, (5-6 µs)
  • very high peakcurrent amplitude (2000-2500 mA)
  • a high-driving voltage(up to 500V)
  • The total current delivered to tissue does not exceed (1.2-1.5 mA)

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(HVPC) High Voltage Pulsed Current

Graph

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(HVPC) High Voltage Pulsed Current

Indications and Advantages

HVPC is particularly useful for:

  • soft tissue wounds, (bedsores, ulcers, burns)
  • Edema
  • Pain conditions, (Ex. Muscle pain, etc.)

Advantages

  • Deeper penetration of tissue
  • risk of pain during application is minimal
  • risk of skin damage is minor

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Diadynamic Currents

(Dia-through)

(Dynamis-Force)

  • Six types of current in which we can distinguish two components: direct current and alternating sinusoidal current
  • first described and used in clinical practice in 1950 by Bernard

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Diadynamic Currents

How are they delivered?

  • These currents are delivered through anode and cathode as:
    • monophasic
      • half-wave pulses
      • full-wave pulses
  • rectified from 50 Hz alternating current
  • Individual pulses have duration of 10 ms

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Diadynamic Currents

Forms

  • MF current
  • DF current
  • CP current
  • LP current
  • RS current
  • MM current

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Diadynamic Currents

(DF) Diphase Fixe

  • DF is the preferred current for pain modulation
  • DF produces a vibrating, prickling sensation which subsides gradually as sensory accomodation occurs in response to the constant amplitude stimulation
  • DF is especially recommended for pain conditions of sympathetic origin

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Diadynamic Currents

(MF) Monophase Fixe

  • MF produces a strong vibratory sensation and much slower sensory accomodation occurs because of the 10 ms delay between successive pulses
  • More suitable to elicit muscle contraction and generally not used for isolated pain conditions

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Diadynamic Currents

(CP) Courtes Periods

  • CP combimes MF and DF currents, so that each one alternates at intervals of 1 second to prevent sensory accomodation
  • CP is usually recommended for the treatment of pain that is associated with sprains, strains, and contustions

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Diadynamics Currents

(LP) Longues Periods

  • LP also combines the MF and DF current modes such that during 5 second periods, MF and DF occur together but out of phase, with DF being amplitude modulated. This is followed by 10 seconds of MF current.
  • LP is recommended for providing longer-lasting pain relief in acute pain conditions

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Diadynamic Currents

(RS) *Russian Stimulation* -not sure

(MM) -not sure

  • RS and MM are generally used for muscle stimulation application

 

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Diadynamic Currents

Graphs Extra

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Diadynamic Currents

Effects/Influence of human body

  • effect of analgesic: (DC, LP, CP)
  • effect of congestion: (LP, CP, MF)
  • muscle relaxation: (DF, LP, CP)
  • muscle tension: (MF)

DF-LP-CP-MF

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Trabert Current - Effects

(Ultra Reiz)

This current has:

  • an analgesic effect
  • a congestive effect
  • Trabert Current causes muscle tremors

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Trabert Current - Parameters & Application

(Ultra Reiz)

Parameters

  • Pulse duration: 2ms
  • Pulse interval: 5ms
  • Frequency: 143 Hz

Application

  • This current is commonly applied in the treatment of spine pain syndromes.

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Kotz' Current

Uses

Kotz' current is used in:

  • muscle atrophy following immobilization
  • for muscle training
  • for muscle stimulation
  • to support strength training or muscle endurance training
  • in order to improve metabolism and reduce muscle tension

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Kotz' Current

Effect and Application

  • this gives the possibilty to set higher amplitude and achieve complete muscle contraction
  • Medium frequency currents penetrate deeper into the tissue due to its partially capacitative nature.
  • Continuous current with an average frequency causes constant muscle contraction. Constant contraction leads to impaired blood circulation and muscle pain. In order to achieve a therapeudic effect, there is need to apply modulation

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Kotz' Current

Parameters and Waveform

  • Kotz' Currents are based on a sin wave wth a frequency of 2.5kHz
  • It is a bipolar current. Carrier frequency is modulated by a rectangular wave with a frequency adjustable in the range from 5Hz to 100Hz
  • Rectangular wave form modulation indicates that the slopes of "packages" are as quick as the filling sin wave

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(NMES) Neuromuscular Electrical Stimulation

Definition and Goal of Treatment

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  • It is the application of electrical current to elicit a muscle contraction: 
    • two waveforms used, asymmetrical biphasic rectangular, and symmetrical biphasic rectangular waveforms
  • Goal of treatment is to elicit a strong muscle contraction through stimulation of the alpha motor nerve

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(NMES) Neuromuscular Electrical Stimulation

Graph Description 

  • The rectangular wave
  • fast-rising leading edge of the pulse
  • flat plateau at peak rapid return to zero at the end

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(NMES) Neuromuscular Electrical Stimulation

Treatment

Neuromuscular electrostimulation is applied for treatment of:

  • disuse athrophy
  • muscle re-education and facilitation
  • spasticity management
  • orthotic substitution
  • and to increase and maintain range of motion

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(NMES) Neuromuscular Electrical Stimulation

Waveforms

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39

Electrical Stimulation of Denervated Muscle

How it works:

  • the electrode configuration is usually monopolar with the active or treatment electrode positioned over the part of the denervated muscle that is the most excitable
  • the inactive electrode is placed over a distant body part.

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Electrical Stimulation of Denervated Muscle

Description of Electrodes

  • size of inactive electrode is very large 
  • size of active electrode is very small (1-2 cm2)
  • the usually used parameters are suggested by Gillert

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Electrical Stimulation of Denervated Muscle

How is Effectiveness determined?

The effectiveness of the electrical stimulation of denervated muscle depends upon many factors:

  • type of current
  • duration of stimulus
  • current amplitude
  • type of contractions
  • length and frequency of therapy sessions

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Interference Current

Definition

  • this is the current of medium frequency
  • it arises as a result of interference of two alternating sinusoidal currents of medium frequency in the tissues, whose frequencies differ a little from each other
  • Currents whose frequency is about 4000Hz is used: for example 3900Hz and 4000Hz or 4000Hz and 4100Hz

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Interference Current

Effect on Tissues

Effect of Modulated Frequency on the Tissues:

  • 0-10 Hz - induces muscle contractions
  • 25-50 Hz - stimulates the muscle to spasm and improves peripheral circulation
  • 50-100 Hz - produces analgesic effect and improves the nutritive processes of tissues
  • 90-100 Hz - causes analgesia and reduces tension of the sympathetic nervous system
  • 0-100 Hz - causes all these effects

>>> Interference is achieved by using 2 independent circuits, using two pairs of electrodes which are placed in such a way that interference occurs deep in the tissues in the area where the disease is located <<<

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Interference Current

Adavantages

  • weaker effects on the sensory receptors of the skin
  • limited electrochemical effects on the tissues
  • better penetration of this current into the tissues