Physics Test Tuesday March 20th Flashcards
(44 cards)
1
Q
Electrotherapy
A
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)
2
Q
Electrotherapy Tests
A
- (TENS) Transcutaneous electrical nerve stimulation
- (HVPC) High Voltage Pulsed Current
- Diadynamic Currents
- Interference Current
- (NMES) Neuromuscular Electrical Stimulation
- Electrical Stimulation of Denervated Muscle
3
Q
(TENS) Transcutaneous electrical nerve stimulation
A
- 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)
4
Q
Types of TENS
A
- conventional TENS
- acupuncture like TENS
- burst train TENS
- brief-intense TENS
5
Q
Conventional TENS
(High Frequency, Low Intensity)
A
- most commonly used mode of electrostimulation
- combination of parameters stimulates A beta afferents
6
Q
Convetional TENS Effects
A
- 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.
-
Analgesia tends to be relatively short, lasting up to a few hours post-treatment
7
Q
Conventional TENS Modes
A
- low intensity
- high frequency, over 100 Hz
- pulse duration is usually short, (50-80µs)
8
Q
Acupuncture like TENS
(Low Frequency, High Intensity)
A
- 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
9
Q
Acupuncture Like TENS Modes
A
- Low frequency, (1-4 Hz)
- High Intensity, (enough to produce visible muscle contractions)
- long pulse duration, (200µs)
10
Q
Acupuncture like TENS Effects
A
- patient will experience paraesthesia and muscle contrations with this mode
- the analgesia lasts longer than with conventional TENS
- <em>paraesthesia is an abnormal sensation, typically tingling or pricking (‘pins and needles’), caused chiefly by pressure on or damage to peripheral nerves.</em>
11
Q
Burst Train TENS
(High Frequency trains of pulses delivered at Low Frequency)
A
- 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
- <em>This type was developed by Eriksson and Sjolund in 1976 as a result of their experiences with chinese electroacupuncture</em>
12
Q
Burst Train TENS Modes
A
- Low frequency of trains, (1-4 Hz)
- High Internal Frequency of Trains, (100 Hz)
- pulse duration, (100-200 µs)
13
Q
Brief-Intense TENS
(High Frequency, Long Pulse Duration)
A
- this mode can be used for painful procedures such as skin debridement, suture removal, etc.
14
Q
Brief-Intense TENS Modes
A
- High Frequency, (100-150 Hz)
- Long duration pulse, (150-250 µs)
15
Q
(Not important)
Postions of Electrode Placement
A
16
Q
TENS Indications
TENS is useful for:
A
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
17
Q
(HVPC) High Voltage Pulsed Current
Parameters
A
- very short phase durations, (5-6 µs)
- very high peak, current 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)
18
Q
(HVPC) High Voltage Pulsed Current
Graph
A
19
Q
(HVPC) High Voltage Pulsed Current
Indications and Advantages
A
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
20
Q
Diadynamic Currents
(Dia-through)
(Dynamis-Force)
A
- 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
21
Q
Diadynamic Currents
How are they delivered?
A
- These currents are delivered through anode and cathode as:
-
monophasic
- half-wave pulses
- full-wave pulses
-
monophasic
- rectified from 50 Hz alternating current
- Individual pulses have duration of 10 ms
22
Q
Diadynamic Currents
Forms
A
- MF current
- DF current
- CP current
- LP current
- RS current
- MM current
23
Q
Diadynamic Currents
(DF) Diphase Fixe
A
- 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
24
Q
Diadynamic Currents
(MF) Monophase Fixe
A
- 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
25
**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
26
**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
27
**Diadynamic Currents**
(RS) \**Russian Stimulation\* -not sure*
(MM) -not sure
* RS and MM are generally used for muscle stimulation application
28
**Diadynamic Currents**
Graphs Extra
29
**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
30
**Trabert Current** - Effects
| (Ultra Reiz)
This current has:
* an analgesic effect
* a congestive effect
* Trabert Current causes muscle tremors
31
**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.
32
**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
33
**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
34
**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
35
**(NMES) Neuromuscular Electrical Stimulation**
Definition and Goal of Treatment
* 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
36
**(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
37
**(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
38
**(NMES) Neuromuscular Electrical Stimulation**
Waveforms
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.
40
**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
41
**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
42
**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
43
**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* \<\<\<
44
**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
