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🔴 Electrotherapy 🔴 > TENS > Flashcards

TENS Flashcards

(42 cards)

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1
Q

What is TENS used for

A

Pain relief / pain modulation

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2
Q

What is TENS

A

Transcutaneous Electrical Nerve Stimulation (TENS)

Application of pulsed electrical current over the skin to stimulate analgesia by stimulating/depolarizing nerve fibers for pain modulation

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3
Q

What type of current is TENS

A

Pulsed current

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4
Q

Waveform involved in TENS

A

Biphasic wave:
- symmetrical
- asymmetrical (balanced)

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5
Q

TENS current can be delivered in single pulses or _____________.

A

BURSTS of pulses

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6
Q

What is meant by pulse frequency?

Range?

Unit ?

Types?

A

The number of pulses delivered per second

Range: 1 - 200 Hz

Unit: Hz (pps)

Types of frequency:
- HIGH ( acute pain )
- LOW (chronic pain )

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7
Q

Range for current amplitude in TENS

A

Between 0 and 120 mA

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8
Q

Range of pulse duration in TENS

A

Ranges from 50 - 400 μs

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9
Q

What is burst duration

What is interburst duration

What is burst frequency

A

The time from the beginning and the termination of one burst

The duration between two bursts

The number of bursts per second (1- 10 bursts/sec)
(NOTE: each burst consists of 5-10 pulses)

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10
Q

What makes TENS very comfortable

A

TENS devices are CC-type stimulators , meaning current amplitude remains constant (no surge)

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11
Q

What are the 5 modes on TENS

A

Conventional
Acupuncture
Burst train
Brief intense
Modulated

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12
Q

What are the two most common TENS used

A

Conventional (most common)
Acupuncture

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13
Q

Conventional is used for what kind of pain

A

ACUTE pain

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14
Q

Acupuncture is used for what kind of pain

A

CHRONIC pain

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15
Q

Pulse duration (pulse width) of Conventional VS Acupuncture

A

Conventional : SHORT pulse duration ( < 150 ms)

Acupuncture: LONG pulse duration ( > 150 ms)

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16
Q

Pulse rate (frequency) of Conventional VS Acupuncture

A

Conventional : HIGH frequency ( > 80 Hz)

Acupuncture: LOW frequency ( < 80 Hz)

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17
Q

Current amplitude (intensity) of Conventional VS Acupuncture

Study These Flashcards
A

Conventional :
- comfortable
- sensory stimulation

Acupuncture:
- comfortable/tolerable
- sensory + motor stimulation ( muscle twitching is ok)

18
Q

Proposed mechanism for pain relief of Conventional VS Acupuncture

Study These Flashcards
A

Conventional : Gate theory

Acupuncture: Endogenous opiates descending pain suppression system

19
Q

Target nerve fibers of Conventional VS Acupuncture

Study These Flashcards
A

Conventional:
- Large A Î’eta sensory afferent mechanoreceptors

Acupuncture:
- A alpha
- Large A Beta
- Small A Delta
- C pain fibers

20
Q

Sensation of Conventional VS Acupuncture

Study These Flashcards
A

Conventional:
- comfortable
- pins and needles
- tingling
- minimal or no muscle contractions

Acupuncture:
- tingling with muscle contraction

21
Q

Onset of analgesia in Conventional VS Acupuncture

Study These Flashcards
A

Conventional: Rapid within minutes ( up to 5 minutes)

Acupuncture: Slow within hours (starts after 15 minutes)

22
Q

Time of treatment of Conventional VS Acupuncture

Study These Flashcards
A

Conventional: minutes or hours

Acupuncture: < 60 minutes

23
Q

Length of pain relief of Conventional VS Acupuncture

Study These Flashcards
A

Conventional: short lasting analgesia ( < few hours)

Acupuncture: long lasting analgesia (> few hours)

24
Q

What is burst train TENS

Sensation ?

Target nerve fibers?

Mechanism of pain relief?

Onset of pain relief?

Length of pain relief ?

Time of application?

Study These Flashcards
A

Delivery of low frequency bursts with current amplitude that stimulates BOTH sensory AND motor (similar to acupuncture)

Tingling + moderate muscle contractions

A delta , motor alpha, and C fibers

Mechanism: opiate system

Slow onset within hours

Long lasting analgesia

15-60 minutes of application

25
What is brief intense TENS? High or low frequency? Short or long pulse duration? Low or high current amplitude ? Target nerve fibers? Mechanism of pain relief ? Sensation ? Onset of analgesia ? Length of analgesia ? Time of application ? When is it used?
Delivery of electrical pulses with LONG durations, HIGH frequency, and current amplitudes capable of NOXIOUS stimulation High frequency ( > 80 Hz) Long pulse duration ( > 150 ms) High current amplitude at noxious level Target nerves: A beta, A delta, and C nerve fibers Mechanism: opiate system Sensation: muscle contraction + maximum tolerable pain Onset: Rapid within minutes Length of analgesia: long lasting Application time: LESS than 15 minutes Used before painful procedures
26
What is modulated TENS What does it prevent
Pulse duration, frequency, and amplitude are randomly modulated at the same time during therapy Prevents nerve adaptations
27
What determines which mode should be used when more than one is applicable ?
Based on trial and error and patient comfort
28
Which mode of TENS is the most comfortable
Conventional
29
Electrodes sizes, shapes, and types
Sizes : -Small (localized small area -Large (distributed larger area / less risk of damage) Shapes : Square, rectangular, or round Types: - carbon impregnated (best conductor) - Silicon rubber electrodes (+ electroconductive gel) - Self adhesive - Sterile electrodes for postoperative pain
30
How are electrodes attached?
Surgical tape Self adhesive electrodes Straps
31
What is the Coupling medium ?
Gel or water
32
Electrode maintenance is done by
Frequent visual inspections Periodic measurement of electrode impedance
33
Why should the electrode be completely covered with gel besides optimizing conduction ?
To prevent burn which can occur because the current will be condensed in the area with little gel
34
TENS channel units
35
TENS indications:
36
General contraindications for TENS (hint: 7)
Impaired mentation ( discomfort/burn) Epileptic patient ( inducing epileptic episode) Thoracic region ( affect heart function) Cervical region ( vagus/phrenic stimulation + carotid sinuses = hypotension + laryngeal spasm) Cranial region ( affect brain function) Malignant areas (metastasis) Cardiac pacemaker / defibrillator (risk of interference)
37
Local contraindications of TENS ( hint: 5)
Impaired sensation ( discomfort/pain) Back, abdomen, pelvic regions of pregnant woman in FIRST TRIMESTER or menstruating woman ( induces labor / risk of bleeding) Damaged skin ( severe pain) Metal implants ( overheating) Hemorrhagic areas ( increase bleeding)
38
Electrode placement includes :
Within or around the area of pain Spinal cord segment General limb pain Over specific body points ( trigger points)
39
Treatment time What happens with inadequate time ?
Low rate : 20 -30 minutes High rate: 10 minutes to several hours Inadequate time = failure and poor pain relief
40
True or false We cannot use TENS on a pregnant woman in her second/third trimester or even during labor
False It is only a contraindication in her FIRST trimester
41
Advantages of TENS
42
Sources of poor results

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