Ther-ex: parameters Flashcards
(24 cards)
conventional TENS
F:
D:
I:
Txt time:
Conventional:
High rate, low intensity (sensory level)
Gate control theory→ Abeta fibers stimulated
Acute pain
Asymmetric biphasic most common
F: 80-125 pps (100)
D: 75-150 microseconds (100)
I: tolerable sensory stimulation
Txt time: until pain is no longer perceived (30 mins up to a few hrs)
what theory for conventional TENS
GCT- stimulates Abeta cells
GCT
increased activity of A-beta afferents triggers release of enkepalin from interneurons in SG –> inhibit synaptic transmission to 2nd order and block pain message ascending brain
Low Frequency TENS
Acupuncture-like, motor-level
F:
D:
I:
Txt time
Duty time
F: <20 pps
D: 100-600 microseconds
I: high enough for sensory and motor
Txt time: 15-60 mins
note: applied over motor point
Duty: 30-60s on, off time as needed
Theory: descending pain control theory
Low frequency TENS acupuncture like, motor level
theory
descending pain control theory
descending pain control theory
opiate receptors in central or peripheral terminals of nocicpetive afferent fibers
*descending pathways from the brainstem, brain sends inhibitory signals down the SC to inhibit 2nd order neurons that transmit pain to brain
noxious-level TENS
F:
D:
I:
Txt time
duty time
*asymmetric biphasic is most common
hyperstimulation analgesia
F: 1-5 pps
D: 100-1000 microseconds
I: high intensity to a noxious level (muscle contraction is acceptable)
Txt time: until pain no longer percieved
Duty: 30-45s , off time as needed
*applied over trigger or acupuncture points
theory of noxious level TENS
endogenous opiate pain control theory
endogenous opiate pain control theory
peripheral blockage and extra segmental analgesia
stimulation of small afferents (Adelta and C) can stimulate the release of endorphins, beta endorphin and dynorphin
- beta endorphin is released by anterior pitutary gland and hypothalamus
-prolonged electrical stimulation on acupuncture points trigger release of beta endorphin and dynorphin
Brief intense TENS
F:
D:
I:
Txt time
*asymmetric biphasic
F: 100 pps
D: 100-600 microseconds
I: muscle fasciculations to sustained muscle contraction
Txt time: 15 mins
theory of brief intense TENS
peripheral and central analgesia
-wound debridement
peripheral and central analgesics
serotonergic efferents: a descending system from thalamus stimulates the periaquetductal gray and the raphe nucleus to activate the enkepalin interneurons
-serotonin suppress release of substance P by A delta and C fibers
-enkephalin is released to block signal transmssion of 2nd order neurons
noradrenergic pathway: projects from pons to dorsal horn
which is high rate and low intensity (sensory level)
conventional
which is best for acute pain
conventional
which uses GCT
conventional
which is low rate and high intensity- motor level
acupuncture like
which is for chronic pain
acupuncture like
which is the descending pain control theory
acupuncture like
*releases enkephalins
which is for hyperstimulation analgesia
noxious level
which uses endogenous opiate pain control theory
noxious level
which is high rate and high intensity
brief intense
which is for fast pain relief during procedure or wound debridement
brief intense
which is peripheral and central analgesics
brief intense
muscle education and strengthening
pulse rate:
duration:
rate: 35-55 pps
D: 200-600 microseconds
