WK7- TENS, IFC, ES for Wound Healing

Question 1

The use of e-stim to modulate pain is referred to as TENS, TENS stands for:

Answer 1

Transcutaneous Electrical Nerve Stimulation

Question 2

Premodulated current is like IFC, BUT it only requires 1 channel (two electrodes). In order to provide this type of sensory-level high-rate (conventional) TENS, the machine must have a premodulated setting.

True or False

Answer 2

True

Question 3

In general, the __________ electrode should be used to promote healing of inflamed or infected wounds, and the __________ electrode should be used to promote healing of wounds without inflammation.

Answer 3

negative, positive

Question 4

Electrical stimulation may be used to treat edema caused by inflammation or by lack of motion. The current applied and subsequent mechanism for controlling edema is vastly different between these two types of edema.

The type of current used to control edema caused by inflammation is
____________
which is a type of sensory-level e-stim.

The type of current used to control edema caused by lack of motion is simply
___________
which is a motor-level e-stim.

Answer 4

HVPC, NMES

Question 5

___________ uses low-amplitude___________ to facilitate delivery of medications through the skin.

Answer 5

low amp, DC

Question 6

The guidelines for application of e-stim for wound healing, specify that the electrodes may be placed:

Answer 6

one electrode directly in the wound with a dispersive electrode of opposite polarity placed several inches away on intact skin

two electrodes around the wound (e.g., on either side of the wound)

Question 7

When e-stim is applied to promote tissue healing (for a wound), a
__________
waveform recommended to be used. Specifically
____________
is the current that evidence shows to be the most effective.

Answer 7

monophasic, HVPC

Question 8

The polarity of an electrode on or nearest to the wound is selected according to the types of cells required to advance a particular stage of wound healing and the presence or absence of infection or inflammation in the wound.
____________
is generally used during the early inflammatory stage of healing.
____________
is used later to facilitate epithelial cell migration across the wound bed.

Answer 8

negative polarity
positive polarity

Question 9

When using iontophoresis, the treatment amplitude should be:

Answer 9

to patient tolerance, but no greater than 4mA

Question 10

For iontophoresis, the drug delivery electrode should have the (same/different) polarity as the active ion of the drug to be delivered.

Answer 10

same

Question 11

Which type of pain is the result of real tissue damage caused by infection, trauma, or the progression of a metabolic disorder or degenerative disease?

Answer 11

acute

Question 12

What is the correct term for the amplification of neural signaling within the central nervous system resulting in an increased perception of pain?

Answer 12

central sensitization

Question 13

Which of the following may occur with the co-administration of opioid medication and TENS?

Answer 13

analgesic tolerance

Question 14

Which mode of TENS is best described as eliciting strong sensory paresthesia but without motor activation?

Answer 14

Conventional TENS

Question 15

Which of the following modes of TENS is best described as using a low-pulse frequency, high intensity to evoke visible muscle contractions?

Answer 15

Acupuncture TENS

Question 16

Stimulation of large-diameter A-beta afferents to activate local inhibitory circuits in the dorsal horn best describes what analgesic mechanism of TENS?

Answer 16

gate theory of pain control

Question 17

Which of the following best describes the evidence-supported level of stimulation amplitude, or intensity, to be used when administering TENS?

Answer 17

Current amplitude should be as strong as is tolerated while still comfortable.

Question 18

Electrode placement for TENS should be selected based on which of the following?

Answer 18

In accordance with the painful area or over the peripheral nerve responsible for the pain

Question 19

Modulation of the beat frequency when using interferential current is known as which of the following?

Answer 19

Sweep

Question 20

When selecting small electrodes to administer TENS, which of the following must be considered in regard to the patient’s perception and tolerance of the stimulation?

Answer 20

Current Density

Question 21

Which of the following modes of TENS is administered with a pulse frequency of 100 Hz and a pulse duration of 100 µsec?

Answer 21

Conventional TENS

Question 22

All of the following are generally accepted as contraindications to TENS except which one?

Answer 22

Over an epiphyseal plate

Question 23

What are the TENS parameters for Conventional/High Rate TENS ?

Answer 23

Frequency: 100-150 pps
Pulse Duration: less than or equal to 100 microseconds
Amplitude: sensory level
treatment time: 30 min or less in clinic; 1 hour at a time at home with at least 30 min off prior to repeating

Question 24

What are the TENS parameters for Low-Rate TENS/ Accupuncture TENS ?

Answer 24

Frequency:less than or equal to 10 pps
Pulse Duration: 200-300 microseconds
Amplitude: motor level; visible contraction
Treatment time: 30 min or less

Question 25

What are the TENS parameters for Burst TENS ?

Answer 25

Frequency: usually preset in unit; example 100Hz delivered at 2 Hz
Pulse Duration: 150-200 microseconds
Amplitude: motor level; visible contraction
Treatment time: 30 min or less

Question 26

In IFC what is the relationship between carrier frequency and beat frequency.

Answer 26

in IFC there are two currents interfering which produce ‘beats’

The lower frequency of the two current is termed the carrier frequency and the difference between the frequency of the two currents is termed the beat frequency.

Question 27

What are the contraindication and precautions to TENS ?

Answer 27

over pregnant uterus, abdomen, or lower back in pregnancy

electrical implants

carotid sinus, eyes, interally or on reproductive organs

over damaged skin

thrombosis

thromboplebitis

Hemorrhage

over malignant tumors

undiagnosed pain

patients with impaired sensation, mentation, and others.

DO NOT USE LOW RATE TENS WHEN MUSCLE CONTRACTIONS MAY DISRUPT HEALING.