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  1. How is pain developed?
    • result of damage to tissue
    • result of chemicals accumulating in the area an mechanical pressure caused by the inflammation
  2. What are some txs for pain?
    • meds (narcotics, non-narcotics)
    • MENS-microunit
    • TENS (sensorym motor, noxious)
    • HVPC
    • LVPC
    • IFC
    • nerve blocks
    • surgery
  3. How is pain transmitted?
    from periphery to CNS via A-delta and C nerve fibers
  4. How does estim help pain?
    can activate A-beta nerves
  5. What is the gate control theory of pain?
    pain perception is decreased bc the relative activity of the A-delta/C fibers to A-beta fibers is decreased
  6. What are the bodys natural pain killers?
    endogeous opiates
  7. What is the pulse width range for conventional TENS?
    • 50-200 microseconds
    • amplitude produces a comfortable sensation which will activate the A-beta fibers
  8. What is the pulse frequency range for conventional TENS?
    • 100-150 pps- most comfortable
    • may be set anywhere from 50-150 pps
  9. How long do the effects of conventional TENS last?
    only while machine is turned on
  10. How does the low frequency mode for TENS work?
    • acupuncture like
    • recruits deep afferent nerves to produce central inhibitory effects through the endogenous opiates
  11. What is the pulse duration range for low frequency TENS?
    200-500 microseconds
  12. What is the pulse rate of the low frequency TENS?
    • 1-5pps (up to 10)
    • amplitude strong enough to produce a local m contraction
  13. How long do the effects of the low frequency TENS last?
    can control pain 4-5 hours after a 20-30 min tx
  14. What type of TENS is tolerated better than low freq?
    burst mode
  15. What are the parameters for burst mode?
    high and low frequency pulses

    • freq- 70-100pps
    • pulse duration- 200-500 ms
    • burst rate- 1-5bps
    • amplitude strong enough to produce local m contraction

    endogeous optiates
  16. What is brief intense mode?
    designed to inhibit pain by using high range frequencies, pulse durations, and amplitude at a comfortable/tolerable level

    • pain relief immediate
    • decreases conduction along A-delta and C fibers
    • gait theory
  17. What are the parameters for brief intense mode?
    • pulse duration- 200-400 ms
    • freq- 75-150pps
    • amplitude tolerance for max parasthesia
    • slight nonrhythmic m contraction may occur
  18. What is modulation mode?
    • decrease pt accomodation
    • parameters may be modulated in isolation or in combination
    • same principle and rationale as conventional mode
  19. What is strength duration mode?
    • decreases pt accomodation
    • direct relation to strength duration curve
  20. What is hyperstimulation mode?
    • uses noxious input to control pain
    • small probe
    • endogeous opiates
  21. What are the parameters for hyperstimulation TENS?
    • pulse duration- really high- 250 ms-10 milliseconds
    • freq- really low- 1-4pps
    • amplitude that produces max tolerable noxious input
  22. What are 2 forms of biphasic?
    • NMES
    • FES
  23. When do innervated mm contract?
    when estim depolarizes their motor nerves
  24. WHen do denervated mm contract?
    when estim depolarizes their m cell membrances directly
  25. What direct effects on the m does estim have?
    • changes from anaerobic to aerobic
    • increases blood flow and oxygen consumption
    • increases glucose consumption and decreases lactate outoput
  26. What mm are depolarized first with estim?
    large diameter - fast twitch fibers-type 2

    longer rest breaks are needed
  27. What mm are depolarized first physiologically?
    smaller - slow twitch-type 1 - fatigue resistant

    perform estim contractions with physiological contractions
  28. What is biphasic?
    • 2 phases
    • muscle re-ed, strengthening, edema reduction
  29. What is NMES?
    • neuromuscular electrical stimulation
    • produce motor response in pts who show difficulty in executing active, colitional mvmt on their own
  30. What is FES?
    • functional electrical stimulation
    • activates innervated but inactive, paretic, or paralyzed mm as a form of orthotic for management of deformity or to assist in purposeful mvmt
  31. What are indications of biphasic?
    • increase joint ROM (contracture management of knee, wrist, or scoliosis)
    • temp spasticity management/spasm reduction
    • increase strength (disuse atrophy)
    • increase endurance
    • increase sensory/motor integration
    • faciliation/re-ed
    • orthotic substiution - FES
    • edema management
    • bulbar stimulation/bowel and bladder
  32. What are contraindications of biphasic?
    • where active motion is contraindicated
    • demand type pacemaker
    • over superficial metal implants
    • active bleeding in tx area
    • malignancies in tx area
    • very disoriented pts
    • 1st trimester of pregnancy
Card Set:
2012-09-19 02:21:44

tens, biphasic, fes/nmes, russian stim
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