Card Set Information
tens, biphasic, fes/nmes, russian stim
How is pain developed?
result of damage to tissue
result of chemicals accumulating in the area an mechanical pressure caused by the inflammation
What are some txs for pain?
meds (narcotics, non-narcotics)
TENS (sensorym motor, noxious)
How is pain transmitted?
from periphery to CNS via A-delta and C nerve fibers
How does estim help pain?
can activate A-beta nerves
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
What are the bodys natural pain killers?
What is the pulse width range for conventional TENS?
amplitude produces a comfortable sensation which will activate the A-beta fibers
What is the pulse frequency range for conventional TENS?
100-150 pps- most comfortable
may be set anywhere from 50-150 pps
How long do the effects of conventional TENS last?
only while machine is turned on
How does the low frequency mode for TENS work?
recruits deep afferent nerves to produce central inhibitory effects through the endogenous opiates
What is the pulse duration range for low frequency TENS?
What is the pulse rate of the low frequency TENS?
1-5pps (up to 10)
amplitude strong enough to produce a local m contraction
How long do the effects of the low frequency TENS last?
can control pain 4-5 hours after a 20-30 min tx
What type of TENS is tolerated better than low freq?
What are the parameters for burst mode?
high and low frequency pulses
pulse duration- 200-500 ms
burst rate- 1-5bps
amplitude strong enough to produce local m contraction
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
What are the parameters for brief intense mode?
pulse duration- 200-400 ms
amplitude tolerance for max parasthesia
slight nonrhythmic m contraction may occur
What is modulation mode?
decrease pt accomodation
parameters may be modulated in isolation or in combination
same principle and rationale as conventional mode
What is strength duration mode?
decreases pt accomodation
direct relation to strength duration curve
What is hyperstimulation mode?
uses noxious input to control pain
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
What are 2 forms of biphasic?
When do innervated mm contract?
when estim depolarizes their motor nerves
WHen do denervated mm contract?
when estim depolarizes their m cell membrances directly
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
What mm are depolarized first with estim?
large diameter - fast twitch fibers-type 2
longer rest breaks are needed
What mm are depolarized first physiologically?
smaller - slow twitch-type 1 - fatigue resistant
perform estim contractions with physiological contractions
What is biphasic?
muscle re-ed, strengthening, edema reduction
What is NMES?
neuromuscular electrical stimulation
produce motor response in pts who show difficulty in executing active, colitional mvmt on their own
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
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 sensory/motor integration
orthotic substiution - FES
bulbar stimulation/bowel and bladder
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