Phys Agents test 3

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bcb2127
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76532
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Phys Agents test 3
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2011-04-01 13:54:33
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Phys Agents test 3
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  1. TENS: Conventional, Modulation, Strength Duration

    Condition:
    Intensity:
    Current:
    Frequency:
    Pulse Duration:
    MOA:
    Tx Time:
    Onset of relief:
    Length of relief:
    • Condition: Sensory
    • Intensity: submotor
    • Current: AC
    • Frequency:50-110 Hz
    • Pulse Duration: 50-125 microsec
    • MOA: Gate Theory
    • Tx Time: 30-60 min (up to 24 hrs)
    • Onset of relief: 5-10 mins
    • Length of relief: only as long as the e-stim is on
  2. Low-Frequency
    Condition:
    Intensity:
    Current:
    Frequency:
    Pulse Duration:
    MOA:
    Tx Time:
    Onset of relief:
    Length of relief:
    • Condition: motor
    • Intensity: rhythmic muscle contraction
    • Current: AC
    • Frequency: 1-5 Hz (also burst frequency)
    • Pulse Duration: 200-500 micro seconds
    • MOA: endorphins
    • Tx Time: 40-60 mins
    • Onset of relief: 20-40 min
    • Length of relief: 2-5 hrs
  3. Burst
    Condition:
    Intensity:
    Current:
    Frequency:
    Pulse Duration:
    MOA:
    Tx Time:
    Onset of relief:
    Length of relief:
    • Condition: Motor
    • Intensity: rhythmic muscle contraction
    • Current: AC
    • Frequency: 1-5 Hz (interburst frequency 70-100 Hz)
    • Pulse Duration: 200-500 microseconds
    • MOA: Endorphins
    • Tx Time: 40-60 mins
    • Onset of relief: 20-40 mins
    • Length of relief: 2-5 hrs
  4. TENS (Brief Intense)
    Condition:
    Intensity:
    Current:
    Frequency:
    Pulse Duration:
    MOA:
    Tx Time:
    Onset of relief:
    Length of relief:
    • Condition: Nerve block
    • Intensity: submotor numbness
    • Current: AC
    • Frequency: 110-200 Hz
    • Pulse Duration: 250-400 microseconds
    • MOA: axonal conduction block
    • Tx Time: no more than 10-15 mins
    • Onset of relief: 1-2 mins
    • Length of relief: only as long as the estim is on
  5. HVPC (sensory)
    Condition:
    Intensity:
    Current:
    Frequency:
    Pulse Duration:
    MOA:
    Tx Time:
    Onset of relief:
    Length of relief:
    • Condition: Sensory
    • Intensity: Submotor
    • Current: Pulsatile DC (150-500V)
    • Frequency:80-120 Hz
    • Pulse Duration: 100-200 microseconds
    • MOA: Gate
    • Tx Time: 30-60 mins
    • Onset of relief: 5-10 mins
    • Length of relief: only as long as e-stim is on
  6. HVPC (motor)
    Condition:
    Intensity:
    Current:
    Frequency:
    Pulse Duration:
    MOA:
    Tx Time:
    Onset of relief:
    Length of relief:
    • Condition: Motor
    • Intensity: rhythmic muscle contraction
    • Current: Pulsatile DC (150-500 Hz)
    • Frequency: 1-5 Hz
    • Pulse Duration: 100-200 microseconds
    • MOA: endorphins
    • Tx Time: 40-60 mins
    • Onset of relief: 20-40 mins
    • Length of relief: 2-5 hrs
  7. Premodulation (sensory)
    Condition:
    Intensity:
    Current:
    Frequency:
    Pulse Duration:
    MOA:
    Tx Time:
    Onset of relief:
    Length of relief:
    • Condition: Sensory
    • Intensity: Submotor
    • Current: AC
    • Frequency: 80-120 Hz
    • Pulse Duration: 125 microseconds
    • MOA: Gate
    • Tx Time: 20-30 mins
    • Onset of relief: 5-10 mins
    • Length of relief: only as long as e-stim is on
  8. Premodulation (motor)
    Condition:
    Intensity:
    Current:
    Frequency:
    Pulse Duration:
    MOA:
    Tx Time:
    Onset of relief:
    Length of relief:
    • Condition: motor
    • Intensity: rhythmic muscle contraction
    • Current: AC
    • Frequency: 1-5 Hz
    • Pulse Duration: ?
    • MOA: Endorphins
    • Tx Time: 20-30 mins
    • Onset of relief: 20-40 mins
    • Length of relief: 2-5 hrs
  9. IFC (Sensory)
    Condition:
    Intensity:
    Current:
    Frequency:
    Pulse Duration:
    MOA:
    Tx Time:
    Onset of relief:
    Length of relief:
    • Condition: Sensory
    • Intensity: submotor
    • Current: AC
    • Frequency: Beat: 80(low)-120(high)
    • Pulse Duration: 125 microseconds
    • MOA: Gate
    • Tx Time: 20-30 mins
    • Onset of relief: 5-10 mins
    • Length of relief: only as long as the e-stim is on
  10. IFC (Motor)
    Condition:
    Intensity:
    Current:
    Frequency:
    Pulse Duration:
    MOA:
    Tx Time:
    Onset of relief:
    Length of relief:
    • Condition: motor
    • Intensity: rhythmic
    • Current: AC
    • Frequency: Beat: 3(low)-5(high)
    • Pulse Duration: 125 microseconds
    • MOA: Endorphins
    • Tx Time: 20-30 mins
    • Onset of relief: 20-40 mins
    • Length of relief: 2-5 hrs
  11. IFC (nerve block/wedensky)
    Condition:
    Intensity:
    Current:
    Frequency:
    Pulse Duration:
    MOA:
    Tx Time:
    Onset of relief:
    Length of relief:
    • Condition: nerve block (wedensky)
    • Intensity: submotor numbness
    • Current: AC
    • Frequency:Beat: 200 Hz (no sweep)
    • Pulse Duration: 125 microseconds
    • MOA: axonal conduction block
    • Tx Time: 8-10 mins Max
    • Onset of relief: 1-2 min
    • Length of relief: only as long as the e-stim is on
  12. Hyperstimulation
    Condition:
    Intensity:
    Current:
    Frequency:
    Pulse Duration:
    MOA:
    Tx Time:
    Onset of relief:
    Length of relief:
    • Condition: noxious
    • Intensity: tolerable pain
    • Current: DC
    • Frequency:1-4 Hz
    • Pulse Duration: 250 microsec-1 sec/ neuroprobe= 125 microsec
    • MOA: endorphins
    • Tx Time: 30 sec for each point; up to 20 points
    • Onset of relief: 10 mins
    • Length of relief: varies (hours to days)
  13. _____: method of afferent nerve fiber stimulation designed to control pain through various mechanisms. Use a pulsed current of asymmetrical, biphasic, square/rectangular or triangular/spike waveforms.
    TENS
  14. _____ _____ ____: pain is based on an imbalance of excitatory and inhibitory input ot the T cells located withing the spinal cord.
    ______ _____ ____: morphine induced analgesia. Opiate receptors inhibit the release of substance P from C fiber terminals and depresses pain transmission.
    • Gate Control Theory
    • Endogenous Opiate System
  15. Indications for TENS: only 1
    Contraindications for TENS: 4 total
    • Indications: painful conditions of either an acute or chronic nature
    • Contraindications: 1. pacemakers, 2. pregnancy, 3. over carotid sinus, laryngeal or pharyngeal muscles, sensitive eye areas, or mucosal membranes, 4. and while operating hazardous machinery.
  16. Conventional Mode TENS:
    Advantages (4)
    Disadvantages (3)
    • Advantages: comfortable, fast acting, used with both chronic and acute conditions, can be applied 24 hrs a day.
    • Disadvantages: short acting, based on chemical mechanisms of action, adaptation to stimulus is common
  17. Modulation TENS
    Advantages (2)
    Disadvantages (2)
    • Advantages: same as conventional essentially, and decreased nerve adaptation
    • Disadvantages: analgesic effects are rarely felt after treatment is stopped, and some patients find the constantly changing stim annoying or uncomfortable
  18. Strength Duration TENS
    Advantages (2)
    Disadvantages (1)
    • Advantages: same as conventional, and decreased nerve adaptation
    • Disadvantages: analgesia is limited ot time of stimulation
  19. Low Frequency TENS
    Advantages (2)
    • 1. longer lasting analgesia following treatment due to the 2-6 hour half life of beta-endorphins
    • 2. adaptation to the stimulus is slight, only requiring slight adjustment
  20. Burst Mode TENS
    Advantages (2 but one is the same as Low frequency TENS)
    1. more comfortable than low frequency TENS
  21. Brief Intense Mode TENS
    Advantages (3)
    • 1. comfortable
    • 2. very fast onset of analgesia
    • 3. my be used on extremely acute conditions
  22. I got lazy so ask questions appropriately

    Dosiometry:

    Chronic Condition

    E-stim Intensity: local, visible muscle contraction
    Frequency: 1 – 4 Hz
    Pulse width/duration: 200 - 500 ms, wide pulse
    width
    Ultrasound:Frequency: 1 MHz (to reach trigger points withindeeper muscle tissue)
    Duty Cycle: 100% continuous for thermal effects
    Intensity: 1.3 – 2.0 W/cm²
    Duration of Treatment: 4 – 6 min, once a day
    do it
  23. I'm still being lazy
    Acute conditions

    E-Stim
    Intensity: comfortable sensation below motor stimulation level

    Frequency: 50 –110 Hz

    Pulse width/duration: 50 – 125 ms, narrow pulse width

    Ultrasound:
    Frequency: 1 MHz or 3 MHz depending on depth of tissue

    Duty Cycle: 20% pulsed for non-thermal effects

    Intensity: 0 - .5 W/cm²
    sorry
  24. _______: TENS like device used to deliver electrical stimulit to accomplish a variety of therapeutic purposes. It is different from the other methods of delivering electricla stimuli becuae of the waveform of the current and the voltage of the generator.
    High Voltage Pulsed Current (HVPC)
  25. What is the shape of the WAVEFORM of High Voltage pulsed current?
    Twin Spike monophasic pulsed current
  26. Advantages of HVPC :2
    Disadvantages: 1
    Advantages: more comfortable because short pulse duration and high voltage bypasses skin impedance

    Disadvantages: short pulse duration sor you can't stimulate a denervated muscle or perform iontophoresis
  27. ______ ______: two unmodulated sine waves of different frequencies are crossed, causing both constructive and destructive interference. This results in an mplitude modulated sine wave. The frequencies of the waves are commonly between 2000 and 5000 Hz.
    Interferential Current
  28. For IFC, higher frequencies have shorter phase durations (_____ hz has a _____ microsec phase duration). and are best suited for sensory nerve stimulation. Lower frequencies have longer phase durations (______ hz frequency has a _____ microsec phase duration.) and is more suited for motor stimulation.
    • 4000 Hz has a 125 micro seconds
    • 2000 Hz has a 250 micro seconds
  29. ______ Inhibition: with stimuli of constant amplitude and frequencies greater than 1000 Hz, successive stimuli prevent the nerve from repolarizing. This temporary nerve membrane depolarization is responsible for decreased sensation under the electrodes.
    Wedensky Inhibition
  30. ______: reciprocal scanning of IFC through an arc of 45 degrees. This allows the current ot perfuse through a greater volume of tissue then if this option was not selected.
    Scanning
  31. ________: a mode in which the two currents are mixed within the machine to produce an amplitude modulated frequency output. This mode only uses two electrodes.
    Premodulation
  32. IF Stimulation:
    __-__ bps: with an amplitude sufficient enough to produce small pulsating muscle contractions, may relieve pain.
    __-__ bps: results in tetany of the muscle, may be able to modulate the contractions, but may not be effective for strengthening.
    >__ bps: with low amplitudes, causes pain relief.
    0-10 bps

    30-50 bps

    >50 bps
  33. With hyperstimulation, _____ inhibits pain.
    pain
  34. True or false: hyperstimulation is NOT motor stimulation.
    True. it is noxious stimulation
  35. 3 Common Responses to hyperstimulation:
    • 1. breakthrough phenomena: points inititially tolerate the stimulus but become hypersensitive within 10-20 seconds.
    • 2. points that are not pathological adapt
    • 3. optimal stimulation sites reach noxious threshold levels very quickly with minimum intensity
  36. Several substances are released by acupuncture including
    1.
    2.
    3.
    • 1. enkephalin
    • 2. dynorphin
    • 3. beta-endorphins
  37. ______: alternative medicine in which the goal is to balance functional disorders of the body in general.
    Ryodoraku
  38. ______: channel/pathway through which energy flows.
    meridian
  39. ______ Phenomenon: pt has organ dysfunction and corresponding distal meridian points are found to have increase pain threshold and differ in heat sensitivity and electrical permeability.
    Akabane Phenomenon

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