e-stim parameters

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e-stim parameters
2011-04-22 15:08:45
stim parameters

e-stim parameters
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  1. inensity
    • important for determining which nerves generate an action potential
    • once threshold amplitude is met for a particular nerve it will not respond any differently
    • inc in amp means inc number of nerves recruited
    • higher amp greater the depth of penetration if all else is held constant
  2. four levels to define intensity
    • subsensory
    • sensory
    • motor
    • noxious
  3. subsensory
    used in pain control and wound healing
  4. sensory
    used in segmental pain control and wound healing
  5. motor
    • 3 levels:
    • minimal- muscle re-education
    • moderate- muscle re-education and possibly use for suprasegmental pain control
    • maximally tolerated contractions (MTC)- muscle strengthening
  6. noxious
    used for suprasegmental pain control
  7. phase duration
    • allows one to fine tune response
    • achieve desired response at a lower intensity with less risk of unwanted responses
    • part of the determination of what nerves are activated
    • unit of measure usec
  8. short phase duration
    • <125usec
    • segmental pain control
    • to minimize chance of uncomfortable tetanic muscle contraction
  9. long phase duration
    • suprasegmental pain control, muscle contraction
    • to reach the stimulus faster
  10. frequency
    • unit of measure is pps, Hz, cps
    • determines how often any nerve activated by the intensity/phase duration combination responds
    • range from 1-250
    • suprasegmental <10
    • segmental 20-250
    • muscle strengthening 35-80
    • wound healing 100-105
    • muscle re-education 30-40
    • muscle pump 1-10
  11. higher frequency the
    stronger contraction and quicker the muscle will fatigue
  12. output channel modes
    • two leads per channel
    • + and -
    • continuous- no interrruption
    • synchronous- on/off simultaneously
    • alternate or reciprocate- on/off alternately
    • possibly delayed- stimulate one then wait a sec or several sec
  13. on/off time
    • only use with muscle strengthening or re-education
    • on time should be sufficient length to perform decent contraction
    • off time is longer than on time
    • smaller ration between on/off faster muscle will fatigue
  14. ramp up/ ramp down
    • used for comfort during motor level stimualtion
    • be sure not to let it eat into your contraction time
  15. polarity
    • only find on DC or monophasic pulsed current generators
    • DC units- polarity influences physiologic response (skin pH which can lead to burns)
    • pain control polarity doesn't matter
    • muscle strengthening bipolar don't matter monopolar active electrode is negative
  16. waveform
    • comfort factor (poly used more often)
    • wound healing must use HVPS
    • iontophoresis and denervated muscles must use DC
  17. modulations
    • reduce patient adaptation during stimulation
    • primarily for segmental pain control
    • most clincs only have frequency on units
  18. treatment time
    • segmental- 15min- 24hrs
    • suprasegmental- 15-30 min
    • muscle strengthening- long enough to get 15 contractions
    • muscle re-education- long enough to do exercise
    • wound healing- 45-60 min