application for NMES

Question 1

NMES frequency

Answer 1

25-50 pps

Question 2

NMES phase duration

Answer 2

200-300 ms

Question 3

NMES cycle time

Answer 3

10 sec on, 10 sec off

Question 4

NMES amplitude

Answer 4

enough to get a contraction

Question 5

NMES ramp

Answer 5

patient preference, usually not more than 2 sec

Question 6

NMEs total treatment time

Answer 6

couple sets of 6-12 reps

Question 7

NMES progression

Answer 7

comes with amplitude or change of duty cycle

Question 8

NMES strengthening principles

Answer 8

• improve force output
• apply overload principle

Question 9

NMES strengthening contraction type

Answer 9

maximal tetanic isometric contraction (maximal voluntary isometric contraction (MVIC)

Question 10

NMES strengthening position

Answer 10

fixed position is best

Question 11

strengthening biphasic frequency

Answer 11

35 pps+ want good force, but low fatigue

Question 12

strengthening biphasic phase duration

Answer 12

200-300+ usec - based on need for motor nerve recruitment

Question 13

strengthening biphasic cycle time

Answer 13

6-10 sec on
30-50 sec off
generally, a 1:5 ratio

Question 14

strengthening biphasic ramp

Answer 14

• patient preference
• size of muscle

Question 15

strengthening biphasic treatment time

Answer 15

10-20 strong contractions

Question 16

strengthening biphasic progression

Answer 16

primarily with amplitude

Question 17

strengthening russian current contraction type and position

Answer 17

MVIC ~60%

Question 18

strengthening russian current frequency

Answer 18

2500 Hz with 50 bps

Question 19

strengthening russian current phase duration

Answer 19

200 usec - determined by bps

Question 20

strengthening russian current cycle time

Answer 20

6-10 sec on
30-50 sec off
generally, a 1:5 ratio

Question 21

strengthening russian current ramp

Answer 21

• patient preference
• sometimes longer than with PC

Question 22

strengthening russian current treatment time

Answer 22

10-20 strong contractions

Question 23

strengthening russian current progression

Answer 23

primarily with amplitude

Question 24

endurance programs contraction type and position

Answer 24

submaximal tetanic

Question 25

endurance programs frequency

Answer 25

minimal tetanizing < 50 pps

Question 26

endurance programs phase duration

Answer 26

200-300 ms

Question 27

endurance programs cycle time

Answer 27

begin 1:5 or 1:6 ratio > 1:1 ratio overtime increase on cycle or decrease off cycle

Question 28

endurance programs amplitude

Answer 28

visible contraction against gravity

Question 29

endurance programs ramp

Answer 29

related to activity

Question 30

endurance programs treatment time

Answer 30

as much as possible; look at function

Question 31

endurance programs progression

Answer 31

look at amplitude but not as much; make cycle time smaller and more contractions in a shorter period of time, and more sessions per day

Question 32

motor control principles

Answer 32

- increase number of motor units firing - increase rate of motor units firing - improve initiation of movement

Question 33

why improve motor control?

Answer 33

improve tactile and kinesthetic inputs using as much of the patients voluntary contraction as possible

Question 34

what are the 2 types of mechanisms for motor control?

Answer 34

motor and cutaneous

Question 35

motor control (motor) contraction type/position

Answer 35

visible contraction

Question 36

motor control (motor) frequency

Answer 36

non-fatiguing

Question 37

motor control (motor) phase duration

Answer 37

200-300 ms

Question 38

motor control (motor) cycle time

Answer 38

per function

Question 39

motor control (motor) amplitude

Answer 39

good contraction

Question 40

motor control (motor) ramp

Answer 40

patient preference

Question 41

motor control (motor) treatment time

Answer 41

frequent

Question 42

motor control (motor) progression

Answer 42

getting rid of unit

Question 43

motor control (cutaneous) contraction type/position

Answer 43

no contraction - sensory only

Question 44

motor control (cutaneous) frequency

Answer 44

non-fatiguing so high frequency

Question 45

motor control (cutaneous) phase duration

Answer 45

lower than 200 ms

Question 46

motor control (cutaneous) cycle time

Answer 46

per function - want tingling

Question 47

motor control (cutaneous) amplitude

Answer 47

sub-motor

Question 48

motor control (cutaneous) ramp

Answer 48

not usually used for this

Question 49

motor control (cutaneous) treatment time

Answer 49

based on function

Question 50

common applications of NMES

Answer 50

shoulder subluxation, orthotic use, spasticity reduction, pelvic floor re-education, improving ROM, edema reduction, and denervated muscle

Question 51

how does NMES reduce spasticity

Answer 51

through fatigue do not use motor point for cutaneous usage

Question 52

what 2 things are needed for pelvic floor re-education?

Answer 52

strength and endurance

Question 53

how does NMES improve ROM?

Answer 53

with frequency, submaximal contraction, and doing it as often as possible

Question 54

how does NMES reduce edema?

Answer 54

- primarily through the muscle pump - sub tetanic/barely motor contraction - fatigue parameters

Question 55

what cycle time is best to reduce edema?

Answer 55

1:1

Question 56

when muscle is denervated what is there an increase of?

Answer 56

chronaxy

Question 57

once atrophy sets in denervated muscle what should you do?

Answer 57

increase amplitude to excitation Ach sensitivity "vermicular" looking contraction

Question 58

purpose for NMES in denervated muscle

Answer 58

decrease atrophy and decrease CT replacement of muscle tissue

Question 59

denervated muscle current type

Answer 59

- AC if long enough phase duration - DC often used - cathode active is DC - higher frequency if no problem with phase duration