What are the goals for NMES?
- atrophy treatment/prevention
- strengthening
- achieve synchronous firing/recruitment of motor units
Parameters for NMES - pulse width/duration, pulse frequency, on:off time, ramp, amplitude
- Pulse width/Duration= 200-800 µsec
- Pulse Frequency= 30-100 pps
- On:Off time - Will vary on your use, 10 sec on:50 sec off is common for >10 reps
- Amplitude - max contraction/tolerance
What type of e-stem is used as an alternative or supplement to orthotic devices or braces? What needs to be intact, but not functioning appropriately?
Functional Electrical Stimulation (FES) - peripheral nerve needs to be intact
- common uses are for shoulder subluxation after stroke and foot drop (tib anterior)
What is the goal of IFC and what are the parameters (pulse width/duration, frequency, duration, amplitude)
- pain modulation - quadripolar set up
- pulse width/duration = 200-400 µsec
- Frequency= 10-150 pps
- Duration = 10-30 mins
- Amplitude: strong but tolerable sensation
How does high rate TENS work? When can it be applied?
- gait control theory
- Pain modulation through activation of central inhibition of pain transmission
- can be applied during the acute or chronic phase of pain
What are the parameters of high rate TENS (pulse rate, pulse duration, duration, amplitude)
- Pulse rate: 50-80pps
- Pulse duration: 50-100 µsec
- duration - 10 min - several hours
- amplitude - comfortable tingling sensation; no muscle response
What is the goal of low rate TENS? What are the parameters (pulse rate, pulse duration, duration of treatment, amplitude)
- Pain modulation through descending pathways generating endogenous opiates
- Pulse rate: 1-5pps
- Pulse duration: 150-300 µsec
- Duration of treatment: 20-40 minutes
- Amplitude: strong, but comfortable rhythmic muscle twitch
What is the goal of brief intense TENS?
Used to provide rapid-onset, short term pain relief during painful procedures (wound debridement, passive stretching, joint mobilizations)
What is the goal of Burst-mode TENS?
- Combines characteristics of both high and low rate TENS. Stimulation of endogenous opiates, but current is more tolerable to patient than low rate TENS
- used for pain relief
What type of e-stem uses noxious stimulus? What does it help relief?
- hyperstimulation
- used for trigger point or local area such as tendonitis
How deep does 3.3 MHz ultrasound go? 1 MHz?
3 MHz - up to 2.5 cm (close to the surface of skin)
1 MHz - up to 5 cm (deep structures)
Current is directly proportional to ______ and inversely proportional to _________.
voltage and resistance
