Explain an Electron…
A negatively-charged particle; found outside the nucleus in an atom.
When does an Electrical Charge occur?
The result when a neutral substance gains/looses an electron. If substance gains electron = negatively charged. Looses an electron = positively charged.
What are the types of Electrical Stimulation?
- NMES
- TENS
- FES
- HVPC (High Volt Pulsatile Current)–Wound healing & Edema reduction
- Iontophoresis
What ability is Electrical Stimulation based on?
The depolarization of nerves/muscles producing Action Potentials (all-or-none response).
Purpose/benefit of E-STIM?
Sensory: Controlling pain.
Motor:
* Assists with joint Positioning
* Circulation
* Endurance
* Function
* Pain
* Spasticity
* Strengthening
Ionic Effects:
* Facilitates tissue healing
* Controls the formation of inflammation related edema
* Promotes trans-dermal drug penetration.
What body tissues are good conductors of electrical current? Bad conductors?
Good: Muscle, Nerves, Blood (high-water content).
Bad: Skin, Bone, Tendon, Fascia, Adipose (low-water content).
In what situations would NMES (Neuromuscular Electrical Stimulation) be chosen?
- Muscle Re-education
- Strengthening
Stimulates motor response to peripheral nerves.
**SCIs, neuro-trauma
In what situations would FES (Functional Electrical Stimulation) be chosen?
To assist with functional activities such as grasping an object.
In what situations would TENS (Transcutaneous Electrical Stimulation) be appropriate?
Pain control (analgesic effect)
In what situations would a High-Voltage Electrical Current or High Voltage Galvanic Current be appropriate?
Used for tissue repair & pain control.
Galvanic Current = Direct Current.
When would Iontophoresis be appropriate?
Used to assist with medication absorption into tissue using low-voltage direct galvanic current.
Direct, Galvanic current (monitor closely for skin reactions-burns).
What are the names of the different Electrodes?
Negative, cathode (black); placed overtop of muscle belly–usually proximal to…
Positive, anode (red); placed distally & in line with negative electrode.
Is a Pulsed Current Unidirectional or Bidirectional?
Can be either.
- Used in NMES
– Used when muscle is unable or difficulty contracting
– Produces normal contraction
When using Electrotherapy, clinician determines…
- Electrode placement
- Waveform
- Polarity
- Amplitude (milliamps (mA))
- Pulse Duration/Width (microseconds–uS, 200=smaller muscles, 300=larger muscles)
- As pulse duration increases, depth of electrical current increases.
- Pulse Frequency (pps, Hz)
- Ramp Time, On/Off times, Treatment time.
What are the Clinical Levels of Stimulation?
(So Subway Makes Nachos?)
Subsensory: No nerve fiber activation. No sensory awareness.
Sensory: Tingling, prickling, or pins & needles. Cutaneous A-beta nerve fiber activation.
Motor: Strong paresthesia (burning or prickling sensation). Muscle contraction. A-alpha nerve fiber activation.
Noxious: Strong, uncomfortable paresthesia. Strong muscle contraction. A-delta & C-fiber activation.
Contraindications of E-stem?
- Pregnancy (pelvis, trunk, lower back).
- Pacemaker or other cardiac implants.
- Cancer
Precautions of using E-stem?
- Peripheral neuropathies
- Metal
- Osteoporosis
- Cognitive impairments
- SCI-Autonomic Dysreflexia
- Seizures
When & why is an Interrupted Direct Current used?
Used with denervated muscles.
Helps maintain state of muscle while awaiting for re-innervation. Decreases muscle atrophy.
