Term
| Biophysical Effects of E-Stim: 1: modulate... |
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Definition
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Term
| Biophysical Effects of E-Stim: 2: in regards to swelling |
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Definition
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Term
| Biophysical Effects of E-Stim: 3: in regards to tissue |
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Definition
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Term
| Biophysical Effects of E-Stim: 4: reeducates what? |
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Definition
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Term
| Biophysical Effects of E-Stim: effect on joint restrictions |
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Definition
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Term
| Biophysical Effects of E-Stim: 6: effect on blood flow |
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Definition
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Term
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Definition
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Term
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Definition
| the rate at which electrons flow |
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Term
| force that moves electrons |
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Definition
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Term
| a term used to describe electrical charge |
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Definition
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Term
|
Definition
| 6.25 x10^18 electrons per second |
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Term
| What are the 3 types of current |
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Definition
| continuous direct, pulsed direct, alternating |
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Term
| current which flows in only one direction for at least 1 second. aka monophasic, galvanic, unidirectional |
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Definition
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Term
| current that flows in only one direction for less than 1 second |
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Definition
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Term
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Definition
| reversing polarity, interrupting current flow, ramping the DC |
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Term
| reversing polarity to modulate DC minimizes this risk |
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Definition
| burn as a result of electrochemical build up |
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Term
| how is DC polarity reversed (3) |
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Definition
| manually reversing the +/- electrodes, flipping the polarity switch on the device, or by a preset internally in the device |
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Term
| in order to DC to be modulated via interrupting current flow, how long must the interruption time be |
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Definition
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Term
| interrupting DC flow is commonly used to do what? |
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Definition
| stimulate denervated muscle to cause a muscle twitch |
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Term
| ramping DC refers to what |
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Definition
| reaching peak amplitude from 0, or reaching 0 from peak amplitude |
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Term
| alternating current flows in which direction |
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Definition
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Term
| alternating current is also called what? |
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Definition
| biphasic or bidirectional |
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Term
| what is important to note about AC aside from it being bidirectional |
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Definition
| the + and - components can be either symmetric or asymmetric |
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Term
| what are the 3 ways to modulate AC current |
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Definition
| modulate phase parameters, current modulation, ramping/surging |
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Term
| modulating phase parameters of AC includes what |
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Definition
| duration, intensity, rate |
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Term
| AC current modulation is good for what |
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Definition
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Term
| AC current modulation involves changes in what |
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Definition
| intensity through interruptions in the current short enough to not be percieved, or long enough to be perceived |
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Term
| what is the purpose of ramping/surging AC current |
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Definition
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Term
| uni or bidirectional flow of charged particles which periodically ceases for a finite period of time |
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Definition
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Term
| monophasic pulsatile current consists of what |
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Definition
| one phase/one pulse either + or - |
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Term
| describe biphasic pulsatile current |
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Definition
| one half of the cycle is above the baseline and half is below |
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Term
| types of biphasic pulsatile current |
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Definition
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Term
| describe polyphasic pulsatile current |
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Definition
| 3 or more phases are produced in a single pulse |
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Term
| a change in the waveform by changing any one of the waveforms's variables (amplitude, frequency, duration) |
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Definition
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Term
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Definition
| amplitude, frequency, duration |
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Term
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Definition
| accommodation or becoming accustomed to the stimulation |
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Term
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Definition
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Term
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Definition
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Term
| what reaction occurs under the anode (+ electrode) |
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Definition
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Term
| what reaction occurs under the cathode (-electrode) |
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Definition
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Term
| repolarization of the muscle results in what more specifically |
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Definition
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Term
| which electrode is considered the active electrode |
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Definition
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Term
| why is the cathode considered the active electrode |
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Definition
| underneath the electrode is the lowest threshold for depolarization and the Estim is typically perceived first under the cathode |
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Term
| resting membrane potential |
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Definition
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Term
| resting membrane potential for peripheral nerve fibers |
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Definition
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Term
| Why is there a lot of impedance to current at the skin? |
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Definition
| d/t a relatively low concentration of fluid |
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Term
| What should NOT be done to try and decrease impedance of the skin |
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Definition
| increasing the amplitude of the current |
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Term
| Why should you not increase the amplitude in order to decrease the impedance of skin |
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Definition
| build of heat under teh electrode causing and electrical burn |
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Term
| skin impedance can be decreased by (3) |
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Definition
| using a heaitng modality to warm the skin, hydrate the skin, cleaning the skin with alcohol |
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Term
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Definition
| carbon electrode, thin metal pads, adhesive |
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Term
| type of electrode made up of flexible, rubber pads with a moist sponge or gel interface |
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Definition
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Term
| electordes that are not pliable with a sponge interface |
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Definition
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Term
| type of electrode with a conductive gel interface |
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Definition
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Term
| how would you increase current density to a trigger point |
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Definition
| place a smaller electrode on the trigger point |
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Term
| increased current density creates what? |
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Definition
| a greater effect on the tissue and the patient's perception of the stimulus is greater |
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Term
| what is the minimum distance between electrode pads |
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Definition
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Term
| what should the orientation of the electrodes be? |
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Definition
| longitudinal or perpendicular to the mm fibers |
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Term
| a monopolar electrode set up is used for what current |
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Definition
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Term
| size of the electrodes used for monopolar set up |
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Definition
| electrodes of different sizes |
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Term
| how many channels are used in either monopolar set up |
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Definition
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Term
| types of leads used in monopolar set up |
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Definition
| 2 leads, bifurcated leads |
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Term
| how many active electrodes are there in the monopolar set up with 2 leads |
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Definition
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Term
| how many active electrodes are there with bifurcated monopolar set up |
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Definition
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Term
| difference between teh active electrodes in the monopolar set ups |
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Definition
| nothing, their surface area must be less than the dispersive pad |
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Term
| electrode size and current densities of the bipolar set up |
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Definition
| same size electrodes, equal current density |
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Term
| types of leads used for bipolar set ups |
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Definition
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Term
| in a bipolar set up, the leads are bifurcated leading to how many treatment electrodes |
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Definition
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Term
| in the bipolar set up, crossing the 2 bipolar leads produces what |
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Definition
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Term
| term used to describe that the electrode must conform to the body part to maximize conduction |
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Definition
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Term
| what could be used to improve electrical coupling (6) |
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Definition
| flexible pads, inflexible pads, straps, conductive liquid, moist sponge, or gel |
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Term
| to generate a tetanic contraction what must the frequency be |
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Definition
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Term
| increasing the frequency of stimuli progressively fuses the individual muscle twitches to a point where individual muscle twitches are not discernable |
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Definition
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Term
| purpose of Estim for innervated muscle |
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Definition
| strengthen weakened muscle |
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Term
| purpose of estim for denervated muscle |
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Definition
| minimize the atrophy that takes place to the affected muscles |
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Term
| muscle atrophy is not the real problem in itself, what is? (2) |
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Definition
| muscle fiber degeneration and fibrosis |
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Term
| denervated muscles differ from normal muscles in these 3 ways |
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Definition
| fibrillation, AcH hypersensitivity, less negative resting membrane potential |
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Term
| spontaneous uncoordinated contraction of individual muscle fibers not visible to the naked eye |
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Definition
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Term
| in denervated mm, the resting membrane potential is what |
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Definition
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Term
| the resting membrane potential of denervated muscle is -60 mV, making it easier for what? |
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Definition
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Term
| 4 arguments for the use of estim for denervated muscle |
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Definition
| slow muscle atrophy, minimize loss of muscle mass and strength, muscle fiber size can be maintained, limit edema and venous stasis delaying muscle fiber fibrosis and degeneration |
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Term
| 3 arguments against the use of ES for denervated muscle |
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Definition
| may interfere with regeneration thus delaying functional return, disrupt the regenerating neuromuscular junction slowing re-innervation, may traumatize denervated muscle since it is more sensitive to trauma than normal tissue |
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Term
| Why can't you substitue normal muscle innervation with ES |
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Definition
| quality and quantity of the contraction does not approach that of normal mm. There is a constant leakage of Ach that keeps muscle alive. Denervated mm loses this leakage of Ach and degenerates even with Estim |
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Term
| the intensity of the current needed to produce a minimal muscle contraction |
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Definition
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Term
| the duration of the stimulus at twice the rheobase intensity |
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Definition
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Term
| what is the chronoaxie of denervated muscle |
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Definition
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Term
| what type of rise time should be used with denervated muscle? why? |
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Definition
| fast or slow, denervated muscle does not accomodate |
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Term
| 9 general indications of estim |
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Definition
| pain modulation, muscle spasm, impaired ROM, muscle reeducation, disuse atrophy, soft tissue repair, edema reduction, reduction of spasticity, denervated muscle |
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Term
| how does estim provide pain modulation |
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Definition
| gate theory of pain, initiation of descending inhibition mechanisms (opiate production) |
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Term
| how does estim treat muscle spasm |
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Definition
| via muscle fatigue caused by sustained tetanic contractions, muscle pump: modulation in current causes contraction and relaxation of the muscle to improve circulation |
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Term
| how does estim treat impaired ROM |
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Definition
| decreasing pain, decreasing edema, mechanical stretching of connective tissue and muscle |
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Term
| how does estim reeducate muscle |
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Definition
| act as an active assistive exercise, provides proprioceptive feedback, assists in coordinated muscle movement |
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Term
| how does estim prevent disuse atrophy |
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Definition
| muscular pumping minimizes/reverses atrophy |
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Term
| which currents help in soft tissue repair |
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Definition
| pulsed (mono, bi, and polyphasic) |
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Term
| pulsed currents with what type of modulation aid in soft tissue repair |
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Definition
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Term
| which current type has bactericidal effects |
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Definition
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Term
| how does estim help with edema reduction |
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Definition
| muscle pump increases lymph and venous flow, interstitial proteins found in edema can be repelled from area with application of (-) charge |
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Term
| how does estim reduce spasticity |
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Definition
| fatigue of the agnoist, reciprocal inhibition (stimulates the antagonist to inhibit the agnoist) |
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Term
| 6 general contraindication of estim |
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Definition
| healing fractures, active bleeding, malignant tumors, phlebitis, superficial metal implants, pharyngeal or laryngeal muscles |
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Term
| 1 general precaution of estim |
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Definition
| demand type pacemakers or other myocardial disease |
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Term
| 1 absolute contraindicaiton to using estim |
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Definition
| any evidence of faulty or frayed wires or ifi the unit is not connected to GFI (ground fault interruptor) |
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Term
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Definition
| Transcutaneous Electrical Nerve Stimulation |
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Term
| what is TENS primarily designed for |
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Definition
| provide afferent stimulation for pain management through the skin |
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Term
| pain modulation through activation of central inhibition of pain transmitters |
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Definition
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Term
| Gate Control Theory: Large diameter A-beta fibers activate inhibitory interneurons founds where |
|
Definition
| dorsal horn of the spinal cord |
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Term
| Gate Control Theory: large diameter A-beta fibers activate inhibitory interneurons found in the dorsal horn of the spinal cord found in the dorsal horn of the spinal cord producing what? |
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Definition
| inhibition of (closing the gate to) smaller A-delta and C-fibers (which normally transmit pain) |
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Term
| Gate Control Theory: what happens if accomodation occurs |
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Definition
| gates open back up and pain returns |
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Term
| pain modulation through descending pathways generates what? |
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Definition
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Term
| stimulation of the descending pathways causes a release of what throughout the CNS |
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Definition
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Term
| stimulation of the descending pathways causes a relase of what from the pituatary gland |
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Definition
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Term
| TENS opiate release: reduction of pain perception is caused by applying the electrical current to what areas |
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Definition
| areas clsoe to the site of pain or to trigger points |
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|
Term
| waveform of TENS, 2 features |
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Definition
| biphasic (symmetrical or asymmetrical), balanaced |
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|
Term
| key features of a balanced waveform (2) |
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Definition
| equal number of electrical charges in each phase, surface area under each phase is equal |
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|
Term
| Why is it important to use a balanced waveform with TENS? (2) |
|
Definition
| avoid irritiation, TENS pain control is used for long durations, multiple times a days |
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|
Term
| what is the pulse duration/width of TENS |
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Definition
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|
Term
| what is the pulse frequency range of TENS |
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Definition
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|
Term
| what is the amplitude/intensity of TENS |
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Definition
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Term
| depending on the TENS settings, what types of nerves can it effect (3) |
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Definition
| sensory, motor, sensory-motor-nociceptive |
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Term
| What are the 5 modes that a TENS can be programmed to deliver |
|
Definition
| conventional, acupuncture-like (strong low rate), burst, brief intense, modulation |
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|
Term
| parameters of conventional mode TENS (duration, frequency, intensity) |
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Definition
| short duration, high frequency, comfortable intensity |
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|
Term
| why is the conventional mode the most frequnely selected by thereapist |
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Definition
| generally the msot comfortable application |
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|
Term
| how does the convential mode modulate pain |
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Definition
| through sensory nerve fibers, gate thoery |
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|
Term
| how quickly does analgesia take place in convential mode |
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Definition
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|
Term
| how long does analgesia last through convential mode |
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Definition
| from turning off the machine to a few hour after the machine has turned off |
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|
Term
| pulse duration, and pulse frequency of convential mode |
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Definition
| <150 microseconds, >80 Hz |
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|
Term
| acupuncutre-like mode parameters (frequency, intensity, duration) |
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Definition
| long duration, low frequency, comfortable current intensity |
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|
Term
| acupuncture mode depolarized what nerves |
|
Definition
| sensory and motor nerve fibers |
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Term
| acupuncutre-like mode modulates pain via what |
|
Definition
|
|
Term
| when does analgesia take place when using acupuncture-like mode |
|
Definition
| hours, slow to take place |
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|
Term
| how long does anaglesia last from acupuncture like mode |
|
Definition
| longer than conventional TENS, hours |
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|
Term
| pulse duration and pulse frequency of acupuncutre like mode |
|
Definition
| <150 microseconds, <10 Hz |
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|
Term
| burst mode paramters (duration, intensity, frequencY) |
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Definition
| bursts of pulses, low frequency, comfortable intensity |
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|
Term
| this mode of TENS may produce visible twitching (fasciculation) of muscle |
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Definition
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|
Term
| burst mode depolarizes which nerves |
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Definition
|
|
Term
| hwo does burst mode modulate pain |
|
Definition
|
|
Term
| how long does analagesia take to set in using burst mode |
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Definition
|
|
Term
| how long does analgesia last usign burst mode |
|
Definition
|
|
Term
| pulse duration and pulse frequency of burst mode |
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Definition
| 200-500 microseconds, 1-5 Hz |
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|
Term
| brief intense mode parameters (duration, intensity, frequency) |
|
Definition
| long duration, high frequency, tolerable current intensity |
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|
Term
| how long is the duration of brief intense mode usually |
|
Definition
| no greater than 15 minutes |
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|
Term
| brief intense mode depolarizes what nerves? |
|
Definition
| sensory, motor, nociceptive |
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|
Term
| brief-intense mode modulates pain how |
|
Definition
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|
Term
| analgesia takes place how soon via brief-intense mode |
|
Definition
|
|
Term
| how long does analgesia last via brief-intense mode |
|
Definition
|
|
Term
| pulse duration and pulse frequency of brief-intense mode |
|
Definition
| >150 microseconds, >80 Hz |
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|
Term
|
Definition
| management of acute/chronic pain, post-operative pain, labor pains, other chronic pain syndromes |
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|
Term
| this current is characterized by the crossing of 2 sinusoidal waves, each having similar but slightly different carrier frequencies which interfere with each other to produce an amplitude-modualted beat frequency |
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Definition
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Term
| interferential current utilizes the strong physiologic effects of medium frequecy electrical stimulation of mm and nerve tissue without what associated side effects? |
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Definition
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|
Term
| IFC depoarlizes what nerves |
|
Definition
| peripheral sensory and motor nerve fibers |
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Term
| IFC may have analgesic that is similar to, if not superior to what? |
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Definition
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Term
| Medium frequency devices are between what frequencies |
|
Definition
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|
Term
| medium frequency devices are also known as what |
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Definition
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|
Term
| medium frequency devices are known to be tolerated well by teh body beacuse of what? |
|
Definition
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|
Term
| the skin's resistance is proportional to the frequency of the current how? |
|
Definition
|
|
Term
| the skin's resistance is inversely proportional to the frequency of the current, meaning what for low current |
|
Definition
| greater resistance in the skin and patient discomfort |
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|
Term
| Why can IFC comfortably penetrate deeper into the body |
|
Definition
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|
Term
| IFC: when two sinusoidal waves are in phase the sum of the two waves is large |
|
Definition
|
|
Term
| IFC: the sum of the two waves is zero when the waves are 180 out of phase |
|
Definition
|
|
Term
| the resultant frequency produces by the 2 waves repeatedly going in and out of phase |
|
Definition
|
|
Term
| beat frequency in which both carrier frequencies are fixed |
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Definition
|
|
Term
| beat frequency in which only one carrier frequency is constant |
|
Definition
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|
Term
| if both carrier frequencies are fixed, one being 4000 and the other 4100, what is the beat frequency |
|
Definition
|
|
Term
| in a constant beat frequency, the beat frequency is carried on what type of carrier frequency? assuming the original carrier frequencies are 4000 and 4100 respectively |
|
Definition
| medium carrier frequency of the 4050 Hz amplitude-modulated current |
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Term
| a variable beat frequency is also known as what |
|
Definition
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|
Term
| Sweep/variable beat frequency is used to minimize what |
|
Definition
|
|
Term
| in order to cause a tetanic contraction through sweep frequency, what must the beat frequency be (range) |
|
Definition
|
|
Term
| which beat frequency is capable of producing a tetanic contraction |
|
Definition
| variable/sweep beat frequency |
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|
Term
| physiologic effects of IFC: 4 |
|
Definition
| pain releif, stress incontinence, improved ciruclation, edema management |
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|
Term
| How does IFC help with pain relief |
|
Definition
| Gate theory, opiate production |
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|
Term
| What frquency should be used with IFC to utilize the gate theory of pain relief |
|
Definition
| higher beat frequency of 90-150 Hz |
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|
Term
| What beat frequency should be used in opiate production for IFC |
|
Definition
|
|
Term
| what should teh overall frequency and intensity be for pain relief through IFC |
|
Definition
| lower frequencies and lower intensities |
|
|
Term
| Stress incontinence through IFC does what to strengthen pelvic floor muscles |
|
Definition
| generate tetanic contractions |
|
|
Term
| how can IFC lead to improved circulation/edema mangament |
|
Definition
| IFC can lead to muscle pumping with the production of tetanic contraction |
|
|
Term
| what frequency is needed for the IFC to improve circulation/edema managament |
|
Definition
|
|
Term
| in IFC where is the greatest concentration of current? |
|
Definition
| where the field intersect |
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|
Term
| Selection of bipolar vs quadripolar IFC depends on wwhat |
|
Definition
| depth of the target tissue |
|
|
Term
| IFC: Pain Relief: Amplitude |
|
Definition
| submotor, a comfortable tingling sensation. No motor response |
|
|
Term
| IFC: Pain Relief: Pulse rate |
|
Definition
| 50-110 bps (gate theory) or 1-10 bps (opiates) |
|
|
Term
| IFC: Pain Relief: pulse duration |
|
Definition
|
|
Term
| IFC: Pain Relief: treatment time |
|
Definition
|
|
Term
| IFC: Muscle Strengthening of Pelvic Floor: amplitude |
|
Definition
| tetanic muscle contraction |
|
|
Term
| IFC: Muscle Strengthening of Pelvic Floor: pulse rate |
|
Definition
|
|
Term
| IFC: Muscle Strengthening of Pelvic Floor: pulse duration |
|
Definition
|
|
Term
| IFC: Muscle Strengthening of Pelvic Floor: treatment time |
|
Definition
| depedent on number of reps/sets desired |
|
|
Term
|
Definition
| pain modulation, muscle spasm, muscle reeducation, disuse atrophy, edema |
|
|
Term
| applicatio of a continuous direct current that is used to transfer medicinal agents through the skin for therapeutic purposes |
|
Definition
|
|
Term
| Iontophoresis: acetate will require which electrode |
|
Definition
| cathode, as acetate is negatively charged |
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|
Term
| Iontophoresis: dexamaethasone will require which electrode |
|
Definition
| cathode, as dexamethasone is negatively charged |
|
|
Term
| Iontophoresis: glucocorticoid will require which electrode |
|
Definition
| cathode, as glucocorticoid is negatively charged |
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|
Term
| Iontophoresis: salicylate will require which electrode |
|
Definition
| cathode, as salicylate is negatively charged |
|
|
Term
| Iontophoresis: hydrocortisone will require which electrode |
|
Definition
| anode, as hydrocortisone is positively charged |
|
|
Term
| Iontophoresis: hyoluranidase will require what electrode |
|
Definition
| anode, as it is negatively charged |
|
|
Term
| Iontophoresis: lidocaine will require what electrode |
|
Definition
| anode, as it is positively charged |
|
|
Term
| Iontophoresis: zinc will require what electrode |
|
Definition
| anode, as zinc is positively charged |
|
|
Term
| Iontophoresis: effect and charge of acetate |
|
Definition
| (-), dissolves calcium deposits in soft tissues |
|
|
Term
| Iontophoresis: charge and effects of dexamethasone |
|
Definition
|
|
Term
| Iontophoresis: charge and effects of glucocorticoid |
|
Definition
|
|
Term
| Iontophoresis: charge and effects of salicylate |
|
Definition
| (-) decreases local pain and inflammation |
|
|
Term
| Iontophoresis: charge and effects of hydrocortisone |
|
Definition
|
|
Term
| Iontophoresis: charge and effects of hyoluronidase |
|
Definition
|
|
Term
| Iontophoresis: charge and effects of lidocaine |
|
Definition
|
|
Term
| Iontophoresis: charge and effects of zinc |
|
Definition
| (+) enhances tissue healing |
|
|
Term
| Iontophoresis indications (6) |
|
Definition
| decrease pain, inflammation, edema, hyperhydrosis, softening of cutaneous tissue, bactericidal effects |
|
|
Term
| iontophoresis contraindicaitons (3) |
|
Definition
| same as other estim devices, skin irritation from the use of galvanic DC, allergy/hypersentivity to ions used |
|
|
Term
| Inteferential Current: Pulse rate for gate theory |
|
Definition
|
|
Term
| IFC pulse rate for opiate production |
|
Definition
|
|
Term
| IFC pulse rate for pain relief |
|
Definition
|
|
Term
| IFC pain relief treatment time |
|
Definition
|
|
Term
| IFC muscle strengthening of pelvic floor: amplitude |
|
Definition
| tetanic muscle contraction |
|
|
Term
| IFC muscle strengthening of pelvic floor:pulse rate |
|
Definition
|
|
Term
| IFC muscle strengthening of pelvic floor:pulse duration |
|
Definition
|
|
