Term
| monopolar russian stim uses what type of pads |
|
Definition
|
|
Term
| monopolar russian stim: how much smaller must the active pad be to the dispersive |
|
Definition
|
|
Term
| bipolar and quadripolar russian stim uses what size pads |
|
Definition
|
|
Term
|
Definition
|
|
Term
| russian stim: carrier frequency |
|
Definition
|
|
Term
| russian stim: on/off ration |
|
Definition
| depends, on time usually 10 seconds, off time from 10-50 |
|
|
Term
| russian stim: current amplitude |
|
Definition
| patient's maximum tolerance |
|
|
Term
| russian stim: treatment time |
|
Definition
| recommended 10 contractions |
|
|
Term
| HVPC: how far must the other electrode be positioned from the electrode on the wound |
|
Definition
|
|
Term
| HVPC: for soft tissue edema, where shoudl teh dispersive pad be plaed |
|
Definition
| proximal to the active pad (between the swelling and the heart) |
|
|
Term
| HVPC: what should teh polarity of the active pad be for soft tissue edema |
|
Definition
|
|
Term
| HVPC: soft tissue edema: pulse frequency |
|
Definition
|
|
Term
| HVPC: soft tissue edema: amplitude |
|
Definition
| enough to cause teh desired muscle contraction |
|
|
Term
| HVPC: pain management: pulse frequency |
|
Definition
|
|
Term
| HVPC: pain management: amplitude |
|
Definition
|
|
Term
| HVPC pain management treatment duration |
|
Definition
|
|
Term
| What is continuous DC stimulation used for |
|
Definition
|
|
Term
| Continuous DC Stimulation: waveform |
|
Definition
|
|
Term
| Continuous DC Stimulation: pulse rate |
|
Definition
| will be determined by the frequency of skin contact by the tap key |
|
|
Term
| Continuous DC Stimulation: pulse width |
|
Definition
| use chronaxie if known, otherwise at least 100 msec. |
|
|
Term
| Continuous DC Stimulation: current amplitude |
|
Definition
| should be strong enough to elicit muscle twitching |
|
|
Term
| Continuous DC Stimulation: treatment time |
|
Definition
| either muscle fatigue or lack of good twitches, or 3 sets of 10-20 reps |
|
|
Term
|
Definition
| >33 pps for optimal tetanic contraction, but as high as tolerable if trying to fatigue the muscle |
|
|
Term
|
Definition
| for muscle strengthening any setting is acceptable but for fatiguing turn the width up as high as possible |
|
|
Term
|
Definition
| on typically 10, off typically 10-60 usually 60 though |
|
|
Term
|
Definition
|
|
Term
|
Definition
| stregthening muscle: enough to evoke a tetanic contraction. fatiguing muscle: intensity up as high as tolerated |
|
|
Term
|
Definition
| dependson the # of evoked contractiosn desire. Stim should be continuous to evoke fatigue. Typical treatment time 15-30 minutes |
|
|
Term
| Biofeedback: how many electrodes must be used in bipolar technique |
|
Definition
| 3. active: +, -, and a reference(ground) |
|
|
Term
| Biofeedback: Bipolar technique: How far apart should the active electrodes be placed from each other |
|
Definition
| at least 15 cm apart if allowable |
|
|
Term
| Biofeedback: bipolar technique: where should the reference electrode be placed |
|
Definition
| either between teh active electrodes or near the actives |
|
|
Term
| Biofeedback: bipolar technique: what happens when the active electrodes are placed closer to each other |
|
Definition
| minimize cross talk, yields small signals, gives a more precise signal |
|
|
Term
| Biofeedback: bipolar technique: what happens when active electrodes are placed further apart |
|
Definition
| allows for more cross talk, yields large signals, and gives a less precise signal (picks up electrical activity from other non targeted tissue) |
|
|
Term
| raw emg signals has what types of phases |
|
Definition
|
|
Term
| difference between raw and rectified emg signal |
|
Definition
| recitified emg signal has positve and negative aspects of teh summated potentials and made unidirectional |
|
|
Term
| How should biofeedback be applied with weak muscles |
|
Definition
| widely spaced electrodes, biofeedback instrument sensitivity set to high to increase detection |
|
|
Term
| how should biofeedback be used to decrease muscle activty (relax muscle) |
|
Definition
| electrodes closely spaced and biofeedback sensitivty to low to minimize cross talk |
|
|
Term
| Criteria for patient selection for biofeedback training (4) |
|
Definition
| good vision, hearing, and communicaiton abilities, good comprehension of simple comands, concentration, good motor planning skills, no profound sensory or proprioceptive loss |
|
|
Term
| Biofeedback: indications for muscle relaxation |
|
Definition
| stress related hyperarousal, pain, spasticity, torticollis |
|
|
Term
| Biofeedback: indications for muscle recruitment (3) |
|
Definition
| peripheral nerve injury (muscle must be reiinervated), muscle weakness s/p immobilization, joint surgery, disuse atrophy, pain, antagnoists to spastic muscles |
|
|
Term
| high volt galvanic stimulation aka |
|
Definition
| high volt pulsed current (HVPC) |
|
|
Term
| HVPC is used for what clinically (3) |
|
Definition
| edema reduction, dermal wound healing, reduction of pain |
|
|
Term
| How does HVPC manage soft tissue edema |
|
Definition
| local muscle pumping through repeated evoked muscle contractions, and fluid repulsion through microvascular changes |
|
|
Term
| how does HVPC manage pain? |
|
Definition
| same as TENS via the gate theory |
|
|
Term
| how does HVPC aid in dermal wound healing |
|
Definition
| mimics and strengthens the natural weakened, skin battery to enhance and maintain the healing process. |
|
|
Term
| what is the skin battery? |
|
Definition
| natural direct current bioelectric system that flows between the dermis and epidermis. Maintains tissue health |
|
|
Term
| Biophysical parameters of HVPC (peaks, phase, type of currents, duration, voltage) |
|
Definition
| twin-peak, monophasic, pulsed currents, fixed durations, high voltage |
|
|
Term
| HVPC: each pulse consists of a pair of twin spiked waveforms having an almost instanteous rise with an exponential decline |
|
Definition
| twin-peak monophasic pulse |
|
|
Term
| How is HVPC pulse duraiton determined |
|
Definition
| teh sum of the duration of both spikes plus the interspike interval |
|
|
Term
| How long are typical HVPC pulses |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Tissue impedance when using HVPC |
|
Definition
| very low tissue impedance making it comfortable for the patient and effective |
|
|
Term
| HVPC: what types of electrode pads should be used when treating edema |
|
Definition
|
|
Term
| HVPC: why are cathode pads used in treating edema |
|
Definition
| edema is (-) charged, need opposite charge to push fluid closer to heart |
|
|
Term
| HVPC: where is the anode dispersive pad placed for edema treatment |
|
Definition
| between the treatment area and the heart |
|
|
Term
| HVPC: parameters for edema (frequency, amplitude, pulse duration, mode, treatment time) |
|
Definition
| PF: as high as possible, amplitude: sensory threshold, PD: usually not manipulated in microseconds, continuous mode, tx time 30-60 mins) |
|
|
Term
| HVPC: parameters to control edema via muscle pumping/contractions (PF, amplitude, on/off time, tx time) |
|
Definition
| PF 1-10 pps, amplitude: motor response, on/off typically 15/45 sec, time =30-60 minutes) |
|
|
Term
| HVPC: type of active electrode used for INFECTED wounds |
|
Definition
|
|
Term
| HVPC: why is the cathode used for INFECTED wounds |
|
Definition
|
|
Term
| HVPC: active electrode for NONINFECTED wounds |
|
Definition
|
|
Term
| HVPC: parameters for wound healing (pf, intensity, tx time) |
|
Definition
| PF=30-200 as high as possible, Intensity = patient comfort without motor response, tx time=30-60 mins) |
|
|
Term
|
Definition
| dermal wounds, edema, pain relief |
|
|
Term
| HVPC: Wound Healing Sussman: proliferative phase parameters (polarity, PF, intensity, duration) |
|
Definition
| (-), PF between 100-128 pps, Intensity: submotor, duraiton 30-60 minutes |
|
|
Term
| HVPC: Wound Healing Sussman: epithelialization phase paramters (polarity, PF, intensity, duration) |
|
Definition
| (+), PF decreased to 64 pps, Intensity: Submotor, Duration 30-60 minutes) |
|
|
Term
| What is continuous DC stimulation used for |
|
Definition
|
|
Term
| Why is continuous DC stimulation used for denervated muscle? |
|
Definition
| minimize the extent of atrophy that occurs while the peripheral nerve is regenerating |
|
|
Term
| Physiologic effects of stimulating denervated muscle: (2) |
|
Definition
| decreased atrophy/increased muscle strength, decreased edema |
|
|
Term
| Continuous DC stimulation parameters: waveform, amplitude, frequency, pulse width |
|
Definition
| continuous DC, amplitude enough to cause a visible muscle contraction, frequency: set by frequency of contact with tap key, pulse width chronaxie if known otherwise at least 100 microseconds |
|
|
Term
| the intensity of the current needed to produce a minimal muscle contraction |
|
Definition
|
|
Term
| the duration of the stimulus at twice the rheobase intensity |
|
Definition
|
|
Term
| What is the chrnoaxie of denervated muscle |
|
Definition
|
|
Term
| Some clinicians advocate the use of what pulse width intially for patient comfort |
|
Definition
|
|
Term
| Continuous DC stimulation: ramp time |
|
Definition
| doesn't matter, denervated muscle does not accomodate |
|
|
Term
| Continuous DC stimulation: location of dispersive pad |
|
Definition
| distant from the treatment site |
|
|
Term
| Continuous DC stimulation: duration of the treatment |
|
Definition
| 3 sets of 10-20 reps daily or until motor point is fatigued |
|
|
Term
| Continuous DC stimulation: contraindication specific to this modality |
|
Definition
| galvanic DC can cause skin irritation |
|
|
Term
| neuromuscular device characterized by a low volt stimulation to depolarize motor nerve fibers to cause a muscle contraciton |
|
Definition
|
|
Term
| EMS+2: is used clinically primarily for what... |
|
Definition
| prevent, or reduce muscle atrophy |
|
|
Term
| Continuous DC stimulation: secondary functions |
|
Definition
| improve circulation, increase ROM, improve muscle endurance |
|
|
Term
| Continuous DC stimulation: end point of muscle strengthening and re-education mode, ie what is the goal |
|
Definition
| elicit a good tetanic contraction |
|
|
Term
| EMS2: muscle strengthening and reeducation: frequency needed to elicit a tetanic contraction |
|
Definition
|
|
Term
| EMS2: frequency needed for edema reduction |
|
Definition
| >33 Hz, to elicit a tetanic contraction |
|
|
Term
| EMS2: what set up would be used to decraese spasm |
|
Definition
|
|
Term
| EMS2: where would the smaller electrode be placed for decreasing spasm |
|
Definition
| motor point of painful muscle |
|
|
Term
| EMS2: What size should the dispersive pad be for decreasing spasm |
|
Definition
| 4x greater than the active pad |
|
|
Term
| EMS2: a bipolar set up for decreasing spasm would cause what? |
|
Definition
| repetitive contract/relax which also induces muscular relaxation |
|
|
Term
|
Definition
|
|
Term
|
Definition
| symmetrical rectangular with net 0 charge |
|
|
Term
|
Definition
|
|
Term
|
Definition
| adjustable between 1 and 6 seconds |
|
|
Term
|
Definition
| adjustable between 4-80 Hz |
|
|
Term
|
Definition
|
|
Term
|
Definition
| tetanic contraction desired |
|
|
Term
|
Definition
| typically 1:6 (10 on, 60 off) |
|
|
Term
|
Definition
| adjustable. continuous, 15,30, 60 minutes. |
|
|
Term
| EMS2: Muscle Strengthening and contract/relax mode: waveform |
|
Definition
| either AC or DC is acceptable |
|
|
Term
| EMS2: Muscle Strengthening and contract/relax mode: ramp up/down time |
|
Definition
| between 2-3 seconds for patient comfort |
|
|
Term
| EMS2: Muscle Strengthening and contract/relax mode: pulse rate (frequency) |
|
Definition
|
|
Term
| EMS2: Muscle Strengthening and contract/relax mode: pulse width |
|
Definition
| 50-300 microseconds (as high as tolerable) |
|
|
Term
| EMS2: Muscle Strengthening and contract/relax mode: amplitude |
|
Definition
| tetanic contraction desired |
|
|
Term
| EMS2: Muscle Strengthening and contract/relax mode: duty cycle |
|
Definition
| 10 on, 60 off. off may be decreased as patient becomes more accustomed to device |
|
|
Term
| EMS2: Muscle Strengthening and contract/relax mode: duration |
|
Definition
|
|
Term
| EMS2: Fatigue mode: waveform |
|
Definition
| either AC or DC is accetable |
|
|
Term
| EMS2: Fatigue mode: ramp up/down time |
|
Definition
| minimize ramp time to lowest possible setting |
|
|
Term
| EMS2: Fatigue mode: pulse rate (frequency) |
|
Definition
| >33 Hz (as high as tolerable) |
|
|
Term
| EMS2: Fatigue mode: amplitude |
|
Definition
| tetanic contraction desired |
|
|
Term
| EMS2: Fatigue mode: duty cycle |
|
Definition
| maximum allowable time on, least allowable time off |
|
|
Term
| EMS2: Fatigue mode: duration |
|
Definition
|
|
Term
| EMS2: Foot Drop: waveform |
|
Definition
|
|
Term
| EMS2: Foot Drop: ramp up/down time |
|
Definition
|
|
Term
| EMS2: Foot Drop: pulse rate (frequency) |
|
Definition
|
|
Term
| EMS2: Foot Drop: Pulse Width |
|
Definition
| 50-300 microseconds (as high as tolerable) |
|
|
Term
| EMS2: Foot Drop: amplitude |
|
Definition
| tetanic contraction desired |
|
|
Term
| EMS2: Foot Drop: duty cycle |
|
Definition
| no duty cycle, stim is triggered with foot switch |
|
|
Term
| EMS2: Foot Drop: duration |
|
Definition
| depends on patient's endurance |
|
|
Term
| specialized form of NMES used to treat dysphagia |
|
Definition
|
|
Term
|
Definition
| re-educates the throat muscles associated with swallowing |
|
|
Term
|
Definition
|
|
Term
| EMS2: does the electrode waveform matter |
|
Definition
|
|
Term
| EMS2: how do you choose the size of the electrode |
|
Definition
| most corresponds with the size of the muscle and the area that you are treating |
|
|
Term
| EMS2: danger in choosing electrodes that are too small for an area |
|
Definition
|
|
Term
| EMS2: current density and depth of muscle stimulation with a greater interelectrode distance |
|
Definition
| greater current density, deeper muscle stimulation |
|
|
Term
| EMS2: ideal placement of electrodes |
|
Definition
| produce the desired muscle contraction with no or minimal discomfort |
|
|
Term
| EMS2: monopolar set up utilizes what type of electrodes |
|
Definition
| small active, 4x larger dispersive |
|
|
Term
| EMS2: monopolar set up is used to do what |
|
Definition
|
|
Term
| EMS2: in the monopolar set up where should the larger pad be placed |
|
Definition
|
|
Term
| EMS2: footswitch set up stimultates what mm group or nereve |
|
Definition
| dorsiflexors or Common Peroneal (common fibular) nerve |
|
|
Term
| EMS2: electrode orientation |
|
Definition
| parallel or in the line of pull of the muscle |
|
|
Term
| what is a motor point CLINICALLY |
|
Definition
| area within the targeted muscle mass that is best stimulated with the smallest amount of amplitude and the shortest pulse duratoin |
|
|
Term
| what is a motor point ANATOMICALLY |
|
Definition
| motor point is the surface entry point of a bundle of motor nerve fibers into a bundle of muscle fibers |
|
|
Term
|
Definition
| strengthen muscle, promote fatigue in hypertonic muscles |
|
|
Term
|
Definition
| same as any EStim. If exercise accompanies EMS2 make sure resisted exercise is indicated for ptnt |
|
|
Term
| Russian Stimulation: clinically uses (3) |
|
Definition
| improve motor recruitment, facilitate muscle hypertrophy, improve strength |
|
|
Term
| Russian Stimulation: Physiologic effects: Evokes what type of contraction |
|
Definition
|
|
Term
| Russian Stimulation: why should the tetanic contraction be painelss |
|
Definition
| sensory nerve blockade due to depoarlization of sensory nerve fibers |
|
|
Term
| Russian Stimulation: is the contraction caused by russian stim stronger or weaker than one created by voluntary control |
|
Definition
|
|
Term
| Russian Stimulation: since Russian stim is relatively painless it can be applied where |
|
Definition
| deeper motor nerve fibers assoicated with high force fast twitch motor units |
|
|
Term
| Russian Stimulation: in electrically evoked muscle stimulation how do motor units fire |
|
Definition
|
|
Term
| Russian Stimulation: in normal muscle recruitment, how do motor units fire |
|
Definition
|
|
Term
| Russian Stimulation: how are muscle fiber types recruited in electrically-evoked muscle stim |
|
Definition
|
|
Term
| Russian Stimulation: how are muscle fiber types recruited under normal contraction |
|
Definition
|
|
Term
| Russian Stimulation: amplitude |
|
Definition
| tetanic muscle contraction |
|
|
Term
| Russian Stimulation: pulse rate |
|
Definition
|
|
Term
| Russian Stimulation: carrier frequency (Hz) |
|
Definition
|
|
Term
| Russian Stimulation: pulse duration |
|
Definition
| 150-200 microseconds, may be higher if trying to decrease spasm/spasticty by fatiguing muscles |
|
|
Term
| Russian Stimulation: current can be applied to provide stimulation for strengthening during the following volitoional activities |
|
Definition
| isometric exercises at various points through the range, slow isokinetic exercise 5-10 degrees/sec, short arc joint movement where movement is restricted |
|
|
Term
| Russian Stimulation: ramp time |
|
Definition
| 1-5 second for patient comfort |
|
|
Term
| Russian Stimulation: duty cycle |
|
Definition
|
|
Term
| Russian Stimulation: to decrease spasm/spasticity: ramp time |
|
Definition
|
|
Term
| Russian Stimulation: duty cycle to decrease spasm/spasticty |
|
Definition
| 10 on, 50-60 off, continuous mode to induce fatigue, or 50 on 10 off |
|
|
Term
| Russian Stimulation: treatment duration |
|
Definition
|
|
Term
| Russian Stimulation: treatment duration for muscle strength |
|
Definition
| 10 contractions = 10 minutes |
|
|
Term
| Russian Stimulation: duration to decrease spasm |
|
Definition
|
|
Term
| Russian Stimulation: when should russian stim be used to decrease spasm |
|
Definition
| prior to functional activity |
|
|
Term
| Russian Stimulation: why should you not pick an electrode that is too small for the area being treated |
|
Definition
| may cause pain or a thermal skin burn |
|
|
Term
| Russian Stimulation: positioning of electrodes |
|
Definition
|
|
Term
| Russian Stimulation: the quadripolaer methods involves placing the electrodes in a way that... |
|
Definition
| the imaginary lines of currents in each pain could interact (run in parallel or crisscross) with each other within the targeted tissue |
|
|
Term
| Russian Stimulation: indications |
|
Definition
| strengthen muscles of healthy individuals |
|
|
Term
| the use of instrumentation to bring specific events to conscious awareness |
|
Definition
|
|
Term
| Biofeedback: examples of instruments which provide biofeedback |
|
Definition
| EMG's, stability/bp cuffs, mirrors |
|
|
Term
| Biofeedback: what does an EMG do for biofeedback |
|
Definition
| does ont provide stimulation but reads the electrical activity of the muscles |
|
|
Term
| Biofeedback: EMG is commonly used for what |
|
Definition
| muscle relaxation, muscle re-education |
|
|
Term
| Biofeedback: Muscle Relaxation: sensitivity |
|
Definition
|
|
Term
| Biofeedback: muscle relaxation: sensitivity as patient progresses |
|
Definition
|
|
Term
| Biofeedback: muscle re-education: what is the sensitivity elvel |
|
Definition
| set at 2/3 max contraction |
|
|
Term
| Biofeedback: muscle re-education: sensitivity as patient progresses |
|
Definition
|
|
Term
| Biofeedback: thereapeutic effects (6) |
|
Definition
| decreased accessory muscle use, decreased muscle spasm, decreased pain, improved muscle strength/recruitment, muscle relaxation, neuromuscular control |
|
|
Term
| Biofeedback: indications (7) |
|
Definition
| incontinence, hemiplegia, impaired motor control, muscle spasm, muscle weakness, pain, SCI |
|
|
Term
| Biofeedback: contraindications |
|
Definition
|
|
