Basics of Electricity and Electrode placement
IFC, Pre Mod, and Russian stimulation are all examples of this type of waveform?
Alternating current (AC)
On/off ratio and an example of on/off time used for strengthening
1:5
5 sec on, 25 sec off
10 sec on, 50 sec off
Location of most arterial insufficiency ulcers
lateral lower leg, top of foot
What helps a PTA choose between using IFC or PreMod?
Treatment area (crossing through the joint-use IFC; wanting to treat two different areas-use PreMod; only need to focus on one side of the joint-use PreMod)
97033
Iontophoresis
Name an over the counter medication used to treat pain AND edema. For which estim for pain parameters do OTC meds interfere?
Aleve/Naproxen OR Ibuprofen/Advil/Motrin OR Aspirin (Bayer); OTC Med timing does not interfere with any pain estim treatments.
The time it takes to go from zero to maximum intensity in Russian stimulation or NMES
Ramp
A patient receiving Russian stimulation, reciprocal to (L) ant tib and gastroc at 50bps, 5 sec on, 5 sec off, 1 sec ramp x30 mins has what clinical indication?
Edema in which the patient cannot produce a muscle contractions to help with edema reduction on their own
Phase of healing in which you use the positive polarity in or nearest the wound
Proliferative phase of healing
For which estim treatment for pain does the timing of prescription pain meds matter?
Low rate TENs, subacute or chronic settings for IFC/Pre Mod
Estim for wounds
GO281
Polarity and indication for the use of dexamethasone in iontophoresis
Negative and inflammation
Why are electrodes placed an inch/two finger widths apart?
To prevent a surface current (burns)
Physiologically, why is Russian stimulation and NMES used?
Stimulation of the (atrophied) type II muscle fibers
Objective measure that can be used to show improvement for a patient with venous insufficiency
Circumferential measures
Why does IFC at 50-150Hz allow for pain relief? How long with the pain relief last?
Gate control theory-stimulation of A beta fibers which inhibit painful messages sent to brain from A delta and C fibers in the periphery; effects last 30min-2 hours post end of estim treatment.
Estim for non Medicare, non wound Patients
97014
Out of all of the estim waveforms used, this one is smallest; therefore safest (least likely to lead to burns).
HVPC
Name two absolute contraindications to electrical stimulation...meaning if the patient has this, estim is contraindicated anywhere in the body.
Pacemaker or defibrillator
Increasing any or all of the three parameters may help a patient to reach a full contraction
Pulse rate (frequency), Pulse width (duration), and electrode size
What HVPC parameters would you use for a patient with bruising and edema around the wrist after a fall onto an outstretched arm (we know it is a sprain and no fracture).
HVPC at 120 pps with negative electrode over the bruising x30 mins with UE elevated and doing wrist pumps, circles, AROM
How does IFC or TENs at 1-10Hz reduce pain? How long can the pain relief last?
Causes the body to release natural endorphins and opioids as well as an anti-inflammatory hormone (adrenocorticotrophic hormone); 4-8 hours
Russian stim for neuro re-ed for 75 y/o patient post TKR for quad facilitation.
GO283
Name a reason to use biofeedback for an above threshold goal.
Facilitation (VMO post sx, pelvic floor, antagonist to spastic muscle, underfiring muscle when imbalance present)
Why do you wet the skin prior to electrode placement?
To reduce tissue impedance (resistance)...so you do not have to turn the intensity up as high...therefore, making the treatment more comfortable
Name two contraindications to motor stimulation such as Russian/NMES.
DVT and any condition/pathology in which movement would be detrimental to healing (fx, recent injury)
Physiologically, how does HVPC work?
Galvanotaxis-using electrical charges/polarity to attract certain cells to the area.
After a patient receives a treatment for subacute or chronic pain, when will the person feel relief? When will the full extent of pain relief be felt?
Immediately; pain continues to decrease for an hour after treatment.
Teaching a patient how to use a TENs unit, apply electrodes, and alter settings.
97032
How long would it take to deliver an 80 mA-min iontophoresis treatment at 2mA?
40 minutes