Wave Forms and Electricity
TENS/IFC
NMES
Ionto
Traction
From the Mind of Dr. G
ElectroMagnetic Spectrum
Case Studies
100
Metal and Water are good at carrying electricity
conductors
100
How many pads for IFC
4
100
Ratio for NMES for ROM
1:1
100
What type of wave form
DC
100
with increase angle of C spine traction, it targets what part of the neck
lower C spine
100
What are the ions that move across the membranes to create the action potential?
K+ and Na+
100
Name 2 contraindications for LASER
direct eye exposure
active malignancy
active hemorrhage
growth plates
endocrine system
100
A patient has a 2 day old ankle sprain, 9/10 pain with walking and swelling. What is the BEST combo of modalities for this patient?
Ice, compression with conventional TENS, IFC or Premod
200
as pad size decreases, current density_____
increases
200
What theory are we using for conventional TENS and IFC
Gate Control
200
Parameters for NMES
PPS: 20-80
PW: 300-600
200
the charge of dexamethasone so which pad?
negative- cathode
200
Name 2 effects of cervical traction
Decease in disc herniation
increase disc height
mixed results on muscle relaxation
increase nutrient flow to annular tissue
200
What do you do if your patient has a pacemaker?
DO NOT USE E-STIM
200
Why might LASER improve diabetic neuropathy
increase mitochondrial activity- increase ATP, promote cell repair
200
A patient is 3 weeks post op total knee replacement and is having a hard time with quad activation. You only have a big unit. What are your settings?
Russian
1:3 (1:5) on/off time
3 sec ramp
big pads
spaced out
300
Asymmetrical Biphasic
300
What theory are we using for noxious stimulus?
Endogenous Opiate
300
Two reasons we increase strength with NMES
Neural Adaptations
Increase in muscle size-overload
300
How long would treatment be if I wanted to deliver 80mAs and my pt could tolerate 4mAs intensity?
20 mins
300
What special test indicates positive outcomes when using lumbar traction?
Positive cross SLR
300
What are two ways a machine gives feedback in biofeedback
visual and auditory
300
What do we do to reduce burns from the plate or drum during the use of diathermy?
Put a cloth between plate/drum and skin
300
You have a patient who is 3 weeks post large quad contusion, is having 1/10 pain at end range flex/ext, just feels tight. What is you best choice of modality? Why?
Diathermy
Deep heat
large area
400
intermittent mono phasic
400
Parameters for motor TENS
PPS: 2-5
PW: 150-200
400
Pad Placement for NMES
Over muscle belly- parallel to fibers
400
Indications for Ionto
Localized problem
fairly superficial
pt can tolerate drug and current dosage
400
If my on off cycle is 3:1 and my on cycle is 60 seconds, what is my off time?
20 seconds
400
If using a heel switch for DF activation, where would you put the pads and which phase of gait would they be active?
anterior tibialis and swing phase
400
Is diathermy use for large or small areas? Superficial or deep?
Large and Deep
400
You want to do conventional tens for pain control but only have a large unit at the clinic. How do you set this up?
symmetrical biphasic
PR: 30-150
PW: 50-100
10-20 mins treatment
continuous
sensory level
500
DC current
500
why we use Sweep or burst
to decrease habituation
500
Why do we use Ramp?
patient comfort and allow for muscle recruitment
500
Lidocaine has what charge, and would go on which pad?
Positive, on the anode
500
What is the max force dosage for cervical spine?
25lbs
500
What is a medical emergency for spinal cord injury patients when using NMES?
Autonomic dysreflexia
500
What is part of the set up that is for safety to the patient to reduce burning in other areas with diathermy?
remove jewelry
500
A patient is 8 week post R shoulder replacement. They have 4/10 pain, 3/5 deltoid MMT, 90 deg shoulder ABD. They are having a hard time sleeping from the pain, but struggle with dressing and showering due to weakness and lack of ROM. What is your BEST treatment?
TENS: conventional, motor or noxious (TELL ME WHY)
IFC/Pre mod- pain
NMES: strength 1:3/5
ROM: 1/1