Electrical Stimulation
What stimulation frequency is typically used to produce a tetanic muscle contraction plateau without causing rapid fatigue during NMES?
What is approximately 50 Hz?
Starts at about 30 Hz, but plateaus at 50 Hz
What does EMG biofeedback measure?
What is electrical activity in muscles?
What does C-B-A-N stand for in cryotherapy?
What is Cold, Burning, Aching, Numbness?
What is the proper storage temperature for moist hot packs?
167°F
(150-170°F on info sheet)
Name a condition treated with compression.
§ After trauma, surgery
§ Vascular disease (diffuse LE swelling)
§ Poor venous return (peripheral edema)
§ Lymphedema
§ Cardiac/pulmonary/renal pathology
This current has a 2500 Hz carrier frequency and 50 Hz burst frequency.
What is Russian Current?
Biofeedback is commonly used in two ways to control muscle contraction, which are facilitation and _______.
What is inhibition?
Physiologically, cryotherapy decreases blood flow and what else?
List 2 minimum
What are metabolic rate, NCV, GMN activity, and Muscle spindle discharge (mm spasticity)?
Name two connective tissue effects of heat.
Alteration of viscoelastic properties
Decreased joint stiffness
Increased muscle flexibility
Increased elasticity
Decreased viscosity
What does IPC stand for in compression therapy?
What is Intermittent Pneumatic Compression?
What is the primary difference in motor unit recruitment between NMES and voluntary muscle contraction?
What is NMES recruits motor units non-selectively and synchronously, while voluntary contractions recruit them progressively and asynchronously?
With voluntary, small motor fibers are recruited first, followed by the fast large motor units (Selective). NMES is non-selective; that is, the small and large motor units are recruited together or not following the physiological principles.
High sensitivity in biofeedback corresponds to what gain setting?
What is low gain?
- Sensitivity is the ability to detect the electrical
activity associated with muscle contraction.
- Typical devices used for EMG biofeedback offer
sensitivity settings (sometimes called gain) of
1, 10, 100, or 1,000 microvolts (μV).
- Sensitivity and gain are inversely related, such
that the gain setting is the lowest at the
highest sensitivity.
What is the primary heat transfer method in ice massage?
What is conduction?
How many towel layers are needed when lying on a hot pack?
-Use 6-8 layers of towels for safe heating
-(cover = 2 layers)
-8-10 layers if lying supine on MHP
Typical IPC pressures post-acute injury fall within what range?
What is 30–60 mmHg?
What is the typical pulse duration used for NMES muscle strengthening?
What is 200-600 microseconds?
Name one condition where facilitatory biofeedback is appropriate.
What is ACL reconstruction?
Urinary incontinence
CNS Dysfunction
Spasticity
Issues with postural control and stress affecting the body
Muscle activity related to chronic pain
Impaired volitional muscle recruitment
Muscle imbalance affects muscle control
Name two mechanisms for cryotherapy-induced pain relief.
What are nerve conduction reduction and gate control theory?
Fluidotherapy uses what mode of heat transfer?
What is convection?
Name one assessment used to measure outcomes of compression treatment.
- Girth Measurements
- Volumetric Measurements
- VAS (pain)
- Goni
- Functional Status
What stimulation method is used for denervated muscles and why?
What is direct stimulation of the sarcolemma due to lack of motor nerve innervation?
Electrical stimulation (ES) activates muscle fibers by depolarizing the sarcolemma
and not via peripheral motor nerves. NMES is for innervated muscle.
§ Necessary parameters:
§ Long pulse duration
§ Greater amplitude of stimulation,
§ Different waveform (direct current, greater risk of skin burns).
Why is biofeedback appropriate for patients who can’t tolerate NMES?
Because it does not deliver current, only records muscle activity.
List two contraindications for cryotherapy.
Raynaud’s phenomenon
Compromised circulation
Cold urticaria
Cryoglobulinemia
Raynaud’s phenomenon
Paroxysmal cold hemoglobinuria
Compromised circulation
Peripheral vascular disease
Over regenerating nerves
Name three contraindications to thermotherapy.
§ Decreased sensation to hot/cold
§ Over areas of severe vascular
insufficiency
§ Areas of recent burns
§ Infections/open wounds
§ Cancer (skin, lymphatic)
§ Acute injury or inflammation
§ Decreased cognition
§ Excessive HTN (resting BP>160/90)
§ Long-term steroid use
Name three contraindications to compression therapy.
§ Acute pulmonary edema
§ CHF
§ Recent or acute DVT
§ Acute fracture
§ Uncontrolled HTN