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General Indication for Electrical Stimulation
- Pain modulation
- Muscle re-education
- Muscle weakness
- Wound healing
- Edema reducation
- Spasticity
- Denervated muscle
- Muscle Spasm
- Impaired ROM
- Increase local circulation
- Use in labor and delivery
- Facial Neuropathy
- Stress incontinence
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General Contraindications for Estim
- Healing Fractures
- Areas of active bleeding
- Phlebitis in treatment area
- Supericial Metal Implants
- Pharyngeal or laryngeal muscle
- Demand ytpe pacemaker
- Myocardial Disease
- Over anterior Transcervical Area
- Over cardiac, transthoracic area
- Over eyes
- stroke or seizure
- Osteomyelitis
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Precautions
- Severe edema
- Skin Allergies to electodes, tape, gel
- Do not use any electrical modality if there is evidence of broken or frayed wires or if the unit is not connectes to a groud fault circuit interrupter
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Therapeutic Effect of E.Stim
- Relaxation of muscle
- Muscle Strengthening
- Improve ROM
- Decrease Pain and Edema
- Eliminate disue atrophy
- Muscle Reeducation
- Increase local cirulation
- Facilitate wound healing
- Facilitate bone repair of a fracture
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Physiological Responses to E. Stim
- Stimulate sensory and or motor tissue: muscle contraction, analgesic effects
- Stimulate cellular activity: alter cellular propterties of tissue (DC is beter than AC)
- Alter circulation and lymphatic activity
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Causes of Pain
- Musculoskeletal vs. nervous
- Disease process vs injury
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Acute Pain
- More successfully managed
- recent onset
- shorter duration
- associated with cause
- well localized
- often goes with inflammation
- fix the sourse relieve the pain
- client percieves control
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Chonic Pain
- less responsive to electroanalgesia
- longer duration
- no longer associated wtih cause
- more general
- associated with behavioral manifestation
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Parameters Used for Sensroy Pain Control
- A-beta nerves
- Short Duraction
- High Frequency
- Submotor intensity
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Parameter Used for Motor Pain Control
- Motor nerve
- Long Duration
- Low Frequency
- Strong Contraction
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Parapemters Used for Noxious Pain Control
- Opiate
- A-delta and C-fibers
- Longer duration
- Low Frequency
- as painful as tolerabe and submotor
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Treatment options for Pain Management
- Interferenctial
- Biphasic
- TENS
- Combination E. Stim with US
- Micrcurrent
- High Voltage Pulsed Current (HVPC)
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Subacute Pain
- Start pain free motor stimulation, continuous or interrupted
- Analgesia and release of muscle spasm
- Might let muscle twitch to fatigue to help muscle relax
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IFC
- the use of higher frequencies allows the current to penetrate deeper and elivering it at low intensity at the skin level allow it to be more comfortable
- can also stimulate a larger area than other waveforms
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How IFC works
- Two waveforms are delivered throught two sets of electrodes through separate channels in the same stimulator
- The electrodes are configures on the skin so that the two AC currents intersect
- Beat Frequency
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Parameters that can be changed with IFC
- Duration and intenstiy
- Can not change frequency
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Define Carrier Frequency
The Frequency of the lower original AC
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Define Beat Frequency
the current in the biological frequency range
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Define Bio-electric Frequency Range
- Excitable and non-excitable tissues can respond to electrical stimulation within a certain frequency range
- 1-200hz
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