-
segmental pain control
gate control
stimulate
intensity
phase duration
frequency
- ascending control (close door)
- A Beta receptors
- sensory/strong comfortable sensation
- short, <125usec
- high, >20Hz, constant tingling you can have between 20Hz and 300Hz
-
segmental pain control
on/off cycle
surge/ramp
modulations
polarity
waveform
- continuous, the gate needs to be short off
- not applicable
- yes to avoid adaptation, could be phase duration, frequency, or intensity
- not necessary
- any pulse waveform is okay (monphasic, bi or polyphasic)
-
segmental pain control
stabilization
treatment
electrode placement
electrode size
other
- N/A
- 15min-24hrs
- monopolar or bipolar site of pain, dermatomes, nerve roots, peripheral nerves, trigger points, acupuncture points
- largest electrode that can fit the area
- onset of relief is relatively fast, but the carryover of relief is relatively short
- used for acute and post-op conditions
-
suprasegmental pain control
gate control
stimulate
intensity
phase duration
frequency
- descending control
- A delta (sharp localized pain) and C fibers (generalized diffused pain)
- noxious
- long, >125usec
- low, <10Hz since you are likely going through motor, you want to prevent tetany
-
suprasegmental pain control
on/off cycle
surge/ramp
modulations
polarity
waveform
- continuous
- N/A
- N/A you can choose a frequency between 2 and 10 Hz
- doesn't matter
- any pulse
-
suprasegmental pain control
stabilization
treatment
electrode placement
electode size
other
- N/A
- 15-20 PRN
- site of pain for sub acute or chronic; accupuncture and trigger points okay
- small, for high density current; mono or bipolar is okay
- relief is slower, but the carryover is longer
-
muscle strengthening
intensity
phase duration
frequency
on/off
surge/ramp
- strong motor, maximal tolerated contraction (MTC)
- long, >125usec
- greater than 25, tetanic contraction (35-80 Hz (as the person gets stronger, increase frequency to increase contraction)
- 1:5 progress to 1:3 ratio
- as comfort dictates
-
muscle strengthening
modulations
polarity
wave form
treatment
stabilization
- this is to prevent adaptation
- if monopolar technique, let the active electrode be (-) polarity doesn't matter in bipolar technique
- any pulse is good for muscle strengthening
- depends on fatigue, tolerance, and the number of contracitions needed which will determine time
- in a comfortable and safe position, better in a lengthened state
-
muscles strengthening
elctrode placement
other
- bipoloar technique, proximal and distal belly of muscles, parallel to muscle fibers; monopolar technique place active electrode on motor point
- early ACL reconstruction result in more strength(recruits large axons (fast twitch)) than volitional contraction (recruits smaller axons (slow twitch)
-
muscle re-education or biofeedback
intensity
phase duration
frequency
on/off
surge/ramp
- moderat motor
- long >125usec
- fused tetany 35-40Hz
- 1:5 sec ratio
- yes for smooth controlled contraction
-
muscle re-education or biofeedback
modulations
waveform
treatment
stabilization
electrode placemnt
other
- N/A
- any form
- long enough to practice the desired activity
- may need to isolate desired mvmt, protect surgery, protect jt, and prevent cramp
- monopolar, bipolar, or peripheral nerve
- always combine re-education with strengthening
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