Electrotherapy Basics
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Questions and Answers

What is a primary contraindication for using FES?

  • Morbid obesity (correct)
  • Controlled hypertension
  • Good skin condition for electrodes
  • Severe spasticity
  • What is the recommended frequency for effective tetanic contraction in FES?

  • 50-60 Hz
  • 70-80 Hz
  • 10-15 Hz
  • 20-40 Hz (correct)
  • Which of the following factors is not needed to support the use of FES for standing?

  • Adequate cognitive skills
  • Strength in upper limbs
  • Good balance
  • Pulmonary function (correct)
  • What is the ideal characteristic of electrodes used in FES applications?

    <p>Transcutaneous and easy to apply (C)</p> Signup and view all the answers

    What is a potential disadvantage of using higher frequency settings above 50 Hz in FES?

    <p>Risk of muscle fatigue (A)</p> Signup and view all the answers

    What type of system uses a handheld pistol-like applicator attached to a pneumatic system?

    <p>Radial system (B)</p> Signup and view all the answers

    Which parameter describes the depth and focus of energy delivery in focused extracorporeal shock wave therapy (f-ESWT)?

    <p>Deep at a focal point (greater than 5 cm) (D)</p> Signup and view all the answers

    What distinguishes focused extracorporeal shock wave therapy (f-ESWT) from radial extracorporeal shock wave therapy (r-ESWT)?

    <p>f-ESWT enables deeper penetration at a specific point (B)</p> Signup and view all the answers

    How is energy flux density (EFD) calculated in extracorporeal shock wave therapy?

    <p>EFD = E / A (D)</p> Signup and view all the answers

    Which type of applicator is specifically designed for acupuncture points and connective tissues?

    <p>Direct beam applicator (A)</p> Signup and view all the answers

    What is the frequency range classified as medium intensity in electrotherapy?

    <p>1000 until 500,000 Hz (D)</p> Signup and view all the answers

    Which type of electrical transfer is specifically noted for its direct contact application?

    <p>Capacitive electrical transfer (C)</p> Signup and view all the answers

    How deep is UHF therapy said to penetrate compared to other forms of electrotherapy?

    <p>More than microwave and shortwave (6 cm) (B)</p> Signup and view all the answers

    What is the minimum pressure applied in shockwave therapy?

    <p>100 MPa (B)</p> Signup and view all the answers

    Which frequency range is classified as high intensity in electrotherapy?

    <p>More than 500,000 Hz (C)</p> Signup and view all the answers

    What does the term 'chronaxie' refer to in the context of pulse duration?

    <p>Best pulse duration for eliciting a response (C)</p> Signup and view all the answers

    What is the wavelength of shortwave therapy?

    <p>11m (C)</p> Signup and view all the answers

    Which type of ultrasound is characterized as having a frequency of more than 20,000 Hz?

    <p>Ultrasound (C)</p> Signup and view all the answers

    Which ultrasound frequency is appropriate for a depth of 4 cm?

    <p>1 MHz (A)</p> Signup and view all the answers

    What is the duty cycle for a pulsed ultrasound with a pulse ratio of 1:2?

    <p>33% (B)</p> Signup and view all the answers

    Which of the following is a contraindication for ultrasound therapy?

    <p>Recent wound (D)</p> Signup and view all the answers

    In which method of application does the soundhead remain motionless over the treatment area?

    <p>Stationary technique (C)</p> Signup and view all the answers

    What is a common precaution when using ultrasound therapy?

    <p>Cavities with air (B)</p> Signup and view all the answers

    Which pulse ratio reflects a duty cycle of 50%?

    <p>1:1 (D)</p> Signup and view all the answers

    What is the primary aim of electrical stimulation in nerve regeneration?

    <p>To maintain muscle trophism while waiting for reinnervation. (A)</p> Signup and view all the answers

    What is the primary use of phonophoresis in ultrasound therapy?

    <p>To deliver medication through the skin (B)</p> Signup and view all the answers

    Which of the following treatments would not typically be indicated for ultrasound therapy?

    <p>Acute inflammation (D)</p> Signup and view all the answers

    Which type of pulse produces a response in both innervated and denervated fibers within the same muscle?

    <p>Rectangular pulses (D)</p> Signup and view all the answers

    What is the significance of the chronaxie in pulse duration?

    <p>It helps to adjust the pulse duration for better response. (B)</p> Signup and view all the answers

    When using biofeedback, what fundamental technique is primarily employed to aid patient learning?

    <p>Operant conditioning (D)</p> Signup and view all the answers

    What is the maximum number of pulses recommended per muscle per day during treatment?

    <p>10 pulses (A)</p> Signup and view all the answers

    Which application condition is specified for denervated muscles?

    <p>Bipolar application over affected muscles. (A)</p> Signup and view all the answers

    What characterizes the feedback received by patients using biofeedback techniques?

    <p>It provides immediate, timely, and accurate information. (A)</p> Signup and view all the answers

    Which pulse duration adjustment is recommended if the chronaxie is higher than 30 ms?

    <p>Apply isolated rectangular pulses with the same duration as chronaxie. (A)</p> Signup and view all the answers

    Which of the following is NOT an advantage of Functional Electrical Stimulation (FES) for gait and standing?

    <p>Reduce use of affected limbs (D)</p> Signup and view all the answers

    What is one of the main benefits of using the HANDMASTER NESS device?

    <p>Restores grip function (D)</p> Signup and view all the answers

    Which frequency range is categorized as therapeutic conventional ultrasounds?

    <p>1-3 MHz (A)</p> Signup and view all the answers

    What does the reverse piezoelectric effect involve?

    <p>High-frequency electrical current causing mechanical deformation (B)</p> Signup and view all the answers

    Which of the following outcomes can be achieved through the PEDAL system for FES-cycling?

    <p>Improvement in vascular health (D)</p> Signup and view all the answers

    What is one of the primary applications of ultrasound therapy mentioned?

    <p>Treating soft tissue pathologies (A)</p> Signup and view all the answers

    Which condition is NOT indicated for antiequinus treatment with Functional Electrical Stimulation?

    <p>Chronic fatigue syndrome (D)</p> Signup and view all the answers

    What can the application of FES provide for neurological patients, as highlighted in the conclusion?

    <p>Improved functional and psychological benefits (D)</p> Signup and view all the answers

    Flashcards

    Functional Electrical Stimulation (FES)

    The use of electrical stimulation to activate muscles and improve function in individuals with neurological impairments.

    Cognitive Skills: Requirement for FES

    FES is recommended for individuals with good cognitive function, capable of understanding and cooperating with the therapy.

    FES: Strength vs Endurance

    FES can be used to improve both muscle strength and endurance. However, focus on endurance is essential as neurological injuries often target slow muscle fibers first.

    Contraindications for FES

    FES requires careful consideration of contraindications like severe spasticity, uncontrolled high blood pressure, or severe osteoporosis. These factors can increase risks or hinder treatment effectiveness.

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    FES Electrode Types: Surface vs Implanted

    FES can be delivered through surface electrodes (placed on the skin) or implanted electrodes (surgically placed). Surface electrodes are easier to apply, while implanted electrodes offer greater precision and autonomy.

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    Low Intensity Electrotherapy

    Electrotherapy with intensities lower than 1000 Hz, delivered in pulsed or uninterrupted modes, is categorized as low intensity.

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    Medium Intensity Electrotherapy

    Electrotherapy with intensities ranging from 1000 to 500,000 Hz, commonly used in Kots therapy and Interferential therapy.

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    High Intensity Electrotherapy

    Electrotherapy with intensities exceeding 500,000 Hz, often involving techniques like capacitive electrical transfer, shortwave diathermy, UHF therapy, microwave therapy.

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    Shortwave Diathermy

    A type of high intensity electrotherapy that relies on shortwave radio frequencies to generate heat within tissues. It's typically used for deep heating.

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    UHF Therapy

    A type of high intensity electrotherapy that utilizes ultra-high frequency radio waves to induce heat in tissues. It offers deeper penetration than shortwave.

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    Microwave Therapy

    A type of high intensity electrotherapy that uses microwave radiation to generate heat in tissues. It's useful for superficial heating and pain management.

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    Shockwave Therapy

    A type of electrotherapy utilizing high-energy sound waves to stimulate tissue repair and pain relief. It can be effective for managing musculoskeletal conditions.

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    Ultrasound Therapy

    A therapeutic modality using sound waves above the human hearing range (20kHz) to treat various conditions. It can promote tissue healing, reduce inflammation, and alleviate pain.

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    Focused ESWT (f-ESWT)

    ESWT therapy using a generator that utilizes piezoelectric crystals to generate shockwaves. The piezoelectric crystals are housed in a concave container and expand and contract when high voltage is applied, transmitting shockwaves through the surrounding water medium.

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    Radial ESWT (r-ESWT)

    ESWT therapy using a pneumatic system that generates shockwaves by rapidly accelerating a projectile. The projectile hits an impact surface, creating a shockwave that is then transmitted through a handheld applicator.

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    Penetration Depth

    The depth at which shockwaves can penetrate tissues. f-ESWT has a deeper penetration than r-ESWT due to its focused nature, allowing it to target deeper structures.

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    Energy Flux Density (EFD)

    The amount of mechanical acoustic energy distributed over a specific area. f-ESWT typically has a higher energy flux density than r-ESWT, concentrating more energy in a smaller area.

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    Compressive Phase

    A phase in the shockwave where the pressure is higher than the ambient pressure. It is represented as P+.

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    Ultrasound Frequency & Depth

    Ultrasound frequency determines the depth of penetration.

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    Continuous Ultrasound Mode

    Continuous ultrasound delivers constant energy, causing heat buildup. Used for chronic conditions.

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    Pulsed Ultrasound Mode

    Pulsed ultrasound delivers energy in bursts, better controlled heating. Used for acute conditions.

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    Duty Cycle

    Duty cycle describes the percentage of time the ultrasound is emitting energy during a pulse cycle. Higher duty cycles lead to more heat.

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    Pulse Ratio

    Pulse ratio is the relationship between the duration of the ultrasound pulse and the pause between pulses. Influences heating effect.

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    Stationary Ultrasound Technique

    A stationary technique involves keeping the ultrasound head in a fixed position over the target tissue.

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    Dynamic Ultrasound Technique

    A dynamic technique involves moving the ultrasound head over the target tissue in a continuous or overlapping pattern.

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    Phonophoresis

    Phonophoresis is a technique that uses ultrasound to enhance drug delivery through the skin.

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    What is Functional Electrical Stimulation (FES)?

    A type of electrical stimulation that uses low-intensity electrical currents to stimulate muscles and nerves, improving gait, reducing spasticity, and promoting motor learning.

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    How does FES improve gait?

    FES devices help improve gait by increasing walking speed, enhancing ankle range of motion, and preventing orthopedic deformities.

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    How does FES reduce spasticity?

    FES can reduce spasticity by stimulating muscles that counteract the spastic ones.

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    How does FES work for upper limbs?

    FES for the upper limbs uses electrodes to stimulate muscles in the hand and arm, allowing for functions like grip or pinching.

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    What is a Handmaster Ness FES device?

    A type of FES device that uses electrodes placed on the wrist and forearm to help with hand function.

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    What is a FREEHAND FES device?

    A type of FES device that uses electrodes implanted in the muscles of the forearm, controlled by movements of the other shoulder.

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    What is a PEDAL FES device?

    A type of FES device that uses electrodes placed on the legs to activate muscles during cycling, promoting fitness and bone health.

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    What is Ultrasound Therapy?

    Ultrasound therapy uses high-frequency sound waves to treat a variety of soft tissue pathologies like bone fractures and dermal wounds, harnessing the phenomenon of piezoelectricity.

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    Collateral Reinnervation

    The process of nerve fibers regrowing after injury, allowing reestablishment of neural control of a muscle previously paralyzed.

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    Trophism of Muscles

    Maintaining muscle health while waiting for reinnervation to occur after nerve injury. It helps prevent muscle atrophy and fibrosis.

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    Electrical Stimulation in Denervation

    The technique of using electrical stimulation to evoke muscle contractions, aiming to maintain muscle function during nerve regeneration.

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    Rectangular Pulses in Electrical Stimulation

    Applying electrical pulses in rectangular shapes, which are more efficient than triangular shapes in terms of muscle stimulation.

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    Chronaxie

    A measure of a muscle's excitability, reflecting its ability to respond to electrical stimulation. It is a key factor in determining the pulse duration for effective stimulation.

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    Strength-Duration Curves (SD Curves)

    A technique that measures the minimum electrical current needed to elicit a muscle twitch, used to determine the optimal intensity for electrical stimulation.

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    Biofeedback

    A biofeedback technique where patients receive real-time information about their physiological activity, allowing them to learn to control their body functions voluntarily.

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    Instrument-Based Learning

    A type of learning based on operant conditioning, where individuals learn by associating their actions with their consequences.

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    Study Notes

    Electrotherapy Ordinary

    • Low intensity: less than 1000 Hz, pulsed, uninterrupted
    • Medium intensity: 1000-500,000 Hz
    • High intensity: more than 500,000 Hz
    • Capacitive electrical transfer: shortwave, UHV, microwave
    • Phototherapy: laser, UV, IR
    • Vibrotherapy: shockwave, ultrasound
    • Magnetotherapy: electrical capacitive transfer (0.448 MHz)
    • UHF: 434 MHz, wavelength 69 cm(non-contact), deeper than microwave and shortwave (6 cm increased skin temp)
    • Shortwave: wavelength 11m, frequency 27 MHz
    • Microwave: 12.5 cm, frequency 2450 MHz, 5-10 cm from patient
    • Shockwave: Max duration 10 ns, pressure 100 MPa or 500 bar, frequency 16-20 MHz
    • Ultrasound: (no specific frequency or wavelength mentioned)

    SD Curves

    • Relationship shows the currents amplitude and pulse duration
    • Aim to maintain the functional state of the neuromuscular system or strengthen muscles.
    • External electrical stimulus needs more intensity to produce same stimulus as pulse duration decreases.

    Electrode Placement

    • Monopolar: cathode, anode
    • Bipolar: Two electrodes (distal/proximal electrodes), voltage and distance vary
    • Variation: neutral (plexus), proximal/distal, neutral over NMP, Active over MMP

    Other notes

    • Pulse duration: Rectangular pulses: 1000ms, interval 3 seconds, decreasing to 0ms
    • Triangular pulses: Similar to rectangular
    • Intensity: Watch for contraction, minimum intensity for minimum contraction
    • MUT: Muscle utilization time (1-10ms)
    • Faradic threshold: Minimum intensity for minimum contraction with 1ms rectangular pulse (burst of rectangular pulses or isolated pulses needed)
    • Chronaxie: Best pulse duration for denervation, higher intensity needed
    • Normal values: 100-700 us (0.1-0.7ms)
    • Different types of nerve fibers: threshold stimulus to create an action potential, denervated skeletal muscle fibers.

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    Electrotherapy Ordinary PDF

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    Test your knowledge on various electrotherapy modalities including low, medium, and high-intensity applications. Explore concepts like capacitive electrical transfer, phototherapy, vibrotherapy, and more. This quiz will help reinforce your understanding of electrical currents and their therapeutic uses.

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