Podcast
Questions and Answers
Which waveform is NOT used in Neuromuscular Electrical Stimulation?
Which waveform is NOT used in Neuromuscular Electrical Stimulation?
Russian stimulation is typically delivered as a continuous current.
Russian stimulation is typically delivered as a continuous current.
False
What is the primary goal of NMES?
What is the primary goal of NMES?
To strengthen innervated muscle.
The pulse duration for NMES is typically set high at __________ microseconds.
The pulse duration for NMES is typically set high at __________ microseconds.
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Match the following NMES parameters with their optimal ranges:
Match the following NMES parameters with their optimal ranges:
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How long is the recommended ramp time for comfort?
How long is the recommended ramp time for comfort?
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Larger electrodes are generally less comfortable than smaller electrodes.
Larger electrodes are generally less comfortable than smaller electrodes.
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What are the two options for duty cycle in NMES?
What are the two options for duty cycle in NMES?
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Electrodes should be placed ________ width away from each other, parallel to muscle fibers.
Electrodes should be placed ________ width away from each other, parallel to muscle fibers.
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What is the effect of using a frequency of 50 pps in NMES?
What is the effect of using a frequency of 50 pps in NMES?
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What is the typical range for frequency settings in NMES to achieve a smooth contraction?
What is the typical range for frequency settings in NMES to achieve a smooth contraction?
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Biphasic symmetrical waveforms are referred to as FES when used for enhancing functional activity.
Biphasic symmetrical waveforms are referred to as FES when used for enhancing functional activity.
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What is the primary purpose of using NMES?
What is the primary purpose of using NMES?
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The amplitude in NMES should be adjusted to achieve __________ muscle contraction.
The amplitude in NMES should be adjusted to achieve __________ muscle contraction.
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Match the following NMES parameters with their descriptions:
Match the following NMES parameters with their descriptions:
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Which electrode arrangement is considered more comfortable?
Which electrode arrangement is considered more comfortable?
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Using larger electrodes typically decreases the comfort of NMES treatment.
Using larger electrodes typically decreases the comfort of NMES treatment.
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What is the recommended treatment frequency for NMES?
What is the recommended treatment frequency for NMES?
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Ramp time in NMES is typically preset at ________ seconds for comfort.
Ramp time in NMES is typically preset at ________ seconds for comfort.
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What is the ideal pulse duration setting for NMES?
What is the ideal pulse duration setting for NMES?
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What is the recommended frequency range for small muscle contractions during NMES?
What is the recommended frequency range for small muscle contractions during NMES?
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Larger electrodes are generally more comfortable than smaller electrodes in NMES applications.
Larger electrodes are generally more comfortable than smaller electrodes in NMES applications.
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What does FES stand for in the context of NMES?
What does FES stand for in the context of NMES?
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The typical pulse duration setting for NMES is __________ microseconds.
The typical pulse duration setting for NMES is __________ microseconds.
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Which duty cycle option is common in NMES treatments?
Which duty cycle option is common in NMES treatments?
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Match the following NMES parameters with their correct description:
Match the following NMES parameters with their correct description:
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What is the purpose of setting a duty cycle in NMES?
What is the purpose of setting a duty cycle in NMES?
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The ideal training frequency for NMES is to have sessions at least four times a week.
The ideal training frequency for NMES is to have sessions at least four times a week.
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The Russian stimulation is often used in clinics for __________.
The Russian stimulation is often used in clinics for __________.
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What effect does a frequency of 50 pps have in NMES treatments?
What effect does a frequency of 50 pps have in NMES treatments?
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Study Notes
Neuromuscular Electrical Stimulation (NMES)
- Two primary waveforms: Biphasic symmetrical (balanced) and Biphasic asymmetrical (unbalanced)
- Used to activate innervated muscles, typically for strengthening.
- Referred to as Functional Electrical Stimulation (FES) when used to enhance functional activity.
- "Russian" stimulation, a type of biphasic balanced AC current delivered in bursts per second, is commonly used for strengthening in clinical settings.
Electrode and Parameter Considerations
- Electrode size and parameters can be adjusted from default settings to enhance comfort or reduce fatigue.
- Amplitude should be sufficient to produce a tetanized muscle contraction, allowing for progression as the patient tolerates.
- Pulse duration is typically high (300 microseconds) and preset on the device. High duration allows for lower amplitude requirements for muscle contraction.
- Frequency: 25-50 pps for smooth contraction; smaller muscles: 25-35 pps; larger muscles: 50 pps; for fatigue with muscle spasm: 50+ pps.
- 50 pps is generally more comfortable than 25 pps, however, it is also more fatiguing.
- Duty cycle options: 1:1 up to 1:5, with an on time of 6-10 seconds, varied based on treatment goals, condition, and patient tolerance.
- Ramp time, usually preset at 2 seconds for comfort, gradually increases the amplitude. No ramp time is typically used with Ankle Foot Orthosis (AFO) applications.
Treatment Protocol
- Treatment duration is based on 10-20 contractions, with sessions recommended at least 3 times a week.
- Electrode placement involves one electrode on the motor point and another electrode at least one electrode width away, parallel to the muscle fibers.
- Larger electrodes are more comfortable than smaller electrodes, and bipolar placement is generally more comfortable than monopolar.
Neuromuscular Electrical Stimulation (NMES)
- NMES uses electrical stimulation to activate innervated muscles, typically for strengthening.
- Functional Electrical Stimulation (FES) is a type of NMES used to enhance functional activity.
- Russian stimulation is a common technique used in clinics for strengthening. It uses a biphasic balanced, alternating current (AC) delivered in bursts per second.
- Electrode size and parameters can be adjusted to improve comfort, reduce fatigue, and optimize muscle contraction.
- Amplitude should be adjusted to achieve a forceful tetanized muscle contraction, but should be progressed as the patient tolerates.
- Pulse duration is typically high (300 microseconds) and preset on the device. High duration allows for lower amplitude stimulation for muscle contraction.
- Frequency ranges from 25-50 pulses per second (pps) for smooth contraction. Smaller muscles may benefit from 25-35 pps, while larger muscles might require 50 pps. Higher frequencies (50+ pps) can be used to combat muscle spasms and fatigue.
- Duty cycle refers to the ratio of on-time to off-time. It can range from 1:1 to 1:5, with on-times typically lasting 6-10 seconds. Duty cycle is adjusted based on treatment goals, patient condition, contraction intensity, and patient adaptation to stimulation.
- Ramp time gradually increases the stimulation amplitude to peak. A 2-second ramp time is typically preset for comfort. No ramp time is needed for applications like ankle-foot orthosis (AFO).
- Treatment time is based on a target of 10-20 contractions and requires at least three treatments per week.
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Electrode placement:
- One electrode should be placed on the motor point of the muscle.
- The other electrode should be placed at least one electrode width away, parallel to the muscle fibers.
- Larger electrodes tend to be more comfortable than smaller electrodes.
- Bipolar electrode arrangements are typically more comfortable than monopolar arrangements.
Neuromuscular Electrical Stimulation (NMES)
- NMES is used to activate innervated muscle, typically for strengthening.
- FES (Functional Electrical Stimulation) is used to enhance functional activity.
- Two main waveform options: Biphasic symmetrical (balanced) or Biphasic asymmetrical (unbalanced).
- Russian stimulation (biphasic balanced, AC current delivered in bursts/sec) is commonly used for strengthening in clinical settings.
Electrode and Parameters
- Electrode size and stimulation parameters are adjustable to enhance comfort and reduce fatigue.
- Amplitude should be adjusted to achieve a tetanized muscle contraction, but should be progressed as the patient tolerates.
- Pulse duration is typically high (300 microsec), preset on the device. Higher duration requires less amplitude for muscle contraction.
- Frequency:
- 25-50 pps (pulses per second) for smooth contraction.
- 25-35 pps for small muscles.
- 50 pps for large muscles.
- 50+ pps for muscle spasm fatigue.
- 50 pps is more comfortable than 25 pps, but it is also more fatiguing.
- Duty cycle: Options include 1:1 up to 1:5 with an on time of 6-10 sec, tailored to the goal, condition, and patient adaptation.
- Ramp time: Gradually ramps up to peak amplitude, typically preset at 2 seconds for comfort. No ramp time is necessary for AFO (ankle foot orthosis) applications.
- Treatment time: Based on 10-20 contractions, at least three times per week.
Electrode Placement
- Electrode placement: One electrode on the motor point, the other at least one electrode width away, parallel to muscle fibers.
- Larger electrodes are more comfortable than smaller electrodes.
- Bipolar electrode placement is more comfortable than monopolar.
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Description
This quiz covers the fundamentals of Neuromuscular Electrical Stimulation (NMES), including key waveforms and their applications. Learn about electrode considerations, adjustments, and the parameters used for effective muscle activation and strengthening. Dive into how different waveforms, like the Russian stimulation, play a role in clinical settings.
