Understanding TENS Therapy
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Questions and Answers

What does TENS primarily aim to relieve?

  • Muscle spasms
  • Inflammation
  • Pain (correct)
  • Infection

    • Which of the following is a characteristic of the electrical current used in TENS?

  • Unipolar current
  • Continuous direct current
  • Low frequency pulsed current (correct)
  • High frequency alternating current

    • What is the primary advantage of TENS therapy over traditional pain management methods?

  • It is non-invasive and has no side effects. (correct)
  • It guarantees complete pain relief.
  • It provides immediate surgery.
  • It requires no professional supervision.

    • Which of the following biophysical characteristics is NOT associated with TENS?

    <p>Resistance</p> Signup and view all the answers

    In TENS therapy, what is the typical frequency range used?

    <p>1-200 Hz</p> Signup and view all the answers

    What is the purpose of electrode placement in TENS treatment?

    <p>To deliver pulsed current across skin to activate nerves</p> Signup and view all the answers

    Which of the following pulse durations is typical for TENS?

    <p>50-400 microseconds</p> Signup and view all the answers

    What is one reason TENS might be preferred over pharmaceuticals for pain management?

    <p>It can be easily administered at home</p> Signup and view all the answers

    What is the sole therapeutic effect of TENS?

    <p>To modulate or decrease pain</p> Signup and view all the answers

    Which nerve fibers are activated first during TENS application?

    <p>A-alpha and A-beta fibers</p> Signup and view all the answers

    According to the gate control theory, which type of nerve fibers help close the neurological 'gate'?

    <p>A-beta nerve fibers</p> Signup and view all the answers

    What sensation does noxious-level stimulation primarily evoke?

    <p>Strong muscle contraction and pain</p> Signup and view all the answers

    What role does the dorsal horn play in pain perception?

    <p>Passing information interpreted as pain to the brain</p> Signup and view all the answers

    What is the main function of the dorsal root ganglion (DRG)?

    <p>Transmitting sensory messages from receptors to the CNS</p> Signup and view all the answers

    Which system is primarily affected by the selective depolarization of specific afferent nerve fibers during pain modulation?

    <p>Both gate and opiate systems</p> Signup and view all the answers

    What results from the stimulation of A-beta nerve fibers in TENS therapy?

    <p>Reduced transmission from pain nerves</p> Signup and view all the answers

    What sensation is typically perceived during acupuncture-like mode of electrical stimulation?

    <p>Tingling and muscle contraction</p> Signup and view all the answers

    Which nerve fibers are primarily depolarized in brief-intense mode?

    <p>A-beta, A-delta, and C fibers</p> Signup and view all the answers

    In which mode does analgesia onset occur relatively rapidly?

    <p>Brief-intense mode</p> Signup and view all the answers

    What is the primary method of pain modulation in the burst mode?

    <p>Via the opiate system</p> Signup and view all the answers

    What characterizes the electrical pulses delivered in burst mode?

    <p>Bursts of pulses with low burst frequencies</p> Signup and view all the answers

    What is the expected sensation during the acupuncture-like mode of stimulation?

    <p>A mix of tingling and muscle contraction</p> Signup and view all the answers

    How does the analgesia of the acupuncture-like mode compare to other modes?

    <p>It has a relatively slow onset and longer duration</p> Signup and view all the answers

    Identify the primary characteristic of brief-intense mode.

    <p>High frequencies and brief durations</p> Signup and view all the answers

    What condition has the strongest evidence for TENS application?

    <p>Postoperative abdominal pain</p> Signup and view all the answers

    Which of the following is a contraindication for using TENS?

    <p>Patients who cannot comprehend physiotherapist's instructions</p> Signup and view all the answers

    During pregnancy, which area is typically contraindicated for TENS electrode placement?

    <p>Over the abdomen</p> Signup and view all the answers

    For patients with a pacemaker, how should TENS be applied?

    <p>It may be used under strictly controlled conditions</p> Signup and view all the answers

    Which precautions should be taken when using TENS?

    <p>Avoiding active epiphyseal regions in children</p> Signup and view all the answers

    What is a safe condition for using TENS during labor?

    <p>Use of TENS as a pain relief method</p> Signup and view all the answers

    What is important regarding electrode placement for patients with abnormal skin sensation?

    <p>Electrodes should preferably be positioned elsewhere</p> Signup and view all the answers

    Which of the following statements regarding TENS for patients with epilepsy is correct?

    <p>Therapist discretion is advised</p> Signup and view all the answers

    What is the primary reason for cleaning the skin surface before applying electrodes?

    <p>To remove impurities and reduce skin impedance</p> Signup and view all the answers

    When should sterile electrodes be used according to the specified conditions?

    <p>For postoperative conditions only</p> Signup and view all the answers

    Which of the following electrode placements is NOT recommended?

    <p>On the opposite side of the body</p> Signup and view all the answers

    How can skin irritation from electrode placement be minimized?

    <p>By changing electrode placement regularly</p> Signup and view all the answers

    What is the correct action if the treatment is performed at home?

    <p>A portable device should be used with written directives</p> Signup and view all the answers

    Which of the following is a required step after the treatment is completed?

    <p>Inspect the skin for unexpected responses</p> Signup and view all the answers

    What type of gel should be applied to the electrodes before placement?

    <p>Electroconductive gel for optimal conduction</p> Signup and view all the answers

    What should you NOT instruct a patient to do regarding the device and electrodes?

    <p>Touch the device before treatment starts</p> Signup and view all the answers

    Study Notes

    Transcutaneous Electrical Nerve Stimulation (TENS)

    • TENS is an electrotherapeutic modality used to stimulate nerves.
    • TENS delivers electricity across the intact surface of the skin.
    • It is a non-invasive analgesic modality.
    • TENS is classified as pulsed current.

    Rationale for TENS

    • TENS is a therapeutic alternative for managing pain.
    • It is non-invasive and has no side effects.
    • TENS can be administered easily at home and at work.
    • TENS is more affordable than drugs and surgery.

    Biophysical Characteristics of TENS

    • Waveforms: Biphasic, symmetrical, asymmetrical
    • Pulses: Single pulse/burst of pulses
    • Frequency: 1-200Hz
    • Pulse width or duration: 50-400 microseconds
    • Amplitude or intensity: 0-120mA

    Therapeutic Effects and Indications of TENS

    • Pain Modulation: TENS modulates or decreases pain by depolarizing peripheral nerves.
    • Gate Control Theory: TENS stimulates non-nociceptive (A-beta) nerve fibers, "closing the gate" to pain signals in the spinal cord.
    • Opiate System: TENS activates the opiate system to reduce pain perception.

    Modes of TENS

    Conventional Mode

    • Low-frequency (1-10Hz), high-intensity.
    • Depolarizes A-beta fibres.
    • Relief through the gate control theory.
    • Rapid onset, short duration.

    Acupuncture-like Mode

    • Low-frequency (1-5Hz), long-duration.
    • Depolarizes A-beta and alpha motor fibers.
    • Relief through the opiate system.
    • Slow onset, long duration.

    Brief-intense Mode

    • High-frequency (80-150Hz), short-duration.
    • Depolarizes A-beta, A-delta, and C fibers.
    • Relief through the opiate system.
    • Rapid onset, long duration.

    Burst Mode

    • Low-frequency bursts.
    • Depolarizes A-delta and alpha motor fibers.
    • Relief through the opiate system.
    • Slow onset, long duration.

    Research Based Indications

    • Postoperative abdominal pain
    • Postoperative thoracic pain
    • Osteoarthritis pain
    • Dysmenorrheal pain
    • Postoperative orthopedic pain
    • Low-back pain
    • Neurogenic pain
    • Chronic pain syndromes
    • Stump/phantom pain
    • Rheumatoid arthritis pain
    • Orofacial pain

    Contraindications

    • Patients who do not comprehend instructions or cannot cooperate.
    • Application over the trunk, abdomen or pelvis during pregnancy, although safe under controlled conditions.
    • Patients with pacemakers, although possible under controlled conditions.
    • Allergic reaction to electrodes, gel or tape.
    • Electrode placement over dermatological lesions.
    • Application over the anterior aspect of the neck or carotid sinus.

    Precautions

    • Place electrodes elsewhere if there is abnormal skin sensation.
    • Avoid placing electrodes over the eyes.
    • Treat patients with epilepsy with caution, especially in the neck and upper thoracic regions.
    • Avoid active epiphyseal regions in children.
    • Avoid abdominal electrode placement during labor as it may interfere with fetal monitoring.

    TENS Application Steps

    • Position the patient comfortably.
    • Instruct the patient to avoid touching the device.
    • Clean the skin surface with rubbing alcohol or soap and water.
    • Clip hair to ensure optimal electrode-skin coupling.
    • Select the appropriate stimulator type (cabinet or portable).
    • Select the mode of delivery ( conventional, acupuncture-like, brief-intense, burst, or modulation).
    • Select the appropriate electrode type (sterile or reusable).
    • Prepare the stimulating electrodes with electroconductive gel.
    • Place the electrodes according to the desired location (painful area, around the area, dermatomes, acupuncture points, trigger points).
    • Attach the electrodes to the skin using tape or patches.
    • Connect the electrodes to the stimulator circuit outputs.
    • Apply the treatment for the prescribed duration.
    • Monitor the patient for any unexpected responses.
    • Remove the electrodes and inspect the skin.
    • Clean the treated surface and reusable electrodes.

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    Description

    This quiz explores Transcutaneous Electrical Nerve Stimulation (TENS), a non-invasive method for pain management. It covers the rationale, biophysical characteristics, and therapeutic effects of TENS, highlighting its advantages over traditional pain relief methods. Test your knowledge about how TENS works and its applications in pain modulation.

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