Week 3 Summary TI PDF

3.7. Therapeutic Electrical Stimulation NAMED CURRENTS can we add Objectives: Know the named currents Different uses Understand basic electro biophysical effects for each named current p's the To graphs these PIS 7 TES named current definition Named currents are variations of basic currents,...

3.7. Therapeutic Electrical Stimulation NAMED CURRENTS can we add Objectives: Know the named currents Different uses Understand basic electro biophysical effects for each named current p's the To graphs these PIS 7 TES named current definition Named currents are variations of basic currents, (direct, alternating, pulse) Interferential: Used for pain control and muscle stimulation, May be more effective in producing force production in muscles vs Russian. A/C easily penetrate skin. Summative currents from this travel deep into tissue Currents travel past superficial afferent nerves which makes it more tolerable Stimulates large area. Parameters interaction of two currents. The sum of the amplitudes creating constructive interference. This is called beat frequency, clover leaf electrical field Typically adminstered with 4 electrodes. Placed in a way that curernts intersect with eachother. QUADRIPOLAR IFC. Russian: Alternating Current, muscle stimulation. Delivered in BURSTS HIGH frequencies. 1000-2500 hz Waveforms= Polyphasic or Biphasic Less resistance in skin= more current to reach deeper nerves HIGH Intensity to stimulate the larger FAST TWITCH motor units. Duration needs to be short for tolerable experience. Parameters 1000hz 2-5ms for best muscle activation Microcurrent: Mimics body’s electrical field to encourage healing Use for bone fractures and tendon ligament healing Intensity is less than 1mil amp, variety of waveforms (ac dc mono and biphasic) Low frequency 0.3-50hz Pulse duration 1-500ms relatively long HIGH Volt Current: stimulate both sensory and motor nerves pain management, soft tissue healing, and muscle stimulation MOST indicative for tissue repair and healing uncomfortable- short duration and high intensity DONT USE to strengthen muscle Parameters: Monophasic waveform Large Intensity Instantaneous rise/rapid decrease Duration 40-100 ms and freq 60-125pulses/sec Great penetration Short durations so its more bearable 3.8 Instrumentation Electrodes What is an electrode? Proper maintenance of electrodes Application Precautions and contraindications for electrical stimulation Electrodes- device that relays the current between electrical stimulator and the patient 2 types- TRANSCUTANEOUS, INDWELLING Care for electrodes only have certain amount of uses, record number of times used Disposable electrodes need gels to be applied Sanitation- patients need to have their own electrodes. Pinlead needs to be inspected - tearing ? Pitting? Application patient allergies? shave hair evaluate treated skin wash skin choose right size - smaller the size the greater the current density what are you treating? Will currents travel to adjacent muscle? ask patient during treatment of perceived sensation Placement of Electrodes 3 methods for placement dermatomal, sclerotomal, myotomal Dermatomal- placed over sensory nerves Myotomal- over motor nerves or points - normally proximal third for appropriate motor response. Placement distance needs to be appropriate Contraindications pacemaker, carotid bodies, peripheral vascular disease, pregnancy, placement on phrenic nerve eyes or gonads, hemorrhages, active osteomyelitis Precautions cardiac dysfunction, impaired cognition, neoplasms, neuropathy, compromised skin 3.9 SHOCKWAVE THERAPY Obj What is Extracorporeal Shockwave Therapy (ESWT) 2 types Parameters Application, Precautions, contraindications ESWT is the transcutaneous use of high energy acoustic waves for a biophysical effect. NOT ultrasound. ESWT is cold tech. Much lower freq, and higher intensity Ultrasound energy is lost in the form of heat Shockwaves is cold tech, so penetrates deeper because of no loss of energy Used to breakdown tissue to promote healing and repair. MACRO affect- promotes inflammatory affect in tissue Microjets promote increased permeability in the same tissue 2 types FOCUS, RADIAL Parameters High peak amplitudes, Short Ramp Times freq 1-4hz. 1000-4000 shock wave pulses. Measured in joules per area (mJ/mm^2) This means 4000 to 16000 pulses/sec Therapeutic Effects from ESWT Increased collagen synthesis cellular proliferation and wound healing pain reduction neovascularization decrease in soft tissue calcifications decrease in inflammation Found to be MOST USEFUL for chronic musculoskeletal conditions for tissue healing like achille tendinopathis, knee osteoarthritis, chronic plantarfaciitis Radial vs Focused Focused- inside applicator or wand , focused be lens , deeper tissues. Radial- means of compressed air through a tube, More superficial, for superficial muscle, and myofascial trigger point treatments Contraindications pacemakers prolonged blood clotting children pregnant acute injuries