NMES and TENS

Flashcards covering the definitions, parameters, and mechanisms of NMES and various TENS modes (Conventional, Acupuncture-Like, Burst, and Brief Intense) for muscle and pain management.

Neuromuscular Electrical Stimulation (NMES)

A modality used to activate muscle contraction for purposes such as muscle strengthening, muscle re-education, and prevention of atrophy.

Electrode Placement (NMES)

Electrodes should be placed where there is least impedance, specifically over the muscle belly for optimal stimulation.

Typical NMES Frequency

The frequency used is typically around $30-50\,\text{pps}$ (Hz).

pps

An abbreviation for pulses per second, which is equivalent to $\text{Hz}$ (hertz).

Transcutaneous Electrical Nerve Stimulation (TENS)

A modality primarily used for pain management, utilizing various frequencies and pulse durations.

Conventional TENS

A mode of TENS based on Gate Control Theory used for chronic pain, featuring high frequency ($50-100\,\text{pps}$) and short pulse duration ($50-125\,\mu\text{s}$).

Gate Control Theory

A mechanism where the stimulation of A-Beta sensory fibers inhibits the transmission of pain signals from nociceptors, reducing pain perception.

A-Beta Fibers

Large sensory fibers that close the 'pain gate' in the spinal cord to produce a peripheral pain-modulating effect.

Acupuncture-Like TENS

A mode of TENS that stimulates endogenous opioid (endorphin) release using low frequency ($1-5\,\text{pps}$) and long pulse duration ($250-400\,\mu\text{s}$).

Muscle Twitches

The required motor response for Acupuncture-Like TENS to be effective in releasing endorphins.

Burst TENS

A TENS mode that delivers 'burst envelopes' of high-frequency current ($70-100\,\text{pps}$ internally) to reach deep tissue pain with reduced skin impedance.

Brief Intense TENS

A mode used for $5-15\,\text{minutes}$ before painful procedures, utilizing high frequency ($100+\,\text{pps}$) and long pulse duration ($250-400\,\mu\text{s}$).

Modulation

The continuous change of stimulation parameters to help prevent nerve accommodation and maintain treatment effectiveness over time.

Higher Frequency (Current Concepts)

Electrical current parameters that result in deeper penetration, lower intensity requirements, and a more peripheral response.

Lower Frequency (Current Concepts)

Electrical current parameters that result in a greater muscle contraction response and more endogenous opioid release.

Parallel Placement

An electrode configuration where electrodes are placed along a painful structure or a nerve pathway.

Criss-Cross Placement

Also called bracket or cross pattern placement, this involves placing electrodes diagonally around a painful area.

Electrode Placement (NMES)

Electrodes should be placed where there is least impedance, specifically over the muscle belly for optimal stimulation.

Parallel Placement

An electrode configuration where electrodes are placed along a painful structure or a nerve pathway.

Criss-Cross Placement

Also called bracket or cross pattern placement, this involves placing electrodes diagonally around a painful area.