NMES, FES, Biofeedback

NMES

any electrical stim that causes a tetanic m contraction

isometric

NMES is usually ___ but can be isotonic if certain parameters are present

NMES

used at various intensities to assist w/ the m action thru full ROM

FES

type of NMES used to aid in functional tasks (reach, sit-to-stand, gait)

neuromuscular and functional electrical stim

NMES and FES

single or double bipolar

NMES set-up is either a ___ (for 1 small m grp) or ___ (for 1 large m grp or 2 m grps working as agonist/antagonist) electrode arrangement

symmetrical biphasic

main waveform from NMES

asymmetrical biphasic or polyphasic

other waveforms that can be used for NMES

on/off time

manipulation of how frequently the charge is flowing thru the electrodes

on time

amount of time in secs electricity is flowing thru the electrodes

off time

rest/recovery period which no electricity is flowing

ramp on

amount of time in secs it takes for wave to reach max intensity

ramp off

amount of time in secs it takes to return to 0 from max contraction

ramp on/off

allows for a smooth m contraction and relaxation

wave symmetry

changed to account for unequal contraction of 2 ms being stimed simultaneously

negative; positive

wave symmetry: a ___ wave would reach peak at a faster rate than a ___ wave, causing a more uniform co-contraction

spasticity

can provide inaccurate assessment of strength

40

fatigue is seen w/ >___pps

30-50pps; 100-400 microsec

atrophy, m strengthening, and edema: frequency and duration

1:3-7; 8-10 contractions; 1-2 sec

atrophy and m strengthening: on/off ratio; treatment duration; ramp

50 (submax)

atrophy: pulse intensity (≤___% of max contraction)

85

m strengthening: pulse intensity (≤___% of max contraction)

twitch <10pps; tetanic 50+pps; 100-400 microsec

spasm reduction/trigger point: frequency and duration

twitch: no ratio/ramp; tetanic 1:1-3, 1-2 sec; 15-60 min

spasm reduction/trigger point: on/off ratio; treatment duration; ramp

50 (submax)

spasm reduction/trigger point: pulse intensity (≤___% of max contraction)

1:1-3; 10-30 min; 1-2 sec

edema: on/off ratio; treatment duration; ramp

acute

for stroke patients, NMES greatest effects are in ___ stage

a/symmetrical biphasic, burst-modulated AC (russian)

recommended waveform for subluxation

10-60 pps; 200-350 microsec

recommended frequency and duration for shoulder subluxation

3 sec/3 sec; 1-15:1; 20 min-6 hrs; 3-7 days per wk; 4-8 wks

shoulder subluxation recommended ramp up/down; cycle; treatment time

hips, abs, pelvis, low back

contraindicated areas for pregnant woman

biofeedback

moskel assessment or monitoring used to affect future activation

biofeedback

allows pt to receive external feedback to facilitate or inhibit m activation

biofeedback

use of electrodes to detect electrical activity of m

2/5

for electromyographic biofeedback to be effective, pt needs partial innervation and voluntary m activation (MMT = ___)

sensitivity

how responsive the electrodes are to electrical activity (biofeedback)

low sensitivity

used for m w/ high electrical activity (MMT 4/5 or greater or later treatment)

high sensitivity

used for ms w/ low electrical activity (MMT 2/5 or less or earlier treatment)

threshold

setting at which auditory or visual feedback is given

inhibition

for ___, threshold is set for auditory feedback when electrical signal is a lower lvl (resting or near resting)

facilitation

for ___, threshold is set for auditory feedback when the electrical signal is a higher lvl (strong contraction)