TENS/IFC/NMES/Laser/Traction Parameters

Conventional TENS Amplitude

Comfort; Submotor

Conventional TENS Pulse Duration

Short: 50-125 µs

Conventional TENS Pulse Rate

High: 50-110 pps

Modulated Conventional TENS Pulse Rate

High: 85pps

Conventional TENS MOA

Gate theory

Conventional TENS Electrode Placement

a) Local area of pain

b) Related spinal segment

Conventional TENS Application Technique

15-60 minute applications

Reassess hourly

Conventional TENS Duration of Relief

Fast/immediate: 5 to 10 minutes

Burst TENS Amplitude

Medium to High- (rhythmic muscular contraction)

Burst TENS Pulse Duration

Long: 200-500 µs

Burst TENS Pulse Rate

High: 70-100 pps bursts delivered at rates of 1-5 bps

Burst TENS MOA

Endogenous Opiate

Burst TENS Electrode Placement

Segmentally related myotomes

Burst TENS Application Technique

15-60 minutes

Burst TENS Onset of Relief

Slow: 20-40 minutes

Low Frequency TENS Amplitude

Medium to High- (muscular contraction)

Low Frequency TENS Pulse Duration

Long: 200-500 µs

Low Frequency TENS Pulse Rate

Low: 1-5 pps

Low Frequency TENS MOA

Endogenous Opiate

Low Frequency TENS Electrode Placement

Segmentally related myotomes

Low Frequency TENS Application Technique

15-60 minutes

Low Frequency TENS Onset of Relief

Slow: 20-40 minutes

Brief-Intense TENS Amplitude

High (below muscular contraction)

Brief-Intense TENS Pulse Duration

Long: 250-400 µs

Brief-Intense TENS Pulse Rate

High: 110-200 pps

Brief-Intense TENS Mechanism of Action

Endogenous Opiate; Gate

Brief-Intense TENS Electrode Placement

Superficial peripheral nerves

Brief-Intense TENS Application Technique

Maximum 15 minutes

Brief-Intense TENS Onset of Relief

Immediate

Sensory Interferential Current (IFC) Indication

Pain

Sensory IFC Pulse Rate

80-250 BEATS per second (bps)

Sensory IFC MOA

Gate Theory

Sensory IFC Electrode Placement

Quadripolar

Sensory IFC Application Technique

15 to 60 minutes

Sensory IFC Program Used

P3

Sensory IFC Onset of Relief

Medium: 10-20 minutes

Sensory to Motor IFC Indication

Muscle spasm

Sensory to Motor IFC Pulse Rate

1-10 bps

Sensory to Motor IFC MOA

Gate OR Endogenous Opiate

Sensory to Motor IFC Electrode Placement

Quadripolar

Sensory to Motor IFC Program Used

P1

Sensory to Motor IFC Application Technique

15 to 60 minutes

Sensory to Motor IFC Onset of Relief

Medium: 10-20 minutes

Sensory and/or Motor IFC Indication

Pain, Muscle Spasm/Guarding

Sensory and/or Motor IFC Pulse Rate

1-150 bps

Sensory and/or Motor IFC MOA

Gate or Endogenous Opiate

Sensory and/or Motor IFC Program Used

P2

Sensory and/or Motor IFC Application Technique

15-60 min.

Sensory and/or Motor IFC Electrode Placement

Quadripolar

NMES+ for Muscle Strengthening Amplitude

strong, visible contraction

NMES+ for Muscle Strengthening Frequency

35-80 pps

NMES+ for Muscle Strengthening Duty Cycle

1:5

NMES+ for Muscle Strengthening Tx Time

produce 10-20 reps

NMES+ for Muscle Strengthening Ramp

at least 2 sec.

NMES+ for Muscle Strengthening Pulse Duration

- 150-200 microseconds (small muscle)

- 200-350 microseconds (large muscle)

Russian Stimulation Amplitude

Strong, visible contraction

Russian Stimulation Frequency

50 pps

Russian Stimulation Duty Cycle

- 6-10 seconds ON

- 50-120 seconds OFF

Russian Stimulation Tx Time

10-20 reps

Russian Stimulation Ramp

at LEAST 2 seconds

Russian Stimulation Pulse Duration

250 microseconds

NMES for Endurance Amplitude

minimal tetanizing

NMES for Endurance Frequency

40 pps or less (minimize fatigue)

NMES for Endurance Duty Cycle

typical = 1:6

NMES for Endurance Tx Time

- initial = Pt tolerance

- progress to longer ON and shorter OFF times

NMES for Endurance Ramp

based on activity (1:5)

NMES for Endurance Pulse Duration

- 150-200 microseconds (small muscle)

- 200-350 microseconds (large muscle)

NMES for Spasm Reduction Amplitude

visible contraction

NMES for Spasm Reduction Frequency

35-50 pps

NMES for Spasm Reduction Duty Cycle

1:1 (2-5 s. ON; 2-5s. OFF)

NMES for Spasm Reduction Tx Time

10-30 min.

NMES for Spasm Reduction Ramp

at least 2 sec.

NMES for Spasm Reduction Pulse Duration

- 150-200 microsec. (small muscle)

- 200-350 microsec. (large muscle)

Functional Electrical Stimulation (FES) Amplitude

sufficient for function

Functional Electrical Stimulation (FES) Frequency

40 pps or less (same as endurance)

Functional Electrical Stimulation (FES) Duty Cycle

- depends on activity

- remote switch may override

Functional Electrical Stimulation (FES) Tx Time

depends on activity

Functional Electrical Stimulation (FES) Ramp

at least 2 s.

Functional Electrical Stimulation (FES) Pulse Duration

- 150 - 200 (small muscle)

- 200 - 350 (large muscle)

NMES for Hypertonicity/Spasticity (Reciprocal Inhibition) Amplitude

visible contraction of ANTAGONIST

NMES for Hypertonicity/Spasticity (Reciprocal Inhibition) Frequency

minimal tetany (<40 pps)

NMES for Hypertonicity/Spasticity (Reciprocal Inhibition) Duty Cycle

1:6 - avoid fatigue

NMES for Hypertonicity/Spasticity (Reciprocal Inhibition) Tx Time

literature varies

NMES for Hypertonicity/Spasticity (Reciprocal Inhibition) Ramp

At least 2 seconds

NMES for Hypertonicity/Spasticity (Reciprocal Inhibition) Pulse Duration

- 150-200 (small)

- 200-350 (large)

NMES for Hypertonicity/Spasticity (Hypertonic Stimulation) Amplitude

visible contraction

NMES for Hypertonicity/Spasticity (Hypertonic Stimulation) Frequency

35-50 pps

NMES for Hypertonicity/Spasticity (Hypertonic Stimulation) Duty Cycle

to avoid fatigue, 1:6

NMES for Hypertonicity/Spasticity (Hypertonic Stimulation) Tx Time

10-30 min.

NMES for Hypertonicity/Spasticity (Hypertonic Stimulation) Pulse Duration

150 - 200 (small)

200-350 (large)

Low Level Laser Therapy (LLLT) Dose for Soft Tissue Healing

5-16 J/cm^2

Low Level Laser Therapy (LLLT) Dose for Arthritis

2-8 J/cm^2

Low Level Laser Therapy (LLLT) Dose for Neuropathy

10-12 J/cm^2

Low Level Laser Therapy (LLLT) Dose for Trigger Points

3-20 J/cm^2

Low Level Laser Therapy (LLLT) Dose for Acute Soft Tissue Inflammation

2-8 J/cm^2

Low Level Laser Therapy (LLLT) Dose for Chronic Soft Tissue Inflammation

10-20 J/cm^2

Low Level Laser Therapy (LLLT) Dose for Muscle Spasm

2-6 J/cm^2

Low Level Laser Therapy (LLLT) Dose for Frozen Shoulder

3-6 J/cm^2

Low Level Laser Therapy (LLLT) Dose for Sciatica

4-8 J/cm^2

Low Level Laser Therapy (LLLT) Dose for Tendinitis

2-10J/cm^2