E Stim for Pain, Edema, and Wounds

Both sensory and motor level e stim have beneficial ___ and __ characteristics that may promote tissue healing.

Vascular and edema

Wound healing benefits of e stim are probably attributable to ___?

Polarity effects

MENS

Delivers extremely low intensity current

- Sub sensory (not felt)

Purposes of MENS (2)

1. Support cellular processes

2. Promote tissue healing

Microcurrent Mechanisms (4)

1. Restores cell membrane potential to normal levels

2. Enhances ATP production and cellular metabolism

3. Promotes protein synthesis and reduces inflammation

4. Accelerates tissue repair and reduces pain through modulation of cellular signaling

Microcurrent Clinical Applications (5)

1. Pain management

2. Wound healing

3. Scar tissue remodeling

4. Edema reduction and inflammation control

5. Support for healing sprains, strains, and fxs

Microcurrent: MENS vs MES vs LIS

MENS = Micro current electrical n stimulation

MES = Microcurrent electrical stimulation

LIS = Low intensity stimulation

Microcurrent is aka

Low volt pulsed current

Microcurrent Amplitude

Below 1mA

Where does the electrode go for premod?

Directly on the site of pain

Sub-Sensory: PD

Not established

Sub-Sensory: F

Less than 3

Sub-Sensory: Amplitude

Less than 1 mA

Sub-Sensory: Treatment Duration

Not established

Sub-Sensory: Duration of Analgesia

Not established

Noxious Level: PD

Up to 1 msec

Noxious Level: F

1-5 or >100

Noxious Level: Amplitude

Noxious

Noxious Level: Treatment Duration

Seconds to minutes

Noxious Level: Duration of Analgesia

Hours

Wound Healing Inflammatory Phase: Cell Polarity

Macrophages: -

Neutrophils: -

Wound Healing Inflammatory Phase: Role in Healing

Phagocytosis and autolysis

Wound Healing Proliferative Phase: Cell Polarity

Fibroblasts = +

Wound Healing Proliferative Phase: Role in Healing

Collagen formation

Wound Healing Remodeling Phase: Cell Polarity

Myofibroblasts: +

Keratinocytes: +

Epidermal: -

Wound Healing Remodeling Phase: Role in Healing

- Wound contraction

- Epithelialization

Positive Polarity

Anode

- Attracts macrophages and neutrophils

- Promotes epithelial growth

Negative Polarity

Cathode

- Increases vascularity

- Stimulates fibroblastic growth

- Collagen production

- Epidermal cell migration

Bactericidal Polarity

Both + and - inhibit bacterial growth

Can e stim decrease edema?

No, it can only slow its formation

Galvanotaxis

Attraction of electrically charged cells towards an electrode

The injury potential typically becomes ___ 24-48 hours after injury and becomes ___ 8-9 days after injury?

+, -

Can e stim enhance fx healing?

Yes

Microcurrent to Increase Fx healing

5-20uA

What type of fx does e stim best help?

Non-union or mal-union

HVPC

High voltage pulsed current

- Delivers high voltage, low total current electrical pulses

HVPC Goals

- Promote tissue healing

- Reduce edema

- Manage pain

HVPC: Clinical Applications

1. Wound healing

- Chronic wounds

- Acute wounds

2. Edema management

3. Pain management

HVPC: Frequency

60-120 Hz

HVPC: PD

40-100us

HVPC: Intensity

Sensory level

HVPC: Polarity

- Use - in early inflammation phase

- Use + in proliferation phase

HVPC: Treatment Duration

20-60 mins