NMES, RUSSIAN, TENS, IONTO PARAMETERS

NMES muscle strengthening pulse frequency

- 30-50 pps

- 30 pps is sufficient (HVPC)

NMES muscle strengthening pulse duration

- 125-200 microseconds for small muscles

- 200-350 microseconds for large muscles

NMES muscle strengthening amplitude

- to greater than 10% MVIC in injured muscle and greater than 50% MVIC in uninjured muscle

- maximum muscle contraction

NMES muscle strengthening on:off time and ratio

- pulsed ratio of 1:5

- good setting = 6:30

- max setting = 10:50

NMES muscle strengthening ramp time

at least 2 seconds

NMES muscle strengthening treatment time

- start with 8-10 contractions and work up to 15-25 contractions

- 3 to 5 times a week for 2 to 3 weeks

if utilizing muscle strengthening with its corresponding NMES parameters, then what can you do after several repeated treatments?

for NMES muscle strengthening, use 1:5 ratio initially but may reduce off time with repeated treatments (like 1:4 then 1:3)

NMES muscle re-education pulse frequency

- 20-30 pps

- 30 pps is sufficient (HVPC)

NMES muscle re-education pulse duration

- 125-200 microseconds for small muscles

- 200-350 microseconds for large muscles

NMES muscle re-education amplitude

- sufficient for functional activity

- strong enough for good muscle contraction

NMES muscle re-education on:off time and ratio

- pulsed ratio of 1:3

- good setting = 4:12

NMES muscle re-education ramp time

at least 2 seconds

NMES muscle re-education treatment time

- 10 to 30 minutes depending on patient's fatigue

- every day to twice a day for 1 to 5 times a week

NMES muscle spasm reduction pulse frequency

100 pps

NMES muscle spasm reduction pulse duration

- 125-200 microseconds for small muscles

- 200-350 microseconds for large muscles

NMES muscle spasm reduction amplitude

to visible contraction

NMES muscle spasm reduction on:off time and ratio

2-5 seconds on and 2-5 seconds off (equal 1:1 ratio)

NMES muscle spasm reduction ramp time

at least 1 second

NMES muscle spasm reduction treatment time

10-30 minutes every 2-3 hours until spasm is relieved

NMES edema reduction using muscle pump pulse frequency

- 20-50 pps

- 30 pps is sufficient (HVPC)

NMES edema reduction using muscle pump pulse duration

- 125-200 microseconds for small muscles

- 200-350 microseconds for large muscles

NMES edema reduction using muscle pump amplitude

high enough for a minimum to moderate visible muscle contraction

NMES edema reduction using muscle pump on:off time and ratio

- pulsed ratio of 1:3

- good setting = 4:12

NMES edema reduction using muscle pump ramp time

at least 1 second

NMES edema reduction using muscle pump treatment time

30 minutes every day to twice a day for 1 to 2 weeks

if using edema reduction using muscle pump NMES parameters, then what should you always make sure to do?

always combine with elevation above the level of the heart!!

russian protocol for strengthening pulse frequency

50 pps

russian protocol for strengthening pulse duration

- 125-200 microseconds for small muscles

- 200-350 microseconds for large muscles

russian protocol for strengthening amplitude

- to greater than 10% MVIC in injured muscle and greater than 50% MVIC in uninjured muscle

- maximum muscle contraction

russian protocol for strengthening on:off time and ratio

- pulsed 1:5 ratio so 1 minute for 1 cycle

- good setting = 6:30

- max setting = 10:50

russian protocol for strengthening ramp time

at least 2 seconds

russian protocol for strengthening treatment time

- start with 8-10 contractions and work up to 15-25 contractions

- 3 to 5 times a week for 2 to 3 weeks

if doing muscle strengthening with its corresponding russian protocol parameters, then what can you do after several repeated treatments?

for russian protocol for muscle strengthening, use 1:5 ratio initially but may reduce off time with repeated treatments (like 1:4 then 1:3)

TENS conventional/high rate pulse frequency

70-120 pps

TENS conventional/high rate pulse duration

short so 40-80 microseconds ideal

TENS conventional/high rate sensation

tingling

TENS conventional/high rate time/action

- up to 24 hours

- enkephalin release

TENS conventional/high rate function

- short term pain relief

- used for acute and chronic pain

TENS brief intense pulse frequency

70-120 pps

TENS brief intense pulse duration

long so 200-300 and up to 500 microseconds

TENS brief intense sensation

strong tingling on edge of contraction

TENS brief intense time/action

- max 15 minutes

- inhibits Na+

TENS brief intense function

- combination of high rate and low rate protocols

- used for acute pain only

- prepares the patient for something they have to get through

TENS low rate pulse frequency

2-10 pps but research shown 2-4 pps is best

TENS low rate pulse duration

long so 200-300 and up to 500 microseconds

TENS low rate sensation

strong muscle twitch

TENS low rate time/action

- max 60 minutes

- endorphin release

TENS low rate function

- long lasting pain relief

- used for chronic pain

TENS modulation pulse frequency

50-120 pps

TENS modulation pulse duration

short, usually the same as high rate but can be increased if needed to prevent accommodation or to increase comfort

TENS modulation sensation

sensory only

TENS modulation time/action

- up to 24 hours

- enkephalin release

TENS modulation function

- used for acute and chronic pain

- prevents accommodation

TENS strength duration pulse frequency

50-120 pps

TENS strength duration pulse duration

short, usually the same as high rate but can be Increased if needed to prevent accommodation or to increase comfort

TENS strength duration sensation

sensory only

TENS strength duration time/action

- up to 24 hours

- enkephalin release

TENS strength duration function

- based on strength duration curve

- used for acute or chronic pain

TENS burst pulse frquency

70-100 pps

TENS burst pulse duration

short so 100-200 microseconds

TENS burst sensation

muscle contractions

- sensory then contraction and so on

TENS burst time/action

- max 60 minutes

- endorphin release

TENS burst function

- used for acute and chronic pain but not super acute

- getting both high rate and low rate benefits

- won't understand until felt on you

- described as "hurts so good"

what should you always have with iontophoresis?

active and dispersive electrodes

what kind of sensation is desired with iontophoresis?

only sensory-level stimulation so tingling sensation

is russian the same as NMES?

NO!!!!!

what does MVIC stand for?

maximum voluntary isometric contraction

what ion is used to treat inflammation?

dexamethasone

what is the polarity of dexamethasone when used to treat inflammation?

negative

what is the dosage of dexamethasone when used to treat inflammation?

40 mA-min

what is the mode of action of dexamethasone when used to treat inflammation?

reduces inflammation

what ion is used to treat scars/adhesions?

chlorine/saline

what is the polarity of chlorine/saline when treating scars/adhesions?

negative

what is the dosage of chlorine/saline when treating scars/adhesions?

40 mA-min

what is the mode of action of chlorine/saline when treating scars/adhesions?

breaks up scar tissue

what ion is used to treat scar stretching?

iodine

what is the polarity of iodine when used to treat scar stretching?

negative

what is the dosage of iodine when used to treat scar stretching?

40 mA-min

what is the mode of action of iodine when used to treat scar stretching?

increases flexibility

what 2 ions can be used to treat for local anesthesia?

- lidocaine

- epinephrine

what is the polarity of lidocaine when treating for local anesthesia?

positive

what is the dosage of lidocaine when treating for local anesthesia?

40 mA-min

what is the mode of action of lidocaine when treating for local anesthesia?

local numbing

what is the polarity of epinephrine when treating for local anesthesia?

positive

what is the dosage of epinephrine when treating for local anesthesia?

10 mA-min

what is the mode of action of epinephrine when treating for local anesthesia?

- numbs deeper and bigger areas

- works on CNS when used systemically

what ion is used to treat fungus?

copper sulfate

what is the polarity of copper sulfate when treating fungus?

positive

what is the dosage of copper sulfate when treating fungus?

150 mA-min

what is the mode of action of copper sulfate when treating fungus?

fungicidal

what ion is used to treat plantar warts?

sodium

what is the polarity of sodium when treating plantar warts?

negative

what is the dosage of sodium when treating plantar warts?

40 mA-min

what is the mode of action of sodium when treating plantar warts?

reduces inflammation

what ion is used to treat shingles?

methylprednisolone succinate

what is the polarity of methylprednisolone succinate when treating shingles?

negative

what is the dosage of methylprednisolone succinate when treating shingles?

40 mA-min

what is the mode of action of methylprednisolone succinate when treating shingles?

reduces pain and inflammation

what ion is used for treating calcium deposits?

acetic acid

what is the polarity of acetic acid when treating calcium deposits?

negative