Estim Parameters

PRACTICAL PARAMETERS

high rate

low rate

burst mode

brief intense 

the four types of TENS are:

high rate, low rate

for IFC, you can do _____ and ______ to target sensory and motor

high rate, low rate

like IFC, for premod you can do ________ for sensory and ______ for motor

HVPC

for wound care, you should be using ______ twin peak monophasic

russian

biphasic symmetrical 

biphasic asymmetrical

for strength, you can use: (3) 

biphasic, russian

for Spasticity, you should use ______ or ______

biphasic, russian

for a shoulder sublux, you should use ______ or ______

50-180 pps

conventional/high rate TENS pulse frequency 

50-100 usec

conventional/high rate TENS pulse duration

strong sensory

conventional/high rate TENS amplitude

15-20 min

conventional/high rate TENS Treatment time

n/a — continuous

conventional/high rate TENS ramp time

M (pulse width)

conventional/high rate TENS modulation

<10, 1-4 pps

low rate pulse frequency

200-300 usec

low rate pulse duration

motor/muscle twitch 

low rate amplitude

20-30 minutes

low rate Treatment Time 

n/a — continuous

low rate ramp time

SD1 — frequency

low rate modulation

no because they’re continuous

do TENS waveforms have ON:OFF times?

100 pps @ 2 pps

burst mode pusle frequency

150-200 usec

burst mode pulse duration 

motor/muscle twitch

burst mode amplitude

20-30 minutes

burst mode treatment time

n/a — continuous

burst mode ramp time

usually not available

burst mode modulation

trigger points

chronic LBP

low rate and burst mode are typically used for: (2)

100-150 pps

brief intense pulse frequency

150-250 usec

brief intense pulse duration

noxious level

brief intense amplitude

wound debridement and c sections

brief intense indication

80-150 pps

high rate IFC pulse frequency

N/A for this waveform — uses a carrier frequency

high rate IFC pulse duration 

strong sensory

high rate IFC amplitude

15-20 minutes

high rate IFC treatment time

N/A because it’s an AC

high rate IFC ramp time

vector scan (100%) or sweep

high rate IFC modulation

pain and large area

high rate IFC indication

1-10 pps

low rate IFC pulse frequency

N/A for this waveform — uses carrier frequency 

low rate IFC pule duration 

motor twitch

low rate IFC amplitude

15-20 minutes

low rate IFC treatment time

N/A because its an AC

low rate IFC ramp time

vector scan (100%) or sweep

low rate IFC modulation

pain and large area, use if pt cannot tolerate Low Rate TENS

low rate IFC indication

80-120

premod high rate pulse frequency

N/A

premod high rate pulse duration

strong sensory

premod high rate amplitude

15-20 minutes

premod high rate treatment time

N/A because its an AC

premod high rate ramp time

treatment area is too small for IFC

premod indication

1-10 pps

premod low rate pulse frequency

N/A

premod low rate pulse duration

motor/muscle twitch

premod low rate amplitude

15-20 minutes

premod low rate treatment time 

N/A because it’s an AC

premod low rate ramp time

100 pps

wound care HVPC pulse frequency

4-100 usec (set at 100 usec)

wound care HVPC pulse duration

strong sensory

wound care HVPC amplitude

45-60 minutes

wound care HVPC treatment time

0.5” — dont want a ramp but have to pick something

wound care HVPC ramp time 

30 (smaller mms.) - 50 (larger mms.) pps

russian pulse frequency

10 usec/bps

russian pulse duration

tetanic motor/muscle contraction

russian amplitude

10 minutes

russian treatment time

2”

russian ramp time

10/50 start

russian On:Off time

neuro re-ed and strength of smaller/larger mms. groups

russian indication

30-50 pps (50 for large mms)

biphasic symmetrical pulse frequency

350-450 usec

biphasic symmetrical pulse duration

tetanic motor/muscle contraction

biphasic symmetrical amplitude

10 minutes

biphasic symmetrical treatment time

2”

biphasic symmetrical ramp time

10/50 start

biphasic symmetrical On:Off time

neuro re-ed and strength of larger mms. groups

biphasic symmetrical indication

30-50 pps (30 for smaller mms.)

biphasic asymmetrical pulse frequency

350-450 usec

biphasic asymmetrical pulse duration

tetanic motor/muscle contraction

biphasic asymmetrical amplitude

10 minutes

biphasic asymmetrical treatment time

2”

biphasic asymmetrical ramp time

10/50 start

biphasic asymmetrical On:Off time

neuro re-ed and strength of smaller mms. groups

biphasic asymmetrical indication

20-100 pps

NMES spasticity pulse frequency

250-500

NMES spasticity pulse duration

3-/5

NMES spasticity amplitude

10-60 minutes per day

NMES spasticity treatment time

0-3” (if attached to antagonist, might need longer ramp) 

NMES spasticity ramp time

1/1 start

NMES spasticity On:Off time

30-60 pps (high is more fatigable)

NMES/FES sublux pulse frequency

200-350 usec

NMES/FES sublux pulse duration

sensory w/out shoulder elevation

NMES/FES sublux amplitude

20 minutes to 6 hours per day

NMES/FES sublux treatment time

3”

NMES/FES sublux ramp time

1/5 start… eventually get to 15/1

NMES/FES sublux On:Off time

switch to IFC low rate

for a patient with chronic low back pain, you try Low Rate TENS. However, your patient rings the call bell and says it’s too painful. what do you do?

conventional high rate TENS or premod high rate

for a patient with an acute ankle sprain, and 7-8/10 pain, what estim method would you use FIRST

NMES russian or biphasic

a patient who is s/p right CVA with flexor spasticity in her left arm will need what kind of estim to maintain wrist and finger extension/ROM

NMES biphasic symmetrical or russian — at least 10 minutes, 3-5x/week, for 4-8 weeks

a patient 2 weeks s/p arthroscopic surgery of his right knee has atrophy of his vastus medialis. he cannot do a straight leg raise in full extension. what form of Estim would you use and what is the treatment time 

NMES/FES biphasic Asymmetrical or Russian 

what is the waveform to use with shoulder subluxations s/p CVAs

Biphasic NMES/FES

30-40pps

200-300 usec

3/5 to clear the ground 

0-1” ramp 

no duty cycle bc it’s timed with Heel Strike

a patient is s/p TBI with left foot drop and ankle DF atrophy. to strengthen the Tibialis Anterior, what kind of Estim would you use and what are the parameters