E-stim Parameters

Iontophoresis waveform

Low level DC

Iontophoresis - Treatment negative ion mediation connects to

Black lead wire

Iontophoresis - Treatment positive ion mediation connects to

Red lead wire

Iontophoresis Tx Duration: 40 mA*min & 0.5 mA intensity

80 minutes

Iontophoresis Tx Duration: 40 mA*min & 1 mA intensity

40 minutes

Iontophoresis Tx Duration: 40 mA*min & 2 mA intensity

20 minutes

Iontophoresis Tx Duration: 40 mA*min & 3 mA intensity

13.3 minutes

Iontophoresis Tx Duration: 40 mA*min & 4 mA intensity

10 minutes

Ionto max amplitude/intensity

4 mA

Typical (range) dosage for Ionto

20-80 mA*min for 5-20 minutes

NMES for Muscle Strengthening: Waveform

Biphasic PC or burst modulation AC (Russian or Aussie)

NMES for Improve ROM/Decrease spasm: Waveform

Biphasic PC or burst modulation AC (Russian or Aussie)

NMES for Reduction of Subacute or Chronic Edema: Waveform

Biphasic PC or burst modulation AC (Russian or Aussie)
(must have limb elevated)

FES: Waveform

Biphasic PC or burst modulation AC (Russian or Aussie)

EMS: Waveform

Monophasic or DC

NMES for Muscle Strengthening: Pulse Duration

200-600 microseconds
- Small muscles: 125-200 microseconds
- Large muscles: 200-250 microseconds

NMES for Muscle Strengthening: Pulse Frequency

20-80 pps or bursts per sec

- Small muscles: 20-30+ pps
- Large muscles: 50+ pps

NMES for Muscle Strengthening: Amplitude/Intensity

As high as tolerated with a goal of reaching > 50% max voluntary contraction (MVC)

NMES for Muscle Strengthening: On:Off Time

1:3 to 1:5 with on-time up to 10 seconds and off time up to 50 seconds

NMES for Muscle Strengthening: Ramp On & Off Time

Ramp up: 1-5 secs

Ramp down: 1-2 seconds

NMES for Muscle Strengthening: Tx Duration

10-20 strong contractions

Or

up to 1hr/ day 3-5x/week for 4-8 weeks

NMES for Improve ROM/Decrease spasm: Pulse Duration

Smaller muscles: 125-200 microseconds

Larger muscles: 200-350 microseconds

NMES for Improve ROM/Decrease spasm: Pulse Frequency

35-50 pps
- Small muscles: 20-30+ pps
- Large muscles: 50+ pps

NMES for Improve ROM/Decrease spasm: Amplitude/Intensity

To visible contraction

NMES for Improve ROM/Decrease spasm: On:Off Time

1:1

On time and off time equal and 2-5 seconds

NMES for Improve ROM/Decrease spasm: Ramp On & Off Time

1-5 seconds ea. up and down

NMES for Improve ROM/Decrease spasm: Tx Duration

10-30 min 1-4x/day

2 weeks-6 mo

NMES for Reduction of Subacute or Chronic Edema: Pulse Duration

100-600 microseconds

NMES for Reduction of Subacute or Chronic Edema: Pulse Frequency

20-80 pps or bursts per sec
- Small muscles: 20-30+ pps
- Large muscles: 50+ pps

NMES for Reduction of Subacute or Chronic Edema: Amplitude/Intensity

MA to tetanic contraction

NMES for Reduction of Subacute or Chronic Edema: On:Off Time

1:1

Equal on:off times

2-5 seconds ea.

NMES for Reduction of Subacute or Chronic Edema: Ramp On & Off Time

1+ seconds ea. Up and down

NMES for Reduction of Subacute or Chronic Edema: Tx Duration

10-20 minutes of rhythmic contractions 1-2x/ day, monitor edema

FES: Pulse Duration

200-600 microseconds

FES: Pulse Frequency

20-60 pps or bursts per sec

FES: Amplitude/Intensity

To level commensurate with functional activity

FES: On:Off Time

Depends on functional activity

FES: Ramp On & Off Time

Depends on functional activity

FES: Tx Duration

Task specific

EMS: Pulse Duration

1-450 msec (long)

EMS: Pulse Frequency

1-500 pps

EMS: Amplitude/Intensity

High enough to obtain contractions but low enough to prevent burns

EMS: On:Off Time

Highly variable;

on: 3-10 secs

off: 30-50 secs

EMS: Tx Duration

30 min/ 8 hours per day; 5-7 days/ week;

4 days to 4 years

Conventional High-Rate TENS: Waveform

Mono-phasic pulsed (hi-volt) or symmetric biphasic pulsed

Conventional High-Rate TENS: Pulse Frequency

100-150 Hz or pps (high)

Conventional High-Rate TENS: Pulse Duration

50-80; <100 microseconds (short)

Conventional High-Rate TENS: Amplitude/Intensity

Sensor level; Highest to patient comfort without muscle contraction

Conventional High-Rate TENS: Tx Duration

30 min or less in clinic; 1 hr at a time at home with at least 30 min off prior to repeating

Acupuncture/Low-Rate TENS: Waveform

Mono-phasic pulsed (hi-volt) or symmetric biphasic pulsed

Acupuncture/Low-Rate TENS: Pulse Frequency

1-10 Hz (low)

Acupuncture/Low-Rate TENS: Pulse Duration

150-200 microseconds (long)

Acupuncture/Low-Rate TENS: Amplitude/Intensity

Motor level: visible contraction

Acupuncture/Low-Rate TENS: Tx Duration

30 min or less

(too long of a duration can cause DOMS)

IFC/ Amplitude Modulated AC Current: Waveform

IFC, Premodulated or Pulsed biphasic AC

IFC/ Amplitude Modulated AC Current: Pulse Frequency

2000 Hz: muscle contraction (250 pulse duration)

4000 Hz: reduce pain (125 pulse duration) High rate

100 Hz (common clinic units)

Will peak and fall at the beat frequency

(pre-mod: sweep between 80-150)

IFC/ Amplitude Modulated AC Current: Pulse Duration

Cannot be set and changes inversely with the carrier frequency (check frequency)

IFC/ Amplitude Modulated AC Current: Amplitude/Intensity

Increases and decreases throughout Tx

IFC/ Amplitude Modulated AC Current: Tx Duration

30 min or less (10-20 most common)

ES for Acute Tissue Healing: Waveform

HVPC, a Monophasic pulsed current

ES (HVPC) for Acute Tissue Healing: Pulse Frequency

Pulse frequency usually set at 100 pps;

Range= 60-125 pps for wound healing

ES (HVPC) for Acute Tissue Healing: Pulse Duration

40-200 microseconds (HVPC is usually set to 100 microseconds)

ES (HVPC) for Acute Tissue Healing: Amplitude/Intensity

Sufficient to produce a comfortable sensation without a motor response

ES (HVPC) for Acute Edema: Electrode Placement

Negative polarity HVPC over area of edema, dispersive electrode over other large flat area

ES (HVPC) for Acute Tissue Wound Healing: Tx Duration

5x/week for 45-60 minutes

ES (HVPC) for Acute Edema Healing: Tx Duration

20-30 minutes

ES (HVPC) for Acute Edema: Pulse Duration

40-100 microseconds

ES (HVPC) for Acute Edema: Pulse Frequency

100-120 pps

ES (HVPC) for Acute Edema: Amplitude/Intensity

Comfortable sensory; below threshold for motor contraction; 90% of visual motor threshold

ES (HVPC) for Acute Tissue Healing to promote healing of inflamed or infected wounds: Polarity

Negative

ES (HVPC) for Acute Tissue Healing to promote healing of wounds without inflammation/Proliferative phase: Polarity

Positive

PSWD Nonthermal: Pulse Width

65 microseconds

PSWD Nonthermal: Pulse Rate

100-200 pps

PSWD Nonthermal: Average Watts

N/A

PSWD Mild Warmth (1C): Pulse Width

100 or 200 microseconds

PSWD Mild Warmth (1C): Pulse Rate

800 or 400 pps

PSWD Mild Warmth (1C): Average Watts

12

PSWD Moderate Warmth (2C): Pulse Width

200 or 400 microseconds

PSWD Moderate Warmth (2C): Pulse Rate

800 or 400 pps

PSWD Moderate Warmth (2C): Average Watts

24

PSWD Vigorous Heating (4C): Pulse Width

400 microseconds

PSWD Vigorous Heating (4C): Average Watts

48