Electrical Stimulation Goals and Techniques

1
Electrical Stimulation Goals and Techniques

• General Applications

2
Motor Level Stimulation

• Therapeutic Gains
• Muscle Re-education
• Muscle Pump (Edema Reduction)
• Atrophy Retardation
• Strength Improvements
• ROM Increases
• Physiology
• Motor Units
• Recruiting Sequence
• Golgi Tendon Organs

3
Motor Level Stimulation

• Treatment Considerations
• Muscle Fatigue
• Muscle Force
• Duty Cycle
• Pulse Amplitude
• Pulse Frequency
• Pulse/Phase Duration

4
Pain Control

• Gate Control General Parameters
• Opiate Control General Parameters
• Beta-endorphins
• Enkephalins

5
Wound Healing

• Stimulator Type
• Polarity

6
Control and Reduction of Edema

• Sensory Level
• Limit edema formation before it appears
• Motor Level
• Remove existing edema

7
Clinical Applications of Electrotherapy
8
High-voltage Pulsed Stimulating Units

• Waveforms Used
• Pulsed monophasic (typically twin peaked)
• Polarity of electrodes is known
• Pulse Duration
• Pulse Frequency
• Tissue Impedence
• Strength-Duration Curve
• Indications
• Electrode Arrangement
• Contraindications/Precautions
• Parameters (See Outline)

9
Neuromuscular Electrical Stimulation

• Waveforms Used
• Balanced biphasic waveforms
• Pulse Duration
• Pulse Frequency
• Electrode Arrangement
• Indications
• Contraindications/Precautions
• Parameters (See Outline)

10
Transcutaneous Electrical Nerve Stimulation (TENS)

• Waveform Used
• Balanced biphasic either symmetrical or
  asymmetrical
• Pulse Durations
• Pulse (Burst) Frequency
• Basic Modes
• Conventional (High Frequency)
• Acupuncture-Like (Low Frequency)
• Brief Intense
• Burst
• Modulation

11
Transcutaneous Electrical Nerve Stimulation
(TENS)

• Electrode Placement
• Direct
• Contiguous
• Over Dermatome Zone
• Spinal Cord Nerve Roots
• Indications
• Contraindications/Precautions
• Parameters (See Outline)

12
Interferential Electrical Stimulation

• Waveform Used
• 2-3 medium frequency biphasic waveforms
• Destructive Interference
• Constructive Interference
• Beat Pattern
• Frequency
• Carrier vs. Beat
• Methods of Delivery Electrode Placement
• Bipolar Method (Premodulated Current)
• Quadripolar Method
• Quadripolar Method with Automatic Vector Scan
• Stereodynamic method

13
Interferential Electrical Stimulation

• Modes of Delivery
• Constant
• Sweep
• Indications
• Contraindications Precautions
• Parameters (See Outline)

14
Russian Stimulation

• Waveforms
• Continuous polyphasic waveform that is burst
  modulated