Application Principles of E-stim

Application Principles of E-stim

1. ENERGY!!!

   • while protecting pt comfort and preventing accomodation
   • muscle
     • twitch
     • strength
       • tetany (W:R 1:3-5)
     • fatigue
       • tetany (W:R 2:1; 3:1)
   • Iontophoresis
     • bone healing
     • wound healing
   • Direct Current/HiVolt
     • (-) negative best for swelling; black lead on polarity of negative
     • (+) positive is best for pain and wound healing; red lead on a polarity of positive

2. Most common types of stimulation

   • Pulsed- monophasic
     • high volt pulsed - twin peaked
     • direct current from Iontophoresis
   • Pulsed biphasic
     • transcutaneous electrical nerve stim (TENS)
     • asymmetric or symmetric biphasic
     • neuromuscular e-stim (NMES)
     • vectra muscle stimulation (VMS)/LoVolt
   • alternating
     • IFC
     • Russian
     • Premod

3. setting up the pads

   • the larger the pad the less density of the current
   • the smaller the pad, the more density of current≥
   • electrode placement technique
     • active electrode and dispersive electrode
       • active applied to tx area
       • dispersive applied to remote location - used to complete the circuit
     • quadpolar technique
       • can cross (only IFC) or not
     • where to put them
       • motor point - find with stimulator Gel and hand technique
       • dermatome or meridian to help pain relief when treating nerve root with bipolar placement
       • site of pain
       • site of pain and associated dermatome/meridian