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AC Electrical Current (PTA 102)

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For muscle strenghtening, how many time per day do you repeat EMS?
EVERY 2-3 HOURS WHEN AWAKE
For muscle strengthening what is the treatment time?
10-20 MINUTES
10-20 REPETITIONS
For muscle strenghtening, what do you want to rise time to be?
AT LEAST 2 SECONDS
For muscle strenghtening, what is the on/off times and ratio?
6-10 SECONDS ON TIME
50-120 SECONDS OFF TIME

RATIO OF 1:5
For muscle strenghtening, what is the amplitude adjusted to?
< 10% OF THE mvic IN INJURED PATIENTS

>50% MVIC IN HEALTHY PATIENTS
For muslce strengthening, what is the pulse duration?
150-200 MICRO SECONDS FOR SMALL MUSCLES

200-350 MICRO SECONDS FOR LARGE MUSCLES
How much frequency is needed to produce a smooth titanic contraction?
35-50 pps

MAY BE INCREASED TO 80 PPS
Frequency?
NUMBER OF CYCLES PER SECOND
As you increase the frequency what will happen to the duration?
IT DECREASES
Number of pulses or cycles delivered per unit time (usually seconds) or pps or hertez for AC?
FREQUENCY
Determined by the duration and amplitude of a phase, pulse, or cycle?
CHARGE
True/False

You will not burn a patient with alternating current?
TRUE
In order for an action to occur what is the threshold that it must reach?
+30mV
The resting potential of an axon or nerve?
-65mV
Current flowing is both directions?
ALTERNATING CURRENT
The ability to store a charge?
CAPACITANCE
How does current flow through a battery?
FLOW OF ELECTRONS FROM NEGATIVE TO POSITIVE
How does current flow in the body?
POSITIVE TO NEGATIVE
What are the 4 impairments that Physical Therapist treat?
-PAIN
-MOTION RESTRICTIONS
-INFLMMATION AND REPAIR
-TONE ABNORMALITY
Time it takes for an individual stimulus to reach a peak level of magnitude?
RISE TIME
Will never drop below the isoelectric ling?
DIRECT CURRENT
This kind of current always drops below the isoelectric line?
ALTERNATING CURRENT
This type of electrical current is always a last resort?
DIRECT CURRENT
How is resistance measured?
OHMS
Pulse duration deals with?
TIME
True/False

PPS is not a unit of time?
TRUE
True/False

TYPE II MUSCLE FIBERS have more myelin than type I muscle fibers?
TRUE
How can deinervated nerves contract?
LOW VOLT AT 10 MILLI SECONDS
How to alpha motor neurons carry impulses?
CARRY IMPULSES FROM THE BRAIN TO THE MUSCLE
By convection, current is said to flow from?
ANODE TO CATHODE
Current flows from?
CATHODE TO ANODE
The more myelin the smaller the?
COMPATENCE
This is more comfortable and can stimulate larger areas?
INTERFERENTIAL THERAPY
True/False

Interferential therapy is associated with the OPIATE THEORY?
FALSE

GATE THEORY
What kind of current is interferential therapy?
ALTERNATION CURRENT
True/False

For interferential therapy, the lower the hertz the deeper the penetration?
TRUE
True/False

Motor TENS activate ASCENDING inhibitory pathways that involve serotonin systmes?
FALSE

DESCENDING
This version of TENS stimulates the production and release of ednorphins and enkephalins (endogenous opiates)
MOTOR TENS
Motor TENS is used for what kind of pain?
CHRONIC PAIN
Conventional TENS is used for what kind of pain?
ACUTE PAIN
What are the paramaters for motor TENS?
-PULSE FREQUENCY: 2-10 PPS
-PULSE DURATION: 100-200 MICRO SECONDS
What are the two methods of TENS units?
-CONVENTIONAL TENS
-MOTOR TENS
What are the paramaters for conventional TENS?
-PULSE FREQUENCY 100-150 PPS
-PULSE DURATION: 50-80 MICRO SECONDS
Conventional TENS is AKA?
-HIGH RATE TENS
-SENSORY TENS
The electrical difference between the inside of a neuron and the outside when the neuron is at rest, usually 60-90 mV, with the inside being negative relative to the outside?
RESTING MEMBRANE POTENTIAL
The reversal of the resting potential in excitable cell membranes where the inside of the cell becomes positive relative to the outside?
DEPOLARIZATION
The rapid sequential depolarization and repolarization of a nere that occurs in response to a stimulus and transmits along the axon?
ACTION POTENTIAL (AP)
A transient increase in threshold to nere excitation?
ACCOMMODATION
The frequency modulation of an interferential current?
SWEEP
The magnitude of current or voltage?
AMPLITUDE (INTENSITY)
How is pulse duration generally expressed?
MICRO SECONDS
The time from the beginning of the first phase of a pulse to the end of the last phase of a pulse?
PULSE DURATION
Voltage is AKA?
POTENTIAL DIFFERENCE
The force or pressure of electricity?
VOLTAGE
The charge of an electrode that will be positive (anode) or negative (cathode) with a direct or monophasic pulsed current and constantly changing with an alternating or biphasic pulsed current?
POLARITY
A principle of strengthening muscle that states the greater the load placed on a muscle and the higher force contraction it produces, the more strength that muscle will gain?
OVERLOAD PRINCIPLE
Motor point?
THE PLACE WHERE ELECTRICAL STIMULATION WILL PRODUCE THE GREATEST CONTRACTION WITH THE LEAST AMOUNT OF ELECTRICITY

GENERALLY LOCATED OVER THE MIDDLE OF THE MUSCLE BELLY
TENS with long duration, high amplitude pulses used to control pain?
LOW RATE TENS

AKA: ACUPUNCTURE LIKE TENS
A theory of pain control and modulation that states pain is modulated at the spinal cord level by inhibitory effects of nonoxious afferent input?
GATE CONTROL THEORY
Galvanotaxis?
THE ATTRACTION OF CELLS TO AN ELECTRICAL CHARE
The movement of flow of charged particles through a conductor in response to an applied electrical field?
ELECTRICAL CURRENT
TENS with short duration, low amplitude pulses used to control pain?
CONVENTIONAL TENS

AKA: HIGH RATE TENS
Anode?
THE POSITIVE ELECTRODE
TENS with long duration, high amplitude pulses used to control pain.
ACUPUNCTURE LIKE TENS
AKA: LOW RATE TENS
The greater distance between electrodes?
THE DEEPER THE CURRENT TRAVELS
The closer electrodes are are placed?
THE MORE SUPERFICIAL THE CURRENT TRAVELS
True/False

Electrodes should not be placed over bony prominences?
TRUE
True/False

Denervated muscles only contract in response to ;ulses of electricity lasting 15 milli seconds or longer?
FALSE

10 MILLISECONDS OR LONGER
NMES?
NEUROMUSCULAR ELECTRICAL STIMULATION
How do you increase endurance using electrical stim?
PROLONGED STIMULATION WITH MORE LOWER-FORCE CONTRACTION SHOULD BE USED
To increase strength, what should be used?
HIGHER FORCE CONTRACTIONS
To produce strength gains in an injured patient, the force of the stimulated contraction needs to be what?
10% OF THE MVIC
To produce strength gains in a healthy muscle, the force of the stimulated contraction needs to be what?
50% OF THE MVIC
The greater the load placed on a muslce and the higher force contraction it produces, the more strength that muslce will gain. This is an example of what?
OVERLOAD PRINCIPLE
How is electrical stimulation thought to strengthen muscles?
OVERLOAD AND SPECIFICITY
Electrically stimulated muscle contractions have what kind of onset?
RAPID AND JERKY ONSET
Physiological muscle contractions usually have what kind of onset?
SMOOTH ONSET
How do smaller slow twitch type I muslce fibers fatigue and atrophy? How are they recruited?
SLOWLY. THEY ARE MORE FATIGUE RESISTANT

They are recruited psychologically
What kind of contractions fatigue and atrophy more quickly?
ELECTRICAL STIMULATION

FAST TWITCH TYPE II MUSCLE FIBERS
Large fast twitch muscle fibers (Type II) will contract to what kind of stimulation?
ELECTRICAL STIMULATION
Describe the order of muscle recruitment with electrical stimulation?
FAST TWITCH TYPE II MUSCLE FIBERS ARE ACTIVATED FIRST FOLLOWED BY. THOSE WITH A SMALLER AXONAL DIAMETER ARE RECRUITED LATER
Describe type II muscle fibers?
-LARGEST DIAMETER AXONS
During electrical stimulation, which nerve fibers are activated first?
TYPE II MUSLCE FIBERS
What is the primary difference between electrically stimulated muscle contraction and physiologically initiated muscle contractions?
THE ORDER OF RECRUITMENT OF MOTOR UNITS
How can electrical stimulation assist with functional recovery?
BY PRODUCING SENSORY INPUT, PROPRIOCEPTIVE FEEDBACK OF NORMAL MOTION, AND INCREASED MUSCLE STRENGTH
What is the recommended on/off time when using electrical stimulation?
6-10 SECONDS ON TIME

50-120 SECONDS OFF TIME

1:5 RATIO
What is the purpose of the on/off time?
TO LIMIT PATIENT FATIGUE
Our goal is to get what kind of contraction?
TETANIC CONTRACTION
Determines the type of response or muscle contraction that the electrical stimulation will produce?
FREQUENCY
Selection of the ideal combination of pulse duration and current amplitude should be based on what?
patient feedback
In an innervated muscle, the pulse duration should be between what to stimulate motor nerves?
150-350 MICROSECONDS
True/False

Most motor points are over the middle of the muscle belly?
TRUE
This is the point where an electrical stimulus will produce the greatest contracation with the least amount of electricity?
MOTOR POINT
True/False

Electrodes should be place PERPINDICULAR to the muscle fibers?
FALSE

PARALLEL
When electrical stimulation is applied to produce a muscle contraction, where should the electrodes be placed?
OVER THE MOTOR POINT OF THE FOR THE MUSCLE AND THE OTHER SHOULD BE PLACED ON THE MUSCLE TO BE STIMULATED
Low rate/ acupuncture like TENS should not be applied for how long?
45 MINUTES

PROLONGING THE REPETITIVE MUSLCE CONTRACTION CAN RESULT IN DELAYED-ONSET MUSCLE SORENESS (DOMS)
How long will low rate/acupuncture like TENS control pain for?
4-5 HOURS AFTER A 20-30 MINUTE TREATMENT
How can you achieve low rate/acupuncture like TENS?
LONGER PULSE DURATIONS AND HIGHER CURRENT AMPLITUDES
Describe low rate/acupuncture like TENS?
REPETITIVE STIMULATION OF MOTOR OR NOCICEPTIVE A DELTA NERVES TO PRODUCE REPETITIVE MUSCLE CONTRACTIONS OR BRIEF SHARP PAIN CAN STIMULATE ENDOGENOUS OPOID PRODUCTION.
When does pain normally return after the dissuse of conventional TENS?
IMMEDIATELY
Conventional TENS uses what pain theory?
GATE CONTROL THEORY
How long can conventional TENS be applied for?
UP TO 24 HOURS
TENS
TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION
When using electrical stimulation, how can A Beta nerves be activated?
BY BOTH SHORT AND LONG DURATION ELECTRICAL CURRENT PULSES
Pain perception is determinded by the activity of?
A-DELTA AND C FIBERS
What is an example of a nonnociceptor?
A-BETA NERVE FIBERS

CAN INHIBIT TRANSMISSION OF NOXIOUS STIMULI FROM THE SPINAL CORD TO THE BRAIN
C nervy fibers?
SMALL UNMYELINATED C NERVE FIBERS
A Delta nerves?
SMALL AND MYELINATED
How does electrical stimulation reduce the sensation of pain?
BY INTERFEREING WITH IT'S TRANSMISSION AT THE SPINAL CORD LEVEL

AKA: GATE CONTROL THEORY
Why do we not want to place electrodes over the carotid sinus?
MAY INDUCE A RAPID FALL IN BLOOD PRESSURE AND HEART RATE. THEY CAN CAUSE THE PATIENT TO FAINT
If your patient is pregnant, where should you NOT place the electrodes?
OVER THE LOW BACK, ABDOMEN, OR HIPS
Are you more likeley to see a burn from electrical stimulation from AC/DC current or pulsed currents?
AC/DC CURRENTS BECAUSE THEY ARE ALWAYS ON
Why is it not recommended for electrical stimulation to be placed on malignant tumors?
ELECTRICAL STIMULATION CAN EHHANCE TISSUE GROWTH
How is an action potential achieved?
BY RAPID SEQUENTIAL DEPOLARIZATION AND REPOLARIZATION IN RESPONSE TO STIMULATION
A longer pulse of 150-350 micro seconds in duration is used to produce?
MUSCLE CONTRACTIONS
A short pulse of about 80 micro seconds in duration is used to produce what kind of stimulation?
SENSORY STIMULATION

LOW AMPLITUDE CURRENT/SHORT PULSE DURATION
Longer pulses and higher amplitudes are used for MOTOR STIMULATION?
TRUE
True/False

Short pulses and low current amplitudes are used for SENSORY STIMULATION
TRUE
True/False

Longer pulses and LOWER amplitudes are used for motor stimulation?
HIGHER
True/False

Short pulses and HIGH current amplitudes are used for sensory stimulation?
FALSE

LOW CURRENT
Higher amplitude or longer pulses are needed to deploarize what kind of nreves?
MOTOR NERVES
Lower current amplitudes and shorter pusle durations can depolarize what kind of nerves?
SENSORY NERVES
True/False

When a nerve is depolarized, no additional action potentials can be generated?
TRUE
When a nerve is as rest, without physiological or electrical stimulation, the insie is more negatively charged that the outside by?
60-90 mV
The basic unit of nerve communication?
ACTION POTENTIAL
How does electrical current exert it's physiological effects?
BY DEPOLARIZING NERVE MEMBRANES AND THEREBY PRODUCING ACTION POTENTIALS
What are the clinical applications of electrical stimulation?
-MUSCLE STRENGTHENING AND REEDUCATION
-PAIN CONTROL
-ASSISTING IN THE HEALING PROCESS
-RESOLVING EDEMA AFTER INJURY OR SURGERY
-TRANSDERMAL DRUG DELIVERY
-
Lapicque introduced the concept of?
THE "STRENGTH DURATION CURVE"
In 1905, Lapicque developed what law and for what purpose?
LAW OF EXCITATION

RELATING THE INTENSITY AND DURATION OF A STIMULUS TO WHETHER IT WOULD PRODUCE A MUSCLE CONTRACTION
True/False

Faradic current cannot be used to produce a muscle contraction?
FALSE

IT CAN BE USED TO GENERATE A MUSCLE CONTRACTION
During the 1830s, Faraday discovered that bidirectional electrical currents could be induced by a moving magnet. What did he call this current?
FAFADIC CURRENT
This person mapped out the locations on the skin where electrical stimulation most effectively cause specific muscles to contract?

These were referred to as?
DUCHENNE

-REFERRED TO AS "MOTOR POINTS"
Who was the man in 1971 who first recorded producing muscle contractions by touching metal to a frog's muscle and what did he call the effect?
GALVANI

-HE CALLED IT "ANIMAL ELECTRICITY"
Electrical current is a flow of charged particles. The charged particles may be?
-ELECTRONS
-IONS
A flow of charged particles?
ELECTRICAL CURRENT
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