Type Treatment Waveform Polari Pulse Pulse Amplitude Modulati On:off Time & Ramp Treatme Times Physiological

ati On:off Time & Ramp Treatme Times Physiological Effect

Goal ty Freq. Duration on Ratio Time nt Time Per Day
(Hz =
pps)
Pain Conventiona TENS or --- High freq: Low duration: Strong Use if --- --- As PRN Exciting A-β (sensory)
Control l (high rate) Premodulated (1 100-150 50-80 μs tingling, available needed (wheneve fibers to gate signals
[acute: channel) or Hz comfortable, for pain r carried by A-δ (fast pain)
(pads along sharp, well- Interferential (2 no muscle control necessar fibers at SC; can break
dermatome localized channels) or VMS contraction (up to 24 y) the pain-spasm-pain
) pain] [AC] hours) cycle
Acupuncture TENS or --- Low freq: High duration: Strong, May use --- --- 20-30 Every 4-5 Muscle contraction
-like (low Premodulated (1 2-10 Hz 200-300 μs comfortable, burst: min hours creates endogenous
rate) channel) or for with muscle may be endorphins & opiates to
[chronic: Interferential (2 twitch, contraction more block pain carried by C
dull, poorly- channels) or VMS 35-80 Hz tolerable (slow pain) fibers
localized [AC] for tetany to pt
pain]
Intense Intense TENS or --- High freq: High duration: To 7/10 pain --- --- --- Pts can Every 4-5 Pain caused by e-stim
TENS VMS [AC] > 200 Hz tolerate hours masks sensation of
> 100 Hz only 15 existing intense pain
min or carried by A-δ fibers;
less intersperse with
conventional
Burst mode TENS or --- 10 bursts High duration: To visible Not usu. --- --- 20-30 --- Muscle contraction
Premodulated (1 (usu. 100-300 μs max contraction possible min creates endogenous
channel) or preset in (usu. preset in in burst endorphins & opiates to
Interferential (2 unit) unit) mode block pain carried by C
channels) or VMS (slow pain) fibers
[AC]
Muscle Muscle Russian or VMS --- Low freq: High duration: To > 10% of --- On: 6-10 sec, 2 sec 10-20 Every 2-3 Muscle depolarization
Contraction strengthenin [AC] 35-80 Hz Small m: 150- MVIC in Off: 50-120 sec or min (for hours (see Strength-Duration
s g 200 μs injured; (ratio 1:5). May more 10-20 when curve)
Large m: 200- To > 50% of reduce on:off reps) awake
(pads on or 350 μs MVIC in time w/
near motor uninjured repeated Txs.
point) Muscle Russian or VMS --- Low freq: High duration: Sufficient for --- Depends on 2 sec Depends NA Affects mechano-
reeducation [AC] 35-80 Hz Small m: 150- functional functional or on receptors and GTOs to
200 μs activity activity more functional reeducate CNS
Large m: 200- activity connection in order to
350 μs fire muscle; denervated
musc. needs longer
pulse duration
Muscle Russian or VMS --- Low freq: High duration: To visible --- On: 2-5 sec, 2 sec 10-30 Every 2-3 ---
spasm [AC] 35-80 Hz Small m: 150- contraction Off: 2-5 sec or min hours
reduction 200 μs (or equal on:off more until
Large m: 200- times) spasms
350 μs relieved
Edema Russian or VMS --- Low freq: High duration: To visible --- On: 2-5 sec, 2 sec 30 min Twice a Muscle contraction
reduction [AC] 35-80 Hz Small m: 150- contraction Off: 2-5 sec or day causes milking effect to
using 200 μs (or equal on:off more decrease edema
muscle Large m: 200- times)
pump 350 μs
(chronic)
Wound Inflammator High-Voltage Neg. Med-high Low-med To produce --- --- --- 45-60 --- Polarity attracts
Healing y phase/ Pulsed Current freq: duration: comfortable min neutrophils,
infected (HVPC) [DC] 60-125 40-100 μs (usu. tingling lymphocytes and
Hz preset in unit) macrophages; decr.
edema by repelling neg-
charged plasma
Proliferation High-Voltage Pos. Med-high Low-med To produce --- --- --- 45-60 --- Polarity facilitates
phase/ clean Pulsed Current freq: duration: comfortable min epithelial cell migration
(HVPC) [DC] 60-125 40-100 μs (usu. tingling and stimulates
Hz preset in unit) fibroblasts
Edema Edema High-Voltage Neg. High freq: Low-med To produce --- --- --- 20-30 --- Repels negative plasma
Control associated Pulsed Current 100-120 duration: comfortable min out of limb
with (HVPC) [DC] Hz 40-100 μs (usu. tingling
inflammatio preset in unit)
n (acute)
Edema Russian or VMS NA Low freq: High duration: To visible --- On: 2-5 sec, --- 20-30 --- Muscle contraction
associated [AC] 35-50 Hz 150-350 μs contraction Off: 2-5 sec min causes milking effect to
with lack of (or equal on:off decrease edema
motion times)
Transderm Iontophoresi Galvanic [DC] Same NA NA To pt --- --- --- Depends --- Dexamethosone: anti-
al Drug s as tolerance, no on inflammatory; Lidocaine:
Delivery drug greater than amplitud anesthetic, analgesic;
ion 4 mA e, to Acetate: sclerolytic;
produce a Salicylate:
total of decongestive, analgesic
40 mA-
min
Contraindications: cardiac pacemaker or unstable arrhythmias; placement of electrodes over carotid sinus; areas where venous or arterial thrombosis or thrombophebitis is present; pregnancy (over or
around the abdomen or low back)
Precautions: cardiac disease; pts with impaired mentation or in areas with impaired sensation; malignant tumors; areas of skin irritation or open wounds; iontophoresis after other physical agents
Contractions: With e-stim: larger, fast twitch (type II) muscles depolarize first. With normal physiology: smaller, slow twitch (type I) muscles depolarize first.