Electrical Stimulation

Treatment Strategies

HVPS: Neuromuscular Stimulation

Output Intensity Strong, intense, comfortable contractions. Pulse frequency If duty cycle cannot be adjusted: Low for individual muscle contractions (<15 pps). Adjustable duty cycle: Moderate for tonic contractions (>50 pps). Duty Cycle Initial treatments should begin with a low (e.g, 20%) duty cycle and be increased as the muscle responds. Electrode placement Bipolar: Proximal and distal to the muscle (or muscle group) to be stimulated. This method offers the most direct method of stimulating specific areas. Monopolar: Over motor points or muscle belly. Place the cathode over motor points

Bipolar electrode arrangement

HVPS: Sensory-level Pain Control

Output Intensity Pulse frequency Phase duration Mode Electrode arrangement Polarity Sensory level 60 to 100 pps <100 sec* Continuous Monopolar or bipolar Acute: Positive Chronic: Negative Directly over or surrounding the painful site

Electrode placement
* Not adjustable on most HVPS units.

HVPS: Motor-level Pain Control

Output Intensity Pulse rate Phase duration Mode Electrode arrangement Polarity Motor level 24 pps 150250 sec Continuous Monopolar or bipolar Acute: positive Chronic: Negative Directly over the painful site, distal to the spinal nerve root origin, trigger points, or acupuncture points

Electrode placement

HVPS: Brief-Intense Pain Control Protocol

Output Intensity Pulse rate Phase duration Mode Noxious >120 pps 300 to 1000 sec Probe 15 to 60 sec at each site Monopolar (probe) Acute: Positive Chronic: Negative Gridding technique, stimulating hypersensitive areas working from distal to proximal

Electrode arrangement Polarity

Probe placement

HVPS: Sensory-level Edema Control

Intensity: Sensory level Pulse duration: Maximum possible duration Pulse frequency: 120 pps. Polarity: Negative electrodes over injured tissues Mode: Continuous Electrode placement: The immersion method should be used when possible, or the active electrodes should be grouped over and around the target tissues. Treatment duration
Four 30-minute treatments, followed by 60minute rest periods

Anode (+)

or
Four 30-minute treatments, each followed by 30-minute rest periods. Start treatment as soon as possible after the trauma. The body part should be wrapped and elevated between sessions. This treatment regimen should not performed if gross swelling is present.

Comments

Cathode (-)

HVPS: Edema Reduction

Intensity: Strong, yet comfortable muscle contraction
Avoid contraindicated joint motio

Pulse frequency: Low Polarity: Positive or negative. Mode: Alternating. Electrode placement
Bipolar: Proximal and distal ends of the muscle group proximal to the edematous area. Monopolar: Active electrodes follow the course of the venous return system.

Comment: Ice may be applied to the injured area, but this could impede venous return by increasing the viscosity of fluids in the area

IFS: Sensory-level Pain Control

Carrier Frequency: Based on patient comfort Burst Frequency: 80 to 150 Hz Sweep: Fast Electrode Arrangement: Quadripolar Electrode Placement: Around the periphery of the target area Output Intensity: Strong sensory level Treatment Duration: 20 to 30 minutes

Premodulated Neuromuscular Stimulation

Carrier Frequency: 2500 Hz Burst Frequency: 30 to 60 bps Burst Duty Cycle: 10 percent Cycle Duration: 400 sec On/off Duty Cycle: 10:50 sec Ramp: 2 sec Electrode Placement: Bipolar: Proximal and distal ends of the muscle Output Intensity: Strong muscle contraction. Discomfort may be experienced Treatment Duration: 10 cycles or until fatigue occurs