Electrotherapy Contradindications Pacemakeer Indweeling electrical PElvics Cardotid sinus Heart Thromobious Thromboflebists Preg Precautions Ca Seizure history

Circulatory impairments Increase duration Increases total current Increases recruitment at the same level Sensory and motor Less comfortable if excessive Increase frequency Increase total current Increase stimulation at the same depth Tetanus motor Amplitude Increae total intensity and increase peak intensity Sitmulaiton of neve fiberst at the same level and deeper Increaed sensory and motor response

Types of stimulus Electroanagesisa PD low (0-100) high (>100) Freq low (<10) high (>10) very high (>150) Amp (pre-sensory, sensory i.e. tingling, motor contraction) Pre sensory not used much microcurrent Acute high volt, IF, TENS, PD low Freq High Amp tingling strong

Chronic PD high Freq low Amp Strong motor contraction NMES Strength PD long 100-600 micro seconds Freq 10-50 Amp 50% MVIC of uninjured leg On off 1:3 to 1:5 Orthotic PD long 100-200 Freq 10-50 Amp low motor level On off 1:3 to 12:2 Work up to progressively longer treatment times NMR PD long 100-200 Freq 10-50 Amp low motor level On off 1:3 to 1:1 ULTRASOUND Therapeutic Uses Deep Heat Continuous (temp increase 1mhz (5cm) 3 Mhz (1cm) Pain Control Soft Tissue Shortening (pre tissue stretch) Circulation (pulsed) Incisions Sound Waves Break up CA++ deposits (Debatable) Depth 3 MHz (aprox 1/3 depth of 1 MHz) Have to turn up the intensity with lower freq Attenuation Absorption Highest to Lowest (Bone, tendon, muscle, fat, water) Half Depth Water 1mhz/3mhz 11.5 M/3.8M Contrainidcations Pregnancy Pacemaker Malignacy Thromobphelibits Reproductive Orgrans

Eyes, Cement or Plastic Joints CNS or laminectomy Precautions Fracture Acute inflammation Breast Implants Epiphseal plants Settings Bone Pulsed/0.15/1 Phonpherisis P/0.5/3 Incsiosn Pulsed 0.5 3MHz Dermal Ulcers P/0.8/3 Tendon Injury C /1.0/1or3 Capral tunnel P/1/1 Soft tissue C/2/1or3 Pain C/1/1or3 Traction Joint distraction Reduction of Disc Protrusion Soft Tissue Stretching Muscle Relaxation Joint Mobilization Patient Immobilization Contrainidcations After Spinal Surgery After Spinal Cord Compression Fracture Acute Injury or inflammation Hypermboible or unstable joint Settings Lumbar 25% force (unless joint distraction then up to 50% of BW) Initial acute static 5-10 min Joint Distraction 15/15sec min 20-30 min Muscle Spasm 5/5sec 20-30 min Disc/soft tissue 60/20sec 20-30 Cervical 5-7 Kg of force (unless joint distraction then up to 13kg of force) Same as lumbar More flexion stresses the posterior structures of the neck More extension stresses the anterior structures Flexion stresses segments further away from the pull cervical (visa versa) Extension stresses segments further away from pull lumbar (visa versa)