Download Treatment Strategies

Electrical Stimulation
Treatment Strategies
HVPS: Neuromuscular Stimulation
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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
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Output Intensity
Pulse frequency
Phase duration
Mode
Electrode arrangement
Polarity
• Electrode placement
* Not adjustable on most HVPS units.
Sensory level
60 to 100 pps
<100 µsec*
Continuous
Monopolar or bipolar
Acute: Positive
Chronic: Negative
Directly over or
surrounding the painful
site
HVPS: Motor-level Pain Control
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Output Intensity
Pulse rate
Phase duration
Mode
Electrode arrangement
Polarity
• Electrode placement
Motor level
2–4 pps
150–250 µsec
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
HVPS: Brief-Intense Pain Control
Protocol
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Output Intensity
Pulse rate
Phase duration
Mode
• Electrode arrangement
• Polarity
• Probe placement
Noxious
>120 pps
300 to 1000 µsec
Probe
15 to 60 sec at each site
Monopolar (probe)
Acute: Positive
Chronic: Negative
Gridding technique,
stimulating hypersensitive
areas working from distal to
proximal
HVPS: Sensory-level Edema
Control
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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
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Anode (+)
Four 30-minute treatments, followed by 60minute rest periods
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Four 30-minute treatments, each followed by
30-minute rest periods.
• Comments
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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.
Cathode (-)
HVPS: Edema Reduction
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Intensity: Strong, yet comfortable
muscle contraction
– Avoid contraindicated joint motio
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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.
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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
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Carrier Frequency: 2500 Hz
Burst Frequency: 30 to 60 bps
Burst Duty Cycle: 10 percent
Cycle Duration: 400 µsec
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