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ECS II - E-Stim for Strength and ROM

Terms in this set (23)

How many pulses per second would you use to generate an unfused tetanic contraction?
3-20 pps
How many pulses per second would you use to generate a fused tetanic contraction?
>30 pps
Why does a lot of myelin increase resistance?
myelin has a lot of fat, fat has a high impedance level
Describe the internal control of force generation
CNS will recruit motor units in order from smallest to largest

CNS tries to be as efficient as possible, recruiting the minimum amount of motor units required to perform a task
T/F smaller motor neurons are more heavily myelinated
true
Describe the external control of force generation
Motor units are recruited from largest to smallest
Why are motor units recruited from largest to smallest using an external source?
Larger motor neurons are less myelinated and thus have the lowest impedance. This means they get stimulated before the smaller motor units.
Describe the relationship between frequency and impedance
high frequency = low impedance

low frequency = high impedancd
What is the best waveform for muscle strengthening?
Nobody knows and it probably doesn't matter
T/F e-stim can provide a stronger contraction than a maximum voluntary contraction
true
What are the two main theories behind electrical strengthening?
1. Overload principle
2. Selective training of fiber types
What is the overload principle in regards to electrical strengthening?
-allows muscle to work at a higher intensity than volitionally achieved
What population does electrical strengthening work best in?
a. very strong
b. normal
c. very weak
a & c (very strong and very weak, limited results in "normals")
What is Functional Electrical Stimulation (FES)?
the use of electrical muscle stimulation to provide functional movement or to maintain functional postures
What is the goal of FES?
facilitate the return of controlled functional muscular activity or maintain postural alignment until recovery from dysfunction occurs or on a continuing basis
What are the uses of FES?
1. increase awareness of contractile motions
2. provide external control of innervated paretic muscles
What are some things FES has been shown to do in studies?
-showed increased ROM, decrease in spasticity in patients with CP
-improve gait speed in patients post-stroke
-improve bone strength and bone mineral density in patients with SCI
-increase quad mass in patients with SCI
-greater mean walking distance in patients in the ICU
-improve ROM in patients post-TKA
T/F the higher the intensity tolerated, the greater the improvements
true (in RA patients at least, the higher intensity also led to better adherence rates)
Indications for FES & NMES
1. increase strength of weak muscles
2. increase range of motion
3. functional substitute for muscle or in place of an external splint
4. reduce muscle spasm
Benefits of E-stim for strengthening
1. prevent muscle atrophy
2. prevent fibrotic changes in muscle
3. prevent venous stasis
4. may facilitate re-innervation in peripheral nerve injuries
Risk of E-stim for strengthening
1. may disrupt regenerating nerve fibers by mechanical movements
2. muscle is sensitive to trauma
3. no strong evidence to show long term benefits
4. using D/C stimulation on someone with sensory compromise
Contraindications of E-stim for strengthening
1. cardiac pacemakers
2. malignant tumors
3. unstable fracture
4. thrombophlebitis
5. anterior neck
6. over the eyes
7. abdomen, lumbar, sacral region if pregnant
8. superficial metal implants
9. tissues vulnerable to injury
Precautsions of E-stim for strengthening
1. obesity
2. osteoporesis
3. epilepsy
4. impaired sensation
5. skin irritation/sensitivity
6. impaired cognition/communication
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