Tens-Transcutaneous Electrical Nerve Stimulation
Tens-Transcutaneous Electrical Nerve Stimulation
Tens-Transcutaneous Electrical Nerve Stimulation
STIMULATION
TAMILVANAN MANI
CONTENTS
INTRODUCTION DEFINITION PHYSIOLOGICAL BASIS GATE CONTROL THEORY OF PAIN OPIOID SYSTEM THEORY MODES OF TENS PARAMETERS OF TENS MODES ELECTRODE PLACEMENT
INTRODUCTION
Primarily used for pain reduction
Any stimulation in which a current is applied across the skin to stimulate nerves 1965 Gate Control Theory created a great popularity of TENS TENS has 50-80% efficacy rate
DEFINITION
A LOW FREQUENCY ,PULSED RECTANGULAR CURRENT APPLIED THROUGH THE SURFACE ELECTRODES ON THE SKIN TO RELIVE PAIN. FREQUENCY-1-600 HZ-COMMOMLY USED FREQUENCY IS 150 HZ PULSE SHAPE - RECTANGULAR PULSE WIDTH-50 - 500 MS-MEASURED IN MICROSECONDS INTENSITY-UPTO TINGLING SENSATION FELT BY THE PATIENT
PHYSIOLOGICAL BASIS
Gate control theory postulated by Melzack and Wall in 1965,says,that pain perception is regulated by a gate which may be opened or closed, thus increasing or decreasing the pain perceived by means of other inputs from peripheral nerves.
OPIOID THEORY
stimulation of A-delta & C neurons, which Cause release of enkephalins (PAG). & RAN
Stimulation of A-delta & C fibers causes release of Bendorphins from the PAG
Mechanism of action similar to encephalin to block ascending nerve impulses Examples: TENS (low freq. & long pulse duration)
MODES OF TENS
BURST TENS
MOTOR 70-100HZ 100-200 MS MODULATED BURST
BRIEF,INTENSE TENS
SENSORY & MOTOR 100HZ 200 MS
TREATMENT DURATION
ONSET OF RELIEF
20-30 MINS/DAY
20-40 MINS
DURATION OF RELIEF
ELECTRODE PLACEMENT
ELECTRODE PLACEMENT STIMULATING PARAMETER/MODE
BURST TENS
PERIPHERAL NERVES
MODULATED TENS
DERMATOME
EACH OF THESE NERVES RELAYS SENSATION (INCLUDING PAIN) FROM A PARTICULAR REGION OF SKIN TO THE BRAIN.
MYOTOME
EACH NERVE ROOT COMING FROM THE SPINAL CORD SUPPLIES A SPECIFIC GROUP OF MUSCLES.
ACCUPUNCTURE POINT
ARE LOCATIONS ON THE BODY THAT ARE THE FOCUS OF ACUPUNCTURE, ACUPRESSURE,
MOTOR POINT
TRIGGER POINT
TRIGGER POINTS, ALSO KNOWN AS TRIGGER SITES OR MUSCLE KNOTS, ARE DESCRIBED AS HYPERIRRITABLE SPOTS IN SKELETAL MUSCLE THAT ARE ASSOCIATED WITH PALPABLE NODULES IN TAUT BANDS OF MUSCLE FIBERS.
INDICATIONS
ANTIEMETIC EFFECT
ANTIEMETIC EFFECT-MORNING SICKNESS(VOMITING & NAUSEA)-CHEMOTHERAPY PLACEMNT OF ELECTRODES -RIGHT SIDE ONLY ACROMION TIP AND HOKU(WEB SPACE BETWEEN THUMB AND INDEX FINGER) FREQUNCY 80-120 HZ PULSE WIDTH- 150MS MIMIMAL INTENSITY 30 MIN EVERY MORNING
BONE HEALING
PLACEMENT OF ELECTRODES POP-PROXIMAL AND DISTAL TO THE CAST 2 ELECTRODES PLACED WITH 15 CM APART 4 ELECTRODES CROSS PATTERN 2 ELECTRODES SANDWITH PATTERN
FREQUENCY-120HZ PULSE WIDTH 300MS INTENSITY LOWEST BARELY SENSED BY PATIENT TIME DURATION - 1 HOUR
DURING LABOR PROXIMAL 2 ELECTRODE AT LEVEL OF T8 DISTAL 2 ELECTRODE PLACED AT THE LEVEL OF T8 TO L1 FREQUENCY-80-120HZ PULSE WIDTH 150 MS INTENSITY LOWEST
POST CESAREAN PAIN
TREATED AS ACUTE PAIN PLACEMENT OF ELECTRODE -2.5 CM AWAY FROM THE INCESION AREA 4 ELECTRODES CROSS PATTERN FREQUENCY-80-120HZ PULSE WIDTH 150 MS INTENSITY MINIMAL
ELECTRODE PLACEMNTS
KNEE PAIN
WRIST PAIN
ELBOW PAIN