Basics of Electrotherapy
Saurab Sharma, MPT Lecturer, KUSMS
TENS (Transcutaneous Electrical Nerve Stimulation)MSK II Physiotherapy IIElectrotherapy Lecture 1
Objectives of sessionAt the end of the class, students will be able to:Understand the theory of TENSExplain the techniques of TENS applicationIdentify the uses of TENS Identify Precautions and Contraindications
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ContentsIntroduction
Features of TENS
Applications of TENS
Uses of TENS common and uncommon
Electrode Placement
Precautions and contraindications3
IntroductionTranscutaneous Electrical Nerve Stimulation
Delivers electricity across the intact surface of the skin to activate underlying nerves
Simple, non-invasive analgesia causing modality
For pain- acute, chronic non-malignant
For palliative care of malignant conditions
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Keys principlesOutcome of treatment is based on the:Knowledge of intent of TENS application Location of electrode placement Selection of appropriate current types Dosage
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Principles of Nerve Fibre ActivationInitially- stimulation of non-nociceptive nerve fibres like A-alpha, A beta fibres which have low threshold of stimulation causing tingling
Followed by activation of A-delta and C-fibres causing pain
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Principles of Nerve Fibre ActivationLow intensity current with pulse duration 50-500 micro seconds stimulates larger diameter fibres (A beta) without activation of smaller diameter fibres (A delta and C)Pulse duration more than 500 micro seconds activates small diameter fibres
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Typical features of TENSPulse wave formMonophasic Symmetric biphasic Asymmetric biphasic Pulse amplitude (adjustable)1-50 mA Pulse duration (often fixed)50- 500 micro seconds Frequency1- 200 HzPulse patternsContinuous Burst Channels Single or double channels
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ParameterHigh-TENSLow TENSBrief -TENSIntensitySensoryMotorNoxiousPulse Frequency (Hz)60-100 Hz2-4 HzVariablePulse (micro sec)60- 100150- 250300 1000 ModeModulatedModulated BurstModulatedTreatment durationAs needed30 minutes15- 30 minutesOnset of relief
