Electrical stimulation motor points and application
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Transcript of Electrical stimulation motor points and application
Electrical Stimulation
Motor points and Application
Sreeraj S R
Motor Points of Axillary Nerve
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Motor Points of Musculocutaneous nerve
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Motor Points of Radial Nerve
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Motor Points of Median Nerve
LOAF
� Lumbricals 1 & 2,
� Opponens pollicis,
� Abductor pollicis
brevis and
� Flexor pollicis brevis.
1 & 2
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Motor Points of Ulnar Nerve
3 & 4
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Motor Points of Femoral Nerve
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Motor Points of Sciatic Nerve
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Motor Points of Tibial Nerve
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Motor Points of Sup. peronei Nerve
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Motor Points of Deep peronei Nerve
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Motor Points of Facial NerveTemporal Br.
� Frontalis
� Orbiclaris Oculi
� Corrugator Supercilii
Zygomatic Br.
� Orbiclaris Oculi
Buccal Br.
� Risorius
� Buccinator
� Levator Labii Superioris
� Levator anguli oris
� Nasalis
� Orbicularis oris
Mandibular Branch
� Mentalis
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Motor Points of Facial Nerve
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Motor Points of the Back
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PRINCIPLES OF APPLICATION
LOW FREQUENCY
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Receiving the patient
� Greet the patient & introduce yourself.
� Develop a good rapport with the patient.
� Provide them a comfortable position to
sit/laydown
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Case sheet reading/History Taking
� Name: Identification of the patient
� Age: Modulation of treatment (Adult/Old )
� Sex: Provide privacy (Male/Female)
� Occupation: Correlate the symptoms/signs of the patient for
ergonomic advice if applicable
� Chief Complaints: Generation of problem list
� Side: Right or Left side of the involvement.
� Site: Specific area/region to be treated
(Anterior/Posterior/Medial/Lateral)
� Duration of the condition: Acute/Sub-acute/Chronic (Treatment
planning & Setting)
� Diagnosis: Condition of the patient
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General contraindications
� Hyperpyrexia
� Epilepsy
� Severe renal and
cardiac problems
� Cardiac pacemakers
� Severe Hypotension
and hypertension
� Infections
� Pregnant women
� Metal Implants
� Mentally retarded
patients
� Mentally upset
patients
� Malignancy
� Eyes
� Anterior aspect of
neck & carotid sinus
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Tray Preparation
� Skin Resistance Lowering Tray � Pillows
� Cotton
� Soap
� Towel
� Mackintosh
� Kidney Tray
� Petroleum jelly or Vaseline
� U – pin (sharp & blunt)
� Clips
� Bowel of water
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Tray Preparation
Treatment Tray
� Pillow
� Towel
� Bed sheet
� Cotton
� Adhesive tapes
� Straps
� Salt
� Powder
� Scissor
� Paper
� Graph paper
� Pencil
� Eraser
� Scale
� Crepe bandages
� Machine & accessories
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Local Contraindications
� Open wounds
� Scars
� Local skin infections
� Cuts
� Abrasions
� Eczema
� Localized haemorrhagic spots
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Skin sensitivity testing
� With the patient's eyes
closed, alternate
touching the patient
with the needle and the
brush at intervals of
roughly 5 sec
� instruct the patient to
tell the therapist if they
notice a difference in
the strength of
sensation on each side
of their body.
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Testing of equipment & Demonstration
� This is to gain the self-confidence & cooperation of the patient for
the treatment.
� Check for mains output by using the tester, look for any frayed part
of power cords, integrity of cables & electrodes.
� Verify that all the knobs/controls in the apparatus are at zero.
� Connect the machine power cord to the mains (220/110 Volts) &
switch on the mains..
� Switch on the machine by turning on the power knob/switch of the
machine.
� Set the timer
� Keep your index and middle fingers on active and indifferent
electrodes to check whether the machine is working or not.
� Demonstrate a muscle contraction to the patient by placing the
electrodes on therapist’s hand.
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Positioning of the patient
� Place patient in a well-supported, comfortable &
relaxed position.
� Use adequate pillows, towels & bed sheets.
� Expose the body part to be treated, have patient
remove all jewelry from the area.
� Drape the untreated part of the patient to
preserve modesty, protect clothing, but allow
easy accesses to the body part.
� If possible give the position in which patient can
see the treatment.
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Positioning of the Therapist
� Appropriate walk stand position
� The therapist should be close to the
machine for operating the machine & also
near to the affected side of the patient.
� If possible the therapists should position
herself so as to observe the face of the
patient.
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Preparation of the part to be treated
Skin Resistance Lowering
� Uncover the part to be treated
� Clean the area with water & soap to
remove any oil/cream/gel/dust
� Use mackintosh and then towel for
supporting and wiping off the water.
� Wipe the treatment area periodically with
saline water for better current conduction.
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Instructions & Warning to the patient
Instruct the patient,
� NOT TO move the treatment part,
� NOT TO touch the power cord & the generator,
� NOT TO sleep during the treatment.
� Inform the patient that he/she should feel a mild prickling
sensation;
� if it is too intense should immediately report to the
physiotherapist.
� If there is any burning sensation immediately inform the
therapist, as it might lead to burn.
� Inform if the position is not comfortable.
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Application of Treatment
� Select appropriate method of treatment
� Make sure the power cords are not touching the
patient.
� Select the current.
� Select parameters.
� Set treatment time.
� Gradually increase the current.
� The patient must be observed throughout to
ensure that treatment is progressing
satisfactorily and without adverse effects.
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Termination of Treatment
� Reduce the intensity gradually to zero
� Switch off the machine and the main supply.
� Remove the electrodes and clean the patient.
� Inspect the treated part for any adverse
reactions.
� If there is any mild Erythema, apply powder.
� If it is too severe, summon the physician or
advise the patient to go to the physician.
� Set the next appointment.
� Do winding up procedure.
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Recording
� An accurate record of all parameters of
treatment including
� region treated,
� technique,
� dosage, and
� the resultant effect must be made.
� This is for both follow up assessment
purposes and for legal requirements.
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References
1. Singh J. Textbook of Electrotherapy. 2 edition. Jaypee. 2012. p 94 – 125
2. Forster A, Palastanga N. Clayton’s Electotherapy, Theory ans Practic. 9th Ed. W B Saunders;
2006. p
3. http://en.wikipedia.org/wiki/Radial_nerve
4. http://en.wikipedia.org/wiki/Median_nerve
5. http://en.wikipedia.org/wiki/Ulnar_nerve
6. http://en.wikipedia.org/wiki/Femoral_nerve
7. http://en.wikipedia.org/wiki/Sciatic_nerve
8. http://en.wikipedia.org/wiki/Tibial_nerve
9. http://en.wikipedia.org/wiki/Superficial_fibular_nerve
10. http://en.wikipedia.org/wiki/Deep_fibular_nerve
11. http://www.microsurgeon.org/facialpalsy
12. http://en.wikipedia.org/wiki/Temporal_branch_of_the_facial_nerve
13. http://en.wikipedia.org/wiki/Zygomatic_branch_of_the_facial_nerve
14. http://en.wikipedia.org/wiki/Buccal_branch_of_the_facial_nerve
15. http://en.wikipedia.org/wiki/Marginal_mandibular_branch_of_the_facial_nerve
16. http://informatics.med.nyu.edu/modules/pub/neurosurgery/sensory.html
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THANK YOU