Clinical Decision Making for Electrical Stimulation
Some items to take into consideration:
- Patient's previous experiences with modality
- Presence of contraindications or precautions
- Type, location, characteristics of pain
- Portability of unit
- Electrical stimulation can be used during a painful procedure
- Electrode options, placement options
- Motor points where peripheral nerves enter the muscle, to elicit motor response, electrodes should be placed over these
- Trigger points within a muscle are sensitive to pressure and electrical stimulation
- Sensory analgesia requires more diffuse electrode placement around an area
- Parameter guidelines are listed in the Behrens text Boxes 12-3 through 12-6 for practice in lab
Expectations
- Acute pain in inflammatory phase = decrease pain intensity, break pain cycle, facilitate healing process
- Subacute phase with pain at end range of motion = control pain created by PT interventions at end range of motion during or post treatment
- Maturation phase = treat pain created by interventions
- Chronic pain = will not cure pain = goal of increased function
- decrease intensity of chronic pain at rest
- decrease pain created by therapeutic techniques
- treat acute "flare ups"
Documentation
- Treatment parameters need to be reproducible by others, Objective needs to include:
- type of electrical stimulation used
- mode of delivery
- pulse duration (PD)
- Frequency (F)
- Rise and fall time if used
- Treatment area
- Electrode placement sites
- Duration of treatment
- Goal/response to treatment