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Modulation of parameters:
As the human body can get used to anything, the electrical
stimulation may become less effective if the body accommodates itself to
the current passage. So, slight alterations in the treatment parameters may
be needed to vary the current in order to avoid accommodation:
- Frequency modulation: 10% periodically (100 Hz, 90 Hz, 100 Hz, 90
Hz, etc).
- Pulse width modulation: 10% periodically (150 msec, 135 msec, 150
msec, 135 msec, etc).
- Amplitude modulation: 10 % periodically (10 ma, 9 ma, 10 ma, 9 ma,
etc).
Treatment procedures:
The use of TENS for pain control is advised to be for one hour per
session, four times daily. As pain decreases, sessions may be gradually
lessened as needed. Prolonged use is also recommended in postoperative
use, painful scars and obstetrics.
1. Preparing the patient:
- Skin in the area of electrode placement should be clean, clear of lesions.
- A conduction medium (gel or spray) is recommended.
- Tapes are required to fix electrodes in position to maintain contact
throughout the period of stimulation.
2. Electrode placement:
There is a great controversy about the exact site for electrode
placement. Several techniques suggested are based on nerve root,
acupuncture points or trigger points. Although all of these techniques are
valuable, they vary with each individual case, as several key anatomical
points should be established to suit each case.
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e) Certain techniques:
- Transarthral placements: Shoulder, elbow wrist, knee and ankle joints.
- Bilateral placement: Midback and low back.
- Contralateral placements: Non-accessible pain sites as in amputation
dressings, open wounds and casts.