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Electrical Modalities

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 Electrical modalities,[object Object],Summer Kepley, OTS,[object Object]
Definition,[object Object],	Different forms of energy, dependent on the specific modality, which can penetrate through the skin, the muscles or even the neurological system of the human body, in order to provide relief from swelling and/or pain, muscle stimulation or to promote healing of different body structures, caused from an acute or chronic injury or condition, (Larson, 2007).,[object Object]
Different Levels,[object Object],Cellular Level,[object Object],Modify skin,[object Object],Increase movement,[object Object],Facilitate wound healing,[object Object],Modulate acute pain,[object Object],Tissue Level,[object Object],Increase tissue extensibility healing,[object Object],Reeducate muscles,[object Object],Modulate acute pain,[object Object],Decrease muscle disuse atrophy,[object Object],Increase movement,[object Object],Segmental Level,[object Object],Increase movement,[object Object],Decrease edema/inflammation,[object Object],Facilitate fracture healing,[object Object],Modulate a pain,[object Object],Systemic Level,[object Object],Modulate chronic pain,[object Object]
General Purpose,[object Object],Modulate pain (acute and chronic),[object Object],Increase tissue extensibility healing,[object Object],Modify skin,[object Object],Decrease edema/inflammation,[object Object],Reeducate muscles,[object Object],Increase movement,[object Object],Decrease muscle disuse atrophy,[object Object],Facilitate fracture and wound healing,[object Object]
When are EM’s used?,[object Object],“…in preparation for or concurrently with purposeful and occupation-based activities or interventions that ultimately enhance engagement in occupation” (McPhee, 2008). ,[object Object]
Who can use EM’s?,[object Object],According to the AOTA, only occupational therapists and occupational therapy assistants with the proper training and skills to integrate the chosen modalities skillfully and safely, and be able to implement them correctly within a proposed occupational therapy program. ,[object Object]

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Editor's Notes

  1. “The unique perspective of the OT is seeing the potential for performance and using modalities that lead incrementally to performance relevant to the lives clients wish to lead” (Pendleton, 2006).
  2. Therefore, using electrical modalities alone cannot be considered treatment, but must be used with the purpose of improving one’s occupational performance.
  3. Furthermore, to be supervised in the use of electrical modalities, the supervisor must be officially documented as having the same competency as described previously (AOTA, 2004).
  4. (note: unless you are trained and certified to do so)
  5. Bullet 3: -Cut hair, rather than shaveBegin each modality with this process, and modify the remaining steps according to the different modalities.
  6. This is done through an electrical stimulator and electrodes connected by lead wires,
  7. Ex. After injury, pain is a signal that warns the individual not to use the affected structure. Therefore, the muscles begin to weaken from disuse and cause potential spasms of the surrounding musculature. As this cycle persists, it exacerbates the initial pain response, into an even more painful and prolonged experience. Therefore, the therapist can use the TENS unit to stop the cycle, and speed up the healing process indirectly through pain reduction.Chronic- Essentially, to keep it from getting worse and causing further damage to the surrounding joints and muscles.
  8. Bullet 1: The therapist presets the phase duration and pulse rate. Both are often battery operated (9-V), but the Therapist’s version is generally larger and less “user friendly”.
  9. The current stimulated unto the patient is controlled and modulated by the therapist. The features that should be modulated include (bullet 1, 2, 3)Bullet 4, 5: Low Fire is more often used with acute pain, and high frequency with chronic pain
  10. Bullet: If any muscles begin to contract, turn down the intensity slightly.
  11. Bullet 1: (hypoallergenic electrodes can then be used)Bullet 2:(ex. Scar)Bullet 3:(avoid putting electrodes on them)Bullet 4:Example: Someone with tendonitis may greatly benefit from pain reduction, but must also be educated on the proper guidelines of tendon protection and rest. If not, the tissues can become overworked and overstressed, and become even more inflamed and/or stiff. Thus, causing an even more painful and debilitating situation in the long run.Bullet 5: is another condition that the OT should be concerned with when utilizing TENS, and should educate the client on proper nerve protection and rest, (Pendleton, 2006).Clients who present with conditions that may further become exacerbated without a pain sensation may need to undergo other techniques that may not stop the pain, but simply reduce it to a more tolerable level.
  12. Bullet 1: , as the currents could cause a seizure.Bullet 2:, as the currents can disrupt the device and cause cardiac arrest.Bullet 3: muscle, with its high content of water, is more conductive than fat. Thus muscle tends to transmit the current, while fat impedes it. /the higher the resistance (ie: skin, fat..), the more heat is generated by the electrodes, causing potential for burn.