Electrical stimulation motor points and application


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Electrical stimulation motor points and application

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Electrical stimulation motor points and application

  1. 1. Electrical Stimulation Motor points and Application
  2. 2. Sreeraj S R Motor Points of Axillary Nerve
  3. 3. Sreeraj S R Motor Points of Musculocutaneous nerve
  4. 4. Sreeraj S R Motor Points of Radial Nerve
  5. 5. Sreeraj S R Motor Points of Median Nerve LOAF Lumbricals 1 & 2, Opponens pollicis, Abductor pollicis brevis and Flexor pollicis brevis. 1 & 2
  6. 6. Sreeraj S R Motor Points of Ulnar Nerve 3 & 4
  7. 7. Sreeraj S R Motor Points of Femoral Nerve
  8. 8. Sreeraj S R Motor Points of Sciatic Nerve
  9. 9. Sreeraj S R Motor Points of Tibial Nerve
  10. 10. Sreeraj S R Motor Points of Sup. peronei Nerve
  11. 11. Sreeraj S R Motor Points of Deep peronei Nerve
  12. 12. Sreeraj S R Motor Points of Facial Nerve Temporal 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
  13. 13. Sreeraj S R
  14. 14. Sreeraj S R Motor Points of Facial Nerve
  15. 15. Sreeraj S R Motor Points of the Back
  17. 17. Sreeraj S R Receiving the patient Greet the patient & introduce yourself. Develop a good rapport with the patient. Provide them a comfortable position to sit/laydown
  18. 18. Sreeraj S R 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
  19. 19. Sreeraj S R 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
  20. 20. Sreeraj S R 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
  21. 21. Sreeraj S R 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
  22. 22. Sreeraj S R Local Contraindications Open wounds Scars Local skin infections Cuts Abrasions Eczema Localized haemorrhagic spots
  23. 23. Sreeraj S R 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.
  24. 24. Sreeraj S R 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.
  25. 25. Sreeraj S R 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.
  26. 26. Sreeraj S R 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.
  27. 27. Sreeraj S R 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.
  28. 28. Sreeraj S R 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.
  29. 29. Sreeraj S R 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.
  30. 30. Sreeraj S R 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.
  31. 31. Sreeraj S R 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.
  32. 32. Sreeraj S R 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
  33. 33. Sreeraj S R THANK YOU