Electrical stimulation motor points and application

Electrical stimulation motor points and application

1. Electrical Stimulation

Motor points and Application

2. SS
Motor Points of Axillary Nerve

3. EE
Motor Points of Musculocutaneous nerve

4. SE _
Motor Points of Radial Nerve

5. “
Motor Points of Median Nerve

LOAF
= Lumbricals 1 € 2,
= Opponens pollicis,

= Abductor pollicis
brevis and

= Flexor pollicis brevis.

6. Sl
Motor Points of Ulnar Nerve

7. -
Motor Points of Femoral Nerve

8. SS
Motor Points of Sciatic Nerve

9. SS
Motor Points of Tibial Nerve

10. TS
Motor Points of Sup. peronei Nerve

11. nn
Motor Points of Deep peronei Nerve

12. -
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

14. FRONTALIS CORRUGATOR SUPERCILII
gro

Test: Raise the eyebrows. wrinkling the forehead, as in Test: Draw the eyebrows together, as in fowning.
an expression of surprise or fright.

15. ORBICULARIS OCULI

Test, Orbital Part: Cl

16. NASALIS, ALAR PORTION

zum

L

Test: Widen the apertures of the nostrils, as in forced or
difficult breathing,

LEVATOR ANGULI ORIS

Test: Draw the angle ofthe mouth straight upward, deep:
ening the furow from the side of the nose to the side of
the mouth, as in sneering. Suggest that the patient try 10
show the "eye" (canine) tooth, first on one side and then
on the other.

17. RISORIUS LEVATOR LABII SUPERIORIS

Test: Raise and protrude the upper lip, as ifto show the
Test: Draw the angle of the mouth backward, upper gums.

18. DEPRESSOR LABII INFERIORIS DEPRESSOR ANGULI ORIS
AND PLATYSMA

A 67.
ae,

Test: Draw down the angles of the mouth,

Test: Draw the lower lip and angle of the mouth doum-
ward and outward, tensing the skin o

19. ORBICULARIS

Test: Close and protrade the lips,

ORIS

as in whistling

BUCCINATOR

Test: Press the cheeks fimly against the side teeth and
pull back the angle of the mouth, as in blowing a tum-
pet. (Drawing the chin backward, as seen in this ilsta-
ion, is not part of the action of the buccinator muscle)

20. MENTALIS DEPRESSOR ANGULI ORIS

| ay

Test: Raise the skin of the chin. As a result. the lower Test: Draw down the angles of the mouth,
lip will protrude somewhat. as in pouting,

21. Sl
Motor Points of Facial Nerve

Frontalis

Facial nerve
(upper branch) Corrugator

Facial nerve Orbicularis ocule
(middle branch) Leavators of upper lip

| Facial nerve Orbicularis oris
É trunk

Facial nerve Risorsis

¡lower branch) A Depressors of
ee 5 lower lip
E

22. SS
Motor Points of the Back

Trapezius
Supraspinatus 4 (upper fibers)
H il
Infraspinatus 17 thers)
Teres major à - Rhomboids
and minor Trapezius
Serratus A (lower fibers)

anterior AN
Latissimus

dorsi

23. LOW FREQUENCY

PRINCIPLES OF APPLICATION

24. um
Receiving the patient

= Greet the patient & introduce yourself.
= Develop a good rapport with the patient.

= Provide them a comfortable position to
sit/laydown

25. . "0
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

26. General contraindications

= Hyperpyrexia

a Epilepsy

m Severe renal and
cardiac problems

= Cardiac pacemakers

= Severe Hypotension
and hypertension

m Infections
= Pregnant women

= Metal Implants
= Mentally retarded
patients

= Mentally upset
patients

= Malignancy

= Eyes

= Anterior aspect of
neck & carotid sinus

27. nn
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

28. ms
Tray Preparation

Treatment Tray

= Pillow = Scissor

= Towel = Paper

= Bed sheet = Graph paper

= Cotton = Pencil

= Adhesive tapes a Eraser

= Straps = Scale

= Salt = Crepe bandages

m Powder m Machine & accessories

29. e
Local Contraindications

= Open wounds

= Scars

= Local skin infections

= Cuts

= Abrasions

m Eczema

= Localized haemorrhagic spots

30. nn
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.

31. 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.

32. Positioning of the patient

= Place patient in a well-supported, comfortable 8:
relaxed position.

m 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.

33. 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.

34. Preparation of the part to be treated

Skin Resistance Lowering

= Uncover the part to be treated

= Clean the area with water 8 soap to
remove any oil/cream/gel/dust

m Use mackintosh and then towel for
supporting and wiping off the water.

= Wipe the treatment area periodically with
saline water for better current conduction.

35. Instructions & Warning to the patient

Instruct the patient,

= NOT TO move the treatment part,

= NOT TO touch the power cord & the generator,
=

a

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.

36. Application of Treatment

= Select appropriate method of treatment

m 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.

37. 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.

38. nn
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.

39. " u
References

Singh J. Textbook of Electrotherapy. 2 edition. Jaypee. 2012. p 94 - 125

Forster A, Palastanga N. Clayton’s Electotherapy, Theory ans Practic. 9" Ed. WB Saunders;
2006. p

http://en.wikipedia.org/wiki/Radial_netve
http://en.wikipedia.org/wiki/Median_nerve
http://en.wikipedia.org/wiki/UInar_nerve

http://en.wikipedia.org/wiki/Femoral nerve

http://en.wikipedia.org/wiki/Sciatic_nerve
http://en wikipedia org/wiki/Tibial_ nerve

http:/en wikipedia.org/wiki/Superficial fibular nerve
http://en.wikipedia.org/wiki/Deep fibular nerve
http://mww.microsurgeon.org/facialpals

http://en wikipedia.org/wiki/Temporal_branch_of the facial nerve
http://en wikipedia.org/wiki/Zygomatic branch of the facial nerve

http://en wikipedia.org/wiki/Buccal branch of the facial nerve
http://en wikipedia.org/wiki/Marginal mandibular branch of the facial nerve
http://informatics.med.nyu.edu/modules/pub/neurosurgery/sensory.html

40. THANK YOU