I will direct you to a small text entitled Evidence-Based Guide to
Therapeutic Agents by Alain-Yvan Belanger, published by Lippincott Williams
and Wilkins. They have concise lists of contraindications for each
modality. In general, although the debate remains controversial, the use of
electrical modalities over implants, i.e. cardiac pacemakers, is
contraindicated. If you had to use them (TENS, NMES, microcurrent) near a
pacemaker then certain precautions must be observed - cardiac monitoring,
etc. I would not use, under any circumstances SWD, Interferential on any
part of the body with a patient that had a pacemaker. The use of TENS on an
ankle with a patient that has a cardiac pacemaker should not be a problem.
Check the text out! Hope this helps.
At 09:19 PM 3/27/2002 -0800, you wrote:
>As part of my PT department review I am looking at contra indications (CI)
>of electro modalities.
>Especially questions have arisen about CI for patients with pacemakers
>(demand or otherwise).
>When I studied PT in the Netherlands in the 80s pacemakers were not a CI
>for TENS, Interferential (IFC) etc. Only for Shortwave diathermy etc.
>Perhaps the view has changed, and definitely here in North America there is
>a more conservative trend around CI. Perhaps because of the thriving "suing
>* Pacemaker an absolute CI for any electro therapy (TENS/ High Voltage/
>* Would you use for instance TENS on other part of the body? e.g.
>an ankle if the patient had a pacemaker?
>* Is there any "real" research out there to substantiate, or do we
>Looking at some web info on pacemakers, people with pacemakers should not
>use cell phones, use a microwave, sleep close to a clock radio etc.
>Your views please.
Rege Turocy, DHCE, PT
Department of Physical Therapy
Rangos School of Health Sciences
Pittsburgh, PA 15282