Pulse currents in physiotherapy. Electrotherapy - treatment using current Electrotherapy in physiotherapy

Electrotherapy is the use of the properties of electric current for therapeutic purposes; it occupies a separate large section in physiotherapy. Modern methods of physiotherapy use electric current to combat various pathologies: injuries of the musculoskeletal system, diseases of the nervous system, during recovery in the postoperative period.

This article will discuss the various uses of electrotherapy in medicine, and also describe the main mechanism of its action on the human body.

Mechanism of action

To understand why electric current has become so widely used in medical practice, you need to understand the subtle mechanisms and principles of its influence on the body.

It affects the human body on several levels:

• Local. Covers the immediate area of ​​application of electric current. Local blood circulation is stimulated, immunity is increased, and metabolism is accelerated.
• Reflex-segmental. Electric current during the procedure causes somatovegetative reflexes, which cause vascular and metabolic changes already at the level of internal organs (after all, as is known, internal organs have connections with certain areas of the skin, influencing which can indirectly influence the organs).
• Organismic level. The effect of electrical procedures on the body extends to the higher parts of the nervous system, then the release of biologically active substances (serotonin, histamine, norepinephrine, acetylcholine) occurs, which, carried through the bloodstream, provide the general effect of physiotherapy - strengthening the immune system, mobilizing the body's strength, accelerating recovery processes and regeneration.

According to the nature of the energy conducted to the patient, electrotherapy methods are divided into remote and contact, according to the voltage - into low-frequency currents (galvanization, electrophoresis) and high-frequency currents (darsonvalization, franklinization), according to the mode of exposure - into direct currents and alternating currents ( pulse). Below we will look at some of them in more detail.

Methods using direct currents

One of the methods of physiotherapy that uses direct electric current is galvanization. At a relatively low current (about 50 mA), the voltage reaches 80 Volts.

The skin has great resistance to current with such parameters, which is why the most significant reactions develop with this method of physiotherapy. The patient's skin under the electrodes turns red, and a burning and tingling sensation appears, which may gradually increase during the session. This occurs due to the formation of heat, changes in the usual movement of ions in the skin and the pH of the environment.

Released biologically active substances and activated enzymes increase blood flow to the application area. Burning and tingling in the area of ​​the procedure depend on the duration of exposure, and also intensify with increasing current strength. Thus, direct current electrotherapy enhances lymph and blood circulation, stimulates metabolic processes, enhances the secretion of glands, and has analgesic and anti-inflammatory effects.

Electrophoresis is used more often in medical practice. Electrophoresis is the combined action of current and a certain amount of drug.

Since ions in the skin move at low speed under the influence of electrical procedures, and the resistance of the skin is high, the pharmaceutical preparation penetrates only into the upper layers of the skin, creating a depot in it. From it, the drug slowly spreads throughout the body through the bloodstream, so you should not expect a quick effect with this procedure. Only a few percent of the dosage of the drug used in electrophoresis ends up in the depot.

The advantages of the procedure include:

• Can be used on almost any part of the body.
• The therapeutic effect can last up to several days, as a drug depot is formed.
• The number of side effects is minimal; drugs introduced into the body in this way do not affect internal organs.
• The drug is in an active form - ionic.

Since the main effect produced by current during electrophoresis occurs directly under the electrodes, the main indication for prescribing such a physiotherapy procedure as medicinal electrophoresis is the presence of various local pathological processes. Systemic effects on the body are usually not observed, with the exception of cases of disorders of the autonomic nervous system, when even a small dose of the drug can develop a reflex systemic reaction.

Methods using pulsed currents

For pulsed currents, strength and voltage do not have constant values. It is these currents that form the basis of electrosleep - the effect on the body as a whole through the scalp. This procedure is designed to normalize the state of the central nervous system. Current is passed through closed eyelids and the mastoid area using special electrodes.

Receptors of the scalp are monotonously irritated by current; weak currents even penetrate into the subcortical-stem regions of the brain, causing normalization of central nervous system function. Since the nervous system begins to function better, its effect on other organs also changes. This is what can explain the positive effect of electrosleep in many diseases.

Diadynamic therapy is another way of using pulsed currents in medicine. It has the following properties:

• Improves local blood flow, dilates blood vessels, relieves vascular spasms.
• Stimulates metabolic processes.
• Has an analgesic effect.

This method of physiotherapy is widely used for diseases of the nervous and musculoskeletal systems.

Amplipulse therapy produces all the effects similar to diadynamic therapy not only in the superficial parts of the skin, but also in the internal organs. At certain current parameters it can cause strong muscle contraction, which is used when electrical stimulation of muscles and nerves is necessary.

Electrical stimulation is used to enhance the functioning of certain organs and systems. The most widely used is electrical stimulation of the heart, muscles and nerves.

Methods using high frequency currents and voltages

Darsonvalization is based on the use of high frequency current. The current, passing through the skin cells, expands small blood vessels and increases the intensity of blood flow in them, eliminating vascular spasms. Thus, tissue ischemia passes and the associated pain and paresthesia go away.

The therapeutic application of exposure to a high-voltage constant electric field is called franklinization.

Having a local effect, this method of physiotherapy activates metabolic processes in the scalp, brain and its membranes, and when exposed to the area of ​​a wound or ulcer, it dilates blood vessels, lowers blood pressure, relieves spasms if present, and stimulates erythropoiesis. Franklinization is indicated for disorders of the nervous system and for poorly healing wounds.

Methods based on the effect of electric and magnetic fields

UHF therapy is the use in medicine of the effects of an ultra-high frequency electromagnetic field on certain areas of the body. Such a magnetic field has great penetrating power. It passes through the skin with subcutaneous fat, penetrates into blood vessels, joints, bones, bone marrow and other tissues.

Inductothermy is the use in medical practice of a high-frequency magnetic field that releases heat in tissues. The method is based on the generation of heat obtained from a cable close to a certain area of ​​the body, through which a high-frequency current passes, producing an alternating magnetic field. Heat arises in the very depths of the tissues of the human body.

During this procedure, various changes occur: blood flow accelerates, blood pressure decreases, peripheral circulation, microcirculation, and rheological properties of blood improve, it has an anti-edematous effect, regeneration processes are stimulated, and blood clotting is reduced. Since the hematopoietic function of the bone marrow is stimulated, the number of red blood cells in the blood increases, accordingly, hemoglobin increases, and the ability of leukocytes to capture (phagocytosis) increases. The immune system is also strengthened, muscle performance increases, and a calming effect appears.

General contraindications

There are some most common contraindications for electric shock treatment. These include:

• Severe general condition of the patient, exacerbation of decompensated somatic disease.
• Heart or respiratory failure.
• Insufficient liver and kidney function.
• Disorders of the blood coagulation system.
• Malignant neoplasms.
• Acute infectious diseases.
• Pregnancy (refers to relative contraindications; most methods can be freely used in the first half of pregnancy, in the second - if indicated).

Despite these contraindications, the final decision to prescribe physiotherapy is made by the physiotherapist based on a general, holistic impression of the patient’s health status and determination of his treatment needs.

Electrotherapy in physiotherapy is widely used in the modern world. Electric current therapy is used in hospitals, outpatient treatment facilities, at home, in cosmetology, and also as part of spa treatment. Specialists - physiotherapists - are familiar with the huge variety of electrotherapy methods. They are the ones who choose one or another treatment method depending on the needs of their patient.

Medical Faculty

Topic: Use of electric current in physiotherapy

Chapter: Electrotherapy

Number of lectures - 1 (2 hours)

Number of practical classes -1 (6 hours)

LEARNING OBJECTIVE OF THE LESSON:

To develop professional competence in the use of physical healing factors (electric current) in clinical practice, interpretation of terms and concepts.

Private goals:

Know the basic mechanisms of the influence of electric current on a living cell, tissue, organ, system, organism;

Know the principles of application and dosing of direct and alternating currents with different frequency and amplitude characteristics;

Be able to use electrotherapy techniques in therapeutic, surgical, neurological, traumatological and obstetric-gynecological practice at each stage of treatment;

Know the necessary terminology and methods for selecting pathogenetically based methods of electrotherapy.

TOPICS COVERED IN PREVIOUS TRAINING COURSES :

Basic principles of operation of medical treatment equipment (medical physics)

Physiological and pathophysiological effects of basic physical factors on tissues, organs and systems (normal physiology, histology, pathological anatomy, pathological physiology)

Principles of pathogenetic and symptomatic effects in the main clinical syndromes (propaedeutics of internal diseases, faculty and hospital therapy, general, faculty and hospital surgery, neurology, traumatology, obstetrics, gynecology).

TRAINING FACILITIES, EDUCATIONAL AND MATERIAL SUPPORT:

Department of Physiotherapy of the KKB, Physiotherapy Department and Department of Medical Rehabilitation of the State Budgetary Healthcare Institution SK City Clinical Hospital No. 2; Physiotherapeutic department of the State Budgetary Institution of Healthcare of the SK Emergency Hospital.

1) Multimedia material on the topic.

2) Sets of test tasks.

3) Sets of situational problems.

4) Sets of educational extracts from the medical history (outpatient records) of patients.

5) Sets of educational physiotherapy prescriptions

6) Scheme of the graphological structure on the topic of the lesson.

QUESTIONS TO BE STUDYED IN CLASS:

The relevance of using non-drug treatment methods

Safety precautions when working with electric current

Classification of types of electric current used for medicinal purposes

Basic parameters of electric current used for medicinal purposes and methods of dosing it

Basic mechanisms of the effect of electric current on human cells, tissues and organs

Therapeutic effects that occur when using electric current

Equipment

Indications and contraindications for the use of direct current

Therapeutic effects of galvanization

Electrophoresis. Execution method

Pulse electrotherapy: electrosonotherapy, transcranial electrical stimulation, neuroelectric stimulation, diadynamic therapy

Low-frequency electrotherapy: amplipulse therapy, interference therapy, fluctuarization.

Mid-frequency electrotherapy: local darsonvalization, ultratonotherapy

Indications and contraindications for the use of alternating current.
RECOMMENDED READING FOR STUDENTS

1. Ponomarenko, G.N. Medical rehabilitation: Textbook / G.N. Ponomarenko – M.: GEOTAR-Media, 2014. – 360 p.

2. Ponomarenko, G.N. General physiotherapy: Textbook / G.N. Ponomarenko – M.: GEOTAR-Media, 2012. – 368 p.
Introductory part of the lesson:

checking the presence of students and their compliance with the established dress code;

input control of knowledge (tests, oral questioning, “case method”);

safety reminder.

Organization of students' work to master the curriculum of the lesson.

The teacher, together with the students, examines the case patient and analyzes the clinical history of the disease. The results of laboratory and instrumental examinations, the treatment performed are discussed, its effectiveness is assessed and the strategy of rehabilitation measures is discussed.

Each student is given an educational extract from the medical history (outpatient card) of the patient with an assignment.

Based on the data obtained using the proposed algorithm, the student (if necessary, with the participation of the teacher) must assess the patient’s functional state, the level of rehabilitation potential and rehabilitation prognosis, the possibility and necessity of prescribing physiotherapeutic treatment, select a rational and effective method (or combination of methods) of electrotherapy, justify his choice.

The student draws up a procedural card (physiotherapeutic prescription).

9. The mechanism of the physiological action of pulsed currents.

10. Parameters of pulsed current used in electrosonotherapy and transcranial electroanalgesia.

11. Clinical effects of electropulse therapy, indications and contraindications.

12. Principles of the therapeutic effect of diadynamic pulse currents on the body.

13. What physiological reactions and therapeutic effects develop in the cells and tissues of the body under the influence of sinusoidal modulated currents?

14. Basic parameters of the current used in amplipulse therapy, its dosage.

15. Indications and contraindications for prescribing the myoelectric stimulation procedure.

16. Interference therapy and fluctuarization. Clinical application of low-frequency currents.

17. Clinical aspects of the use of Darsanval currents. Indications and contraindications.

INDEPENDENT WORK OF STUDENTS IN THE CLASS:

1) Analysis of an educational extract from the medical history (outpatient card).

2) Work with medical documentation.

3) Interpretation of research results for a particular patient.

4) Drawing up a summary of pathological data.

5) Assessment of clinical diagnosis from the standpoint of rehabilitation potential and prognosis.

6) Determining the tactics of treating the patient (stages, type of medical care).

7) Drawing up a plan for rehabilitation and preventive measures.

8) Justification for the choice of electrotherapy technique. Registration of a physiotherapeutic prescription.

9) Drawing up a list of instructions for the patient on rational nutrition and lifestyle.

10) Solving situational problems.

11) Control of knowledge using test tasks.

PRACTICAL SKILLS:

physical examination of the patient, assessment of laboratory and instrumental examination data, assessment of the treatment (principles of treatment of the underlying disease, monitoring of effectiveness, etc.), determination of rehabilitation potential and prognosis, assessment of indications and contraindications for prescribing non-drug treatment methods, drawing up a rehabilitation plan, choice of electrotherapy technique (possibly a combination of methods) taking into account the mechanism of therapeutic action, dosage regimen and frequency, methods of monitoring effectiveness, instructions for the patient to change his lifestyle.

PROJECTED RESULTS:

AT THE COMPLETION OF THE CLASS THE STUDENT SHOULD:

Classification of means and methods of electrotherapy;

The main mechanisms of the influence of electric current on the body, the biomechanism of the influence of direct, pulsed and alternating currents on various levels of normal and pathological regulation of the function of organs and systems;

Pathogenetic rationale for the use of various electrotherapy techniques for major pathological processes;

Features of the use of electrotherapy in patients of different age groups;

Principles of the combined use of various methods of electrotherapy;

Main indications and contraindications for electrotherapy.

BE ABLE TO:

- draw up an examination plan to determine the level of the patient’s rehabilitation potential;

Give a clinical interpretation of the obtained laboratory and instrumental data;

Interpret a detailed clinical diagnosis;

Assess the rehabilitation prognosis;

Formulate the purpose of the therapeutic use of preformed physical factors (electric current);

Determine a medical rehabilitation strategy for a specific patient;

Determine the presence of individual indications and contraindications for prescribing electrotherapy;

Carry out a pathogenetically substantiated choice of means and methods of electrotherapy, and, if necessary, use a combination of them;

Plan clinical, instrumental and laboratory monitoring of the effectiveness of treatment and rehabilitation measures.
- HAVE AN INTRODUCTION:

On high-tech methods for studying patients with various pathologies to assess functional status;

On innovative technologies in electrotherapy and electrodiagnostics;

On the principles of evidence-based medicine in physiotherapy.

-
EDUCATIONAL, METHODOLOGICAL AND INFORMATION SUPPORT OF CLASSES

LITERATURE FOR STUDENTS

Internet resources: medialink.
Key words: physiotherapy, therapeutic physical factor, electrotherapy, current parameters, dosing of the procedure, direct current, pulsed current, sinusoidal current, interference therapy, fluctuarization, neuromyostimulation, control means.
CONTROL MATERIALS ON THE TOPIC: Electrotherapy
TEST TASKS

Clinical objectives

annotation
Electrotherapy- a method of physiotherapy based on the use of dosed effects on the body of electric currents, magnetic or electromagnetic fields. The term "electrotherapy" currently refers to a group of physiotherapeutic methods based on the action of electric current on the body. The methods differ from each other, primarily in what currents they use - the current can be alternating or constant, have different strength (amps), voltage (volts), frequency (hertz). The combination of these parameters ultimately determines the final effect.

Mechanism of action and effect

Electrical signals are adequate stimuli not only to nervous and muscle tissue, but to almost all organs and systems of the body. The use of electrical methods of influence is advisable when pathological phenomena have not yet caused gross destructive changes in the organ that are incompatible with its functions. Electrical signals, spreading in the body, cause specified changes in various human life processes: increase blood flow, enhance lymph circulation, change the speed of tissue repair processes, activate enzyme systems, promote the removal of lactic acid, and have an analgesic and anti-inflammatory effect. Carrying out a course of electrical influence using special methods is accompanied by an improvement in general well-being, mood, normalization of sleep, increased tone of the autonomic nervous system, and stabilization of heart rate and blood pressure.

Electrotherapy methods

In medicine, direct, pulsed and alternating currents are used.

Direct current treatment

Direct electric current causes physical and chemical effects in the tissues of the body: electrolysis, polarization, electrodiffusion and electroosmosis. Direct current increases the permeability of biological membranes, increases the passive transport of protein molecules and the movement of free and water molecules captured by ions and proteins. There are local, segmental and generalized reactions.

Galvanotherapy is the use of continuous direct electric current for medicinal purposes. For this, low current (up to 50 mA) and low voltage (30-80 V) are used. This method was named after the Italian doctor L. Galvani. Direct current passes through the tissues of the body, in which certain physicochemical changes occur. The tissues of the human body contain colloids and salt solutions. Colloids are proteins, glycogen and other large molecular substances. All these substances are part of body fluids, muscles and glandular tissue. Their molecules break down into electrically charged ions. Electric current in the human body does not move in a straight line. This movement and conduction of current depends on the presence of good conductors and the amount of fat tissue that does not conduct current well. During galvanization, skin receptors are primarily irritated. This occurs due to changes in ionic concentration. The current is carried out by applying electrodes. During the procedure, the patient may experience a slight burning and tingling sensation under the electrodes. Due to irritation of nerve endings, nerve impulses enter the central nervous system. This contributes to the occurrence of general and local reactions of the body. Under the influence of galvanic current, blood vessels dilate and blood flow accelerates. At the site of influence of this current, the production of such biologically active substances as histamine, serotonin, etc. occurs. Galvanic current has a normalizing effect on the functional state of the human central nervous system, helps to increase the functionality of the heart, and stimulates the activity of the endocrine glands. It also leads to acceleration of regeneration processes. Increases the defenses of the human body.

Electrophoresis – introduction of medicinal substances into the body using direct current. Electrophoresis is a complex therapeutic complex that combines the effect on tissues and the body of direct electric current and particles of medicinal substances introduced through intact skin or mucous membranes. Medicinal substances that dissociate into ions in solutions are administered with a current depending on the charge of the ion. Anions of hydroxyl groups, acid radicals, organic anions, penicillin, etc. are introduced from the cathode. Hydrogen cations, metals, organic cations, alkaloids, ganglion blockers, and antibiotics (except penicillin) are introduced from the anode. Drug particles under the influence of electric current become electroactive, which probably explains the high therapeutic effectiveness of the method.

Pulse currents

Transcutaneous electrical nerve stimulation(TENS)

A special group consists of methods that use weak pulsed currents. In the English-language literature, these methods are referred to as TENS (Transcutaneous Electrical Nerve Stimulation - transcutaneous electrical nerve stimulation (TENS). The term "short-pulse electroanalgesia" is widely used. The main purpose of this method is to combat pain.

Transcranial electrical stimulation (TPP)

Experience shows that one of the methods that can be very effectively used for various diseases is transcranial electrical stimulation (TES) or transcranial electroanalgesia. Transcranial electrical stimulation is a therapeutic effect of pulsed currents on the brain system.

Myoelectrostimulation

Under natural conditions, the excitation and contraction of muscles is caused by nerve impulses entering the muscle fibers from the nerve centers. Such excitation can be caused by applying electric current - electromyostimulation (EMS).

Bioregulated electrical stimulation

Biological electrical stimulation is the effect on areas of the skin with pulsed currents, the parameters of which change. The main difference of the method is the presence of biofeedback based on changes in skin impedance. Thanks to this solution, each impulse affecting the body is different from the previous one, because it already responds to the body’s reaction. As a result, the effect activates a significantly larger proportion of nerve fibers, including thin C-fibers.

Treatment with continuous (constant) or impulsive electric current of low strength and low voltage is called LF electrotherapy and is divided into two types: direct current treatment and pulsed current treatment.

Areas of application of electrotherapy methods

The scope of application of electrotherapy is very wide: 1. Relief or significant reduction of pain

Electrical anesthesia is one of the most popular and most effective methods of pain relief. With this method, a person has the opportunity to independently influence acute or chronic pain and reduce the use of painkillers. It is very important that no side effects have been identified when using such therapy. A special place is occupied by the section on the use of electrical anesthesia methods for such processes as bruises, cuts, wounds, fractures, radiculitis, osteochondrosis.

2. Targeted impact on the muscle structure and musculoskeletal system

This direction, which is often called electromyostimulation (EMS), is a targeted effect on the muscle structure and nerve endings of the body with special pulses of electric current. The advantages of the EMS method are its high efficiency, wide range of applications, small size of the equipment used, simplicity of procedures, comfort for patients, and the absence of side effects and harmful consequences. Using it, it is possible to achieve a reduction in the time and increase the effectiveness of rehabilitation treatment after injuries to the musculoskeletal system in the postoperative period. Treatment of patients with neurovertebrogenic diseases is confirmed by a decrease in pain intensity, elimination of soreness in muscle areas, restoration of the range of active movements in the spine, as well as the degree of normalization of muscle tone and a decrease in the severity of tension symptoms.

Long-term studies in various types of vertebrogenic syndromes show that the use of EMS provides significant improvement in 25 - 30% of cases, improvement in 45 - 50%, slight improvement in 5 - 10%, which confirms the need for widespread use of this method.

When using EMS, it is possible to achieve a general and special training effect. There are numerous results on the use of EMS to increase physical performance, endurance, muscle strength and mass, reduce the time required for strength recovery after heavy physical activity, prevent fatigue and muscle atrophy in conditions of physical inactivity, and prolonged exposure to a monotonous position. Particular attention should be paid to the possibilities of eliminating excess weight in case of nutritional obesity. When treating patients with degrees I-IV obesity, a significant effect of EMS of the rectus abdominis and thigh muscles on fat metabolism was noted, mainly due to increased oxidation of free fatty acids and cholesterol. Reduction of excess body weight when applying EMS effects occurs mainly due to the fat component, reducing the thickness of the skin-subcutaneous fat layer. Along with the normalization of fat metabolism and a decrease in excess body weight, there was an improvement in the well-being of patients, a decrease in high blood pressure, and a decrease in fatigue.

3. Use in the complex treatment of diseases of internal organs in neurological, cardiological, gastroenterological, obstetric and urological practice.

Main action and scope: · pain relief (bruises, cuts, wounds, fractures, radiculitis, osteochondrosis, headaches and toothaches, etc.), · increased performance, endurance, muscle strength and mass, recovery after heavy physical exertion, · treatment of neuroses, depression, chronic fatigue, insomnia, cosmetology, obesity, cellulite, constipation, kidney stones.

Enhances lymph circulation, accelerates tissue restoration, activates enzyme systems, promotes the removal of lactic acid, anti-inflammatory effect, activates blood circulation, has an analgesic and anti-inflammatory effect, normalizes the state of the central nervous system, relieves nervous-emotional tension, agitation, feelings of fear, drowsiness, helps improve mental performance.

A correct and comprehensive assessment of the patient’s condition, his endurance and compensatory capabilities is important. No less important is the question of the dosage of exposure to electric current. Research shows that intensification of treatment, especially in patients with severe autonomic disorders, as well as in elderly and senile children, can lead to a breakdown of compensatory mechanisms, aggravate the course of the disease, and worsen the general condition of the patient. Consequently, in the effectiveness of electrotherapy, the choice of factors that are adequate to the patient’s condition is essential not only, but also the methodological methods of their influence. Therefore, it is necessary to approach the organization of treatment of patients differently, based on the stage, clinical symptoms, age, and concomitant diseases.

Electrotherapy applied in the complex treatment of diseases of internal organs in neurological, cardiological, gastroenterological, obstetric and urological practice.

Electrotherapy is contraindicated with: presence of an artificial heart pacemaker; pregnancy; individual intolerance to electric current; status epilepticus; fever of unknown origin; neoplasms of any etiology and localization; vein thrombosis; states of acute mental, alcoholic or drug agitation.

Electrotherapy devices

Among the electrotherapy devices presented on the Russian market, the most famous are: DENAS devices (DENAS-mini, DENAS, DiaDENS-T, DiaDENS), “Potok - 1”, Electroson - 5

AC Application

Amplipulsetherapy

This original domestic method is based on the physiological effect of amplitude pulsations of alternating currents with a frequency of 2-5 kHz, although pulsations of rectified, i.e. direct, current can be used for indications (for example, for medicinal electrophoresis, in chronic sluggish processes).

Sinusoidal modulated currents activate voltage-gated ion channels of the neurolemma and sarcolemma, which leads to a change in the initial polarization of the membranes and the generation of action potentials (spikes). Conduction currents formed in the underlying tissues excite nerve and muscle fibers. The number of activated ion channels is determined by the correspondence of the modulation frequency of the alternating current and the kinetic characteristics of the ion channels, as well as the depth of the amplitude modulation: the lower the modulation frequency of the acting alternating current, the longer the duration of its series of oscillations. Not only quickly, but also slowly activated ion channels open. As a result, the stimulating effect of the current increases. Increasing the modulation frequency and decreasing the duration of the pulse series weakens the effect of the current. The neurostimulating effect of sinusoidal modulated currents depends parametrically on their frequency and modulation depth. The exciting effect of these currents is stronger than that of direct currents.

Due to the reduced tissue resistance to alternating current and the significant current density in deeper tissues, cutaneous, muscle and visceral efferent fibers, as well as motor and autonomic nerve fibers, are involved in the excitation process. This allows the widespread use of sinusoidal modulated currents for pain relief.

Due to weak adaptation to modulated currents, a pronounced dominant rhythmic stimulation is formed in the central nervous system. This dominant leads to rapid extinction of the pain dominant, and also stimulates the trophic function of the sympathetic nervous system and the release of opioid peptides in the brain stem.

Sinusoidal modulated currents activate the microvasculature of ischemic tissues, reduce venous stagnation and perineural edema, which are often the cause of pain.

As a result of the convergence of ascending afferent flows at various levels of the central nervous system, activation of the vasomotor and respiratory centers occurs, which is enhanced by the direct influence of sinusoidal modulated currents on the subcortical centers of the cerebrum, which is accompanied by pronounced changes in hemodynamics and external respiration function - the heart rate and breathing decreases, the tone increases cerebral vessels, arterial inflow and venous outflow increases. Such currents increase the tone of the intestines, biliary tract and ureters, and effectively modulate indicators of central and regional (cerebral and renal) hemodynamics, regardless of their initial disorders. Activation of trophic fibers restores the functions of internal organs during their dystrophic changes and stimulates reparative regeneration.

During amplipulse therapy, when operating in alternating current mode, it is necessary to use thin subelectrode pads. However, when it is necessary to apply rectified current, the hydrophilic gaskets should be the same as for galvanization.

In many cases, exposure to diadynamic and sinusoidal modulated currents is carried out with longitudinal or transverse arrangement of electrodes. The types of currents, duration of procedures, and current strength will be different. In particular, if they are treated with diadynamic currents, then for one localization 2-3 types of current are often used, gradually increasing the intensity of the effect. Begin the procedure with a full-wave for about 2 minutes, then apply for 3 minutes. “short period” and for the same time “long period”, although depending on the characteristics of the pathological process, other relationships are possible.

With amplipulse therapy, more often for 3-5 minutes. III and IV PP are used. Such a stamp should also not exist. Due to the lack of irritation under the electrodes, the duration of exposure to each RR can be significantly increased. This also applies to intermittent frequencies, which at V PP alternate with pauses. It is necessary to take into account the dependence of the exciting effect on the modulation frequency, its depth, and contrast when different current impulses influence the tissues.

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The concept of physiotherapy. Sections of physiotherapy. Electrotherapy methods.

Tyumen - 2014.

Introduction

1. Concept of physiotherapy

2. Sections of physiotherapy

3. Electrotherapy methods

Conclusion

Bibliography

Introduction

Relevance: Currently, issues related to treatment using natural and physical factors are becoming of great importance.

Purpose of the work: To study the field of clinical medicine, which studies the physiological and therapeutic effects of natural and artificially created physical factors on the human body.

Job objectives:

1) Learn the concept of physiotherapy

2) Understand the purpose of physical therapy

3) Get acquainted with

1. Sections of physiotherapy

2. Physiotherapeutic methods

4) Research electrotherapy methods

5) Draw a conclusion

Object of study: Area of ​​clinical medicine

Subject of research: Properties and significance of physiotherapy and electrotherapy.

Research methods: Collection, processing and analysis of information.

1. Concept of physiotherapy

Physiotherapy (translated from Latin as treatment by the forces of nature) is a branch of medicine that deals with the use of physical factors for therapeutic and preventive purposes.

Depending on the factor used, physiotherapy includes the following sections: electrotherapy (electrotherapy), phototherapy (phototherapy), water and heat therapy (hydro- and thermotherapy), movement treatment (massage, therapeutic exercises, gymnastics on apparatus) and treatment with spa factors.

Physical methods of treatment are widely used for many diseases, both independently and in combination with other therapeutic measures. Like medications, different types of physical therapy are used at different stages of the disease.

The use of physical methods of treatment in Russia began more than 100 years ago. Their introduction was facilitated by scientists of the second half of the last century S.P. Botkin, G.A. Zakharyin, V.M. Bekhterev and others. However, in pre-revolutionary Russia, physiotherapy developed very slowly; physiotherapy rooms were organized only in some clinics and hospitals. Physical methods of treatment were not available to the population, since there was no state organization of physiotherapeutic care.

Only after the Great October Socialist Revolution did physiotherapy begin to develop rapidly in our country. Physiotherapeutic care is considered an integral part of all medical and preventive institutions. Physiotherapy is used in the most remote places of the Soviet Union, including rural medical institutions (rural medical stations, first aid stations) and it has become available to the broad masses of workers. A large network of government institutions has been created where physiotherapy is used. Physical methods are also used at factory health centers to combat the consequences of industrial injuries.

In special research institutes they study the mechanism of action of physical factors on the human body, expand the indications for the use of physical methods of treatment in combination with drugs and other drugs, and successfully develop problems of physical prevention.

Physical methods of treatment were widely used in wartime at most stages of evacuation of the wounded.

However, to date, questions about the mechanism of the therapeutic effect of physical factors on the human body have not yet been resolved. It is necessary to study and know this mechanism, since without this it is impossible to correctly use physical factors in practical medicine.

The mechanism of the therapeutic effect of physical factors on the human body is very complex. When using most of them, the main role is given to the skin, which performs very important physiological functions. It is involved in thermoregulation, metabolism, and the release of metabolic end products from the body; irritations from the world around us enter the body through the skin.

Human skin is richly supplied with blood and lymphatic vessels; its capillary network can accommodate up to 1/3 of all blood circulating in the body.

The skin contains a large number of nerve fibers and nerve endings. The terminal nervous apparatus (receptors), having a different structure, perceive certain types of irritation, for example, temperature, mechanical, etc. With the help of temperature, light and electrical stimuli, it is possible to reflexively influence the state of the lumen of blood vessels, and thereby influence the distribution of blood in the body . Irritations of skin receptors and internal organs by physical factors are transmitted along appropriate pathways to the central nervous system, right up to the cerebral cortex. In response to these stimuli, various unconditioned and conditioned reflexes arise.

The development of conditioned reflexes is influenced by the conditions under which the procedures are carried out, and therefore it is important that they are not changed during the entire course of treatment.

Unfavorable temperature conditions in a treatment room, high humidity in a hydropathic clinic, and insufficient ventilation of the room can cause inhibition in a person’s cerebral cortex, and thereby influence the responses caused by physical factors.

The impact on the patient by the words and behavior of medical personnel is of great importance.

As studies conducted in the laboratory of I.P. Pavlov on dogs have shown, mild irritations of the skin with electric current induce sleep, while deep sleep appears after a series of irritations of the same area of ​​the skin with heat or cold. Currently, warm baths, electrosleep, etc. are used for sleep treatment.

The effect of physical factors is not limited only to their influence on nerve endings. It should be borne in mind that changes also occur in the tissues on which they act.

Exposure of the skin, for example, to ultraviolet radiation or direct current, in addition to morphological changes, causes the formation of a number of chemical substances in it, which, entering the blood and lymph flow, through the corresponding vascular receptors, can cause various reflex reactions.

The reflex mechanism of action of physical factors was also pointed out by the founders of Soviet physiotherapy A.E. Shcherbak and S.A. Brushtein.

When using physical methods of treatment, a distinction is made between general procedures (affecting the whole body) and local ones (affecting limited areas of the body). Local reactions usually appear primarily in those tissues and organs on which the agent acts directly, although with local procedures the general reaction of the body is also caused by a reflex.

Depending on the characteristics of the receptors of a given area of ​​​​the skin, their sensitivity, the reactivity of the nervous system, the state of blood circulation, the type and intensity of the stimulus, the body's responses are different; sometimes the local reaction predominates, while the general reaction may be weakly expressed, sometimes the local reaction is weakly expressed and the general reaction comes first.

When applying physiotherapeutic procedures, nursing staff must know the basics of physiotherapy, the technique and methodology of carrying out medical procedures, which will ensure the correct implementation of the doctor’s prescriptions, and, consequently, their beneficial effect.

2. Sections of physiotherapy

Currently, physiotherapy includes sections of electrotherapy, phototherapy, mechanotherapy, physical pharmacotherapy, hydrotherapy and thermal treatment. Each of these sections includes a group of treatment methods based on the action of certain physical factors.

The largest number of methods combines electrotherapy. It includes methods based on the use of various types of electric current: galvanization, ampripulse therapy, diadynamic therapy, interference therapy, electronarcosis, electrosleep, electrical pain suppression, electrical stimulation, fluctuarization, darsonvalization and others. Electrotherapy also includes methods based on the use of a constant electric field of high intensity (Franklinization), an alternating magnetic field of low frequency (low-frequency magnetotherapy), electromagnetic fields of high (inductothermy), ultra-high (UHF therapy) and ultra-high (microwave therapy) frequencies.

Light therapy combines methods that use the energy of electromagnetic oscillations of light and wavelengths close to it, in particular ultraviolet, infrared, and visible radiation.

Hydrotherapy is a treatment method using fresh water in the form of various showers, douses, rubdowns, wraps, partial and general baths, whirlpool baths, and underwater shower-massage. Balneotherapy is based on the use of baths of various gas and chemical compositions.

Thermal treatment includes methods that use the heat of heated paraffin, ozokerite, sand, various muds, as well as a Russian bath and sauna. Mechanical therapy combines methods based on the influence of mechanical energy: various types of massage, manual therapy, vibration therapy, ultrasound, as well as mechanotherapy using various devices.

Physicopharmacological treatment is a complex effect on the human body of physical factors and pharmacological agents. This includes medicinal electrophoresis, phonophoresis, and electroaerosol therapy.

physiotherapy electrotherapy natural

3. Electrotherapy methods

As mentioned earlier, physical therapy has many sections, the most common of all is electrotherapy. The following methods of electrotherapy are distinguished:

Method name	Purpose of application
Galvanization	use for therapeutic purposes of continuous direct electric current of low strength (up to 50 mA) and low voltage (30 - 80 V).
Ionic galvanization	a method of combined simultaneous exposure of the patient to direct current and a certain medicinal substance introduced into the tissue using current.
Faradization	use of low frequency alternating current for therapeutic purposes
Darsonvalization	use of alternating current of high frequency, high intensity and low strength for therapeutic purposes
Diathermy	use for therapeutic purposes of high frequency alternating current (500,000 - 2,000,000 periods), relatively low voltage (hundreds of volts) and high power (up to several amperes)
Inductothermy	use of high frequency alternating electromagnetic field from 3 to 30 MHz for therapeutic purposes
Franklinization	the use of static electricity for medicinal purposes
Diadynamothermy	treatment with two constant low-frequency pulsed currents of low strength (up to 50 mA).
UHF therapy	a treatment method in which a specific area of ​​the patient’s body is exposed to a continuous or pulsed ultra-high frequency electric field
Electropuncture	a method of influencing biologically active points of the body with certain types of low and high frequency currents (low frequency pulsed currents are often used)
Magnetotherapy	use of alternating low-frequency, pulsating and constant magnetic fields for therapeutic purposes

Conclusion

Thus, to summarize the above, we can conclude that physiotherapy is an integral part of treatment and rehabilitation after severe injuries, as well as a method of maintaining health in chronic diseases of various organs.

Modern physiotherapy is actively developing. At the moment, there are a large variety of modern and innovative methods that can have a beneficial effect on both the body as a whole and local problem areas.

Physiotherapeutic techniques effectively complement the medication component of the complex treatment process, avoid unwanted side effects and achieve lasting positive treatment results. But the key link in a successful diagnostic and treatment process is the doctor. Therefore, procedures should be performed only after preliminary consultation with a specialist - for maximum effectiveness of therapy and patient safety.

Bibliography

1. Textbook “Physiotherapy”,

2. Textbook “General physiotherapy”, authors: V.M. Bogolyubov, G.N. Ponomarenko, publishing house "Medicine", Moscow, 2003

3. Textbook “Practical physiotherapy”,

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Treatment of diseases with the help of electric current was practiced even before the invention of current sources, through living beings that generate electricity. The ancient Greeks successfully healed paresis and treated tissue diseases using stingrays living near the coast. In modern electrotherapy, treatment using currents of various frequencies is in demand and is always popular in the treatment of neuralgia, muscle atrophy and even gynecological diseases.

Methods of using electricity

Physiotherapy has a wide arsenal of techniques for restoring health using electricity. There are several directions:

Electrical treatment devices

For galvanization sessions, the “Potok 1” electrotherapy device has become widespread in physiotherapy rooms; it can be used for both electrophoresis and galvanization even at home. The price of the device is a little more than ten thousand rubles.

The Elesculap 2 low-frequency therapy device is more expensive, but also more convenient; it has a modern design, a liquid crystal display and a wide frequency range. This device allows you to generate pulses of various shapes.

The most expensive device, "Radius-01FT", is designed for use in medical institutions, but, if necessary, can also be used at home. The device allows for almost all known effects of electric current on the body, including electrosleep.

Diseases that prevent current treatment

Electrotherapy has quite extensive contraindications, under which the use of electric current for therapeutic purposes becomes dangerous. Treatment should not be carried out on pregnant women at any stage of pregnancy or with the following diseases:

• Feverish conditions, purulent diseases of the skin and internal organs, acute inflammatory processes.
• Intolerance to electrical current or the medication used for electrophoresis.
• Heart defects, heart attack or coronary heart disease.
• Having a pacemaker or other implanted device.
• Bone fractures with multiple fragments.
• Any acute convulsive conditions such as angina or surgery.

The doctor prescribing electrotherapy procedures will definitely conduct a full analysis of the patient’s health condition and warn him about the possible consequences. That is why it is advisable to carry out all procedures in a medical institution, and at home it will be safe to use special devices only after consulting a doctor.

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Electrotherapy(synonym for electrotherapy) - methods of physiotherapy based on the use of dosed effects on the body of electric currents, electric, magnetic or electromagnetic fields.

Electrical phenomena play a large role in the most important physiological processes - excitement and its implementation, in the transfer of substances through biological membranes and etc. Bioelectric potentials - indicators of bioelectrical activity of tissues, determined by the difference in electrical potentials between two points of living tissue, are directly related to the physiological state of cells and the metabolic processes occurring in them. Electric current and electromagnetic oscillations in certain parameters are physiological stimuli and are widely used to influence the functional state of individual organs and systems of the body, incl. for medicinal purposes.

The largest share among all physiotherapeutic methods falls on E. Achievements in physics, biophysicists, electronics, which made it possible to obtain various types of electric current and electromagnetic field and study their effect on the body at different levels, created the basis for the continuous development and improvement of electrotherapy methods.

One of the first methods of E. was franklinization (general electrostatic shower) - a combined effect on the body of a constant high-voltage electric field, accompanied by a “quiet” electric discharge, as well as ozone, nitrogen oxides and air ions formed in low concentrations. The method is named after the American scientist Franklin, who worked on the production of static electricity. Franklinization improves capillary blood circulation, enhances inhibition processes in the central nervous system, reduces blood pressure, has an analgesic and hyposensitizing effect, and accelerates the epithelization of wounds. The method is used for neurasthenia, insomnia, fatigue, skin problems, trophic problems, etc.

The use for therapeutic purposes of galvanic (constant, not changing over time) electric current of low voltage (30-80 IN) and low strength (up to 50 mA) is called galvanization (see. Galvanotherapy ).

The description by the French physicist S. Leduc of the phenomenon of penetration of a number of substances through intact skin with an electric current and the development by the Swedish physical chemist S. Arrhenius of the theory of electrolytic dissociation led to the creation of the method electrophoresis medicinal, which combines the effect on the body of a direct electric current and a medicinal substance entering the tissues along with it, which ensures the prolonged action of this substance, its higher pharmacological activity and the virtual absence of side effects.

The discovery of the laws of electromagnetic induction by the English physicist M. Faraday (1831), the development by the French neurologist G.B. Duchenne of the foundations of modern methods of using direct and faradic currents and the use of alternating low-frequency current for treatment led to the emergence of methods electrical stimulation, electrosleep And electroanaesthesia.

After the development in 1891 by the inventor N. Tesla of a method of high-frequency high-voltage voltage transformation, the French physiologist and physicist J. A. D'Arsonval proposed E. methods based on Tesla's discovery, called darsonvalization. During local darsonvalization, individual areas of the body are exposed to high-frequency alternating pulse current (100-400 kHz). During general darsonvalization (inductotherapy), the body is exposed to a weak pulsed electromagnetic field of high frequency. Local darsonvalization is used to reduce pain, paresthesia, relieve spasm of smooth muscles, increase the elasticity of vascular walls in Raynaud's disease stages I and II, with normal varicose veins, non-healing wounds, etc.

General darsonvalization is prescribed for stage I-IIA hypertension, menopausal syndrome, and insomnia.

In the early 40s. 20th century it was proposed to use rectified sinusoidal currents for electrical energy with a frequency of 50 to 100 Hz. In the 50s 20th century method using these currents, called diadynamic (see. Diadynamic therapy ), was introduced into medical practice. In 1963, it was proposed to use sinusoidal modulated alternating currents with a frequency of 5,000 for electricity. Hz, arriving after low-frequency conversion to the electrodes in the form of groups (portions) of oscillations with a frequency from 10 to 150 Hz, which are introduced into medical practice under the name “amplipulse therapy”. In 1964 it was developed fluctuarization - method E. fluctuating (aperiodic) currents with a frequency from 100 to 2000 Hz, used in dentistry.

Using the work of D'Arsonval, the Czech physician R. Zeyneck and the German physician K.F. Nagelschmidt in 1905 proposed and introduced into medical practice the method of diathermy - the effect on the body of a current of high frequency, low voltage and great strength (until 3 A). In this case, an endogenous increase in the temperature of the skin and deeply located tissues and organs occurs, accompanied by their hyperemia, which helps improve blood circulation, enhance metabolism, and increase immunological reactivity. In this regard, diathermy has an anti-inflammatory effect. desensitizing, antispasmodic and analgesic effect. This E. method is used for chronic inflammatory processes, vasospasms, and diseases with pain syndrome.

Discovery of A.S. Popov's use of radio waves (1895) and L. Stieböck's use of a radio-electronic lamp as a generator of high-frequency electromagnetic oscillations in diathermy devices contributed to the creation of inductothermy (short-wave diathermy) - a method of electrotherapy in which the patient's body is exposed to an alternating high-frequency and magnetic field, exerting mainly a thermal effect on biological objects.

In the affected area, tissue temperature rises, capillary spasm is relieved, arterioles and larger vessels dilate, and blood supply improves. Inductothermy promotes the resorption of inflammatory foci, increasing the intensity of phagocytosis, metabolic processes, etc. This method of E. is used in the treatment of pneumonia, non-calculous cholecystitis, gastric and duodenal ulcers, diseases of the musculoskeletal system, polyneuritis, hypertension, etc. .

Sometimes, if pyrotherapy is necessary, inductopyrexia (method of E. with an alternating high-frequency magnetic field) or electropyrexia (alternating electric or electromagnetic field of ultra-high or high frequency) is used to increase the patient’s body temperature to 39° and above.

Method E. electromagnetic field with a frequency from 30 to 3000 MHz is called UHF therapy (see. Ultrahigh frequency therapy ).

Electromagnetic method based on the use of ultra-high frequency (microwave) electromagnetic field energy from 300 to 300,000 MHz, called microwave therapy (see. Ultrahigh frequency therapy ).

Electrotherapy also includes magnetic therapy - a method based on the effect of alternating magnetic fields on the body. Magnetotherapy is incompatible with inductotherapy, UHF therapy, microwave therapy, UV irradiation, and general electrophoresis.

Electro-aerosol therapy is also used in physiotherapy - aerosols whose particles have a unipolar charge (positive or negative). Electroaerosols are obtained using special devices. The method is used as a general procedure (electric aerosol inhalation) and as a local effect. Unlike conventional aerosols, electric aerosols are more dispersed, which increases the surface of medicinal substances and reduces their costs; they also increase their ability to penetrate deep into tissues; electroaerosol therapy is used for the prevention and treatment of inflammation, chronic inflammation,

occupational lead poisoning and other occupational diseases, pneumonia, nonspecific diseases of the upper respiratory tract, etc. Local aerosol therapy is prescribed for wounds that take a long time to heal, etc. In medical practice, combined methods of electrophoresis are widely used, for example, medicinal electrophoresis and diadynamic currents or mud inductothermy (exposure to the body with mud applications and a high-frequency alternating magnetic field), mud inductophoresis, exposure to mud applications, medicinal electrophoresis and a high-frequency alternating magnetic field.

Contraindications to E. are determined by the nature and intensity of the reactions caused by each of the methods. Most methods of E., causing dilation of blood vessels, activation of blood circulation and metabolic processes, are contraindicated at elevated body temperature, tendency to bleeding, malignant neoplasms, active tuberculosis, closed purulent processes.

E. in childhood should be carried out at an intensity of exposure 2-3 times less than in adults, and with a shorter duration of procedures. In elderly people, due to a decrease in the body's reactivity and ability to compensate for changes caused by electrotherapy, procedures should also be carried out at a lower intensity of exposure, shorter duration of procedures and with longer intervals between them.

To ensure the safety of the patient and staff, E. should be carried out in conditions that exclude the possibility of the patient touching grounded objects (pipes of water supply and heating systems, etc.). E. should not be carried out in damp rooms, in rooms with walls and floors covered with tiles. Electrotherapeutic procedures can only be performed by specially trained medical personnel.

Bibliography: Klyachkin L.M. and Vinogradova M.N. Physiotherapy, M., 1988; Balneology and physiotherapy, ed. V.B. Bogolyubova, vol. 1, M., 1985; Ulashik VS. Complex use of medicinal electrophoresis in physiotherapy, Minsk, 1985; Shemetilo N.T. and Vorobiev M.G. Modern methods of electrotherapy and light therapy, L., 1980; Yasnogorodsky V.G. Electrotherapy, M., 1987.