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LIST OF NECESSARY MEDICAL SERVICES AND PROCEDURES PROVIDED IN SPECIALIZED SANATORIUMS TO THE PATIENT ACCORDING TO HIS PROFILE... Relevant in 2018

ON THE COMPATIBILITY OF PHYSICAL FACTORS AND PROCEDURES

In sanatorium practice, the patient is usually prescribed a complex treatment, including elements of balneotherapy, instrumental physiotherapy, exercise therapy and massage. The use of certain factors can be combined (simultaneous exposure), sequential (one after the other with a short interval), alternating (every other day or in another order) and step-by-step (the first course of any procedures is followed by a course of other procedures). When correctly prescribing an individual treatment complex, physical factors seem to interact, exerting a potentiating effect and enhancing the effect. However, when prescribing procedures, one should always take into account not only the possible effectiveness, but also the incompatibility of individual procedures, which can lead to an exacerbation of the disease or simply a deterioration in the patient’s well-being or condition. So, for example, during one course of treatment, even on different days, it is impossible to use those physical factors whose mechanism of action is similar in the physical essence of the processes caused. Treatment overload should not be allowed, taking into account the nature of the disease, the body's response, age and other circumstances.

The group of incompatible factors includes: UHF and microwave, inductothermy and UHF, microwave and inductothermy, microwave and alpha therapy, general sunbathing and general UV irradiation, diadynamic and sinusoidal modulated currents, underwater intestinal lavages and intestinal irrigation. It is not recommended to take procedures using antagonistic factors during treatment: a) thermal procedures (mud, ozokerite, etc.) and bathing in cold and cool water; b) inductothermy and other thermal procedures and cool showers, bathing for inflammatory diseases; c) irradiation with UV rays and subsequent infrared or visible radiation of the same area after the use of novocaine electrophoresis, which blocks nerve endings and inhibits the development of UV erythema; e) electrophoresis of sedatives (magnesium, bromine, aminazine) and soul (Charcot, Scottish, cool circular); f) electrosleep and souls (Charcot, Scottish, cool circular); g) general franklinization and Charcot or Scottish shower. It is also not recommended to prescribe two procedures affecting individual active reflexogenic zones (collar, panty zones, nasal mucosa).

It is undesirable to prescribe physical factors with the energy of which the patient has constant professional contact, for example, the use of UHF, high-power microwaves, radon baths for those who come into contact with HF, UHF, microwave generators and sources of ionizing radiation at work.

Compatibility groups for physiotherapeutic procedures.

In some cases, if necessary, general and local physiotherapy for the underlying disease can be prescribed on the same day. In this case, local procedures, as a rule, precede general procedures. For example, a general bath, a galvanic collar according to Shcherbak, general electrophoresis according to Vermeule, electrosleep can be combined with local procedures: ultrasound, diadynamic sinusoidal modulated currents, darsonvalization, inductothermy, low-power microwave oscillations, local applications of paraffin, ozokerite, mud, etc.

When treating the underlying disease, the patient is prescribed two different physical factors with localization of the effect in the affected area. Examples: ultrasound and thermal factor (dirt, paraffin, ozokerite); ultrasound and electrical stimulation; dirt and electrophoresis of medicinal substances; UHF and UV, etc.

When assigning two factors to one area, the issue of their compatibility and sequence of application is decided, taking into account the changes caused by each of the factors. These rules are also used when prescribing physiotherapy in parallel for the underlying and concomitant diseases. In a course of treatment using several factors, general and local procedures can be distributed over different days. Procedures are usually carried out every other day. They are prescribed daily only when necessary (acute pain syndrome, etc.).

COMBINATION OF ELECTROTHERAPEUTIC FACTORS

Note:

0 - procedures are not combined at all for one disease and one area;

1 - combined on one day;

2 - combined on different days.

Procedures	Galvanization and electrophoresis (general techniques)	Galvanization and medicinal electrophoresis	Electroson	Diadynamic therapy	Amplipulsetherapy	Electrical stimulation	Local darsonvalization	General darsonvalization	UHF therapy	Inductothermy	Microwave	Magnetotherapy	Ultrasound
1	2	3	4	5	6	7	8	9	10	11	12	13	14
			2	1, 2	1, 2	1, 2	1, 2	2	1, 2	2	1, 2	2	2
			1, 2	2	2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2
3. Electrosleep	2	1, 2		1, 2	1, 2	1, 2	1, 2	2	1, 2	1, 2	1, 2	1, 2	1, 2
4. Diadynamic therapy	1, 2	2	1, 2		0	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2
5. Amplipulse therapy	1, 2	2	1, 2	0		1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2
6. Electrical stimulation	1, 2	1, 2	1, 2	1, 2	1, 2		1, 2	2	1, 2	1, 2	1, 2	1, 2	1, 2
7. Local darsonvalization	1, 2	2	1, 2	1, 2	1, 2	1, 2			0	0	0	1, 2	2
8. General darsonvalization	2	1, 2	2	1, 2	1, 2	2			0	0	0	0	1, 2
9. UHF therapy	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	0	0		0	0	2	1, 2
10. Inductothermy	2	1, 2	1, 2	1, 2	1, 2	1, 2	0	0	0	0	0	0	1, 2
11. Microwaves	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	0	0	0	0		2	1, 2
12. Aeroionotherapy	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2
13. Aerosol therapy	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2
14. Magnetic therapy 15. Ultrasound	2 2	1, 2 1, 2	1, 2 1, 2	1, 2 1, 2	1, 2 1, 2	1, 2 1, 2	1, 2 2	0 1, 2	2 1, 2	0 1, 2	2 1, 2	2	2
16. General Ural Federal District	2	1, 2	2	1, 2	1, 2	1, 2	1, 2	2	1, 2	1, 2	1, 2	1, 2	1, 2
17. Local Ural Federal District	0	0	1, 2	0	0	0	0	1, 2	1, 2	2	2	2	0
18. Infrared radiation	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2
19. Mud therapy	2	1, 2	1, 2	1, 2	1, 2	1, 2	2	1, 2	2	2	2	2	2
20. Paraffin, ozokerite	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	2	2	2	2	2
21. Radon baths	2	2	2	1, 2	1, 2	1, 2	2	2	2	2	2	2	2
22. Hydrogen sulfide baths	2	2	2	1, 2	1, 2	1, 2	2	2	2	2	2	2	2
23. Mineral baths	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	2	1, 2	1, 2	1, 2	1, 2	1, 2
24. Carbon dioxide baths	2	2	1, 2	1, 2	1, 2	1, 2	2	2	2	2	2	2	2
25. Fresh baths	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	2	1, 2	1, 2	1, 2	1, 2	1, 2
26. Souls	2	2	2	1, 2	1, 2	1, 2	1, 2	2	2	2	2	2	2

COMBINATION OF LIGHT THERAPY, THERMAL THERAPY AND BALNEOTHERAPEUTIC PROCEDURES

Procedures	General Ural Federal District	UFO local	Infrared rays	Mud therapy	Paraffin, ozokerite	Radon baths	Hydrogen sulfide baths	Mineral baths	Carbon dioxide baths	Fresh baths	Aerosoltherapy	Aeroionotherapy	Souls
1	2	3	4	5	6	7	8	9	10	11	12	13	14
1. Galvanization and electrophoresis (general techniques)	2	0	1, 2	2	1, 2	2	2	1, 2	2	1, 2	1, 2	1, 2	2
2. Galvanization and electrophoresis (local effects)	1, 2	0	1, 2	1, 2	1, 2	2	2	1, 2	2	1, 2	1, 2	1, 2	2
3. Electrosleep	2	1, 2	1, 2	1, 2	1, 2	2	2	1, 2	1, 2	1, 2	1, 2	1, 2	2
4. Diadynamic therapy	1, 2	0	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2
5. Amplipulse therapy	1, 2	0	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2
6. Electrical stimulation	1, 2	0	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2	1, 2
7. Local darsonvalization	1, 2	0	1, 2	2	2, 1	2	2	1, 2	2	1, 2	1, 2	1, 2	1, 2
8. General darsonvalization	2	1, 2	1, 2	1, 2	1, 2	2	2	2	2	2	2, 1	1, 2	2
9. UHF therapy	1, 2	1, 2	1, 2	2	2	2	2	1, 2	2	1, 2	1, 2	1, 2	2
10. Inductothermy	1, 2	2	1, 2	2	2	2	2	1, 2	2	1, 2	1, 2

Massage and heat therapy. Therapeutic factors based on heat include water, ozokerite, paraffin, therapeutic mud and other agents that affect the body through temperature, mechanical and chemical irritation. Temperature irritants mainly affect the skin. Irritation of skin receptors has an effect similar to the skin-visceral reflex on tissues and organs, helping to reduce and even stop pain. It should be noted that high temperature causes a sensation of pain, while cooling certain areas of the skin (ice, chlorethyl) reduces pain sensitivity. Thermal procedures significantly enhance the physiological effect of massage, causing vasodilation, which accelerates the absorption of medicinal rubs, ointments, creams, and relieves spasms of muscles and blood vessels. The sequence of application of thermal procedures and massage in each specific case is determined by special indications. For example, in case of dysfunction of the musculoskeletal system, neuritis, neuralgia, or lumbosacral radiculitis, thermal effects are always first used, and then massage according to the method recommended for this disease. The combination of massage with thermal procedures enhances the healing effect. In case of vascular disorders, tissue swelling, lymphostasis phenomena, first massage the body parts located above the pathologically changed areas using the suction method, and then use thermal effects.

Massage and light therapy. Light therapy is most often used in the form of irradiation with infrared rays using an incandescent lamp (sollux), Minin lamp, etc. With a sufficient dose of irradiation, redness (hyperemia) is noted on the patient’s body, which is caused by dilation of skin vessels, which usually lasts for 30-60 minutes . Naturally, metabolic processes accelerate in this area, and the increased tone of individual muscle groups decreases. Moderate doses of radiation have an analgesic effect, but locally applied short-term and intense heat can cause increased pain. You need to be very careful, especially if the procedures follow one after another. You can simultaneously warm up the Sollux lamp and massage certain areas of the body, for example, for injuries of the musculoskeletal system, lumbago, lumbosacral radiculitis, osteochondrosis, myositis. Recently, short-wave ultraviolet irradiation (SWUV) has been used in practice to influence individual BAPs, using erythemal doses. In this case, pronounced local hyperemia appears on the skin, which lasts from 4-6 hours to 2-3 days or more, after which pigmentation (tanning) appears.

Massage and electrotherapy. Diadynamic currents of significant strength cause muscle contraction, which is used for electrical stimulation of muscles (electro-gymnastics). In addition, rhythmic galvanization, faradization, low-frequency pulse currents, etc. are used. When combining electrotherapy with therapeutic massage, a certain sequence must be followed; massage is carried out after electrotherapy. For electrical stimulation, the devices “Stimul-1” and “Endoton-1” are used. Electrophoresis is used after massage, since in the reverse order the administered medications can be quickly removed.

Massage and hydrotherapy. The types of water procedures are extremely diverse. These include dousing, rubbing, wet wrapping, showers (circular, needle, rain, fan, Charcot, Scottish, ascending, underwater, massage shower), as well as various baths: fresh, contrast (2 adjacent pools, the temperature of which varies by 5-10 °C); turbine-type whirlpool baths (LAZ-3, previously produced in the Czechoslovak Republic), vibration baths (in which vibration waves with a frequency of 50-200 Hz are applied to a separate area of ​​the patient’s body). The following types of therapeutic baths are also used: sodium chloride (Staraya Russa, Sestroretsky resort, Druskininkai), iodine-bromine (Goryachiy Klyuch, Maykop), sulfide (Sochi, Matsesta, Khilovo), baths in which the patient’s body is exposed to air bubbles or some kind of some gas - nitrogen (Tskaltubo), carbon dioxide (Kislovodsk, Borjomi, Essentuki), pearl, oxygen (Pyatigorsk); in addition, baths where radioactive and other substances are exposed - radon (Pyatigorsk), aromatic, turpentine, pine (Fig. 153).
All of the above types of hydrotherapy have a diverse effect on the patient’s entire body. Depending on the indications, they can be used before, after, or simultaneously with therapeutic massage.
The use of massage after a thermal water procedure should be recommended for conditions after injuries and diseases of the musculoskeletal system, accompanied by scar tissue changes, joint stiffness (contracture), for muscle changes after injuries and for diseases of the peripheral nervous system (lumbosacral radiculitis, neuromyositis).
If there is severe pain, it is better to first do a massage and then a water procedure. It is better to alternate different types of baths with massage (day - massage, day - general bath).
In conclusion, it should be emphasized that massage cannot be used during a number of physio- and balneological procedures.
Thus, it is not recommended to prescribe general massage and general diathermy or a general light bath, as well as ultraviolet irradiation and general massage on the same day. There should be a break of several hours between the mud therapy procedure and the massage; For example, it is better to alternate the appointment of a carbon dioxide bath with a massage every other day.
A combination of massage with measured movements. Massage is often combined with gymnastic exercises. They can be in the form of active, passive movements and movements with resistance, relaxation, stretching. Breathing exercises are often used at the end of the massage.
Passive movements are performed not by the patient, but by the massage therapist, i.e., without volitional tension and contraction of the patient’s muscles. They are an additional means of influence along with massage and are widely used in the treatment of diseases of the musculoskeletal system.

It should be noted that under the influence of passive movements, effusions in the joints resolve much faster, wrinkling and shortening of ligaments and muscles are prevented, muscle elasticity is restored (especially in case of bone fractures after wearing a plaster cast for a long time), and contractures are prevented (Fig. 154-158).
When performing passive movements, the following basic rules must be observed:
1. The direction and amplitude of movements must correspond to the anatomical structure of a given joint.
2. When performing passive movements, the person being massaged sits on the upper limbs, and lies on the lower limbs. It is necessary to ensure that muscle relaxation is as maximum as possible.
3. The massage therapist should perform passive movements in only one joint, fixing the proximal and distal parts of the limb.
4. The difficulty of passive movements should increase gradually during treatment. Initially, all movements are performed in straight lines - directions, in the same plane, with small amplitude and at a slow pace. Then the amplitude, tempo and complexity of the movements are gradually increased (combination with circular, semicircular).

The main thing is that all movements should be done smoothly, rhythmically, at a calm pace, without causing pain in the patient.
Active movements are movements that the patient makes himself, at the command of the massage therapist; in complex therapy together with massage, they should be given special attention. Active movements can be used before, during and after massage (for joint stiffness).

Massage and active movements simultaneously increase the performance of muscle tissue, accelerate the healing of fractures and prevent muscle atrophy, especially with damage to a nerve, tendon, joint, with prolonged immobilization (immobilization), or with a fracture.
Movements with resistance. The main goal is to strengthen muscles. Such exercises are characterized by strength tension; The massage therapist strictly measures the force and makes these movements from various starting positions. So, exercises for the muscles of the upper extremities are done in the initial position sitting or standing, and for the lower extremities - in a lying position.

In conclusion, it is necessary to once again note the importance of the sequence of procedures: it is more correct to use, for example, first a mud application, then, after some time, massage and then gymnastics (physical therapy). When treating contractures, heat is first used, then massage and then exercise therapy.

Related information.

121 - Acute myocardial infarction

182 -- Embolism and thrombosis of other veins

000-29 - Pregnancy

Q00 -07 - Congenital anomalies (malformations) of the nervous system

R50 - Fever of unknown origin

R64 - Cachexia

R53 - Physical overexertion

COO-D48 - Benign and malignant neoplasms

D55-59 - Hereditary hemolytic anemias

D65 -68 - Blood clotting disorder

D69 - Purpura and other hemolytic conditions

J84, R04.2 - Pneumosclerosis with a tendency to pulmonary hemorrhage

Appendix 3

Compatibility and consistency when prescribing physical remedies

There are two main types of combining physical treatments: combination and combination.

Combined physical effects- simultaneous use of two or three physical and non-physical therapeutic effects (galvanoinductothermy, vacuum electrophoresis of medicinal substances, etc.).

Combined physical therapeutic effects- sequential administration of several physical therapeutic agents.

Possible benefits of using physical and medication in combination:

Increasing the effectiveness of treatment with less tissue adaptation to the action of one factor, synergism and potentiation are more pronounced;

Combination of effects in weaker dosages with better tolerability of procedures;

Saving time for patients and staff;

Greater cost-effectiveness of treatment courses.

In addition to combining the actual physical factors, one should take into account the inclusion of exercise therapy, massage, climatic therapeutic effects, inhalation, medications, psychotherapy procedures (autotraining, hypnosis, etc.) and x-ray therapy in treatment complexes.

It is also necessary to consider various options for combining various physical therapeutic agents:

Combination with effects on the same skin area, organ or system;

Combination with effects on different zones, organs or systems (in the treatment of the main and concomitant diseases);

Combination with different time intervals (without a significant interval, after 1.5-2 hours, daily, every other day, etc.);

Combination of physical factors of different strengths (two strong, strong and weak or weak);

Combination of factors with different directions of influence (antagonistic, synergistic, etc.).

Combination options

a) combination of physical factors;

b) combining physical factors with exercise therapy and massage;

c) combining physical factors with climatotherapeutic procedures;

d) combination of physical and medicinal means;

e) combination of physiotherapy and x-ray radiotherapy:

f) combining physiotherapy with psychotherapy (for example, light or other heat with auto-training).

Combination principles

There are no absolutely incompatible procedures in physiotherapy. By varying methodological techniques (sequence, intensity, duration, localization), you can reasonably and purposefully assign two almost any factors. However, there are physical factors, the combination of which is simply impractical, and they are practically not combined (diadynamic currents and SMT). There are factors, the possibility of combining which needs to be studied.

Synergy- unidirectional influence of physical factors with their application either to the same or to different zones, organs and systems (synergistic, but different mechanism of therapeutic action).

Sensitization- preparation of a tissue, organ or organism by one therapeutic factor for the more effective action of another.

Adequacy- the prescribed physical factors should not exceed the adaptive capabilities of tissues, organs, and systems of the body (do not overload the body with an excessive amount of exposure).

Combination of local and general effects (to enhance the local focal reaction). When prescribed on the same day, local procedures should be carried out first.

Antagonism- application of multidirectional influences

a) to weaken by one factor the undesirable effects of another;

b) to provide a training effect (contrast procedures).

Gentle effect. The purpose of combining certain types of influences may be to reduce the intensity of each of them, shorten the duration of procedures, and the course of treatment. Combination rules

1. If one impact prepares a tissue, organ (system) for the more effective impact of another, the second can be carried out after the first without a significant interval.

2. The interval between procedures that do not provide for this should be at least 1.5-2 hours.

3. Two procedures with a common effect on the body are not prescribed on the same day, especially if they are considered strong (allowed for the weak).

5. Local physiotherapeutic interventions are usually prescribed before general procedures.

6. Local UV irradiation in erythemal dosages is not prescribed after water procedures (to avoid, in particular, maceration of the skin 0.

7. Electrophoresis of many medications for the purpose of greater and deeper administration is carried out immediately after the following local procedures: ultrasound through water (but not oil), microwaves, inductothermy, paraphyo-ozokerite ashtlication, local baths.

8. Electrophoresis of medicinal substances in order to create a stable skin depot of medications is recommended to be carried out before the specified procedures using adrenaline, cold and preferably in different skin areas.

9. General physiotherapeutic procedures are not carried out on the days of stress-related examinations of patients.

10. When carrying out complex treatment with physical factors, it should be taken into account whether it is carried out without exemption from active work or with exemption. In the first case, a 1.5-2 hour interval is established between the end of work and the conduct of physiotherapeutic procedures.

Rules for combining climatic and physiotherapeutic procedures

1. Hardware physiotherapy procedures should be carried out, as a rule, after climatic conditions (especially local thermal ones) - an interval of about 2 hours. Water, mud, ozokerite, paraffin and other procedures are also carried out after climatic conditions (after air and sun baths).

2. Sunbathing is often taken before sea and other swimming.

3. On days of sea (estuary, river) bathing, it is not recommended to carry out thermotherapy procedures, or they are carried out after swimming at intervals of many hours.

4. Climatic influences are usefully combined with exercise therapy (climate-kinesitherapy), they have a high hardening and healing effect.

5. It is advisable to carry out simultaneous mud and climate therapy - the “Egyptian” method of mud therapy or mud therapy using solar heating methods.

Impacts that are incompatible within the same procedure

1. Technically incompatible (for example, light and many water procedures).

2. Opposite to the mechanism of action (for example, cold and inductothermy),

3. Causing overload of tissues, organs, systems, organisms.

Procedures incompatible on the same day

1. Procedures that cause a generalized reaction of the body, affecting the general reactivity, causing noticeable fatigue or agitation of the patient. In particular, electrosleep is incompatible with other electrical procedures for general effects on the body (general franklinization, etc.).

2. Procedures of unidirectional action, but exceeding the adaptive capabilities of an organ or tissue: in particular, erythemal effects and intense thermal procedures.

3. Procedures that are multidirectional in the mechanism of therapeutic action and do not provide for one goal: sedative and stimulating, cold and hot procedures,

The course of treatment does not combine

1. Intensive water, mud and electrical treatments with acupuncture.

2. Sea therapy with intensive thermotherapy (especially mud therapy).

3. Aerotherapy for severe cold loads with intensive mud therapy.

4. Similar in their physical characteristics: sunbathing and UV irradiation, two high-frequency procedures (inductothermy and microwaves).

5. Massage and erythemal UV therapy of the same areas.

6. Incompatible in the course of treatment are procedures that may result in tissue damage: erythemotherapy, galvanization, massage, local darsonvalization in the same skin areas.

Massage is an effective, non-drug method of functional therapy, which is widely used in various areas of treatment and restoration of the body.
Massage is used at all stages of medical rehabilitation of patients. They are used in complex rehabilitation treatment of subacute and chronic diseases of the circulatory system, nervous system, musculoskeletal system, internal organs, as well as in the manifestation of certain skin diseases.

Massage has proven itself to be an excellent means of preventing and restoring mental and physical activity. Massage occupies a special place in sports and health practice, standing out as a separate type of “sports massage”. The widespread use of various massage techniques in cosmetology gives amazing results in healing and rejuvenation.

In the application of complex therapy for various diseases, in addition to massage, various types of physiotherapy are included, and their compatibility must be taken into account.

Massage can be combined with various physical procedures, applied “simultaneously” or “combined”, applied sequentially, depending on what effect the massage should have: relaxing, tonic, etc. The purpose of a sequence or combination of physiotherapy procedures depends not only on the signs of similarity in their physiological effect. It is necessary to take into account the depth and intensity of the impact of the procedures, the nature of the pathological process, and most importantly, the patient’s reaction to this procedure and his condition at the time of its appointment. When using various massage techniques, as well as combining them with other physiotherapy procedures, the state of health, age and reactivity of the nervous system must be taken into account.

It is not recommended to use such powerful stimuli as a general massage and a general light bath on the same day, due to the fact that both physical factors have a very energetic effect on the patient’s body.

When prescribing a course of treatment with massage and electrophoresis, it is not recommended to massage the areas of skin on which the electrodes were applied after the electrical procedure; however, if necessary, massage should be performed 30-60 minutes before electrophoresis or procedures should be prescribed every other day.

A number of physiotherapeutic procedures are incompatible in the nature of the reactions that these procedures cause, for example, general ultraviolet irradiation and massage, Charcot's shower and general massage.

• Do not massage areas of the body that have been irradiated by a quartz lamp.

Physiotherapeutic procedures that do not cause long-term consequences and are not a heavy burden on the cardiovascular and nervous systems can be prescribed on the same day, but at different times of the day:

• water bath (short and low temperature) and massage;

• steam bath and massage, mud therapy (local application) and massage, paraffin application and massage.

Low pressure showers (fan, circular, rain) can be prescribed every other day.

Combined use of massage and other physiotherapy.

• on the same day you can perform massage and inhalation, quartz tube. The order of these procedures does not matter.

• for hypertension, massage is prescribed before therapeutic exercises.

• It is effective to combine daily massage with therapeutic exercises and every other day with ultrasound and pine baths.

• the use of preliminary massage on areas of the body undergoing reflexology (acupuncture) increases its effectiveness

• It is recommended to perform a massage before and after the cold procedure. After hardening activities, the massage should be more intense. Segmental reflex massage reduces meteosensitivity.

• massage for the consequences of injuries to the musculoskeletal system, bruises, sprains, fractures, contractures should be performed after paraffin and mud applications, mud therapy or baths, this promotes quick and effective recovery.

It is believed that mud therapy, exercise therapy and massage are synergistic procedures that should follow each other with minimal intervals.

Massage can be combined with other physical factors in different sequences. N.A. Belaya* recommends that for coronary heart disease, alternate massage with baths on different days or perform it before taking a bath.

• for asthenic syndrome and vascular atony, O. F. Kuznetsov recommends massage, then therapeutic exercises, after that - an oxygen bath, and for vascular spasm - first an oxygen bath, then therapeutic exercises and massage.

• for dermatogenic, desmogenic and myogenic scar contractures, L. A. Kunichev advises first prescribing a physiotherapeutic procedure (diathermy, paraffin and mud therapy), and then therapeutic exercises, after which massage is performed.

• It is considered advisable for injuries to peripheral nerves to prescribe massage after therapeutic exercises, as it relieves fatigue, or before a physiotherapeutic procedure as preparation (vasodilation) for it.

• The sequence of procedures for radiculitis (cervicothoracic, lumbosacral) depends on the severity of the pain syndrome: in case of severe pain, massage is done before LH, when pain subsides - before and after LH.

• Massage before applying an orthopedic product to a limb is useful. Preliminary massage of the limb and light stroking of the palmar surface of the II or II and III fingers of the muscle, which contracts when the limb moves while in a movable splint, increases the effectiveness of orthopedic measures.

It should be noted that a set of physical procedures (heat treatment, massage, electrical procedures, light therapy, reflexology, etc.) is prescribed and recommended only by the attending physician. The therapist treating the patient applies certain methods of influence, based on the pathology of the disease, the patient's susceptibility to this procedure, and the patient's condition at the time of treatment.

* N. A. Belaya - Doctor of Medical Sciences, Professor, Consultant of the 4th Moscow Medical and Physical Education Dispensary.

UDC 61 BBK54.132

Developer organization:

Bashkir State Medical University, Research Institute of Regenerative Medicine and Balneology

Compiled by: L. T. Gilmutdinova, S. A. Vecherova

Reviewers: Professor Yu. O. Novikov, Professor R. S. Nizamutdinova"

Physiotherapist's Quick Guide: Methodological recommendations K78 / comp. L. T. Gilmutdinova, S. A. Vecherova. Ufa: DesignPolygraph-Service, 2007. 40 p. ISBN 978-5-94423-119-2

UDC 61 BBK54.132

SBN 978-5-94423-119-2

"Research Institute of Regenerative Medicine and Balneology BSMU, 2007

REQUIREMENTS FOR REGISTRATION OF PASSPORTS OF DEPARTMENTS AND PHYSIOTHERAPY OFFICES

Basic rules for organizing physiotherapy departments and rooms regulated by the state standard OST 42-21-16-86 “Design, operation and safety precautions of physiotherapy departments (offices)”, approved by Order of the USSR Ministry of Health No. 1453 of November 4, 1986. Based on this document, a “passport” of the physiotherapy department (office) is issued .

The passport is a file of regulatory documentation used in the work of the service:

• name of health care facility, location, full address;
• indication of the type of physiotherapy;
• operating procedure of the department (office) 1-1.5- or 2-shift work;
• sanitary and hygienic characteristics of the premises: number of rooms, area, presence and type of ventilation, water supply, sewerage, location of equipment;
• list of equipment according to the scheme:

Table 1

Device name	Quantity	Year of issue	Passports	Since what time has it been working?	Since when has it not been working?	For 1 device per shift (average per year)

List of department (office) employees according to the form:

table 2

Note. Copies of employee certificates and IDs are attached to the list

List of regulatory documentsin the passport of the physiotherapy department:

1. A log of safety briefings and a log of preventive inspection and repair of equipment (the form is attached to OST 42-21-16-85).
2. Order No. 1440 of December 21, 1984 “On approval of standard units for the performance of physiotherapeutic procedures, time standards for massage, regulations on physiotherapeutic units and their personnel.” The order approved the regulations on the physiotherapy clinic and hospital, the coefficients of procedures performed by nurses in physiotherapy rooms.
3. The positions of physiotherapists and nurses are determined by orders of the USSR Ministry of Health No. 999 of October 1982, No. 600 of June 6, 1979 and No. 900 of September 26, 1978.
4. Order of the Ministry of Health of the USSR No. 1000 of September 23, 1981 “On measures to improve the organization of work in outpatient clinics,” which stipulates the workload standards and working hours of a physiotherapist and a physiotherapy nurse.
5. Order of the Ministry of Health of the Russian Federation No. 337 of August 20, 2001 “On measures for the further development and improvement of sports medicine and exercise therapy” on the workload standards for doctors in physical therapy, sports medicine, massage nurses and exercise therapy instructors.
6. Order of the Ministry of Health of the RSFSR No. 245 of August 30, 1991 “On standards for the consumption of ethyl alcohol for healthcare, education and social security institutions.”
7. Collection of official guidelines for the organization of cancer care, 1985.
8. Decree of the Government of the Russian Federation No. 101 of February 14, 2003 “On the working hours of medical workers depending on their position and (or) specialty.”
9. Standard instructions on labor protection for personnel of departments and physiotherapy rooms, approved by the USSR Ministry of Health on August 8, 1987.
10. Letter of the USSR Ministry of Health No. 02-14/28 dated May 30, 1978 “On the positions of physical therapy nurses in tuberculosis and infectious diseases hospitals.”
11. Order of the Ministry of Health of the Russian Federation No. 377 of October 15, 1999 “On approval of the regulations on remuneration of healthcare workers.” The order stipulates benefits and a 15% additional payment to the salary.
12. Resolution of the Ministry of Labor and Social Protection of the Russian Federation of June 8 1992 No. 17, section 2, paragraph 24 “On a 15% bonus to the official salary of doctors and nurses working with laser systems.”
13. Order of the Ministry of Health of the Russian Federation No. 90 of March 14, 1996 “On mandatory admission re-employment and periodic (at least once a year) medical examination of PTO personnel.”
14. Collection of staffing standards and standard staffing levels for healthcare institutions. / Ed. S. P. Burenkova. M.: Medicine, 1986.
15. Order of the USSR Ministry of Health No. 1-M dated January 3, 1956 “On staffing standards for sanatorium and resort institutions.”
16. Resolution of the All-Russian Central Council of Trade Unions of 1986 on staffing standards and workload standards for medical personnel in sanatorium and resort institutions.
17. Order of the Ministry of Health of the Russian Federation No. 249 of August 19, 1997 “On the qualification characteristics of specialists with secondary medical and pharmaceutical education.”
18. Law of the Russian Federation of June 28, 1991 “On medical insurance of citizens of the RSFSR.”
19. Decree of the Government of the Russian Federation No. 41 of January 23, 1992 “On measures to implement the law.”
20. “Foundations of the legislation of the Russian Federation on the protection of the health of citizens” No. 5487-1 of July 22, 1993;
21. Model rules for compulsory health insurance.
22. Register of medical services.
23. Tariffs for medical services in the system.
24. Law of the Russian Federation No. 2-FZ of January 9, 1996 “On the protection of consumer rights.”
25. Order No. 297 of July 1, 2003 “On the doctor of rehabilitation medicine.”
26. Order of the Ministry of Health of the Russian Federation No. 296 of July 1, 2003 “On improving the organization of rehabilitation treatment in the Russian Federation.” This order approves the regulations on the organization of the Center’s activities restorative medicine and rehabilitation and instructions for the referral and selection of patients for rehabilitation treatment.
27. Order of the Ministry of Health of the Russian Federation No. 1453 of November 4, 1986 “On the introduction into force of the industry standard OST 42-21-16-86 SSBT. Departments, physiotherapy rooms. General safety requirements."
28. Order of the Ministry of Health of the Russian Federation No. 534 of August 22, 2005 “On measures to improve the organization of neurorehabilitation care for patients with afterbirth effects of stroke and traumatic brain injury.”
29. Order of the Ministry of Health of the Russian Federation No. 633 of October 13, 2005 “On the organization of medical care.”
30. Decree of the Government of the Russian Federation No. 124 of June 6, 2003 “On the implementation of sanitary and epidemiological rules and regulations SanPiN 2.1.3.1375-03.”
31. Law of the Republic of Belarus No. VS-12/31 of June 15, 1992 “On medical insurance of citizens in the Republic of Belarus.”
32. Order of the USSR Ministry of Health No. 288 dated March 23, 1976 “On approval of Instructions tions on the sanitary and anti-epidemic regime of hospitals and on the procedure for the implementation by bodies and institutions of the sanitary and epidemiological service of state sanitary supervision over the sanitary condition of medical institutions.”
33. Order of the Ministry of Health of the Russian Federation No. 1000 of April 24, 2003 “On introducing amendments and additions to the order of the Ministry of Health of the Russian Federation No. 377 of October 15, 1999.”
34. Order of the Ministry of Health of the Russian Federation No. 52 of January 31, 2006 “On introducing changes to the list of compliance of medical and pharmacist specialties with positions of specialists, approved by Order of the Ministry of Health of the Russian Federation No. 377 of August 27, 1999.”
35. Order of the Ministry of Health of the Russian Federation No. 241 of June 9, 2003 on introducing an amendment to the order of the Ministry of Health of the Russian Federation No. 377 of August 27, 1999 “On the nomenclature of specialties” in healthcare institutions of the Russian Federation."
36. Order of the Ministry of Health of the Russian Federation No. 434 of September 16, 2003 “On approval of the requirements for the qualifications of a doctor in physical therapy and sports medicine.”
37. Order No. 753 of December 1, 2005 “On equipping outpatient clinics and inpatient clinics in municipalities with diagnostic equipment.” In addition to the specified regulatory documentation, the “passport” of the office is supplemented by orders on the profile of the institution and the sanitary and epidemiological regime of the institution (orders on AIDS, OOP, hepatitis prevention, etc.).

Copies of the following documents are also required:

1. Certificate with the attachment of the licensing and accreditation commission under the Ministry of Health of the Republic of Belarus
2. License and protocol thereto.
3. Certificate of inspection of the sanitary and hygienic condition of physiotherapy premises therapeutic department (office).
4. Sheets of stamping of physiotherapeutic equipment.
5. Conclusions on compliance with the requirements at the license applicant’s facilities fire safety.
6. Conclusions on the condition of medical equipment (agreements with a medical equipment company)
7. Technical report on commissioning and testing of electrical installations.
8. Protocol for checking the presence of a circuit between the ground loop and ground line elements.
9. Protocol for testing the insulation resistance of electrical equipment.
10. Protocol for measuring the spreading resistance of main grounding conductors.
11. Regulations on the physiotherapist of health care facilities.
12. Regulations on the physical therapy nurse at health care facilities.
13. Job description of a physiotherapist.
14. Job description of a medical nurse (office).
15. Methods of physiotherapeutic treatment used in this institution.
16. Monthly and annual reports on the work done by doctors and nurses according to the scheme: for everyone specialist working in the department individually(additions are possible at the discretion of the administration): total patients (including primary ones), total procedures (medical, nursing), completed treatment (received 7 or more procedures) patients, number of procedures per patient completed treatment (for each type of treatment), total units (for doctors and nurses according to orders by specialty individually),% of patients who completed treatment, number of days worked, workload per shift per specialist (based on the number of patients received or units according to orders in the specialty individually), in the presence of disabled people, visually impaired, specify the load; load on each medical device (simulator) per shift (for nurses and doctors, if they perform medical procedures). The number of procedures per patient is calculated from the following indicators: total procedures for a given type of treatment and the number of patients who completed treatment, when dividing them by each other.

The number of procedures received per person treated in a health care facility (sanatorium) is the sum of all types of treatment offered in this institution, including medical ones.

The basis of a rational approach to meeting the annual planned need of healthcare institutions for physiotherapeutic equipment is the development of a form for physiotherapeutic equipment. The register is based on the Register of Medical Equipment Products. The form is a list of necessary apparatus and devices for non-invasive treatment with preformed physical factors, sufficient to meet the needs of the physiotherapeutic service of treatment, preventive and sanatorium institutions of various levels and profiles. The form can include up to 60 names of devices and devices contained in the Register of Medical Equipment. Formulary restrictions provide significant cost savings. When developing a formulary list, each institution should take into account:

1. Nosological categories of patients requiring the appointment of certain methods of hardware treatment.
2. ABC analysis, which allows you to obtain an objective picture of the expenditure of funds from the budget of a medical institution. Represents the distribution of devices into three groups in accordance with the frequency of their use (A the most frequently used, for which up to 70-80% of the budget is used; B average level of use, C low frequency of use).
3. VEN analysis of physical methods of treatment in accordance with their classification into vital (Vital) methods important for saving life and necessary for its maintenance; necessary (Essential) effective in treating less dangerous but serious diseases and states and minor ( Non- essential) methods of treating mild and non-life-threatening diseases.

Table 3 Sample form for physiotherapy equipment

No.	Selection devices		Number of devices (items) in health care facilities, per number of beds
	Apparatus for galvanization and medicinal electrophoresis
	Electrosound therapy device
	Apparatus for local darsonvalization
	Apparatus for treatment with supra-tonal frequency current
	Portable UHF therapy device
	Eddy current applicator EVT-1
	Portable microwave therapy device
	Mobile microwave therapy device
	Device for high-frequency magnetic therapy
	Apparatus for treatment with traveling magnetic field
	Device for pulsed magnetic therapy
	Infrared lamp "Sollux" tabletop
	Mercury-quartz irradiator on a tripod
	Protective glasses for eyes from ultraviolet rays during therapeutic irradiation
		Biodosimeter for ultraviolet irradiation (Gorbachev Danfeld)
		Steam inhaler
		Biocontrolled aeroionotherapy device
		Dry salt aerosol therapy device
		Specialized device for ultrasound therapy (ENT, gynecology, dentistry, etc.) according to the profile of the departments
		Apparatus for saturating water with carbon dioxide
		Device for monitor bowel cleansing
		Bath for underwater spinal traction
		Electric paraffin heater
		Thermochemical heating pad
		Treatment clock with electric sound signal
		Aquadistiller
		Drying and sterilization cabinet
		Forceps straight Shch-20-1
		Ethyl alcohol (ethanol), g/procedure
		Medical ether (diethyl ether), g/procedure
		Dressing scissors, straight, length 235 mm
		Rubber bandages, pcs.
		Non-sterile medical gauze bandages 7 m x 1 4 cm tttt
		Non-sterile medical gauze bandage, size 5 m x 7 cm, pcs.
		Medical hygroscopic surgical cotton wool
		Medical hygroscopic gauze, m
		Rubber fabric oilcloth lining, m
		Bike (flannel) white, m
		Measuring tape, pcs.
		Filter paper, kg
		Procedural map f. 044/у, pcs.

CLASSIFICATION PREFORMED PHYSICAL FACTORS

(Ponomarenko G. N., 2006)

Table 4

Methods of therapeutic use of electric current,

Type and nature of currents, fields and radiation	Methods of therapeutic use
Direct electric current
Continuous Pulse	Galvanization Drug electrophoresis Electrosleep therapy Transcranial electroanalgesia Electrical stimulation Diadynamic therapy * Short-pulse electroanalgesia
Alternating electric current
Low frequency Mid frequency	Interference therapy Fluctuarization Ultratonotherapy Amplipulse therapy Local darsonvalization
Electric field
Constant Pulse Pulse low frequency High and ultra high frequency	Franklinization Electrostatic massage Infitatherapy UHF therapy
A magnetic field
Constant Pulse Low Frequency High Frequency	Permanent magnetotherapy Pulsed magnetotherapy Low-frequency magnetotherapy High-frequency magnetotherapy
Radio frequency electromagnetic radiation
Ultra-high frequency decimeter centimeter Extremely high frequency		Microwave therapy decimeter wave therapy centimeter wave therapy EHF therapy
Electromagnetic radiation in the optical range
Infrared radiation Visible radiation Ultraviolet radiation: long-wave (LUV) medium-wave (SUV) short-wave (AF) Monochromatic coherent radiation		Infrared irradiation Chromotherapy Ultraviolet irradiation: long-wave medium-wave short-wave Laser therapy Photodynamic therapy

Table 5Methods of therapeutic application of mechanical factors

Type and nature of the factor	Methods of therapeutic use
Mechanical stress
Created by hand Created by needles
Mechanical vibrations
Vibration Ultrasound	Vibration therapy Ultrasound therapy Medicinal ultraphonophoresis
Airspace factors
Periodically changing atmospheric pressure Gas mixtures with different partial pressures Aeroions Aerosols	Local barotherapy Hypobarotherapy Positive end-expiratory pressure ventilation (PEEP) Positive pressure ventilation (CPAP therapy) Normobaric hypoxic therapy Oxygen barotherapy Long-term low-flow oxygen therapy Aeroion therapy Aerosol therapy Halotherapy

Table 6Methods of therapeutic use of thermal factors

Type and nature of the factor	Methods of therapeutic use
Fresh water	Hydrotherapy: wet wrapping, dousing - rubbing - souls. - baths - intestinal lavage
water vapor
Ice and other refrigerants	Cryotherapy
	Paraffin therapy
Ozokerite	Ozocerite therapy
Chemical coolants	Batch Heat Therapy
Chemical refrigerants	Batch cryotherapy

Therapeutic use of electric current,electromagnetic fields and radiation

DIRECT CONTINUOUS ELECTRIC CURRENTS

Galvanization the therapeutic use of a constant, time-invariant electric current of low voltage and low strength. Under the influence of an applied external electromagnetic field, a conduction current arises in tissues, which causes a change in the ratio of ions in cells and intercellular spaces.

Therapeutic effects: anti-inflammatory (draining-dehydrating), analgesic, sedative (at the anode), vasodilator, muscle relaxant, secretory (at the cathode).

Indications: inflammatory diseases of the gastrointestinal tract (chronic gastritis, gastric and duodenal ulcers, chronic cholecystitis, hepatitis, colitis), diseases of the musculoskeletal system, diseases of the peripheral nervous system (neuralgia, neuritis, plexitis, radiculitis), functional diseases of the central nervous system with autonomic disorders and sleep disorders , hypertonic disease I-P stages, hypotension, diseases of the eyes, ENT organs, skin, chronic diseases of the female genital organs, etc.

Contraindications: acute and purulent inflammatory processes of various localizations, skin sensitivity disorders, individual intolerance to current, violation of the integrity of the skin at the sites where electrodes are applied, eczema.

Drug electrophoresis the combined effect on the body of a direct electric current and a medicinal substance administered with its help.

Therapeutic effects: potentiation of the effect of galvanization and spices physical pharmacological action of a drug substance administered by current.

Indications: determined by the pharmacological properties of the drug and the presence of indications for galvanization.

Contraindications: determined by contraindications to the use of the administered drug.

CONSTANT PULSE ELECTRIC CURRENTS Electrosleep therapy therapeutic effect of pulsed currents on hypnogenic structures of the brain.

Therapeutic effects: hypnotic, sedative, antispasmodic, tro physical, secretory.

Indications: diseases of the central nervous system (neurasthenia, reactive and asthenic conditions, disturbance of night sleep, logoneurosis), diseases of the cardiovascular system (atherosclerosis of cerebral vessels in the initial period, coronary heart disease, angina pectoris I-P FC, hypertension stage I-P , peptic ulcer of the stomach and duodenum, bronchial asthma, neurodermatitis, eczema, enuresis.

Contraindications:

Devices:"ES-10-5", "Electroson-4T" Russia.

Transcranial electroanalgesia therapeutic effect of pulse currents on the antinociceptive endogenous opioid system of the brain stem (posterior, lateral, some anterior nuclei of the brain pothalamus, lateral septal area, cingulate fasciculus, periaqueductal gray matter, dorsal hippocampus, habenulointerpeduncular tract and raphe nuclei).

Therapeutic effects: analgesic, vasodilator, reparative and regenerative, sedative, anti-withdrawal.

Indications: pain syndromes associated with craniocerebral lesions spinal nerves (trigeminal neuralgia, sensorineural hearing loss) and disorders of spinal innervation (spondylogenic radicular and autonomic pain), phantom pain, neurocirculatory dystonia of all forms, coronary heart disease, angina pectoris I-P FC, peptic ulcer of the stomach and duodenum, pruritic dermatoses, neurasthenia, fatigue, anesthesia during surgery, acute alcohol withdrawal syndrome, nervous-emotional tension, sleep disturbance, meteopathic reactions.

Contraindications:angina pectoris, myocardial infarction, renal colic, childbirth, short-term short-term surgical interventions), closed brain injuries, epilepsy, diencephalic syndrome, thalamic pain, cardiac arrhythmia, skin damage at the sites where electrodes are applied.

Devices:"TRANSAIR" Russia.

Electrical stimulation therapeutic use of pulsed currents (direct and alternating) to restore the activity of damaged muscle nerves as well as internal organs containing smooth muscle elements in their walls (bronchi, gastrointestinal tract).

Contraindications: epilepsy, decompensated heart defects, electric current intolerance, inflammatory eye diseases (conjunctivitis, blepharitis).

Therapeutic effects: trophostimulating, vasodilating, myo-neurostimulating, catabolic, plastic.

Indications: primary muscle atrophy developing as a result of damage to the peripheral motor nerves (poliomyelitis, polynev rhitis, plexitis, radiculoneuritis, traumatic neuritis, osteochondrosis with severe radicular syndrome, cerebral palsy), flaccid paralysis with the presence of pain and severe trophic disorders, secondary muscle atrophy as a result of prolonged immobilization after bone fractures, physical inactivity, in diseases and traumatic injuries of the joints, fatigue, enuresis, atony of smooth muscles of internal organs (stomach, intestines, biliary system, bladder).

Contraindications: acute inflammatory purulent processes, spastic paralysis and paresis, increased electrical excitability of muscles, with friendly pathological muscle contractions, early stages of contracture development, joint ankylosis, bone fractures before their consolidation, varicose and post-thrombotic disease, hemorrhagic stroke.

Diadynamic therapy therapeutic effect on the body of diadynamics ical pulse currents.

Therapeutic effects: myoneurostimulating, analgesic, vasodilator, trophostimulating.

Indications: acute and subacute diseases of the peripheral nervous systems (radiculitis, neuritis, radiculoneuritis, sympathalgia, spinal cord injuries), acute traumatic injuries of the musculoskeletal system (ligament damage, bruise, myalgia, periarthritis, muscle atrophy), diseases of the arteries and veins, hypertension Stages I-II, bronchial asthma, diseases of the gastrointestinal tract (non-calculous cholecystitis, biliary dyskinesia, atonic and spastic colitis, pancreatitis), rheumatoid arthritis, enuresis, deforming osteoarthritis, ankylosing spondylitis, chronic inflammatory diseases of the female genital organs gans, adhesive disease.

Contraindications: bone fractures with non-immobilized bone fragments, urinary and cholelithiasis, thrombophlebitis, acute pain of visceral origin (coronary heart disease, angina pectoris class III, myocardial infarction, renal colic, childbirth, surgical procedures), increased sensitivity to electric current, multiple sclerosis.

Short-pulse electroanalgesia. therapeutic effect of pulsed currents on the painful focus.

Therapeutic effects: analgesic, vasodilator, trophostimulating.

Indications: pain syndromes associated with damage to peripheral nerves (neuralgia, neuritis), phantom pain syndrome, pain syndrome of vertebrogenic etiology, analgesic component in general combined anesthesia.

Contraindications: acute pain of visceral origin (with angina pectoris, myocardial infarction, renal colic, childbirth, surgical procedures), diseases of the lining of the brain (encephalitis and arachnoiditis), neuroses, psychogenic and ischemic pain.

Amplipulsetherapy therapeutic effect on the body with sinusoidal modulated currents.

Therapeutic effects: neuromyostimulating, analgesic, vasodilator, trophic.

Indications: diseases of the central nervous system with motor, vegetative-vascular and trophic disorders, diseases of the peripheral nervous system with pain syndrome (causalgia, neuromyo zit, neuralgia, lumbago, radiculitis, sympathalgia), hypertension I-II stages, diseases of the respiratory system (chronic bronchitis, bronchial asthma), gastrointestinal tract (functional stomach disorders, peptic ulcer of the stomach and duodenum, reflux esophagitis, dyskinetic constipation, biliary dyskinesia), joint diseases (rheumatoid arthritis, deforming arthrosis, periarthritis), inflammatory diseases of the pelvic organs, enuresis.

Contraindications: acute and subacute inflammatory diseases internal organs, fractures with non-immobilized bone fragments, cholelithiasis and urolithiasis, increased sensitivity to electric current, psychosis, multiple sclerosis, post-thrombotic disease.

Therapeutic effects: myoneurostimulating, analgesic, tro fostimulant, antispasmodic, vasodilator.

Indications: pain syndromes with overirritation of pain sensitivity conductors and autonomic fibers (vegetalgia, neuralgia, radiculopathy, herpes zoster), diseases and injuries of the musculoskeletal system (bruise, ligament damage, bone fractures after immobilization), vasospasms, stage I-II hypertension, obliterative endarteritis, Raynaud's disease, diseases of the gastrointestinal tract (chronic gastritis, biliary dyskinesia, atonic and spastic colitis), deforming arthrosis (especially of large joints), inflammatory diseases of the female genital organs.

Contraindications: acute inflammatory diseases of internal organs, fractures with non-immobilized bone fragments, che- and urolithiasis, thrombophlebitis, implanted pacemakers, skin defects in the affected area, intra-articular fractures with hemarthrosis in the early period (2 weeks).

Fluctuarization therapeutic use of alternating currents with spontaneously changing frequency and amplitude.

Therapeutic effects: local myostimulating, trophostimulating, anti-inflammatory, analgesic.

Indications: diseases of the peripheral nervous system with pain syndrome (causalgia, neuromyositis, myalgia, glossalgia, neuralgia, osteochondrosis), pain after tooth extraction, gum disease, chronic inflammatory diseases of superficial tissues, arthritis of the temporomandibular joint.

Contraindications: acute infectious diseases, thrombophlebitis, obliterating endarteritis, vibration disease, obsessive-compulsive neurosis, vestibular disorders, individual intolerance to current, post-infarction cardiosclerosis (within 6 months).

Devices:"FT-30-05", "FS-100" Russia.

Ultratonotherapy therapeutic use of high voltage alternating currents.

Therapeutic effects: local anti-inflammatory, vasodilator fiery, catabolic.

Indications: neuritis and neuralgia of the cranial nerves, inflammatory diseases of the skin and mucous membranes of the oral cavity, nose, external ear, herpes zoster, seborrheic alopecia, neurodermatitis, long-term non-healing wounds and ulcers, chronic diseases of the female genital organs, prostatitis.

Contraindications: increased sensitivity to electric current.

Devices:"Ultraton", "Ultradar" Russia.

ALTERNATING ELECTRIC CURRENT OF MIDDLE FREQUENCY

Local darsonvalization therapeutic effect on individual parts of the patient’s body with a weak pulsed alternating current of medium frequency and high voltage.

Therapeutic effects: analgesic, vasodilator, trophostimulating, anti-inflammatory, antipruritic, bactericidal.

Indications: diseases of the peripheral nervous system with pain syndrome (neuralgia, neuromyositis, spinal osteochondrosis, hypoesthesia, paresthesia), sensorineural hearing loss, neurocirculatory dystonia of the cardiac type, migraine, sleep disorders, enuresis, alopecia, varicose veins, hemorrhoids, diseases of the oral mucosa, trophic ulcers and skin lesions, itchy dermatoses, eczema, non-healing wounds, vasomotor rhinitis, inflammatory diseases of the female genital organs, prostatitis, impotence.

Contraindications: individual intolerance to current, pain when introduction of cavity electrodes.

Devices: "Iskra-1".

ELECTRIC FIELD TREATMENT

Franklinization therapeutic effect on the patient with a constant high-intensity electric field.

Therapeutic effects: sedative, actoprotective, analgesic, vasodilator.

Indications: functional diseases of the central nervous system (neurasthenia, asthenic condition, migraine, sleep disorders), paresthesia, hypersthesia, neurocirculatory dystopia of the hypertensive type, stage I-II hypertension, skin itching, neurodermatitis, trophic ulcers, fatigue, decreased performance.

Contraindications: depressive states, organic diseases of the central nervous system, conditions after acute cerebrovascular accident (in the first 3 months).

Inphytatherapy therapeutic application of pulsed low-frequency electric field of low intensity.

Therapeutic effects:

Indications: hypertension, vegetative-vascular dystonia, bronchitis, bronchial asthma, restoration of performance, allergies.

Contraindications: hypersensitivity to electric and electromagnetic fields, pregnancy.

Electrostatic massage therapeutic use of high-intensity pulsed electric fields.

Therapeutic effects: myostimulating, vasodilating, trophic.

Indications: diseases of the musculoskeletal system, myositis, neuritis, local trophic disorders, skin diseases.

Contraindications: skin sensitivity disorders and reducing the integrity of the skin in the affected area. "

Ultrahigh frequency (UHF) therapy therapeutic use of the electrical component of the alternating electromagnetic field of high and ultra-high frequencies.

Therapeutic effects: anti-inflammatory, secretory, vasodilator, muscle relaxant, immunosuppressive, enzyme stimulating.

Indications: inflammatory, including acute, processes of various localization (furuncle, carbuncle, abscess, phlegmon, felon, etc.), acute and subacute inflammatory diseases of various internal organs (lungs, stomach, liver, genitourinary organs), injuries and diseases of the musculoskeletal system system and peripheral nervous system, frostbite pain, phantom pain, causalgia and other diseases of the peripheral vessels of the extremities, diseases occurring with a pronounced allergic component (bronchial asthma, chronic obstructive bronchitis, rheumatoid arthritis), vegetative-vascular dysfunctions, hypertension I-II stages, menopausal and post-menopausal syndromes.

Contraindications: aortic aneurysm, hypotension, coronary heart disease, angina pectoris class III, presence of artificial cardio stimulant in the area of ​​influence, formed purulent focus of inflammation, purulent sinusitis, vascular lesions of the brain, pregnancy from the 3rd month.

MAGNETOTHERAPY

Permanent magnetic therapy therapeutic use of permanent magnetic fields.

Therapeutic effects: coagulocorrecting, immunostimulating, enzyme-stimulating.

Indications: polyneuritis, radiculitis, neurocirculatory dystonia of the hypertensive and cardiac types, diseases of the arteries and veins of the extremities, trophic ulcers, diseases of the musculoskeletal system.

Contraindications: coronary heart disease, angina pectoris III FC, aortic aneurysm, severe hypotension, the presence of artificial pacemakers.

Magnetic recorders, magnetoelastas, insoles, and bracelets are used.

Pulse magnetic therapy therapeutic use of high-intensity magnetic field pulses.

Therapeutic effects: neuromyostimulating, vasodilating, trophostimulating, analgesic, anti-inflammatory (drainage dehydrating).

Indications: diseases and injuries of the peripheral nervous system (plexitis, radiculitis, etc.), degenerative-dystrophic diseases of bones and joints (osteochondrosis, deforming spondylosis of the spine, glenohumeral periarthritis), consequences of traumatic brain injury with movement disorders, slow-healing wounds, trophic ulcers.

Contraindications: coronary heart disease, angina pectoris III FC, diffuse toxic goiter III degree, cholelithiasis, diseases of the arteries and veins of the extremities, the presence of artificial pacemakers in the affected area, acute and purulent inflammatory diseases.

Low frequency magnetic therapy therapeutic use of the magnetic component of a low-frequency alternating electromagnetic field. Is Various types of low-frequency magnetic fields are used: alternating (PeMF), pulsating (PuMP), rotating VrMP) and traveling (BeMP).

Therapeutic effects: vasodilator, catabolic, anti-inflammatory (draining-dehydrating), actoprotective, trophy chelic, hypocoagulant.

Indications: coronary heart disease, angina pectoris class I-II, post-infarction cardiosclerosis, stage I hypertension, peripheral vascular disease of the extremities, consequences of closed brain injuries and ischemic stroke, diseases and damage to the peripheral nervous system, neuroses, vegetalgia, chronic inflammatory diseases of internal organs (lungs, stomach, liver, duodenum, kidneys, genitals), bone fractures, arthrosis and arthritis, osteomyelitis, periodontal disease, ENT diseases, slow-healing purulent wounds, burns, keloid scars.

Therapeutic effects: sedative, vasodilator.

Contraindications: individual hypersensitivity to the factor, condition after myocardial infarction (1-3 months), hemorrhagic stroke, coronary heart disease, angina pectoris III FC ,hypertension, presence of pacemaker.

POLYGAM-01 (low-frequency low-intensity MP) - ELAMED-Russia.

POLYUS-ZU (extra- and intracavitary nozzles) - therapy with a pulsed rotating electromagnetic field.

High frequency magnetic therapy therapeutic use of the magnetic component of the electromagnetic field of high and ultra-high frequencies

Therapeutic effects: anti-inflammatory, vasodilator, secretory, muscle relaxant, immunosuppressive, catabolic,

Indications: subacute and chronic inflammatory diseases of internal organs (bronchitis, pneumonia, cholecystitis, glomerulonephritis, adnexitis, prostatitis), peptic ulcer of the stomach and duodenum, muscle contractures, vasospasms, metabolic and post-traumatic arthrosis, hypertension stage I-II, diseases occurring with severe allergic component (bronchial asthma, chronic obstructive bronchitis, rheumatoid arthritis).

Contraindications: acute and purulent inflammatory diseases, coronary heart disease, angina pectoris 3 FC, the presence of metal objects (tubes, buckles, keys, fragments, fonts) and artificial pacemakers in the affected area, severe hypertension, a formed focus of inflammation, purulent sinusitis, hemorrhagic stroke.

Therapeutic effects of artificially modified air environment

EXPOSURE TO PERIODICALLY CHANGING ATMOSPHERIC PRESSURE

Local barotherapy-therapeutic effects of compressed or rarefied air on the patient’s tissues. Local (local) exposure to air with pressure below atmospheric pressure is called vacuum massage.

Therapeutic effects: catabolic, antispasmodic. Anti-inflammatory, vasodilator.

Indications: osteochondrosis of the cervicothoracic and lumbosacral spine, neuralgia, myalgia, intestinal atony, pneumonia in the recovery stage, atonic colitis, pyelonephritis, prostatitis.

Contraindications: acute inflammatory diseases of the skin and subcutaneous tissue (pyoderma, furunculosis, abscess), venous disease of the lower extremities, elephantiasis, coronary heart disease, angina pectoris FC 3, stage 2 hypertension, reconstructive vascular surgery.

Equipment: vacuum massager VM-01 "Electronics" ("Axion-Holding"), pressotherapy equipment Pressomed (Italy), PULSTAR from MEDIK SYSTEMS (France), vacuum roller massager (STARVAC SP) from the same company, apparatus for vacuum therapy Physiodyn-V etc., from PHYSIOMED (Germany).

Hypobarotherapy- therapeutic use of air under reduced atmospheric pressure.

Therapeutic effects: adaptive, hemostimulating, metabolic, detoxifying, immunomodulating, reparative-regenerative, actoprotective.

Indications: chronic inflammatory lung diseases (chronic bronchitis, mild and moderate bronchial asthma), neurocirculatory dystonia of hypertensive and mixed types, stage 1 hypertension, post-infarction cardiosclerosis (6 months), iron deficiency anemia in remission, toxic blood lesions, diabetes mellitus diabetes, neurasthenia, asthenic condition, vegetative-vascular dysfunctions, chronic inflammatory diseases of the female genital organs, preparation for childbirth.

Contraindications: consequences of traumatic brain injury, cerebrovascular accidents, fibroids and uterine fibroids, hepatitis, renal failure, diabetes mellitus in the stage of decompensation, diffuse toxic goiter, ENT diseases with impaired barofunction, claustrophobia.

Positive End Exit Pressure Ventilation (PEEP) - a method of therapeutic effects on the respiratory tract with an air mixture with increased atmospheric pressure (PEEP method from “Positive End-Expiratory Pressure”).

Therapeutic effects: bronchodrainage , mucolting, recompression.

Indications: chronic obstructive pulmonary disease, aspiration syndrome, pulmonary atelectasis, chronic asthmatic bronchitis, pulmonary edema.

Contraindications: bronchial asthma with frequent and severe attacks, panacinar pulmonary emphysema, persistent gas embolism, severe pneumosclerosis.

Continuous positive pressure ventilation (CPAP-tera)Piya,) a method of therapeutic treatment of a patient’s airways with high air pressure throughout the entire respiratory cycle (CPAP therapy from “Continuous Positive Airways Pressure”).

Therapeutic effects: recompression, bronchodrainage, mucoltic.

Indications: acute inflammatory lung diseases, obstructive sleep apnea, increased upper respiratory resistance syndrome pathways, pneumofibrosis, pneumoconiosis, cerebral edema.

Contraindications: severe bronchial asthma, exudative pleurisy, severe pneumosclerosis and emphysema, bronchiectasis, chronic lung abscesses, spontaneous pneumothorax, condition after lung surgery in the presence of fistulas.

EXPOSURE TO GASESWITH DIFFERENT PARTIAL PRESSURE

Normobaric hypoxic therapy is the therapeutic use of a hypoxic gas mixture alternating with breathing atmospheric air. (reoxygenation of body tissues).

Therapeutic effects: adaptation, hemostimulating, metabolism chemical, bronchodrainage, immunomodulatory, reparative-regenerative.

Indications: chronic nonspecific lung diseases (chronic obstructive bronchitis in remission, pneumonia in convalescence, dry and exudative pleurisy), bronchial asthma with rare attacks, neurocirculatory dystonia of hypertensive and mixed types, hypertension Stage I, coronary heart disease FC I-II, post-infarction cardiosclerosis (6 months), iron deficiency deficiency and hypoplastic anemia, thyrotoxicosis, metabolic disorders, neurasthenia, asthenic conditions, vibration disease.

Contraindications: acute pneumonia at its height, obstructive respiratory diseases, pleural adhesions, bronchial asthma with frequent and severe attacks, bronchiectasis, acute infectious diseases, stage II hypertension, consequences traumatic brain injury, cerebrovascular accidents, fibroids and uterine fibroids, individual intolerance to oxygen deficiency. Oxygen barotherapy therapeutic use of gas mixtures with increased partial pressure of oxygen.

Therapeutic effects: adaptation, metabolic, detoxification nal, bactericidal, immunostimulating, reparative-regenerative, actoprotective, vasopressor.

Indications: neurocirculatory dystonia, gastric and duodenal ulcers, nonspecific ulcerative colitis, acute and chronic hepatitis, sepsis, peritonitis, obliterating vascular diseases of the extremities, diseases and injuries of the musculoskeletal system, diseases and injuries of the oral mucosa, long-term non-healing wounds, trophic ulcers, burns, anaerobic infection, toxic blood damage (poisoning with carbon monoxide, poisonous mushrooms, etc.), thyrotoxicosis, diabetes mellitus, neurasthenia, asthenic conditions, chronic inflammatory diseases of the female genital organs gans, preparation for childbirth.

Contraindications: circulatory failure stage II, coronary heart disease, angina pectoris I-III FC, hypertensive stage 1-P disease, consequences of traumatic brain injury, fibroids and uterine fibroids, acute ENT diseases with impaired barofunction, claustrophobia, acute and chronic inflammatory diseases of the respiratory system (bronchitis, tracheitis, exudative and dry pleurisy).

Equipment: chamber capsules for individual and group hypo- and hyperbarotherapy, ventilators for the upper respiratory tract with constant air movement (ISTOK-SYSTEMA, NPO, Russia).

Long-term low-flow oxygen therapy is a method of prolonged breathing of a patient with an air mixture enriched with oxygen, under slight pressure.

Therapeutic effects: catabolic, bronchodilator, reparative-regenerative.

Indications: chronic obstructive pulmonary diseases with respiratory failure stages I-P, cor pulmonale, obstructive apnea syndrome.

Contraindications: acute and chronic (in the acute stage) inflammatory lung diseases, severe emphysema, bronchial asthma with frequent and severe attacks.

EXPOSURE TO IONIZED AIR

Aeroionotherapy method of therapeutic use of air ions.

Therapeutic effects: metabolic, immunostimulating, bronchial drainage, vasoactive, bactericidal.

Indications: bronchial asthma with infrequent and mild attacks, chronic asthmatic bronchitis, pneumonia in the reverse phase, chronic obstructive bronchitis, inactive pulmonary tuberculosis, bronchiectasis, occupational lung diseases, diseases of the peripheral nervous (paresthesia, hyperesthesia, neuralgia, myositis) and cardiovascular ( neurocirculatory dystonia of the hypertensive type, hypertension stage I-II) systems, neurasthenia, sleep disorders.

Contraindications: depressive states, organic diseases of the central nervous system, conditions after myocardial infarction, acute cerebrovascular accident, pneumonia in the acute phase, severe pulmonary emphysema, bronchial asthma with frequently recurring and severe attacks, rheumatoid arthritis (in the acute phase), increased sensitivity to ionized air.

Equipment: aeroionizer "AEROMED", St. Petersburg; air ionizer with air purification function (Naberezhnye Chelny).

APPLICATION OF AEROSOLS

Aerosoltherapy method of therapeutic use of aerosols of medicinal substances. An aerosol is a disperse system consisting of many small liquid particles of a medicinal substance (dispersed phase) suspended in a homogeneous medium of gas, mixture of gases, air (dispersion medium). Dispersing the drug substance increases the total volume of the drug suspension and the surface of its contact with the affected tissue areas, which significantly accelerates the mass transfer of drugs. Depending on the area of ​​exposure to aerosols, inhalation therapy and external aerosol therapy are distinguished.

Therapeutic effects: mucolytic, mucokinetic, potent bath pharmacological effects of the inhaled drug substance (vasoactive, bronchodrainage, etc.).

Indications: acute pneumonia, condition after pneumonia, tracheobronchitis, chronic obstructive bronchitis in the phase of stable remission, emphysema, bronchial asthma, pulmonary tuberculosis, bronchus oectatic disease in pulmonary heart failure is not higher Stage II, occupational lung diseases, concomitant diseases of the ENT organs, acute respiratory viral diseases, damage lesions of the skin and mucous membranes, burns and trophic ulcers.

Contraindications: bronchial asthma with frequently recurring and severe attacks, individual intolerance to inhaled drugs medicinal drug, pulmonary hemorrhage and hemoptysis, coronary heart disease, angina pectoris FC II, diseases of the inner ear, tubootitis, atrophic rhinitis, vestibular disorders.

Equipment: PARI, Ultrasonic, Pari BOY asthma kit (Germany), nebulizers, ultrasonic and turbine inhalers, .

AEROPHYTOTHERAPY

Halotherapy (Greek hah salt) medicinal use of table salt aerosol (sodium chloride) or dry aerosol for native stone salts (haloaerosols).

Therapeutic effects: secretolytic (mucolytic, bronchodres nating), anti-inflammatory, immunosuppressive, neurostimulating, sanogenic.

Indications: chronic nonspecific lung diseases (subacute bronchitis, chronic non-obstructive bronchitis with an asthmatic component, chronic obstructive bronchitis without signs of pulmonary heart disease, bronchial asthma, tracheobronchitis), cystic fibrosis, pneumonia in the convalescent phase, diseases of the ENT organs, skin diseases (eczema, neurodermatitis, allergic dermatitis, alopecia areata), vegetative-vascular dystonia, functional depressive states, combined cardiovascular pathology.

Contraindications: high activity of the inflammatory process, respiratory failure of the third degree, bronchial asthma with frequent and severe attacks, acute bronchitis, severe emphysema, chronic nonspecific lung diseases, kidney diseases in the decompensation stage.

Haloinhalation therapy a method of delivering a dry highly dispersed aerosol of natural rock salt into the respiratory tract.

Therapeutic effects: mucoltic, bronchodrainage, sanogenic, anti-inflammatory, immunoregulatory.

Indications: respiratory diseases (subacute bronchitis, chronic clinical non-obstructive bronchitis with an asthmatic component, chronic obstructive bronchitis without signs of cor pulmonale, bronchial asthma, tracheobronchitis, cystic fibrosis, etc.), diseases of the ENT organs, hay fever, ARVI, bronchial hygiene.

Contraindications: high activity of the inflammatory process, stage III respiratory failure, general contraindications for inhalation therapy.

Equipment: AEROMED (Russia), halocomplex and halocabinet for controlled halotherapy (speleotherapy), HALONEB (inhaler for dry salt halotherapy).

Use of healing factorsthermal nature and natural healing factors

The classification of thermal factors is based on the concept of indifferent temperature, at which the relative constancy of different areas of the body (“thermal comfort”) is maintained. It is different for different types of coolants. So, for example, for water it is numerically equal to the temperature of the internal organs of the body (36-37 °C), and for air 25-26 °C. In accordance with the value of indifferent temperature, therapeutic thermal factors are divided into cold, cool, indifferent, warm, hot and very hot.

Mud procedure, directly irritating the mechano-thermo-osmoreceptors of the skin, it causes the formation of biologically active substances in the body and affects the nature of neurohumoral regulatory mechanisms. General wraps, local applications, galvanic mud have an analgesic, absorbable and anti-inflammatory effect, accelerate the restoration of damaged tissues, and increase immunity. The changes in the body caused by the mud procedure usually persist for a long time after its completion, causing an aftereffect.

Their thermophysical properties play an important role in the therapeutic effect of mud. The thermal effect of the peloid causes a complex neuroreflex reaction with the participation of humoral factors, as well as the direct influence of thermal energy on body tissues, which determines the activation of thermoregulation mechanisms. At the same time, blood and lymph circulation, tissue respiration, and tissue trophism change locally.

An essential place in the mechanism of action of mud therapy belongs to the ability to limit proliferative connective tissue reactions, reducing the formation of granuloma and keloid connective tissue in response to the introduction of a foreign body.

The effect on the immune system, shifts in bioenergetic processes, and the effect on the functional state of the neuroendocrine systems are also important in the therapeutic effect of peloids.

The desensitizing effect of a course of mud applications is explained by a pronounced effect on the reactivity of the body, especially allergic changes, through the central nervous and neuro-endocrine mechanisms, immunological homeostasis, and metabolic processes. All this determines the wide possibilities of using mud therapy for various diseases.

The method is used in a complex of restorative and preventive measures for patients with diseases of the musculoskeletal system and consists of general and local techniques depending on the indications: general mud baths, general gas mud baths, local (four-chamber) mud baths, local applications (compresses) , galvanic mud therapy (diadynamo or SMT mud phoresis), magnetopeloidophoresis. Due to the variety of techniques used, it is possible to use peloids in patients with concomitant pathologies that previously excluded the use of mud therapy.

General mud baths the dirt is diluted with highly mineralized sodium chloride water and fed into the bath. It is possible to use “thick” mud baths (the ratio of therapeutic mud and water is 2:1), “medium” - 1:1 and “liquid” - 1:2. During the procedure, the heart area remains free. The solution temperature is 36-38 °C. The duration of the procedure is 10-12 minutes. The course of treatment is 8-12 procedures (daily or every other day). After the procedure, the dirt is washed off in a shower at a temperature of 37-38 ° C, then the patient wets the body with a towel, gets dressed and rests for 30 minutes to 2 hours.

Gas and mud baths - this is a combination of “medium” or “liquid” mud baths with pearl baths. The solution temperature is 36-38 °C. The duration of the procedure is 10-12 minutes. The course of treatment is 8-12 procedures (daily or every other day). After the procedure, the dirt is washed off in a shower at a temperature of 37-38 ° C, then the patient wets the body with a towel, gets dressed and rests for 30 minutes to 2 hours.

Local (four-chamber) mud and mud baths represent special containers for the upper and lower extremities. The temperature of mud or mud “thick”, “medium” or “liquid” mud solution is 40-42 ° C, exposure is 10-15 minutes, course of treatment is 10-15 procedures (daily or every other day). After the procedure, the dirt is washed off in a shower at a temperature of 37-38 ° C, then the patient wets the body with a towel, gets dressed and rests for 30 minutes to 2 hours.

When conducting mud compress A layer of therapeutic mud 2-3 cm thick is applied to the skin, covered with a larger oilcloth, and a layer of soft woolen fabric larger than the size of the oilcloth is placed on top. Compresses can be made from unheated or heated to 40^13-45 °C

Mud. Exposure of a cold compress is 2-4 hours, from heated mud from half an hour to 2-3 hours (daily or every other day). After the procedure, the dirt is washed off in a shower at a temperature of 37-38 ° C, then the patient wets the body with a towel, gets dressed and rests for 30 minutes to 2 hours.

Local mud applications carried out using an intensive or mitigated (gentle) technique. For intensive use, a relatively higher temperature of the mud is used (42-46 °C). These are applications that are more widespread in area and have longer procedures (20 minutes or more).

Mitigated peloid therapy determined by the temperature of the peloid (usually 38-40 ° C), duration up to 15 minutes and a smaller area of ​​application of therapeutic mud. Recommended every 1 or 2 days, with a course duration of 12-14 procedures (daily or every other day). After the procedure, the dirt is washed off in a shower at a temperature of 37-38 ° C, then the patient wets the body with a towel, gets dressed and rests for 30 minutes to 2 hours.

Galvanic mud therapy (diadynamo or SMT mud phoresis, magnetopeloidophoresis and inductothermic peloidophoresis) application of direct or alternating current, alternating magnetic and electromagnetic fields through a mud cake.

The mud is placed in gauze bags ranging in size from 50 to 400 cubic meters. cm. The thickness of the mud layer is 3-5 cm, it is possible to use thin-layer mud up to 1.5 cm, temperature 38^2 °C. The dirt placed in this way is applied to the skin of the patient’s affected area, and the current-carrying electrode is placed on top and covered with oilcloth. The electrode is fixed with a bag of sand or an elastic bandage.

At amplipulsepeloidotherapy mud pads are prepared in a similar way and placed under both electrodes. The operating mode of the device and the impact parameters are determined individually, taking into account the clinical manifestations of the main and concomitant diseases. The procedure is carried out similarly diadynamopeloidophoresis, magnet- and inductothermope- Loidophoresis.

At ultraphonopeloidophoresis The sonication procedure is carried out through a 2 cm thick mud cake in a gauze bag, the temperature of the mud is 39-42 °C. An ultrasonic emitter is tightly placed on the cake and move slowly across the surface. The sound intensity is 0.2-0.4 W/cm 2 in continuous or pulsed mode. The duration of the procedure is up to 15 minutes. There are 8-12 procedures per course of treatment (daily or every other day).

Exposure to general and local mud, mud and gas mud baths is carried out in the balneological department of a healthcare facility. General baths with a capacity of up to 200-300 liters, installations (compressors) for saturating the mud solution with air bubbles, and special containers (four-chamber baths) for the patient’s limbs are used.

Indications: diseases and consequences of injuries of the musculoskeletal system (diseases of the joints, traumatic injuries of the limbs, ligaments and muscles, contractures, osteomyelitis), nervous system (consequences of closed brain injuries, radiculitis, neuritis, plexitis), respiratory organs (chronic bronchitis, pneumonia), digestion (peptic ulcer of the stomach and duodenum without exacerbation, chronic gastritis, colitis, cholecystitis), diseases of the female and male genital area, skin diseases, diseases of the ENT organs, eyes, adhesions in the abdominal cavity, trophic ulcers, cicatricial adhesions of various localizations .

Contraindications: acute inflammatory processes of various localization and chronic in the stage of severe exacerbation, heart defects in the stage of decompensation, stage III hypertension, coronary heart disease, angina pectoris above FC class III, bronchial asthma, glomerulonephritis, cirrhosis of the liver, chronic inflammatory diseases of the female genital organs with severe hypofunction of the ovaries, uterine fibroids, ovarian cysts, menstruation, varicose veins, thyrotoxicosis, infectious diseases (including sexually transmitted diseases).

Equipment: the devices “Potok-1”, “Tonus”, “Stimulus”, various modifications of the “Amplipulse” device, any physiotherapeutic devices with generators of alternating magnetic, electromagnetic fields and ultrasonic waves can be used.

OZOCERITOTHERAPY

Ozocerite therapy medicinal use of medical ozokerite.

Therapeutic effects: anti-inflammatory, reparative-regenerative, catabolic, desensitizing, vasodilator, antispasmodic.

Indications: chronic inflammatory diseases of superficial tissues and internal organs, consequences of diseases and injuries of the musculoskeletal system and peripheral nervous system, diseases of the female and male genital area, diseases of the skin, ENT organs, adhesions in the abdominal cavity, trophic ulcers.

Contraindications: acute inflammatory processes, coronary heart disease, angina pectoris above FC III, liver cirrhosis, myoma and fibromyoma, ovarian cyst, grade P-P1 thyrotoxicosis, severe

Neuroses with autonomic disorders, chronic glomerulonephritis, pregnancy and lactation.

Equipment: paraffin heaters, tables for working with paraffin.

PARAFFIN THERAPY

Paraffin therapy therapeutic use of medical paraffin.

Therapeutic effects: anti-inflammatory (dehydrating), reparative and regenerative, vasodilator, antispasmodic.

Indications: consequences of diseases and injuries of the musculoskeletal system (bone fractures, joint dislocations, ligament and muscle ruptures, arthritis, arthrosis) and peripheral nervous system (radiculitis, neuralgia, neuritis), diseases of internal organs (chronic bronchitis, tracheitis, pneumonia, pleurisy, hypertension I-II stages, chronic gastritis, ulcers disease of the stomach and duodenum, chronic cholecystitis, adhesions in the abdominal cavity, chronic colitis), chronic inflammatory diseases of the female genital area, varicose veins, polio, skin diseases (scaly lichen, neurodermatitis, dermatoses), wounds, burns, frostbite, trophic ulcers

Contraindications: acute inflammatory processes, pronounced atherosclerosis, coronary heart disease, angina pectoris above II FC, chronic glomerulonephritis. Liver cirrhosis, ovarian cyst, rheotoxicosis, infectious diseases, vegetative-vascular dysfunctions, second half of pregnancy and lactation.

PACKAGE HEAT THERAPY

Batch Heat Therapy therapeutic use of artificial coolants of various chemical natures.

Their heat capacity and heat-holding capacity are higher than those of steam fina iozokerite. They transfer heat to tissues for a long time. Thermal pads of various sizes and shapes wrapped in transparent plastic sections are heated in warm water and a thermostat to 70 °C, and placed on the affected area of ​​the body.

Warming pads with binary substances and electrochemical heating pads are also used. Heat is released in them due to a chemical reaction between substances (for example, acetic acid and sodium hydroxide), which is initiated by mechanical rupture of the internal shell him package. The outer package of the heating pad is placed on an area of ​​the patient’s body and the outside is tightly wrapped with a towel or blanket. pertensive type, hypertension Stages I-II, hypotension, post-infarction cardiosclerosis, chronic gastritis, peptic ulcer in remission, chronic colitis and functional intestinal disorders, menstrual irregularities, menopause, hemorrhoids, sexual neurosis, vascular diseases, obesity of the first degree.

Contraindications: coronary heart disease, angina pectoris III FC, diseases of the respiratory system, urolithiasis, calculous cholecystitis, second half of pregnancy, hysteria, cerebral atherosclerosis, weeping dermatitis.

Devices: shower chairs, installations for rain, needle, dust showers, Charcot showers, Scottish, fan, circular, perineal (ascending), steam, underwater.

Baths therapeutic effects on a patient immersed in an aquatic environment. When they are carried out on the patient, unlike showers, mechanical, thermal and chemical factors act during the entire procedure (constantly). Depending on the chemical composition and temperature of the water There are different types of baths: fresh, gas, mineral gas and aromatic (general and local).

Therapeutic effects: vasodilator, catabolic, trophostimulating, tonic, sedative, antispasmodic, analgesic.

Indications: diseases and consequences of injuries of the peripheral (neuritis, neuralgia, radiculitis, myalgia) and central (neuroses, closed injuries brain, spastic paralysis, atherosclerosis of cerebral vessels

Brain) nervous system; diseases of the respiratory system (bronchial asthma, chronic obstructive bronchitis), blood circulation (neurocirculation) latory dystopia of the hypertensive type, hypertension I-II stages), digestion (chronic gastritis, colitis, bile dyskinesia excretory tract, chronic non-calculous cholecystitis), kidney stones, obesity I-III degrees, impotence, hemorrhoids.

Contraindications: acute inflammatory diseases or exacerbation diagnosis of chronic diseases of internal organs, autonomic polyneuropathy, hypotension, recurrent thrombophlebitis, coronary heart disease, angina pectoris III-IV FC, weeping dermatitis.

Mineral baths therapeutic effects on a patient immersed in mineral water. Along with thermal and mechanical factors, when taking such baths, the patient is significantly influenced by chemical factors (chemicals dissolved in mineral water).

Sodium chloride baths

Therapeutic effects: analgesic, vasodilator, catabolic, immunostimulating, anti-inflammatory, secretory, hypocoagulant.

Indications: diseases of the cardiovascular system (neurocirculation torturous dystonia of cardiac and hypertensive types, hypertension Stages I-II, initial symptoms of atherosclerosis, post-thrombotic and varicose veins), diseases of the musculoskeletal system (rheumatic and infectious-allergic polyarthritis, ligament damage, tendons, bones), diseases and consequences of damage to the peripheral nervous system (plexitis, radiculitis), chronic inflammatory diseases of the genitourinary organs, skin diseases (psoriasis, neurodermatitis, scleroderma) and metabolism.

Contraindications: individual intolerance to the therapeutic environment, chronic renal failure stage II-III.

Iodine-bromine baths

Therapeutic effects: anti-inflammatory (reparative-regenerative) tive), secretory, sedative, hypocoagulant.

Indications: diseases of the cardiovascular system (coronary heart disease, angina pectoris I and II FC, hypertension stage I-II, atherosclerotic and post-infarction cardiosclerosis (not earlier than 10 weeks after myocardial infarction), diseases of the central nervous system (neurasthenia) and the peripheral nervous system ( lumbosacral radiculitis, neuritis, myalgia), skin diseases (eczema, neurodermatitis, scaly lichen), cerebral atherosclerosis, inflammatory diseases and consequences of damage to the musculoskeletal system (polyarthritis, damage to ligaments, tendons, bones, deforming osteoarthritis), endocrine forms of female infertility.

Contraindications: thyrotoxicosis, pituitary diseases, gout.

Gas baths therapeutic effect on the patient of fresh water supersaturated with gas.

Therapeutic effects: tonic (pearl baths), catabolic (oxygen baths), sedative, analgesic, hyposensitizing (nitrogen baths).

Indications: diseases of the peripheral nervous system, neurasthenia, obsessive-compulsive neurosis, schizophrenia, psychasthenia, chronic alcoholism, menopausal syndrome, initial manifestations of atherosclerosis coronary vessels, myocardial dystrophy, cardiosclerosis with circulatory failure not higher Stage I, stage I hypertension, chronic inflammatory diseases of internal organs (bronchitis, pneumonia in the recovery stage, chronic gastritis, colitis, adnexitis), vascular diseases.

Contraindications: coronary heart disease, angina pectoris II-IV FC, increased excitability of the central nervous system, vegetative-vascular dysfunctions, autonomic polyneuropathies.

Carbon dioxide baths

Therapeutic effects: hypotensive, cardiotonic, anti-inflammatory, catabolic, tonic.

Indications: diseases of the cardiovascular system (coronary artery disease, angina pectoris I-II FC, stage I-P hypertension, post-infarction cardiosclerosis (PICS) (1-3 months), initial symptoms of atherosclerosis), respiratory diseases (pulmonary emphysema, pneumosclerosis, bronchial asthma in progress remission). Functional disorders of the central nervous system: neurasthenia, sexual neurosis, autonomic neurosis, post-stroke hemiparesis, chronic inflammatory diseases of the female genital organs (adnexitis, salpinoophoritis), menopause, metabolic disorders (obesity Stages I-II, gout in remission), mild form of diabetes.

Contraindications: IHD, angina pectoris III-IV class, mitral heart defects, hyperthyroidism, poor tolerance of the therapeutic environment (sweating, dizziness, etc.) when taking baths, chronic diffuse glomerulonephritis.

Hydrogen sulfide baths

Therapeutic effects: reparative-regenerative, catabolic (glycolytic and lipolytic), epithelializing, immunostimulant lysing, detoxifying, secretory, sedative, hypocoagulant.

Indications: IHD, angina pectoris class I-II, myocardial dystrophy, PICS (4-6 months), myocardial and atherosclerotic cardio sclerosis, diseases of the peripheral (neuralgia, toxic polyneuritis, lumbosacral radiculitis, myelitis) and central (encephalitis, neurasthenia) nervous system, diseases of the musculoskeletal system (polyarthritis, spondylosis, osteoarthritis), skin diseases, diseases of peripheral veins and arteries, tubal infertility , chronic poisoning with salts of heavy metals (lead and mercury).

Contraindications: acute and chronic diseases of the liver, bile- excretory tract and kidneys, ischemic heart disease, angina pectoris III FC, toxicoallergic reactions to hydrogen sulfide, vegetative-vascular dysfunctions.

Radon baths

Therapeutic effects epithelizing, analgesic, reparative-regenerative, catabolic(glycolytic and lipolytic), immunostimulating, vasodilating.

Indications: diseases of the cardiovascular system (ischemic heart disease, angina pectoris I-II FC, hypertension stages I-II, myocardial dystrophy, mitral heart defects, PICS (1 month), myocardial and atherosclerotic cardiosclerosis, diseases and consequences of peripheral injuries (neuralgia, neuritis , radiculitis, plexitis) and central (neurasthenia, sleep disturbance) NS, diseases of the musculoskeletal system (arthritis, polyarthritis, osteomyelitis, bone fractures with delayed consolidation, osteoarthritis), chronic diseases of the lungs, gastrointestinal tract and kidneys, skin diseases, ( scaly lichen, neurodermatitis, scleroderma, psoriasis), keloid scars, long-term non-healing wounds and trophic ulcers, gout, diabetes mellitus, diffuse toxic goiter I-III degrees, obesity II-III degrees, chronic inflammatory diseases of the female genital organs with hormonal-dependent neoplasms (fibroids, endometriosis), prostatitis.

Contraindications: acute inflammatory diseases ischemic heart disease, steno tension cardia IV FC, leukopenia, hyperthyroidism, poor tolerance to radon mineral water (sweating, shortness of breath, dizziness, etc.), professional contacts with ionizing radiation, benign tumors, vegetative-vascular dysfunctions.

Mineral gas baths therapeutic effects on a patient immersed in natural or artificially prepared mineral water with gases dissolved in it, which are the leading active factor.

Aromatic baths the therapeutic effect on the patient’s body of fresh water with aromatic substances dissolved in it.

Therapeutic effects: sedative, vasodilator, tonic, astringent, analgesic, antipruritic, immunostimulating, metabolic, actoprotective.

Indications: diseases and consequences of injuries to the musculoskeletal system, peripheral nervous system (lumbosacral radiculitis, autonomic polyneuropathy), neurasthenia, stage I-P hypertension, vascular diseases, chronic prostatitis, itchy dermatoses, chronic diseases of the female genital organs, fatigue.

Contraindications: acute inflammatory diseases of internal organs, increased excitability of the central nervous system, weeping dermatitis, coronary heart disease, angina pectoris III-IV FC, chronic glomerulonephritis, chronic hepatitis, liver cirrhosis, recurrent thrombophlebitis, diabetes mellitus, thyrotoxicosis, mycoses, hypersensitivity of the skin to mustard or turpentine.

Colon hydrotherapy periodic irrigation of the walls of the large intestine with liquid.

Therapeutic effects: defecation, detoxification, anabolic cue, column motor.

Indications: chronic colitis of various etiologies, chronic constipation (alimentary, dyskinetic, mixed), chronic gastritis, diseases of the liver and biliary tract, metabolic diseases (gout, diabetes, diathesis), exogenous constitutional obesity of I-III degree.

CRYOTHERAPY

Cryotherapy (Greek Krios ice) therapeutic effect on organs and tissues of the body Cold factors that reduce the temperature of tissues not below the limits of their cryostability and do not lead to a significant change in the thermoregulation of the body (local and general hypothermia).

Therapeutic effects: analgesic, anesthetic, hemostatic, anti-inflammatory (decongestant), vasoconstrictor, desensitizing, reparative-regenerative.

Indications: diseases and injuries of joints, ligaments and tendons, fractures of long tubular bones, burns, bedsores, diseases and injuries of the nervous system, rheumatoid arthritis, peptic ulcers of the stomach and duodenum, acute pancreatitis, erysipelas, burns, trophic ulcers, wounds, preoperative period with extensive lacerations, bruises, infected and crushed wounds, gunshot wounds injuries and amputations of limbs.

Contraindications: peripheral vascular diseases (Raynaud's disease, obliterating endarteritis, varicose veins), sickle cell anemia, hypersensitivity to the cold factor, decrease in soft tissue temperature to 28-30 ° C.

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