The use of pulsed electrotherapy in medicine. Low frequency therapy indications and contraindications Low frequency therapy

Electric currents are widely used in physiotherapy. Changes in their parameters in this case can diametrically affect the mechanisms of action and the observed effects on the body.

High frequency currents in physiotherapy

Currents used for medical purposes are divided into low, medium and high. High-frequency current is determined at a frequency of more than 100,000 hertz.

High frequency currents are generated by special equipment and applied without direct contact with the patient. An exception is the method of local darsonvalization, which uses exposure to high-frequency currents through special electrodes on the body.

Many physiological effects of HF currents are based on the formation of endogenous heat in tissues. High-frequency currents cause small vibrations at the molecular level, resulting in the release of heat. This heat acts at different depths in the tissues, and the effect persists for some time after the procedure is completed.

The use of HF currents in medical practice

The effect of high-frequency currents on the central nervous system is sedative and on the autonomic system - sympatholytic, in general, high-frequency currents have a relaxing effect on the nervous system. The same can be said about their effect on the smooth muscles of the bronchi, where the antispasmodic effect is combined with an anti-inflammatory effect.

HF currents are indicated for pain syndromes with neuralgia, neuritis, sciatica, etc. The analgesic effect is due to an increase in the pain threshold of skin receptors and inhibition of the transmission of pain signals through the nerves.

Procedures with the use of high-frequency currents are effective in slow overgrowth of tissues in wounds, bedsores and trophic diabetes. This mechanism of action is associated with the induction of endogenous vasodilating heat. In spastic conditions such as Buerger's disease or Raynaud's syndrome, HF currents can also relieve some of the symptoms.

In another case, the effect of high frequency currents on blood vessels is tonic and is used in the treatment of varicose veins and hemorrhoids. Sometimes the bactericidal effect of high-frequency currents is used to treat infected wounds. The bactericidal and antimicrobial action of HF currents has indirect mechanisms that increase local blood flow, stimulate and accelerate the phase of the inflammatory process.

Contraindications to the use of all types of currents in medicine are large metal objects in tissues, implanted pacemakers, pregnancy, a tendency to bleeding, and some others.

UHF currents

UHF currents are another group of high frequency currents. They also work on the principle of endogenous heat generation and targeted activation of metabolism in certain tissues. Their action is applied in response to a variety of pathological processes. The time of one procedure is on average 10-15 minutes, and the courses vary in length depending on the result achieved.

Irradiation of the kidney with ultra-high frequency currents in acute and chronic glomerulonephritis has a vasodilating and anti-inflammatory effect, acting on the vessels, and enhances diuresis. On the other hand, adrenal irradiation naturally stimulates the production of corticosteroids and is used in the treatment of certain autoimmune diseases.

The third group of high-frequency currents used in medicine is centimeter high-frequency currents. Microwave waves affect the blood, lymph and parenchymal organs. Centimeter waves have a depleted effect 3-4 centimeters deep into the surface of the body.

The principle of operation of all types of high-frequency currents is associated with the formation of endogenous heat. The latter has a different effect on different organs. The difference between the currents in frequency determines the depth of heat penetration into the body and the preference for treating a certain type of tissue, with more or less water content. Treatment with HF currents must strictly correspond to the type of pathology, location and type of tissue.

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Low frequency currents in physiotherapy

The low frequency current is defined from one to 1000 hertz. Within this range, depending on the frequency, the effects of low-frequency currents are different. Most medical equipment uses low frequency currents with a frequency of 100-150 Hz.

In general, the therapeutic effect of pulsed currents of low frequency can be divided into irritating and suppressive. What will be the effect of such therapy depends mainly on the frequency of the current. Low frequency currents affect electrically excitable structures such as nerves and muscles.

The use of low-frequency currents is carried out by means of electrodes that are placed on injured muscles, a diseased area of ​​​​the body or another place. In most cases, electrodes are applied to the skin. Perhaps, however, their introduction into the vagina, rectum or implantation in certain muscle groups and the medullary canal, and even in the brain.

The normal process of excitation of nerve and muscle cells is achieved by changing the charge on both sides of the positive and negative electrodes. The application of an electric current with certain characteristics near excitable structures has a stimulating effect on them. The local mode of action of the current is due to a change in the charge of the cell membrane.

The use of low-frequency currents in medicine

Low-frequency currents are used to stimulate muscles with preserved innervation, for example, when, during immobilization after bone fractures, hypotrophy and hypotension (low tone) of muscles develop in the immobilized area. This is because the muscles do not move and are not stimulated by the nerves.

In these cases, an applied low frequency current causes a portion of the muscle fiber to contract, which improves blood circulation and, to a certain extent, helps prevent severe malnutrition. However, to achieve this effect, electrical stimulation must be applied frequently enough.

In other cases, muscle stimulation may be impaired by innervation (paralysis, paresis). It is necessary to reuse low-frequency currents, but with their different physical characteristics. The goal is to stimulate the muscles and restore nerve integrity.

Electrical stimulation can be applied not only to the skeleton, but also in various smooth muscle diseases, such as postoperative atony of the intestine, postpartum atony of the uterus, etc. Another application of this method is the stimulation of the venous wall during varicose veins and hemorrhoids. Contraindications for stimulation with low-frequency currents are pregnancy, pacemakers and some other conditions.

The second main application of low frequency currents is the reduction of pain in neuralgia, myalgia, tendonitis, headaches and other conditions. The most common method is transcutaneous electrical nerve stimulation. With this type of stimulation, there is an effect on specific very sensitive nerve fibers that block the transmission of pain information at the level of the spinal cord. The duration of one session of such therapy is from 10 minutes to 1-2 hours. The most appropriate frequency to achieve an analgesic effect is around 100 Hz.

Denial of responsibility: The information provided in this article on the use of low and high frequency currents in physiotherapy is intended to inform the reader only. It cannot be a substitute for the advice of a health professional.

MOTIVATION

The most promising direction of modern physiotherapy should be considered the further improvement of pulsed rhythmic effects in the treatment of various pathological conditions, since pulsed effects in a certain given mode correspond to the physiological rhythms of functioning organs and their systems.

PURPOSE OF THE LESSON

Learn how to use the following techniques to treat diseases:

electrosleep;

Transcranial electroanalgesia;

short-pulse electroanalgesia;

diadynamic therapy;

Electrodiagnostics;

Electrical stimulation and electropuncture.

TARGET ACTIVITIES

Understand the essence of the physiological action of pulsed low-frequency currents. Be able to:

Determine indications and contraindications for the use of pulsed low-frequency currents;

Choose the appropriate type of therapeutic effect;

Independently appoint procedures;

Evaluate the effect of pulsed currents on the patient's body.

To study the principles of operation of the devices "Electroson-5", "LENAR", "Tonus-3", "Miorhythm".

BLOCK OF INFORMATION

Impulse methods of exposure to physical factors are the most adequate stimuli for the body, and with impaired functions, their therapeutic effect is most effective. The main advantages of pulse physiotherapy techniques:

Selectivity of action;

Possibility of deeper impact;

Specificity;

Lack of rapid adaptation of tissues to the physical factor;

Therapeutic effect with the least load on the body.

Impulse currents consist of rhythmically repeated short-term changes in electrical voltage or current strength. The possibility of using pulsed current for a stimulating effect on various organs, tissues and body systems is based on the nature of electrical impulses that mimic the physiological effect of nerve impulses and cause a reaction similar to natural excitation. The action of electric current is based on the movement of charged particles (ions of tissue electrolytes), as a result of which the usual composition of ions on both sides of the cell membrane changes and physiological processes develop in the cell that cause excitation.

Excitability can be judged by the smallest stimulus strength necessary for the occurrence of a reflex reaction, or by the threshold current strength, or by the threshold potential shift sufficient for the occurrence of an action potential. Speaking of excitability, they use such concepts as rheobase and chronaxia. These concepts were introduced into physiology in 1909 by L. Lapik, who studied the smallest (threshold) effect of excitable tissues and determined the relationship between the strength of the current and the duration of its action. Rheobase (from the Greek "rheos" - flow, flow and "basis" - move, movement; base) - the smallest force of direct electric current that causes excitation in living tissues with a sufficient duration of action. Rheobase, like chronaxia, allows you to assess the excitability of tissues and organs.

new in terms of the threshold strength of stimulation and the duration of its action. Reobase corresponds to the threshold of irritation and is expressed in volts or milliamps.

The rheobase value can be calculated using the formula:

where I is the current strength, t is the duration of its action, a, b are constants determined by the properties of the tissue.

Chronaxia (from the Greek "chronos" - time and "axia" - price, measure) - the shortest time of action of a direct electric current of a double threshold force (double rheobase), causing tissue excitation. As established experimentally, the magnitude of the stimulus that causes excitation in the tissues is inversely proportional to the duration of its action, which is graphically expressed by hyperbole (Fig. 6).

A change in the functional state of cells, tissues and organs under the influence of an external electrical stimulus is called electrical stimulation. Within the limits of electrical stimulation, electrodiagnostics and electrotherapy are distinguished. In electrodiagnostics, the reaction of the body to electrical stimulation by pulsed currents is studied. It has been established that the irritating effect of a single current pulse depends on the steepness of the rise of its leading edge, the duration and amplitude of the pulse. The steepness of the rise of the front of a single pulse determines the acceleration of ions during their movement. In addition, the effect of alternating electric current on the body depends significantly on its frequency. At a low pulse frequency (of the order of 50–100 Hz), the displacement of ions is sufficient to irritate the cell. At medium frequencies, the irritating effect of the current decreases. At a sufficiently high frequency (of the order of hundreds of kilohertz), the displacement of ions becomes commensurate with the magnitude of their displacement during thermal motion, which no longer causes a noticeable change in their concentration and does not have an irritating effect.

The threshold amplitude determines the maximum instantaneous displacement of ions and depends on the pulse duration. This relationship is described by the Weiss-Lapick equation (see Fig. 6).

Each point of the curve in Fig. 6 and the points lying above the curve correspond to impulses that cause tissue irritation. Extremely short pulses do not have an irritating effect (the displacement of ions is commensurate with the amplitude

Rice. 6. Muscle electrical excitability curve (Weiss-Lapic).

fluctuations during thermal motion). With fairly long pulses, the irritating effect of the current becomes independent of the duration. Pulse parameters that provide an optimal response to irritation are used for therapeutic electrical stimulation. The modern development of electronics provides the possibility of obtaining pulsed currents with any necessary parameters. In modern devices, pulses of various shapes are used, with a duration from tens of milliseconds to several seconds, with a repetition rate from fractions of a Hertz to ten thousand Hertz.

electrosleep

Electrosleep is a method of neurotropic non-pharmacological effects on the central nervous system with a constant pulsed current of a rectangular configuration, low frequency (1-160 Hz) and low power (10 mA). The method is distinguished by harmlessness, lack of toxic effects, allergic reactions, addiction and cumulation.

It is believed that the mechanism of action of electrosleep is based on the direct effect of current on the structures of the brain. The impulse current, penetrating the brain through the holes of the eye sockets, spreads through the vascular and liquor spaces and reaches the sensitive nuclei of the cranial nerves, the pituitary gland, the hypothalamus, the reticular formation and other structures. The reflex mechanism of action of electrosleep is associated with the impact of low-power direct current pulses on the receptors of the reflexogenic zone: the skin of the eye sockets and the upper eyelid. Through the reflex arc, irritation is transmitted to the subcortical formations, the cerebral cortex, causing the effect of protective inhibition. In the mechanism of the therapeutic effect of electrosleep, an important role is played by the ability of brain nerve cells to assimilate a certain rhythm of pulsed current.

Influencing the structures of the limbic system, electrosleep restores disturbances in the emotional, vegetative and humoral balance in the body. Thus, the mechanism of action consists of the direct and reflex influence of current pulses on the cerebral cortex and subcortical formations.

Impulse current is a weak stimulus that has a monotonous rhythmic effect on such brain structures as the hypothalamus and the reticular formation. Synchronization of impulses with biorhythms of the central nervous system causes inhibition of the latter and leads to the onset of sleep. Electrosleep has an analgesic, hypotensive effect, has a sedative and trophic effect.

The electrosleep procedure is characterized by two phases. The first is inhibitory, associated with stimulation of subcortical formations by impulse current and manifested by drowsiness, drowsiness, sleep, slowing of the pulse, respiration, decrease in blood pressure and bioelectrical activity of the brain. This is followed by a disinhibition phase associated with an increase in the functional activity of the brain, self-regulation systems and manifested by increased performance and improved mood.

Electrosleep has a calming effect on the body, causing sleep close to physiological. Under the influence of electrosleep, conditioned reflex activity decreases, breathing and pulse slow down, small arteries expand, blood pressure decreases; an analgesic effect appears. In patients with neurosis, emotional stress and neurotic reactions weaken. Electrosleep is widely used in psychiatric practice; while ascertaining the disappearance of anxiety and sedation. Indications for the appointment of electrosleep for patients with chronic coronary heart disease (CHD) and postinfarction cardiosclerosis:

Cardialgia;

Feeling of fear of death;

Insufficient effectiveness of sedative and hypnotic drugs.

Electrosleep effects:

In the first phase:

❖ anti-stress;

❖ sedative;

❖ tranquilizing;

In the second phase:

❖ stimulating;

❖ relieving mental and physical fatigue.

For carrying out electrosleep therapy procedures, voltage pulse generators of constant polarity and rectangular configuration with a certain duration and adjustable frequency are used: "Electroson-4T" and "Electroson-5".

Procedures are carried out in a quiet, darkened room with a comfortable temperature. The patient lies on the couch in a comfortable position. The technique is retromastoid. Eye electrodes with moistened hydrophilic pads 1 cm thick are placed on closed eyelids and connected to the cathode; occipital electrodes are fixed on the mastoid processes of the temporal bones and attached to the anode. The strength of the current is dosed by a slight tingling or painless vibration that the patient feels. If unpleasant sensations appear in the area of ​​application of the electrodes, the strength of the supplied current should be reduced, usually not exceeding 8-10 mA. The pulse frequency is chosen depending on the functional state of the patient. In diseases caused by the development of organic, degenerative processes in the vessels and nervous tissue of the brain, the effect occurs if an impulse frequency of 5-20 Hz is used, and in case of functional disorders of the central nervous system - 60-100 Hz. Simultaneously with electrosonotherapy, electrophoresis of medicinal substances can be carried out. Procedures lasting from 30-40 to 60-90 minutes, depending on the nature of the pathological process, are carried out daily or every other day; the course of treatment includes 10-20 exposures.

Indications for treatment:

neuroses;

Hypertonic disease;

IHD (coronary insufficiency I degree);

Obliterating diseases of the vessels of the extremities;

Atherosclerosis of cerebral vessels in the initial period;

Bronchial asthma;

Rheumatoid arthritis in the presence of neurasthenia or psychasthenia;

Pain syndrome;

phantom pains;

Post-traumatic encephalopathy (in the absence of arachnoiditis);

Schizophrenia during asthenia after active drug treatment;

diencephalic syndrome;

Neurodermatitis;

Toxicosis of pregnancy;

Preparation of pregnant women for childbirth;

Violation of menstrual function;

Premenstrual and menopausal syndrome;

Meteotropic reactions;

Logoneurosis;

Stressful conditions and prolonged emotional stress. Contraindications:

current intolerance;

Inflammatory and dystrophic eye diseases;

Retinal disinsertion;

High degree of myopia;

Dermatitis of the skin of the face;

Hysteria;

Post-traumatic arachnoiditis;

The presence of metal objects in the tissues of the brain and eyeball.

Transcranial electroanalgesia

Transcranial electroanalgesia is a method of neurotropic therapy based on the impact on the central nervous system by pulsed currents of a rectangular configuration with a frequency of 60-2000 Hz with variable and constant duty cycles.

The therapeutic effect is based on the selective excitation of the endogenous opioid system of the brain stem by impulse currents of low frequency. Impulse currents change the bioelectrical activity of the brain, which leads to a change in the activity of the vasomotor center and is manifested by the normalization of systemic hemodynamics. In addition, the release of endogenous opioid peptides into the blood activates regenerative and reparative processes in the focus of inflammation.

Transcranial electroanalgesia is a method that has a pronounced sedative (at a frequency of up to 200-300 Hz), tranquilizing (at 800-900 Hz) and analgesic (above 1000 Hz) effects.

Equipment and general instructions for performing procedures

For transcranial electroanalgesia procedures, devices are used that generate rectangular pulses with a voltage of up to 10 V with a frequency of 60-100 Hz, a duration of 3.5-4 ms: "TRANSAIR", "Etrans-1, -2, -3" - and a voltage of up to 20 V with a frequency of 150-2000 Hz ("LENAR", "Bi-LENAR"). The strength of the analgesic effect increases when an additional constant component of the electric current is turned on. The ratio of direct and pulse current 5:1-2:1 is considered optimal.

During the procedure, the patient lies on the couch in a comfortable position. The fronto-mastoid technique is used: a bifurcated cathode with gaskets moistened with warm water or 2% sodium bicarbonate solution is installed in the region of the superciliary arches, and a bifurcated anode is placed under the mastoid processes. After selecting the parameters of transcranial electroanalgesia (frequency, duration, duty cycle and amplitude of the constant component), the output voltage amplitude is smoothly increased until the patient has a tingling sensation and slight warmth under the electrodes. The duration of exposure is 20-40 minutes. The course of treatment includes 10-12 procedures.

For transcerebral electroanalgesia, sinusoidally modulated currents are also used with the following parameters:

The duration of half-periods is 1:1.5;

Variable mode;

Modulation depth 75%;

Frequency 30 Hz.

The duration of the procedure is 15 minutes. The procedures are carried out daily, the course of treatment includes 10-12 manipulations. During the procedure, an electronic rubber half-mask from the apparatus for electric sleep is used, replacing the plug with a plug device for the apparatus of the Amplipulse series.

Indications for treatment:

Neuralgia of the cranial nerves;

Pain caused by vertebrogenic pathology;

phantom pains;

Vegetodistonia;

Angina pectoris I and II functional class;

Peptic ulcer of the stomach and duodenum;

Neurasthenia;

Neurodermatitis;

Overwork;

Alcohol withdrawal syndrome;

Sleep disturbance;

meteopathic reactions. Contraindications:

General contraindications to physiotherapy;

current intolerance;

Acute pain of visceral origin (angina attack, myocardial infarction, renal colic, childbirth);

Closed brain injury;

diencephalic syndrome;

thalamic syndrome;

Violation of the heart rhythm;

Damage to the skin at the electrode sites.

Therapeutic techniques

In hypertension stage I and II and coronary artery disease for electrosleep, an orbital-retromastoid technique is used using a rectangular pulsed current with a frequency of 5-20 Hz, lasting from 30 minutes to 1 hour, daily. The course of treatment consists of 12-15 procedures.

Transcranial electrotranquilization is carried out according to the loboretromastoid technique using a rectangular pulsed current with a frequency of 1000 Hz, lasting 30-45 minutes daily. The course of treatment consists of 12-15 procedures.

For stable hypertension apply electrosleep using a rectangular pulsed current with a frequency of 100 Hz (the first 5-6 procedures); then go to a frequency of 10 Hz. The duration of the procedures is 30-45 minutes. The course of treatment includes 10-12 daily procedures.

With diencephalic syndrome and neuroses apply electrosleep using a rectangular pulse current with a frequency of 10 Hz lasting from 30 minutes to 1 hour, every other day. The course of treatment consists of 10-12 procedures.

Transcranial electrotranquilization is carried out according to the loboretromastoid technique using a rectangular pulsed current with a frequency of 1000 Hz, lasting 30-40 minutes. The course of treatment includes 12-15 daily procedures.

With traumatic encephalopathy electrosleep is used according to the oculo-retromastoid method using a rectangular pulsed current with a frequency of 10 Hz for a duration of 30 minutes to 1 hour, every other day. The course of treatment includes 10-12 procedures.

Short pulse electroanalgesia

Short-pulse electroanalgesia (transcutaneous electrical neurostimulation) - the impact on the painful focus with very short (20-500 μs) current pulses, followed by bursts of 20-100 pulses with a frequency of 2 to 400 Hz.

The duration and repetition rate of the current pulses used in short-pulse electroanalgesia are very similar to the corresponding pulse parameters of thick myelinated Ap-fibers. In this regard, the stream of rhythmic ordered afferentation created during the procedure excites the neurons of the gelatinous substance of the posterior horns of the spinal cord and blocks the transmission of nocigenic information at their level. Excitation of the intercalary neurons of the posterior horns of the spinal cord leads to the release of opioid peptides in them. The analgesic effect is enhanced by electrical impulse action on the paravertebral zones and areas of reflected pain.

Fibrillation of smooth muscles of arterioles and superficial muscles of the skin, caused by electrical impulses, activates the processes of utilization of algogenic substances (bradykinin) and mediators (acetylcholine, histamine) released during the development of pain. Strengthening of local blood flow activates local metabolic processes and local protective properties of tissues. Along with this, the perineural edema decreases and the oppressed tactile sensitivity in the areas of local pain is restored.

Equipment and general instructions for performing procedures

For the procedures, the devices "Delta-101 (-102, -103)", "Eliman-401", "Bion", "Neuron", "Impulse-4", etc. are used. During the procedures, the electrodes are applied and fixed

in the projection area of ​​the pain focus. According to the principle of their placement, peripheral electroanalgesia is distinguished, when the electrodes are placed in areas of pain, exit points of the corresponding nerves or their projections, as well as in reflexogenic zones, and segmental electroanalgesia, in which the electrodes are placed in the region of paravertebral points at the level of the corresponding spinal segment. Most often, two types of short-pulse electroanalgesia are used. In the first case, current pulses with a frequency of 40-400 Hz with a power of up to 5-10 mA are used, causing rapid (2-5 min) analgesia of the corresponding metamer, which lasts at least 1-1.5 hours. When exposed to biologically active points (BAP) use current pulses up to 15-30 mA, supplied at a frequency of 2-12 Hz. Hypoalgesia develops in 15-20 minutes and captures, in addition to the area of ​​influence, and neighboring metameres.

Parameters of pulsed currents are dosed in terms of amplitude, repetition rate and duty cycle, taking into account the stage of development of the pain syndrome. Along with this, the appearance of a feeling of hypoalgesia in the patient is taken into account. During the procedure, the patient should not have pronounced muscle fibrillations in the area where the electrodes are located. Exposure time - 20-30 minutes; procedures are carried out up to 3-4 times a day. The duration of the course depends on the effectiveness of pain relief.

Indications for treatment are pain syndromes in patients with diseases of the nervous system (sciatica, neuritis, neuralgia, phantom pain) and the musculoskeletal system (epicondylitis, arthritis, bursitis, sprain, sports injury, bone fractures).

Contraindications:

current intolerance;

General contraindications to physiotherapy;

Acute pain of visceral origin (angina attack, myocardial infarction, renal colic, labor pains);

Diseases of the membranes of the brain (encephalitis and arachnoiditis);

neuroses;

Psychogenic and ischemic pain;

Acute purulent inflammatory process;

thrombophlebitis;

Acute dermatoses;

The presence of metal fragments in the impact zone.

diadynamic therapy

Diadynamic therapy (DDT) is a method of electrotherapy based on exposure to a low-frequency impulse current of a constant direction of a half-sinusoidal shape with an exponential trailing edge with a frequency of 50 and 100 Hz in various combinations.

DDT has an analgesic effect. The analgesic effect of DDT is due to processes that develop at the level of the spinal cord and brain. Irritation by a rhythmic impulse current of a large number of nerve endings leads to the appearance of a rhythmically ordered stream of afferent impulses. This flow blocks the passage of pain impulses at the level of the gelatinous substance of the spinal cord. The analgesic effect of DDT is also facilitated by the reflex excitation of the endorphin systems of the spinal cord, the resorption of edema and the reduction of compression of the nerve trunks, the normalization of trophic processes and blood circulation, and the elimination of hypoxia in tissues.

The direct effect of DDT on body tissues differs little from the effect of galvanic current. The reaction of individual organs, their systems and the organism as a whole is due to the pulsed nature of the supplied current, which changes the ratio of ion concentrations at the surface of cell membranes, inside cells and in intercellular spaces. As a result of changing ionic composition and electrical polarization, the dispersion of colloidal cell solutions and the permeability of cell membranes change, the intensity of metabolic processes and tissue excitability increase. These changes are more pronounced near the cathode. Local changes in tissues, as well as the direct effect of current on receptors, cause the development of segmental reactions. At the forefront is hyperemia under the electrodes, due to vasodilation and increased blood flow. In addition, when exposed to DDT, reactions caused by current pulses develop.

Due to the changing concentration of ions at the surface of cell membranes, the dispersion of cytoplasmic proteins and the functional state of the cell and tissue change. With rapid changes in the concentration of ions, the muscle fiber contracts (with a low current strength, it strains). This is accompanied by an increase in blood flow to the excited fibers (and to any other working organ) and an intensification of metabolic processes.

Blood circulation is also enhanced in areas of the body innervated from the same segment of the spinal cord, including the symmetrical region. This increases blood flow to the area of ​​influence, as well as venous outflow, improves the resorption capacity of the mucous membranes of the cavities (pleural, synovial, peritoneal).

Under the influence of DDT, the tone of the main vessels normalizes and collateral circulation improves. DDT affects the functions of the stomach (secretory, excretory and motor), improves the secretory function of the pancreas, stimulates the production of glucocorticoids by the adrenal cortex.

Diadynamic currents are obtained by one- and two-half-wave rectification of alternating mains current with a frequency of 50 Hz. In order to reduce adaptation to influences and increase the effectiveness of treatment, several types of current have been proposed, representing the sequential alternation of currents with a frequency of 50 and 100 Hz or the alternation of the latter with pauses.

A half-wave continuous (OH) half-sinusoidal current with a frequency of 50 Hz has a pronounced irritating and myostimulating property, up to tetanic muscle contraction; causes a large unpleasant vibration.

A full-wave continuous (DN) half-sinusoidal current with a frequency of 100 Hz has a pronounced analgesic and vasoactive property, causes fibrillar twitching of muscles, and small diffuse vibration.

A half-wave rhythmic (RR) current, the impulses of which alternate with pauses of equal duration (1.5 s), has the most pronounced myostimulating effect during current impulses, combined with a period of complete muscle relaxation during the pause.

The current modulated by a short period (KP) is a series combination of ON and DN currents following equal parcels (1.5 s). Alternation significantly reduces adaptation to exposure. This current first has a neuromyostimulating effect, and after 1-2 minutes - an analgesic effect; causes the patient to experience an alternation of large and soft gentle vibration.

Current modulated by a long period (DP) - a simultaneous combination of OH current bursts with a duration of 4 s and

current DN duration 8 s. The neuromyostimulating effect of such currents decreases, but the analgesic, vasodilating and trophic effects gradually increase. The patient's sensations are similar to those in the previous mode of exposure.

Half-wave wave (SW) current - a series of pulses of a half-wave current with an amplitude that increases from zero to a maximum value within 2 s, remains at this level for 4 s, and then decreases to zero within 2 s. The total duration of the pulse sending is 8 s, the duration of the entire period is 12 s.

Full-wave wave (DV) current - a series of pulses of a full-wave current with an amplitude that varies in the same way as that of the OB current. The total duration of the period is also 12 s.

The diadynamic current has an injecting ability, which determines its use in the methods of drug electrophoresis (diadynamophoresis). Yielding to the galvanic current in terms of the amount of drug administered, it contributes to its deeper penetration, often potentiating its action. It is best to prescribe diadynamophoresis when the pain syndrome prevails.

Equipment and general instructions for performing procedures

To carry out DDT procedures, devices are used that generate bursts of pulses of different durations, frequencies and shapes with different durations of pauses between bursts, such as "Tonus-1 (-2, -3)", "SNIM-1", "Diadynamic DD-5A" and etc.

During the DDT procedure, hydrophilic pads of electrodes of the required size are moistened with warm tap water, squeezed out, metal plates are placed in the pockets of the pads or on top of them. Cup electrodes are placed in the area of ​​the most pronounced pain and during the procedure they are held by the hand by the handle of the electrode holder. An electrode is placed on the painful point, connected to the negative pole of the apparatus - the cathode; another electrode of the same area is placed next to the first at a distance equal to its diameter or more. With electrodes of different areas, the smaller electrode (active) is placed on the pain point, the larger (indifferent) is placed on a significant

distance (in the proximal nerve trunk or limb). With DDT on the area of ​​small joints of the hand or foot, water can be used as an active electrode: it is filled with a glass or ebonite bath and the bath is connected to the negative pole of the apparatus through a carbon electrode.

Depending on the severity of the pathological process, the stage of the disease, the reactivity of the patient (the property of the tissue to respond differentially to the action of an external stimulus; in this case, the action of a physiotherapeutic factor or a change in the internal environment of the body), the individual characteristics of the body and the therapeutic tasks to be solved, one or another type of DDT is used, as well as their combination. To reduce addiction and gradually increase the intensity of exposure, 2-3 types of DDT current are used on the same part of the body.

The current strength is selected individually, taking into account the subjective sensations of the patient (slight tingling, burning, feeling of electrode sliding, vibration, intermittent compression or contraction of muscles in the area of ​​influence). With DDT pain syndrome, the current strength is selected so that the patient feels a pronounced painless vibration (from 2-5 to 15-30 mA). During the procedure, addiction to the action of DDT is noted; this must be taken into account and, if necessary, to increase the intensity of the impact. The duration of the procedure is 4-6 minutes in one area, the total exposure time is 15-20 minutes. The course of treatment includes 5-10 daily procedures.

Indications for treatment:

Neurological manifestations of osteochondrosis of the spine with pain syndromes (lumbago, sciatica, radicular syndrome), motor and vascular-trophic disorders;

Neuralgia, migraine;

Diseases and injuries of the musculoskeletal system, myositis, arthrosis, periarthritis;

Diseases of the digestive system (peptic ulcer of the stomach and duodenum, pancreatitis);

Chronic inflammatory diseases of the uterine appendages;

Hypertension in the early stages. Contraindications:

current intolerance;

General contraindications to physiotherapy;

Acute inflammatory processes (purulent);

thrombophlebitis;

Unfixed fractures;

Hemorrhages in the cavity and tissue;

Ruptures of muscles and ligaments.

Therapeutic techniques

Diadynamic therapy in the treatment of trigeminal neuralgia

Small round electrodes are used. One electrode (cathode) is installed at the exit site of one of the branches of the trigeminal nerve, the second - in the area of ​​pain irradiation. Influenced by the current DN 20-30 s, and then the current KP for 1-2 minutes. The current strength is gradually increased until the patient feels a pronounced painless vibration; the course of treatment includes up to six daily procedures.

Diadynamic therapy in the treatment of migraine

The position of the patient is lying on his side. Influenced by round electrodes on a manual holder. The cathode is placed 2 cm behind the angle of the lower jaw on the region of the upper cervical sympathetic ganglion, the anode is 2 cm higher. The electrodes are placed perpendicular to the surface of the neck. Apply current DN for 3 min; the current strength is gradually increased until the patient feels a pronounced vibration. The impact is carried out from two sides. The course consists of 4-6 daily procedures.

Diadynamic therapy for headaches associated with a hypotensive state, atherosclerosis of cerebral vessels (according to V.V. Sinitsin)

The position of the patient is lying on his side. Use small double electrodes on a manual holder. The electrodes are placed in the temporal region (at the level of the eyebrow) so that the temporal artery is in the interelectrode space. The KP current is applied for 1-3 minutes, followed by a change in polarity for 1-2 minutes. During one procedure, the right and left temporal arteries are treated alternately. The procedures are carried out daily or every other day, the course of treatment consists of 10-12 procedures.

Diadynamic therapy on the gallbladder area

Plate electrodes are positioned as follows: an active electrode (cathode) with an area of ​​40-50 cm 2 is placed on the projection area of ​​the gallbladder in front, a second electrode (anode) with a size of 100-120 cm 2 is placed transversely on the back.

Apply OB in a constant or variable mode of operation (in the latter, the duration of the period is 10-12 s, the rise time of the leading edge and the fall of the trailing edge are 2-3 s each). The current strength is increased until pronounced contractions of the muscles of the anterior abdominal wall begin under the electrodes. The duration of the procedure is 10-15 minutes daily or every other day, the course of treatment consists of 10-12 procedures.

Diadynamic therapy on the muscles of the anterior abdominal wall Electrodes with an area of ​​200-300 cm 2 are placed on the abdominal wall (cathode) and in the lumbosacral region (anode). DDT parameters: OB-current in continuous mode; the current strength is increased until pronounced contractions of the abdominal wall appear, the exposure time is 10-12 minutes. The course of treatment includes up to 15 procedures.

Diadynamic therapy on the perineum

Electrodes with an area of ​​40-70 cm 2 are arranged as follows:

Above the pubic joint (anode) and on the perineum (cathode);

Above the pubic joint and on the perineal area under the scrotum (polarity depends on the purpose of exposure);

Above the pubic joint (cathode) and on the lumbosacral spine (anode).

DDT parameters: one-half-wave current in an alternating mode of operation, the duration of the period is 4-6 s. It is possible to use the syncopated rhythm in the alternating mode of operation. With good tolerance, the current strength is increased until the patient feels a pronounced vibration. The duration of the procedure is up to 10 minutes daily or every other day, the course of treatment includes up to 12-15 procedures.

The impact of diadynamic therapy on the genitals of a woman

Electrodes with an area of ​​120-150 cm 2 are placed transversely over the pubic joint and in the sacral region. DDT parameters: DN with polarity reversal - 1 min; CP - 2-3 minutes each, DP - 2-3 minutes each. Procedures are carried out daily or every other day. The course of treatment consists of 8-10 procedures.

Diadynamic therapy for diseases of the shoulder joint

Plate electrodes are placed transversely on the anterior and posterior surfaces of the joint (the cathode is at the site of the pain projection).

DDT parameters: DV (or DN) - 2-3 min, CP - 2-3 min, DP -

3 min. With pain under both electrodes in the middle of exposure

For each type of current, the polarity is reversed. The current strength is increased until the patient feels a pronounced painless vibration. The course is prescribed 8-10 procedures carried out daily or every other day.

Diadynamic therapy for bruises or sprains of the joint

Round electrodes are placed on both sides of the joint on the most painful points. Influenced by current DN for 1 min, and then - KP for 2 min in the forward and reverse direction. The current strength is increased until the patient feels the most pronounced vibration. Procedures are carried out daily. The course of treatment consists of 5-7 procedures.

electrical stimulation

Electrical stimulation is a method of therapeutic exposure to pulsed currents of low and increased frequency, used to restore the activity of organs and tissues that have lost their normal function, as well as to change the functional state of muscles and nerves. Apply separate impulses; series consisting of several impulses, as well as rhythmic impulses alternating with a certain frequency. The nature of the reaction elicited depends on:

Intensity, configuration and duration of electrical impulses;

The functional state of the neuromuscular apparatus. These factors are closely related to each other.

based on electrodiagnostics, allowing you to select the optimal parameters of the pulsed current for electrical stimulation.

Electrical stimulation maintains muscle contractility, enhances blood circulation and metabolic processes in tissues, and prevents the development of atrophy and contractures. Procedures carried out in the right rhythm and at the appropriate current strength create a stream of nerve impulses that enter the central nervous system, which in turn helps to restore motor functions.

Indications

The most widely used electrical stimulation in the treatment of diseases of the nerves and muscles. These diseases include various paresis and paralysis of the skeletal muscles, as flaccid, caused by disorders of the peripheral nervous system.

we and the spinal cord (neuritis, the consequences of poliomyelitis and spinal injuries with spinal cord injury), and spastic, post-stroke. Electrical stimulation is indicated for aphonia due to paresis of the muscles of the larynx, paretic state of the respiratory muscles and diaphragm. It is also used for muscle atrophy, both primary, developed as a result of injuries of the peripheral nerves and spinal cord, and secondary, resulting from prolonged immobilization of the limbs due to fractures and osteoplastic operations. Electrical stimulation is indicated for atonic conditions of the smooth muscles of the internal organs (stomach, intestines, bladder). The method is used for atonic bleeding, to prevent postoperative phlebothrombosis, to prevent complications during prolonged physical inactivity, to increase the fitness of athletes.

Electrical stimulation is widely used in cardiology. A single high-voltage electric discharge (up to 6 kV), the so-called defibrillation, is able to restore the work of a stopped heart and bring a patient with myocardial infarction out of a state of clinical death. An implantable miniature device (pacemaker), which delivers rhythmic impulses to the patient's heart muscle, ensures long-term effective work of the heart in case of blockade of its conduction pathways.

Contraindications

Contraindications include:

gallstone and kidney stones;

Acute purulent processes in the abdominal organs;

Spasmodic state of the muscles.

Electrical stimulation of facial muscles is contraindicated in case of their increased excitability, as well as early signs of contracture. Electrical stimulation of the muscles of the extremities is contraindicated in case of ankylosis of the joints, dislocations before their reduction, bone fractures before their consolidation.

General instructions for performing procedures

Electrical stimulation procedures are dosed individually according to the strength of the irritating current. During the procedure, the patient should experience intense, visible, but painless muscle contractions. The patient should not experience discomfort. Absence of muscle contractions or painful sensations indicate incorrect placement of the electrodes or the inadequacy of the applied current. The duration of the procedure

ry is individual and depends on the severity of the pathological process, the number of affected muscles and the method of treatment.

In physiotherapy, electrical stimulation is used mainly to act on damaged nerves and muscles, as well as on the smooth muscles of the walls of internal organs.

Electrodiagnostics

Electrodiagnostics is a method that allows you to determine the functional state of the peripheral neuromuscular apparatus using some forms of current.

When a nerve or muscle is irritated by current, their bioelectrical activity changes and spike responses are formed. By changing the rhythm of stimulation, one can detect a gradual transition from single contractions to dentate tetanus (when the muscle has time to partially relax and contract again under the action of the next current pulse), and then to full tetanus (when the muscle does not relax at all due to the frequent repetition of current pulses). These reactions of the neuromuscular apparatus when irritated by direct and pulsed currents formed the basis of classical electrodiagnostics and electrical stimulation.

The main task of electrodiagnostics is to determine the quantitative and qualitative changes in the reaction of muscles and nerves to irritation with tetanizing and intermittent direct current. Repeated electrodiagnostic studies allow you to establish the dynamics of the pathological process (restoration or deepening of the lesion), evaluate the effectiveness of treatment and obtain the necessary information for the prognosis. In addition, a correct assessment of the state of electrical excitability of the neuromuscular apparatus makes it possible to select the optimal current parameters for electrical stimulation.

Electrical stimulation maintains muscle contractility and tone, improves blood circulation and metabolism in the affected muscles, slows down their atrophy, and restores the high lability of the neuromuscular apparatus. During electrical stimulation, on the basis of electrodiagnostic data, the shape of the pulsed current, the pulse repetition rate are selected and their amplitude is regulated. At the same time, pronounced painless rhythmic muscle contractions are achieved. The duration of the used pulses is 1-1000 ms. The current strength for the muscles of the hand and face is

3-5 mA, and for the muscles of the shoulder, lower leg and thigh - 10-15 mA. The main criterion for adequacy is to obtain an isolated painless muscle contraction of the maximum magnitude when exposed to a current of minimum force.

Equipment and general instructions for performing procedures

For electrodiagnostics, the Neuropulse apparatus is used. In electrodiagnostics use:

Intermittent direct current with a rectangular pulse duration of 0.1-0.2 s (with manual interruption);

Tetanizing current with triangular pulses, frequency 100 Hz and pulse duration 1-2 ms;

Rectangular pulse current and exponential pulse current with pulse frequency adjustable from 0.5-1200 Hz and pulse duration adjustable from 0.02-300 ms.

The study of electrical excitability is carried out in a warm, well-lit room. The muscles of the area under study and the healthy (symmetrical) side should be as relaxed as possible. When conducting electrodiagnostics, one of the electrodes (guide, area 100-150 cm 2) with a wetted hydrophilic pad is placed on the sternum or spine and connected to the anode of the apparatus. The second electrode, previously covered with a hydrophilic cloth, is periodically moistened with water. In the process of electrodiagnostics, a reference electrode is placed on the motor point of the nerve or muscle under study. These points correspond to the projection of the nerves in the place of their most superficial location or to the places where the motor nerve enters the muscles. Based on special studies by R. Erb at the end of the 19th century. compiled tables indicating the typical location of the motor points, where the muscles contract at the lowest current strength.

For myoneurostimulation, the Miorhythm and Stimul-1 devices are used. With slightly pronounced lesions of the nerves and muscles, devices for DDT and amplipulse therapy (in a straightened mode) are also used for electrical stimulation. Stimulation of internal organs is carried out using the device "Endoton-1".

The device "Stimulus-1" generates three types of pulsed currents. For electrical stimulation with this device, plate electrodes with hydrophilic pads of various sizes are used,

as well as strip electrodes of a special design. In addition, electrodes are used on the handle with a push-button interrupter. The location of the points is noted by the doctor during electrodiagnostics.

For electrical stimulation of nerves and muscles with pronounced pathological changes, a bipolar technique is used, in which two equal-sized electrodes with an area of ​​​​6 cm 2 are placed as follows: one electrode (cathode) - at the motor point, the other (anode) - in the area of ​​\u200b\u200btransition of the muscle into the tendon, in distal section. In the bipolar technique, both electrodes are placed along the stimulated muscle and fixed with a bandage so that the muscle contraction is unobstructed and visible. During electrical stimulation, the patient should not experience unpleasant pain; after muscle contraction, it needs to rest. The greater the degree of muscle damage, the less often the contractions are caused (from 1 to 12 contractions per minute), the longer the rest after each contraction. As the muscle movements are restored, the frequency of contractions is gradually increased. With active stimulation, when the current is turned on simultaneously with the patient's attempt to produce a volitional muscle contraction, the number and duration of the pulses are regulated by a manual modulator.

The current strength is regulated during the procedure, achieving pronounced painless muscle contractions. The current strength varies depending on the muscle group - from 3-5 mA to 10-15 mA. The duration of the procedure and the course of electrical muscle stimulation depends on the nature of the muscle lesion and its severity. Procedures are carried out 1-2 times a day or every other day. The course of treatment is 10-15 procedures.

Indications for electrical stimulation:

Flaccid paresis and paralysis associated with nerve injury, specific or non-specific inflammation of the nerve, toxic damage to the nerve, degenerative-dystrophic diseases of the spine;

Central paresis and paralysis associated with impaired cerebral circulation;

Muscle atrophy with prolonged physical inactivity, immobilization bandages;

Hysterical paresis and paralysis;

Postoperative intestinal paresis, various dyskinesias of the stomach, intestines, biliary and urinary tract, ureteral stones;

Muscle stimulation to improve peripheral arterial and venous circulation, as well as lymphatic drainage;

Increase and strengthen the muscle mass of athletes. Contraindications:

current intolerance;

General contraindications to physiotherapy;

Acute inflammatory processes;

Contracture of mimic muscles;

Bleeding (except dysfunctional uterine);

Fractures of bones before immobilization;

Dislocations of the joints before reduction;

Ankylosis of the joints;

Fractures of bones before their consolidation;

Cholelithiasis;

thrombophlebitis;

Condition after acute cerebrovascular accident (first 5-15 days);

Seam of the nerve, vessel during the first month after the operation;

Spastic paresis and paralysis;

Heart rhythm disturbances (atrial fibrillation, polytopic extrasystole).

Electropulse therapy (EIT) - methods used in the restoration of cardiac arrhythmias. Cardioversion is used in the treatment of atrial fibrillation and paroxysmal tachycardia. Represents the impact on the myocardium with a direct current of great strength.

The discharge is given in a certain phase of the heart rhythm. It differs from safety, because in the first case there is a risk of applying electric shock to the patient in the most vulnerable phase of the cardiac cycle. It is used in case of ventricular fibrillation. These two methods are electropulse therapy, which is indispensable for cardiology.

Indications for electropulse therapy

• Patients with ventricular dysfunction (flutter and fibrillation).
• With persistent gastric tachycardia. If hemodynamics is disturbed, cardioversion is immediately applied. To further stabilize the patient's condition, drug therapy is used.
• People with supraventricular tachycardia. In this case, electropulse therapy is indicated for patients whose condition is rapidly deteriorating or traditional treatment is ineffective.
• When atrial fibrillation or flutter is diagnosed, cardioversion is prescribed based on the patient's condition.
• EIT is used to treat tachyarrhythmias. However, for patients with this type of disease, reentry is more effective than for people with a disease caused by increased automatism.
• Electropulse therapy is indicated for patients with shock, which appeared as a result of tachyarrhythmia and with pulmonary edema.
• This type of therapy is indicated for patients with pronounced tachycardia, when more than 150 beats per minute are diagnosed. People with acute myocardial infarction and those who suffer from unstable hemodynamics. EIT is irreplaceable if therapy with antiarrhythmic drugs is contraindicated.

cardioversionDefibrillation is an important and indispensable method by which serious conditions are stabilized.

EIT

To use EIT, the doctor must know about all the patient's diseases that can complicate the condition, about the individual characteristics of the body.

Electropulse therapy: contraindications for conducting

There are cases when this type of therapy is contraindicated. If a patient is diagnosed with atrioventricular blockade, this type of treatment is not used. This applies to people with sick sinus syndrome, with heart defects, if treated with an operative method. If there is no threat to the life of the patient, cardioversion is not applied, as there is a risk of ventricular fibrillation.

It is strictly forbidden to carry out EIT with an overdose of digitalis preparations. When the body is saturated with glycosides, and the level of potassium is lowered due to the use of diuretics, this therapy is not recommended. The low efficiency of the method is observed in the treatment of patients with severe heart failure and cardiomegaly.

How to prepare patients for the procedure

There is no general scheme that doctors adhere to in EIT. If the procedure is scheduled for the patient, it is recommended not to eat for 6-8 hours.

If the patient does not require extreme care, certain drugs are administered, about an hour before the procedure, to create a background concentration. It is strictly contraindicated for such a purpose to administer beta-blockers, which can lead to serious consequences.

When cardioversion or defibrillation is performed on an emergency basis, and a person's life is in danger, doctors do without preparation, as there is no time for this. If possible, do oxygen therapy with 100% humidified oxygen. Correct electrolyte balance and CBS.

If the patient has not lost consciousness, it is necessary to give painkillers and sedatives before the procedure.

If respiratory depression is observed, the patient is injected with analgesics that do not contain narcotic drugs, for example: analgin. Next, a person is introduced into a drug-induced sleep by administering diazepam intravenously, doing it slowly, in a stream, first 5 mg, and then adding 2 mg each until the patient falls asleep. To avoid respiratory depression, drugs with a minimum dose of narcotic drugs are used. Quite often there is a violation of breathing in a patient during the period of falling asleep, so doctors need to be especially careful.

Procedure technique

To begin with, the energy of the discharge is determined, it all depends on the diagnosis and the condition of the patient.

• 50 J is enough for supraventricular tachycardia, when the heartbeat increases sharply and paroxysmal, the heart rate exceeds 100 beats. The same discharge is used for atrial flutter.
• An impulse of 100 J is used for atrial fibrillation - this is one of the varieties of supraventricular tachycardia, there is a randomness of the electronic activity of the atria, the heart rate fluctuates between 350 - 700 per minute. And with ventricular tachycardia, the frequency of contractions of the ventricles exceeds 100 beats per minute. Characterized by a sudden cessation of violations and the same sudden resumption, occurs regularly. Severe and life-threatening cardiac arrhythmias.
• 200 J is used if the patient has polymorphic tachycardia, a serious violation of the heart rhythm can cause arrhythmic death. Or ventricular fibrillation - a violation of the coordinated work of the heart muscles, in which the main function of the organ is disrupted.

The diagnosis and condition of the patient determines the energy of the discharge

The strength of the first discharge is indicated, if it is ineffective, doctors increase it. The impulse can reach the maximum mark - 360 J.

If the necessary equipment is available, and if the patient's condition allows, synchronization of the electronic discharge is used in a certain phase of the heart rhythm. More precisely, when an R wave appears on the ECG, they immediately give a discharge. This is cardioversion.

In order to minimize the electronic resistance before EIT, the electrodes are placed on the patient's defatted skin using alcohol or other methods. After the electrodes are strongly pressed against the patient's chest, the first discharge is applied. This should be done when the person has taken a deep breath.

When the defibrillation is over, the heart rate is checked, if it is restored, it is necessary to register an ECG in 12 leads, for this, the potential difference between the two electrodes, which are located on the patient's body, is recorded.

Antiarrhythmic drugs and how they are used in EIT

In the case when, after three discharges, the heart rhythm did not recover, and the doctors constantly increased the strength of the impulse, then the fourth maximum is 360 J. It is applied after the administration of an antiarrhythmic drug intravenously, which is prescribed for rhythm disturbances. Thus, the effect that electropulse therapy gave is fixed.

What determines the effectiveness of EIT

Cardioversion-defibrillation is effective and safe if the following work has been done by doctors:

1. Correct diagnosis.
2. Preparation of equipment and necessary equipment, all necessary solutions and preparations.
3. Appropriate patient preparation.
4. The introduction of the correct painkillers and sedatives.
5. Compliance with the methodology in which the procedure is carried out taking into account all the rules and norms for the dosage of drugs, with skin degreasing.
6. Prescribing antiarrhythmic drugs.
7. Accounting for and compliance with safety regulations.
8. The technical capabilities of the defibrillator used in the work were checked.

If cardioversion-defibrillation is ineffective, we can talk about incorrect implementation of the technique, incorrect definition of indications for electropulse therapy, a serious condition of the patient, when the electronic balance or CBS are significantly disturbed, in which case correction is required.

More:

When is cardioversion indicated for the treatment of atrial fibrillation in patients?

It is simply amazing how diverse the methods and methods of treating a particular disease are now. I constantly come across something new. For example:

Impulse therapy of the central nervous system (TES) or, as its creator himself called it, the Method of transcranial electrical stimulation of the protective mechanisms of the brain, was developed in the 90s of the XX century.

This method appeared at the Institute of Physiology. I.P. Pavlov of the Russian Academy of Sciences (SPB). This is the latest development in the field of physiotherapy and was carried out by a group of scientists led by a very talented specialist - Doctor of Medical Sciences, Professor, Academician of the Russian Academy of Natural Sciences and the Academy of Medical and Technical Sciences Valery Pavlovich Lebedev.

In the course of clinical trials of the technique, its high efficiency in the treatment of a wide range of diseases, including alcohol and drug addiction, was proved. It is important that the principles of evidence-based medicine were involved in the preparation of the methodology, which ensured recognition in domestic and foreign medical circles.

To date, TES-therapy is one of the most popular methods of physiotherapy treatment and is used both at the stage of inpatient treatment of alcoholism, and in a later period of rehabilitation.

There are a large number of devices that work according to this method, but Doctor TES-03 is the only home medical device that reliably activates the production of endorphins. Undoubtedly, Doctor-TES is a highly effective and safe therapy in your home.

What is the method itself? Impulse therapy of the central nervous system is usually carried out in courses. The doctor prescribes their number individually, depending on the task and the patient's health status.

The session takes place in a lying or sitting position. To certain points on the head (in the region of the forehead and temporal bones, called the mastoid processes), electrodes are applied, connected to a device that generates weak electrical impulses. The patient may feel only a slight tingling sensation where the electrode contacts the skin.

After the session, the electrodes are removed, and since the technique is non-invasive, no damage remains on the skin.

At the moment, the method of impulse therapy of the central nervous system has earned recognition in a wide medical community. Despite the relative youth of the technique, it is already used in many medical institutions, including those of a narcological profile.

After a course of TES therapy, patients notice a significant decrease in craving for alcohol, headaches, insomnia, and depressive states that often accompany patients during treatment for alcoholism disappear. In addition, impulse therapy of the central nervous system allows you to quickly remove the withdrawal syndrome, eliminates the effects of the post-abstinence period.

The method of magnetotherapy is based on the impact on the human body of magnetic fields. Even Aristotle in the 4th century BC. mentioned in his writings the use of the mineral magnetic iron ore for the treatment of many diseases. Later it was used by Galen (II century AD), Avicenna (X century AD) and Paracelsus (XVI century), while Charcot and Trousseau began to use artificial magnets.

At present, a magnetic field is understood as a set of time-varying, interconnected electrical and magnetic phenomena. A magnetic field occurs wherever there is a moving electric charge or current.

There are no special receptor zones found in the body that perceive electromagnetic oscillations, however, there are numerous scientific data that natural magnetic fields affect the higher centers of nervous and humoral regulation, the permeability of biological membranes, the properties of water and colloidal systems of the body, the biocurrents of the brain and hearts. With the help of modern magnetotherapy devices, it is possible to control the body by changing the physical characteristics of the magnetic field.

Classification of magnetic fields

Origin:

• natural or natural (geomagnetic field of the Earth, the Sun),
• artificial,
• fields of biological objects;

By change in space:

• homogeneous,
• heterogeneous;

By intensity:

• weak
• average,
• strong,
• superstrong;

By change over time:

• permanent (PMP),
• variable (PEMP),
• impulse (IMP),
• pulsating (PUMP).

A constant magnetic field is constant in time at a given point in space, and a variable one changes in time in magnitude and direction. The pulsed magnetic field changes in time in magnitude, but not in direction. A pulsed traveling magnetic field (IBMP) moves in space relative to a stationary patient and pulses in time. It is the most biologically active, and therefore most often used for medicinal purposes.

Today, magnetotherapy is widely used in medical institutions, sanatoriums, rehabilitation, sports and health centers. Portable magnetotherapy devices "Imedis" and "ALMAG" are well-known and well-proven, a similar technology is also implemented in the hardware-software complex "Bioscanner" BIORS.

The effect of a pulsed magnetic field on the body

Pulse magnetotherapy or the so-called magnetic stimulation is a treatment with a pulsed magnetic field of weak (with a pulse amplitude of 20-100 mT) and strong intensity (100-1400 mT). Magnetic field impulses cause eddy electric currents in living tissues.

Organs and systems react differently to a magnetic field. It depends on the electrical and magnetic properties of tissues, differences in microcirculation, metabolic rate, etc. The nervous and endocrine systems are most sensitive to the magnetic field. It also affects the sense organs, the cardiovascular system, the properties of the blood, the muscular, digestive, urinary, respiratory and skeletal systems.

Magnetic therapy devices have a local (on the pathological focus) or general effect (on the body as a whole). However, in essence, these effects are inseparable, since any local influence includes reflex mechanisms, which causes a response from the central regulatory mechanisms. As a rule, the impact of a magnetic field on the pathological area is often supplemented by stimulation of the Zakharyin-Ged reflex zones and biologically active points (BAP).

The use of magnetotherapy causes the following effects:

• Correction of the functional systems of the body (with a pathological increase in the function of an organ or system, its decrease is observed, and with oppression - activation of the function).
• Decreased pain sensitivity due to inhibition of the conduction of pain impulses along the nerves.
• Normalization of sleep (sedative effect) and reduction of emotional stress by stimulating the processes of inhibition of the sympathetic-adrenal system.
• Expansion of blood vessels, including small capillaries, which leads to improved delivery of oxygen and nutrients to various organs, as well as the removal of toxins and toxins, acceleration of metabolism, reduction of inflammatory edema and restoration of damaged tissues.
• A low-intensity magnetic field reduces the tone of cerebral vessels with an improvement in its blood supply, which has a particularly beneficial effect on the patient's condition after a stroke.
• Due to the expansion of the arteries and the effect on the brain, magnetotherapy helps to reduce blood pressure.
• Activation of lipid metabolism processes leads to a decrease in cholesterol in the blood.
• The impact on the cervical-occipital region improves the blood circulation of the brain in vertebrobasilar insufficiency (osteochondrosis of the cervical region, disc herniation, etc.).
• Stimulation of nerve fibers of skeletal muscles during magnetic therapy improves their contractility. Improving conductivity and accelerating the growth of nerve endings is favorable for a faster recovery of the functions of injured peripheral nerves.
• An increase in vascular permeability contributes to the resorption of edema (a therapeutic effect in inflammation, wounds and injuries). Enhancement of metabolic processes and protein synthesis with local exposure leads to faster healing of fractures.
• Stimulation of thyroid function (useful for its hypofunction).
• An increase in the tone of the veins, a decrease in blood viscosity and a decrease in intravascular parietal thrombosis is favorable for chronic venous insufficiency, varicose veins and obliterating atherosclerosis of the vessels of the lower extremities.

Negative effects of the magnetic field

Exposure to a magnetic field does not cause skin irritation or the formation of endogenous (internal) heat. As a rule, the method is well tolerated, including by debilitated and elderly patients who suffer from concomitant diseases of the cardiovascular system. This makes it useful to use the magnetotherapy apparatus even in cases where other means of physiotherapy are contraindicated.

However, magnetic fields of 70 mT and above, with improper dosing, can disrupt the activity of various functional systems, lead to hypoxia and dystrophic processes. Therefore, when conducting magnetotherapy, it is necessary to strictly observe safety precautions, control the time and dose of exposure.

In addition, electromagnetic radiation also extends to the doctor, therefore, with frequent magnetic therapy, the specialist is advised to leave the room. However, BIORS medical complexes implement several therapy programs (mainly targeted contact methods), which allows the use of treatment methods that minimally affect the doctor. For the same reason, EHF (extremely high frequency therapy) and other methods of remote exposure are not used in BIORS devices. As for other magnetotherapy devices (“ALMAG”, “Imedis”, etc.), you can get acquainted with their features by reading the corresponding instructions for the devices.

What is treated with pulsed magnetotherapy:

inflammatory, traumatic, toxic and ischemic lesions of the peripheral nervous system (sciatica, infectious-allergic polyradiculoneuritis, toxic polyneuropathy, plexitis, neuritis, neuralgia, reconstructive surgery on the nerves, etc.);

diseases and injuries of the central nervous system (transient cerebrovascular accident, ischemic stroke of the brain, consequences of a traumatic brain injury with movement disorders, closed spinal cord injuries with movement disorders);

acute, subacute and chronic inflammatory processes;

inflammatory and degenerative-dystrophic diseases of bones and joints (osteoarthrosis, osteochondrosis, periarthritis, spondylosis deformans, ankylosing spondylitis);

injuries of the musculoskeletal system and their consequences, including bruises, dislocations, sprains, open fractures of bones and joints, delayed consolidation of fractures, etc. (three days after osteosynthesis or immobilization);

hemorrhages in muscles, joints, subcutaneous tissue (three days after injury);

treatment of trophic ulcers, slowly healing wounds, furunculosis;

hypo- and muscle atrophy as a result of physical inactivity, including in the postoperative period;

training of the neuromuscular apparatus in athletes;

atherosclerosis;

diseases of the respiratory system (bronchial asthma of mild and moderate severity, chronic bronchitis);

diseases of the digestive system (hypomotor-evacuation disorders of the stomach after gastric resection and vagotomy, chronic pancreatitis with secretory insufficiency, hypomotor dysfunction of the stomach, colon and gallbladder, chronic hepatitis with moderate liver dysfunction);

urological diseases (stone in the ureter, condition after lithotripsy, bladder atony, sphincter weakness, prostatitis);

gynecological diseases (inflammatory diseases of the uterus and appendages, ovarian hypofunction);

dental disorders (periodontal disease).

Contraindications to pulsed magnetotherapy:

severe cardiovascular diseases (acute myocardial infarction, severe cardiovascular insufficiency and cardiac arrhythmias, severe hypotension, aneurysm of the heart, aorta and large vessels, acute period of cerebrovascular accident);

acute infectious diseases (active tuberculosis, purulent inflammatory processes before drainage, fever);

neuropsychiatric disorders (CNS diseases with severe agitation, epilepsy);

systemic blood diseases and a tendency to bleeding;

thrombophlebitis, acute thrombosis, gangrene;

malignant neoplasms;

diffuse toxic goiter III degree;

cholelithiasis;

pregnancy;

age up to 1.5 years (local magnetotherapy is contraindicated) and up to 18 years (general exposure is contraindicated);

the presence of an implanted pacemaker (its operation may be disrupted);

the presence of metal objects freely located in the tissues of the body - for example, fragments after injuries.

In metal synthesis, the use of the Ilizarov apparatus and metal implanted joints, magnetotherapy NOT contraindicated.

Magnetic therapy programs in APK "Bioscanner" BIORS

In "Bioscanner", unlike many magnetic therapy devices, it is possible to carry out treatment according to 90 programs, including therapy according to the above indications and psycho-correction programs. Psychocorrection programs use signals that coincide with electromagnetic waves of different frequencies emitted by the human brain. Such therapy launches mechanisms of self-regulation and allows harmonizing the processes of information exchange in the body.

With the help of psycho-correction programs, the following effects are carried out:

Activation of intellectual activity, concentration of attention, extraction of relevant information from the subconscious, while improving the blood supply to the brain - can be used for a short time or during training, and the greatest effect is observed when perceiving material by ear (useful for learning difficulties, for faster assimilation of new material , including when studying foreign languages, with stress and sleep disturbances before exams);

Restoring the mechanisms of adaptation of the body, immersion in deep sleep, expanding the possibilities of the subconscious to search for solutions or answers;

Relaxing, meditative effect (especially useful for prolonged tension of different muscle groups and / or sleep disturbances, to achieve clarity of thought and self-confidence in order to reduce stress levels, explore one's own consciousness and psycho-modeling new behaviors);

Expansion of the possibilities of consciousness, including the improvement of creative abilities (activation of the subconscious, imagination and memory, stimulation of imaginative thinking, etc.);

Rapid recovery of strength after intense mental or stressful work, energization of the body (this program of magnetotherapy helps to reduce fatigue and increase efficiency, improve concentration);

Simultaneous relaxation and activation of the psyche (it is beneficial to use the appropriate program of magnetotherapy before sports, as it allows you to focus and reduce anxiety);

Stimulation of the control of internal needs (used in the complex treatment of alcoholism, substance abuse and other addictions, including smoking, helping to resist cravings by achieving emotional stability and self-confidence);

Overcoming fears (with phobias, neuroses) - regular implementation of an appropriate magnetotherapy program helps to cope with the fear of making decisions, public speaking, etc.;

Stabilization of the immune system during stress, anxiety, psychosomatic symptoms from the cardiovascular system, tension in the muscles of the collar zone and spine (often occurs with osteochondrosis), neurocirculatory dystonia;

Sleeping effect for insomnia and other sleep disorders that are not corrected by relaxation programs;

Mental stabilization in various psychosomatic disorders, including weakened immunity (recurrent infections of the upper respiratory tract, allergies, bedwetting, learning difficulties, including due to hyperkinetic syndrome);

Treatment of stress and associated disorders of the immune status and hormonal balance (used as an adjunctive therapy for allergies, tumors (including myomas) and fungal infections, insufficiency of the function of any endocrine glands, diabetes mellitus, neuroses, eczema, gastric and duodenal ulcers gut, asthma, lymphedema, migraine, hypotension, varicose veins, dysmenorrhea, osteoporosis, nephrolithiasis, impotence/frigidity, during puberty and menopause);

Treatment of stress, which is manifested by spasms of various types (stabbing pains in different parts of the body with vegetative-vascular dystonia, tension pains in the shoulder-occipital region, headaches, including migraine, spasms of smooth muscles) - this program is not applicable for any types of tumors ;

Therapy of depressive conditions, including those with phobias and anxiety, psychosomatic complaints from the cardiovascular system, peptic ulcer, endocrine disorders (including depression in premenstrual syndrome and menopause);

Treatment of disorders associated with brain diseases, including cerebral atherosclerosis, Parkinson's and Alzheimer's diseases;

Pain relief associated with an increase in the level of endorphins, as well as with the activation of the body's ability to heal itself (successfully used for tension headaches and other chronic pains, especially those of a psychogenic nature);

Reproduction of Schumann waves. Between our planet and the lower layer of the atmosphere, electromagnetic waves of ultra-low and low frequencies arise. Their fundamental frequency (7.8 Hz) coincides with the frequency of the human brain (the alpha rhythm of newborns or a waking person in a state of meditation). The impact on the body of Schumann waves improves concentration, gives a "charge" of energy, expands the possibilities of consciousness.

Technique for conducting pulsed magnetotherapy

The methods of carrying out the procedures depend on the specific magnetotherapy apparatus (“ALMAG”, “Imedis”, “Bioscanner”, etc.), but, as a rule, the general principle is that the inductors are installed motionless over the pathological focus or smoothly moved around this areas. The procedures are carried out daily or every other day, depending on the pathology, are dosed according to the pulse repetition rate, the amplitude of the magnetic induction, the interpulse interval and the duration of the procedure (usually from 5 to 15 minutes). As a rule, the course of treatment consists of 10-12 procedures, which, if necessary, can be repeated after 1-2 months, however, each magnetotherapy program has its own characteristics. For example, some psychocorrection programs can be carried out twice a day, in short courses or once.