Physiotherapy

Instrumental physiotherapy.

This term refers to a group of non-drug therapies carried out with a help of special equipment. Most of these methods are based on the usage of the healing qualities of electric current, magnetic field and a different spectrum of light radiation. This group also includes methods based on mechanical physical action. For treating and preventing  diseases, the energy of various types of electric current, electric, magnetic fields, ultrasound, light of various spectra is used.

Unlike natural healing factors, these artificially created healing factors are called preformed factors. The mechanism of action of artificial physical factors, like natural ones, is based on the body’s reflex response to the stimulus. This happens due to power conversion (electrical, mechanical, and thermal) into biological processes. The power conversion of physical factors is not carried out directly, but through its transformation into biological processes among molecular level.

Using preformed therapeutic factors for medicinal purposes practically does not give any collateral damage. 

Physiotherapy allows you to reduce medication by increasing body sensitivity, minimizes collateral damage and unpleasant consequences of both disease itself and its treatment, helps to reduce treatment time, accelerates recovery, activates the most important biochemical processes in the body, adjusting the body’s natural forces to recover .

Physical factors have always had a great influence on a person throughout his life on earth, as a result of which physiotherapeutic procedures still affect body more efficiently than many Medicine remedies. For the purpose of therapy, they can be the main or additional method in the complex of therapeutic measures, including spa treatment.

The main goal of physiotherapy is to achieve the best effect in treatment of the disease with a nominal load on the patient’s body.

In the sanatorium ‘CRYSHTALEVE DZHERELO’ the following methods of Instrumental physiotherapy are used:

• galvanization
• electrophoresis of Medicine remedies;
• amplipulse therapy;
• diadynamic therapy;
• arsonvalization;
• ultrahigh frequency treatment;
• magnetotherapy;
• ultrasonic therapy;
• quartz tube;
• singlet oxygen therapy.

Galvanization is a therapeutic use of a direct electric current of low voltage (up to 80 V) with a small current strength (up to 50 mA). Currently, galvanization uses only current received by rectification and smoothing of the alternating current of the network.

Passing through the skin, galvanic current meets a great resistance of the epidermis. A significant part of the current energy is spent on overcoming this resistance, and wright here, in the place where the main part of it is absorbed; the most significant ones develop during the galvanization of the reaction. First of all, it is hyperemia and a feeling of burning with tingling under the electrodes, which appear as a result of a change in the usual ratio of tissue ions, pH environment, and heat generation. Along with this, the release of biochemically active substances, activation of enzymes and metabolic processes reflexively cause an increased blood flow to the affected area.

A feeling of burning and tingling rises with increasing current strength as well as duration of exposure till unbearable and appearance of chemical burns with prolonged transmission of current.
When current spreads through the tissues with good electrical conductivity and a very rapid decrease in hardness in the depths of tissues, the direct current effect decreases from the surface to deeper tissues. Under the influence of galvanization, blood and lymph circulation increases, resorbability of tissues  increases, metabolic trophic processes are stimulated, the secretory function of the glands increases, and there is a painkiller effect.

Galvanic current, applied to the liver. It enhances the effect of blood-thinner and increases its presence in body by 2-4 hours. The potentiation effect lasts for 4-6 hours after galvanization. On the contrary, the effect of blood-thinner used in small doses during galvanization, is weakened and developed later in (30 to 120 minutes). Galvanization also enhances the hypercoagulable action of adrenaline, acetylcholine, thrombin and histamine. The galvanic current which is use according to the oculo-occipital technique prolongs and potentiates the influence of psychoactive drug (Hardol, seduxen, benactyzine, sodium oxybate, etc.), reduces the number and frequency of adverse reactions that are caused.

Using galvanization, it is possible to reduce the dosage of desensitizing and immunosuppressive agents, since galvanic current enhances their effect, favorably impacts on immunological processes and general responsiveness.

Indications for galvanization: the disease and damage to different parts of the peripheral nervous system of infectious, toxic and traumatic origin (radiculitis, plexitis, neuritis, neuralgia of different localization), the consequences of  brain and spinal diseases and lesions as well as meninges, neurotic conditions, vegetovascular disorders, traumatic or chronic inflammation of the joints (arthritis), and rheumatic and metabolic origin, etc.

Electrophoresis of Medicine remedies is a simultaneously combined with direct current, often galvanic, and a small amount of Medicine remedies or a cocktail that consists of several products gets into body.

Due to the very low speed of ion movement, the high resistance of the epidermis, the limited time of the procedure and the strength of the current, during the procedure, the ions of the Medicine remedies get only into epidermis, forming a kind of repository in it. From it, the Medicine remedy is gradually washed out by the circulatory and lymphatic systems and spreads throughout the body, and therefore patient should not count on quick effect of Medicine remedy while electrophoresis. And the amount of substance getting to the skin repository is only 2-3% of the volume that was used during the procedure.

Medicines that are introduced by electrophoresis, firstly, have the ability to enter into local metabolic processes, directly affecting the pathological and physiological reactions path in the tissues where its effect is carried out. Secondly, they cause prolonged and continuous irritation of nerve receptors of the skin, which leads to the formation of reflex reactions of a generalized and metameric nature. Thirdly, those medicinal substances that get into the blood and lymph from the repository have a humorl affect those tissues which most sensitive to them.
The leading role of therapeutic action in the mechanism of this method belongs to current, which simultaneously increases the sensitivity of tissues to the drugs action. 

The particularities of therapeutic action of Medicine remedies electrophoresis include:

1)the ability of focusing on any surface-located area of ​​the body, for example a joint
2) the long duration of the procedure’s action  – the repository of the drug substance saves for several days
3) the exclusion of the influence of drugs on the digestive organs;
4) the  the flow of drugs into the body in the form of ions, in an active form

The way of introducing the medication into body using electrophoresis has several advantages compared with the introduction of the same medication, but in other medication forms (in the form of capsules, tablets, injections, pills, etc.):

• there is a possibility of introducing not only one, but several drugs simultaneously from different poles;
• the highest concentration of medicine is formed precisely in the abnormal focus;
• the medicine is introduced into the body without disturbing the skin, so there is no need for its sterilization .

Recently, instead of a galvanic current during electrophoresis direct pulse currents have been used— inverted sine modulated current or Bernard’s ones. Although the total amount of substance getting into body is lower, due to the selection of certain impulse forms, the peculiarity of the method can be increased. So, for a deeper propagation into tissues and rapid entry into the blood, it is advisable to do electrophoresis by sine modulated currents (SMT) in an inverted mode.

Indications for electrophoresis of Medicine remedies are quit wide. They are determined by the pharmacotherapeutic properties of the inserted drug, with the obligatory consideration of indications for the usage of direct current. Medicinal electrophoresis is used for diseases of the central and peripheral nervous system, locomotion system, gynecological diseases, etc.

Contraindications to galvanization and electrophoresis:

• frank atherosclerosis, idiosyncrasy to galvanic current or applied medicinal substances, 
• acute cardiovascular diseases,
• advanced dermatoses ,
• malignant neoplasms,
• hemorrhagic tendency 
• acute pyoinflammatory processes.

Amplipulse therapy is an electrical therapy technique in which all the necessary sinusoidal modules are used: current low power. They combine the advantages of high and low frequency currents.

For amplipulse therapy, replaceable sine currents with a frequency of 2000-10000 Hz, modulated by low frequency sine oscillations (within 10-150 Hz) are used. Unlike low-frequency currents, which have an overt exciting effect on the neuromuscular and vascular systems, the high-frequency current does not meet much resistance from skin, interpenetrate into tissues, and does not cause noticeable irritation of skin receptors.

Having synchronous action with normal natural vibrations of the body’s biological current arising brain activity, nerves and muscles (from 10 to 150 Hz), and enhancing their action with sine modulated currents, in that way  we restore the normal function of the tissue and organ. To reduce the phenomena of adaptation, range expansion of tissues involved in excitation process, and increase the effectiveness of treatment, two different modulated frequencies are alternated.

At the same time, one of them remains unchanged – 150 Hz, and the second is regulated within 10-150 Hz with separate adjustment of their duration within 1-5 seconds.

Alternating modulated oscillations with pauses, as well as modulated and unmodulated oscillations is also used.

Indications for amplipulse therapy:

• diseases of the digestive system (chronic gastritis with secretory deficiency, gastroduodenal ulcer in acute phase and incomplete remission, peptic esophagitis, hypoisotonic and hypokinetic disorders of bile ducts and cholecystis in the absence of calculus, etc.); 
• injuries and peripheral nervous system disorders with reflexly tonic and pain syndromes; 
• diseases of vegetative part of the nervous system with neurotrophic and vascular disorders, 
• diseases of the nervous system with motor impairment in the form of central, peripheral and mixed paresis and paralysis; 
• idiopathic hypertensia of the I-II it;
• CHD
• atherosclerotic obliteration of limbs;
• chronic lymphostasis;
• impaired fat metabolism of exanthropic- statical habit;
• diabetes mellitus,
• diseases of the respiratory system(chronic recrudescence of chronic pneumonia, chronic bronchitis and bronchiectasia in non-acute phase, spasmodic asthma mild, moderate or severe disease );
• pseudorheumatism mild and moderate degree of process activity , arthrosis, parasynovitis;
• chronic inflammatory conditions of female genital organs;
• men’s sexual debility of functional aspect;
• neoformation assumption of them,
• general  blood diseases,
• advanced atherosclerosis, 
• instable ischemic heart disease (IHD)
• idiopathic hypertensia of II-IIIst.,
• cardiac insufficiencyII-IIIst, 
• active tuberculosis,
• cachexia,
• hemorrhagic tendency,
• patient-specific hypersensitization to current,
• skin lesion and diseases on surface where electrode is put,
• acute suppurative inflammatory process,
• bone fracture, abarticulation, effusion of blood,
• thrombophlebitis,
• kidney disease and biliary lithiasis.

Diadynamic therapy – direct current treatment with half-sine wave pulses with a frequency of 50 and 100 Hz. Basically, two types of Bernard’s currents are used: single-phase continuous and two-phase continuous, as well as various modulations and combinations of these currents – intermittent rhythmic current modulated by short or long periods, etc.

Being constant these currents, meet a great resistance of the epidermis and, and first of all, cause the excitation of receptors, appears a sensation of burning and tingling under the electrodes, as well as hyperemia due to the expansion of the surface vessel and  blood flow acceleration through them. With increasing current strength, rhythmic excitation of nerves and muscle fibers is caused.

This leads to activation of peripheral blood circulation, metabolism, and reduction of pain in area of​action. Mainly used for diseases of the peripheral nervous system, organs of supporting-motor system. With more increasing of current strength, a tetanic muscle contraction occurs. The main features of Bernard’s currents in a body are blocking sensitive nerve endings and because of it increasing pain threshold. It causes almost complete anesthesia, as well as stimulation of trophic processes, tissue metabolism and absorption of perineural edema.

Bernard’s currents normalize subereous neurodynamics, acting reflexively on the peripheral part of the algetic analyzer; the breakage of reflex arc of vicious loop of abnormal impulse is significant.  Due to irritation of vegetative formations, peripheral vessels expand, trophism and blood supply of tissues is improved, ionic concentration and membrane permeability is changed. All this contributes edemas to disappearance and disordered function to normalize.

Indications for diadynamic therapy: acute pain syndrome in a peripheral part nervous system affect (neurological evidence of osteochondrosis vertebralis, neurodynia, mono-polyneuropathy, ganglionitis, plexitis) Diseases of the musculoskeletal system or its injuries(myositis, parasynovitis, epicondylitis, arthrosis, low degree of joints mobility after injuries and operative measures, ect.) diseases of the digestive system(gastritis, gastroduodenal ulcer,  colitis, dyskinesia of bile ducts, pancreatitis, and dumping stomach) and respiratory disease(chronic pneumonia, spasmodic asthma ); chronic inflammatory uterine appendages diseases, menstrual colic; urinary retention and urinary incontinence, enuresis; sexual debility, prostatitis, incipience of idiopathic hypertensia and obliterating diseased vessels of limbs; bilious headache, giant urticarial, ENT-organ diseases(tonsillitis, otitis, sinusitis, rhinitis, vocal cord paralysis) temporomandibular joint arthritis, periodontosis; itching dermatosis,  cicatricial keloid etc.

Arsonvalization is an electrotherapy method based on action of a pulsed alternating low strength current, but of a high frequency and power. An electric current of low strength does not cause significant heat generation in tissues. The alternating nature of the current does not have time to cause significant ionic shifts in tissue membranes and, and as a consequence under the influence of arsonvalization, muscle contractions do not occur. By pulses affecting, skin blood circulation in the vessels is improved, that is how the therapeutic effect is achieved. As a result of its effect, in patient’s body, an increase in microcirculation is observed; tissues are supplied better with oxygen. In the depths of tissues, electromagnetic radiation appears that stimulates metabolism, positively affects the functioning of nervous system, and contributes to regeneration of damaged tissue.

Indications for arsonvalization

• varix dilatation of lower limbs
• radiculitis
• osteochondrosis
• bilious headache
• bronchitis, bronchial asthma
• cervical erosion
• cystitis
• prostatitis.
• baldness and hair loss
• acneiform rash and acne
• cellulite

Contraindications to arsonvalization:

• pregnancy
• sacred disease
• anisorhythmia
• thrombophlebitis
• pulmonary tuberculosis
• malignant neoplasms

UHF – therapy is a physiotherapeutic treatment method in which the coefficient is an alternating electric field of ultrahigh frequency (UHF).

The mechanism of the effect of UHF – therapy is based on two components: thermal and oscillometric. When the UHF electric field exposures, Local and general reaction responses are interdependent and are based on irritation of nerve receptors of organs and systems. The UHF electric field enhances blood and lymph circulation in the affected area, stimulates the function of the reticuloendothelial system, increases the activity and intensity of englobement, promotes the formation of a cell leukocyte shaft, narrows down the area of ​​inflammation from healthy tissues, reduces exudation, general edema, increases the concentration of calcium in tissues. In addition, the UHF field has an antispasmodic effect on unstriated muscles of the stomach, intestinal canal, cholecystis, bronchus and bronchial tubes, stimulates bile flow, reduces the secretion of bronchial glands, and accelerates the regeneration of nerve elements in inflammatory- degenerative and traumatic injuries. The action of the UHF electric field goes along with expansion of capillaries, arteriolas, accelerates blood circulation, decreases of blood pressure, and occurring of brachycardia. Filtration increases in glomerule as well as blood circulation in kidneys.

Indications:

• acute and subacute pyoinflammatory diseases, furunculus, carbuncles, abscesses, phlegmon, panaris, hidrosadenitis, septic wound, as well as otitis, sinusitis, tonsillitis, periodontal disease, osteomyelitis, frostbite, thrombophlebitis.
• internal medicine disease – lung abscess, multiple bronchiectasis, acute pneumonia, bronchitis, bronchial asthma, polyarthritis, pseudorheumatism, cholecystitis, subacute hepatitis, nephritis.
• acute and subacute infiltrative-exudative inflammatory processes of uterus, appendages, acute prostatitis.
• nervous system diseases – neuritis, radiculoneuritis. Raynaud’s disease, obliterating endarteritis.

Contraindications:

• malignant and benign neoplasms
• genera bloodl diseases;
• cardiovascular collapse II-IIIst.;
• ischemic heart disease with ratediorder;
• cardiac angina
• hypotension
• idiopathic hypertensia II и в.;
• decompensated diabetes mellitus
• thyrotoxicosis;
• pregnancy
• present of extraneous thing to the body
• chronic pneumonia, bronchitis.

Magnetotherapy is based on the effect of low-frequency variable magnetic field on the body in whole or on a part of it. Under the influence of this field, the tissues of the human body do not become magnetized. But such constitutive elements of tissue as water and blood elements can receive magnetic properties.

For treatment, variable(low-highfrequency) or permanent magnet magnetic fields are used. They can be used in continuous or in pulsed (intermittent) modes. Depending on the method, pulses can have different frequencies, durations and shapes.

In the human body, magnetic fields lead to changes in biologically active substances – enzymes, proteins and nucleic acids. They also affect free radicals.

It can be said that magnetotherapy methods affect t body at very deep levels: submolecular, molecular and subcellular.

 

 

Magnetotherapy effects

• overall improvement of  well-being, normalization of sleep,
• easing or complete disappearance of pain,
• improvement of blood microelements properties  ,
• Improving joints mobility
• lymph node reduction,
• lowering blood pressure
• temperature normalization
• urinary tract clarification
• recovery of peripheral nerve function,
• normalization of blood sugar
• resorption of infiltrative tissue

Indications:

• cardiovascular disease(hypertonia в I в. and II st., vegetative-vascular dystonia, venous disorders)
• diseases of the respiratory system (bronchitis, sinusitis, pneumonia);
• intestine issues(gastritis, cholecystitis, pancreatitis, irritable bowel syndrome, gastric ulcer);
• Diseases of the musculoskeletal system (arthrosis, arthritides, osteochondrosis, pyoinflammatory processes, diseases of soft tissues)
• nervous system(neurodynia, neuropathy, circulatory encephalopathy, abnormal dreams, initial presentation of anencephalemia, neurotic disorders, injury consequences)
• ear deseases(otitis and inflammation)
• ophthalmic disease (conjunctivitis, early case  of glaucoma, corneitis, iritis, optic atrophy)
• diseases of the genitourinary system(urethritis, cystitis, pyelonephritis, hysteritis, prostatitis, adnexitis, sexual debility, infertility );
• skin disease(psoriasis, neurodermatitis, burns, frostbite);
• dental disease(gingivitis, inflammation of mouth  mucous membrane, parodontosis)

Contradictions:

• pregnancy
• tisis
• disorders of blood clotting ability 
• decompensated heart failure
• presence of cardiostimulator

Ultrasound therapy is the usage of a unique physical factor, which is based on influence on tissues of high-frequency sound vibrations in the frequency range 800-3000 kHz, it carries out a micromassage of tissues and cells of the body, increases the rate of certain biochemical reactions, and has a noticeable anti-edematous and analgesic effect. Under the influence of ultrasound, cell metabolism and lymph circulation are activated. The influences of ultrasonic vibrations continuously or in a pulsed mode are applied.

Ultrasonic waves can get deeply under the dermis, to a depth of 5 cm deep into the tissues, and to provide their therapeutic effect there.

Ultrasound has a mechanical, physico-chemical and weak thermal effect on the body.

The mechanical effect of ultrasound is based on a variable acoustical pressure that causes microvibration, a kind of “micromassage” of tissues, which leads to a change of functional cells state: the permeability of the cell membranes increases, diffusion and osmosis presses increase, acid-alkali balance changes as well as the spatial relationship of submicroscopic structures in the cell.

On the one hand, the thermal effect of ultrasound is related to the transition of mechanical energy into heat, and on the other hand, to the intensification of biochemical processes. Endogenous heat generated in tissues is spreads unequally; it appears more in dense tissues and upper layers. Increase of the temperature in tissues causes the expansion of blood and lymph vessels, changes in microcirculation. As a result of this, tissue metabolic processes are activated, and the anti-inflammatory and absorbable effects of ultrasound appear.

The physicochemical effect of ultrasound is based on the spatial alteration of cellicolous molecular complexes. The intensity of tissue oxidation-reduction process, the activity of a number of enzymes increases, the mitotic activity of cells rises, the formation of biologically active substances — heparin, histamine, serotonin, etc. — develops in tissues.

The mechanism of therapeutic effect of ultrasonic waves is quite diverse and versatile. It consists of both local and general reactions. These reactions develop in phases and characterized by a long aftereffect.

With the right dosage, ultrasound has a painkiller, absorbable, anti-inflammatory, antispasmodic, fibrinolytic effect. Under its influence, regenerative and reparative processes are speeded, the excitability of the neuromuscular apparatus increases, the conduction of impulses along the peripheral nerve filament increases, the transmission of nerve impulses in sympathetic ganglia is activated, and trophic function of tissues improves.

Indications for using ultrasound therapy

• Diseases of the musculoskeletal system (arthrosis, arthritides, pseudorheumatism),
• traumas and peripheral nervous system disorder,
• diseases of the digestive system(gastroduodenal ulcer),
• eye disorders(conjunctivitis, corneitis),
• ENT-organ diseases(tonsillitis, pharyngitis),
• urological condition(prostatitis),
• gynecological disorders(adnexitis),
• dental disease(parodontosis)
• some skin diseases

Contradictions for using ultrasound therapy:

• ischemic heart disease with cardiac angina and anisorhythmia symptoms
• idiopathic hypertensia III stage
• thrombophlebitis
• years old

Tube blue light therapy session. The principle of the apparatus is based on the ultraviolet irradiation procedure; local ultraviolet irradiation of the throat, nose, and throat is carried out. It is proved that UV rays have a powerful therapeutic bactericidal effect; therefore, they are effective in the treatment of microbial and viral infections. Ultraviolet rays are distinguished by shallow penetrating quality, which is quite enough for successful activation of many organic biological processes. Moreover, the short UF rays are believed to be the most useful ones, which are used in tube blue light apparatus, are considered to be mycorrhizal.

These devices are popular with patients and doctors because of its high efficiency.

The way of proceeding of device UV radiation: 

• contributes to the improvement of organic chemical balance;
•  normalizes the nervous function; 
• activates internal tone;
•  improves blood circulation;
• It has an antimicrobial, antibacterial effect, eliminating pathogenic bacteria and microorganisms.
• Therefore, the widespread usage of tube blue light in nose and throat for eliminating infectious processes in the upper respiratory tracts; contributes to an increase of body’s overall resistance to many unfavorable extrinsic factors.

In general, UV radiation within acceptable range (254-257 nm) promotes the activation of the body’s immune forces, accelerates the patient’s adaptation and recovery after illness.

Indications:

– respiratory, infections, flue

– furunculus, abscess

-dry eczema;

– erysipelas;

– dermatitis;

– otitis externa;

– acute rhinitis

– pharyngitis;

– sinusitis

Contradictions for using Tube blue light therapy sessions:

• malignant neoplasms
• hemorrhagic tendency;
• active tuberculosis;
• hypersensitization to light (photosensitization).

Single – oxygen therapy is one of the newest promising methods of physiotherapy. This method is based on the biological effect of active oxygen, which is formed with a help of water activation by ultraviolet radiation. The obtained singlet-oxygen mixture is used for inhalation.

The therapeutic effect of singlet oxygen and nitric oxide ensures the activation of biochemical and biophysical processes in body, a decrease in prothrombin index, as well as fibrinogenic level, and an increase in time  of blood coagulation in post-infarction patients; normalization of the cardiovascular system; improvement in regenerative and metabolic processes of tissues, reducing of inflammatory process inflammation site, reducing the healing time and improving of granulations, reducing pyoinflammatory process of the wound surface; improvement of cerebral, pulmonary and coronary circulation, normalization of arterial pressure, restoration of the bronchial mucosa, normalization of respiratory function indicators, reduction of hypoxic symptoms due to different levels of respiratory failure, reduction of lactic acid level in the respiratory muscles, increase of hemoglobin level and improvement of sputum discharge, reduction of asthma attacks and hormone-dependence in severe bronchial asthma, accelerated absorption of inflammatory pulmonary infiltrate during pneumonia, normalization of the level of bilirubin, cholesterol, beta-lipoproteins and alkaline phosphatase, a decrease in blood sugar.

Indications for singlet oxygen therapy:

– prophylaxis and treatment of disease recrudescence, peculiarly seasonal, on contact with infected(for example “grippal” patients and etc.)
– circulation diseases(atherosclerosis, hyperlipemia with fatty degeneration and without it, arterial hypertension, ischemic heart disease, myocardiodystrophy, cardiomyopathy)
– diseases of the respiratory system (pneumonia, bronchitis, spasmodic asthma, multiple bronchiectasis, silicosis, pulmonary fibrosis)
– diseases of the digestive system (gastritis, peptic ulcer, chronic pancreatitis, hepatitis, cirrhosis, pathology  of bile ducts, chronic enteritis, colitis, dysbacteriosis, girardiasis, helminthiases),
– prevalency carbohydrates or protein deficiency in  dietary intake, presentce of nitrite in food, nitrate, chemical pesticide, pesticides, lead compounds, quicksilver, cadmia, high-calorie diet, consuming of saturated fat, foods rich in cholesterin;
– infective – toxicological  processes;
– hypoxemia;
– lasting medicamentous therapy;
– chronic stress (psychoemotional over load, work in extreme , unfavourable weather conditions);
– hypodynamia and, vice versa, strenuous exercise;
– negative manufacturing ecological situation: influence of different  chemical toxic materials, heavy metals, nitrogen oxide, carbohydrates, quartz dust  and etc…