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Electrotherapy

Electrotherapy (or electrotherapy) is the use of various types of electricity for therapeutic purposes. Based on the property of certain types of electrical energy at therapeutic doses to change the functional state of organs and systems.

Energy during electrotreatment is supplied to the body in the form of electric current, magnetic or electric fields, and their combinations. The type of energy determines the place of its absorption in the tissues and the nature of the primary physico-biological processes underlying the reactions of the whole organism. Apply general, local and segmental effects. The body in all cases reacts to the impact as a whole, but depending on the area of ​​application of energy, its reactions can be both general and mainly local. With segmental techniques, exposure to superficial reflexogenic zones also causes reactions in deeply located organs that receive innervation from the same segment of the spinal cord as these zones. In all methods, the so-called non-specific reactions that are common to many physical factors are manifested in the form of increased blood circulation, metabolism, and trophism of tissues. At the same time, the action of each factor is also characterized by specific reactions peculiar only to it. Thus, galvanic current causes the redistribution of ions and changes in biochemical processes in tissues. Acting as a biological stimulant, it contributes to the processes of restoring disturbed nerve conduction. The use of this current with the simultaneous introduction of small amounts of medications through the intact skin (see Electrophoresis, medicinal substances ) ensures their active action for a long time.

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Constant and alternating impulse currents (see Pulsed current ) can cause, depending on the frequency, intensity and other parameters, an increase in the inhibitory processes in the CNS, an analgesic effect and improves blood circulation , muscle contraction. Pulsed high-frequency currents (see darsonvalization, local), stimulating the receptors of the skin and deep-lying organs with high-frequency discharges, contribute to a decrease in the excitability of the nervous system and the elimination of vascular spasm . When exposed to high-frequency pulsed magnetic field (see darsonvalization, general), weak eddy currents are induced in the tissues, under the influence of which the metabolism increases and functional disturbances of the nervous system can be eliminated. An alternating continuous magnetic field of much greater frequency and intensity (see Induction) induces intense eddy currents in the body, as a result of which considerable heat is generated in the tissues and conditions are created for the reverse development of subacute and chronic inflammatory processes.

Under the influence of a high-voltage constant electric field (see Franklinization ), the charge ratio of the tissues of the whole body changes and the functional state of the nervous system, hematopoiesis and metabolism improve. In addition, aeroions, ozone, and nitrogen oxides, which are formed during a “quiet” discharge, also have an effect. The electric field of ultra-high frequency (see UHF-therapy ), causing rotation and oscillation of dipole protein molecules of tissues, affects mainly tissues that are close in physical properties to dielectrics (nerves, tendons , adipose, bone, brain tissue), and has a healing effect not only in chronic, but also in acute, including purulent, inflammatory processes.

Electromagnetic oscillations of ultra-high frequency (see. Microwave therapy), absorbed by tissue fluids , cause local heat generation at a depth of up to 4-5 cm. Electromagnetic oscillations of the decimeter range with the same mechanism of energy absorption and action on the tissues of the body provide for a deeper and more uniform heating them and have therapeutic effect in various sub-acute and chronic inflammatory processes.

Indications - see articles on individual types of electrotherapy (Darsonvalization, Pulsed current, Induction, etc.).

Contraindications for electrotherapy are malignant neoplasms, a tendency to bleeding, fresh significant hemorrhages in the cavity or tissue, severe heart failure, and pregnancy.

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Electrotherapy (electrotherapy) - the use of electrical energy for therapeutic purposes.

Depending on the structure of electric current, direction, intensity, frequency, duration of exposure, place of application, combination with other therapeutic factors, as well as depending on the stage of the disease, individual response to certain types of electrical energy, treatment with electric current causes various reactions of tissues, organs and body systems. Neurohumoral and neuroreflex by various types of electrotherapy regulate the functions of the nervous system, metabolism, endocrine organs, blood and lymph circulation, etc. The most lasting effect is achieved in treating patients in the subacute, and in some cases in the acute period of the disease. Some types of electrotherapy are contraindicated in some cases, for example, the use of tetanizing current in spastic paralysis, diathermy (long and medium wave) - in purulent processes that do not have pus exit paths, etc. Do not use electrotherapy in patients with grade III blood circulation insufficiency, hypertension Stage III, with acute bleeding, malignant diseases, etc. Some patients do not tolerate certain types of electrotherapy.

Electric current is applied in continuous and pulsed mode. The types of electrical current used for therapeutic purposes are listed in the table.

Basic Electrotherapy
D.C Alternating current
Continuous low voltage current
a) galvanic
b) electrophoresis

Low voltage pulse current
a) rectangular (Leduc's currents)
b) tetanizing (faradic)
c) exponential (Lapika currents)
Diadynamic current (Bernard current)
Constant high voltage electric field - static electricity (franklinization)


Low voltage current
a) sinusoidal
b) interfering
c) sinusoidal modulated
High frequency currents
a) d'Arsonval currents (high frequency pulse current)
b) diathermy
Electromagnetic field of high frequency
a) general darsonvalization (autoinduction)
b) inductothermy (short-wave diathermy)
c) continuous UHF electromagnetic field
d) pulsed electromagnetic field UHF
e) microwaves

Continuous low voltage direct current . Galvanization (see) improves the permeability of the cell membrane, enhances lymphatic circulation, promotes the resorption of decay products, improves trophism and tissue regeneration processes, and accelerates the restoration of disturbed nerve conduction. These changes depend on the body's reactivity, the course of the pathological process, the reaction of the central nervous system; dry skin resists direct current; the electrical conductivity of the skin and different tissues is different; the lines of force of the tissues are unevenly distributed in different tissues. Medicinal substances are injected into the body by galvanic current through the skin and mucous membranes (see Medicinal electrophoresis). Previously, this effect was called ionophoresis, ion-galvanization, etc. A.E. Scherbak developed the theory of “ionic reflexes”, in which, along with the local skin reflex, a general response of the organism arises.

Medicinal substances injected by galvanic current, even in small quantities, last longer in tissues, adverse reactions are significantly reduced, inactivation of certain substances (for example, antibiotics) slows down. In these processes, in addition to changes in tissue reactivity (under the influence of galvanic current), the influence of current on the structure of the drug substance can play a role.

Low-voltage pulsed direct currents (see. Pulsed current) enhance the braking processes in the brain, are used for electrosponing therapy (see); tetanizing (previously called faradic) current reduces skeletal muscle, is used for electro-gymnastics and classical electrodiagnostics; The exponential current (Lapika) in its structure resembles the current of the action of the nerve, causes a motor reaction and in deep muscles, it is used mainly for electro-gymnastics.

Diadynamic current (Bernard) - a constant pulsating, rectified sinusoidal current, used in various modifications (single or two-phase, with short or long periods, etc.); one of the most effective painkillers for acute, subacute and chronic lesions of the peripheral nervous system, muscles, joints, etc.

Constant high-voltage electric field (see. Franklinization). There is an electric field and charged air particles - ozone aeroions and nitrogen oxides. The entire body is affected, peripheral blood circulation is expanded, the trophic function of the nervous system is enhanced, and blood and metabolism are stimulated.

Alternating current of low voltage - interfering (ion modulation). The current is formed by the addition of two AC circuits with a frequency of 3900-4000 Hz and 3990-4000 Hz; interference is created in the frequency range of 10–100 Hz; Ion modulation acts directly on deep tissues and organs, causing a blockade of the path between the lesion focus and the central nervous system. It is used to treat non-purulent inflammatory diseases, some lesions of the muscles and the nervous system with severe pain.

The sinusoidal modulated current received from the Amplipuls-3 apparatus is characterized by a carrier frequency of 5000 Hz and modulations in frequency from 10 to 150 Hz and amplitudes from 0 to the maximum value; It has a pronounced analgesic effect and effect on the nervous trophism.

High frequency currents . Impulse current of high frequency and high voltage - local darsonvalization (see) - with a frequency of 300-400 kHz and voltage up to 10-15 kV causes reflex reactions of all systems (and internal organs), reduces the excitability of the neuromuscular apparatus, has a pronounced analgesic, antipruritic, antispastic effect, improves trophism, promotes the growth of granulations and epithelium. Diathermy (see) - the frequency of 500-1500 kHz, voltage 100-150 V, current up to 1-2 a; endogenous heat is formed in tissues, biochemical processes and trophicity are activated, metabolism, phagocytosis are increased, an analgesic and especially antispastic effect is pronounced. It is used for subacute and chronic processes, and in some cases for acute. It is advisable to combine diathermy with other physical factors - galvanodiatremia (see), diathermoplasty, diatherm and mud therapy.

Electromagnetic field of high frequency . With general darsonvalization (autoinduction), there are weak high-frequency currents that the patient does not feel; inhibitory processes in the central nervous system are enhanced, arterial blood pressure in patients with hypertension I B, II A stage decreases slightly, metabolic processes are enhanced, and functional disorders of the nervous system are corrected. Induction (see) - short-wave diathermy, frequency 13.56 MHz; electromagnetic high-frequency field induces eddy currents. With the same indications, inductothermy has significant advantages over diathermy (long and medium wave) due to a more even current distribution and uniform heat development in the tissues, it is better tolerated by patients and gives a more lasting therapeutic effect. Continuous electromagnetic field UHF (see UHF-therapy), the frequency of 40.68 MHz, the power of the generators from 10 to 350 watts. Athermic and oligothermal doses are mainly used. It is advisable to treat not only subacute, but also acute inflammatory and purulent processes (boils, carbuncles, etc.). A pronounced anti-inflammatory, resolving, anesthetic, hypotensive, bacteriostatic and other actions allowed to establish an extremely wide area of ​​application of UHF-therapy. Pulsed electromagnetic field of UHF: frequency 39 MHz, average power 15 W, pulse 15 kt. Oscillatory action is greater than with a continuous UHF electromagnetic field; appointed at about the same indications (hypertension I B, stage II A, endarteritis, inflammatory diseases of the liver and biliary tract, diseases of the joints of various etiologies, etc.). Microwaves (see. Microwave therapy) - electromagnetic oscillations of ultra-high frequency (2375 MHz), the maximum power of the output circuit is 150 watts. With this method of electrotherapy, an even more uniform distribution is achieved than with the described methods of treatment, and the distribution of heat in the tissues, and an even greater oscillatory effect. Bacteriostatic action, increased phagocytic activity, increased activity of the reticuloendothelial system, etc., have been established. Treatment of acute inflammatory processes, metabolic disorders, trophic disorders, diseases of the joints, peripheral nervous system, etc. is effective.