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Electrotherapy

Electrotherapy

Electrotherapy  is a physiotherapy method based on application of dosed effect of electric currents, electric, magnetic or electromagnetic fields on organism.

During electrotherapy electricity is used for therapeutic purposes as the reduction of pain, restoration of movement and sedative purposes for treating such diseases as neuralgia, paralysis, diseases stimulating or irritating neuromuscular system, increased atrophy, rheumatic conditions and other diseases. Electrotherapy involves almost all types of electric energy: galvanic current, faradic current, high-voltage and high-frequency currents, static electrotherapy.

Pulse current electrotherapy (SMC, DDT, TENS) in combination with ultrasonic and vacuum therapy provides apparent analgesic action, relaxing and hypertensive actions.

Electrotherapy methods:

  • Interference therapy
  • Electric stimulation
  • Galvanization
  • Ultra Sound
  • medicinal electrophoresis
  • Decompression Therapy
  • Phonophorosis  etc.
  • Interference therapy
  • Interference therapy is a medicinal application of low-frequency (1-100 Hz) “pulses”, which could be either homogeneous in frequency during the procedure or alternate periodically within a selected frequency range. “Pulses” represent series of medium-frequency current fluctuations and are generated inside the tissues due to interference (combination) of two medium frequency currents, being initially applied to the body surface through two separate chains of different frequency.
  • Being of medium frequency (3850-4000 Hz), such initial currents easily penetrate the epidermis with no significant excitation of the surface tissues and no unpleasant sensation under the electrodes. At the same time, the “pulses” render excitation on motor nerves and muscular fibers, thus stimulating intensive blood circulation, activating metabolic reactions and reducing pain in the area of application. Interference currents with less excitation performance, as compared to direct currents, are used for treating peripheral nervous system, basically in the subacute stage of pathology.
  • The leading role in the interference therapy curative performance is served by peripheral blood circulation intensification. This benefits to normalization of the pathologically changed tone of main arteries and capillary network, increase of collateral number, microcirculation improvement. When dealing with peripheral vessels enlargement, inhibition of sympathetic vegetative nervous system and intensive generation of vasoactive substances, caused by interference currents, provide the major effect. Besides, the currents cause muscular contractions, exert specific massage effect, which may result in intensified peripheral blood circulation and lymphokinesia.
  • Stimulated blood circulation leads to local temperature increase, improved oxygen supply to tissues and their anoxemia eradication, faster excretion of toxic products of metabolism, reticuloendothelial system activation. During interference therapy pH value in tissues is reduced to alkaline area, thus benefiting to inflammation healing. Reference to many researchers, interference current is characterized with bactericidal or bacteriostatic features. It also possesses trophicoregenerative action.
  • Indications for use: diseases of the nervous system (neuritis, neuralgia, neurological manifestations of spine osteochondrosis, causalgia, phantom pain, bedwetting, etc.), diseases of the cardiovascular system (hypertension Degree I and II, vegetative dystonia, atherosclerotic occlusion of the extremity vessels, varicose veins, thrombophlebitis effects, etc.), injury of musculoskeletal system, arthritis, arthrosis, joint contractures, osteochondropathy, diseases of the gastrointestinal tract with predominant motility disorders, inflammatory diseases of the uterus, some skin diseases, etc.
  • Interference therapy methods and techniques.
  • During the procedure the patient is sitting or lying down, depending on the nature of the disease and place of application. For interference therapy, metal electrodes (two pairs) with thin hydrophilic spacers are used. For the most widely used stable method of exposure, electrodes are set in such a way that the electric currents overlap in the pathological focus or target structures (tissues). Zakharyin-Ged zone, corresponding segmental areas, specific sympathetic nodes can also be effected, or transcerebral technique can be used. Also, moving (kinetic) method of interference can be used, which specifies for two of the four electrodes to be moved along the patient body during the procedure, thus influencing expansively the skin surface.
  • The current strength during interference therapy is adjusted depending on its density at the electrodes and patient’s sensations. The patient should feel deep, strong enough, but pleasant vibration when rhythmically varying frequencies or feeling "crawling" at a constant frequency. Please remember: the more intense painful sensations, the weaker should be the current value. In the acute stage, typically weaker currents are used, but in chronic cases – stronger currents shall be applied. Because of tissue habituation phenomenon, in the process of application the current strength should be gradually increased to compensate reduction of sensations

 

Electrostimulation

Electrostimulation is an electric current application method used for excitation and activation of certain organs and systems of the human body. Although many organs and systems can be stimulated by electric currents by adequate methods and techniques applied, the most widely practiced application is electro stimulation of motor nerves and muscles.

For electro stimulation, direct impulse currents of different impulse shapes (rectangular, exponential, semi-sinusoidal) are applied at different duration (ranging from 1 to 300 msec) and series modulation of variable duration and frequency at current strength up to 50 mA. For these purposes, alternate sinusoidal modulated currents of 2000 and 5000 Hz carrier frequency at current strength up to 80 mA are used as well.

Physiology-   When impulse current passes through tissues with fast actuation and breaking at semipermeable membranes, including cytomembranes, there appears a sudden accumulation of great number of likely charged ions. This leads to reversible changes of cell colloids and cellular excitation, in particular, motor-related excitation, if exposed to motor nerve or muscle. Stimulation of muscular elements benefits to venous blood circulation and lymph flow. Motor excitation results in increased blood flow in excited muscles, to intensification of metabolic processes, nucleic acid synthesis, including RNA. Besides, due to stimulation, afferentation of muscles to CNS is increased, DNA volume in large pyramidal cells rises, which serves an evidence of increased CNS functions. The blood content of somatotropic hormone, immunoreactive insulin and C-peptide is increased as well.

For prophylaxis, electrical stimulation is used to sustain and supply the muscles, preventing its atrophy during forced immobilization and hypokinesia caused by other factors (diseases of the joints, etc.), as well as for prevention of postoperative phlebothrombosis.

 For therapeutic purposes, electrical stimulation is most frequently used to restore the function of damaged motor nerve, to treat paresis and paralysis, neuritis, facial muscles restoration, as well as in spastic paralysis.

For patients with peripheral paresis(weakness), electrostimulation helps to prevent muscle atrophy, increase contractility, muscles tone, improve the conduction of nerve trunks and electroexcitability of neuromuscular system, decreased inhibition of segmental motoneurons in the area of functional asynapsis and, thus, to reduce the severity of movement disorders, rehabilitation of movements. For patients with central paresis due to elimination of imbalance between the facilitating and inhibitory supraspinal systems, electrostimulation improves the regulation of motor activity, partially restores the reciprocal relations and contractile force of antagonist muscles, creates a new dynamic stereotype, activates functionally inactive neurons around the lesion, helps to reduce spasticity, to increase range of motion and improve coordination.

Stimulation of muscle function of the internal organs leads to improved efficiency and interaction and regulate their systems. This helps to reduce or eliminate existing pathological processes of functional character. Electrical stimulation also leads to improved function of the weakened sphincter and improves secretory and motor functions of the organ.

Indications for use of electrostimulation: motor impairments (paresis, paralysis) due to diseases and injuries of the central and peripheral nervous systems, disorders of motor or closing function of the stomach, intestines, biliary tract, bladder, ureters, uterus and its appendages, impotence, muscle stimulation to improve peripheral arterial and venous blood circulation, lymphatic drainage, stimulating the diaphragm and abdominal wall muscles to improve breathing, increase and strengthening the muscle mass in athletes; scoliosis, etc

Galvanization

Galvanization is medical treatment by direct electric current, having constant value, of low voltage (up to 80V) and low intensity (up to 50 mA). At present, only current received by rectification and smoothing of alternating public current is used for galvanization.

Passing through skin, galvanic current meets with great resistance by epidermis. Major part of current energy is spent on overcoming this resistance and right there, in the place of its major absorption, most significant galvanization reactions trend to develop. First of all, it is hyperemia and burning sensation accompanied by tingling under electrodes, resulting from the change of standard correlation of tissular ions, pH medium, heat production caused by the current. Along with that, discharge of biochemically active substances, activation of enzymes and metabolic processes cause intensified blood supply to the exposed area by reflex. Burning sensation and tingling increase to unbearable values upon increase of current intensity and exposure time, and chemical burns appear during long application of current.

Due to current distribution along tissues with good electroconductivity and very quick reduction of density deep in tissues, direct action of current reduces from the surface to the tissues located deeper. Galvanisation improves blood circulation and lymphokinesia, increases resorption ability of tissues, stimulates metabolic and trophic processes, increases secretory functions of glands, develops analgesic effect.

Galvanic current, especially applied to the hepatic area, increases action of coagulants and prolongs their presence in the organism by 2-4 hours. Potentiation effect remains for 4-6 hours after galvanization. Action of anticoagulants, first of all applied in small doses, against galvanization, on the contrary, reduces and develops later (after 30-120 min.). Galvanization also increases hypercoagulating effect of adrenalin, acetylcholine, thrombin and histamine. Galvanic current, applied by orbital and occipital method, prolongs and potentiates effect of psychotropic agents (haloperidol, seduxen, amizylum, sodium oxybutyrate, etc.), reduces the number and frequency of caused adverse reactions.

Doses of antisensitizers and immunosuppressants can be reduced during galvanization because galvanic current increases their action, favourably influences immunologic processes and general reactivity.

Indications for galvanization:

 diseases and lesions of different sections of peripheral nervous system of infectious, toxic and traumatic origin (radiculitis, plexitis, neuritis, neuralgia of different locality), consequences of diseases and lesions of brain, spinal cord, brain tunics, neuroticisms, vegetative and vascular disorders, chronic joint inflammations (arthritis) of traumatic, rheumatic and metabolic origin, etc.