ELECTROTREATMENT (synonym electrotherapy) — the methods of physical therapy based on use of the dosed impact on an organism of electric currents, electric, magnetic or electromagnetic fields.
All processes of life activity are followed by emergence In cells and fabrics of the electromotive force; the electric phenomena play a large role in the major fiziol. processes — excitement and carrying out excitement (see), In transfer of substances through biological membranes (see Membranes biological, Transport of ions), etc. Bioelectric potential (see) — the indicators of bioelectric activity of fabrics determined by electric potential difference between two points of living tissue — are directly connected with fiziol. the condition of cells and metabolic processes proceeding in them. Electric current and electromagnetic oscillations in certain parameters are fiziol. also are widely used by irritants for influence on a functional condition of separate bodies and systems of an organism, including with the medical purpose.
The largest specific weight among all physiotherapeutic methods (see Physical therapy) is necessary a pas methods E. Achievements of physics, biophysics (see), the electronic engineers who allowed to receive different types of electric current and the electromagnetic field and to study their influence on an organism at the different levels created a basis for continuous development and improvement of methods of electrotreatment.
After Gerike's invention (O. of Guericke) the elementary car to apply to receiving static electricity of its steel more widely with to lay down. the purpose in a type of electric discharges and constant electric field of a high tension (see Franklinization) since established that they well influence an organism at overfatigue, sleeplessness, headaches, and also promote healing of trophic ulcers, disappearance of papular rash at neurodermatitises, etc.
Use with the medical purpose galvanic (constant, not changing in time) electric current of low tension (30 — 80 in) and small force (to 50 ma) received the name of galvanization (see) by name ital. physiologist L. Galvani. Under the influence of a galvanic current the bioelectric potential of cellular membranes changes, there is a polarization (see), is created electrokinetic (see. The electrokinetic phenomena) and diffusion potentials (see. Membrane equilibrium). At the cathode note increase in excitability of fabrics, at the anode — decrease in their excitability (see. Electrotopical phenomena). The largest resistance to current is shown by skin, a bone, connecting fabric, the smallest — blood, a lymph, muscles. Dry skin has resistance about 1•10 6 The ohm, at its moistening, napr, during the imposing of electrodes with wet hydrophilic laying, resistance goes down to 2•10 2 Ohm and below. Current, getting through skin (hl. obr. through output channels of sweat glands), has direct effect on it as well as on the subject fabrics. A galvanic current, irritating receptors of skin, causes local and general reactions of an organism. Local, reactions from internals arise at action by current on skin of one or several next metameres of a body (see the Metamerism, Segmentary-reflex therapy). Galvanization is applied at defeats of a peripheral nervous system of various origin, neurasthenia, hypertensive and ulcer diseases, vasculomotor and trophic disturbances, etc.
Ledyuk (S. Leduc) the phenomena of penetration with electric current of a number of substances through the unimpaired skin and development of the theory of electrolytic dissociation by S. Arrhenius (see Acids and the bases, Electrolytes) led the description to creation of a method of a medicinal electrophoresis (see the Electrophoresis), in Krom are combined impact on an organism of direct electric current and the medicinal substance coming together with it to fabrics that provides the prolonged effect of this substance, his higher pharmakol. activity and practical referential transparency.
Opening by Faraday (M. Faraday) laws of electromagnetic induction (1831), development of bases of modern techniques of use of constant and faradic currents by G. Dyushenn and use by the Russian doctor A. Kabat of alternating low-frequency current of the induction coil for treatment of a number of diseases (1848) caused emergence of methods of electrostimulation (see), an electrosleep (see) and electroanesthesias (see).
After development in 1891. J.-A. D'Arsonval offered N. Tesla of a method of high-frequency high-voltage transformation of tension the methods E based on opening of Tesla., called darsonvalization (see). At local darsonvalization influence separate body parts an alternating impulse current (see. Impulse currents) of high frequency (100 — 500 kHz). At the general darsonvalization (induktoterapiya) affect an organism with the weak pulse electromagnetic field of high frequency. Local darsonvalization is applied for the purpose of reduction of pain, paresthesias, by spasmolyses of smooth muscles, increase in elasticity of vascular walls at a Raynaud's disease of I and II stages, at a varicosity, is long not healing wounds, etc. The general darsonvalization is appointed at an idiopathic hypertensia of I — IIA of a stage, neurosises, a menopausal syndrome, sleeplessness.
At the beginning of the 40th in State in-those it was offered to physical therapy (nowadays Central scientific research institute of balneology and physical therapy) to use 20 century for E. the straightened harmonic currents with a frequency from 50 to 100 Hz. In the 50th 20 century the method with use of these currents called diadynamic (diadynamotherapy) implemented in to lay down. to the practician P. Bernard. In 1963
G. Yasnogorodsky it was offered to use for E. the harmonic modulated alternating currents with a frequency of 5000 Hz arriving after low-frequency transformation on electrodes in the form of groups (portions) of fluctuations with a frequency from 10 to 150 Hz to-rye are entered in to lay down. to the practician under the name «amplipulsetherapy». L. R. Rubin in 1964 developed a flyuktuorization — a method E. fluctuating (aperiodic) currents with a frequency from 100 to 2000 Hz, applied in stomatology.
Using D'Arsonval's works, R. Zeyneck and F. Nagelschmidt in 1905 offered and entered in to lay down. to the practician a method of a diathermy (see) — impact on an organism current of high frequency, low tension and big force (to 3 and).
Opening of radio waves (1895) by A.S. Popov and use of a radio-electronic lamp by L. Stiebock as the generator of high-frequency electromagnetic oscillations in devices for a diathermy promoted creation of an inductothermy (see) — a method E., at Krom affect an organism of the patient with the variation high-frequency magnetic field rendering hl. obr. thermal action on biol. objects.
In a zone of influence temperature of fabrics increases, the spasm of capillaries is removed, arterioles and larger vessels extend, blood supply improves. The inductothermy promotes a rassasyvaniye of the inflammatory centers, increase in intensity of phagocytosis, exchange processes, etc. This method E. apply at treatment of bronchitis, pneumonia, hepatitis, not calculous cholecystitis, a peptic ulcer of a stomach and duodenum, diseases of a musculoskeletal system, polyneurites, an idiopathic hypertensia, etc.
Sometimes in need of a pyrotherapy (see) apply an inductopyrexia — a method E. variation high-frequency magnetic field for the purpose of fervescence of the patient to 39 ° above.
Method E. the electromagnetic field with a frequency from 30 to 300 MHz carries the name of UVCh-therapy (see). Electric field of UVCh has high penetration, edges depends on electric and dielectric properties (see. Dielectric permeability) of fabrics, cells and their components. In to lay down. to practice use continuous and pulse electric field of UVCh, Power of electric field throughout an impulse by 100 times and more exceeds the power of continuous electric field. Under the influence of electric field of UVCh in the lost-circulation zone of energy blood circulation amplifies, there is dehydration of fabrics, phagocytosis is stimulated, processes of regeneration accelerate (see) nervous elements and speed of carrying out nervous impulse. Electric field of UVCh reduces sensitivity of pain receptors, has anti-spastic effect on smooth muscles of a stomach, intestines, a gall bladder, and also a promoting effect on a zhelchevydeleniye and release of intestinal juice. UVCh-therapy is applied at an acute purulent surgical infection (furuncles, an anthrax, phlegmons, etc.), at acute, including purulent, diseases of eyes (a keratitis, a blepharitis, etc.), fish soup, throats, a nose (otitis, antritis, etc.), bronchial tubes, lungs, a liver, a gall bladder, kidneys, a uterus and its appendages, at trophic ulcers, etc.
Method E., based on use of energy of the electromagnetic field of the ultrahigh frequency (microwave oven) from 300 to 300 000 MHz, received the name microwave therapy (see).
In the USSR in to lay down. the purposes use microwaves in centimetric (wavelength of 12,6 cm) and decimeter (wavelength of 6,5 dm) ranges. Microwaves of the electromagnetic field microwave oven cause heating of fabrics due to endogenous heat, especially those, to-rye contain a large amount of water (blood, a lymph, muscles, parenchymatous bodies). Use of electromagnetic fields microwave ovens at an adjusted (oligotermichesky) dosage improves a functional condition of cells, fabrics and bodies. Believe that in implementation of these processes play a part of change of conformation (see) proteinaceous molecules, extent of their hydration, change of bioelectric processes in fabrics. In to lay down. doses of a microwave render antiinflammatory, bacteriostatic, soothing and spasmolytic action, and also the stimulating effect on nervous and endocrine systems and on a metabolism. Microwave therapy is applied at dystrophic diseases of joints and a backbone, a pseudorheumatism (in cases of the minimum and average degrees of activity of process), diseases of peripheral nerves, an acute pneumonia (without the phenomena of destruction In lungs and toxicosis), bronchial asthma easy and moderately severe.
Refer to electrotreatment also magnetotherapy (see) — the method, to-rogo is the cornerstone action on an org a nizm of variation magnetic fields (see). Magnetotherapy can render antiinflammatory and analgesic effect, improve blood circulation, reduce hypostasis of fabrics. Magnetotherapy is shown at hron. venous insufficiency, trophic ulcers, polyneurites in the period of an aggravation, an idiopathic hypertensia, coronary heart disease. Magnetotherapy is incompatible with an induktoteraiiya, UVCh-therapy, microwave therapy, UF-radiation, the general electrophoresis.
In medical practice the combined methods E are widely used., e.g. a medicinal electrophoresis and diadynamic currents (see Diadinamoelektroforez) or a mud-inductothermy, gryazeinduktoforez.
Contraindications to E. are defined by character and intensity of the reactions caused by each of methods. Majority of methods E., the blood vessels causing expansion, activation of blood circulation and exchange processes, it is contraindicated at an elevated temperature of a body, tendency to bleedings, at malignant new growths, active tuberculosis, the closed purulent processes.
AA. at children's age it has to be carried out at intensity of influence by 2 — 3 times smaller, than at adults, and at the smaller duration of procedures. At persons of senile age in connection with decrease in reactivity of an organism and ability to compensate the changes caused by electrotreatment, procedures should be carried out also at smaller intensity of influence, smaller duration of procedures and with big intervals between them.
For safety of the patient and personnel E. it has to be carried out in the conditions excluding a possibility of a touch of the patient to the grounded objects (pipes of water and heating systems, etc.). It is impossible to carry out E. in crude rooms, in rooms with the walls and a floor covered with a tile. Electrotherapeutic procedures can be carried out by only specially prepared medical staff using the equipment allowed M3 of the USSR.
Bibliography: Anikin M. M. and Varshaver G. S. Fundamentals of physical therapy, page 12, M., 1950; Clinical physical therapy, iod of an edition of V. V. Orzheshkovsky, Kiev, 1984; Parfyonov A. P. Electrophoresis of medicinal substances, L., 1973; The Guide to physical therapy and physioprevention of children's diseases, under the editorship of A. N. Obrosov and T. V. Karachevtseva, page 20, M., 1976; Ulashchik V. S. Theory and practice of a medicinal electrophoresis, Minsk, 1976; Edel H. Fibel der Elektrodiagnostik und Elektrotherapie, V., 1983; Electrotherapy, ed. by S. L. Wolf, N. Y. a. o., 1981.
V. G. Yasnogorodsky.