From Big Medical Encyclopedia

FIZIOTER APYYa (Greek physis nature + therapeia treatment; synonym: physical therapy, physical therapy, physical therapy, physical medicine, physical methods of treatment) — the field of medicine studying action on a human body of the natural and artificially created physical factors and using these factors with the medical and preventive purposes.

The term «physical therapy» was accepted in 1905 on the I International congress on physical therapy in Liege and included to lay down. use of all physical factors used at that time — sweet and mineral water, heat, mechanical influences including to lay down. gymnastics and massage, electricity, light, ionizing radiation.

In historical development F. it is possible to allocate three stages conditionally. The first, the earliest, is connected with practical use by ancient people of surrounding natural physical factors — a sunlight, water, air, heat, smoke, etc. — for maintenance of the existence and fight against diseases (see Medicine). The beginning of the second stage belongs to 1 — 2 centuries when A. Tseljs gave the first classification of the most streaming underground mineral waters found by then, and K. Galen developed a number of methods of treatment by mineral waters and dirt. The beginning of the third stage consider the middle of 19 century when deep and consecutive knowledge of properties of the physical factors operating on an organism and development of methods of their medical use began. Significant contribution to development F. brought in our country I. Ya. Deych, A. A. Lozinsky,

C. A. Shchukarev, P. N. Paley, A. N. Ogiljvi, I. G. Koniashvili,

A. N. Bakuradze, Sh. M. Gasanov, E. A. Chernyavsky, L. A. Chubukov, P. G. Mezernitsky, in Western Europe — Messini (M. Messini), Besançon (F. Bezan^on), R. F. Fox, H. Debray, Ya. Wang Times, Bert (J. Century of Burt), H. Fogt, R. Gualtierotti, A. Daissky, etc.

Lech. use of the transformed forms of natural energy (the pre-created physical factors) began in the middle of 18 century. It was promoted by opening of physics and technical science. So, on the basis of Gerike's works (O. of Guericke, 1672) who opened a way of receiving static electricity was created to lay down. the method of franklinization (see), in Krom is used action of constant electric field of a high tension. Researches of Volta (A. Volta, 1792 — 1794) and L. Galjvani (1797) gave rise to use in physiology of direct (galvanic) current and were a basis of creation to lay down. a method of galvanization (see). Opening by Faraday (M. of Faraday, 1833 — 1834) laws of electrolysis led to creation of a method of a medicinal electrophoresis (see the Electrophoresis), and opening of laws of electromagnetic induction (1831) by it, along with use by the Russian doctor A. - baht of the induction coil for receiving alternating low-frequency current (1848), caused emergence modern to lay down. methods of electrostimulation (see), an electrosleep (see), an electroanaesthesia (see the Electroanesthesia). In 1891. N. Tesla opened a method of high-frequency high-voltage transformation of tension, and in 1892 the physiologist Zh.-A. d'Arsonval suggested for to lay down. practicians the method developed by it on the basis of opening of Tesla which received the name of darsonvalization (see). Using J.-A. D'Arsonval's works, R. Zeyneck and F. Na-gelschmidt in 1905 developed and entered in to lay down. to the practician a method of impact on the organism current of high frequency, low tension and big force which received the name of a diathermy (see); the method laid the foundation to lay down. to use of high-frequency currents.

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 a method of a short-wave diathermy known in our country as an inductothermy (see). Shlipkhake, Pet-tsold and Ezau (E. Schliephake, J. Pat-zold, A. Esau) in 1926 developed a method of UVCh-therapy (see), and then and methods of microwave therapy (see). In the next years G. L. Frenkel, V. V. Tatarinov, A. M. Ku-gushev, etc. conducted the basic researches of action of high-frequency electromagnetic oscillations on an organism which proved their wide to lay down. use.

Thanks to opening in 1803

by V. Petrov of an electric arch and to the invention in 1874 by A. N. Lodygin of an electric filament lamp there was an opportunity to use energy of artificial light sources — Minin's lamps (see. Infrared radiation), open arc electrolamps of Finsen, etc. A research of properties of an electric arch in vapors of mercury [Arons, 1892; A. Kush, 1911;

A. Maklakov, 1911, etc.] led to development and broad use in medicine of a method of UF-radiation (see. At l ypraf and about l of et about e radiate N iye). On the basis of the method of a luminescence developed by S. I. Vavilov the equipment for obtaining Uv-radiation of different ranges was created. In the 30th years in F. began to apply a method of an aeroionoteragsha (see Aeroionization), and in the 40th — a method of ultrasonic therapy (see). Also various techniques of a vibrotherapy were developed (see).

Creation of the laser equipment led to use of nek-ry types of the lasers (having low-energy radiation) in physical therapy (see the Laser) in recent years. Intensively also the method to lay down is developed. influences by constant and variation low-frequency magnetic field (see Magnetotherapy).

To lay down. action of physical factors is characterized by a community fiziol. reactions that complicates classification them on made fiziol. to effect. Thereof all physical factors can be divided by the form to energy and the nature of physical impact.

In a crust, time in physical therapy select sections of electrotreatment (see), phototherapy (see), mechanotreatments (see Mekhanoterapiya), a fizi-kofarma to treatment, balneotherapy (see) and thermal treatment (see). Each of them includes group of the methods which are based on action of certain physical factors. The greatest number of methods combines electrotreatment. The methods based on use of different types of electric current enter it: constant invariable size — galvanization (see); sinusoidal modulated — amplipulsetherapy (see. Impulse currents) \the constants pulsing with a frequency of 50 and 100 pulsations of 1 sec. — diadynamotherapy (see. Impulse currents); interfering with a frequency of 3 — 6 kHz — interference-therapy; short-pulse low frequency for impact on c. N of page — an electroanaesthesia (see the Electroanesthesia), an electrosleep (see) and on peripheral nerves — a method of electrosuppression of pain; pulse low frequency with various parameters — electrostimulation (see); sinusoidal, randomly changing on amplitude and frequency within 100 — 2000 Hz — a flyuktuorization; sinusoidal pulse with a frequency of 20 kHz — a method of treatment by currents of supratonal frequency; sinusoidal pulse with a frequency of 110 kHz — darsonvalization (see). Also the methods based on use of constant electric field of a high tension — franc tenches a zation enter electrotreatment (see); the methods based on action of variation magnetic field of low frequency — low-frequency magnetotherapy (see M an agnitoterapiya)’, the methods based on action of electromagnetic fields high (see the Inductothermy), ultrahigh (see UVCh-therapy) and ultrahigh frequencies (see. Microwave therapy).

Phototherapy combines the methods using energy of electromagnetic oscillations light and wave bands, close to it, in particular ultra-violet (see. Ultraviolet radiation), infrared (see. Infrared radiation ■), visible radiation (see Phototherapy).

Balneotherapy combines the methods based on use of sweet water in the form of various flourishes (see the Shower), douches, rubdowns, wrappings (see Balneotherapy), partial and general bathtubs, contrast hydrotherapeutic procedures, bathtubs with gradually changing water temperature, vortex bathtubs (see Bathtubs), an underwater shower massage (see the Shower massage). Balneoterapiya is based on use of bathtubs of various gas and chemical structure.

Thermal treatment includes methods, in to-rykh is used warmly heated paraffin (see Iiarafinolecheniye), ozokerite (see the Ozoceritotherapy), sand (see. Sand bathtubs), various peloid (see Mud cure), and also the Russian bath and a sauna (see Balneotherapy).

Mechanotreatment combines the methods based on influence of mechanical energy: different types of massage (see), manual therapy (see Chiropractic), a vibrotherapy (see), influence by ultrasound (see Ultrasound), and also mechanotherapy using various devices (see Mekhanoterapiya).

Fizikofarmakolecheniye combines methods of simultaneous impact on an organism of physical factors and pharmaceuticals. Treat him a medicinal electrophoresis (see), fonoforez (see. Ultrasonic therapy), an electrical aerosol therapy (see the Aerosoltherapy).

As a rule, methods F. are used as a component in a complex with other methods of treatment. In some cases F. it can be applied as the leading method.

On modern representations, action of physical factors is defined on an organism by set of the changes caused by them physical. - chemical properties of cells and the exchange processes proceeding in them, and also the general reactions, to-rye arise in physiological functional systems under the influence of their influence and have the nervnoreflektorny and humoral nature. The energy of physical factors absorbed by various structures of an organism causes in them formation of iyerekisny connections, free radicals, ionic particles or interstitial heat. Their emergence gives rise to a number physical. - chemical and biochemical transformations, products to-rykh (biologically active agents) influence a humoral way various systems of an organism. Besides, also forward reflex reactions in response to absorption of energy of physical factors take place. The most frequent physiological reaction is strengthening of a blood-groove that promotes elimination in a zone of influence of excess of heat or to removal of biologically active agents.

Physical factors, influencing an organism, cause specific and nonspecific reactions. Reactions are specific, to-rye develop under the influence of only a certain physical factor (e.g., formation of vitamin D and an erythema at UF-radiation, reduction of muscle fibers at use of impulse currents, etc.). The reactions of an organism inherent to influence of many physical factors are nonspecific (e.g., endogenous heat generation, strengthening or redistribution of a blood-groove, change of exchange processes in various systems and bodies). Nonspecific reactions are inseparable from specific and hl are observed. obr. at action of physical factors in high doses.

T. possesses means of anesthesia, improvement of the central, peripheric and regional circulation, improvement of a trophicity of fabrics, normalization of neyrogumo-ralny regulation and the broken reactions of immunity that defines Broad use it at various diseases. T. it is used also for prevention and recovery treatment.

At cardiovascular diseases physical factors apply to improvement of noncardiac nervous control of cordial activity, normalization of the broken functional condition of c. N of page, exchange processes in a myocardium, a tone of vessels, regional and peripheric circulation, and also for unloading of a myocardium and rendering on it the training influence.

At diseases of a nervous system F. it is directed to normalization of functions of the central and peripheral nervous system by immediate effect on nervous structures, and also by means of

improvement of blood circulation and a trophicity of nervous tissue. Soothing action of physical factors and ability to normalize their functions century of N of page is widely used. Special value has use of physical factors for the purpose of recovery or compensation of the broken motive functions as a result of diseases or injuries of a nervous system.

At diseases of the digestive system F. it is directed to improvement of a trophicity and functional condition of bodies went. - kish. a path, and also on recovery or compensation of the functions of the digestive device lost or sharply reduced as a result of operative measures.

At diseases and injuries of a musculoskeletal system influence of physical factors is directed to normalization of blood circulation, a trophicity of bone, cartilaginous and muscular fabrics, removal of a pain syndrome and inflammation, stimulation of processes of regeneration in the damaged fabrics, recovery of their innervation, increase in amplitude of Movements in joints.

Physical factors are applied in obstetrics and gynecology at nek-ry types of pathology of pregnancy, complications of a climacteric, at treatment hron. inflammatory diseases of a uterus and appendages, infertility.

T. apply during all age periods of life. At advanced age because of decrease in resistance of an organism to loadings, reduction of adaptation opportunities and sensitization to action of environmental factors reduce intensity, duration, and also frequency of repetition of procedures. Exclude also the procedures representing considerable loading for an organism (the general bathtubs and mud applications on a big body surface).

For treatment of children use the same physical factors, as for treatment of adults. However they are appointed and dosed taking into account ana-tomo-physiological features of an organism of the child. To newborns and babies physiotherapeutic influences carry out carefully because of incompleteness of formation of many bodies and systems (first of all nervous), the adaptive reactions insufficiently developed, intensive growth, lack of information on feelings. During the holding physiotherapeutic procedures teenagers should be careful in connection with the deviations which are quite often taking at them place in a functional condition

of nervous, endocrine and cardiovascular systems, and also because of a hyperreactivity of an organism.

The physical factors having ability to stimulate functions of bodies and systems, to have the «training» effect apply to increase in body resistance to adverse influences of the environment. At light starvation (see) carry out UF-radiation, using for this purpose the long-wave area UF-spekt-ra. Apply all types of balneotherapy in combination with a physical activity to the prevention of respiratory diseases.

Medical and preventive use of physical factors is carried out in physiotherapeutic offices (see) and departments of BC and policlinics, in chambers of hospitals, at home, in physiotherapeutic hospitals (see), dispensaries (see Sanatorium dispensary), sanatoria (see), rest houses, kindergartens, a day nursery, summer camps, tourist bases.

By the beginning of the 80th in system of healthcare institutions more than 20 thousand physiotherapeutic offices and departments and more than 50 physiotherapeutic BCs accepting annually St. 80 million patients worked. In the country there are

more than 2 thousand sanatoria, boarding houses with treatment and the same number of sanatoria dispensaries at the industrial enterprises which are widely using physiotherapeutic methods in a complex of remedies.

Perspective of further development F. consists in a broad research molecular, cellular and system-wide (neurogenic, humoral, immune) mechanisms of action of physical factors, search of new physical means for selective impact on various intracellular processes and structures, and also functional systems of an organism. Urgent are researches on optimization of physiotherapeutic influences: to definition

of the most effective doses, localization of influence of a physical factor, a combination of physical factors in to lay down. process, development of modes of exposure according to daily allowance biol. rhythms of an organism and phase activity of bodies and systems. Also development of techniques of use F is necessary. in the acute period of diseases, at recovery treatment, and also treatment of new growths, including malignant. Researches of a possibility of increase pharmakol are of great interest. activities of pharmaceuticals with the help fizichesky factors.

Research, methodical and scientific and organizational work on F. in our country it is conducted industry Scientific Research Institute M3 SSSR and federal republics (see Nauchno-is-sledovatelskiye institutes, the tab.), and also a number of specialized departments of republican scientific institutions of health care, departments of physical therapy of in-t of improvement of doctors and separate laboratories of territorial councils for management of resorts of labor unions. Head establishment is the Central scientific research institute of balneology and physical therapy of M3 of the USSR.

In the USSR specialists in the area F. are united in All-Union scientific medical in physiotherapists and balneologists, founded in 1951 on the basis of organized in 1923. All-Union association of physiotherapists, and also about-va balneologists. Tasks All-Union about-va include illumination of theoretical and methodical questions of physical therapy and balneology, use of physiotherapeutic methods in practice of health care, promotion among the population of the correct use of natural physical factors, coordination of work republican physiotherapists and balneologists. All-Union about-in held eight all-Union congresses, an all-Union conference and two plenums since 1953, on to-rykh scientific and organizational questions were considered.

Training of specialists in the area F. and their improvement are carried out at departments of physical therapy f-tov improvements of medical institutes, in in-ta of improvement of doctors, and also in scientific research institute of balneology and physical therapy. Central and nek-ry republican scientific research institutes of physical therapy publish collections of scientific works, the guides and reference books on physical therapy and balneology for doctors and average medics.

Since 1923 in the USSR the specialized magazine «Voprosy Kurortologii, Fizioterapii I Lechebnoy Fizicheskoy Kultury» is issued. Abroad problems of physical therapy are covered by hl. obr. in magazines «Physiotherapy», «American Journal of Physical Medicine», «Zeitschrift fur Phy-siotherapie», etc. (the short list of periodicals on F. — see the bibliography).

Bibliography: History — Belyav with to and y F. Galvanizm in use to medical practice, M., 1859; To about in and l e in with to and y the Lake.

About electricity and its methodical use to the medical purposes, p.1, SPb., 1858; To about w a r s e h i k J. Elek-trotherapie, B., 1929; R about 1 1 i e r A.

Heliotherapy, L. — Oxford, 1927; S with h 1 i-e p li a k e E. Short wave therapy, L., 1936.

Textbooks, the guides, the reference

media — Ania to and M. M N „and In and r-

sh and in e r G. S. Fundamentals of physical therapy, M., 1950; Balneoterapiya at diseases at children's age, under the editorship of T. V. Ka-rachevtseva, M., i960; Bernard P.

Diodinamicheskaya therapy, the lane with fr., M., 1961; Voronin H. M. Fundamentals of medical and biological climatology, M., 1981; Gilyarovsky V. A., etc. Electrosleep, M., 1958; The Lip

N. I. and At t e p is new e r e N about in A. A, Medical biophysics, M., 1978; I. I. Radonoterapiya's Hussars, M., 1974; E f and N about in O. I. and D z and N and the island and T. F. Fizioterapiya of dental diseases, M., 1980; To and r and h and nanosecond to and y A. R. Reflex physical therapy, Kiev, 1959; Kreymer A. Ya.

Vibration as medical factor, Tomsk, 1972; L and in e N of c e in H. M and L and in e nanosecond about A. R N. Electromedical equipment, M., 1974; About r about with about in A. N. and L and venets of H. M. Elektrodiagnostika and electrostimulation of muscles at defeat of peripheral nerves, M., 1953; Olefirenko V. T. Water-teplole-cheniye, M., 1978; P about r tn about in F. G.

Elektroaerozolterapiya, Riga, 1976; The Guide to physical therapy and physioprevention of children's diseases, under the editorship of

A. N. Obrosov and T. V. Karachevtseva, M., 1976; From hens and cinchona L. A. Physical factors in treatment of patients with diseases of cardiovascular system, M., 1979; With about with and I. N. N and Lants-m and Yu. V. Fizioterapiya's N in traumatology and orthopedics, Tomsk, 1981; Speransky A. The item and R about to and t I am nanosecond to and y V. I. Ultrasound and its medical use, M., 1970; The Reference book on physical therapy, under the editorship of A. N. Obrosov, M., 1976; Strugatsky V. M. Physical factors in obstetrics and gynecology, M., 1981; T and r I am I. Fizik's N for doctors and biologists, the lane with Wenger., Budapest, 1969; At l and shch and to V. S. Theory and practice of a medicinal electrophoresis, Minsk, 1976; it, Introduction to theoretical bases of physical therapy, Minsk, 1981; The Manual on physical therapy, under the editorship of A. P. Speransky, M., 1975; Physical factors in complex treatment and prevention of internal and nervous diseases, under the editorship of A. N. Obrosov, M., 1971; C and r f and with P. G. Action of natural factors on the person, M., 1982; The P e r and to the h and L. E. Fizioterapiya in ophthalmology, Kiev, 1979; Chir-kin A. A., Bogdanovich I. JT. both Ulashchik V. S. Ultrazvuk and reactivity of an organism, Minsk, 1977; Sh e-marked And. And In about r about e in M. G. Modern methods electro-and phototherapy, L., 1980; D and y with to and A. G. Bal-neologiya, Sofia, 1977; To and r h e in and S. S. and d the river Obshcha physical therapy, Sofia, 1959; To about the h and N to about in D. and Mikhalkov of M. Fizioprofilaktik and the zakalyavena, Sofia, 1975; E d e 1 H. Fibel der Elektrodiag-nostik und Elektrotherapie, Dresden, 1975; Fizykoterapia ogolna i neihiozna, pod red. J. Jankowiaka, Warszawa, 1972; Knocli H. - G» u. Knauth K. The-rapie mit Ultraschall, Jena, 1977; S e-dan R. e. a. La neurostimulation of £lectri-que tl^rapeutique, P., 1978.

Periodicals — Questions of balneology, physical therapy and medical physical culture, M., since 1955 (1923 — 1928 — Resort business, 1929 — 1931 —

Resort and sanatorium business, 1932 — Resorts, physical therapy and working rest, 1933 — 1936 — Balneology and physical therapy, 1937 — 1941 — Questions of balneology); Physical therapy, M., 1937 — 1941; Kurorto

a logiya and physical therapy, Sofia, since 1964; Acupuncture and Electrotherapeutics Research, The International Journal, Oxford and. the lake, since 1976; American Journal of Physical Medicine, Baltimore, since 1952 (1922 — 1951 — Occupational Therapy and Rehabilitation); Annales de l’lnstitut d’hydrologie et de climatologie, P., since 1913; Archives of Physical Medicine and Rehabilitation, Chicago, since 1953 (1920 — 1925 —

Journal of Radio logy, 1926 — 1944 — Archives of Physical Therapy, X-ray, Radium, 1945 — 1952 — - Archives of Physical Medicine); Balneolo-gia Polska, Warszawa, since 1951; Clinica ter-male, Roma, since 1948; Excerpta medica, Section XIX, Rehabilitation and Physical Medicine, Amsterdam, since 1947; Fysiatricky a Revmatologicky Vestnik, Praha, since 1966 (1953 — 1965 — Fysiatricky Vestnik); Journal of Japanese Association of Physical Medicine, Balneology and Climatology, Tokyo, since 1937; Physical Therapy, N. Y., since 1964; Physiotherapy, L., since 1916; Physiotherapy, Montreal, since 1923; Presse thermale et climatique, P., since 1886; Scandinavian Journal of Rehabilitation Medicine, Stockholm, since 1969; Zeitschrift fiir angewandte Bader-und Klimaheilkunde, Stuttgart, since 1954; Zeitschrift fiir Bader-und Klimaheilkunde, Stuttgart, since 1980; Zeitschrift fiir Physiotherapie, Lpz., since 1949.

A. H. Obrosov, V. G. Yasnogorodsky