From Big Medical Encyclopedia

SEGMENTARY-REFLEX THERAPY — the method of physical therapy, to-rogo is the cornerstone the influence by physical factors on skin of a certain metamere of a body which is followed by functional changes in the bodies and fabrics belonging preferential besides to a metamere.

Irritation of skin of certain body parts by grindings, introduction of so-called abscessing means, vibration, pressure, etc. used for treatment of various diseases in an extreme antiquity. It is characteristic, as then sites of application of skin irritations corresponded a topic of metameres of a human body (see. Metamerism ). So, at diseases of a bladder put front sights on lumbar area, at quinsy — banks on occipital area, at a sciatica dripped the boiling oil on skin of the lower extremity and lumbar area, etc. Saw exclusively distracting action in the mechanism of influence of these influences. With development of anatomy and physiology premises to interpretation of the mechanism of their action appeared. The works devoted to the reflex mechanism of action of physical fakto-tor, in particular electric irritations began to be published from the second half of 19 century. In 1918 A. Abrams, the author of a method of a spondylotherapy, stated the idea of use of the segmented reflexes arising owing to irritation of body parts on both sides from a backbone for treatment of a number of diseases. M. N. Lapitsky in 1906 — 1916 showed that the therapeutic effect of such influences as banks, mustard plasters, cauterizations of separate body parts, is based on the anatomofiziologichesky bonds which are existing between skin and separate internals and fabrics and having metameric character. In 1924 — 1926 N. M. Rudnitsky and A. R. Kirichinsky drew the same conclusions during the use for treatment of various physical factors.

A. E. Shcherbak distinguished the general, or generalized, regional, universal and segmented reflexes. The general, or generalized, the reflex arises at irritation of all or almost all body surface at the general bathtubs, souls, etc. The regional reflex appears at irritation of the certain areas connected by a vegetative innervation with more deeply the lying bodies and fabrics (e.g., a hepatic, vibration, sexual reflex, etc.) * The universal reflex arises at irritation of any body part and at once accepts generalized character. At a segmented reflex the tone of a vegetative innervation preferential in fabrics of that metamere changes, the irritated surface of skin belongs to Krom. This type of a reflex is a basis of the collar and zone methods which are widely used in physical therapy.

The irritation of skin of a certain part of a body by means of these or those physical factors is followed by functional changes in the bodies and fabrics belonging besides to a metamere, as the irritated skin surface. At the same time there occur changes of a tone of vessels, muscles, secretory and motor activity of internals. The irritation is implemented by the principle of a segmented vegetative reflex. Afferent part of an arch of such reflex are sensitive nerve fibrils, back roots, and at deeper action of a number of physical factors efferent fibers of century of N of page can be an initial part of a reflex arc (see. Vegetative reflexes ).

Metameric reactions are not limited only to vascular manifestations, reactions of muscles, etc., and include also change of microcirculation and metabolism of cells, fabrics and bodies. The nature of reaction is defined by specificity of a physical factor, the Crimea influence the surface of skin. So, thermal irritants influence preferential vasculomotor mechanisms, motor and secretory activity of internals, radiant and electrical energy causes changes during biochemical processes at the level of fabrics and cells that promotes education in fabrics of biologically active agents.

One of widespread methods C. - river of t. the collar method offered by A. E. Shcherbak is. As a zone of influence in this case serves the collar area: neck, area of nadplechiya and verkhneperedny part of a thorax. In to lay down. to practice influence this zone various physical factors: a galvanic current — galvanic or ionic collars on Shcherbaka (see. Galvanization ; Electrophoresis, medicinal ), Uv-radiation (see. Ultraviolet radiation in physical therapy ), electric field of ultrahigh frequency (see. UVCh-therapy ), the electromagnetic field of ultrahigh frequency (see. Microwave therapy ).

The collar area is innervated by back roots of the lower cervical and upper chest spinal nerves and the corresponding segments spinal cord (see). The irritation of skin of this area causes change of a functional condition of cervical nodes of sympathetic trunks of century of N of page that exerts impact on a trophicity of the fabrics innervated by them, on a condition of vessels of the head, heart, upper extremities, on processes of excitement and braking in c. N of page. The therapeutic effect of irritation of collar area under the influence of the physical factors applied in physical therapy is explained by it and indications to use of a collar method at diseases of vessels of the head are defined, at hron. inflammatory processes in the head and a neck, at neurosises. Except metameric reactions, at use of a collar method there is always the general adaptive reaction that allows to use more widely this method at treatment of various diseases.

Along with a collar method in physical therapy widely apply a zone method, i.e. influence by physical factors on skin of lumbosacral (trusikovy) area. At the same time the irritation is applied on the sites of skin connected with lumbar and sacral seg-mentakhm of a spinal cord and by that exert impact on blood supply and a trophicity of bodies of a small pelvis and the lower extremities. As an irritant use a galvanic current (galvanic «belt» and «pants» according to A. E. Shcherbak), Uv-radiation, impulse currents (see). At a zone method widely use also thermal treatment (see). The method is applied at diseases of the lower extremities, intestines (colitis), functional diseases of the men's sexual sphere (impotence), functional and inflammatory diseases of female generative organs, a bladder, in the period of rehabilitation after diseases and injuries of a spinal cord. The zone method, except private metameric reactions, causes the composite general reactions which are expressed in tonic action on all organism, improvement of a dream, appetite, increase in the general tone.

To S. - river of t. carry also a method of influence by various physical factors on mammary glands. The zone of skin and nipple of mammary glands is segmentarno connected with chest segments of a spinal cord and, besides, has the old, ontogenetically defined metameric bonds with lumbar and sacral segments of a spinal cord. Therefore at irritation women of skin of mammary glands or a nipple have responses from bodies of a small pelvis that is used in a wedge, practice for a stop of uterine bleeding, for strengthening of pains and attempts at women in labor, etc.

At diseases of separate internals influence physical factors Zakharyin's zones — Geda — certain areas of skin, in to-rykh at a disease of internals there are so-called synalgias, and also a painful and temperature hyperesthesia (see. Zakharyina — Geda of a zone ). The irritations applied on these zones by the principle of a somatovistseralny reflex (see. Visceral reflexes ), allow to use more locally physical factors for the purpose of impact on certain internals. This principle is used in acupuncture (see), at segmented massage (see), etc. The choice of an irritant and its dosing determine by a preliminary research of skin sensitivity in Zakharyin's zone — Geda.

See also Reflexotherapy .

Bibliography: To A. R causings. Reflex physical therapy, Kiev, 1959; Shcherbak A. E. The main works on physical therapy, L.1936.

M. I. Antropova.