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about the patient's treatment
in JSC " Medical services» Polyclinic No. 6

1. All appointments of specialists of Polyclinic No. 6 are carried out by appointment. In this regard, you can make an appointment with the specialist you are interested in by calling +7 495 474-00-00 or +7 499 189-98-48, as well as through our website www.site
2. If you do not know exactly which specialist to contact, you need to make an appointment with a doctor general practice(therapist) for a full examination and, if necessary, for further referral to narrow specialists.
3. During the initial visit, in order to draw up the necessary documents (contract for the provision of services, consent to the processing of biometric personal data, rules for providing medical organizations paid medical services, as well as informed voluntary consent for medical intervention and refusal of medical intervention in relation to certain types of medical interventions), you must come to the registration desk no later than 15 minutes before the appointment time of a specialist, be sure to have an identity document with you.
4. Medical services are provided both for cash in rubles, by bank transfer (bank cards), under a voluntary medical insurance policy (VHI), under concluded agreements. Payment can be made at the box office on the 1st floor, as well as at the box office of the Dental Department of the Polyclinic on the 2nd floor. In addition, for the convenience of patients, calling doctor at home, it is possible to pay for this service through the Internet portal www.site
5. When entering the Polyclinic, please wear shoe covers, as well as take outerwear to the wardrobe located to the left of the entrance to keep the Polyclinic clean.
6. We kindly ask you to arrive at the Polyclinic in advance in order to avoid being late for an appointment with a specialist. In case of a delay of more than 10 minutes, the specialist will be forced to accept the next patient, rescheduling your visit to a free time from the appointment (possibly to another appointment day).
7. If the Patient has test results or other research methods obtained in other medical institutions Russian Federation, please provide them to the specialist for consideration on paper in a readable form at the beginning of the appointment.
8. Please note that the estimated appointment time is no more than 30 minutes, and therefore you should respect the work of our specialists, as well as patients who are waiting for their appointment, including turning off the sound mobile phone before entering the office, and also not to try to communicate with a specialist on topics that are distracted from the medical appointment.
9. Having received the results of all the prescribed studies, it is necessary to sign up for a second consultation (at a discount) with a doctor who, based on these results, will make a final decision and prescribe necessary treatment. In case of incomplete registration and loading of a specialist, we will be happy to carry out a second consultation on the day of the initial appointment.
10. If there is a need to obtain an extract or a copy of medical records, please make a written application to the Head Physician of the Polyclinic. We undertake to provide the relevant documents within five days.
11. We are happy to provide documents for the tax service. To do this, you must first contact the reception of the Chief Physician of the Polyclinic.
12. Treatment of children under 18 years of age is carried out necessarily accompanied by a legal representative (one of the parents or another person with a notarized power of attorney).
13. If you have any questions about the quality of treatment, please submit a written application to the Deputy Chief Physician of the Polyclinic at medical work. Our registrars will help you with this. We will definitely consider each request as soon as possible and report the results.
14. It seems necessary to inform that we reserve the right to refuse to provide the service without explanation to visitors with the smell of alcohol, inappropriate behavior.
15. If you are late or cannot arrive at the appointment at all, please notify us by phone: +7 495 474-00-00 or +7 499 189-98-48. At this time, we can help a person who needs our help.

We hope that visiting our clinic will help you solve your health problems!

Sincerely,
Administration of JSC "Medical Services" Polyclinic No. 6

Thanks to this, oxygen and nutrients saturate the blood vessels faster and regeneration takes place quickly, and pain and inflammation gradually disappear.

Diseases that ICT treats

This therapy is used in the treatment of a variety of diseases:

• Osteochondrosis;
• Arthritis;
• Vertebral hernia;
• Injuries;
• heel spur;
• Vascular system;
• Diseases of the prostate.

I must say that IWT has helped many women cope with cellulite. It decreases after several treatments.

Arthrosis

The use of IWT in the treatment of arthrosis has only recently begun. Conducted studies, numerous patient reviews show that this method in the treatment of affected joints can be an excellent assistant in restorative therapy.

Pulsed Wave Therapy also treats:

• Diseases of the spine;
• Arthrosis of the hip joint;
• Deforming arthrosis of the knee joint;
• Heart disease.

The IWT apparatus, thanks to sound vibrations, makes the structure of osteophytes much “softer”. A patient with arthrosis, in which the disease is expressed by spike-like processes, feels great relief after taking a course of IWT. After some time, the spikes completely dissolve, and complete recovery occurs.

The skeletal system and its treatment

Pulsed wave therapy has become the most modern way to treat the musculoskeletal system.

She first appeared in Switzerland. Here, doctors began to treat the affected tissues with acoustic waves operating at the frequency of infrasound.

When exposed to IWT, calcium salts, which are a source of pain, are destroyed, blood circulation and ligament elasticity improve, swelling and inflammation go away, and metabolism is restored.

Impulse waves greatly increase the movement of microcirculation in all small vessels.

Due to the specific action of acoustic waves, certain processes begin to occur:

• Improves metabolism;
• Cells are updated;
• Increases vascular blood flow.

As a result of the use of IWT, accelerated healing occurs, joint mobility is restored. This procedure has an excellent analgesic effect.

Treatment effectiveness

Impulse therapy today is considered the most promising area of ​​modern medicine. Now, in return surgical intervention, doctors began to use the IWT method. The effectiveness of this method has been proven by thousands of recovered patients.

Patients who have completed a course of IWT note the following positive symptoms:

• Affected tissues began to recover at an accelerated pace;
• Much improved metabolism;
• Puffiness subsided completely;
• There was an opportunity to start working again;
• have dropped a lot pain. After a few sessions, the pain completely disappeared.

Note that pulse therapy shows excellent results in the treatment of various pathologies.

Osteochondrosis

• After several procedures, blood circulation in the body improves, microcirculation returns to normal.
• The patient no longer experiences severe pain, the inflammatory process gradually disappears.
• Pathological outgrowths become smaller;
• Work is getting better nervous system.

Thrombosis

Thanks to high-frequency vibration, complications are minimized.

There is a destruction of the thrombus and its resorption after a few days.

Scoliosis

• Damaged tissues begin to recover quickly.
• The patient ceases to feel severe back pain.

The number of diseases that are very effectively treated with the help of IWT is growing every day. Today, this method is used in various departments of medicine:

erectile disfunction

With age sexual function in men it gradually decreases. But when the work of the vessels through which blood enters the penis is disrupted in the body, impotence or erectile dysfunction occurs. Impulse wave therapy is also applicable for the treatment of impotence.

Today, hundreds of methods have been developed that treat erectile dysfunction. However, not all of them give a positive result, professional doctors have reasonable claims to some.

Physiotherapy deals with the problem of male erectile dysfunction. The most promising method of treatment is pulsed wave therapy.

This procedure is completely painless, lasts 25 minutes and is performed on an outpatient basis. No contraindications have been identified. Pulse therapy restores the work of blood vessels by acting on them with short-term discharges.

The best result of treatment is the complete restoration of the work of blood vessels, there is a complete return of erectile function.

Efficiency of impulse application wave therapy fully proven by scientists and helps to get rid of many diseases.

Pulsed wave joint therapy: indications

In the structure of morbidity, one of the main places is occupied by joint diseases. Currently for their treatment pharmaceutical companies They offer a wide variety of medications and supplements. Along with them, no less effective physiotherapy treatment can be used. The main place among physiotherapeutic methods is occupied by pulsed wave therapy of the joints. The principle of impact on the articular cavity, indications and contraindications for this treatment will be discussed below.

Shock wave therapy for joints

Pulsed wave therapy is also called shock wave therapy. This method belongs to one of the modern methods of treating articular diseases. Shock wave therapy for joints (SWT) is based on low-frequency sound, less than 16 Hz, which is not heard by the human ear.

The principle of operation of UVT

What is the treatment of articular pathology with a shock wave based on? The mechanism of action is as follows:

1. In the process of wave action on the cell wall, it is stretched, its permeability for various substances entering and leaving the cell increases, that is, the metabolism is accelerated. By improving microcirculation, accelerated recovery damaged structures, calcium deposits dissolve.
2. Due to the pressure of the wave, cavities are formed. If the pressure is continued, the cavities burst, which allows the destruction of intra-articular calcium deposits.
3. After the cavities have burst, smaller waves are formed, which contribute to the further destruction of pathological formations.
4. An important point is to reduce the intensity of pain due to a decrease in the passage of pain nerve impulses. In addition, the production of the hormone endorphin, which also helps to reduce pain, increases. Also, UVT destroys areas of fibrosis.

What joint diseases does SWT treat?

Shock waves are used in the following pathological conditions:

1. Arthrosis. This pathology is found in almost 80% of the population, is in third place in prevalence after cardiac and oncological diseases. Basically, shock wave therapy is used for arthrosis of the knee joint, as well as for the treatment of arthrosis of the ankle.
2. Contracture. The result of improved microcirculation is the return of elasticity of the ligaments. After therapy, the range of motion increases.
3. Degenerative changes in the joint cavity.
4. Injuries and fractures in the articular region. By improving blood circulation, there is a fairly rapid recovery of articular tissues and structures.

SWT is designed to quickly relieve pain and restore joint mobility.

SWT is also used to develop the joint in the process of rehabilitation of patients after surgery. In addition, this method is used if conventional drugs no longer help and there is a question about surgical intervention. Pulsed wave treatment will help to avoid surgery.

Contraindications to the procedure

In which case it is impossible to use shock wave therapy for arthrosis? Contraindications to such treatment are:

1. Pregnancy.
2. Low blood clotting. This is due to the likelihood of bleeding due to damage to blood vessels by waves.
3. Age up to 18 years. This is due to the fact that the growth zone on the bones is not yet closed, and when exposed to waves, tissue growth can stop and lead to bone deformation.
4. The presence of tumors in the body, especially near the focus of application of the SWT apparatus.
5. The presence of a pacemaker. Wave action can disrupt its operation or disable it.
6. The presence of an inflammatory infectious process in the knee, ankle or other joints. Due to increased intra-articular circulation, infectious agents can be spread to all organs and tissues.
7. When exposed to waves on nerves or nerve plexuses, paresis or impaired sensitivity may develop.
8. You can not use the UVT device on the border with organs that contain gas inside themselves: lungs, intestines.

• swelling of the joint;
• redness of the skin over it;
• occurrence of intraarticular hematoma.

The listed side effects are not an indication for interrupting the course. As a rule, they pass within 10 days.

How is the procedure?

Treatment of joints with shock wave therapy is carried out as follows:

1. The doctor palpates the affected area.
2. A special gel is applied to the pathological focus, which facilitates the transmission of impulses from the device to the application site.
3. The doctor determines the necessary frequency and time of exposure to the pathological focus. Next, the applicator is pressed against the site of exposure and the procedure begins, which lasts 15-30 minutes.

The course requires about 6 procedures. Each procedure is carried out with an interval of 7-10 days. During this period of time, the body removes the remnants of calcifications from the site of exposure. The procedure is completely painless.

SWT of the knee joint gives a good result: remission lasts 2-3 years.

Shock wave therapy for arthrosis: reviews

Here's what doctors and patients think about shock therapy.

Alexey Mikhailovich, orthopedist, Moscow:

“I have been treating joints with a shock wave for about three years. Efficiency is high, especially in relation to arthrosis. The condition of patients with pathology of muscles and tendons also improves. The method can be used as monotherapy, while the effectiveness is higher than that of other methods of treatment. SWT allows you to restore damaged structures and relieve inflammation and pain.

“Worried about the pain due to arthrosis of the ankle joint. I will do a course of injections prescribed by the doctor - the pain subsides, but not completely. I read about shock wave treatment on the Internet. I consulted with the doctor, he recommended taking a course. The procedure is inexpensive. After the first time, the pain was much reduced, but did not disappear. She completed the course, the pain went away and has not returned. I recommend UVT treatment for ankle arthrosis to everyone.”

Eugene R., 52 years old:

“I have been suffering from arthritis of the knee for a long time. Constant pain, subsiding only for a while after taking or injecting painkillers. Heard about such treatment as shock wave therapy of the knee joint. Decided to try. After the first procedures, the pain became noticeably weaker, and after the course of treatment, the pain was gone. I recommend to everyone to treat the knee joint with shock wave therapy.”

Gonarthrosis or deforming arthrosis is an inflammatory disease of the knee joint. With this disease, degenerative dystrophy or osteoarthritis of the cartilage occurs. Not only the cartilage inside the joint is deformed, but the entire joint (ligaments, capsule, subchondral bone, periarticular muscles, synovial membrane).

Gonarthrosis usually occurs after exposure to subtle underlying causes, but is most likely a consequence of idopathic or primary osteoarthritis. Gonarthrosis begins to gradually affect various sections of the joint, for example, the inner section, anterior or outer section.

There are a number of reasons why you need to see a doctor immediately. You may have gonarthrosis if:

• You have stiffness in a joint or partial restriction of movement;
• You have severe joint pain that occurs after exercise;
• You feel a feeling of instability in the joint;
• You have swelling or swelling in the joint area;
• Your joint has changed or deformed.

Gonarthrosis develops in stages, depending on its severity or duration, there are several stages of this disease:

• Stage 1 - pain appears periodically, but most often it occurs after strong physical exertion. Slightly noticeable swelling or slight deformity of the joint.
• Stage 2 - symptoms of stage 1 gonarthrosis increase significantly. The pain increases in degree and duration. Often there is a feeling of stiffness or a crunch in the affected joint. The joint is severely deformed or changes in size.
• Stage 3 - severe pain appears both with strong movement and at rest. There are severe pains due to weather changes, there is a sharp change in movement and severe deformity of the joint.

Shock wave therapy has a positive effect on the affected tissues. Charged pulses break down the formed calcium salts or the resulting areas of fibrosis, which are usually formed in gonarthrosis after chronic injuries, where there are micro-tears of muscles, tendons, ligaments. Shock wave therapy changes the chemical environment inside the inflamed joint. After this exposure, the pain becomes almost imperceptible or disappears completely.

The effect of shock wave therapy is noticeable after the first procedure.

Charged impulses affect the blood flow inside the damaged tissue, this stimulates tissue regeneration. The formed calcium salts leave the human body with the bloodstream. Then a sharp recovery of the affected area is noticed: swelling, inflammation disappear, the tissue becomes elastic. A person can calmly and painlessly endure physical activity. After the positive effect of shock wave therapy, new microcapillaries are formed - this has a positive effect on the rapid recovery of the patient.

Treatment of gonarthrosis is completely painless. The duration of one session varies from 10 to 40 minutes. For full recovery usually about 4-10 sessions are enough. Between procedures it is necessary to maintain an interval of 5-10 days. During the session, the patient lies down, the skin is treated with a special gel, and treatment with shock wave therapy begins.

Step 1: F-SW (combination therapy)

The pain already after the first session is significantly reduced or disappears completely, but after 2-3 hours after the procedure, the pain may occur again. Don't worry, this is a normal healing process. At the end of all treatment sessions, the pain will leave your body forever. No recurrence or complications after treatment have yet been observed.

Before the treatment itself, your consulting doctor will determine the duration of your course of treatment and draw up a post-treatment rehabilitation program. Most likely, it will be a set of physical exercises or additional procedures. For each patient, the treatment, the duration of the periods between sessions and the duration of the sessions themselves are selected only individually. It depends on the degree of gonarthrosis, the presence of concomitant diseases and the personal characteristics of the patient.

Shock wave therapy completely relieves swelling, accelerates healing, relieves pain and inflammation, gives elasticity and tone to muscles, completely removes formed calcium, increases collagen production, increases microcirculation of the affected area and increases metabolism. Charged impulses act only on the affected tissues, not touching the healthy ones at all. This guarantees the treatment of gonarthrosis without injury to soft tissues and skin. In a healthy area, new vessels form. This allows you to maintain a healthy state of the newly affected area.

Doctor Dunaev Vladimir Igorevich

Treatment of arthrosis shock

therapy for joints

Shock wave therapy restores the capillaries, fills the painful area with oxygen. It also completely restores the former mobility of the joint, removes scars or scars on the skin. Shock wave therapy is a modern method of treatment that allows you to completely cure not only gonarthrosis, but also many other diseases.

It might be interesting

Shock wave therapy doctors in our clinic

Dunaev Vladimir Igorevich

Urologist, chiropractor, acupuncturist, UVT specialist

Doctor the highest category. He has extensive experience in the non-surgical treatment of herniated intervertebral discs, the treatment of pain, degenerative, vascular syndromes associated with the pathology of the musculoskeletal system. Professional, with a constant desire for improvement.

Work experience in the specialty - more than 25 years.

The cost of treating diseases of the knee joint with shock wave therapy

Book a consultation about shock wave therapy

Questions from users on our website about shock wave therapy

Good afternoon. I ask you to formulate the question more precisely and indicate the UVT of which area you plan to perform?

Good day, Andrey! Are you interested in the possibility of SWT in general, in the presence of an endoprosthesis, or specifically on the operated joint? In general, it is possible. In particular, on the operated joint - extremely rarely, and in conjunction with the examination data, the nature of complaints, risk assessment and the expected effect of treatment. I want to inform you that in addition to SWT, there are quite a few modern methods of influencing the knee joint, which are used depending on the main complaints of the patient. This is HILT (high intensity laser therapy), joint taping, the use of specialized orthoses, manual therapy, kinesiology, exercise therapy, massage, griseo-hirudotherapy, etc., etc., etc. But the main thing is the patient, his condition and his complaints. If you decide to contact us at the clinic, then your treatment and examination will be based on this postulate. Sincerely, V.I. Dunaev, Deputy General Director of the clinic. UVT Specialist.

Ask your question about shock wave therapy

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Pulsed wave therapy - contraindications and benefits

Medicine now simply surprises every person with its new developments, one of these areas is IWT - pulsed wave therapy. This is a modern method that allows you to cope with many ailments in the body of each person. Thanks to this process, soft tissues are restored, as well as the growth of blood vessels in the area of ​​their damage. As a result, this process removes inflammation, and the pain goes away.

How does this recovery process work?

Many are interested in how it all works, and for what problems does the treatment process take place? This method helps to cope with many diseases:

• Arthritis.
• Osteochondrosis.
• The presence of vertebral hernias.
• Any other injury.
• Violation in the vascular system.
• Problems of sexual significance, etc.

In addition, this method helps every woman to cope with such a problem that worries many - this is cellulite. When carrying out this procedure, after a couple of receptions, everything is significantly reduced. As a result, it turns out that pulsed wave therapy brings benefits. But many, when various new methods of treatment appear, are always wondering if there are any contraindications that can negatively affect human health. Of course, this is always present, for this reason, any method of treatment should be prescribed with the approval of a competent specialist so that there are no side effects.

In what situation is the use of pulsed wave therapy contraindicated:

• If blood clotting is low, then this method should not be used.
• If diagnosed with cancerous tumors.
• If the work of the heart is not working properly, or there are various deviations from the norm.

Now this method of treatment is recognized as the most effective and in an efficient way in the treatment of various problems with the musculoskeletal system. The effect of this is always noticeable, the first mention of this can be found in Switzerland. As a result, experts understood how it works and what brings a big effect. Now many surgeons do not use intervention in the human body, but simply choose the IWT method. And already after the first procedures, each patient experiences an improvement, which is why this is recognized as the best way.

Each person feels an improvement, because the pain goes away, and this is the main thing for many patients. The recovery process begins and the fight against many pathologies becomes effective.

Shock wave therapy - cost and reviews. Indications for shock wave treatment and contraindications

Special sound waves began to be used for the treatment of pathologies of the musculoskeletal system quite recently. Nevertheless, the results obtained over the entire period of their application indicate high efficiency this technology. Find out more about what this method is and why it is needed.

What is shock wave therapy

This technique was developed from lithotripsy exposure, which is widely used in urology. Extracorporeal shock wave therapy (ESWT) is based on the principle of cavitation and the acoustic resistance of cartilage and bone structures human body. Conducted clinical trials have shown that the method has a positive effect on other tissues of the body.

The shock wave in medicine has become so widespread due to its special therapeutic effect. The latter lies in the fact that low-frequency radiation is capable of breaking up solid calcifications encountered in its path without harm to healthy tissues. At the end of the procedure, these pathological accumulations, as a rule, completely resolve. It is important to note that the technique is ineffective against malignant neoplasms.

Shock wave therapy - indications

Low-frequency sound vibrations are used in the treatment of a wide variety of musculoskeletal pathologies. The wave-impact method helps to deal with many urological problems. So, ESWT is indicated for erectile dysfunction. In addition, this non-invasive procedure is used in the complex therapy of ailments that previously required only surgical treatment: intervertebral hernia and popliteal tendinitis in advanced form. In general, the use of shock wave therapy has the following indications:

• intervertebral hernia;
• avascular necrosis;
• arthrosis;
• Achilles tendonitis;
• pain after endoprosthetics;
• pain when rotating the shoulder;
• valgus deformity of the toe;
• knee chronic tendonitis;
• inflammatory processes of non-infectious nature;
• bone on the leg;
• false joints;
• plantar fasciitis;
• osteocondritis of the spine;
• healing of bones after fractures;
• tendinosis of the tendon;
• revascularization of damaged areas of the vascular network;
• rehabilitation after injuries of muscles and ligaments;
• epicondylitis;
• foot ulcers.

Treatment with shock wave therapy

In many diseases, low-frequency sound waves are used as good alternative surgical intervention. In the process of treatment with shock wave therapy, the permeability of cell membranes increases, which contributes to the activation of regeneration processes in the affected area. In addition, under the influence of UVT, cavitation bubbles are formed, which, when bursting, create a counter-force directed against calcific formations.

Shock wave therapy device

A significant advantage of such devices is the possibility of outpatient SWT. Modern devices of shock wave therapy are effective and high level security. One of the most budget options is considered to be a pneumatic device for ESWT. This device, like its other analogues, generates waves of the ultrasonic spectrum. Such characteristics help the device to influence the course of cavitation processes in the cell. Depending on the source that generates the shock wave, devices are distinguished:

• electromagnetic;
• electrohydraulic;
• piezoelectric;
• pneumatic.

Shock Wave Therapy Procedure

Conducting an SWT session does not require any special training from the patient. The procedure of shock wave therapy is carried out in an outpatient setting. The patient is located on the couch. Before the session, the specialist sets up the UVT device in the mode necessary for a particular diagnosis. A special gel is first applied to the problem area, after which the sensor is pressed tightly against the body. The duration of the procedure is 7-25 minutes. The course of treatment includes about 10 sessions, which are carried out with a 4-6-day interval.

Shock wave therapy - contraindications

The SWT procedure has some limitations. Contraindications of shock wave therapy mostly relate to oncology, diabetes mellitus. It is important to say that pregnancy is also considered an obstacle to the appointment of ESWT. Questions often arise among patients about the permissibility of treating bone necrosis with shock wave therapy. Experts say that this diagnosis is not a contraindication for the appointment of the procedure. Meanwhile, doctors strongly do not recommend doing SWT in the following conditions:

• blood clotting disorders;
• implanted pacemaker;
• acute infectious process;
• angina.

Where is shock wave therapy done?

You can undergo the SWT procedure in specialized private physiotherapy clinics. Before contacting one of these medical institutions, read patient reviews about the quality and cost of the services provided there. Recently, shock wave therapy has been carried out in many rehabilitation centers and sanatoriums. SWT sessions can be easily carried out at home. To make this idea a reality, you will need to purchase the appropriate technical equipment.

UVT devices are sold in specialized medical equipment stores. It should be said that often the prices for such products are unreasonably high. It is important for the consumer to know that a reliable device for shock wave therapy can be bought inexpensively in an online store by pre-ordering it from the photo catalog presented on the website.

Price for shock wave therapy

The cost of the SWT procedure depends on the nature of the disease and the number of sessions required for the cure. The duration of the course, as a rule, is determined purely individually for each patient. In addition, the cost of shock wave therapy in different clinics is formed taking into account the class and level of technical equipment of the latter. Thus, the prices for SWT for some diseases are presented in the table below.

Physiotherapy for osteochondrosis complements the main treatment and greatly facilitates the patient's condition. Selectively acting on the painful focus, physiotherapy has practically no undesirable side effects.

This type of therapy does not cause an exacerbation and allows you to reduce the dose of drugs. Fewer medications reduce the risk of allergies and side effects.

Physiotherapy procedures:

• Normalize metabolism
• Improve the condition of organs and tissues
• Activate immunity
• Activate neurohumoral functions
• Stop the pain
• Improve microcirculation in the affected area
• Have anti-edematous and anti-inflammatory effect
• Reduce movement disorders.

Physiotherapy for osteochondrosis, depending on the condition of the patient, is used both in combination and independently. The healing effect on the human body is achieved with the help of a modified form of electrical and mechanical energy and natural factors (light, climate, dirt, water).

Types of physiotherapy in the treatment of osteochondrosis

With osteochondrosis, the following types of physiotherapy are used:

1. Laser therapy
2. Detensor - therapy
3. Electrotherapy
4. shock wave therapy
5. Magnetotherapy
6. Balneotherapy
7. Vibration exposure (ultrasound therapy, zonal or acupressure vibration massage)
8. Ultraviolet irradiation (UVI)

UFO

Under the influence of UV radiation, vitamin D is formed in the skin, which helps calcium to be absorbed. The method is carried out with the help of irradiators, which have a bactericidal, anti-inflammatory and some analgesic effect.

With cervical osteochondrosis, UVR physiotherapy is used on the back of the neck and upper part of the shoulder blades, subclavian region, and the outer surface of the shoulder. At thoracic osteochondrosis affect the midline of the spine in the sternum. With lumbar - on the lumbosacral region, buttocks, back of the thigh and lower leg.

Before therapy, be sure to check the sensitivity to ultraviolet rays. At the first procedure, the smallest biodoses are prescribed and they are gradually increased with each subsequent session. Usually appoint 10-15 procedures.

Contraindications:

• Oncological diseases
• Taking drugs whose effect is enhanced by exposure to ultraviolet rays.
• Blood diseases.

vibration impact

The method underlies many effective methods treatment. Due to its effect, the method relieves pain of various localization.

During ultrasound therapy, the body is exposed to high-frequency sounds (from 20,000 Hz or more). This method is combined with drugs for better penetration into the affected tissues.

Contraindications for carrying out:

• Oncological diseases
• vibration sickness
• Dermatitis or skin lesions in the affected area
• Mental disorders.

shock wave therapy

The method consists in transmitting an acoustic wave to a painful area of ​​the body. This kind:

• Eliminates pain
• Improves microcirculation
• Improves metabolism.

Detensor therapy

The method consists in stretching the spine with the help of the patient's body weight.

Laser therapy

The method has a healing effect with the help of helium-neon lasers.
Due to the activation of bioelectrical processes in the tissues of the nervous system, laser therapy has the following properties:

• Wound healing
• Anti-inflammatory
• Painkillers

Laser radiation is carried out along the inflamed spinal roots. In osteochondrosis, the impact on the paravertebral zones (paravertebral) of the affected spine is used. The duration of exposure to each zone (spinal root) is no more than 2 minutes. The total session time does not exceed 14 minutes.

Electrotherapy

The method acts with the help of an electric field and current. Under the influence of electric current, heat is generated in the tissues, which contributes to increased local blood circulation. Electrotherapy has the following effects on the body:

• Eliminates pain and discomfort
• Speeds up healing.

Current treatment is contraindicated in patients who have metal parts and devices in their bodies, pacemakers.

Impulse currents

Impulse currents have a very effective therapeutic effect. Their mechanism of action on the body is determined by the effect on nerve receptors. Low-frequency pulses contribute to the extinction of pain.

Diadynamic therapy (DDT)

DDT is used in the treatment of osteochondrosis by exposure to double continuous or wave current. The current strength increases until a slight vibration is felt at the site of exposure. Sessions are prescribed daily for up to 10 days. Already after the second procedure, acute pains become aching character relieves muscle tension and symptoms of nerve root tension. A full course of treatment with DDT leads to normalization of muscle tone and increased mobility of the spine.

interference therapy

The method is used for acute pain. The method consists in a rhythmic change in the frequencies of the electric current. The current strength increases until vibration appears in the affected tissues. The procedure lasts up to 15 minutes.

Exposure to sinusoidal modulated currents (SMT)

The frequency of the current and the depth of modulations with this method of physiotherapy is selected depending on the pain syndrome. With each subsequent procedure (as pain decreases), the frequency of modulations is reduced, and the depth is increased.

Transcutaneous electrical neurostimulation (TENS)

TENS uses plate electrodes with hydrophilic pads. Stimulation is achieved by activating the nerves without direct action on the motor structures. Electrodes are applied to the entire area of ​​the paravertebral affected area, to the projection area of ​​the spinal roots. The current strength increases until vibration appears in the affected area. The method is effective in the acute period.

UHF electric field

Electrodes for UHF therapy are installed on the paravertebral zones along the roots. The duration of the procedure is up to 14 minutes, first daily, then every other day and combined with other physiotherapy. Course up to 15 procedures.

Magnetotherapy

Physiotherapy for osteochondrosis includes the use of magnetic therapy. Inductors are located on the affected spine and limb. Magnetic therapy uses continuous mode with magnetic field induction from 28 to 35 mT. The procedure lasts up to 20 minutes, the course is up to 20 procedures daily.

Balneotherapy

Balneotherapy for osteochondrosis consists in the use of mud and mineral waters (local and general baths, pools, showers) for the purpose of treatment and rehabilitation. Minerals during the procedure, they penetrate the skin and act on receptors and nerve centers.

In the treatment with mud (peloidothermia), the effect on the body occurs under the influence of temperature and the chemical composition of the healing mud. Mud is used in the form of applications. Balneotherapy stimulates metabolism, improves blood circulation and relieves inflammation.

Combined methods of physiotherapy

The most commonly prescribed combined methods of physiotherapy of osteochondrosis. For example, with severe pain, diadynamic therapy and electrophoresis (diadynamophoresis) using novocaine are used.

For a one-time effect on biological active points use the method of acupuncture. Its action is to activate points with acupuncture needles and laser radiation. Mud therapy is often used with electrotherapy (electrophoresis with mud solution, inductothermy with mud, galvanic mud therapy).

• Application methods
• Current treatment devices
• Diseases preventing electric treatment

Treatment of diseases with the help of electric current was practiced even before the invention of current sources, by means of living beings that produce electricity. The ancient Greeks successfully healed paresis and treated tissue diseases using rays that lived near the coast. In modern electrotherapy, treatment with current of various frequencies is in demand and is always popular in the treatment of neuralgia, muscle atrophy, and even gynecological diseases.

Ways to use electricity

Physiotherapy has a wide arsenal of methods for restoring health with the help of electricity. There are several directions:

Current treatment devices

For galvanization sessions, the Potok 1 electrotherapy apparatus has become widespread in physiotherapy rooms; it can be used for both electrophoresis and galvanization even at home. The price of the device is a little more than ten thousand rubles.

The Elesculap 2 low-frequency therapy device is more expensive, but also more convenient, it has a modern design, a liquid crystal display and a wide frequency range. This device allows you to generate pulses of various shapes.

The most expensive device "Radius-01FT" is designed for use in medical institutions, but if necessary, it can also be used at home. The device allows you to carry out almost all known effects of electric current on the body, including electric sleep.

Diseases preventing electric treatment

Electrotherapy has quite extensive contraindications, in which the use of electric current for medicinal purposes becomes dangerous. It is impossible to treat pregnant women at any time, and with the following diseases:

• Fever, purulent skin diseases and internal organs, acute inflammatory processes.
• Intolerance to electric current or medication used for electrophoresis.
• Epilepsy.
• Heart disease, heart attack or coronary heart disease.
• The presence of a pacemaker or other implanted device.
• Fractures of bones with multiple fragments.
• Any acute convulsive conditions such as renal colic, angina, or surgery.

The doctor prescribing electrotherapy procedures will definitely conduct a complete analysis of the patient's health status and warn him of possible consequences. That is why it is desirable to carry out all procedures in medical institution, and at home it will be safe to use special devices only after consulting a doctor.

Diseases of the joints of the hands: symptoms and treatment of pain

To learn more…

Perhaps the most common complaint of patients who seek the help of a rheumatologist is pain in the joints of the hands. Such symptoms are so pronounced that they interfere with a person’s professional activities or do not allow him to satisfy his usual household needs at all.

Sometimes the pain syndrome is so excruciating that the patient is not able to dress, comb or eat without help.

Immediately it is worth emphasizing that pain in the joints of the hands can be different nature. It is the type of discomfort that will become the determining factor during the diagnosis of pathology already at the initial examination of the patient.

Doctors usually divide joint pain into two large groups:

• mechanical pain. Occurs during degenerative processes, for example, the disease osteoporosis. Pain without feeling of stiffness in movements morning time, or there is stiffness, but lasts no more than 30 minutes. Pain in a state of complete rest decreases, symptoms of local inflammation are practically absent or they are invisible to the patient;
• inflammatory pain. Completely different from mechanical. During the movement it hurts less, morning stiffness lasts more than half an hour. At the same time, in almost 90% of cases there are other symptoms of the inflammatory process: redness of the skin, a decrease in the volume and amplitude of movements.

Why does pain occur?

At the moment, the most common disease that provokes arthralgia is osteoarthritis - a degenerative process in which the destruction of articular cartilage tissue and pathological changes in the articular surfaces of the hands occur.

It is believed that about 7% of people suffer from osteoarthritis accompanied by pain. Much more people suffer from other signs characteristic of this disease, and changes in the body. However, at the time of the medical examination, they may not feel pain.

No less diagnosable disease that causes pain in the joints of the upper limbs is rheumatoid arthritis. The disease is associated with autoimmune failures in the body, because with this form of arthritis, antibodies to one's own tissues arise. Such antibodies damage the structure of the joints, causing an inflammatory process.

With rheumatoid arthritis, the thumbs and distal parts of the hand (located near the fingertips) almost never suffer. All pathological changes and pain are symmetrical, that is, both hands hurt at once.

The classic sign of the disease will be stiffness during movement, the peak of which occurs in the morning after the patient wakes up. This restriction of mobility lasts from half an hour to two hours, and after that the discomfort fades. The problem affects about 1% of the population of our country.

Another cause of pain is the disease gout, and predominantly men are ill. If there is a violation of purines (special substances that come with food and are necessary for creating cells), then the level of uric acid in the blood rises sharply. Urates are actively deposited in the articular tissues, provoking their damage.

The causes of the disease are different. Among the main physicians note:

1. hereditary predisposition;
2. excessive consumption of alcoholic beverages;
3. inadequate diet (addiction to foods rich in purines).

With gout, there is pain, redness in the area of ​​\u200b\u200bthe joints of the hands. Lesions always affect the phalanges of the fingers and the wrist joint. The pathological process includes both one joint and several at the same time.

Inflammation can be observed in acute rheumatic fever, psoriasis (psoriatic arthritis), infectious, traumatic injuries.

As you can see, pain is a symptom of various diseases, each of which provides an individual approach to treatment.

Treatment with drugs

In order to qualitatively and fully fight arthralgia, it is necessary to correctly establish the causes of the pain syndrome. to one clinical sign can lead to many diseases that differ in the mechanism of their development and causes. In other words, the same drug can be completely useless, harmful, or highly effective.

In addition, it should be noted that pain in the hands can be stopped with universal drugs. They work in most cases. This includes drugs of the symptomatic group. They will not be able to help the patient get rid of the disease or prevent its causes, but they will allow you to forget about the pain.

Medicines are widely used:

• Indomethacin;
• Diclofenac;
• Ibuprofen.

These drugs are characterized by a powerful anti-inflammatory and analgesic effect, despite their low cost. However, they also have many side effects on the body. First of all, drugs, especially when long-term use, provoke an exacerbation of diseases of the digestive system, namely, erosion of the stomach, 12 duodenal ulcer, hepatitis, bleeding.

Nowadays, non-steroidal anti-inflammatory ointments and agents are used to eliminate pain and inflammation in the joints of the hands. Such drugs have a selective effect - the so-called cyclooxygenase-2 inhibitors. These differ from their predecessors in minimal detrimental effects on the kidneys, intestines and liver.

Non-steroidal anti-inflammatory dot suppress the secretion of biologically active substances that cause inflammation in the tissues of the joints. These include drugs:

• Celecoxib;
• Nimesil.

To relieve pain caused by autoimmune diseases (rheumatoid arthritis), treatment involves the mandatory use of glucocorticosteroid hormones.

They have a strong anti-inflammatory effect and reduce symptoms in a fairly short time. Sometimes glucocorticosteroids are also used to relieve pain in acute gout or psoriatic arthritis:

1. Prednisolone;
2. Dexamethasone;
3. Metipred.

Treatment will require not only the elimination of symptoms, but also the impact on the causes of the development of diseases of the joints of the hands. In each specific clinical case the set of drugs will vary.

To reduce discomfort in case of illness and inflammation, expressed weakly and moderately, together with classical therapy, special anti-inflammatory ointments, creams, gels are used. It can be traditional Diclofenac, Finalgon or other means with a distracting, analgesic effect.

If destruction occurs in the large joints of the hands, then hormones (glucocorticosteroid preparations) are injected immediately into the joint cavity. Usually in such cases, injections of Diprospan, Hydrocortisone are practiced.

Physiotherapy treatment

Not only pharmaceutical treatment can be useful for joint diseases and pain. Significantly reduce discomfort and other unpleasant sensations will help:

• impulse currents;
• ultrasonic irradiation in erythemal dosage;
• applications with anti-inflammatory drugs (this can be Dimexide, diluted with water in a ratio of 1 to 1);
• electrophoresis with nonsteroidal agents;
• phonophoresis with preparations of glucocorticosteroid hormones.

You should know that treatment with physiotherapeutic methods is mainly auxiliary. It is an organic addition to drug therapy, indicated in the form of applications or internally.

Traditional medicine recipes

Alternative medicine knows an uncountable number of methods for getting rid of pain and diseases of the joints. Many patients with articular pathologies note positive dynamics diseases almost immediately after applying half a gram of mummy, if mixed with 100 grams of natural bee honey. Such a mixture will be an excellent basis for a compress.

Some recipes are based on the warming local and distracting action of certain substances. This should include treatment with steamed leaves of cabbage, burdock and honey.

Healing herbs that relieve inflammation have a good effect on joint diseases and their causes. Leaves are used:

• dandelion;
• plantain;
• nettles;
• cranberries.

Sometimes recipes call for the use of the rhizomes of these plants. It is believed that their active substances penetrate the joint, suppress the pathology, reducing its symptoms.

Naturally, similar treatment should take place under the close attention of the doctor and with his approval, because some seemingly harmless plants can affect patients in completely different ways. Also, we must not forget that getting rid of the pathologies of the joints and bones should be well thought out and necessarily complex. If the doctor's recommendations are not fully followed or there is no treatment, then in this case there is a high probability of aggravation of the situation and rapid progression of the disease.

• Relieves pain and swelling in the joints with arthritis and arthrosis
• Restores joints and tissues, effective for osteochondrosis

To learn more…

Pulsed wave therapy (IWT) is the latest method in the treatment of various diseases. IWT helps to restore soft tissues and the growth of new blood vessels in the damaged area. Thanks to this, oxygen and nutrients saturate the blood vessels faster and regeneration takes place quickly, and pain and inflammation gradually disappear.

This therapy is used in the treatment of a variety of diseases:

• Osteochondrosis;
• Arthritis;
• Vertebral hernia;
• Injuries;
• heel spur;
• Vascular system;
• Diseases of the prostate.

I must say that IWT has helped many women cope with cellulite. It decreases after several treatments.

Arthrosis

The use of IWT in the treatment of arthrosis has only recently begun. Conducted studies, numerous patient reviews show that this method in the treatment of affected joints can be an excellent assistant in restorative therapy.

Pulsed Wave Therapy also treats:

• Diseases of the spine;
• Arthrosis of the hip joint;
• Deforming arthrosis of the knee joint;
• Heart disease.

The IWT apparatus, thanks to sound vibrations, makes the structure of osteophytes much “softer”. A patient with arthrosis, in which the disease is expressed by spike-like processes, feels great relief after taking a course of IWT. After some time, the spikes completely dissolve, and complete recovery occurs.

The skeletal system and its treatment

Pulsed wave therapy has become the most modern way to treat the musculoskeletal system.

She first appeared in Switzerland. Here, doctors began to treat the affected tissues with acoustic waves operating at the frequency of infrasound.

When exposed to IWT, calcium salts, which are a source of pain, are destroyed, blood circulation and ligament elasticity improve, swelling and inflammation go away, and metabolism is restored.

Impulse waves greatly increase the movement of microcirculation in all small vessels.

Due to the specific action of acoustic waves, certain processes begin to occur:

• Improves metabolism;
• Cells are updated;
• Increases vascular blood flow.

As a result of the use of IWT, accelerated healing occurs, joint mobility is restored. This procedure has an excellent analgesic effect.

Treatment effectiveness

Impulse therapy today is considered the most promising area of ​​modern medicine. Now, instead of surgery, doctors have begun to use the IWT method. The effectiveness of this method has been proven by thousands of recovered patients.

Patients who have completed a course of IWT note the following positive symptoms:

• Affected tissues began to recover at an accelerated pace;
• Much improved metabolism;
• Puffiness subsided completely;
• There was an opportunity to start working again;
• Significantly decreased pain. After a few sessions, the pain completely disappeared.

Note that pulse therapy shows excellent results in the treatment of various pathologies.

Osteochondrosis

• After several procedures, blood circulation in the body improves, microcirculation returns to normal.
• The patient no longer experiences severe pain, the inflammatory process gradually disappears.
• Pathological outgrowths become smaller;
• The functioning of the nervous system improves.

Thrombosis

Thanks to high-frequency vibration, complications are minimized.
There is a destruction of the thrombus and its resorption after a few days.

Scoliosis

• Damaged tissues begin to recover quickly.
• The patient ceases to feel severe back pain.

The number of diseases that are very effectively treated with the help of IWT is growing every day. Today, this method is used in various departments of medicine:

• Orthopedics;
• Traumatology;
• Cosmetology;
• Vascular surgery.

erectile disfunction

With age, sexual function in men gradually decreases. But when the work of the vessels through which blood enters the penis is disrupted in the body, impotence or erectile dysfunction occurs. Impulse wave therapy is also applicable for the treatment of impotence.

Today, hundreds of methods have been developed that treat erectile dysfunction. However, not all of them give a positive result, professional doctors have reasonable claims to some.

Physiotherapy deals with the problem of male erectile dysfunction. The most promising method of treatment is pulsed wave therapy.

This procedure is completely painless, lasts 25 minutes and is performed on an outpatient basis. No contraindications have been identified. Pulse therapy restores the work of blood vessels by acting on them with short-term discharges.

The best result of treatment is the complete restoration of the work of blood vessels, there is a complete return of erectile function.

The effectiveness of the use of pulsed wave therapy has been fully proven by scientists and helps to get rid of many diseases.

FEDERAL AGENCY FOR EDUCATION

STATE EDUCATIONAL INSTITUTION OF HIGHER PROFESSIONAL EDUCATION

"Tyumen State Oil and Gas University"

Institute of Oil and Gas

COURSE WORK

by discipline

"Medical devices, devices, systems and complexes"

"APPARATUS FOR PULSE CURRENT THERAPY AND MAGNETOTHERAPY"

Completed: student gr. MBP-05-1

Vedernikova M.A.

Checked by: Glushkov V.S.

Tyumen 2009

Treatment with impulse currents

In electrotherapy, the principle of alternating short-term effects - impulses (from Latin impul-sus - shock, push) with low voltage and low frequency current with pauses between them is used. Each pulse is a rise and fall in current strength, followed by a pause and repetition. The impulses can be single or make up a series (parcels) consisting of a certain number of impulses, they can be repeated rhythmically with one or another frequency. Electric current, consisting of individual impulses, is called impulse current.

Pulse currents differ in shape, duration and frequency of pulses (Fig.). Depending on these characteristics, they can have an excitatory effect and be used for electrical muscle stimulation or have an inhibitory effect, on which their use for electrosleep and electroanalgesia is based. The combination of stimulating and inhibitory action of pulsed currents is used in diadynamic therapy and amplipulse therapy.

Rice. Direct and impulse currents. a - direct current; b - rectangular pulses; c - exponential pulses; g half-sine pulses

Amplipulse therapy

Amplipulse therapy is a method of electrotherapy, which consists in exposing the body to a modulated sinusoidal current of sound frequency. The method, which is widely used, was proposed by Soviet scientists V. G. Yasnogorodsky and M. A. Ravich (1963). An alternating sinusoidal current with a frequency of 5000 Hz is used, modulated by a low-frequency current (10-150 Hz), as a result of which series of carrier frequency pulses are formed, following at a frequency of 10-150 Hz. Such a series of pulses (modulation) is referred to as a sinusoidal modulated current (SMT) (Fig.).

The high-frequency component of SMT facilitates its penetration through the skin and promotes deep distribution in the tissues. Devices for obtaining SMT allow you to vary both the frequency of modulations and the duration of the series of pulses and pauses between them, create different combinations of modulations (type of work), change their depth and direction - the mode of operation (variable and rectified).

There are several varieties of SMT, referred to as "type of work." The type of work, or "current - constant modulation" (PM), has a frequency of 5000 Hz, modulated by low-frequency oscillations of 10-150 Hz. PM, acting on the interoreceptors of the neuromuscular apparatus, has a pronounced irritating effect, therefore it is used for electrical stimulation. change within 1-6 s. PP also has a pronounced irritating effect and is used mainly for electrical stimulation. The type of work, or “carrier-frequency sending” (PN), is a type of current in which the sending of modulated oscillations of pulse series of 10-150 Hz alternates with an unmodulated current with a frequency of 5000 Hz. The duration of sending series can also be changed within 1-b s. PN has a weak irritating effect, it is used to relieve pain. The type of work, or "current-intermittent frequency" (IF), is a type of current in which modulations of two frequencies alternate: a fixed constant frequency (150 Hz) and series of modulated oscillations, frequency which can be changed within 10-150 Hz. The duration of sending series of different frequencies is 1-6 s. This type of current does not develop addiction, it has a pronounced analgesic effect.

All of the listed types of currents or types of work can be used in a rectified mode (mode II), i.e., with a series of pulses of a half-sinusoidal shape, and in an unrectified mode (mode I). Mode II is used when sensitivity to current is reduced, the pathological process is sluggish, for electrical stimulation in cases of deep tissue damage and the introduction of medicinal substances.

To reduce or enhance the excitatory action of the CMT, the modulation depth is changed. Under the depth of modulation understand the change in the amplitude of oscillations between series of pulses in comparison with the amplitude of the current-carrying frequency. Reducing the depth of modulation (up to 25-50%) reduces the excitatory effect of the current, an increase (up to 75-100%) enhances it. In medical practice, a modulation depth of 25-50-75% is usually used.

For analgesic action, mode I of operation (non-rectified), III and IV type of operation, modulation frequency 100 Hz, modulation depth 50%, duration of sending a series of modulated oscillations 2-3 s, current strength - until a pronounced vibration is felt, the duration of each type of work - 5-7 min. Procedures are prescribed daily. The course of treatment is 5-8 procedures.

For electrical stimulation, I and II types of work are used, the frequency of modulations is 50-100 Hz, the depth of modulations depends on the severity of the pathological process (25-100%), the duration of sending series of modulated oscillations is 5-6 s.

Apparatus for amplipulse therapy

Currently, for amplipulse therapy, the medical industry produces the Amplipulse-4 and Amplipulse-5 devices.

On fig. machine control panel shown

Rice. Control panel of the device "Amplipulse-4" (diagram): I - mains voltage switch; 2, 3 - signal lights; 4 - range switch; 5 - keys for switching operating modes; 6 key for switching on the first kind of work; 7 - power key; II kind of work; 8 - key for switching on the III kind of work; 9 - key for switching on the IV type of work; 10 - keys for switching the modulation frequency; 11 - keys for setting the modulation depth; 12 - keys for switching the duration of half-periods; 13 - key for switching the output voltage to the load resistance ("Control"), 14 - key for switching to the patient's terminals; 15 - signal lamp for switching to the patient's terminals; 16 - plug connector for connecting the patient's wires; 17 - connector for connecting mains voltage; 18 - mains fuses; 19 - key for adjusting the device; 20 - knob for adjusting the current strength in the patient circuit

"Amplipulse-4". It is a portable model that operates on AC voltage 127-220 V. The device is made according to the II class of protection. It comes with a set of electrodes.

The block diagram of the device "Amplipulse" consists of the following blocks:

carrier frequency generator (G1);

modulating frequency generator (G 2);

modulation depth regulator (d V);

switching unit (SWT);

amplitude modulator (A 1);

pre-amplifier (A 2) and power amplifier (A3);

pulse generator (G3);

protection block (not shown in the block diagram).

The switching unit SWT performs switching of the frequency-setting circuits of the generator G 2, the output signals of the generators G 1, G 2, as well as the selection of the operating mode. From the output of the switching unit, the signals are fed to the modulator, then to the preliminary and final amplifiers. The power amplifier unit has an output for connecting a protection module.

G3 pulse generator provides key switching of the SWT unit

electrical stimulation

Electrical stimulation is a method of electrotherapy using various pulsed currents to measure the functional state of muscles and nerves for therapeutic purposes. For electrical stimulation, pulsed currents of rectangular, exponential and half-sinusoidal shapes with a pulse duration in the range of 1-300 ms, as well as alternating sinusoidal currents with a frequency of 2000-5000 Hz, modulated by low frequencies in the range of 10-150 Hz, are used.

The impact of electric current causes muscle contraction at the moment of change in current strength and depends, according to the Dubois-Reymond law, on the speed with which this change occurs. The effect of current irritation occurs at the moment of closing the circuit and reaches its greatest strength under the cathode. Therefore, it is the current pulses that have an irritating, stimulating effect, and the cathode is the active electrode during electrical stimulation. Individual impulses, series consisting of several impulses, as well as rhythmic impulses alternating with a certain frequency are used.

The nature of the evoked reaction depends on two factors: firstly, the intensity, shape and duration of electrical impulses and, secondly, the functional state of the neuromuscular apparatus. Each of these factors and their relationship are the basis of electrodiagnostics, which is a method for determining the functional state of an organ or system in response to dosed exposure to electric current. Using this method, it is possible to qualitatively and quantitatively determine the degree of response of muscles and nerves to stimulation by current impulses, as well as to select the optimal parameters of the impulse current for electrical stimulation.

Electrical stimulation maintains muscle contractility, increases blood circulation and metabolic processes in tissues, prevents the development of atrophy and contractures. Conducted in the correct rhythm and at the appropriate current strength, electrical stimulation creates a flow of nerve impulses entering the central nervous system, which in turn has a positive effect on the restoration of motor functions.

The most widely used electrical stimulation in the treatment of diseases of the nerves and muscles. These diseases include various paresis and paralysis of the skeletal muscles, both flaccid, caused by disorders of the peripheral nervous system and spinal cord(neuritis, the consequences of poliomyelitis and spinal injuries with spinal cord injury), and spastic post-stroke, as well as hysterogenic. Electrical stimulation is indicated for aphonia due to paresis of the muscles of the larynx, paretic state of the respiratory muscles and diaphragm. It is also used for muscle atrophy, both primary, developed as a result of injuries of the peripheral nerves and spinal cord, and secondary, resulting from prolonged immobilization of the limbs due to fractures and osteoplastic operations. Electrical stimulation is also indicated for atonic conditions of the smooth muscles of the internal organs (stomach, intestines, bladder, etc.).

In recent years, electrical stimulation has been increasingly used in atonic bleeding, to prevent postoperative phlebothrombosis, to prevent complications during prolonged physical inactivity, to improve the fitness of athletes. Currently, electrical stimulation is widely used in cardiology. A single high-voltage electrical discharge (up to 6 kV), the so-called defibrillation, can restore the work of a stopped heart and bring a patient with myocardial infarction out of a state of clinical death. An implantable miniature device (pacemaker), which delivers rhythmic impulses to the patient's heart muscle, ensures effective heart function for many years in case of blockage of its conduction pathways.

Contraindications to electrical stimulation are different. It is impossible, for example, to produce electrical stimulation of the muscles of internal organs with cholelithiasis and kidney stones, acute purulent processes in the organs of the abdominal cavity, the spastic state of the muscles. Electrical stimulation of facial muscles is contraindicated in case of early signs of contracture, increased excitability of these muscles. Electrical stimulation of the muscles of the extremities is contraindicated in case of ankylosis of the joints, dislocations until they are repositioned, bone fractures before their consolidation.

Dosing of electrical stimulation procedures is carried out individually according to the strength of the irritating current. During the procedure, the patient should experience intense, visible, but painless muscle contractions. During electrical stimulation, the patient should not experience discomfort. Absence of muscle contraction or painful sensations indicate incorrect placement of the electrodes or inadequacy of the applied current.

The duration of the procedure is also individual and depends on the severity of the pathological process, the number of affected muscles and the treatment method. The impact on one zone can last from 1 to 4 minutes. Total duration procedure should not exceed 30 minutes. For mild lesions, the exposure should be longer than for severe ones. Procedures are prescribed daily or every other day, in some cases - 2 times a day. The course of treatment is 15-30 procedures.

Apparatus for electrical stimulation

For electrical stimulation, devices "Neuropulse", "Miorhythm-040", as well as devices of diadynamic ("Tonus-1", "Tonus-2") and sinusoidal modulated currents ("Amplipulse-4", "Amplipulse-5", "Stimulus -1", "Stimulus-2").

The doctor's prescription should indicate the area of ​​influence, the location and polarity of the active and indifferent electrodes, the type and frequency of the current, the duration of the pulses, the frequency of modulations, the current strength, the duration of the procedure, their number per course.

To carry out the procedure, connect the wires with electrodes to the switched off device, observing the polarity of the electrodes, and then turn on the device. At the same time, the signal lamp lights up. It takes some time to warm up the device - until a glowing zero line appears on the oscilloscope screen. At this time, the device should be adjusted to the electrical stimulation parameters corresponding to the medical prescription, for which they turn on rhythmic or manual stimulation, set the type of current, pulse frequency, duration, and frequency of rhythmic modulation. After the zero line appears on the screen of the oscilloscope, the pointer of the measuring device should be set to the zero position.

Rice. Varieties of electrodes; a - for electrodiagnostics; b - for electrical stimulation

For electrical stimulation, small (3-5 cm2) or large (50-300 cm2) plate electrodes are used, as well as electrodes with a push-button interrupter (for electrodiagnostics) (Fig. 19). The choice of electrode depends on the area of ​​influence, muscle mass. Stimulation of the muscles of the limbs, torso, muscles of internal organs is carried out with plate electrodes, and facial muscles - with push-button or needle electrodes. When exposed to a significant muscle mass, for example, the abdominal wall, muscles of the stomach, bladder, large-area electrodes are used, when exposed to skeletal muscles, small (4-b cm).

Wet-padded electrodes should fit snugly against the skin surface. They are fixed with bandages. Electrical stimulation can be single or double pole. Depending on the localization and mass of the muscles, the location of the active and indifferent electrodes can be transverse or longitudinal. The choice of the active electrode is determined by the doctor according to electrodiagnostics.

Fluctuating

Fluctuorization is a method of electrotherapy using a sinusoidal alternating current of low strength and low voltage, randomly changing in amplitude and frequency within the range of 100-2000 Hz.

At present, three forms of currents are used for fluctuorization: I form - a bipolar symmetrical fluctuating current of alternating direction with approximately the same amplitude and frequency in the negative and positive phases; II form - bipolar asymmetric fluctuating current of alternating direction, having a large amplitude and frequency in the negative phase; III form - unipolar fluctuating current with the presence of pulses of one polarity. III form of current is used to administer medicinal substances of fluctuophoresis.

Fluctuating currents, like all impulse currents, actively affect the endings of sensory nerves and have an analgesic effect. Therefore, they are widely used in various diseases accompanied by pain syndromes. In addition, they have an anti-inflammatory effect and accelerate tissue regeneration, they are less addictive. The use of fluctuating currents in dental practice is especially common.

Indications for the appointment of these currents are dental diseases (periodontal disease, alveolitis), inflammatory diseases of the cranial nerves (neuritis of the trigeminal, facial nerves, etc.), diseases of the musculoskeletal system (arthritis, arthrosis, osteochondrosis, myositis, etc.).

Fluctuating currents are contraindicated in case of current intolerance, fractures of bones and joints, and complete break ligaments, bruises, with hemorrhages in the tissue, hematomas, stones in the gallbladder or renal pelvis, thrombophlebitis.

Dosing of fluctuorization procedures is carried out according to the current strength, which depends on its density. Distinguish ^ and doses of fluctuorization according to current density: small - Up to 1 mA / cm2; average-1-2 mA/cm2; large - above 2 mA / cm2. When carrying out the procedure, it is necessary to focus on the subjective sensations of the patient: at a low dose - tingling, at an average dose - a weak painless vibration, at a strong dose - pronounced vibration and muscle contraction under the electrodes. The duration of the procedures is in the range from 5 to 15-20 minutes. Procedures are prescribed daily or every other day. Kvrs treatment 5-15 procedures.

Devices for fluctuorization

Currently, the domestic industry produces the ASB-2-1 apparatus for fluctuorization (Fig. 18), which operates from an alternating current network with a voltage of 127 and 220 V. The apparatus is made according to protection class II and does not require grounding.

Rectangular electrodes are used, which are placed transversely or longitudinally. For treatment dental diseases use bifurcated electrodes connected to one terminal of the device.

When preparing the device for the procedure, it is necessary to check the compliance of the installed fuse with the mains voltage, then plug the power cord into the mains socket. Turn the current regulator knob to the leftmost position. The plug of the electrode cord with electrodes fixed at its other end and fixed on the patient is inserted into the socket on the end wall of the apparatus. Then the mains switch is pressed, and the signal lamp lights up. After that, the key corresponding to the assigned form of fluctuating currents is pressed. After 1-2 minutes, with a slow smooth movement, turn the knob of the current strength regulator, focusing on the patient's sensations and the readings of the milliammeter. Since the needle of the milliammeter constantly deviates, which is associated with a change in the amplitude of the current strength, the true value of the current strength corresponds to the reading of the milliammeter multiplied by 10.

Rice. Apparatus for fluctuating currents ASB-2-1; 1 - signal light; 2 - milliammeter; 3 - current regulator knob; 4 - key bipolar symmetrical current; 5 - key bipolar asymmetric current; 6 - unipolar current key

electrosleep

Electrosleep is a method of electrotherapy that uses low-frequency pulsed currents to directly affect the central nervous system, which causes its diffuse inhibition, up to the onset of sleep in the patient. For this purpose, rectangular pulsed currents with a frequency of 1-150 Hz, a duration of 0.4-2 ms and an amplitude of 4-8 mA are used.

The mechanism of action consists of the direct and reflex influence of current pulses on the cerebral cortex and subcortical formations. The impulse current is a weak stimulus that has a monotonous rhythmic effect on such brain structures as the hypothalamus and the reticular formation. Synchronization of impulses with biorhythms of the central nervous system causes its inhibition and leads to the onset of sleep.

Currently, Electrosleep is considered as a method of neurotropic treatment. It normalizes higher nervous activity, has a sedative effect, improves blood supply to the brain, affects the functional state of subcortical structures and central departments autonomic nervous system.

In the very first minutes of the action of the pulsed current, the initial (braking) phase occurs. It is manifested by drowsiness, drowsiness, slowing of the pulse and respiration, changes in the electroencephalogram parameters. This is followed by the second phase - an increase in the functional activity of the brain, characterized by cheerfulness, increased efficiency, increased bioelectrical activity of the brain.

Depending on the initial functional state of the nervous system during the electro-sleep procedure, four types of reactions are distinguished: 1) the gradual development of drowsiness or sleep; 2) the development of only a mild intermittent drowsiness; 3) the patient quickly falls asleep immediately after turning on the current, the state of sleep during the entire procedure, however, awakening occurs immediately after the device is turned off; 4) sleep during the entire procedure, continuing for some time after its completion.

Electrosleep has several advantages over drug-induced sleep. Under its influence, blood circulation improves, the minute volume of breathing increases. Electrosleep stimulates redox processes, increases blood oxygen saturation, reduces pain sensitivity, normalizes the functions of the endocrine glands, metabolic processes, which is associated with the direct effect of pulsed current on subcortical formations. In addition, it does not have a toxic and allergic effect, unlike many drugs.

Currently developed new method central electroanalgesia with the use of Electro-narcon-1 and Lenar devices, in which a wider frequency range allows you to regulate the state of the central nervous system and obtain an electro-tranquilizing effect in case of sleep disorders, psycho-emotional stress, physical overload, for the prevention of complications during pregnancy and childbirth, as well as the treatment of gynecological patients.

Electrosleep is indicated for nervous and mental diseases (neurosis, some forms of schizophrenia, atherosclerotic and post-traumatic diseases of the brain, etc.), diseases of the cardiovascular system (hypertension, neurocirculatory dystonia, coronary heart disease, obliterating vascular diseases), digestive organs (gastric ulcer, gastritis, functional disorders of the gastrointestinal tract), respiratory organs ( bronchial asthma), musculoskeletal system (rheumatoid arthritis, etc.).

Particular contraindications for electrosleep are acute inflammatory diseases of the eyes, a high degree of myopia, the presence of metal fragments in the substance of the brain or the eyeball, weeping dermatitis of the face, arachnoiditis, individual current intolerance.

Electrosleep procedures are dosed according to the pulse frequency and current strength. In children, a small current is used up to 2-4 mA and a stepwise increase in frequency is made from 5 to 20 Hz. In adults, depending on the functional state of the nervous system, different frequencies are used. With reduced excitability, pronounced weakness of nervous processes, pulses of low frequency (5-20-40 Hz) are used. In unstable arterial hypertension, low frequencies are also used. With stable high blood pressure, procedures begin with a low frequency current, gradually moving to high (up to 80-100 Hz). The current strength is dosed in accordance with the sensations of the patient, who should feel a slight vibration during the procedure.

Apparatus for electrosleep

In physiotherapy practice for electrosleep, the following devices are currently used: Electrosleep-2 (ES-2), Electrosleep-3 (ES-3) (for 4 patients), Electrosleep-4 (ES-4) , "Electroson-5" (ES-10-5). These devices generate a pulsed current of low power, constant polarity, low frequency (1-150 Hz), with a rectangular pulse shape.

The device "Electroson-4T" is a small-sized transistor device that generates a pulsed current with a frequency of 4-150 Hz, a pulse duration of 0.5 ms. The device operates on AC 220 and 127 V.

diadynamic therapy

Diadynamic therapy is a method of electrotherapy using direct pulsed currents of a half-sinusoidal shape with a frequency of 50 and 100 Hz and their various combinations.

Diadynamic therapy was developed and introduced into medical practice by the French doctor P. Bernard. He proposed and introduced into medical practice various types of pulsed (diadynamic) currents and their combinations, which were subsequently supplemented by Soviet scientists A. N. Obrosov and I. A. Abrikosov.

There are several types of diadynamic currents (Fig. 13). Single-cycle continuous current (OH) has a frequency of 50 Hz and a half-sine waveform. Under the action of OH, the patient first experiences a slight tingling sensation, which, as the current increases, is replaced by a sensation of vibration, and then by fibrillar twitching of the muscles.

The push-pull continuous current (DN) has a half-sinusoidal shape and a frequency of 100 Hz. DN is better tolerated by patients. Under its action, a tingling sensation also occurs, turning into a fine vibration.

A feature of DN is an increase in the electrical conductivity of the skin, therefore it is used to prepare for exposure to other types of diadynamic currents. A single-cycle intermittent rhythmic current (OR), or the so-called syncopation rhythm, has a frequency of 50 Hz for 1.5 s, alternating with pauses that also last 1.5 s.

The current modulated by short periods (KP) represents the alternation of a series of pulses of currents ON and DN, repeating every 1.5 s. This alternation reduces the habituation to these currents.

The current modulated by long periods (DP) represents the alternation of currents ON and DI, and the duration of the passage of the current ON is 4 s, and DN is 8 s. The duration of one modulation period is 12 s. Single-cycle wave current (0V) with a frequency of 50 Hz. Its amplitude gradually increases from zero to the maximum value within 2 s, remains at this level for 4 s, and decreases to zero in 2 s, followed by a pause of 4 s. The total duration of the period is 12 s. Push-pull wave current (DV) with a frequency of 100 Hz. The change in the amplitude of the pulses occurs similarly to the current 0V. The total duration of the period is also 12 s. Single-cycle wave current prima (0V ") with a frequency of 50 Hz. The amplitude of the pulses increases within 1 s from zero to the maximum value, is held at this level for 2 s, then decreases to zero in 1 s. The total duration of the period is b s. The push-pull wave current prima (DV") with a frequency of 100 Hz. The change in the amplitude of the pulses occurs similarly to the current 0V. The total duration of the period is also 6 s.

Diadynamic currents primarily have an analgesic effect. Irritation of the peripheral endings causes an increase in the threshold of their pain sensitivity. At the same time, rhythmically repeating impulses from peripheral nerve receptors entering the central nervous system, according to the teachings of A. A. Ukhtomsky, lead to the formation of a “dominant of rhythmic irritation” in it, which suppresses the “dominant of pain” and relieves pain. To enhance the irritating effect of diadynamic currents, reduce addiction to them during the procedure, pole switching is used.

Pulse currents activate blood and lymph circulation, improve tissue trophism, stimulate metabolic processes, which in turn enhances the analgesic effect of their action. Pulse currents reflexively cause muscle contractions, so they are used for electrical stimulation of striated muscles and smooth muscles, internal organs (ORiON). The diadynamic currents of CP and DP have the most pronounced analgesic effect. Wave currents to a greater extent than others improve blood circulation.

In recent years, with the help of diadynamic currents, medicinal substances are administered (diadynamophoresis).

Devices for diadynamic therapy

Various domestic and imported devices are used for diadynamic therapy. Among domestic ones, Tonus-1, Tonus-2 are most widely used, among imported ones - Diadynamic DD-5A (France), Bi-pulsar (Bulgaria).

Rice. Control panel of the device "Tonus-1" (scheme). 1 - network switch; 2 - signal light; 3 - oscilloscope screen; 4 - keys for switching on certain types of diadynamic currents; 5 - milliammeter; 6 - polarity switch on the terminals of the electrode; 7 procedural hours; 8 - patient current regulator. Above the keys 4 are letter designations (a - and), corresponding to certain types of diadynamic currents

As an example, consider the device of the Tonus-1 device and get acquainted with the rules for its use.

The portable device "Tonus-1" operates from an alternating current network with a frequency of 50 Hz and a voltage of 127-220 V. The device generates 9 types of diadynamic currents. It belongs to the II class of protection. There is a control panel on the front wall of the device (Fig. 14). On the back wall The machine has a plug for connecting the power cord to a wall outlet and a voltage switch. On the left wall there is a connector for connecting an electrode cord, consisting of two red (anode) and blue (cathode) wires attached to the electrodes. A set of electrodes is attached to the device. Consider the device "Tonus-2m". Electrical function diagram:

Rectifier

Modulator

Shaper

Output Current Regulator

Output transistor

Polarity switch

milliammeter

Patient

Current type switch

Mains frequency divider

Integrating chain

Protective device

Locking device

Magnetotherapy

Magnetotherapy is a group of physiotherapy methods that involve the use of a magnetic field for therapeutic and prophylactic purposes.

Types of applicable magnetic fields. The applied magnetic fields can be variable (high or low frequency) or constant. In this case, both constant and variable magnetic fields can be used both in continuous and in pulsed (intermittent) modes; Depending on the method, pulses can have different frequencies, durations and shapes.

When a human tissue is exposed to a magnetic field, electric currents arise in them. Under their influence, the physicochemical properties of the water systems of the body, the orientation of large ionized biological molecules (in particular, proteins, including enzymes) and free radicals. This entails a transformation in the rate of biochemical and biophysical processes. The reorientation of liquid crystals that form the cell membrane and intracellular membranes changes the permeability of these membranes.

In Russia, magnetotherapy methods are recognized as medical and are used both in public hospitals and in private clinics in physiotherapy rooms. There are a number of academic medical publications pointing to the clinically proven effectiveness of magnetotherapy.

In the United States, Food and Drug Administration (FDA) regulations prohibit the sale and advertising of any magnetotherapy products as medical devices because claims of therapeutic effect such devices are considered unreasonable in the US.

In the American scientific community, there is also no consensus on this issue. While some American scientists support the position of the FDA, calling magnetotherapy a pseudoscientific method, explanations of the mechanisms of its action are “fantastic” and arguing that there is no clinical evidence of its effectiveness, other scientists point out in their works the obvious relationship of the human body with magnetic fields and the therapeutic effect that magnetic fields can exert.

Industrial magnetotherapy devices

The classification of mass-produced magnetotherapeutic devices and devices is based on the degree of localization of the field of action on the patient, since this is the most significant factor from the point of view of building the device itself, its complexity, as well as the terminal device for generating a magnetic field. In the first chapter, three classes of impact localization were identified:

local (local) impact,

distributed impact,

overall impact.

The first class includes devices containing one or two inductors designed to irradiate a certain organ or part of the patient's body with a magnetic field. They also include devices of magnetopuncture action with the possibility of irradiating at any time only one biologically active point. A feature of this class is the absence of spatial displacement of the magnetic field. They also include magnetotherapy products with permanent magnets: bracelets, tablets, clips, etc., which are not considered in this paper.

The second class includes devices containing a number (three or more) of inductors, with which you can cover a number of organs of the patient or a significant area of ​​the patient's body and even place on different parts body. This class is characterized by the ability to move the magnetic field in space around the patient.

The third class includes equipment with the most voluminous terminal device, which should accommodate the entire person. These devices provide a general effect, and, as a rule, such equipment provides for the movement of the field in space and change in time.

In the first two classes, the magnetic field emitters themselves have a simple design and are often organized in bulk, so during treatment they can be set arbitrarily, depending on the desire of the physiotherapist or in accordance with medical methods. At the same time, emitters make up a small part in the total cost of the device compared to the electronic part that generates power currents. This is especially true for devices of distributed action and less true for devices of local action, where the simplest power frequency current converters are often used.

In devices of the third class, stationary, rather voluminous terminal devices are used, in which the patient is placed. Their design can be very diverse - from a magnetic suit to a magnetic room. Here, the cost of terminal devices sometimes exceeds the cost of an electronic control unit that generates the entire ensemble of power currents. It is these devices that are the subject of close attention of the authors of the book, since they are the systems of complex magnetotherapy.

An analysis of the principles of construction of industrial magnetotherapy devices allows us to present their generalized block diagram (Fig.).

With the help of the control unit, a set of biotropic parameters of the magnetic field is set. Functionally, the control unit may contain setters of time-frequency parameters, synchronization parameters, magnetic field intensity, etc.

The shaper is designed to obtain a current of a certain form in inductors and, in the simplest case, it may contain a converter for the type of inductor supply current in the form of a rectifier diode. As a rule, the shaper includes a power amplifier.

The terminal device is designed to generate a magnetic field and is an inductor or a set of inductors (magnetic field emitters) made in the form of electromagnets, solenoids, short (flat) inductors.

Magnetotherapy devices of local action

Magnetotherapy devices (MTA) of local action can be divided into portable - for individual use and portable - for general use. The division is based on the interposition of the control unit and the terminal device - the inductor.

Let's call Mag-30 as the first MTA under consideration. It is intended for exposure to a sinusoidal MF of the same intensity. The device is a U-shaped inductor with two coils in a plastic case and is powered directly from the mains. Its distinguishing feature is the absence of a control unit as such. The device is produced in 4 sizes: 130x115x130 mm, 105x80x54 mm, 115x80x47 mm, 110x72x34 mm, power consumption is not more than 50 watts.

The next MTA "Magniter" generates sinusoidal and pulsating magnetic fields and is made in the form of an inductor-electromagnet and a converter combined in a single design (Fig. 2.2). The converter is a device that generates current pulses that feed the electromagnet winding. The intensity is adjusted by switching the winding leads. The device has dimensions of 243x93x48 mm and consumes no more than 30 watts of power.

Rice. Structural diagram of MTA "Magniter"

MTA "Polyus-2D" forms a pulsating MF with a smoothly rising front and a pulse decay. The inductor consists of 4 electromagnetic coils connected in series. A feature of the device is the presence of a common ferromagnetic screen. Power consumption is not more than 4 watts.

Portable magnetotherapy equipment of local action is represented by a wide range of devices. Thus, the Polus family of devices includes more than five items. "Pole-1" is designed to influence the patient with a sinusoidal or pulsating one-half-wave MP of industrial frequency in continuous or intermittent modes. The device has a 4-step adjustment of the MP intensity. A distinctive feature is the presence of a timer and an indication device consisting of signal lamps connected in series with inductors. The setting of the intermittent mode is carried out by a control device made according to the multivibrator scheme. The set of inductors includes electromagnets of 3 types: cylindrical, rectangular, cavity. Cylindrical inductor poles of which are the working surface. The rectangular inductor has as a working surface not only the front, but also the end and side walls (160x47x50 mm). 2 coils connected in series are fixed on the core. The cavity inductor is a coil, inside of which a core (25x165 mm) is placed. Power consumption is not more than 130 W.

The Polus-101 device is designed to be exposed to a sinusoidal magnetic field of increased frequency and has 4 levels of MF intensity adjustment. The set of inductors consists of two solenoids (220x264x35 mm). The mode of alternate inclusion of inductors in intermittent mode is provided. Power consumption is not more than 50 watts. A feature of this apparatus is that the inductors and capacitors connected in series with them form resonant circuits, which allows saving in power consumption. Another distinguishing feature is that in order to obtain a sinusoidal current in the inductors, it is not the supply network that is used, but the voltage generated by a separate generator (Fig.).

Rice. Structural diagram of MTA "Pole-101"

MTA "Polus-2" is designed for exposure to sinusoidal and pulsating MF with 4 stages of regulation of the intensity and frequency of MF pulses. The device kit includes 3 types of inductors: cylindrical (110x60 mm), rectangular (55x40x175 mm), intracavitary (25x165 mm), solenoid inductor (240x265x150 mm) . The cylindrical inductor is made in the form of 4 separate coils with cores placed along the perimeter of the inductor. A distinctive feature of the device is the automatic matching of the intensity of the magnetic field of the inductor when it is changed with the generator and the presence of an MP pulse shaper, which makes it possible to obtain an exponential current shape in the inductor circuit with adjustable decay time.

Rice. Structural diagram of MTA "Pole-2"

MTA "Gradient" is intended for exposure to sinusoidal and pulsating one- and two-half-wave MF with a frequency of 50, 100 Hz in continuous and intermittent modes with 8 steps of MF intensity adjustment. The instrument kit includes three types of electromagnetic inductors (131x60; 85x60; 32x82 mm). All magnetic field inductors are enclosed in a steel screen. The device has a built-in digital MF intensity indicator and a timer. Distinctive features are: the power supply of the inductor by current modulated by rectangular pulses, and the ability to work from an external source of a sinusoidal and pulsed signal.

The list of mass-produced devices of local action, their comparative technical characteristics and main features are given in Table.

Table 1. Domestic and foreign equipment of local impact

Machine name	Type of inductor supply current	Max, induction value, mT (number of steps)	MP frequency	Inductor type	Distinctive features
magneter
	Sin, PU 1p/p
				Solenoid
	Sin, imp., exp			EM, solenoid
					Magnetophoresis, automatic reverse MP
					Automatic reverse MP
Gradient-1	Sin, PU 1p/p and 2p/p				Current modulation, operation from an external generator
			Programmable		Possibility of synchronization from the pulse sensor
		100 (smooth)			Impact on BAP
			0,17...0,76; 30; 130	Solenoid	Magneto stimulation
				Solenoid	Magneto stimulation
Inductor-2
			2...5, 6, 8, 10,12,16
Atfa Pulsar
				Solenoid	MP modulation
Biomagnetiks (Germany)				Solenoid
Magnetotron (Germany)				Solenoid
Ronefort (Italy)				Solenoid	Moving the inductor over the patient's body
Magnet-80 (Bulgaria)				Solenoid
Magnet-87 (Bulgaria)				Solenoid
UP-1 (Bulgaria, Germany)			1,4, 8, 16, 25, 50
1 Mela (Germany)				Solenoid
Rodmagnetik 100 (Germany)			2, 4, 8, 10, 17, 25
				Solenoid

Note. The following designations of currents are accepted in the table: sin - sinusoidal; imp. - impulse; exp - exponential; PU - pulsating; In / p and 2p / p - one- and two-half-wave rectification, respectively.

Magnetotherapy devices of distributed action

Most MTAs of local action have several modes of operation, in one of which it is possible to carry out a distributed effect. For example, in the MTA "Pole-101" it is possible to alternately turn on one of the two coils, which leads, as it were, to the displacement of the field in space. However, for directional movement, and even more so for the creation of a traveling or rotating field, at least three inductors and a three-phase supply current are required.

MTA "Atos" (Fig. 2.5) is intended for the treatment of diseases in ophthalmology with a magnetic field rotating around the optical axis of the eye, created by a six-channel source made on the basis of solenoids and generating an alternating or pulsed reversible magnetic field with a frequency of 50 or 100 Hz. A feature of this device is the ability to influence simultaneously at 3 frequencies: the frequency of each solenoid at the time of switching on, the modulation frequency of the IBMP, the switching frequency of adjacent solenoids.

Rice. Structural diagram of MTA "Atos"

MTA "Alimp-1" is an 8-channel source of a pulsed traveling MP with a frequency of 10, 100 Hz with a two-stage adjustment of the field intensity. The device is equipped with a set of 3 types of inductors, forming 2 solenoid devices, consisting of 5 and 3 solenoid inductors, respectively, and a set of 8 solenoids placed in the pockets of the package (720x720x20 mm) (Fig. 2.6). The first solenoid device (480x270x330 mm) is a set of 5 cylindrical coils arranged one after the other. The second (450x450x410 mm) is a structure of 3 cylindrical coils located at an angle to each other. Power consumption is not more than 500 W. A distinctive feature of the device is the use of a pulsed traveling MP, as it has a more pronounced therapeutic effect.

Rice. Structural diagram of the MTA "Alimp-1

The apparatus "Madakhit-010P" is a medical and diagnostic complex designed for therapeutic effect pulsed complexly modulated electromagnetic field on a diseased organ and its diagnostics. Devices of this type are built according to the scheme shown in Fig.

Rice. Structural diagram of MTA "Malachite-OYUSh

A distinctive feature of the device is the presence of a communication channel with a computer for automatic control of MF parameters and optimization of the treatment process due to feedback. The set of inductors consists of 12 electromagnets.

The list of devices for magnetic therapy of distributed action, produced by the industry, their main technical characteristics and features are given in Table. 2.2.

table 2

Domestic and foreign equipment of distributed impact

app name-			Max, value					Distinctive
					inductor		peculiarities
	inductor		(number of steps)
						Solenoid
Malachite-01							Automatic adjustment of parameters
Malachite-010P	Imp., with l.-mod						OS channel, computer control
	PT, Sin, Imp. mp and bp
					Solenoid		Running MP
					Solenoid		Running MP
Magnetizer, type M-CHR (Japan)							Magnetic field + vibration
Magnetizer, type M-RZ (Japan)							Magnetic field + vibration
Magneto-diaflux (Romania)	PU 1p/p and 2p/p				EM, solenoid		Rhythmic mode of operation

Note. The following designations of currents are accepted in the table; PT - permanent; sl.-mod - complexly modulated; mp and bp - mono- and bipolar, respectively; the rest of the designations are the same as in Table. one

Magnetotherapeutic devices of general effect

General impact devices are the most complex and expensive devices, so there are very few mastered by industry and certified by the Ministry of Health of the Russian Federation. These currently include devices of the Aurora-MK class, devices of the Magnetoturbotron 2M and Magnitor-AMP types, and the Bio-magnet-4 complex. MTA "Aurora M.K-01" is designed for general exposure of the patient to a complex dynamic magnetic field with a very large set of possible MF configurations from "running" to randomly moving, which are programmed in advance and, in principle, are selected for each patient individually. The patient is located on a special couch, where inductor systems are fixed in the form of flexible planes: separately for all limbs, head and torso of a person. Then each of the parts is covered by flexible planes, forming a closed volume like a space suit, inside which the patient is located. In the future, devices of the Avrora-MK class will be considered in detail as the most appropriate for the task of complex magnetotherapy. Here we confine ourselves to bringing in table. 2.3 major specifications for comparison with other devices.

Table 3

MTA "Magnitor-AMP" is intended for exposure to a rotating MF in the range of 50 ... 160 Hz with a programmable automatic cyclic-periodic adjustment of the MF intensity from 0 to 7.4 mT and with tension modulation according to an arbitrary law on the entire body of the patient. The inductor is a three-dimensional electromagnet, made in the form of a stator of a 3-phase 2-pole AC electric machine, in which the patient is placed.

The control and measuring unit is made on the basis of a PC. A distinctive feature of the device is the impact of a rotating homogeneous MF on the entire body of the patient with simultaneous control over the pulse rate and temperature of the patient's body. The device is characterized by a large mass of the inductor (about 500 kg), power supply from a 3-phase network, high power consumption (2.5 kW).

Rice. Structural diagram of MTA "Magnitor-A

MTA "Biomagnet-4" (or BM-4), according to the manufacturer, affects the patient "with a special electromagnetic environment created by bioactive radiation filtered from the harmful component, provided that the geoelectric field and, partially, the geomagnetic field are completely shielded." The patient is placed in a rectangular chamber with a tightly closed door, where he can sit on a wooden chair. Management and diagnostics is carried out from a PC. In table. 2.3 shows the main comparative information on the above MTAs of the general effect.

Thus, the development of MTA goes along the path of creating devices that generate magnetic fields with an increasingly wide range of biotropic parameters, increasing the area of ​​influence, introducing elements of monitoring the patient's health, controlling and synchronizing with the patient's biorhythms, introducing a feedback mode based on measuring diagnostic equipment for general and special purposes and computing facilities.

Hardware-software complex for dynamic magnetic field control "Aurora MK-02"

The complex is designed to form 16 independent currents or voltages, adjustable in value, duration of cycles, polarity, on and off moments, and all parameters are independently adjustable within 32 cycles of operation.

The hardware-software structure of the complex is shown in fig. 4.16, and the hardware structure is shown in fig. 4.17.

The complex (Fig.) includes a block for creating or modifying a magnetic field configuration (MCF), which is understood as a specific sequence of the appearance of output currents with specified intensities, attributes, and durations. The set of generated ILCs, including previously recorded ones, is stored in the ILC information bank on media (read-only memory devices - ROM), reprogrammable ROM (PROM) and non-volatile random access memory (RAM). Configurations are stored in compressed form to save memory.

Rice. Hardware and software structure of the Avrora MK-02 system

For operation, the selected KMP file is first decoded. In this case, the intensity parameters are placed in a special, independently (from the processor) interrogated random access memory (SpRAM) using the CTA counter and the RGA address register, and the frequency-time parameters with attributes (polarity, modulation) are entered into the processor RAM and are under its constant observation. In this case, the frequency-time parameters in the processor are transferred to special timers and the processor forms time intervals based on them. The processor unit has custom software for CMP synthesis, output and decoding, and finally for real-time operation.

Power sources (SI) of currents (16 pieces) perceive information in the form of a 16-bit code according to the principle of one bit - one power source (SI). Two additional inputs to the SI determine its attributes (polarity, modulation).

The operation of the Aurora MK-02 software and hardware complex, the appearance of which is shown in fig. 4.20 can be divided into three stages.

The first stage is the creation or modification of the magnetic field configuration (MCF). This stage is supported by the SINTEZ program. Here you can call any of the configurations stored as files in the KMP information bank, or start with an "empty" configuration file.

A generalized model of the magnetic field configuration (MCF) appears on the display screen in the form of 16 signal formats, an example for one of which is shown in Fig. 4.21. Under each measure, digital values ​​of the duration of the measure interval, intensity and duration of the pause interval are displayed.

The choice of a setting parameter is made by moving the marker to the corresponding location of the parameter. By setting command, the waveform is enlarged to full screen to improve setting accuracy. Then, by moving the marker, the necessary intensities and attributes are set in each measure of the signal format.

The duration of tact intervals and pause intervals are set by bringing the marker to the corresponding location on the screen and sequentially dialing numbers. After formation or modification, a new KMP is recorded as a file with a given name in the KMP information bank.

Rice. Appearance hardware-software complex "Aurora MK-02"

This stage is supported by the ZAGR program. Here, the selected ILC is shown on the display screen as a generalized model with all graphical and alphanumeric data.

At the same time, all the parameters of the ILC, recorded, as mentioned above, in a compressed form, are decoded and placed in the specified places of the complex. So, the intensity value in each cycle, stored digitally in the CMP (6-bit code), is converted into a PWM signal as follows. The intensity level, for example, 17 is converted to a sequence of 17 ones and 47 zeros, consisting of 64 bits, and the intensity level, for example, 13 is converted to a sequence of 13 ones and 51 zeros, consisting of 64 bits. The resulting sequences are entered into a special SpRAM (16-bit RAM) in the lower 6 bits, the upper 5 bits of which are selected depending on the cycle number in the cycle. This SpRAM is external to the processor and is mainly designed to work independently under the control of its own generator and address counter. Only in decode and write mode does the addressing of this RAM go to the processor.

The values ​​of durations of cycle intervals, pause intervals, modulation frequencies, as well as attributes recorded in the CMP in the form of a mantissa and an order, are converted to integers and recorded in the processor RAM, where they are under the full control of the processor.

The third stage is the stage of direct work (generation of the IMF and its control in real time).

Rice. Generalized magnetic field configuration model

The work is supported by the RABOT program. First, the processor sets the upper addresses of SpRAM related to the first cycle of intensity (Fig. 4.18), and the lower bits begin to be sorted out by a special counter of the SCHA address with a high frequency f0 (about 2 MHz). Since each digit of the SpRAM contains a sequence of 1s and 0s according to the pattern of Fig. 4.19, then a PWM signal of the set intensity of the first cycle appears at the output of its each discharge. Simultaneously, one of the timers is filled with the intensity cycle interval code, and the attribute registers are filled with the polarity and modulation codes of the first cycle for each bit, and, in fact, for each output. The complex begins to generate PWM signals of the 1st cycle on all 16 outputs. Since the formation of PWM signals proceeds without the participation of the processor, the latter switches to servicing the CONTROL program, which is designed to control the currents at the SI outputs using an ADC and display the actual picture of operation on the screen.

At the same time, the processor periodically returns to the timer, tracking the remaining time for the first cycle of intensity. As soon as the interval for the first cycle ends, the processor enters the value of the pause interval into the same timer, resets all SI outputs, and again switches to servicing the CONTROL program, at the same time tracking the remaining pause time. At the end of the pause, the processor switches the upper addresses of SpRAM. corresponding to the second cycle of intensities, reads the code of the interval of the second cycle of intensities, enters the latter into the timer, reads and enters the attribute value at each output into the RG register. The complex begins to generate PWM signals of the 2nd cycle on all 16 outputs. The processor, freed up for the clock cycle, again switches to servicing the CONTROL program, which continues to display the actual picture of the currents on the display screen. With the end of time 2 cycles of intensities, the processor includes a pause interval similar to the first cycle.

With the beginning of the 3rd cycle, the processor repeats the algorithm described above for the first two cycles, and so on until the 32nd cycle or, if a number less than 32 is written in the service cell No. 14 of the selected ILC, then up to the cycle number recorded in the cell No. 14 service information of the selected ILC file. At the same time, at the end of the cycle, the processor estimates the remaining time of the entire procedure and, if time remains, the processor returns to the first clock cycle of the complex. Work continues in this way until the end of the entire procedure, the value of which is recorded in service cell No. 15 of the selected ILC and recorded by the processor in a special timer. Another timer is used to generate the modulation frequency fm, the value of which is set along with the attribute setting on each clock cycle. In the procedure supported by the CONTROL program, visual control over the operation of the complex and comparison of the actual parameters with the specified ones is carried out.

From the very beginning, when selecting a CMP file, as noted above, a generalized model of the selected CMP appears on the display screen. When turned on, the generalized model acquires a grayscale image, and only at the particular moment the part of the format corresponding to the working cycle is highlighted with full brightness for the full time of this cycle. At the end of the next measure and the next one, the full brightness moves to the adjacent part of the format.

At the same time, the actual values ​​of the intensities at 16 outputs of the complex are measured using an ADC, entered into the processor, compared with the specified values, and displayed on the screen as deviation signs, which makes it possible to unambiguously evaluate normal work complex during the procedure.

Description of the program for decoding loading and operation.

The program consists of two blocks: the unpacking-decoding program and the load and work program.

The decompressing-decoding program includes three procedures:

amplitude unpacking procedure "RASPO";

procedure for unpacking attributes "ATRO";

the unpacking procedure of the "TAYO" times.

In the RASPO procedure, the following operations are carried out:

space is allocated in RAM for 128 words, which is preliminarily cleared;

the amplitudes of the first cycle of all 16 channels are read;

in each of them, the lower 5 digits are allocated;

are converted into a sequence of as many units as the code in the number, which are entered in the allocated space in RAM;

the recorded array of the first cycle is transferred to the buffer storage device SpRAM, which is external to the computer;

switching to the amplitudes of the next cycle, which are unpacked in the same way and written to the SpRAM, having previously changed the page of the SpRAM by switching the high bits;

go to the "ATRO" procedure, while the following sub-procedures are carried out in the "ATRO" attribute unpacking procedure:

the 6th, 7th, 8th bits of the array of amplitudes are allocated;

decoded in accordance with the encoding table and entered into the controller RAM in the form of an unpacked array of attributes;

go to the TAYO unpacking procedure, the following is carried out in the TAYO times unpacking procedure:

the next code of the time interval is read;

five junior digits are allocated;

three senior digits are allocated;

the five least significant digits are multiplied by a number equal to two to the power of the code in the three most significant digits, i.e. shift to the left as many times as the code in the selected three high-order bits;

the resulting product is multiplied by 15.5 times and as a 16-bit code is written to the array of clock times and, similarly. - into an array of pause times and modulation periods, thereby forming three arrays of times.

The loading and running program block performs the following sequence of operations:

loads the total procedure time into a special timer and switches it on for subtraction with a frequency of 50 Hz;

loads the upper 5 bits of the SpRAM memory address (zero address is entered for the first cycle);

loads the attributes of the first cycle into external registers for controlling power sources of currents;

loads the clock time into the clock timer, turns it on and includes access to the counter of the least significant digits of the address of the SpRAM of the reference frequency, the operation of power sources (SI) begins;

launches a control program that displays the configuration of the magnetic field on the screen and compares the actual values ​​with the given ones;

checks the state of the takt timer and, if there is enough time, then returns to control, if the time is short, then waits for the end of the takt time;

with the arrival of the end of the takt time, loads the pause time into the takt timer, turns off the SI and waits for the end of the pause;

with the arrival of the end of the pause, it returns to the algorithm for loading the upper 5 bits of the SpRAM memory address, increasing the code of the latter by one, and repeats all of the above elements of the sequence 32 times, corresponding to 32 cycles;

checks the state of the timer of the general procedure and, if the time has not expired, then returns to the algorithm for loading the addresses of the high-order bits of SpRAM, zeroing the address;

continues to execute the above sequence until the timer of the general procedure is reset to zero;

after resetting the timer for the general procedure, it stops the operation and turns on the sound signal.

Magnetotherapeutic complex "Multimag MK-03"

The complex is intended for receiving from a PC and storing the configuration of the magnetic field with subsequent autonomous formation of power currents to power the magnetoscan inductors for the time of the cycle, pause and cycle of the Multimag MK-03 magnetotherapy complex. The structure of the entire complex is shown in fig. 4.22.

The complex consists of the following blocks:

Computer software compatible with IBM.

An interface with an ADC built into a computer and having the following characteristics:

digital signals: 8 bits - data, 2 bits - tracking;

analog signals: 8 channels, ±2 V range, 12 bits, sampling frequency - 10 kHz.

A control unit, into whose memory an array of the magnetic field configuration is entered from the computer and which, on command, is put into operation, generating power currents to power the magnetoscan inductors.

MagnetoScan is a special couch with inductors for generating a dynamic magnetic field around the patient.

Diagnostic sensors that are formed depending on the problem being solved and in the standard set include: temperature sensors, rheograms, cardiosignals, blood pressure, etc.

Diagnostic equipment that contains amplifying-converting devices that receive signals from sensors and generate normalized signals for feeding to the ADC.

Rice. Structural diagram of the complex "Multimag MK-03

Technical characteristics of the control unit:

number of channels................................................... .....eight;

intensity (current) ............................... up to 3 A (±);

number of strokes .................................................. ...up to 32;

measures can be separated by pauses;

current polarity is channel-independent;

the pause is independent by canapes;

to control the current there is an output from each channel with amplitude .............................................. .........up to 1 V;

memory size .............................................. 8x2048;

built-in oscillator frequency ........................... 2 MHz.

The structure of the control unit is shown in fig. 4.23. An array of the magnetic field configuration is entered into the memory of the SpRAM controller. During operation, the memory is interrogated by the built-in generator. Information in the form of a PWM signal is distributed to 8 channels of power sources (SI) of current, along with setting the polarity and pause, independently by channels. Each power source is loaded onto the corresponding inductors of the magnetoscan (I^Ig). The current in the inductors is measured and fed to the analog output of the control unit for conversion into an ADC.

The functional diagram of the controller of the control unit is shown in fig. 4.24. The block address is selected by the AB circuit. Register RG1 serves to address registers and modes. Recording in RG1 is carried out by the accompanying signal OUTA and only when this block is selected by the AB circuit. The format of addressing and modes is shown in Table. 4.3.

Data from the computer is distributed depending on the last address recorded in the register RG1. The data is accompanied by the OUTB signal and written to the following registers:

RAM memory address register, composed of register RG3 (higher 5 bits) and counter CT2 (lower 6 bits); - RG2 data register for RAM memory

polarity register RG5;

pause register RG6.

Rice. Functional diagram of the control unit controller

After entering all the data into the registers and into the RAM memory, the combination 00 is entered into the register RG1 (in bits a4, a3), which turns the control unit into the mode of checking and monitoring the correct installation. If, however, a combination of 10 is entered in the categories a4, a3, then the control unit is switched on in the "work" mode. In this mode, the internal oscillator G (2 MHz) using the counter CT2 iterates over the lower 6 bits of the RAM memory, in which the codes of the PWM signals of all 8 channels are recorded. The RG4 register at the RAM output generates PWM signals, which are additionally strobed with pauses from the RG6 register and fed to the controller output to control the SI power sources.

Table 4

In the PWM memory, the codes are recorded for the entire cycle of operation. The duration of the cycle and pause is monitored by the computer with a special timer located in the interface. With the end of a cycle or pause, the computer increments the highest of the 5 bits of RAM memory. overwrites, possibly with changes, the polarity and rest data and starts work on a new measure or rest. The code in the least significant bits (a2,al,a0) of the RG1 register determines the channel from which the current in the inductors is measured (in the form of voltage) for output to the computer.

A functional diagram of one of the SI power current sources is shown in fig.

Rice. Functional diagram of the power source

Depending on the polarity bit (LPO), either odd keys (Kl1, Kl3) are open, and then the current flows into the inductor AND in one direction, or with another POL bit, even keys (Kl2, Kl4) are open, and then the current flows into the inductor in another direction. Keys Kl1 and Kl2 are additionally switched by a PWM signal, thereby providing regulation of the current intensity in the inductor. The PWM ripple is smoothed out by the F filter. Resistor R4 serves as an overload sensor and, in case of excess current consumption in the power source, the SZ protection circuit turns off this source. Resistor R0 serves as a measuring current sensor through the inductor, the voltage from which, through the U.S multiplexer, is supplied to the ADC board in the computer. The choice of the channel for measurement is carried out by the bus code S. The divider Rl, R2, R3 is a sensor for the correct setting of the parameters of the power source and its operability. When monitoring the installation, the keys KLZ and Kl4 open, and the PWM signals through the specified resistors, as through a divider, are fed to the multiplexer and then as an analog signal to the ADC input to the computer. There is no current in the inductor.

Rice. Appearance of the electronic current generation system of the Multimag MK-03 complex

The appearance of the electronic current generation system of the Multimag MK-03 complex is shown in fig.

Software for the magnetotherapy complex. Description of the software package "MK-03"

Appointment.

The software package "MK-03" is designed to work as part of the hardware-software complex "Multimag MK-03", in combination with IBM-compatible PCs.

Package contents:

MK03.EXE; READMY.TXT; *.DAT;

MK03.HLP; MK03.RES; LITR.CHR.

Main functions.

The MK03.EXE executable module allows you to perform the following functions:

Choice of methodology;

Viewing the parameters of the technique;

Editing method parameters (for version 2);

Work with the complex "Multimag MK-03" (for versions 1.2);

Information about the program.

When you start the program, the main menu for the above functions appears on the screen. The function is selected using the cursor keys (-,<-). При этом перемещается подсветка функции. Для выбора необходимо нажать клавишу «Enter». Рассмотрим последовательно выбираемые функции.

The choice of methodology.

This function allows you to select a file of MMF (magnetic field configurations) with the extension ".DAT" and ".MFR" for further work or modification. An example of the screen image is shown in fig. 4.27.

Selection is made using the cursor keys (<г-, Т, I, ->). This moves the highlight of the file. The choice is confirmed with the "Enter" key, and the selection is canceled with the "Esc" key. The selected technique is graphically displayed on the screen, one example of which is shown in Fig. Here, in addition to the main menu, the ILC field appears, consisting of several areas.

Rice. Displaying Method Selection Mode

The main field is occupied by the intensity matrix (8x32), where 8 rows correspond to 8 channels of the power block of the magnetotherapy apparatus and 32 columns correspond to the cycles in time of connecting the corresponding intensities in the channels. The duration of the cycles can be different by lines and are displayed in a logarithmic scale by a special line at the bottom. Here, the pauses between measures are also displayed on a logarithmic scale.

At the very bottom of the screen, an area of ​​reference information appears: by type of disease, by file name, by duration of the procedure. To the right of the main field is the column "Deviations", where during operation the correspondence of the set parameters in terms of intensities to the actual ones will be displayed. Below it is an area for highlighting averaged time parameters.

Rice. Graphical representation of the technique on the screen

Viewing the parameters allows you to define specific magnetic field configuration parameters. In this mode, one of the cells of the main field is framed in white, and the values ​​of the parameters in this cell are displayed in a window that appears on the right side of the screen. Moving between the individual elements of the field is carried out with the keys (arrows, PgUp, PgDn, End, Home).

The image on the screen takes the form shown in fig. 4.29. The window on the right side of the screen shows the following numerical parameters:

field intensity; - cycle duration;

pause duration; - modulation parameters;

kind of modulation.

Rice. Screen image in Preview mode

The F3 key allows you to switch to viewing additional information that is the same for the entire file:

method version number;

name of the method file;

main purpose;

the number of cycles in the method.

The image on the screen then takes the form shown in Fig. 4.30. This information is also permanently displayed on the bottom line of the screen regardless of the operating mode. The view mode is exited using the Esc key. From the mode of viewing additional information, the output is carried out in the mode of viewing information about measures, so you need to press the Esc key twice.

Editing.

The edit function allows you to change the parameters of individual measures and additional information. It is called from the "View" mode by pressing the "F4" key. Moving around the main field of the methodology is carried out by pressing the keys Ctrl + (<-, Т, 4-, ->, PgUp, PgDn, End, Home). Selecting the parameter to be edited with the keys: ("Tab", "Enter", 1) - move down; ("Shift + Tab", Т) - move up.

Rice. Screen image in the "View additional information" mode

Confirmation of changes during editing is carried out by the measure parameter selection keys and the movement between measures keys. Cancellation of changes in the current editing is carried out by the "Esc" key. Switching to the mode of editing additional information is carried out using the "F3" key. Exit the edit mode by pressing the "Esc" key. From the mode of editing additional information, the output is carried out in the mode of editing information about measures. From the mode of editing information about measures, the output is carried out in the view mode.

When exiting the view mode, if changes have been made in the method, the program will offer to write the method to a file with the name specified in the "Additional Information" as the name of the method.

In line edit mode:

"Ins" key - switches the insert-replace mode (initially, work is carried out in the replace mode);

Arrows End, Home - moving along the line.

If no cursor keys have been pressed, the old line is erased before a new line is entered. In modulation method edit mode:

arrows - mode selection;

"Space" - mode change. About the program.

Program information shows:

program version;

a phone number where you can express all your wishes and comments, as well as receive qualified assistance in working with the software product.

Working with the methodology.

This mode is the main one, designed to launch the selected CMP and load it into the power unit of the Multimag magnetotherapy apparatus. When accessing this mode (by pressing the "Enter" key), the dynamics of moving one cell of the field (white background) along the bar of cycles appears on the screen in accordance with the specified parameters and the power block of the Multimag magnetotherapy apparatus is launched into operation also in accordance with the specified parameters. In the lower right corner, the line of the procedure vacation time is filled in, and upon completion of its filling, the sound signal of the end of the procedure is turned on.

When any key is pressed, the beep is interrupted. The column called "Deviations" shows the correspondence of the set field intensity levels with the actual levels that come from the power unit. Under the column "Deviations" information is given on the average values ​​of the duration of the cycles and the average frequency of switching cycles. You can abort the procedure prematurely with the Esc key.

The software of the MK-03 complex continues to be improved, and, above all, in terms of expanding the possibilities for modifying and creating new ILCs.

Methodology for the construction of magnetotherapy complexes and cabinets

Therapeutic and diagnostic complex.

It makes sense to form the complex already in the presence of one magnetotherapy apparatus of the Avrora MK-01 type. Additionally, diagnostic equipment is required. The structure of the diagnostic and treatment complex can be represented as shown in Fig.

Rice. The structure of the medical diagnostic complex

The minimum set of diagnostic equipment should, in accordance with 5.5, 5.6, include a heart monitor, a rheograph, a blood pressure meter, and a skin temperature meter (thermometer).

Organizationally, it is advisable to include a physiotherapist, a nurse, as well as an electronics engineer in the staff of the complex.

Methodological support includes a standard set of treatment and diagnostic methods depending on the type of disease, the individual characteristics of the patient and the stage of the disease.

Each treatment technique includes a type of magnetic field configuration (MCF), a table of intensities, directions of magnetic field vectors, cycle frequency, as well as the duration and number of procedures. The diagnostic technique contains a list of measured parameters and the procedure for performing measurements. The doctor prescribes the technique, and the nurse releases the procedures in accordance with this technique. She carries out diagnostic measurements before, during and after the session, places the patient in a magnetoscan, turns on the device and monitors the procedure for a specified time. She may temporarily interrupt the session for diagnostic measurements, if specified in the methodology. At the end of the procedure, the nurse again performs diagnostic measurements. The results of diagnostic measurements must be recorded on a special form. An approximate form of the form is shown in table.

Computerized medical diagnostic complex

The next step in the direction of increasing the efficiency of magnetotherapy is the creation of a medical and diagnostic complex of the highest level, namely, an automated workplace for a specialist doctor (ARMVS). ARMVS releases medical personnel from the routine work of manually measuring the physiological parameters of the patient's body, processing and documenting them, and choosing the optimal method of therapeutic exposure. Increasing the level of automation of diagnostic and treatment technology opens up new opportunities not only in the practice of treatment, but also in research to develop fundamentally new approaches and solutions. The block diagram of ARMVS, which can be used as a computerized diagnostic and treatment complex, is shown in fig. 6.2.

The basis of ARMVS is a personal computer (PC), usually IBM-compatible. Signals from the diagnostic system are sent to the laboratory interface. This interface converts analog signals into digital form. Digitized signals are processed by a computer, written to disk, and then they can be output to a screen, printer, or plotter.

Based on the analysis of the current diagnostic information and data stored in the computer database, the doctor, using the capabilities of the expert system installed on the computer, forms a method of magnetic exposure, which in one form or another enters the control unit of the Aurora apparatus, creating the required configuration of the magnetic fields.

Rice. The structure of the computerized medical diagnostic complex

In the presence of interference-proof measuring channels, it is advisable to monitor the patient's physiological parameters in order to promptly select the most rational CMP that meets the individual characteristics of the patient.

Connecting a personal computer provides a more efficient use of the diagnostic and treatment complex. The time spent on maintaining medical records is drastically reduced. Given that physicians are most comfortable with tools they are already familiar with, the PC program should display scorecards and other forms that physicians use on a daily basis.

Equipped with appropriate laboratory interfaces, a PC can monitor the patient's condition, control field-forming inductors, collect primary data with their subsequent analysis and decision-making.

Diagnostic information collected from the patient during the session (as well as 2 minutes before and 2 minutes after the session) is sent to a PC, which is controlled by a doctor and an operator-engineer. All incoming information is processed by a special program and presented in a concise visual form to the doctor and operator. The doctor monitors the patient's condition and makes the necessary adjustments to the operation of the complex.

Methodological software (SW) is offered at several levels.

The software of the first level has a database of magnetic field configurations (MCF) and their parameters and a database of patients. The latter is formed in the form of the form presented in the table, so there is no need to work with papers. The diagnostic results in each session are entered into the database selectively for each patient automatically. In addition, the first level software has a program for processing diagnostic information to identify trends and a program for visually displaying the process of exposure and treatment.

The database of CMP and their parameters includes all standard methods developed in practice and is formed into packages depending on the type of disease, individual characteristics and stage of the disease.

The ILC is selected in accordance with the pyramidal menu, as shown in Fig.

The CMP database is constantly updated with new or more effective CMP, either for new types of diseases, or more fully taking into account the individual characteristics of the patient. They are developed in special rooms with higher professional level staff and higher levels of hardware, software and software.

Rice. Pyramid menu for selecting ILC

The software of the second level, firstly, fully implements the tasks of the first level and, secondly, makes it possible to eliminate the existing standard methods and create new ones. At the same time, a doctor working with second-level software must receive an additional training certificate with an assessment of knowledge and skills in the field of magnetotherapy of the diseases he has chosen.

The software of the third level, including all the possibilities of the first and second levels, will be additionally equipped with an expert system and a mathematical model of the effect of magnetic fields on the patient, which will allow closing the feedback. That is, depending on the a priori and current diagnostic information and the results of their processing, the PC can independently modify the included CMP and its parameters to optimize the treatment process. At the same time, the system should have elements of artificial intelligence, the main credo of which should be the condition “Do no harm”. The software of the third level is under development. Naturally, software of all levels will be constantly improved and improved.

The organizational support of the offices is carried out by a doctor, an operator-engineer and two nurses per shift. The throughput of the rooms is at the level of 45-50 people per shift (taking into account the preparation time of the apparatus before the session, the time of the procedure and if there are 2 Aurora MK-01 devices in the office).

The process of collecting and processing data during a medical diagnostic procedure can be divided into three stages: data collection, data analysis, data presentation (Fig.). For each stage, special software and hardware tools are used, which are usually called subsystems.

Rice. Stages of data collection and processing

At the first stage, analog signals are usually normalized - amplification, filtering, switching, etc. The main task of the subsystem that performs these operations is to bring the parameters of the signals received from the primary converters to the values ​​used for perception by the data conversion subsystem used. In turn, the latter performs directly analog-to-digital conversion of analog signals.

At the second stage, the data processing subsystem performs the primary analysis of data using algorithms that are specific for each diagnostic feature. Here, as a rule, methods of digital filtering, analysis in the frequency and time domains, matrix algebra tools, regression analysis methods and other statistical methods are used. In some cases, the doctor, on the basis of the received data or other information, has the ability to actively influence the course of the medical procedure by changing the parameters of the magnetic field. For these purposes, the control subsystem serves.

The third stage involves the presentation of the parameters of the patient's physiological state obtained as a result of processing in the form of graphs, tables or diagrams. At this stage, both operational visualization and documentation of the results obtained take place.

In ARMVS, the considered functions can be distributed in various ways between the software and hardware of a computer and specialized measuring and computing tools.

For example, the diagnostic subsystem can be organized as follows. The computer is connected via a standard interface (IEEE-488.RS-232) to multifunctional control and diagnostic devices (cardiograph, rheograph, blood pressure monitor), which provide not only the functions of converting analog signals, but also many functions of analysis, data presentation and generation of control signals. In this case, the computer is usually entrusted with the functions of general control, more detailed analysis (secondary processing), and documentation of the results.

Another variant of the ARMVS layout is the use of a laboratory interface made on separate expansion modules that are installed in free slots on the computer. This option, of course, implements fewer hardware features than multifunctional instruments. However, the relatively low cost of this variant and the availability to a wide range of users, combined with the flexible software implementation of procedures performed by specialized devices, make this variant the most preferable for building ARMCS.

There are three main components of the ARMS:

hardware platform,

Software,

intellectual means.

Hardware and software are traditional components of any information and computing system, in this application they differ in some features that will be discussed below. Equally important is the third component - knowledge and ability to work with hardware and software.

In order to learn how to effectively operate ARMVS, medical personnel need directed work and help from engineers. No matter how good the hardware is and no matter how user-friendly the software is, it takes time and constant effort to acquire new knowledge.

Magnetotherapy room

If there are several MTK or LDK, then the problem arises of organizing their optimal operation to ensure maximum throughput. To solve this problem, it is advisable to integrate all ITCs in one office. At the same time, it is easier to plan the loading of each MTK, maintenance and repair. In addition, there is no need to strictly bind a particular patient to a specific MTC, and in the event of failure of one of the MTCs, patients can be distributed evenly among the remaining complexes.

Planning the work of the MT cabinet consists in the fact that, on the one hand, for each patient, the method and duration of exposure to a magnetic field, the number and frequency of sessions are determined, and on the other hand, all this should be linked to the total throughput of all MTCs. In addition, for the development of methods of magnetic therapy, a set of statistics on the treatment of various diseases is important.

It is not difficult to imagine that when deploying more than three MTCs in the office, a lot of routine work will appear on planning the optimal load of the office and documenting the treatment process, since the flow of patients will be very significant.

This problem is mainly solved if, instead of one MTC, an ARMVS is introduced into the office and all routine operations are shifted to a computer that is part of the ARM. In this case, firstly, the stage of determining the treatment method for each patient is facilitated, since ARMVS can monitor the most important physiological parameters, has specialized means for processing the information received, and includes an expert system. Secondly, when using the database, which is part of the ARMVS, the office registry is automated, as well as the collection and processing of treatment statistics.

But this raises the problem of sharing one computer by personnel of different MTCs, which is not always convenient, and sometimes impossible. Therefore, for more efficient use of all MTCs, multiple access to the ARMVS computer and, above all, to the database located on it is necessary. This task can be solved by organizing in the office either a local area network (LAN) or a multi-user system (MPS). Let's consider each approach and determine which and in which case is optimal for a magnetotherapy room.

A local area network is usually a number of independent computers that are interconnected by some kind of communication equipment. At the same time, the application software running on these computers must have fairly simple and fast means of transmitting data through the existing communication equipment. The computers of such a network are usually located at a small distance from each other (about 1...5 km). For the local network to work, you must perform the following steps. First, to connect computers by means of any communication equipment. Secondly, run on these computers special network software that will perform the necessary operations on the local network.

A multi-user system links hardware into a single complex in a different way: “non-intelligent” type terminals (workstations without a processor) are connected to the main computer.

The difference between LAN and MPS is obvious. In a LAN, each workstation or "node" is a personal computer with its own operating system and its own copy of the network OS. In a network, each node takes part in information processing: the more complex the network, the more complex the interaction of its nodes. Unlike a LAN, in a multi-user system, the workstation does not take part in data processing. Here the user works on an inexpensive terminal that does not have a processor, disk drives and other important components of a personal computer. All processing is carried out on a powerful central PC - the main computer. The user accesses the resources of the host computer and works with applications and files that are permanently located on this machine. Each user is given his own section of memory, in which he perceives the work with the main PC as an interaction with a single-user machine. The generated files are stored in a central storage subsystem connected to the host computer.

On fig. the organization of a magnetotherapy room based on a local computer network is shown, and in fig. - Based on a multi-user system.

Rice. Organization of a magnetotherapy room based on a local area network: PC - personal computer, A - network adapter

Rice. Organization of a magnetotherapy room based on a multi-user system: MX - multiplexer, T - "non-intelligent" type terminal

magnetotherapy treatment pulsed current

It should be noted that the LAN capabilities in the magnetotherapy room will be used to a small extent, since intensive data exchange between individual PCs (network node) is not required, and only centralized access to the database and printer is needed. In addition, individual PCs will also be operated extremely inefficiently, since no local data processing is required. And the last remark concerns administration and maintenance. Here, multi-user systems have a distinct advantage over LANs. After installation, testing and subsequent launch, the multi-user system works without any problems. Diagnostic tasks are also much easier to solve for a system with a single processor than for a network with many processors. A multi-user system needs little to no administration, while a LAN requires a system programmer to keep the network up and running.

Based on the foregoing, when organizing one magnetotherapy cabinet, it is advisable to use a multi-user system, using a computer that is part of the ARMVS as the main computer. Such a system will have relatively low initial and operational costs and will automate the routine operations associated with maintaining the office registry, collecting and processing treatment statistics.

Let us give some remarks on the construction of a multiuser system. Depending on the type of terminal and how it is connected to the host PC, the terminal must be provided with either an RJ-11 phone jack or an RS-232 serial port connector. It is possible to use relatively cheap domestic terminals. PCs equipped with programs emulating the operation of these devices and having an RS-232 interface can be used as terminals. The terminals are usually connected to the host computer through boards with communication ports and cables. These boards vary in cost and complexity, with some board models containing up to 16 ports. The simplest boards perform only communication functions and are used as ordinary serial ports. These boards are available in four and eight port designs. In addition, "smart" communication boards (eg, Maxpeed's 4- and 8-port Series II boards) are available that include a processor that manages the serial communications, thereby offloading some of the load from the main processor. An inexpensive way to connect terminals is to use a twisted pair telephone. Some terminals have RS-232 serial connectors. They are connected using cables and are commonly used to connect modems and laser printers. The distance between the terminal and the main computer can reach 25...30 m without installing additional repeaters. In addition to hardware, a multi-user system also includes system software. Since the ARMVS software works in the MS-DOS environment, the multi-user operating system installed on the host computer must be fully compatible with this software. There are several multi-user operating systems compatible with MS-DOS: PC-MOS (The Software Link Company); Concurrent DOS/386 (Digital Research); VM/386 (IGC). Most systems allow connection of 5-10 users, which is quite enough for one cabinet.

In conclusion, it should be noted that if in a medical institution where a magnetotherapy room is being organized, there is already some branched LAN and there is an engineering and technical staff servicing it, then it is probably easier and faster to organize an office as a segment of the existing network.