Physiotherapy for osteochondrosis complements the main treatment and significantly alleviates the patient’s condition. By selectively acting on the painful area, physiotherapy has virtually no unwanted side effects.

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

Physiotherapeutic procedures:

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

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

Types of physiotherapy in the treatment of osteochondrosis

For 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 effects (ultrasound therapy, zonal or acupressure vibration massage)
8. Ultraviolet irradiation (UVR)

Ural Federal District

Under the influence of ultraviolet radiation, vitamin D is formed in the skin, which helps to absorb calcium. The method is carried out using irradiators, which have bactericidal, anti-inflammatory and some analgesic effects.

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

Before carrying out therapy, sensitivity to ultraviolet rays must be checked. During the first procedure, the smallest biodoses are prescribed and are gradually increased with each subsequent session. Usually 10-15 procedures are prescribed.

Contraindications:

• Oncological diseases
• Taking medications whose effects are enhanced by exposure to ultraviolet rays.
• Blood diseases.

Vibration effect

The method underlies many effective treatments. Thanks to its effect, the method relieves pain of various localizations.

With 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:

• Oncological diseases
• Vibration disease
• Dermatitis or skin lesions in the affected area
• Mental disorders.

Shock wave therapy

The method involves transmitting an acoustic wave to a painful area of ​​the body. This type:

• Eliminates pain
• Improves microcirculation
• Improves metabolism.

Detensor therapy

The method involves stretching the spine using the patient's body weight.

Laser therapy

The method has a healing effect using helium-neon lasers.
Due to the activation of bioelectric 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. For osteochondrosis, treatment is applied to the paravertebral zones of the affected spine. 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 works using an electric field and current. Under the influence of electric current, heat is generated in the tissues, which helps to increase local blood circulation. Electrotherapy has the following effects on the body:

• Eliminates pain and discomfort
• Speeds up treatment.

Electrical treatment is contraindicated for patients who have metal parts, devices, or pacemakers in their bodies.

Pulse currents

Pulsed currents have a very effective therapeutic effect. Their mechanism of action on the body is determined by their effect on nerve receptors. Low-frequency impulses help relieve pain.

Diadynamic therapy (DDT)

DDT is used in the treatment of osteochondrosis using double continuous or wave current. The current strength increases until a slight vibration appears at the site of exposure. Sessions are scheduled daily for up to 10 days. After the second procedure, acute pain becomes aching, muscle tension and symptoms of nerve root tension are relieved. A full course of DDT treatment leads to normalization of muscle tone and increased mobility of the spine.

Interference therapy

The method is used for acute pain. The method involves rhythmically changing the frequencies of 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 (SMC)

The frequency of current and the depth of modulation with this method of physiotherapy are selected depending on the pain syndrome. With each subsequent procedure (as the 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 nerves without directly affecting motor structures. Electrodes are applied to the entire area of ​​the paravertebral affected area, to the area of ​​projection of the spinal roots. The current strength increases until vibration appears in the affected area. The method is effective in the acute period.

Electric field UHF

During UHF therapy, electrodes 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 procedures. A course of up to 15 procedures.

Magnetotherapy

Physiotherapy for osteochondrosis includes the use of magnetic therapy. Inductors are placed on the affected spine and limb. Magnetic therapy uses a continuous mode with a 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 involves the use of mud and mineral waters (local and general baths, pools, showers) for the purpose of treatment and rehabilitation. During the procedure, minerals penetrate the skin and act on receptors and nerve centers.

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

Combined methods of physiotherapy

Most often, combined methods of physiotherapy for osteochondrosis are prescribed. For example, for severe pain, diadynamic therapy and electrophoresis (diadynamophoresis) using novocaine are used.

For immediate impact on biological active points, the method of acupuncture laser puncture is used. 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).

• Methods of application
• Electrical treatment devices
• Diseases that prevent current treatment

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

Methods of using electricity

Physiotherapy has a wide arsenal of techniques for restoring health using electricity. There are several directions:

Electrical treatment devices

For galvanization sessions, the “Potok 1” electrotherapy device 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, can also be used at home. The device allows for almost all known effects of electric current on the body, including electrosleep.

Diseases that prevent current treatment

Electrotherapy has quite extensive contraindications, under which the use of electric current for therapeutic purposes becomes dangerous. Treatment should not be carried out on pregnant women at any stage of pregnancy or with the following diseases:

• Feverish conditions, purulent diseases of the skin and internal organs, acute inflammatory processes.
• Intolerance to electrical current or the medication used for electrophoresis.
• Epilepsy.
• Heart defects, heart attack or coronary heart disease.
• Having a pacemaker or other implanted device.
• Bone fractures with multiple fragments.
• Any acute convulsive conditions such as renal colic, angina or surgery.

The doctor prescribing electrotherapy procedures will definitely conduct a full analysis of the patient’s health condition and warn him about the possible consequences. That is why it is advisable to carry out all procedures in a 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

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

Sometimes the pain syndrome is so excruciating that the patient is unable to dress, comb his hair or eat without assistance.

It’s worth immediately emphasizing that pain in the joints of the hands can be of different types. It is the type of discomfort that will become the determining factor during the diagnosis of pathology already during the initial examination of the patient.

Doctors usually divide joint pain into two large groups:

• mechanical pain. Occurs during degenerative processes, for example, osteoporosis. It hurts without a feeling of stiffness in movements in the morning, or there is stiffness, but it 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. It hurts less when moving, morning stiffness lasts more than half an hour. Moreover, in almost 90% of cases there are other symptoms of the inflammatory process: redness of the skin, decreased volume and range of motion.

Why does pain occur?

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

It is generally accepted that about 7% of people suffer from osteoarthritis, accompanied by pain. Many more people suffer from other signs characteristic of this disease and changes in the body. However, when examined by a doctor, they may not feel pain.

Rheumatoid arthritis has become an equally diagnosed disease that causes pain in the joints of the upper extremities. The disease is associated with autoimmune disorders in the body, because with this form of arthritis, antibodies arise to one’s own tissues. Such antibodies damage the structure of the joints and cause inflammation.

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

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

Another cause of pain is gout, which affects mostly men. If there is a violation of purines (special substances that come from food and are necessary for the creation of cells), then the level of uric acid in the blood rises sharply. Urates are actively deposited in joint tissues, causing their damage.

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

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

With gout, there is pain and redness in the area of ​​the joints of the hands. Lesions always affect the phalanges of the fingers and the wrist joint. The pathological process involves 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 requires an individual approach to treatment.

Treatment with drugs

In order to effectively and fully combat arthralgia, the causes of pain must be correctly identified. 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 relieved with universal drugs. They are effective in most cases. This includes medications from 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 them to forget about the pain.

Medicines are widely used:

• Indomethacin;
• Diclofenac;
• Ibuprofen.

These drugs are characterized by powerful anti-inflammatory and analgesic effects, despite their low cost. However, they also have many side effects on the body. First of all, drugs, especially with long-term use, provoke an exacerbation of diseases of the digestive system, namely erosion of the stomach, duodenum, hepatitis, and 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 having minimal harmful effects on the kidneys, intestines and liver.

Nonsteroidal anti-inflammatory drugs specifically suppress the secretion of biologically active substances, which cause inflammation in joint tissues. 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 eliminating the symptoms, but also addressing the causes of the development of diseases of the hand joints. In each specific clinical case, the set of medications will vary.

To reduce discomfort during illness and inflammation, mild to moderate, special anti-inflammatory ointments, creams, and gels are used along with classical therapy. This may be traditional Diclofenac, Finalgon or other drugs with a distracting, analgesic effect.

If destruction occurs in the large joints of the hands, then hormones (glucocorticosteroids) are injected directly into the joint cavity. Usually in such cases injections of Diprospan and Hydrocortisone are used.

Physiotherapeutic treatment

Not only treatment with pharmaceutical drugs can be useful for joint diseases and pain. The following will help significantly reduce discomfort and other unpleasant sensations:

• impulse currents;
• ultrasonic irradiation in erythema dosage;
• applications using anti-inflammatory drugs (this can be Dimexide diluted with water in a ratio of 1 to 1);
• electrophoresis with non-steroidal drugs;
• phonophoresis with glucocorticosteroid hormone preparations.

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

Traditional medicine recipes

Alternative medicine knows a countless number of methods for getting rid of pain and joint diseases. Many patients with articular pathologies note positive dynamics of the disease almost immediately after using half a gram of mumiyo, if it is mixed with 100 grams of natural bee honey. This mixture will be an excellent base for a compress.

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

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

• dandelion;
• plantain;
• nettle;
• lingonberries.

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

Naturally, such treatment should take place under the close attention of a doctor and with his approval, because some seemingly harmless plants can have completely different effects on patients. We also must not forget that getting rid of pathologies of joints and bones must be well thought out and necessarily comprehensive. If the doctor’s recommendations are not fully followed or there is no treatment, then there is a high probability of the situation worsening and the disease progressing quickly.

• Relieves pain and swelling in joints due to arthritis and arthrosis
• Restores joints and tissues, effective for osteochondrosis

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Electric current has a large number of biological effects on the human body. In this regard, its effects began to be used in the treatment of diseases, conducting physiotherapeutic sessions for patients of various ages. Pulse electrotherapy involves the use of specific types of electric current, primarily to change the activity of structures of the nervous system. Such physical therapy should always be carried out as prescribed by the attending physician, since the method has a number of indications and contraindications that should be taken into account for each patient.

About the method

During the process of pulsed electrotherapy, biological tissues are affected by pulsed currents with a frequency of 50 and 100 Hz. Short and long periods of pulses constantly alternate.

Electrotherapy with pulsed currents, according to the mechanism of its effect, is divided into neurotropic and general, or diadynamic therapy. In the case of neurotropic pulsed electrotherapy, electric current affects the structures of the central nervous system. The biological effects of physical therapy are associated with changes in the activity of groups of neurons in various centers of the brain and spinal cord. The electromagnetic field leads to normalization of the reactivity of the nervous system, which indirectly improves the functioning of the cardiovascular and respiratory systems, provides a pronounced analgesic effect, and also accelerates regeneration processes in the body of a child or adult patient.

In turn, the impact of pulsed current of various frequencies on structures outside the central nervous system improves blood circulation and lymphatic drainage in internal organs, reduces the severity of pain, stimulates the immune system and accelerates metabolism. This is of great importance for the treatment of diseases of various organs and systems. A similar procedure is used in gynecology, traumatology, etc.

Neurotropic pulsed electrotherapy plays a supporting role in the treatment of diseases. In no case should you use it as the only method of therapy, as this is fraught with further development of the disease.

Types of current

Therapy using pulsed currents allows for a selective biological effect through the use of certain exposure parameters. The following types of electric current are used in physiotherapy:

• Monopolar current maintaining a low frequency of 50 Hz. With such exposure, the patient experiences an increase in the tone of smooth and striated muscle tissue, as well as an irritating effect on tissues and cells.
• Bipolar high-frequency current with a frequency of 100 Hz has an analgesic effect and dilates blood vessels, improving blood supply to internal organs and muscles.
• Intermittent types of electric current reduce the intensity of pain and normalize muscle tone.

The differences between pulsed electrotherapy modes are minor. However, the attending physician by choosing a specific stimulation mode can significantly improve the patient’s condition and his prognosis for recovery.

Purpose of treatment

Physiotherapeutic procedures are regulated by certain indications and contraindications. Compliance with them makes it possible to increase the effectiveness and safety of treatment for patients. Pulse electrotherapy is prescribed in the following cases:

• Diseases of the central nervous system associated with changes in the activity of various parts of the brain or spinal cord. Neurotropic procedures are effective for neurasthenia, asthenic conditions, sleep disorders, logoneurosis and diseases of internal organs associated with impaired reactivity of nervous structures.

• Pathology of the peripheral nervous system in the form of neuritis, neuralgia, myalgia and neuromyositis.
• Diseases of the musculoskeletal system: degenerative changes in the intervertebral discs, arthrosis, arthritis and inflammatory lesions of the ligaments and intra-articular structures. Diadynamic therapy is widely used in the treatment of musculoskeletal injuries.
• Diseases of the gastrointestinal tract: chronic gastritis, duodenitis, peptic ulcer of the stomach and duodenum, disorders of the tone of the biliary tract, etc.
• Gynecological pathology of inflammatory and non-inflammatory origin.
• Diseases of the cardiovascular and respiratory systems.

Depending on the patient’s pathology, the doctor selects the required pulse therapy mode and electrode application points. In no case should you try to self-medicate, as in most cases this leads to aggravation of the disease or the development of side effects.

Prevention of negative effects of the procedure requires compliance with contraindications to pulsed electrotherapy:

• history of epilepsy or epileptic seizures;
• increased sensitivity to electric current;
• malignant or benign tumors;
• progressive weight loss of a person, regardless of the reasons;
• acute period of infectious diseases;
• decompensated diseases of internal organs;
• the presence of implanted electrical devices, such as a pacemaker.

Identification of contraindications to physical therapy is carried out during a conversation with the patient and his examination.

Carrying out the method

Pulsed electrotherapy can be carried out either with the patient lying or sitting, depending on the intended area of ​​influence. The person should be relaxed and not afraid of the upcoming impact. The attending physician selects the required size and shape of the electrodes to ensure precise impact on the pathological focus.

Gauze soaked in an electrically conductive solution is placed under the electrodes, and they themselves are fixed with bandages to prevent them from shifting during the procedure. The device for pulsed electrotherapy is turned on from the minimum current values, gradually increasing them until the patient feels a slight vibration under the electrode. During the physiotherapeutic course, the current strength should be gradually increased to prevent the development of the effect of “getting used” of the body to such an effect.

The choice of a specific electrotherapy regimen is made by the attending physician, depending on the patient’s disease and its clinical manifestations. At the same time, in the process of physiotherapy it is recommended to use various types of current and their modulation, which improves the therapeutic effect and reduces the risks of developing negative consequences. Modern devices for this type of treatment can independently change exposure modes or combine them.

All devices that are used for physical therapy at home or in a medical institution must be in good working order and undergo regular technical inspection.

The duration of one procedure is from 10 to 15 minutes. At the end of the procedure, the electrotherapy device is turned off and the electrodes are removed from the skin. The patient is not recommended to get up immediately. You need to stay on the couch for another 10-20 minutes. If physiotherapy is carried out in childhood, then exposure to electric current should not exceed 10 minutes in one session.

A physiotherapeutic course consists of 10-15 procedures of a specified duration. They should be carried out either daily or with a break of one day, which depends on the patient’s condition. If necessary, additional sessions can be performed after a break of 2-3 weeks.

When using pulsed electrotherapy at home, the patient should carefully study the operating instructions for the device. It should be noted that the neurotropic type of physiotherapy is recommended to be used only in a medical institution.

Possible complications

Physiotherapeutic treatment methods rarely lead to the development of side effects in patients. However, if the rules for prescribing therapy and the methodology for its implementation are not followed, the following negative consequences are possible:

• Irritation and pain under the electrodes during a physiotherapy session. This discomfort may persist after the procedure is completed.
• Worsening of the course of concomitant diseases related to contraindications: epilepsy, acute infectious processes, tumor pathology, etc.

Prevention of the development of side effects is based on compliance with the indications and contraindications for the use of pulsed electrotherapy, as well as on constant monitoring of the patient’s health during treatment.

Pulsed electrotherapy is used to treat a large number of diseases. Exposure to high- or low-frequency current can improve the results of therapy for patients with pathologies of the central nervous system and internal organs. Physiotherapeutic procedures can be performed in specially equipped departments of a medical hospital or at home if the necessary equipment is available. It should be noted that self-medication using pulsed electrotherapy is unacceptable, as it can cause progression of the underlying disease or lead to aggravation of concomitant diseases.

Electrical currents are widely used in physiotherapy. Changes in their parameters can diametrically influence the mechanisms of action and the observed effects on the body.

High frequency currents in physiotherapy

Currents used for medical purposes are divided into low, medium and high. High frequency current is detected at frequencies greater than 100,000 hertz.

High frequency currents are generated by special equipment and are applied without direct contact with the patient. An exception is the local darsonvalization method, which uses high-frequency currents through special electrodes on the body.

Many physiological effects of HF currents are based on the formation of endogenous heat in tissues. High-frequency currents cause small vibrations at the molecular level, resulting in heat. This heat acts at different depths in the tissues, and the effect lasts for some time after completion of the procedure.

Application of RF currents in medical practice

The effect of high-frequency currents on the central nervous system is sedative and on the autonomic system - sympatholytic; in general, HF currents have a relaxing effect on the nervous system. The same can be said about their effect on the smooth muscles of the bronchi, where the antispasmodic effect is combined with an anti-inflammatory effect.

HF currents are indicated for pain syndromes such as neuralgia, neuritis, radiculitis, etc. The analgesic effect is due to an increase in the pain threshold of skin receptors and inhibition of the transmission of pain signals through nerves.

Procedures using high-frequency currents are effective for slow tissue healing in wounds, bedsores and trophic diabetes. This mechanism of action is associated with the induction of endogenous vasodilating heat. In spastic conditions such as Buerger's disease or Raynaud's syndrome, HF currents can also relieve some symptoms.

In another case, the effect of high frequency currents on blood vessels is tonic and is used in the treatment of varicose veins and hemorrhoids. Sometimes the bactericidal effect of high-frequency currents is used to treat infected wounds. The bactericidal and antimicrobial effect of HF currents has indirect mechanisms that increase local blood flow, stimulate and accelerate the phase of the inflammatory process.

Contraindications to the use of all types of currents in medicine are large metal objects in tissues, implanted pacemakers, pregnancy, a tendency to bleed, and some others.

Ultra-high frequency currents

Ultra-high frequency currents are another group of high-frequency currents. They also work on the principle of generating endogenous heat and targeted activation of metabolism in certain tissues. Their action is used in response to a wide variety of pathological processes. The duration of one procedure is on average 10-15 minutes, and courses vary in length depending on the result achieved.

Irradiation of the kidney with ultra-high-frequency currents in acute and chronic glomerulonephritis produces a vasodilating and anti-inflammatory effect, acting on blood vessels, and increases diuresis. On the other hand, radiation to the adrenal glands naturally stimulates the production of corticosteroids and is used in the treatment of some autoimmune diseases.

The third group of high-frequency currents used in medicine is centimeter high-frequency currents. Microwave waves affect blood, lymph and parenchymal organs. Centimeter waves have a depleted effect 3-4 centimeters deep into the body surface.

The principle of operation of all types of high-frequency currents is associated with the formation of endogenous heat. The latter has different effects on different organs. The difference between the currents in frequency determines the depth of heat penetration into the body and the preference for treating a certain type of tissue, with more or less water content. Treatment with HF currents must strictly correspond to the type of pathology, location and type of tissue.

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Low frequency currents in physiotherapy

Low frequency current is defined from one to 1000 hertz. Within this range, depending on the frequency, the effects of LF currents differ. Most medical equipment uses low frequency currents with a frequency of 100-150 Hz.

In general, the therapeutic effect of low-frequency pulsed currents can be divided into irritating and suppressive. What the effect of such therapy will be depends mainly on the frequency of the current. Low frequency currents affect electrically excitable structures such as nerves and muscles.

The application of low frequency currents is carried out through electrodes that are placed on injured muscles, a diseased area of ​​the body or other place. In most cases, electrodes are placed on the skin. It is possible, however, to insert them into the vagina, rectum, or implantation in certain muscle groups and the medullary canal, and even in the brain.

The normal process of excitation of nerve and muscle cells is achieved by changing the charge on both sides of the positive and negative electrodes. The use of electric current with certain characteristics near excitable structures has a stimulating effect on them. The local mode of action of the current is due to a change in the charge of the cell membrane.

Application of low-frequency currents in medicine

Low-frequency currents are used to stimulate muscles with preserved innervation, for example, when, during immobilization after bone fractures, muscle wasting and hypotonia (low tone) develop in the immobilized area. This occurs because the muscles do not move and are not stimulated by the nerves.

In these cases, the applied low frequency current causes contraction of part of the muscle fiber, which improves blood supply and, to a certain extent, helps prevent the occurrence of severe malnutrition. However, to achieve this effect, electrical stimulation must be used quite often.

In other cases, muscle stimulation may be impaired by innervation (paralysis, paresis). It is necessary to reuse low frequency currents, but with their different physical characteristics. The goal is to stimulate the muscles and restore nerve integrity.

Electrical stimulation can be applied not only to the skeleton, but also for various smooth muscle diseases, such as postoperative intestinal atony, postpartum uterine atony, etc. Another application of this method is stimulation of the venous wall during varicose veins and hemorrhoids. Contraindications for stimulation with low-frequency currents are pregnancy, pacemakers and some other conditions.

The second main use of low frequency currents is to reduce pain in neuralgia, myalgia, tendinitis, headaches and other conditions. The most common method is transcutaneous electrical nerve stimulation. With this type of stimulation, specific very sensitive nerve fibers are affected, which block the transmission of pain information at the level of the spinal cord. The duration of one session of such therapy ranges from 10 minutes to 1-2 hours. The most suitable frequency to achieve an analgesic effect is about 100 Hz.

Disclaimer: The information presented in this article about the use of low-frequency and high-frequency currents in physical therapy is intended for informational purposes only. It is not intended to be a substitute for advice from a healthcare professional.

In the structure of morbidity, one of the main places is occupied by joint diseases. Pharmaceutical companies now offer many different medications and supplements to treat them. Along with them, no less effective physiotherapeutic treatment can be used. The main place among physiotherapeutic methods is occupied by pulse-wave therapy of joints. The principle of impact on the joint cavity, indications and contraindications for this treatment will be discussed below.

Pulse wave therapy is also called shock wave therapy. This method is one of the modern methods of treating joint diseases. Shock wave therapy for joints (SWT) is based on low-frequency sound, less than 16 Hz, which the human ear cannot hear.

Operating principle of UVT

What is the basis for curing articular pathology with a shock wave? The mechanism of action is as follows:

1. In the process of exposure to a wave on the cell wall, it stretches, its permeability to various substances entering and exiting the cell increases, that is, metabolism accelerates. By improving microcirculation, accelerated restoration of damaged structures occurs and calcium deposits dissolve.
2. Due to the pressure of the wave, cavities are formed. If the pressure continues, the cavities burst, allowing intra-articular calcium deposits to be destroyed.
3. After the cavities burst, smaller waves are formed, which contribute to the further destruction of pathological formations.
4. An important point is the reduction in pain intensity due to a decrease in the passage of pain nerve impulses. In addition, the production of the hormone endorphin increases, which also helps reduce pain. SWT also destroys areas of fibrosis.

What joint diseases does UVT treat?

Shock waves are used for the following pathological conditions:

1. . This pathology is found in almost 80% of the population and ranks third in prevalence after heart and cancer diseases. Shock wave therapy is mainly used for arthrosis of the knee joint, as well as for the treatment of arthrosis of the ankle.
2. Contracture. The consequence of improved microcirculation is the return of elasticity of the ligaments. After therapy, the range of motion increases.
3. Degenerative changes in the articular cavity.
4. and fractures in the articular region. By improving blood circulation, joint tissues and structures are restored quite quickly.

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

Shockwave therapy is also used to develop the joint during the rehabilitation of patients after surgery. In addition, this method is used if conventional medications no longer help and there is a question about surgical intervention. Pulse wave treatment will help avoid surgery.

Contraindications to the procedure

In what cases should shock wave therapy not be used for arthrosis? Contraindications to this 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 site of application of the UVT device.
5. Presence of a pacemaker. Wave action can disrupt its operation or damage 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 distributed to all organs and tissues.
7. When exposed to waves on nerves or nerve plexuses, paresis or sensitivity may develop.
8. You cannot use the UVT device at the border with organs that contain gas inside them: lungs, intestines.

Side effects:

• joint swelling;
• redness of the skin over it;
• the occurrence of intra-articular hematoma.

The listed side effects are not an indication to interrupt the course. As a rule, they disappear within 10 days.

How is the procedure done?

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 to facilitate the transmission of impulses from the device to the site of application.
3. The doctor determines the required frequency and time of exposure to the pathological focus. Next, the applicator is pressed to the site of exposure and the procedure begins, which lasts 15-30 minutes.

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

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

Shock wave therapy for arthrosis: reviews

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

Alexey Mikhailovich, orthopedist, Moscow:

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

Elena M., 49 years old:

“I am worried about pain due to arthrosis of the ankle joint. I take 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 decreased significantly, but did not disappear. I completed the course completely, the pain went away and never came back. I recommend UVT treatment for ankle arthrosis to everyone.”

Evgeniy R., 52 years old:

“I have been suffering from knee arthrosis for a long time. Constant pain that subsides only temporarily after taking or injecting painkillers. I heard about such treatment as shock wave therapy of the knee joint. I decided to try it. After the first procedures, the pain became noticeably weaker, and after the course of treatment the pain disappeared. I recommend everyone to treat the knee joint with shock wave therapy.”

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, apparatus, systems and complexes"

“DEVICES FOR PULSED CURRENT THERAPY AND MAGNETOTHERAPY”

Completed by: student gr. MBP-05-1

Vedernikova M.A.

Checked by: Glushkov V.S.

Tyumen 2009

Treatment with pulsed currents

Electrotherapy uses the principle of alternating short-term effects - impulses (from the Latin impul-sus - blow, push) with low voltage and low frequency current with pauses between them. Each pulse represents a rise and fall of current, followed by a pause and repetition. Pulses can be single or form series (messages), consisting of a certain number of pulses, and can be repeated rhythmically with one frequency or another. Electric current consisting of individual pulses is called pulse current.

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

Rice. Direct and pulse currents. a - direct current; b - rectangular pulses; c - pulses of exponential shape; d half-sinusoidal pulses

Amplipulsetherapy

Amplipulse therapy is a method of electrotherapy that involves exposing the body to a modulated sinusoidal current of sound frequency. A method that 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 a series of carrier frequency pulses are formed, following with a frequency of 10-150 Hz. Such series of pulses (modulations) are referred to as sinusoidal modulated current (SMC) (Fig.).

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

There are several types of CMT, designated 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 interoceptors of the neuromuscular system, has a pronounced irritating effect, therefore it is used for electrical stimulation. The type of work, or “send-pause” (SP), represents the alternation of modulated current sends with pauses, and sending a series of modulated oscillations and a pause can be change within 1-6 s. PP also has a pronounced irritating effect and is used mainly for electrical stimulation. The type of work, or “send-carrier frequency” (PN), is a type of current in which the sending of modulated oscillations of a series of pulses of 10-150 Hz alternates with an unmodulated current with a frequency of 5000 Hz. The duration of the series sendings can also be changed within 1-6 seconds. PN has a mild irritating effect, it is used to relieve pain. a type of work, or “current-alternating frequency” (IF), a type of current in which modulations of two frequencies alternate: a fixed constant frequency (150 Hz) and a series of modulated oscillations, frequency which can be changed within 10-150Hz. 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 half-sinusoidal pulses, and in a non-rectified 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 administration of drugs.

To reduce or enhance the excitatory effect of SMT, the depth of modulation is changed. The depth of modulation is understood as a change in the amplitude of oscillations between series of pulses compared to the amplitude of the current-carrying frequency. Reducing the depth of modulation (up to 25-50%) reduces the exciting effect of the current, increasing it (up to 75-100%) enhances it. In medical practice, a modulation depth of 25-50-75% is usually used.

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

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

Devices for amplipulse therapy

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

In Fig. the machine's control panel is 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 activation key of the first type of operation; 7 - power key; II type of work; 8 - activation key of the third type of operation; 9 - activation key of 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-cycles; 13 - key for switching the output voltage to the load resistance (“Control”), 14 – key for switching to the patient terminals; 15 - signal light for switching to the patient terminals; 16 - plug connector for connecting patient wires; 17 - connector for connecting mains voltage; 18 - mains fuses; 19 - key for adjusting the device; 20 - current control knob in the patient circuit

"Amplipulse-4". It is a portable model, powered by an AC mains voltage of 127-220 V. The device is made according to protection class II. It comes with a set of electrodes.

The block diagram of the "Amplipulse" device 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 unit (not shown in the block diagram).

The SWT switching unit switches the frequency-setting circuits of generator G 2, the output signals of generators G 1, G 2, as well as selecting 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 provides an output for connecting a protection module.

The G3 pulse generator provides key switching for the SWT block

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.

Exposure to electric current causes muscle contraction at the moment the current strength changes and depends, according to the Dubois-Reymond law, on the speed with which this change occurs. The effect of current stimulation occurs at the moment the circuit is closed and reaches its greatest strength under the cathode. Therefore, it is the current pulses that have an irritating, stimulating effect, and the active electrode during electrical stimulation is the cathode. 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 the electrical impulses and, secondly, the functional state of the neuromuscular system. 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 based on its 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 pulses, as well as select the optimal parameters of the pulse current for electrical stimulation.

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

Electrical stimulation is most widely used in the treatment of diseases of the nerves and muscles. Such diseases include various paresis and paralysis of skeletal muscles, both flaccid, caused by disorders of the peripheral nervous system and spinal cord (neuritis, consequences of polio and spinal injuries with damage to the spinal cord), and spastic post-stroke, as well as hysterogenic. Electrical stimulation is indicated for aphonia due to paresis of the laryngeal muscles, paretic condition of the respiratory muscles and diaphragm. It is also used for muscle atrophy, both primary, which developed as a result of injuries to peripheral nerves and the 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 internal organs (stomach, intestines, bladder, etc.).

In recent years, electrical stimulation has been increasingly used for atonic bleeding, to prevent postoperative phlebothrombosis, to prevent complications during prolonged physical inactivity, and 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 functioning of a stopped heart and bring a patient with myocardial infarction out of a state of clinical death. An implanted miniature device (pacemaker), which supplies rhythmic impulses to the patient’s heart muscle, ensures the effective functioning of the heart for many years when its conduction pathways are blocked.

Contraindications to electrical stimulation vary. For example, it is impossible to perform electrical stimulation of the muscles of internal organs in case of cholelithiasis and kidney stones, acute purulent processes in the abdominal organs, or spastic condition of the muscles. Electrical stimulation of facial muscles is contraindicated in case of early signs of contracture or increased excitability of these muscles. Electrical stimulation of the muscles of the extremities is contraindicated in case of ankylosis of the joints, dislocations before their reduction, 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 any 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. The total duration of the procedure should not exceed 30 minutes. For mild lesions, 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.

Devices for electrical stimulation

For electrical stimulation, the devices “Neuropulse”, “Miorhythm-040” are used, as well as devices for diadynamic (“Tonus-1”, “Tonus-2”) and sinusoidal modulated currents (“Amplipulse-4”, “Amplipulse-5”, “Stimulus”) -1", "Stimulus-2").

The doctor's prescription must 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 modulation frequency, the current strength, the duration of the procedure, and their number per course.

To carry out the procedure, you should 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 warning light comes on. It takes some time to warm up the device until a glowing zero line appears on the oscilloscope screen. At this time, you should configure the device to the electrical stimulation parameters corresponding to the medical prescription, for which you turn on rhythmic or manual stimulation, set the type of current, pulse frequency, duration, and rhythmic modulation frequency. After the zero line appears on the oscilloscope screen, the arrow of the measuring device should be set to the zero position.

Rice. Types 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 breaker (for electrodiagnostics) (Fig. 19). The choice of electrode depends on the area of ​​influence and muscle mass. Stimulation of the muscles of the limbs, torso, and muscles of internal organs is carried out with plate electrodes, and facial muscles with push-button or needle electrodes. When influencing large muscle masses, for example, the abdominal wall, muscles of the stomach, bladder, large-area electrodes are used; when influencing skeletal muscles, small ones (4-6 cm).

Electrodes with a wet pad should fit tightly to the surface of the skin. They are fixed with bandages. Electrical stimulation can be one- or two-pole. Depending on the location and muscle mass, the location of the active and indifferent electrodes can be transverse or longitudinal. The choice of active electrode is determined by the doctor based on electrodiagnostic data.

Fluctuarization

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

Currently, three forms of currents are used for fluctuarization: Form I - bipolar symmetrical fluctuating current, alternating direction with approximately the same amplitude and frequency in the negative and positive phases; Form II - bipolar asymmetrical 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 the same polarity. III form of current is used for the introduction of medicinal substances by fluctuophoresis.

Fluctuating currents, like all pulsed currents, actively influence the endings of sensory nerves and have an analgesic effect. Therefore, they are widely used for 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 is especially common in dental practice.

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

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

Dosing of fluctuarization procedures is carried out according to the current strength, depending on its density. Fluctuarization doses are distinguished according to current density: low - 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 patient’s subjective sensations: with a small dose - tingling, with a medium dose - weak, painless vibration, with a strong dose - pronounced vibration and muscle contraction under the electrodes. The duration of the procedures ranges from 5 to 15-20 minutes. The procedures are prescribed daily or every other day. Kvрс treatment 5-15 procedures.

Fluctuarization devices

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

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

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

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

Electroson

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

The mechanism of action consists of the direct and reflex influence of current pulses on the cerebral cortex and subcortical formations. Pulse current is a weak stimulus that has a monotonous rhythmic effect on such cerebral structures as the hypothalamus and the reticular formation. Synchronization of impulses with the 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 cerebrum, affects the functional state of subcortical structures and the central parts of the autonomic nervous system.

In the very first minutes of the action of the pulsed current, the initial (inhibitory) phase occurs. It manifests itself as drowsiness, drowsiness, decreased heart rate and breathing, and changes in electroencephalogram parameters. Then follows the second phase - an increase in the functional activity of the brain, characterized by vigor, increased performance, and 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) gradual development of drowsiness or sleep; 2) development of only a light intermittent drowsiness; 3) the patient quickly falls asleep immediately after turning on the current, the state of sleep during the entire procedure, but awakening occurs immediately after turning off the device; 4) sleep during the entire procedure, continuing for some time after its completion.

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

Currently, a new method of central electroanalgesia has been developed using the 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 electrotranquilizing effect in case of sleep disorders, psycho-emotional stress, physical overload, to prevent complications during pregnancy and childbirth, as well as treatment of gynecological patients.

Electrosleep is indicated for nervous and mental diseases (neuroses, some forms of schizophrenia, atherosclerotic and post-traumatic brain diseases, etc.), diseases of the cardiovascular system (hypertension, neurocirculatory dystonia, coronary heart disease, obliterating vascular diseases), digestive organs (peptic ulcer, gastritis, functional disorders of the gastrointestinal tract), respiratory system (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 eyeball, weeping dermatitis of the face, arachnoiditis, and individual intolerance to current.

Electrosleep procedures are dosed according to pulse frequency and current strength. In children, a small current of up to 2-4 mA is used 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 and severe weakness of nervous processes, pulses of low frequency (5-20-40 Hz) are used. For unstable arterial hypertension, low frequencies are also used. With stable high blood pressure, procedures begin with the use of low frequency current, gradually moving to high frequency (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.

Devices for electrosleep

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

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

Diadynamic therapy

Diadynamic therapy is a method of electrotherapy using constant pulse 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-sinusoidal shape. Under the influence of OH, the patient first experiences a slight tingling sensation, which is replaced as the current strength increases by a feeling of vibration, and then by fibrillary twitching of the muscles.

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

A special feature of DN is that it increases the electrical conductivity of the skin, which is why 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, which also last 1.5 s.

The short-period modulated current (CP) represents an alternation of a series of pulses of the ON and DN currents, repeated every 1.5 s. This alternation reduces habituation to these currents.

The current modulated by long periods (DP) represents an alternation of currents OH and DI, and the duration of passage of the OH current is 4 s, and DN - 8 s. The duration of one modulation period is 12 s. Single-cycle wave current (0V) with a frequency of 50 Hz. Its amplitude smoothly 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 lasting 4 s. The total duration of the period is 12 s. Push-pull wave current (WW) with a frequency of 100 Hz. The change in pulse amplitude occurs similarly to the 0V current. 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 6 s. Push-pull wave current prima (DV") with a frequency of 100 Hz. The change in pulse amplitude occurs similarly to the 0V current. 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, suppressing the “dominant of pain” and relieving pain. To enhance the irritating effect of diadynamic currents and 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 the CP and DP have the most pronounced analgesic effect. Wave currents, more than others, improve blood circulation.

In recent years, medicinal substances have been administered using diadynamic currents (diadynamophoresis).

Devices for diadynamic therapy

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

Rice. Control panel of the device “Tonus-1” (diagram). 1 - power switch; 2 - signal light; 3 - oscilloscope screen; 4 - keys for turning on certain types of diadynamic currents; 5 milliammeter; 6 - polarity switch on the electrodon terminals; 7 procedural clock; 8 - patient current regulator. Above keys 4 there are letter designations (a - i), corresponding to individual types of diadynamic currents

As an example, let’s look at the device “Tonus-1” 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 protection class II. There is a control panel on the front wall of the device (Fig. 14). On the back wall of the device there is a plug for plugging the power cord into a socket 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 included with the device. Let's consider the device "Tonus-2m". Electrical functional diagram:

Rectifier

Modulator

Shaper

Output current regulator

Output transistor

Polarity switch

Milliammeter

Patient

Current type switch

Network frequency divider

Integrating chain

Safety 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 applied magnetic fields. The applied magnetic fields can be alternating (high or low frequency) or constant. Moreover, both constant and alternating magnetic fields can be used in both continuous and pulsed (intermittent) modes; Depending on the method, pulses can have different frequencies, durations and shapes.

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

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

In the United States, Food and Drug Administration (FDA) regulations prohibit the sale or promotion of any magnetic therapy products as medical devices, as claims for the therapeutic effects of such devices are considered unsubstantiated in the United States.

In the American scientific community there is also no consensus regarding this problem. While some American scientists support the position of the FDA, calling magnetic therapy a pseudoscientific method, explanations of the mechanisms of its action “fantastic” and claiming the absence of 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 , which magnetic fields can exert.

Industrial magnetotherapy devices

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

local (local) impact,

distributed impact,

general 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. These also include magnetic puncture devices with the possibility of irradiating only one biologically active point at any time. A feature of this class is the absence of spatial movement of the magnetic field. These also include magnetotherapeutic products with permanent magnets: bracelets, tablets, clips, etc., which are not considered in this work.

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

The third class includes equipment with the most voluminous terminal device, which must 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 installed arbitrarily, depending on the desire of the physiotherapist or in accordance with medical techniques. At the same time, emitters make up a small part of the total cost of the device compared to the electronic part that generates power currents. This is especially typical for distributed devices and less true for local devices, where simple power frequency current converters are often used.

In devices of the third class, stationary, fairly voluminous terminal devices are used in which the patient is placed. Their design can be very diverse - from a magnetic spacesuit to a magnetic room. Here, the cost of terminal devices sometimes exceeds the cost of the 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 magnetic therapy.

An analysis of the principles of constructing industrial magnetic therapy devices allows us to present their generalized structural diagram (Fig.).

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

The shaper is designed to produce a current of a certain shape in inductors and, in the simplest case, may contain a converter of the type of inductor supply current in the form of a rectifying 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.

Local magnetic therapy devices

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

Let's name the Mag-30 as the first MTA under consideration. It is designed to be exposed to 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 network. Its distinctive feature is the absence of a control unit as such. The device is available in 4 sizes: 130x115x130 mm, 105x80x54 mm, 115x80x47 mm, 110x72x34 mm, power consumption no more than 50 W.

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 power the winding of an electromagnet. The intensity is adjusted by switching the winding terminals. The device has dimensions of 243x93x48 mm and consumes power no more than 30 W.

Rice. Block diagram of MTA "Magniter"

MTA "Polyus-2D" generates a pulsating MF with a smoothly rising edge and decay of the pulse. The inductor consists of 4 electromagnetic coils connected in series. A special feature of the device is the presence of a common ferromagnetic screen. Power consumption no more than 4 W.

Portable local magnetic therapy equipment is represented by a wide range of devices. Thus, the Polyus family of devices includes over five items. "Polyus-1" is intended to influence the patient with sinusoidal or pulsating half-wave MF of industrial frequency in continuous or intermittent modes. The device has a 4-step adjustment of MF intensity. A distinctive feature is the presence of a timer and an indication device consisting of signal lamps connected in series with inductors. The intermittent mode is set by a control device made according to a multivibrator circuit. The set of inductors includes electromagnets of 3 types: cylindrical, rectangular, cavity. Cylindrical inductive 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). There are 2 series-connected coils mounted on the core. A cavity inductor is a coil with a core (25x165 mm) placed inside it. Power consumption no more than 130 W.

The Polyus-101 device is designed to be exposed to a high-frequency sinusoidal magnetic field and has 4 stages of MF intensity adjustment. The inductor set consists of two solenoids (220x264x35 mm). There is a mode for alternating switching on of inductors in intermittent mode. Power consumption no more than 50 W. A special feature of this device is that inductors and capacitors connected in series with them form resonant circuits, which allows for savings in power consumption. Another distinctive feature is that to produce 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. Block diagram of MTA "Polyus-101"

MTA "Polyus-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), intracavity (25x165 mm), solenoid inductor (240x265x150 mm). The cylindrical inductor is made in the form of 4 separate coils with cores located around 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 MF pulse shaper, which makes it possible to obtain an exponential shape of the current in the inductor circuit with adjustable decay time.

Rice. Block diagram of MTA "Polyus-2"

MTA "Gradient" is intended for exposure to sinusoidal and pulsating single- and full-wave MF with a frequency of 50, 100 Hz in continuous and intermittent modes with 8 steps of MF intensity adjustment. The device kit includes three types of inductor-electromagnets (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 inductor is powered by a current modulated by rectangular pulses, and the ability to operate from an external source of sinusoidal and pulsed signals.

The list of commercially produced local devices, their comparative technical characteristics and main features are given in table.

Table 1. Domestic and foreign local impact equipment

Device name	Type of inductor supply current	Max, induction value, mT (number of stages)	MP frequency	Inductor type	Distinctive Features
Magniter
	Sin, PU 1p/p
				Solenoid
	Sin, imp., exp			EM, solenoid
					Magnetophoresis, automatic MP reverse
					Automatic MP reverse
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
Biomagne-tix (Germany)				Solenoid
Magneto-tron (Germany)				Solenoid
Ronefort (Italy)				Solenoid	Moving the inductor over the patient's body
Magnit-80 (Bulgaria)				Solenoid
Magnit-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 table uses the following designations for currents: sin - sinusoidal; imp. - impulse; exp - exponential; PU - pulsating; In/p and 2p/p - single- and full-wave rectification, respectively.

Magnetic therapy devices of distributed action

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

MTA "Athos" (Fig. 2.5) is intended for the treatment of diseases in ophthalmology by 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 special feature of this device is the ability to act simultaneously on 3 frequencies: the frequency of each solenoid at the moment of switching on, the modulation frequency of the IBMP, and the switching frequency of adjacent solenoids.

Rice. Structural diagram of MTA "Athos"

MTA "Alimp-1" is an 8-channel source of pulsed traveling MF with a frequency of 10, 100 Hz with two-stage field intensity adjustment. The device is equipped with a set of inductors of 3 types, forming 2 solenoid devices, consisting of 5 and 3 inductor solenoids, respectively, and a set of 8 solenoids located in the pockets of the package (720x720x20 mm) (Fig. 2.6). The first solenoid device (480x270x330 mm) is a set of 5 cylindrical coils located one behind the other. The second (450x450x410 mm) is a design of 3 cylindrical coils located at an angle to each other. Power consumption no more than 500 W. A distinctive feature of the device is the use of a pulsed running MP, which has a more pronounced therapeutic effect.

Rice. Block diagram of MTA "Alimp-1"

The “Madahit-010P” device is a diagnostic and treatment complex designed for the therapeutic effect of a pulsed, complexly modulated electromagnetic field on a diseased organ and its diagnosis. Devices of this type are built according to the scheme shown in Fig.

Rice. Structural diagram of MTA "Malachite-OSH"

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

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

Table 2

Domestic and foreign distributed impact equipment

App name			Max, value					Distinctive
					inductor		peculiarities
	inductor		(number of steps)
						Solenoid
Malachite-01							Automatic parameter adjustment
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		Irregular operating mode

Note. The following current designations are used in the table; PT - constant; sl.-mod - complex modulated; mp and bp - mono- and bipolar, respectively; other designations are the same as in table. 1

Magnetotherapeutic devices of general influence

General impact devices are the most complex and expensive devices, therefore there are very few industrially developed and certified by the Ministry of Health of the Russian Federation. These currently include devices of the Aurora-MK class, devices of the Magnitoturbotron 2M and Magnitor-AMP types, and the Bio-Magnit-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 MP configurations from “running” to randomly moving, which are programmed in advance and, in principle, selected for each patient individually. The patient is located on a special couch, where inductor systems are reinforced in the shape of flexible planes: separately for all limbs, the head and torso of a person. Then each of the parts is covered by flexible planes, forming a closed volume like a spacesuit, inside which the patient is located. In the future, devices of the Aurora-MK class will be considered in detail, as they are most suitable for the task of complex magnetotherapy. Here we will limit ourselves to tabulation. 2.3 main technical characteristics for comparison with other devices.

Table 3. General-impact magnetotherapeutic equipment, commercially produced

MTA "Magnitor-AMP" is intended for exposure to rotating MF in the range of 50... 160 Hz with programmable automatic cyclic-periodic adjustment of MF intensity from 0 to 7.4 mT and with modulation of tension according to an arbitrary law on the entire body of the patient. The inductor is a volumetric 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 PC-based. A distinctive feature of the device is the effect of a rotating homogeneous MF on the entire patient’s body with simultaneous monitoring of the patient’s pulse rate and body temperature. The device is characterized by a large inductor mass (about 500 kg), power supply from a 3-phase network, and high power consumption (2.5 kW).

Rice. Block 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 harmful components, subject to complete shielding of the geoelectric field and, partially, the geomagnetic field.” The patient is placed in a rectangular chamber with a tightly closed door, where he can sit on a wooden chair. Control and diagnostics are carried out from a PC. In table 2.3 provides basic comparative information on the above general impact MTAs.

Thus, the development of MTA is moving 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 for monitoring the patient’s health status, controlling and synchronizing with the patient’s biorhythms, introducing a feedback mode based on measuring diagnostic equipment for general and special purposes and computing tools.

Hardware and software complex for dynamic magnetic field control “Aurora MK-02”

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

The hardware and 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 the magnetic field configuration (MF), which is understood as a specific sequence of the appearance of output currents with specified intensities, attributes and durations. A set of generated CMPs, including those recorded earlier, is stored in the CMP 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 Aurora MK-02 system

To operate, the selected KMP file is first decoded. In this case, the intensity parameters are placed in a special, independently (from the processor) polled random access memory (SPRAM) using the CTA counter and the RGA address register, and the time-frequency parameters with attributes (polarity, modulation) are entered into the processor RAM and are under its constant control. observation. In this case, the time-frequency parameters in operation by the processor are transferred to special timers and the processor uses them to generate time intervals. The processing unit has user software for CMP synthesis, output and decoding and, finally, for real-time operation.

Power sources (PS) of currents (16 pcs.) perceive information in the form of a 16-bit code according to the principle of one digit - one power source (PS). 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 (MF). This stage is supported by the SINTEZ program. Here you can call up any of the configurations stored as files in the KMP information bank, or start with an “empty” configuration file.

A generalized magnetic field configuration model (MFC) 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 beat, digital values ​​for the duration of the beat interval, intensity and duration of the pause interval are displayed.

The selection of an installation parameter is carried out by moving the marker to the corresponding location of the parameter. Upon installation command, the signal format is enlarged to fill the entire screen to improve installation accuracy. Then, by moving the marker, the necessary intensities and attributes are set in each clock cycle of the signal format.

The duration of tact intervals and pause intervals are set by moving 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 of the hardware and software complex "Aurora MK-02"

This stage is supported by the ZAGR program. Here the selected KMP is shown on the display screen in the form of a generalized model with all graphic and alphanumeric data.

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

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

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

Rice. Generalized model of magnetic field configuration

The work is supported by the RABOT program. First, the processor sets the high-order SRAM addresses related to the first intensity cycle (Fig. 4.18), and the low-order bits begin to be sorted by a special SRAM address counter with a high frequency f0 (about 2 MHz). Since each bit of the SpRAM contains a sequence of ones and zeros according to the example in Fig. 4.19, then at the output of each digit a PWM signal of the set intensity of the first cycle appears. At the same time, the intensity cycle interval code is entered into one of the timers, and the polarity and modulation codes of the first cycle are entered into the attribute registers for each digit, and, in essence, for each output. The complex begins to generate PWM signals of the 1st cycle on all 16 outputs. Since the formation of PWM signals occurs 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 the operation on the screen.

In this case, the processor periodically returns to the timer, tracking the remaining time for the first intensity cycle. As soon as the interval for the first clock 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 monitoring the remaining time for the pause. At the end of the pause, the processor switches the higher addresses of the SRAM. corresponding to the second intensity cycle, reads the interval code of the second intensity cycle, enters the latter into the timer, reads and writes the attribute value at each output to the RG register. The complex begins to generate PWM signals of the 2nd cycle on all 16 outputs. The processor, freed for the clock period, again switches to servicing the CONTROL program, which continues to display the actual picture of the currents on the display screen. When the time of 2 intensity cycles ends, the processor turns on the pause interval in the same way as the first cycle.

With the beginning of the 3rd cycle, the processor repeats the algorithm outlined above for the first two cycles, and so on until the 32nd cycle or, if a number less than 32 is written in service cell No. 14 of the selected CMP, then until the number of the cycle recorded in the cell No. 14 service information of the selected KMP file. At the same time, at the end of the cycle, the processor evaluates the remaining time of the entire procedure and, if time remains, the processor returns to the first 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 KMP 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 at each clock cycle. In the procedure supported by the CONTROL program, visual monitoring of the operation of the complex and comparison of actual parameters with the specified ones is carried out.

From the very beginning, when selecting a KMP file, as noted above, a generalized model of the selected KMP appears on the display screen. When switched on for operation, the generalized model acquires a halftone image and only at a given moment the part of the format corresponding to the working cycle is illuminated with full brightness for the full time of this cycle. At the end of the next cycle and the start of the next one, the full brightness moves to the adjacent part of the format.

At the same time, the actual intensity values ​​at 16 outputs of the complex are measured using an ADC, entered into the processor, compared with the specified values ​​and shown on the screen in the form of deviation signs, which allows you to unambiguously assess the normal operation of the complex during the procedure.

Description of the download and operation decoding program.

The program consists of two blocks: an unpacking-decoding program and a loading and operating program.

The decompression-decoding program includes three procedures:

amplitude unpacking procedure “RASPO”;

procedure for unpacking attributes “ATRO”;

procedure for unpacking the times of "TAYO".

The following operations are carried out in the “RASPO” procedure:

space is allocated in RAM for 128 words, which is pre-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 into a allocated space in RAM;

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

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

switch to the “ATRO” procedure, while in the “ATRO” attribute unpacking procedure the following subprocedures are carried out:

the 6th, 7th, 8th digits of the amplitude array are highlighted;

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

switch to the “TAYO” unpacking procedure, in the “TAYO” times unpacking procedure the following is carried out:

the next time interval code is read;

five junior digits are allocated;

three senior digits are highlighted;

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. shifted to the left as many times as the code in the selected three most significant bits;

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

The boot and run program block performs the following sequence of operations:

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

loads the highest 5 bits of the address of the SRAM storage device (for the first cycle, a zero address is entered);

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

loads the clock time into the clock timer, turns it on and enables access to the low-order counter of the address of the SRAM of the reference frequency, the operation of the 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 specified ones;

checks the state of the tact timer and, if there is enough time, returns to control; if there is not enough time, then waits for the end of the takt time;

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

when the end of the pause arrives, it returns to the algorithm for loading the highest 5 bits of the address of the SpRAM memory device, increasing the code of the latter by one, and repeats all the above sequence elements 32 times, corresponding to the 32nd clock cycles;

checks the state of the general procedure timer and, if the time has not expired, then returns to the algorithm for loading the addresses of the most significant bits of the SpRAM, resetting the address to zero;

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

after the general procedure timer is reset, it stops operation and turns on the sound signal.

Magnetotherapeutic complex "Multimag MK-03"

The complex is designed to receive from a PC and memorize the configuration of the magnetic field with subsequent autonomous generation of power currents to power the magnetoscan inductors for the duration of the tact, pause and cycle of the magneto-therapeutic complex “Multimag MK-03”. 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, range ±2 V, bit depth 12 bits, sampling frequency - 10 kHz.

A control unit in whose memory an array of magnetic field configurations is stored from a computer and which, upon command, is put into operation, generating power currents to power the magnetoscan inductors.

Magnitoscan is a special couch with inductors to form a dynamic magnetic field around the patient.

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

Diagnostic equipment that contains amplification-converting devices that receive signals from sensors and generate standardized signals for supply to the ADC.

Rice. Block diagram of the Multimag MK-03 complex

Technical characteristics of the control unit:

number of channels........................................................ .....8;

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

number of cycles................................................... ...up to 32;

measures may be separated by pauses;

current polarity is independent across channels;

the pause is independent in ditches;

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

memory capacity........................................ 8x2048;

frequency of the built-in generator......................2 MHz.

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

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

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

RAM memory address register, composed of register RG3 (high 5 bits) and counter CT2 (low 6 bits); - data register RG2 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 register RG1 (in digits a4, a3), which turns the control unit into the mode of checking and monitoring the correct installation. If the combination 10 is entered into the a4, a3 digits, then the control unit is switched to the “operation” mode. In this mode, the internal generator G (2 MHz), using counter CT2, sorts through the lower 6 bits of RAM memory, which contains the PWM signal codes of all 8 channels. The RG4 register at the RAM output generates PWM signals, which are additionally gated by pauses from the RG6 register and are sent to the controller output to control SI power sources.

Table 4

PWM codes are written into the memory for the entire operating cycle. The duration of the beat and pause is monitored by the computer with a special timer located in the interface. At the end of a clock cycle or pause, the computer increments the highest of the 5 RAM memory bits. rewrites, possibly with changes, the polarity and pause data and starts work on a new measure or pause. The code in the low-order digits (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 a power source

Depending on the polarity bit (POL), either the odd switches (Cl1, Cl3) are open, and then the current flows into the inductor I in one direction, or with a different POL bit, the even keys (Cl2, Cl4) are open, and then the current flows into the inductor in a different 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 if the current consumption in the power source is exceeded, the SZ protection circuit turns off this source. Resistor R0 serves as a measuring current sensor through the inductor, the voltage from which is supplied through the U.S multiplexer to the ADC board in the computer. The choice of channel for measurement is carried out by the S bus code. The divider Rl, R2, R3 is a sensor for the correct setting of the parameters of the power source and its performance. When monitoring the installation, the switches KlZ and Kl4 are opened, and the PWM signals through the indicated resistors are sent to the multiplexer as a divider and then, as an analog signal, to the input of the ADC in the computer. There is no current in the inductor.

Rice. External view 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 magnetotherapeutic complex. Description of the software package "MK-03"

Purpose.

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

Package contents:

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

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

Basic functions.

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

Selection of methodology;

Viewing method parameters;

Editing method parameters (for version 2);

Working with the Multimag MK-03 complex (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.

Choice of methodology.

This function allows you to select a MFC (magnetic field configuration) file with the extension “.DAT” and “.KMR” for subsequent 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 file highlight. Confirm the selection by pressing the “Enter” key, canceling the selection by pressing 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 KMP field appears, consisting of several areas.

Rice. Displaying the “Method Selection” mode

The main field is occupied by an intensity matrix (8x32), where 8 rows correspond to 8 channels of the power unit of the magnetotherapeutic device and 32 columns correspond to clock cycles of connecting the corresponding intensities in the channels. The durations of the measures can be different by line and are displayed on a logarithmic scale with a special line at the bottom. The duration of pauses between measures are also displayed here on a logarithmic scale.

An area of ​​reference information appears at the very bottom of the screen: by type of disease, by file name, by duration of the procedure. To the right of the main field is the “Deviations” column, where during operation the correspondence of the set intensity parameters to the actual ones will be displayed. Below it is an area for displaying averaged time parameters.

Rice. Graphic representation of the technique on the screen

Viewing parameters allows you to determine specific magnetic field configuration parameters. In this mode, one of the cells of the main field is framed in white, and the parameter values ​​in this cell are displayed in a window that appears on the right of the screen. Moving between individual field elements is carried out using 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 numeric parameters:

field intensity; - takt duration;

pause duration; - modulation parameters;

type of modulation.

Rice. Screen image in Preview mode

The F3 key allows you to view additional information that is common to the entire file:

method version number;

name of the method file;

main purpose;

number of cycles in the technique.

The image on the screen then takes the form shown in Fig. 4.30. This information is also constantly displayed in the bottom line of the screen, regardless of the operating mode. Exit the viewing mode using the “Esc” key. From the additional information viewing mode, you exit to the cycle information viewing mode, so you need to press the “Esc” key twice.

Editing.

The editing function allows you to change the parameters of individual measures and additional information. Called from the “View” mode by pressing the “F4” key. Moving through the main field of the method is carried out by pressing the Ctrl + (<-, Т, 4-, ->, PgUp, PgDn, End, Home). Selecting an edited parameter using the keys: (“Tab”, “Enter”, 1) - move down; (“Shift+Tab”, T) - move up.

Rice. Screen image in “View additional information” mode

Confirmation of changes during editing is carried out using the keys for selecting bar parameters and the keys for moving between bars. Cancel changes in the current edit by pressing the “Esc” key. Switching to the additional information editing mode is carried out using the “F3” key. Exit editing mode by pressing the “Esc” key. From the additional information editing mode, you exit to the cycle information editing mode. From the mode of editing information about bars, you exit to the viewing mode.

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

In line editing mode:

“Ins” key - switches the insertion-replacement mode (initially the work is carried out in the replacement mode);

arrows End, Home - move along the line.

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

arrows - mode selection;

"Space" - change mode. About the program.

Program information shows:

program version;

a telephone 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 magnetic therapy device. When accessing this mode (by pressing the “Enter” key), the dynamics of moving one field cell (white background) along the line of measures in accordance with the specified parameters appears on the screen and the power unit of the “Multimag” magnetic therapy device is launched into operation, also in accordance with the specified parameters. In the lower right corner, the procedure release time line is filled in and upon completion of its filling, the sound signal for the end of the procedure is turned on.

When you press any key, the sound signal 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 “Deviations” column, information is provided on the average values ​​of the duration of the cycles and the average frequency of switching cycles. The procedure can be interrupted prematurely by pressing the “Esc” key.

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

Methodology for constructing magnetotherapy complexes and rooms

Treatment and diagnostic complex.

It makes sense to form a complex already with one magnetic therapy device of the Aurora MK-01 type. Additionally, diagnostic equipment is required. The structure of the diagnostic and treatment complex can be presented as shown in Fig.

Rice. Structure of the diagnostic and treatment complex

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

Organizationally, it is advisable to include a physiotherapist, a nurse, and an electronics engineer in the complex's service personnel.

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

Each treatment method includes a type of magnetic field configuration (MF), a table of intensities, directions of magnetic field vectors, clock frequency, as well as the duration and number of procedures. The diagnostic technique contains a list of measured parameters and the procedure for carrying out measurements. The doctor prescribes a technique, and the nurse administers the procedure in accordance with this technique. She takes diagnostic measurements before, during and after the session, places the patient in the magnetic scanner, turns on the device and monitors the procedure for a given time. She may temporarily interrupt the session to perform diagnostic measurements if specified in the procedure. Once the procedure is complete, the nurse performs diagnostic measurements again. The results of diagnostic measurements must be recorded on a special form. An approximate form of the form is shown in table.

Computerized diagnostic and treatment complex

The next step towards increasing the effectiveness of magnetic therapy is the creation of a higher-level diagnostic and treatment complex, namely an automated specialist workstation (ARMWS). ARMVS frees 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 treatment method. Increasing the level of automation of diagnostic and treatment technology opens up new opportunities not only in the practice of treatment, but also in conducting 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 ARMBC 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, recorded on disk and can then be displayed on a screen, printer or plotter.

Based on the analysis of current diagnostic information and data stored in the computer database, the doctor, using the capabilities of the expert system installed on the computer, creates a magnetic influence technique, which in one form or another is sent to the control unit of the Aurora device, creating the required magnetic configuration fields.

Rice. Structure of a computerized diagnostic and treatment complex

In the presence of noise-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 ensures more efficient use of the diagnostic and treatment complex. The time spent on maintaining medical records is sharply reduced. Given that physicians are most comfortable with tools they are already familiar with, the PC program should display the scorecards and other forms that physicians use every day.

Equipped with appropriate laboratory interfaces, the PC can monitor the patient’s condition, control the 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, at the control panel of which a doctor and an operator-engineer are located. 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 (software) is offered at several levels.

The first level software has a database of magnetic field configurations (MFCs) and their parameters and a database of patients. The latter is formed in the image 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 CMPs and their parameters includes all standard methods developed in practice and is compiled into packages depending on the type of disease, individual characteristics and stage of the disease.

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

The ICM database is continuously updated with new or more effective ICM, 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 personnel of a higher professional level and equipped with hardware, software and mathematical support of higher levels.

Rice. Pyramid menu for selecting KMP

Second-level software, firstly, fully implements the tasks of the first level and, secondly, makes it possible to eliminate existing standard methods and create new ones. At the same time, a doctor working with second-level software must receive an additional training certificate assessing knowledge and skills in the field of magnetic therapy for the diseases of his choice.

The third-level software, including all the capabilities of the first and second levels, will be additionally equipped with an expert system and a mathematical model of the impact of magnetic fields on the patient, which will close the feedback loop. That is, depending on 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. In this case, the system must have elements of artificial intelligence, the main credo of which should be the condition “Do no harm.” Level 3 software is currently under development. Naturally, software at all levels will be constantly improved and improved.

Organizational support for 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 device before the session, the procedure time and the presence of 2 Aurora MK-01 devices in the room).

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

Rice. Stages of data collection and processing

The first stage usually involves normalization of analog signals - amplification, filtering, switching, etc. The main task of the subsystem that carries out 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 directly performs analog-to-digital conversion of analog signals.

At the second stage, the data processing subsystem carries out primary data analysis using algorithms 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, based on the data received or other information, has the opportunity to actively influence the course of the treatment procedure by changing the parameters of the magnetic field. The control subsystem serves for these purposes.

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 occur.

In ARMWS, the considered functions can be distributed in various ways between computer hardware and software 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) with multifunctional control and diagnostic devices (cardiograph, rheograph, blood pressure meter), 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 assigned the functions of general management, more detailed analysis (secondary processing), and documentation of the results.

Another option for ARMBC layout is to use a laboratory interface made on separate expansion modules that are installed in free computer slots. This option, of course, implements fewer hardware capabilities than multifunction devices. However, the relatively low cost of this option and accessibility to a wide range of users, combined with flexible software implementation of procedures performed by specialized devices, make this option the most preferable for building an automated computer system.

Three main components can be distinguished as part of ARMVS:

hardware platform,

Software,

intellectual tools.

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. The third component should be recognized as equally important - knowledge and ability to work with hardware and software.

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

Magnet therapy room

If there are several MTC 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 MTCs in one office. At the same time, it is easier to plan the load of each MTK, maintenance and repair. In addition, there is no need to strictly link a specific patient to a specific MTC, and in the event of failure of one of the MTCs, patients can be distributed evenly between the remaining complexes.

Planning the work of the MT room is that, on the one hand, the technique and duration of exposure to the magnetic field, the number and frequency of sessions are determined for each patient, and on the other hand, all this must be linked to the total throughput of all MTKs. In addition, for the development of magnetotherapy methods, 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 an 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 can mainly be solved if, instead of one MTK, an automated computer system is introduced into the office and all routine operations are transferred to the computer that is part of the automated workplace. In this case, firstly, the stage of determining the treatment method for each patient is simplified, since ARMVS can monitor the most important physiological parameters, has specialized means for processing the received information and includes an expert system. Secondly, when using the database included in ARMWS, the office registration, as well as the collection and processing of treatment statistics, are automated.

But this raises the problem of sharing one computer by personnel from different medical centers, which is not always convenient and sometimes impossible. Therefore, for more efficient use of all MTKs, multiple access to the ARMBC computer and, above all, to the database located on it is necessary. This problem can be solved by organizing either a local area network (LAN) or a multi-user system (MPS) in the office. 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 connected to each other by some kind of communication equipment. At the same time, application software running on these computers must have fairly simple and fast means of transmitting data through existing communication equipment. Computers in such a network are usually located at a short distance from each other (about 1...5 km). For the local network to work, you must complete the following steps. First, connect computers through some kind of communication equipment. Secondly, run special network software on these computers, which 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 terminals (workstations without a processor) are connected to the host 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 way its nodes interact. 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 application programs and files that are permanently located on this machine. Each user is provided with his own memory section, in which he perceives working with the main PC as interacting with a single-user machine. The files created are stored in a central memory subsystem connected to the host computer.

In Fig. shows the organization of a magnetotherapy room based on a local computer network, and Fig. - based on a multi-user system.

Rice. Organization of a magnetotherapy room based on a local computer 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

magnetotherapeutic treatment pulsed current

It should be noted that the capabilities of the LAN in the magnetotherapy room will be used to an insignificant extent, since intensive data exchange between individual PCs (network node) is not required, but only centralized access to the database and printer is required. In addition, individual PCs will also be operated very inefficiently, since no local data processing is required. One final note concerns administration and maintenance. Here, multi-user systems have a clear 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 requires virtually no administration, while a LAN requires a system programmer to maintain the network in working order.

Based on the above, when organizing one magnetotherapy room, it is advisable to use a multi-user system, using a computer included in the ARMVS as the main computer. Such a system will have relatively low initial and operating costs and will automate routine operations associated with maintaining an office registry, collecting and processing treatment statistics.

Here are some notes on building a multi-user system. Depending on the type of terminal and how it is connected to the host PC, the terminal must have either an RJ-11 telephone jack or an RS-232 serial port connector. It is possible to use relatively cheap domestic terminals. PCs equipped with programs that emulate the operation of these devices and have an RS-232 interface can be used as terminals. The terminals are usually connected to the host computer through cards with communication ports and cables. Such boards vary in cost and complexity; some board models contain up to 16 ports. The simplest boards perform only communication functions and are used as ordinary serial ports. These boards are available in designs with four and eight ports. In addition, there are "smart" communication cards (for example, Maxpeed's 4- and 8-port Series II cards) that include a processor that controls serial data exchange, which allows you to remove some of the load from the main processor. An inexpensive way to connect terminals is to use a twisted telephone pair. Some terminals have RS-232 serial interface connectors. They are connected using cables and are usually used to connect modems and laser printers. The distance between the terminal and the host computer can reach 25...30 m without installing additional repeaters. In addition to hardware, the multi-user system also includes system software. Since ARMBC software runs 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 the connection of 5-10 users, which is quite enough for one office.

In conclusion, it should be noted that if in the medical institution in which the magnetotherapy room is being organized, there is already some kind of branched LAN and there are engineering and technical personnel servicing it, then it may be easier and faster to organize the room as a segment of the existing network.