RU2290221C1 - Method for treating vibration disease cases - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves carrying out multi-channel anterior abdominal wall region, trapezoid muscle electrostimulation in superior thoracic vertebral column segment and arms in shoulder and forearm region. First, abdominal wall region and trapezoid muscle are treated in one stage in the superior thoracic vertebral column segment. Then, arm, forearm and hand are treated in turn, each during 2 s. Stellar nodes region are concurrently treated in continuous mode during the last 3 min. The treatment time is 10-20 min. The total treatment course is 8-10 procedures long.

EFFECT: retarded pathologic state progress; improved neuromuscular and microcirculation state.

Description

The invention relates to medicine, in particular to restorative medicine, physiotherapy and the treatment of occupational diseases, and relates to a method for treating patients with vibrational disease, including Raynaud's syndrome.

The essence of the invention lies in a complex effect (drug treatment, massage, physiotherapy exercises) on the area of muscles and nerves of the trunk and extremities, as well as lymphatic drainage of these areas, using a low-frequency pulsed electric current.

A known method of treating vibrational disease, including exposure to mud applications on the cervical-collar reflexogenic zone and distal parts of the upper extremities. In addition, they additionally and simultaneously act on sinusoidal modulated rectified currents of 1 and 111 types of operation for 7 min each, with a frequency of 100 Hz and a modulation depth of 50-75% (RF Patent No. 2104060, IPC A 61 N 1/18, publ. 1998 g.).

The disadvantage of this method is the possibility of an electrochemical burn as a result of the formation of chemically active substances under the cathode and anode, respectively, in the form of acids and alkalis against the background of sensory impairment in patients with vibrational disease. In this method, the effect is mainly directed only to pain relief. With a long duration of the disease, patients also develop motor disorders, therefore, in addition to the analgesic effect, it is also necessary to cause an electrical stimulation effect. The simultaneous use of mud applications and currents requires compliance with certain requirements for the design of physiotherapy rooms: they must be specially equipped and protected from electric shock by patients and staff, since the use of dirt creates high air humidity. Therefore, the methodology proposed by the authors can be performed only in specialized departments and is not available in wide practice. The disadvantages of this method include low efficiency.

The closest is a method of treating a vibrational disease using diadynamic therapy in the stellate nodes and brushes. A push-pull continuous current of 3 minutes to the maximum tolerated intensity is used on the region of the stellate nodes, then on the hand - a short period of 2 minutes to the maximum tolerance. The total time does not exceed 10-12 minutes, the course consists of 5-6 procedures every other day (M.V. Rataev, E.V. Molchanov, Z.S. Schwartz. Physiotherapeutic prescription reference book, 2nd ed., T ., Medicine, 1967, S.230).

The disadvantage of this method is the possibility of injury to the skin due to electrolysis products. In addition, with vibrational disease, in addition to the hands, other body systems are also involved in the pathological process, which requires a certain correction of these disorders. But the effects on patients with vibrational disease should be gentle, and at the same time, therapy should affect the internal organs.

To avoid these shortcomings was included in the task of the proposed method, due to the elimination of the causes of the electrochemical burn, as well as exposure to a large number of muscles, nerves and internal organs. At the same time, this effect was gentle, as it was carried out sequentially on each field. Compared with the prototype, we were able to create a technique in which the reflexogenic zone and limbs can be affected by the same physical factor with high efficiency. The high efficiency of the proposed method with respect to the effect on neuromuscular conduction in patients was important, as a result, blood circulation in the affected area normalized and motor activity was restored, which significantly improved the treatment results.

To this end, in a method of treating a vibrational disease, including multichannel electrical stimulation of the stellate ganglion region, hands, it is proposed to further stimulate the region of the anterior abdominal wall, trapezius muscle in the upper thoracic spine, the arms in the shoulder region, the forearm, while first acting simultaneously on areas of the anterior abdominal wall and trapezius muscle in the upper thoracic spine, and then sequentially on the shoulder, forearm, hands, 2 s for each however, during the last 3 minutes of the procedure, simultaneously act on the region of the stellate nodes in a continuous mode, the total exposure time is 10-20 minutes, on the general course of 8-10 procedures.

To perform the method, you can use any electrical stimulator. For practical work, the microprocessor multichannel electrostimulator Miomodel turned out to be the most effective.

The method is as follows.

Electrodes (fabric physiotherapeutic, depending on the size of the affected area, from 16 × 2 cm to 4 × 2 cm) were applied perpendicular to the muscle fibers in the area of the posterior surface of both hands - on the triceps (or biceps) of the shoulder muscle, on the forearm in the area of the common extensor (or flexor) of the hand, on the interosseous muscles in the area of the hand (or palmar surface), in the projection of the stellate node - one electrode was superimposed between the legs of the sternocleidomastoid muscle, the second electrode - 2 cm higher. In the area of the trapezius muscle and in the upper thoracic spine, electrodes were placed and electrodes were used in the anterior abdominal wall.

The electrodes were connected respectively to the channels of the Miomodel apparatus (1-10). The channels worked in sequential stimulation mode for 2 s in each field in the indicated areas. This cycle of exposure was repeated several times in one procedure. In the last 3 minutes of the procedure, exposure was continuously connected to the region of the stellate nodes.

Multichannel electrical stimulation is carried out by a low-frequency pulse current with a bipolar asymmetric pulse shape. The current strength was regulated under each pair of electrodes according to the patient's individual sensations: from mild vibration at the beginning of the course of treatment to slight muscle contraction under the electrodes by the end of the course (from 0.1 to 30 mA). The procedures were dispensed from 10 minutes on the first two or three procedures, with a subsequent increase to 20 minutes, daily or every other day. The course of treatment ranged from 8 to 10 procedures, depending on the severity of the patient's condition and the presence of concomitant diseases.

All patients (29 people) were in the hospital, in the clinic of medical and labor examination and occupational diseases, they started treatment after the examination.

The treatment was controlled by clinical and laboratory research methods, including electrocardiography, radiography, rheography, neuromuscular diagnostics, microcirculation research and other methods.

Clinical and functional research methods revealed an improvement in the condition of patients after complex treatment (85% of cases): the subjective state of patients improved, complaints of pain in the extremities and seizures in them decreased, night sleep and the state of the psycho-emotional sphere improved, microcirculation normalized the muscles that were exposed, as well as improved indicators of neuromuscular diagnostics. Patients tolerated treatment well, and there was no exacerbation of concomitant diseases.

Example.

Patient K., 1956, with a diagnosis of Vibration disease, stage II, polyneuropathy, arthrosis of the joints of the hands. Complaints of pain in the arms and neck-shoulder girdle, aggravated by movement, sometimes cramps in the hands, numbness and whitening of the 2nd - 4th fingers, chilliness and parasthesia of the hands. Weakness and loss of objects from the hands, fatigue, headache, sometimes dizziness, poor sleep, depressed mood. An objective examination: marbling of the skin, moisture in the hands and cyanotic fingers. A positive symptom of a white spot, a decrease in pain and vibration sensitivity, hyposthesia of the middle and lower third of the forearm of the area of the hands, a cold test positive for 30 minutes, impaired neuromuscular conduction, impaired microcirculation, angiospastic type of cerebral blood circulation. On the ECG - sinus arrhythmia, tachycardia. On roentgenograms of the hands osteoporosis, racemose enlightenment, arthrosis of the interphalangeal joints.

The patient received a course of treatment according to the method described above (at the same time, drug therapy and physiotherapy exercises were carried out).

The course of treatment was 10 procedures, which were carried out daily for 10 minutes in the first 2 procedures, and then for 20 minutes in subsequent ones. The strength of the current was regulated from sensations of slight vibration in the patient under the electrodes to slight muscle contraction in 3 to 10 procedures (from 0.1 to 30 mA).

During a dynamic examination, the patient's condition improved, pain decreased, cramps in the hands became less frequent, the cold test was reduced to 15 minutes, the general condition of the patient improved. The patient was discharged from the hospital with a recommendation to repeat the course of treatment after two months.

The advantage of the proposed method is to improve the condition of the neuromuscular apparatus and microcirculation both in the pathological focus in patients with vibrational disease and in improving the function of internal organs, which contributes to a more effective treatment. As a result, the progression of pathology slows down and the quality of life of patients with vibrational disease increases.

Depending on the patient’s condition, the repeated course of treatment can be continued on an outpatient basis, which reduces the length of the patient’s hospital stay. The treatment method can be carried out in any physiotherapy department (office) by a nurse and does not require additional training.

Claims (1)

A method of treating a vibrational disease, including multichannel electrical stimulation of the region of the stellate nodes of the hands, characterized in that it further performs electrical stimulation of the region of the anterior abdominal wall, trapezius muscle in the upper thoracic spine, arms in the shoulder, forearm, while first acting simultaneously on the anterior abdominal region walls and trapezius muscle in the upper thoracic spine, and then sequentially on the shoulder, forearm, hand, 2 seconds per field, When this during the last 3 min treatments at the same time are applied to the star-shaped nodes in a continuous mode, the total exposure time of 10-20 min, the overall course of 8-10 procedures.