RU2410074C1 - Method of physiotherapeutic treatment of human body - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: at the first stage, patient's state information is collected, and sections with pathologically changed structure are detected. At the second stage, examination and palpation procedures are applied to determine the condition of skin, musculoligamentous apparatus, osteoarticular system. Palpation is combined with manual massage carried out for 5-15 minutes to determine body responsiveness to general exposure and to control the condition of soft tissues and their responsiveness. The third stage involves local mechanical physiotherapeutic treatment of the problem regions to ensure tissue adaptation on each problem region with local body reactions to be monitored. At the fourth stage, general physiotherapeutic treatment of the whole patient's body is performed simultaneously with manual massage to control the patient's state by response anti-stress body reactions.

EFFECT: method provides higher therapeutic effectiveness.

2 ex

Description

The invention relates to medicine, in particular to physiotherapy, and can be used for the treatment, rehabilitation of patients, as well as the prevention of diseases.

The prior art methods and methods of healing, disease prevention and treatment using various types of physiotherapeutic effects.

A known method of treating osteochondrosis (RF application 2000108973, A61H 7/00), including manual and vacuum massages, characterized in that they initially act on the osteoarticular, and then on the muscle-tendon components of the pathological process.

A well-known diploma for the opening of "The regularity of the development of qualitatively different general non-specific adaptive reactions of the organism" No. 158 with a priority of October 3, 1969 with the following formula: experimentally established previously unknown regularity of the development of qualitatively different general non-specific adaptive reactions of the body to the action of environmental and internal factors, consisting in that under the action of factors having weak (threshold) or medium (moderate) biological activity, a different set arises kc change in the neuroendocrine system, metabolism and, accordingly, a gradual or rapid increase of nonspecific resistance of the organism. Authors: Garkavi L.Kh., Ukolova MA, Kvakina EB

Also known work L.Kh. Garkavi "Activation therapy. Antistress activation and training reactions and their use for healing, prevention and treatment ”(Rostov-on-Don, Rostov University Press, 2006), which examines the body's reactions to the effects of all existing external and internal factors. In the works of L.Kh Garkavi et al. “Antistress reactions and activation therapy. Activation reaction as a way to health through self-organization processes ”part 1, part 2 (Yekaterinburg, RIA“ Filantrop ”, 2002, 2003) gives the concept and essence of activation therapy.

A known method of activation therapy of diseases (patent for the invention No. 2159116, A61K 35/32), including the ingestion of a medicinal product, characterized in that as a medicine use ASD, fraction 2 in an effective daily dose, depending on the type of disease and the type of response of the body . It is proposed to normalize the patient’s condition due to changes in the central nervous system due to the introduction of a “control” factor from the outside, requiring a strict intake regimen (every day at a certain time), and there is no direct direct effect on soft tissues.

In addition, various methods of physiotherapeutic effects on the human body are known from the prior art. For example, methods of healing a person using vacuum massage, which is based on the reflex mechanism associated with irritation of skin receptors by a vacuum formed inside a medical jar (P. Mykhaylichenko et al. “Vacuum massage”, St. Petersburg, 2007). Banks with an increasing neck diameter are applied to areas of exposure to the patient’s skin along the course of the venous outflow. After persistent hyperemia or extravasation occurs at the sites of the cans, the effect of the cans is weakened. Then, in turn, banks move along the venous and lymphatic outflows. Before carrying out vacuum therapy and at the end of it, general warming of the body is carried out by taking water procedures and manual massage of body parts exposed to vacuum therapy.

A known method of therapeutic and recreational effects on the human body (US Pat. RF 2179431), including conducting a session of vacuum therapy by applying several vacuum cans to the patient's skin. At the same time, several vacuum jars are placed having different neck diameters and the amount of vacuum installed in them. Create a horizontal-vertical differential pressure on the surface of soft tissues.

Closest to the claimed one is a method (patent for an invention. No. 2109503) for correcting weight and a person’s figure with manual massage, including general massage, characterized in that before the general massage, the area of the skin affected by cellulite is determined by lubricating it with cellulite, grease it with a fat cream, carry out heating of a selected part of the body by successively stroking, rubbing and kneading it with his hands. Further, by palpation examination, cellulite formations are localized and destroy them by force exposure to them. After that, hands perform extruding, rubbing and smoothing force effects on cellulite formations in the direction of lymphatic flows in the corresponding area of the body. At the end of the session, a general massage is performed.

The disadvantages of the known methods of massage include the fact that “often there are so-called functional disorders that have a reflex character” (M.A. Eremushkin “Medical Massage”, from “Science and Technology”, 2009, chap. 9), limited opportunities for their use and low efficiency, because the individual approach to the exposure is not fully used, namely: as a rule, the appointment of exposure to the body is based on the initial diagnosis and / or initial examination of the patient, then during exposure the dosage on the body is usually not adjusted, i.e. . the response of the body to exposure is not taken into account.

The aim of the present invention is to increase the effectiveness of therapeutic and physiotherapeutic effects on the human body by invoking and maintaining adaptive reactions in the body, taking into account the nature of the response of specific and nonspecific reactions of the body and soft tissues during the procedure and the entire course of the procedures.

The problem is solved in that in the method of physiotherapeutic effects on the human body, which includes the first stage of collecting information about the patient’s condition and identifying problem areas with a pathologically altered structure, at the second stage, the condition of the skin, musculo-ligamentous apparatus, and bone are determined by examination and palpation -articular system, simultaneously with palpation, carry out manual massage lasting 5-15 minutes in order to determine the reactivity of the body to the general effect and control the condition soft tissues and their reactions to exposure, at the third stage they carry out a local mechanical physiotherapeutic effect on problem areas to the state of tissue adaptation in each problem area, while controlling the local reactions of the body, at the fourth stage carry out a general physiotherapeutic effect on the entire patient’s body with manual massage, simultaneously controlling the patient's condition according to the response antistress reactions of the body.

Information about the patient’s condition and the identification of areas with a pathologically altered structure are collected through questioning, examination and palpation.

At the first stage, the patient's psychoemotional status is determined by the following parameters: anxiety, irritability, fatigue, depression, working capacity, sleep, appetite.

The condition of the skin, muscular-ligamentous apparatus, and osteo-articular system is determined by the presence of signs of an acute or chronic inflammatory process in individual parts of the body - temperature changes, pain, swelling, hyperemia.

The state of tissue adaptation in the problem area is established on the basis of changes in soft tissues in response to exposure.

Based on the discovery of L. Garkavi and others, the authors of the proposed method use the questions of discovery in relation to physiotherapeutic influences.

Any effect on the body, including the therapeutic one, causes responses in the body, in response to this, the body develops changes that characterize this reaction. Moreover, these changes develop at all hierarchical levels of the body, down to the subcellular (Garkavi L.Kh., “Activation therapy. Anti-stress activation and training reactions and their use for healing, prevention and treatment” (Rostov-on-Don, Publishing House Rostov University, 2006, p. 62. Reactions of an organism to exposure are divided into general (reaction of the whole organism as a whole) and local (reactions of subsystems, individual organs, tissues, etc.). There are specific reactions related to the quality of the acting factor , and nonspecific mainly related to the strength, dose, and biological activity of each acting factor (“Activation Therapy” by L.Kh. Garkavi, Rostov-on-Don, Rostov University Press, 2006, pp. 5-6). controlled challenge and maintenance in the body of the necessary adaptive reaction in the given case of the desired level of reactivity is called activation therapy, its main principle is the targeted call of antistress reactions that determine the functional state of the body, which is characteristic of health. Antistress reactions are “reactions of training, calm and increased activity,” which determine the functional state of the body that is characteristic of health. Antistress reactions develop in response to exposure (spontaneously) or are caused by any effect on the body.

"Adaptation" reaction, i.e. adaptive reaction - the reaction of a biological system when exposed to environmental factors or during shifts within the system itself, aimed at its survival, at preserving its condition or properties ”(Big Dictionary of Medical Terms. Compiled by Fedotov VD - M.: ZAO Centropoligraf, 2007, p. 688).

The proposed method of physiotherapeutic effects on the human body includes the following steps and steps. At the beginning, at the first stage, information is collected on the patient's condition. The first step is to collect data on existing diseases, the patient’s condition at the time of treatment, and also to identify areas that have a pathologically altered structure (organ, body part, region, point), i.e. “Problem areas” of the patient’s body.

The patient's condition at the time of treatment can be determined, for example, by interrogation, examination and palpation.

When conducting a questioning, they find out complaints (for example, pain, a feeling of stiffness, general fatigue, etc.), clarify them according to the time of occurrence, duration, intensity, degree of anxiety caused, find out what methods stop (for example, taking painkillers) unpleasant or painful sensations and what provokes (for example, sharp bending in the spine). Complaints that the patient calls himself are his priority problems.

Then, the patient’s psycho-emotional status is determined by the following parameters: anxiety, irritability, fatigue, depression, working capacity by time, speed and intensity, appetite, sleep, activity and optimism, for example, using either the Questionnaire L. Garkavi (see Appendix), or test method using a computer program L. Garkavi ("AntiStress", version 2.5 for Windows, Rostov-on-Don, Russia, 1997), or by general blood analysis (computer program "Antistress - blood program." Version 1.02 Activation Center ter FDI during TOO BIS, Rostov-on-Don, the Academy of Natural Sciences, GPI, 1997).

Second step. Using the method of examination and palpation, they determine the condition of the skin, muscular-ligamentous apparatus, and the condition of the osteoarticular system. In this case, special attention is paid to the presence of signs of an acute or chronic inflammatory process in certain parts of the body - temperature changes, pain, swelling, hyperemia, impaired function, i.e. local "problem areas" of the patient are identified that have a pathologically altered structure. Palpation, as a rule, is carried out simultaneously with a short (5-15 minutes) manual massage. At the same time, the body is exposed to a general effect in order to determine the reactivity of the body to the general effect, as well as to monitor the state of soft tissues and their reactions to exposure. Palpation in combination with massage also allows you to more accurately determine the type of existing adaptive reaction in the local "problem" area to determine the methods and parameters of further therapeutic effects. Preliminary (preparatory) short massage from the first seconds affects the receptors of the skin and internal organs (tactile, temperature and pain baroreceptors), which send impulses to the central nervous system and cause a response of the device to the effect.

At the first stage, after collecting information, which includes a short massage, taking into account the initial condition of the patient and his priority problems, together with the patient, they formulate the tasks of the entire course of therapeutic and recreational effects using physiotherapy methods.

The effectiveness of the impact is evaluated using the responses of the soft tissues (in the area of impact) and the whole organism.

Massage at this stage is carried out in order to determine the reactivity of the body to the general effect and control the state of soft tissues and their reactions to the effect.

The manual massage carried out at this stage does not have any features in the techniques. The goal of manual massage at this stage is to identify the general reactivity of the body as a whole and local reactions of soft tissues to exposure.

The author determines the reactivity of an organism by means of a manual classical massage. The technique of manual classical massage is given in the federal standard “Classical” massage technique in the complex of rehabilitation measures in the treatment of injuries of the musculoskeletal system. Medical technology No. FS-2007/062-U. The 2 types of reactions to classical massage given in the federal standard are considered normal (in terms of pathophysiology, the body reactivity is normergic), if the reactions are excessive, then the body reactivity is hyperergic, if the effects are weak, then the reactivity is hypergic, if there is no general reaction, the reactivity is anergic. “The severity of the body’s response to the effect manifests itself in the form of a normergic, hyperergic, hypergical and anergic reaction (here - the reaction of the whole organism - reactivity, approx. L.P.

- Normergic reactivity is expressed quantitatively and qualitatively by an adequate response to the action of an agent.

- Hyperergic reactivity is manifested by an excessive reaction to the stimulus.

- Hypergic reactivity is characterized by an inadequately weak response to exposure.

“Energy is characterized by a lack of response to exposure ...” Livitsky P.F. Pathophysiology: Textbook. - 4th ed. Re-worker. And add. - M.: GEOTAR-Media, 2008 .-- p.22.

The reactions of the body, including skin integument resulting from the effects of massage, are known to specialists. These reactions are described in various sources.

From the source of L.Kh. Garkavi “Activation therapy. Antistress reactions of activation and training and their use for healing, prevention and treatment ”, Rostov-on-Don, ed. Rostov University, 2006, p. 5, it is known that there is a response of the body to any factor affecting the body (including massage - approx. The applicant). Without the reaction of the organism or its subsystems, no factor will act.

What are the reactions? General and local. General reactions are reactions of the whole organism as a whole. A local reaction is a reaction of a subsystem, organ, tissue, etc. A local reaction cannot develop without a general one, as develops in response to a stronger acting factor than the general.

Thus, in response to the massage effect, reactions arise - general (of the whole organism) and local (specific organs, tissues, muscles, etc.). There are no local reactions (reactions of tissue, muscles, etc.) to massage without the appearance of general reactions of the whole organism. Knowing this, the applicant in the invention controls both general reactions — the body’s reactivity to general effects, and local reactions — the state of soft tissues.

How do these reactions manifest?

The determination of the body's reactivity to the general effect is carried out according to the following.

Known reactions that occur as a result of massage exposure (M.A. Eremushkin "Medical massage, from the" Science and Technology ", 2009):

- reactions of the receptor apparatus to massage effects (p. 188-213);

- transfer of tactile information from receptors to the structures of the central nervous system (p. 213-218);

- reflex effects resulting from massage effects (p. 218-362);

- humoral effects resulting from massage effects (p. 363-369)

Reactions of the receptor apparatus are as follows.

Reception of the skin consists of three varieties - tactile (tactile), temperature (thermal, cold) and pain (M.A. Eremushkin, “Medical Massage, Science and Technology, 2009, p. 189).

It is known ("A Practical Guide to Manual Medicine," S.V.Dubrovsky, Moscow, ed. "AISHA print", 2003, p. 42) that the internal organs are closely connected with the skin, subcutaneous fatty tissue, muscles and other body tissues, and with their diseases, the blood supply to these tissues changes, their sensitivity to various stimuli increases, their consistency changes. Such areas are called reflexively altered areas.

Hypersensitivity of the skin or hyperesthesia is characterized by a strong increase in tactile sensitivity. With a slight lifting of the skin fold, the patient notes severe pains of a pressing and burning nature ("A Practical Guide to Manual Medicine", S.V. Dubrovsky, Moscow, ed. "AISHA print", 2003, p. 46).

The response of tissues to tactile action is checked by the presence of painful reactions in certain areas of the body's tissues.

For example, the skin is folded (in a changed tissue, the patient experiences cutting, pressing or stitching pains).

They irritate the skin with a light touch (tickle). In disturbed areas, this action may not be felt, because tissue has lost its sensitivity ("A Practical Guide to Manual Medicine", S.V. Dubrovsky, Moscow, AISHA print, 2003, p. 47).

As a result of the massage, a change in the blood supply to the skin occurs, which is determined by comparing different areas of the skin. A narrowing or expansion of blood vessels is observed ("A Practical Guide to Manual Medicine", S.V. Dubrovsky, Moscow, ed. "AISHA print", 2003, p. 47). Correspondingly, redness is observed on the skin areas or, on the contrary, individual skin areas become paler as a result of the massage.

Pathological changes in the connective tissue are detected as a result of their reactions to the following effects:

- By palpation (palm flat with slightly bent fingers is installed on the test surface). The second hand gently advances the palpating hand. In reflexively disturbed areas, palm sliding meets resistance ("A Practical Guide to Manual Medicine", S.V. Dubrovsky, Moscow, AISHA print, 2003, p. 47).

- Perform sliding movements with the tips of straightened fingers at an angle of 40-60 ° to the surface. Uniform sliding meets resistance in reflexively altered areas.

- Capture and pull (lift) the skin fold. With increased tension, the tissue rises worse than in healthy areas, and at the same time the patient experiences unpleasant, painful sensations.

- Perform a massage squeeze. During the massage action in the disturbed areas, the glide slows down and the hand “sticks” to the changed tissue (“Practical Guide to Manual Medicine”, S.V.Dubrovsky, Moscow, AISHA print, 2003, p. 47 -48).

Changes in muscles are also detected by reactions to massage effects. Muscles are best studied by massage techniques: “forceps”, “drilling”, “compression”, etc.

The study should be deep, penetrating, but at the same time not cause sharp pain. Any compacted structure (tight cord) in the muscle feels like something is rolling under the fingers, this cord is springy, slides. There may be several seals. Strong pressure on the trigger points almost always causes the patient a “jump” reaction associated with pain, involuntary muscle trembling. In addition, the study of muscles can be carried out using passive and active movements of the subject. In certain positions, the algic muscle is uncomfortable and painful (“A Practical Guide to Manual Medicine”, S.V. Dubrovsky, Moscow, AISHA print, 2003, p. 48).

Changes in the periosteum are detected by the following reactions during massage.

The most pronounced form of changes in the periosteum is pain during penetrating massage with your fingertips. Irregularities and swelling may also be felt on the surface of the bone.

Weakly expressed reflex changes are able to manifest only during massage manipulations. During the massage session, it is necessary to clarify the location and nature of reflex changes each time ("A Practical Guide to Manual Medicine", S.V. Dubrovsky, Moscow, AISHA print, 2003, p. 48).

Types of reflex changes in tissues (tissue reactions to massage effects) are summarized and are shown in table 2 “Types of reflex changes” (“A Practical Guide to Manual Medicine”, SV Dubrovsky, Moscow, AISHA print, 2003 p. 45).

The reactions relate to changes manifested in a disorder of sensitivity, blood supply, a change in the elastic-viscous properties of tissues.

table 2 Fabrics Nature of change Leather Superficial tenderness, increased sensitivity when touched, superficial increase in tone, impaired blood supply Connective tissue Soft and gross bulges, strip-like, ribbon-like, umbilical, widespread depressions; during the massage the tissue “rustles” Muscle Soreness, hypersensitivity, overstrain, sagging, painful muscle tightness, hard or heavy tensions Periosteum Impressions, compaction, swelling, bumps, swelling Bones Violation of posture, thickening, curvature of the spine

(“A Practical Guide to Manual Medicine,” S.V.Dubrovsky, Moscow, AISHA print, 2003, p. 45).

The impact on various tissues of the human body includes the corresponding reflexes (reactions):

- on the skin - viscero-tangled reflex of Zakharyin-Ged;

- in the muscles - viscero-motor reflex of Mackenzie;

- in vessels - viscerovasomotor reflex;

- in the periosteal tissue - the visceroperiostal Vogler-Kraus reflex ("A Practical Guide to Manual Medicine", SV Dubrovsky, Moscow, ed. "AISHA print", 2003, p. 45).

Thus, all tissue responses to massage effects are known. Techniques are also known to determine these reactions. In the inventive method, the reaction of tissues is determined by the above methods. The main thing is not the methods of exposure, but the determination of the presence or absence of reactions on individual tissue sites.

The reactions of the body to massage effects are also widely known.

These reactions are described in the literature and are given above (Livitsky PF Pathophysiology: Textbook. - 4th ed. Revised. And add. - M .: GEOTAR-Media, 2008. - p.22).

Based on the information collected, depending on the patient’s condition and on the task for the therapeutic and recreational effects, the next step is the direct physiotherapeutic effect.

Third step. First, a local mechanical physiotherapeutic effect on the “problem” areas is performed. In the “problem” area, as a rule, the system of capillary circulation is disturbed, the properties of tissues are changed, salts are deposited, and other changes are signs of local stress. This can affect the state of the body as a whole. Under the influence of physiotherapeutic methods on “problem” zones, a more intense microcirculation of blood, lymph, interstitial fluid is created in them, that is blood flow improves, and metabolic and regulatory processes are strengthened: the soft tissues of the body begin to function as a whole, harmonizing the internal environment of the body, increasing resistance to environmental factors.

The task of local exposure to "problem", pathologically altered areas is local tissue adaptation in this area. The absence of changes in soft tissues in response to exposure is a local adaptation of tissues to a physiotherapeutic factor, which serves as a signal for a change in the method of exposure or its parameters.

Acting directly on a pathologically altered portion of the patient’s body during exposure, they cause local reactions. Local reactions of the body are controlled by the degree of aseptic inflammation in pathologically changed soft tissues and by changes in the patient's subjective sensations after the procedure. The determining criterion for achieving the adaptation of the “problem” site is the absence of extravasates and signs of aseptic inflammation of the soft tissues.

The claimed method uses methods of physiotherapy based on the use of mechanical factors: medical massage (manual, hardware or combined), acupuncture, vibration therapy, ultrasound therapy, barotherapy (M.A. Eremushkin "Medical massage", because of the "Science and Technology ”, 2009 p. 18). Their combination can also be used - the effect of two or more physical factors on one area of the body within a single procedure or combination - separate use for one day or by alternating them. When performing vacuum massage cans can be used (manual can massage), a vacuum vibrating massager PRV02 from HeVaTech GmbH (Germany) or a vacuum massager "Electronics BM-02" Axion "(apparatus massage), or other vacuum massage devices with similar characteristics.

The achievement of the state of adaptation is controlled taking into account the following.

From the source “Medical massage. Theory and Practice ", study guide, M.A. Eremushkin, ed. “Science and Technology”, 2009, p. 135. It is known that “The universal property of an organism in its interaction with environmental factors, as you know, is adaptation (adaptation).

From this position, massage as a therapeutic physical factor is an irritant that can cause certain changes in the external and / or internal environment of the body. “For every change in the conditions of its existence, including that caused by the action of massage as a physiotherapeutic agent, the body responds with a systemic adaptive response.”

From the source “Pathophysiology”, a textbook for universities, P.F. Litvitsky, publishing group “GEOTAR-Media”, 2008, p. 44 it is known that “Adaptation is an adaptation in response to changes in the conditions of existence of cells (including exposure to a damaging factor). ”

Among the signs of achieving an adaptation state are known signs such as:

- elimination of signs of stress reactions (reactions to effects, including exposure to massage) (P.F. Litvitsky, publishing group "GEOTAR-Media", 2008, p. 267).

It is also known that the universal property of an organism in its interaction with environmental factors is adaptation (adaptation). In organic life, there are no other regulatory processes besides adaptive. The relative dynamic constancy of the internal environment in the human and animal body, i.e. homeostasis is provided by a complex system of adaptive mechanisms. From this position, massage as a therapeutic physical factor is an irritant that can cause certain changes in the external and / or internal environment of the body. The body responds to any change in the conditions of its existence, including that caused by the action of massage as a physiotherapeutic agent, with a systemic adaptive response (M.A. Eremushkin “Medical Massage”, “Science and Technology” Publishing House, 2009, p. 135).

Thus, the state of adaptation is the adaptation of tissues in the local area to the effects of massage techniques. In the course of course treatment, it is determined by the moment when the reaction to the effect in the problem area becomes similar to the reaction to the same effect in pathologically unchanged areas. During one procedure, the criterion for terminating the exposure is the appearance of positive dynamics in the area of exposure, for example, reduction or disappearance of pain, softening of tissue conglomerates, loosening of dense edema - if the process is acute, if there are active complaints and the reactivity of the body is hyperergic, that is, excessive; if the process is chronic and local reactivity is hypergical, that is, less than normal, or locally anergy, that is, the tissues do not respond to the average diagnostic effect, carried out in the second stage for 5-15 minutes, then the appearance or intensification of the reaction is a positive dynamics, which it can manifest itself in the form of a vascular tissue reaction - hyperemia, redness, the appearance of a feeling of warmth.

Those. when monitoring the achievement of the state of tissue adaptation, they control the presence of changes in the above reactions of tissues and the body as a whole or their absence resulting from the effect of massage.

Local responses control visually - examination, palpation - by touch, hearing - the disappearance of crepitus, by the method of questioning (whether the nature of the pain has changed, whether there has been a sensation of warmth, whether movements in the joint have become easier, etc.).

Influencing physiotherapeutic methods on local "problem" areas, they cause antistress reactions. The challenge of a certain antistress reaction, as well as its maintenance for some time, provides an improvement in overall well-being, improved tolerance to local intense influences and the inclusion of nonspecific immunity mechanisms that stimulate the body to fight diseases independently by mobilizing the hidden reserves of the body (L.Kh. Garkavi et al. "Antistress reactions and activation therapy. Activation reaction as a way to health through self-organization processes", Yekaterinburg, RIA Filantrop, 2002, part 1, p. 138). Physiotherapeutic methods, their combination and / or combination and strength of action are chosen individually, at each session, depending on the general and local response antistress reactions that occur in a particular patient; the effect varies in strength and frequency depending on the condition of the patient and on the condition of the soft tissues of the problem areas

When conducting physiotherapeutic methods on problem areas, both local responses (typical and characteristic of this method only) and the general responses of the body (fever, pain threshold, etc.) are monitored. By dosed irritation of the soft tissues in the body, antistress responses are elicited, i.e. general non-specific reactions. Monitoring the development of such nonspecific reactions of the body can be carried out according to the psychoemotional status (for example, using the Periodic System of the Body L. Garkavi, see Appendix), laboratory data (general blood test, biochemistry) or by other means.

At the same time, with local exposure, priority problems of the patient are solved, for example, pain reduction. In other words, local reactions of the body are caused, which can manifest themselves in a local change in temperature, a change in the nature of pain, a change in skin color, a change in the size of the edema, the number and quality of skin rashes along the meridians and at biologically active points, etc.

To control the response of antistress reactions after each session, a screening examination is carried out: a patient is questioned about his health; examination of the areas affected, palpation to determine the pain of the patient, etc. Before each next session, the same screening examination is carried out, which allows us to evaluate the effectiveness of the previous exposure to the body. Based on the results of the control, a correction of the plan for further exposure is carried out (by time, intensity, choice of exposure technique - manual, hardware massages, etc.).

In the process of local exposure to “problem” areas, exposure is also made to nearby areas of the body. Thus, involving the body parts adjacent to the “problematic” ones in the process of physiotherapeutic influence, we improve blood circulation around the pathological focus, harmonize the relationship between the pathological focus and neighboring normal tissues, which allows us to accelerate the recovery process after the treatment.

At the final stage, step four, after exposure to individual parts of the patient’s body, they switch to a general physiotherapeutic effect on the entire human body in order to emphasize the central nervous system on the antistress response caused and prevent the stressful effect of the pathological focus on the whole body.

The general therapeutic effect on the whole body is performed by manual massage, while ensuring the removal of excessive neuromuscular tension.

Monitoring the patient's condition before and after the general exposure, adjusting the exposure for duration and intensity is also carried out on the basis of monitoring the response of antistress reactions of the body.

Manual massage at the 4th stage is carried out exclusively by manual classical massage techniques. So, in the source “Massage Therapy A. A. Biryukov, Moscow, Publishing Center“ Academy ”, 2008, pp. 54-55, a classification of classical massage techniques is presented. The classical massage technique is presented in the source “Classical” massage technique in a complex of rehabilitation measures in the treatment of injuries of the musculoskeletal system. ”Medical technology No. FS-2007/062-U.

Manual massage techniques are known and widely described in the literature.

So in the source "Practical Guide to Manual Medicine", S.V.Dubrovsky, Moscow, ed. "AISHA print", 2003, p. 34 describes the essence of the techniques of massage (manual).

Squeezing: Moving the skin roller with a sliding motion to empty the soft tissue from blood, lymph and interstitial fluid.

Rubbing: The displacement of the integumentary tissue in relation to the subject, as well as between each other (gliding is not allowed).

Kneading:

Kneading on flat muscles - pressing the muscle to the bone surface, pressing on it, should be crushed, washed, stretched the muscle.

Kneading on relief muscles - grab a muscle, lift it, pull it away from its usual position and rinse it with your fingers.

Stroking: soft, sliding movement on the massaged surface.

Percussion techniques: Fixed fast, rhythmic strokes on a massaged surface.

Stunning techniques: Shaking the massaged area with a quick and rhythmic action.

Vibration techniques: multifrequency trembling effect on the massaged area.

Thus, talking about the fact that they carry out manual massage, it becomes clear for the specialist what techniques are being implemented. There is no specificity in the claimed method in the techniques of manual massage. Perform a general manual massage with standard techniques.

The concept of "antistress reactions" of the body is widely known to specialists in activation therapy.

Information about what constitutes antistress reactions is published on the Internet at http://ru.wikipedia.org/ (a printout from the site is attached).

"Antistress reactions" is a concept first introduced in 1968 by L.Kh. Garkavi.

"Antistress reactions" are nonspecific adaptive reactions of the body.

It is proved that stress (as a classical nonspecific reaction in G. Selye's description) is just one of the reactions that make up the general periodic system of nonspecific adaptive reactions of the body, since the body, as a more sensitive system than its subsystems, responds to different and quality irritants causing fluctuations in homeostasis within, primarily, normal indicators.

These non-specific reactions are the antistress Nonspecific Adaptive Reactions of the Body (NARO). The theory of NARO and the practice of detecting and purposefully triggering these reactions in the body (activation therapy) were developed by domestic scientists L.X. Garkavi and E.B. Kvakina.

Described:

- the reaction of the training in response to a threshold, relatively small value of the acting factor. (Garkavi L.X. - 1969, Kvakina E.B., Ukolova M.A. - 1969),

- the activation reaction in response to different quality factors of medium (intermediate between weak threshold and strong, stressful) values. (Garkavi L.X. - 1968). The activation reaction is divided into a calm activation reaction and an increased activation reaction.

- a reactivation reaction, which, like stress, is a non-specific basis for many pathological processes. It is characterized by high lymphocytosis (more than 40-45%, individually) and unnecessarily high activity of the nervous and endocrine subsystems of the body with tight synchronization, and then desynchronization of processes with excessive hyperergicity (Garkavi L.X., Kvakina EB - 1990, Garkavi L.X. - 2006).

Thus, there is a whole system of non-specific adaptive reactions of the body.

Brief characteristics of NARO

The training reaction is a nonspecific antistress adaptation reaction of the body to the acting factors of the “threshold” value, which is characterized by a signal indicator - the content of lymphocytes in the blood (from 20 to 27%), as well as the production of hormones by the endocrine glands - thyroid, genital, pituitary - within the lower half of the normal zone. The secretion of ACTH and glucocorticoids is within the upper half of the normal zone. The last circumstance is associated with a mild (unlike stress, without signs of immunosuppression) anti-inflammatory effect of the training reaction.

The biological meaning of the training reaction is the preservation of homeostasis within the lower half of the normal zone under the action of weak, insignificant stimuli. In order for the training reaction to last for a long time, it is necessary to influence the patient with factors of nonlinearly increasing intensity - to increase the strength of the acting therapeutic factor, due to the sensitivity of the central nervous system that is moderately reduced during this reaction.

The activation reaction is a nonspecific antistress adaptive reaction of the body to acting factors of “medium” intensity, which can be of two types: - increased activation and calm activation. The lymphocyte content (signal indicator) is 28-33% (with a calm activation reaction), and with a high activation reaction - 40-45% (individually). The activation reaction is between workout and stress reactions.

With an increase in the strength of the acting factor, the reaction of calm activation is first formed, and then the reaction of increased activation (Garkavi L.X. - 1969, 1990). Changes in many body systems during these reactions differ only in severity. So, with a reaction of increased activation, an increase in the activity of the organs of the thymo-lymphatic system, cellular immunity, secretion of thyroid hormones, sex glands, tropic hormones of the pituitary gland is more pronounced (Garkavi L.X. - 1990, 2006). In the reaction of calm activation, this increase lies within the upper half of the normal zone, and in the reaction of increased activation it captures the upper third of the normal zone, the upper limit of the normal and slightly higher.

If during the reaction of calm activation, the secretion of ACTH and glucocorticoids is within the lower half of the normal zone, then in the reaction of increased activation it lies within its upper half. This determines the different effect of these reactions on inflammation (a more pronounced anti-inflammatory effect during an increased activation reaction) and a certain ratio of the activity of the blood coagulation and anticoagulation systems. In a calm activation reaction, they are well balanced, and in an increased activation reaction, anticoagulant system activity moderately prevails. It also determines the different effects of calm and increased activation reactions in patients with coagulation disorders. In reactions of calm and increased activation, processes of anabolism predominate, especially with increased activation. Plastic and energy exchanges are well balanced. Both activation reactions (but, especially, increased activation) cause a rapid and substantial increase in the active nonspecific resistance of the body due to a true increase in the activity of its protective systems (Garkavi L.X., Kvakina EB - 1990, 1995, 1996).

The biological meaning of both activation reactions is to adequately increase the activity of protective systems in response to an average stimulus, which corresponds to the optimal level of the body's protective response. With these reactions, the fastest and most adequate restructuring of the defenses occurs in response to damaging effects, the fastest healing of wounds, or restoration of strength after an illness. (Garkavi L.X., Shepelev A.P., Tatkov O.V., Maryanovsky A.A. - 2000, Tatkov O.V., Garkavi L.X., Rubtsov V.V., Fatkina N.B. - 2004).

Reactivation reaction

When the body is exposed to potent factors, either a stress reaction develops (the classically described Selye and characterized by severe lymphopenia - less than 20%), or a reactivation reaction, which is characterized by an excessive (above the upper limit of normal) increase in the percentage of lymphocytes in the leukoformula. The biological meaning of re-activation is in an attempt to maintain activation in response to an excessive load without "dumping" into stress. Reactivation is indeed better than stress, but it is dangerous to “breakdown” into it, and is also a non-specific basis for some diseases.

NARO reactivity levels

As the intensity of the acting factor increases, the five main known non-specific adaptive reactions of the body repeat - training, calm activation, increased activation, stress or reactivation at different levels of the body's reactivity (Garkavi L.X., Kvakina EB - 1975, 1990). Moreover, each adaptation reaction can be caused by stimuli of various modality, since it is nonspecific.

When the intensity of the stimulus changes, the reaction goes into the next one: when the stimulus strength is increased by the reaction coefficient during the training reaction, a calm activation reaction occurs, when the stimulus strength decreases by the reaction coefficient during stress, a reaction of increased activation occurs, etc. The combination of five known adaptive reactions is one level of reactivity.

At low levels of reactivity, changes in the body are less favorable, so-called elements of tension of reactions appear (Garkavi L.X., Kvakina EB - 1990). Elements of tension, as well as a signal indicator, can be determined by the leukocyte formula. If the type of reaction is determined by the percentage of lymphocytes, then other elements of the leukocyte formula determine the level of reactivity. As the level of reactivity decreases (the strength of the controlling acting factor causing the reaction increases), the percentage of blood cells (eosinophils, stab neutrophils, monocytes, basophils) deviates more and more from the norm. Tension is also characterized by a deviation from the norm of the total number of leukocytes and an increase in ESR.

In a broader sense, elements of tension include any deviations from the norm in the body, including metabolic disorders. If, for example, during sanatorium-resort treatment, adaptive reactions of stress, reactivation, training, and activation of low levels of reactivity develop, they reduce the specific therapeutic effects of resort factors (Garkavi L.X., Kvakina EB, 1990). When favorable reactions are formed, especially the activation of high levels of reactivity without pronounced elements of tension, the activity of the organism and its subsystems is restored, the reserves of adaptation and non-specific resistance are increased. At the same time, a particularly pronounced therapeutic effect of the sanatorium-resort stage of rehabilitation is noted (Tatkov O.V. - 2002, Garkavi L.X. - 2006.).

With an increase in the dose or strength of the stimulus by the reaction coefficient, adaptation reactions successively replace each other: training - quiet activation - increased activation - stress or reactivation - training the next level - calm activation of the next level, etc. In response to low-intensity stimuli, reactions develop at high levels of reactivity, in response to medium-intensity stimuli, at medium levels, and to high-intensity stimuli, at low levels of reactivity. The state of the body during the development of reactions at high levels of reactivity is characterized by high sensitivity and reactivity. On the contrary, at low levels of reactivity, a low sensitivity of the organism is noted and reactions develop on high-intensity factors.

Reactions of high levels of reactivity are more favorable. Even stress becomes mild, and the inherent disturbances become less pronounced. With the development of antistress reactions at high levels of reactivity, all changes in the immune and endocrine systems, except for the secretion of glucocorticoids, approach the upper limits of the norm of this reaction, and glucocorticoids - hormones of the “load” - approach, on the contrary, lower limits.

In addition to reactions of stress training and activation at medium and low levels of reactivity, a reactivation reaction develops, which, like stress, is a non-specific basis for many pathological processes, especially at low levels of reactivity. It is characterized by high lymphocytosis (more than 40-45%, individually) and unnecessarily high activity of the nervous and endocrine subsystems of the body with tight synchronization, and then desynchronization of processes with excessive hyperergicity (Garkavi L.X., Kvakina EB - 1990, Garkavi L.X. - 2006).

Psychotypology of reactions of NARO

Each type of reaction has its own psycho-emotional state. The reaction of increased activation, especially at high levels of reactivity, is characterized by optimism, emotional upsurge, a high level of working capacity, especially in terms of work speed, excellent sleep and appetite. In a calm activation reaction, changes are similar, but their severity is less: the mood is good, but without a pronounced uplift. As reactivity decreases with increased activation, irritability appears, even aggressiveness, and it becomes similar to a reactivation reaction. Sleep is disturbed, performance deteriorates (in time). With quiet activation with a decrease in the level of reactivity, lethargy appears, even depression, a superficial sleep, impaired appetite, decreased performance in all respects. Under stress, depression, pessimism predominates, less aggressiveness, decreased performance, sleep and appetite are disturbed. When reactivated, aggressiveness, irritability, sleep disturbance are noted. These changes are especially pronounced at low levels of reactivity (Garkavi L.X., Kvakina EB - 1996, Garkavi L.X. - 2006).

The criteria for the antistress reactions of the body are also known and are described in the source of L.Kh. Garkavi “Activation therapy. Antistress reactions of activation and training and their use for healing, prevention and treatment ”, Rostov-on-Don, ed. Rostov University, 2006, pp. 37-46.

“When the body reacts, then everything is included in the reaction - from the body as a whole in the first place, since the body as an open self-regulating system is the most complex and therefore the most sensitive. Then all hierarchical levels of the body are involved in the overall reaction. ”

Self-assessment questionnaire created after accumulating a lot of experience about the well-being of people with different reactions at different levels of reactivity (including their own experience) is highly informative and fairly accurate (94% of matches).

10 questions are asked:

1) anxiety;

2) irritability;

3) fatigue;

4) depression;

5) working time (how long you can work);

6) speed performance (how fast you can work);

7) appetite;

8) sleep;

9) optimism;

10) activity.

Each respondent must evaluate his own answer in the range from -3 to +3 (-3, -2, -1, 0, +1, +2, +3).

What answers are typical for different types of reactions and, approximately, for different groups of reactivity levels.

The most severe stress, which occurs most often: lymphocytes - 14%, eosinophils - 4%, white blood cells - 6000, i.e. chronic stress with a predominance of processes of transcendental inhibition in the brain with inhibition of the neuroendocrine system (except for the secretion of glucocorticoids), the immune system:

1) high anxiety - + 2 ÷ + 3;

2) irritability is not very high - 0 ÷ + 1 (in acute stress, high - + 2 ÷ + 3);

3) high fatigue - + 1 ÷ + 2;

4) large depression - + 2 ÷ + 3;

5) time efficiency low -1 ÷ -3;

6) speed performance average 0 ÷ -1;

7) poor appetite -1 ÷ -3;

8) shallow sleep -1 ÷ -3;

9) optimism is low 0 ÷ -3;

10 activity - from 0 to -3 (low or very low 0 ÷ -3).

The more severe the stress, the lower the level of reactivity, the greater the severity of depression, anxiety, decreased performance, appetite, sleep, and, of course, optimism.

What is the main thing in stress as?

Depression, decreased optimism, activity, anxiety. With regard to anxiety, you need to understand that in severe patients, especially cancer patients who are afraid of a bad outcome, anxiety can be masked - they are very anxious, but they hide this from themselves and often give an deliberately incorrect answer. Let's take the best health condition - increased activation of high levels of reactivity: lymphocytes - 36%, and everything else is normal.

In the brain - a moderate predominance of physiological arousal, many endorphins. Everything else is within the upper half of the normal zone, everything is well coordinated, harmonious:

1) anxiety -3 (lowest);

2) irritability happens especially with a decrease in the level of reactivity, but with a physiological -2;

3) fatigue in relation to quick work is low -2 ÷ -3, and in relation to long work (especially monotonous) above - 0 ÷ -1;

4) depression is the lowest - -3;

5) time efficiency is not the highest 0 ÷ + 1;

6) speed performance - the highest - +3;

7) appetite - +3;

8) sleep - + 2 ÷ + 3;

9) optimism - +3;

10) activity - +3.

As tension increases, and reactivity decreases during a reaction of increased activation, shifts toward the reactivation reaction occur - irritability increases, sleep worsens (either they do not fall asleep for a long time or wake up in the middle of the night). Other parameters do not change for a long time.

In a reactivation reaction — a reaction opposite to stress — the psychoemotional state is also in many ways the opposite of stress. For example, the number of lymphocytes is 49%, the white blood cell count is 4000 (when reactivated, the total number of white blood cells is often close to the lower limit of the norm). The psychoemotional state is characterized by the following indicators:

1) anxiety - low 0 ÷ + 1;

2) irritability - high +3, often turning into aggressiveness;

3) fatigue - low -2 ÷ -3;

4) depression - low -2 ÷ -3, although it may periodically occur;

5) time performance is quite high - + 1 ÷ + 2, but is fraught with failure;

6) high speed performance + 2 ÷ + 3, but also fraught with failure;

7) the appetite is excellent - + 2 ÷ + 3;

8) sleep is disturbed 0 ÷ -1 (either they do not fall asleep for a long time, or wake up at night);

9) optimism + 2 ÷ + 3, but there are disruptions;

10) activity is high - + 2 ÷ + 3, but there are breakdowns.

As you can see, the main features of reactivation are irritability, sleep disturbance (which is also characteristic of intense increased activation) and frequent breakdowns, which deprives this reaction of reliability.

With a calm activation reaction, the predominance of excitation in the brain is less pronounced than with increased activation. Psycho-emotional state is more calm:

1) anxiety is not high, but higher than with increased activation 0 ÷ + 1 (it increases with the transition to low levels of reactivity);

2) irritability is less than with increased activation, - 0 ÷ -1;

3) fatigue is low for all types of work + 1 ÷ 0 ÷ -1 (when switching to low levels of reactivity increases);

4) depression - rather low -1 ÷ -2, but higher than with increased activation 0 ÷ -1, with a decrease in the level of reactivity (tension) increases;

5) operability in time and 6) operability in speed with quiet activation are approximately the same and rather high: + 1 ÷ + 2. With increasing tension, the first decreases working speed;

7) good appetite - + 1 ÷ + 2 (worse than with increased activation);

8) a good sleep - + 1 ÷ + 2 (not as deep as with increased activation, and when the reactivity level decreases, it becomes even less deep;

9) optimism - + 1 ÷ + 2;

10) activity - + 1 ÷ + 2 (with a decrease in the level of reactivity, optimism and activity decrease).

What is the main thing with a calm activation reaction? Greater uniformity and balance of change.

As reactivity levels decrease, changes in psychoemotional status begin to approach the training reaction.

During the reaction of training in the brain, weak, protective inhibition prevails:

1) low anxiety - 0 ÷ -1;

2) irritability is low - -2 ÷ -3;

3) fatigue during long-term loads is low -1 ÷ -2, and high - with fast loading - + 1 ÷ 0;

4) depression is quite low - -1 ÷ -2, but higher than with quiet activation - 0 ÷ -1, with a decrease in the level of reactivity (tension) increases;

5) time performance during a training reaction is good - up to +2;

6) speed performance during the training reaction is approximately the same and rather low 0 ÷ -1. With increasing tension, the first decreases working speed;

7) good appetite - + 1 ÷ + 2 (worse than with calm activation);

8) a good sleep - + 1 ÷ + 2 (worse than with calm activation and with a decrease in the level of reactivity it becomes even less deep);

9) optimism 0 ÷ -1;

10) activity - 0 ÷ + 1 (with a decrease in the level of reactivity, optimism and activity decrease).

As the reactivity level decreases during the training reaction, very sharp changes do not occur, unlike other reactions. The reaction of training is a little closer to stress - depression, anxiety increases, working capacity decreases, sleep and appetite worsen, but these changes are not very pronounced.

Thus, the type of reaction and the level of reactivity are so clearly reflected in the psychoemotional state of the body that the characteristics of the psychoemotional state can determine both the type of reaction and, approximately, the level of reactivity.

Thus, it is possible to control the antistress reactions of the body by monitoring the patient's psycho-emotional state according to the state of the central nervous system after massage, according to the Garkavi questionnaire.

Maintenance of antistress reactions is ensured by the massage procedure itself, since even the same techniques can not be performed by a massage therapist at the same speed and intensity, thus providing the necessary random fluctuations in dosages in the range of 5-10%, which are necessary to maintain the achieved desired antistress reaction of the whole body .

Since stress is almost always a local reaction in problem areas, the tactics for massaging pathological areas are as follows: in the first 1-2 sessions, a minimal effect on this area is performed. In subsequent sessions, the intensity of receptions and the time of "work" with the problem area increase exponentially with a coefficient of 0.7. At Garkavi on page 98, (source Garkavi L.Kh. Activation therapy. Anti-stress activation and training reactions and their use for healing, prevention and treatment. - Rostov n / A: Publishing house Rost. Un-ta, 2006) is described tactics of managing patients according to the programmed regime by exposing the drops exponentially with a coefficient of 0.7 under stress. The impact of massage on the pathological site is similar to physical activity. For physical activity there are features: "Unlike other activators, physical activity should not decrease, but increase ... Each person has his own limit - the optimum around which there should be fluctuations - a little up (≈10%) and a little down" (there p.115) (! Note: The general effect of massage is much more complicated and cannot be explained only by analogy with physical activity). That is, to obtain local reactions, it is necessary to increase the local effect until the local reaction and the general reaction of the body synchronize (the criterion is the same reaction to the massage effect of the problem area and neighboring unchanged tissues). However, if the general reaction of the body at this point has not yet reached the desired, then the massage effect continues, but without emphasis on pathologically altered tissues and organs.

The essence of the proposed method is that the applicant, having knowledge in the field of massage and pathophysiology, knowing the body's reactions (general and local) to the massage effect, applied the knowledge of the antistress reactions of the body to massage in order to solve the problem posed by the invention - to increase the efficiency of medical physiotherapy physiotherapy massage effects on the human body by invoking and maintaining adaptive reactions in the body, taking into account the nature of the response of specific and non-specific reactions of the body ism and soft tissues during the procedure and the entire course of the procedures.

To determine the level of antistress reactions, the applicant uses the questionnaire in accordance with the questionnaire set forth at Garkavi. Then the answers are entered into the computer program, or the respondent answers the same questions directly on the computer. Next in the text is a questionnaire with scoring, similar to a computer program. Questionnaire from source Garkavi L.Kh., Kvakina EB, Kuzmenko T.S., Shikhlyarova A.I. Antistress reactions and activation therapy. Activation reaction as a way to health through self-organization processes. - Yekaterinburg, "Philanthropist", 2002, p.131-132.

Profile:

1. Anxiety:

-3: only vital situations can alarm me, I'm calm (calm)

-2: I am calm (calm), I can be alarmed, except for the vital ones, only significant troubles

-1: I am calm (calm), but minor troubles can also alarm me

0: perhaps I’m calm (calm), but not loyal (a) that this will happen all day

+1: I worry about nothing, at the same time about my health and my loved ones, about the future, etc.

+2: the slightest threat of a change in ordinary existence makes me anxious

+3: I am covered by causeless anxiety and anxiety

2. Irritability:

-3: even if they accuse me or insult me, I will not get irritation or even desire to get angry

-2: in case of accusations and insults, I will get a little annoyance

-1: only if loved ones conflict with me, they can briefly "get me crazy"

0: while everyone is friendly with me, nothing annoys me today

+1: I, perhaps, can flare up and even yell at someone if the opportunity presents itself

+2: just touch me - it will be worse for you: I will flare up and scream

+3: everyone around me, and strangers, and my own, annoy me very much, so I would have “beat” someone.

3. Fatigue:

-3: I can "carry water" on me, and I won’t get tired, and instantly recover

-2: I can work quite a lot without getting tired

-1: perhaps I'm not very tired today

0: I guess I'm tired of regular work today, but only a little

+1: after normal work I'm too tired today

2: I get very tired today, even with a little work

+3: at the slightest load, I immediately get very tired

4. Depression:

-3: I am not completely depressed (a), enjoy life, almost fly, I want to sing and laugh, high spirits

-2: no depression, good mood

-1: I'm more in a good mood than in a bad

0: I am not depressed (a), but there is no lightness and fun either

+1: a little depressed (a), I have a bad mood

+2: depressed (a), sad, heaviness in the soul

+3: I am completely depressed (a), depressed (a), in a nasty mood, the darkest and most difficult thoughts

5. Working time:

-3: I can work productively only in very short periods with long breaks.

-2: I can’t work continuously for a long time

-1: I am not very suitable for long continuous work

0: I can work for a long time, but with difficulty

+1: I can probably work for quite a while

+2: I can work for many hours without fatigue

+3: I can work at least from morning to night

6. Speed performance:

-3: I’m not able to work fast at all, performance is extremely low

-2: I work not intensively, not fast

-1: the pace (intensity) of the work is low

0: I can work, but not very fast (intensively)

+1: I can work, perhaps quickly enough (intensively)

+2: I can work very intensively (quickly)

+3: I can work with very high speed (intensity)

7. Appetite:

-3: even the thought of food is unpleasant

-2: no appetite, indifference to food

-1: eat something, although without pleasure

0: average appetite, favorite food to eat

+1: today there is an appetite, although not very big

+2: good appetite, I eat with great pleasure

+3: "brutal" appetite, enjoy eating

8. Sleep:

-3: sleep was almost absent, terrible night

-2: there was almost no good sleep, I slept a little all night

-1: the dream was unsatisfactory: either did not fall asleep (a) immediately, or woke up (slept) in the middle of the night, or did not sleep (slept), although he slept for a long time

0: sleep is not quite enough, but there is no big lack of sleep

+1: satisfactory sleep

+2: slept well and slept well

+3: a great dream, I immediately fall asleep, sleep deeply, wake up rested (s) and awake (oops)

9. Optimism:

(I mean today's emotional attitude, not a philosophical or political position)

-3: I am sharply pessimistic (on), sure (a) that everything will be bad

-2: I do not expect good from the future

-1: I'm more pessimistic (on) than optimistic (on)

0: neither optimism nor pessimism prevails in me

+1: I'm more optimistic than neutral

+2: I have enough optimism

+3: I directly express optimism and I am sure that everything will be fine

10. Activity:

-3: I absolutely want to do nothing, just to leave me alone

-2: I don’t want to get down to business, but I don’t mind having fun

-1: I can work, but completely without desire, only if necessary

0: no special desire, but I can work

+1: perhaps there is a desire to do something

+2: I want to work

+3: I have a thirst for activity

An advantage of the proposed method is that general non-specific reactions are mediated by a complex combined mechanism. A preliminary (preparatory) short-term massage from the first seconds acts on the receptors of the skin and internal organs, which send impulses to the central nervous system, causing a response antistress response to the effect. Subsequently, under the influence of a combination of massage techniques and vacuum exposure, physiologically active substances are produced in the body, such as histamine, neurotransmitters, etc., which in turn are “internal medicines” for the body. And later they became the "controlling" factor for the central nervous system. These factors are “internal” formed by the body itself, in contrast to the known ones, and as a result, the effect caused by the exposure is more natural and lasting.

The claimed method allows for physiotherapeutic therapeutic effect in the acute period of the disease, because based on controlling the body’s own responses before, after and during each session and correcting the effects based on these reactions. The impact is gentle, i.e. the intensity and duration of exposure decreases or increases by as much as the body is able to "perceive" this effect and "respond" to it. For the same reason, the claimed method can be used in the treatment of pregnant women, elderly and debilitated patients.

As a result of the physiotherapeutic effect, the claimed method involves numerous subsystems of lower levels (cells, intercellular fluid, muscles and ligaments, glands, internal organs), which are simultaneously converted into antistress reactions, when numerous synchronized systems push the central nervous system to maintain a beneficial antistress reaction. As a result of this, the effect of using the proposed method of physiotherapeutic effect occurs earlier and is significantly more resistant compared to various known massage methods.

The therapeutic or therapeutic effect of the proposed method allows the effect at any time of the day, and the time between sessions can vary significantly (for example, from 1 day to 2 weeks), without compromising the effectiveness of treatment, because general and local reactions of the body are controlled before the session, which allows you to adjust the intensity of the physiotherapeutic effect at any stage.

Example 1

Patient E., 38 years old. She contacted in March 2009 about osteochondrosis of the cervical, thoracic, lumbar spine with complaints of pain in the chest in the spine, aggravated by inhalation, acute pain in the lumbar region, a feeling of stiffness in the back. In the anamnesis: osteochondrosis of the thoracic, cervical, lumbar, vertebral artery syndrome, myocardial dystrophy of dysmetabolic origin, paroxysmal atrioventricular nodular tachycardia with a / c dissociation. Extrasystolic arrhythmia. Atrial pacemaker migration. Erosive esophagitis. The abnormal course of the right vertebral artery outside the spinal canal along the front surface of the transverse processes. Extravasal compression of the left vertebral artery at the entrance to the skull. On an x-ray from 07/01/2002 - left scoliosis L2-L5, a decrease in the height of the vertebral bodies L5-S1, the presence of osteophytes L4-L5. The diagnosis of degenerative changes L4-S1, scoliosis of the I degree.

At the stage of collecting information, a patient survey was conducted and complaints of daily severe headaches spreading from the region of the base of the skull to the temporal and parietal areas, shortness of breath, dizziness, and flickering of flies in front of the eyes were identified. Visual examination revealed hyperlordosis of the lumbar spine. Palpation revealed hypertonicity in the muscles of the neck and belt of the upper extremities, swelling of the left leg and increased sensitivity in the area of the ankle fracture (fracture of the left tibia in 2003). Constant daily intake of NSAIDs (non-steroidal anti-inflammatory drugs), such as diclofenac since 2002, beta-blockers (obzidan) since 1997, painkillers (ketanov, ketanal, nurofen) since 2002.

Based on all the collected data, as well as laboratory studies, using the “Periodic System of the State of the Body” by L. Garkavi (see Appendix), the type of adaptive reaction (stress, training, calm activation, etc.) of the patient’s body and the level of reactivity of the organism high, medium, low, very low).

The patient's condition is rated as “training for low reactivity levels”.

To improve the patient's condition, it was necessary to change the initial adaptive reaction and the level of reactivity of the body, by purposefully calling and maintaining antistress reactions throughout the body or in its individual areas.

The body’s transition to the necessary level of adaptive reaction (See L. Garkavi’s Periodic System of Body Conditions), by triggering an antistress reaction in the body and maintaining it for some time, improves overall well-being, improves tolerance to local intense influences and enables nonspecific immunity mechanisms that They stimulate the body to fight diseases independently.

Objectives of the course of physiotherapeutic effects: obtaining anti-inflammatory effect and the abolition of NSAIDs. Locally: normalize muscle tone, normalize blood circulation in the thoracic and cervical spine. Those. according to the Periodic system of body conditions, the goal of the course is to transfer the body to a state of “training medium or high levels of reactivity,” the challenge of general and local antistress reactions in order to transfer the body to the necessary adaptive reaction of the required level.

To obtain the reaction of the “training”, in the process of exposure, the intensity of subsequent physiotherapeutic procedures is adjusted (either intensifies, weakens, or does not change in intensity, but varies in duration, or is combined, etc.). For example, in accordance with the rules of activation therapy, in order to switch to a neighboring adaptation reaction of the same reactivity level (See “The periodic system of body conditions” in the Appendix), it is necessary to reduce the effect on the body by approximately 20% (L. Garkavi, “Activation therapy. Antistress activation and training reactions and their use for healing, prevention and treatment ”, Rostov-on-Don, Rostov University Press, 2006, p. 93).

Local pathological foci are characterized by the adaptive reaction of “stress” or “training” of low levels of reactivity. In the presence of all signs of acute aseptic inflammation, the pathological site is characterized by the adaptive stress response of high and medium levels of reactivity or “training” of medium levels. Chronic inflammatory processes are “stress” of medium and low levels of reactivity or “training” of very high levels of reactivity. At the same time, by the presence and degree of local responses of body parts to medium-intensity effects, the degree of influence on “problem” areas in the following procedure (similar to the general one) is determined by increasing or decreasing the force and time of exposure by 5-20%. (Garkawi, vol. 2 p. 52 in paragraph 8).

The transition of local pathologically altered tissues into antistress reactions (harmonization with the body) provides a faster restoration of the structure of tissues and their functions, prevents the transition of acute processes to chronic ones, prevents the development of local pathological processes if they are at the stage of pre-illness, and also prevents the appearance of new diseases.

As a therapeutic effect, vacuum therapy and manual massage were used.

Appointed: therapeutic physiotherapeutic procedures 1 time per week with a gradual increase in intensity, duration and area of exposure.

1st session - a classic massage of medium intensity lasting 35 minutes, on the back, neck, gluteal region, back surface of the legs, in order to transfer the body to an antistress reaction.

After the session, the patient's condition was monitored and the following body reactions were noted: pain in the neck decreased, the intensity of the headache decreased. There was a decrease in pain and localization of pain at the trigger points. Local reactions - persistent hyperemia, in the area of pain points there were isolated skin rashes according to the type of papules.

2nd session. A preliminary survey revealed the following: within a week after the 1st session, the intake of anti-inflammatory drugs decreased by 1/3. Overall health has improved. According to the periodic system of L. Garkavi, the patient’s adaptive response is assessed as “training medium reactivity levels”.

A local effect was performed - a classic massage on the back, neck, buttock, back surface of the legs for 15 minutes to improve blood circulation and cause a general antistress reaction.

Then, vacuum therapy with banks with a diameter of 40 mm locally on the thoracic spine 3 times for 4-5-6 minutes to grade III extravasates for 20 minutes.

In conclusion, a classic massage was performed with soft techniques for 5 minutes.

Monitoring the patient's condition after the session showed the following: the headache completely stopped, the flashing of flies in front of the eyes stopped. Pain in the spine decreased, a feeling of lightness and mobility in the back appeared. Locally - extravasates II-III degree, a decrease in swelling of the left leg.

3 session. The survey showed that within a week after the 2nd session, an increase in working capacity was observed. Locally - restoration of the physiological paint of the skin in places of processing by vacuum. Leg swelling decreased by 2/3, the appearance of discomfort in the leg was observed only with intense load at the end of the working day.

A classical massage was performed on the back, neck, buttock, back of the legs (as in the 1st session) and the front surface of the legs for 15 minutes. Then, vacuum therapy was applied with banks with a diameter of 40, 79, 80 mm on the chest, lumbar and hip joints (2 times on the back and three times on the lumbar and hip joints) until extravasates of 1-11 degrees appear. Duration of exposure is 25 minutes. In conclusion - a manual massage for 5 minutes on the whole body of the patient.

After the session, the following reactions were observed in the patient: normalization of the tone of the muscles of the shoulder girdle, improvement of overall health.

Consultation of a physician and cardiologist regarding drug therapy is recommended.

Further exposure (4-8 procedures) was carried out in a similar way, with a gradual increase in the duration of the session up to 60 minutes, an increase in the time of exposure to vacuum up to 30-35 minutes and an increase in the treated surface area of the body with constant monitoring of the local reactions of the body and the general condition of the patient.

During treatment, the following reactions of the body were observed: after the 4th session, the patient completely refused NSAIDs and painkillers. After the 6th session, the patient noted a decrease in arrhythmia, in consultation with a cardiologist, reduced the dose of beta-blocker with a gradual cancellation by the 8th procedure. The frequency of headache episodes decreased to 1 time in 20 days.

When monitoring the patient's condition after the 8th session, the following reactions of the body were recorded. Locally - the disappearance of extravasates, the absence of pain during palpation. On the left leg is the absence of pain, swelling. According to the periodic state system of the body of L. Garkavi, the patient’s condition was assessed as a state of “training high levels of reactivity”,

Thus, the task of the course of physiotherapy was completed,

The purpose of further physiotherapeutic effects is the prevention of relapse, improving overall well-being and performance, i.e. transfer of the patient’s body to the state of adaptive reaction, which is called the reaction of “calm activation”. The frequency of exposure is 1 time per week, the intensity of exposure is 60 minutes.

9-12 sessions. Preliminary manual massage - 5 minutes. Vacuum apparatus massage for 35-45 minutes at a pressure of 200-400 MPa. The duration and pressure parameters were selected within the specified limits by a random method. The area of influence is the scalp (25-50 MPa), back, hip joints, back surfaces of the legs. Vacuum can massage for 5-10 minutes with cans of 80, 90 mm in diameter on the front surface of the chest, shoulder joints and shoulders.

Monitoring the patient’s condition after the 12th session showed: the patient felt a surge of strength, increased efficiency, a feeling of lightness in the body appeared, mobility in the joints increased. An increase in resistance to extreme temperature influences (bath, cold water procedures) was noted. There was a need for additional physical activity (exercise therapy). Further, an increase in the duration and intensity of working capacity was noted. Normalized sleep and appetite.

13-16 sessions. The interval between visits was randomly selected and ranged from 1.5-2 weeks. Gradual decrease in vacuum load and variations of methods and techniques.

After the 16th session: local - adaptation of soft tissues, which was manifested by painlessness on palpation, when exposed to vacuum therapy and the absence of extravasates and skin rashes. General well-being at a high level, sleep, appetite - good. There are no complaints.

After 16 sessions, according to the "Periodic system of body conditions", the state of "calm activation of high levels of reactivity" was reached.

During treatment, the patient was monitored for antistress reactions according to the questionnaire.

At the first session, during the survey, the type of nonspecific adaptive reaction of the organism was established. The following answers were received to the questionnaire questions:

1. Anxiety:

+1: I worry about nothing, at the same time about my health and my loved ones, about the future, etc.

2. Irritability:

-1: only if loved ones conflict with me, they can briefly "get me crazy"

3. Fatigue:

2: I get very tired today, even with a little work

4. Depression:

+1: a little depressed (a), I have a bad mood

5. Working time:

+1: I can probably work for quite a while

6. Speed performance:

-2: I work not intensively, not fast

7. Appetite:

0: average appetite, favorite food to eat

8. Sleep:

0: sleep is not quite enough, but there is no big lack of sleep

9. Optimism:

0: neither optimism nor pessimism prevails in me

10. Activity:

-1: I can work, but completely without desire, only if necessary

Thus, at the 1st session, the patient's condition corresponded to “training low levels of reactivity”.

In the second session, the following responses were received:

1. Anxiety:

0: perhaps I’m calm (calm), but not loyal (a) that this will happen all day

2. Irritability:

-2: in case of accusations and insults, I will get a little annoyance

3. Fatigue:

0: I guess I'm tired of regular work today, but only a little

4. Depression:

0: I am not depressed (a), but there is no lightness and fun either

5. Working time:

+2: I can work for many hours without fatigue

6. Speed performance:

-1: the pace (intensity) of the work is low

7. Appetite:

+1: today there is an appetite, although not very big

8. Sleep:

+1: satisfactory sleep

9. Optimism:

+1: I'm more optimistic than neutral

10. Activity:

0: no special desire, but I can work

The results of the survey corresponded to the state of training of an average level of reactivity.

After the 8th session, the following responses were received:

1. Anxiety:

-1: I am calm (calm), but minor troubles can also alarm me

2. Irritability:

-3: even if they accuse me or insult me, I will not get irritation or even desire to get angry

3. Fatigue:

-1: perhaps I'm not very tired today

4. Depression:

-1: I'm more in a good mood than in a bad

5. Working time:

+3: I can work at least from morning to night

6. Speed performance:

0: I can work, but not very fast (intensively)

7. Appetite:

+1: today there is an appetite, although not very big

8. Sleep:

+2: slept well and slept well

9. Optimism:

+1: I'm more optimistic than neutral

10. Activity:

+1: perhaps there is a desire to do something

According to these answers, the patient's condition corresponds to the reaction of training high levels of reactivity.

After 16 sessions, the following answers were received:

1. Anxiety:

-2: I am calm (calm), I can be alarmed, except for the vital ones, only significant troubles

2. Irritability:

-3: even if they accuse me or insult me, I will not get irritation or even desire to get angry

3. Fatigue:

-2: I can work quite a lot without getting tired

4. Depression:

-2: no depression, good mood

5. Working time:

+3: I can work at least from morning to night

6. Speed performance:

+2: I can work very intensively (quickly)

7. Appetite:

+2: good appetite, I eat with great pleasure

8. Sleep:

+2: slept well and slept well

9. Optimism:

+2: I have enough optimism

10. Activity:

+2: I want to work

The answers to the questions correspond to the reaction of calm activation of high levels of reactivity.

An increase in the level of reactivity from 1 to 8 sessions with massage exposure was provided.

To switch to a state of calm activation, massage effects were changed in accordance with the change in antistress reactions.

Example 2

Patient K, 24, came in May 2008 with complaints of weakness, drowsiness, and heaviness in her head. The main diagnoses: pregnancy, the 35th week, gestosis of mild to moderate severity, obesity of the II degree. On examination, HELL 125/90 on the right hand, 130/90 on the left hand. General blood test from 04.29.08 (before the start of the course) Tr - 222, Hb - 114, white blood cells 12.1, e - 1, n - 7, s - 77, l - 7, m - 8, ESR - 40 mm / hours According to the computer program "Antistress" by L. Garkavi, a state of stress of very low levels of reactivity was ascertained. Palpation and short massage at the stage of collecting information were also revealed swelling of the legs and lower third of the abdominal wall. The lower limbs on palpation are cold, sensitivity is reduced.

The treatment was carried out for gestosis with the local obstetrician-gynecologist Hofitol, internal glucose infusions of 0.5 l every other day at 32-34 weeks of gestation. By the 35th week (at the time of treatment) the condition is unchanged.

After collecting information, depending on the patient’s condition, the following procedures were prescribed: vacuum therapy without preliminary and final massage using the non-apparatus method using cans on the area of the anterior and posterior tibial surface, lateral and dorsal thigh surfaces, on the lumbosacral and cervical-collar areas. Diameter of cans: different depending on the site of exposure. The duration of the cans from 30 seconds. The pressure in the banks is 150-250 MPa.

Course objectives: local - to improve microcirculation in the areas of influence, increase venous outflow. General - remove the body from the state of "stressful reactivity", if possible cause an adaptive reaction of "training".

At the 1st session, sequential staging of cans on the feet, lower leg, thigh, gluteal region was performed. The duration of exposure was 20-30 seconds and stopped when pain appeared. Each area was exposed 3-4 times. Extravasates were not observed due to swelling of the soft tissues. Within 5-7 minutes after the cessation of exposure, the following reactions of the body were observed: locally - a noticeable decrease in the degree of edema on the anterior abdominal wall and upper third of the thigh. The general condition improved, there was an increase in the sensitivity of tissues in the area of influence, as well as reflex hyperemia of the face, accompanied by a sensation of improved vision clarity and clarification of consciousness.

The 2nd session is scheduled for the next day. The survey showed that within a day after the procedure, a gradual increase in the volume of excreted fluid was noted. Signs of edema of the anterior abdominal wall completely disappeared, which made it possible to increase the duration of exposure by an average of 20% in proportion to tolerance. Effects on the cervical-collar and lumbar areas were added with tactics similar to the first session.

After the session, a survey was conducted according to the method of L. Garkavi. There was an improvement in well-being and an increase in the level of reactivity - from a very low level to a low.

Locally - the appearance of extravasates I degree in the lumbosacral region and the upper third of the thigh.

After the 2nd session, a blood test was done Tr - 193, HB - 122, white blood cells 10.2 e - 1, p - 1, s - 80, l - 13, m - 5, soe - 30 mm / h; Urinalysis according to Nechiporenko - 800 leukocytes, no red blood cells. MHO - 1.02, which corresponds (according to L. Garkavi's “Periodic System of the State of the Body”) to stress of a low level of reactivity.

Subsequent sessions are scheduled daily in the first week and every other day in the 2nd week.

The duration of exposure gradually increased within 15-20% of the level of the 2nd session and was chosen randomly. The overall well-being of the patient improved after each session.

After the described course of exposure, at 37 weeks, blood pressure 120/85, 125/90, the signs of edema of the anterior abdominal wall and thighs completely disappeared. Swelling of the legs partially decreased and began to be defined as pastiness. There was an increase in urine output, which was indirectly confirmed by weighing (weight gain in 2 weeks 200 grams). Drug treatment for this period was not prescribed. According to the survey, the condition at the end of the course corresponded to the reaction “training medium reactivity levels”. Pastility of the legs did not progress until the 38th week. The births were independent at the 39th week, without complications, a live full-term baby was born, height 51 cm, weight 3420, indicators on the Apgar scale - 7/8 points. During the 1st year of life, the psychophysical development of the child without deviations from the norm.

The primary diagnosis, which was carried out using the Antistress computer program, was based not on the results of a study of psychoemotional status, but on a general blood test: leukocyte formula + ESR.

After the 2nd session, a survey was conducted according to the method of L. Garkavi, to which the following answers were given:

1. Anxiety:

+2: the slightest threat of a change in ordinary existence makes me anxious

2. Irritability:

+2: just touch me - it will be worse for you: I will flare up and scream

3. Fatigue:

2: I get very tired today, even with a little work

4. Depression:

+2: depressed (a), sad, heaviness in the soul

5. Working time:

-2: I can’t work continuously for a long time

6. Speed performance:

0: I can work, but not very fast (intensively)

7. Appetite:

-2: no appetite, indifference to food

8. Sleep:

-2: there was almost no good sleep, I slept a little all night

9. Optimism:

-2: I do not expect good from the future

10. Activity:

-2: I don’t want to get down to business, but I don’t mind having fun

These responses are consistent with low reactivity stress.

A blood test that was performed the next day confirmed the result obtained by the survey method.

At the end of the course, the following survey results were obtained:

1. Anxiety:

0: perhaps I’m calm (calm), but not loyal (a) that this will happen all day

2. Irritability:

-2: in case of accusations and insults, I will get a little annoyance

3. Fatigue:

0: I guess I'm tired of regular work today, but only a little

4. Depression:

0: I am not depressed (a), but there is no lightness and fun either

5. Working time:

+1: I can probably work for quite a while

6. Speed performance:

-1: the pace (intensity) of the work is low

7. Appetite:

+1: today there is an appetite, although not very big

8. Sleep:

+1: satisfactory sleep

9. Optimism:

+1: I'm more optimistic than neutral

10. Activity:

0: no special desire, but I can work

The results of the survey corresponded to the state of training of an average level of reactivity.

Example 3

Patient F. turned in the autumn of 2007 at the age of 63 with complaints of persistent (within 6 months) severe pain in the right shoulder joint, aggravated by movement, limited mobility in the right shoulder joint, increased fatigue, poor sleep, irritability.

During examination revealed: significant asymmetry of the muscles of the shoulder girdle, with hypertrophy on the right. By palpation it was established: increased density of soft tissues, seals in the form of cords and lumps in the right subscapular region, in the region of the right shoulder joint. Soreness and hypertonicity of muscles in the region of the right shoulder. Passive shoulder movements on the right are significantly reduced: arm abduction was carried out by 30%, the volume of rotational movements was reduced 4 times from the norm. No signs of acute inflammatory process were found.

A history of TUR of the bladder in 2001 for a tumor of the prostate gland. Type II diabetes mellitus since 2005

In accordance with the general blood test and the results of examination and palpation on the basis of the “Periodic system of body conditions” by L. Garkavi, the patient’s condition was assessed as “reactivation of low levels of reactivity”.

The objective of the course of physiotherapeutic effects: reduction of pain, normalization of muscle tone and tissue reduction in the region of the right shoulder, which corresponds to the adaptive reaction of "increased activation".

Appointment: courses of medical procedures 1 time in half a year for 7-9 sessions.

1 course. 7 sessions in 2 days lasting 20-30 minutes. Preparatory manual massage for 5-7 minutes. Then, non-apparatus vacuum therapy was used on the back with an emphasis on the shoulder joints - banks with a diameter of 40-90 mm for 10-15 minutes. When using vacuum therapy, a horizontal-vertical pressure differential is created on the surface of soft tissues, which allows working out the deep layers of muscles, ligaments up to the periosteum, and also creating more intensive microcirculation of blood, lymph, interstitial fluid and enhancing metabolic and regulatory processes. The activation of processes in the tissues exposed. The final massage.

After the 1st course, the state is defined as the state of "increased activation of the average level of reactivity", which is characterized by the absence of pain, an increase in the amplitude of movements in the joints up to 50% of the norm. The muscles of the right and left shoulder became more symmetrical. The density of soft tissues in the region of the right shoulder decreased.

2 course was held in the spring of 2008. Pain in the region of the right shoulder arising from a moderate load. Movement in the right shoulder joint in the amount of 50% of the norm. The general condition is satisfactory, allowing you to work for 8-10 hours a day. Low activation state. Appointed 8 sessions in 2-3 days lasting from 30-40 minutes. A preparatory massage was carried out for 5-7 minutes. Non-apparatus vacuum therapy on the back with an emphasis on the shoulder joints (banks with a diameter of 40-90 mm) 20-35 minutes. Final massage 5-7 minutes. After the course, overall health improved: sleep became deep and effective. Efficiency increased. The volume of active movements in the right shoulder joint increased by 15-20% from the beginning of the 2nd course. Pain with a moderate intensity load stopped. A state of increased activation of an average level of reactivity.

3 course was held in October 2008. General condition is good. Reactivation reaction of medium reactivity. Pain in the right shoulder does not bother. On examination: unsharp hypertrophy of the shoulder muscles on the right. Palpation: the density of hypertrophic areas is average, dull pain in the right shoulder joint in extreme positions. The range of motion in the joint is 60-65% of the norm. 9 sessions were appointed in 3 days lasting from 45 to 60 minutes. Preparatory massage for 10 minutes. Vacuum therapy (in a combined hardware and non-hardware way) on the back, neck, arms and hips (with a gradual increase in the area of the treated surface to 100% of the body by the 4th session, except for the scalp and lower third of the abdomen) 25-40 minutes. Final massage 10 minutes.

After the 3rd course, a reaction of increased activation of an average level of reactivity was detected, taking into account the general blood test from 11.21 08. An increase in the volume of active movements in the right shoulder joint to 70-75%. Lack of pain in extreme situations.

The 4th course was held in the spring of 2009. Age 65 years. She is in stable good condition, sleep, normal appetite, high working capacity (10 hours working day, mental work; work in the country). The reaction of increased activation of medium levels of reactivity. Course objective: general prevention.

Appointed 7 sessions in 2-3 days lasting 30-40 minutes. First, a preparatory massage was carried out for 5-7 minutes. Vacuum therapy (in a combined apparatus and non-apparatus way) on the back, neck, chest surface, hip joints, face, scalp for 20-25 minutes. Final massage 5-7 minutes.

After the course, an increase in mood was noted, as well as an increase in the tolerance of longer intense physical exertion, including loads on the right shoulder joint.

Patient antistress responses were also monitored based on the questionnaire.

Before the 1st course of procedures - determination of a nonspecific adaptive reaction according to a general blood test: basophils - 0.5%, eosinophils - 0.5%, monocytes - 5%, lymphocytes - 41%, stab - 0%, segmented - 53%, total leukocytes - 4.7 · 10 ⁹ / l, which is defined as the state of reactivation of low levels of reactivity.

After the 1st course of procedures - a state of increased activation of an average level of reactivity, which was determined by the questionnaire L. Garkavi:

1. Anxiety:

-2: I am calm (calm), I can be alarmed, except for the vital ones, only significant troubles

2. Irritability:

-1: only if loved ones conflict with me, they can briefly "get me crazy"

3. Fatigue:

-2: I can work quite a lot without getting tired

4. Depression:

-2: no depression, good mood

5. Working time:

+1: I can probably work for quite a while

6. Speed performance:

+3: I can work with very high speed (intensity)

7. Appetite:

+3: "brutal" appetite, enjoy eating

8. Sleep:

+2: slept well and slept well

9. Optimism:

+3: I directly express optimism and I am sure that everything will be fine

10. Activity:

+2: I want to work

At the beginning of the second course, a nonspecific adaptive reaction was determined by a general blood test: basophils - 0%, eosinophils - 0.5%, monocytes - 6%, lymphocytes - 40.5%, stab - 0%, segmented - 53%, total leukocytes - 5.2 · 10 ⁹ / l.

At the end of the second course - a state of increased activation of the average level of reactivity according to the questionnaire L. Garkavi:

1. Anxiety:

-2: I am calm (calm), I can be alarmed, except for the vital ones, only significant troubles

2. Irritability:

-1: only if loved ones conflict with me, they can briefly "get me crazy"

3. Fatigue:

-2: I can work quite a lot without getting tired

4. Depression:

-2: no depression, good mood

5. Working time:

+1: I can probably work for quite a while

6. Speed performance:

+3: I can work with very high speed (intensity)

7. Appetite:

+3: "brutal" appetite, enjoy eating

8. Sleep:

+3: a great dream, I immediately fall asleep, sleep deeply, wake up rested (s) and awake (oops)

9. Optimism:

+3: I directly express optimism and I am sure that everything will be fine

10. Activity:

+2: I want to work

Before the beginning of the third course of procedures - the definition of the adaptive reaction according to the questionnaire:

1. Anxiety;

0: perhaps I’m calm (calm), but not loyal (a) that this will happen all day

2. Irritability:

0: while everyone is friendly with me, nothing annoys me today

3. Fatigue:

-2: I can work quite a lot without getting tired

4. Depression:

-2: no depression, good mood

5. Working time:

-1: I am not very suitable for long continuous work

6. Speed performance:

+2: I can work very intensively (quickly)

7. Appetite:

+3: "brutal" appetite, enjoy eating

8. Sleep:

+1: satisfactory sleep

9. Optimism:

+2: I have enough optimism

10. Activity:

+2: I want to work

After the 3rd course, the determination of a nonspecific adaptive reaction by a general blood test: basophils - 0%, eosinophils - 1%, monocytes - 6%, lymphocytes - 36%, stab - 1%, segmented - 56%, total leukocytes - 5, 4 · 10 ⁹ / l, which according to a computer program is defined as a reaction of increased activation of an average level of reactivity.

Claims (5)

1. The method of physiotherapeutic effects on the human body, including: at the first stage, collecting information about the patient’s condition and identifying areas with a pathologically altered structure, at the second stage, the condition of the skin, muscle-ligamentous apparatus, and osteo-articular system are determined by examination and palpation with palpation, a manual massage is carried out lasting 5-15 minutes in order to determine the reactivity of the body to the general effect and to monitor the state of soft tissues and their reactions to the effect on the rd step the local mechanical physiotherapeutic impact on problem areas until adaptation state of tissue at each problem area, controlling the local reaction of the organism, in the fourth step is carried general physiotherapeutic impact on all of the patient's body, manual massage while controlling the state of the patient's response antistress reactions of the organism. 2. The method according to claim 1, characterized in that the collection of information about the condition of the patient and the identification of areas having a pathologically altered structure is carried out by means of a survey, examination and palpation. 3. The method according to claim 1, characterized in that at the first stage the patient's psychoemotional status is determined by the following parameters: anxiety, irritability, fatigue, depression, working capacity, sleep, appetite. 4. The method according to claim 1, characterized in that the condition of the skin, muscular-ligamentous apparatus, and osteo-articular system is determined by the presence of signs of an acute or chronic inflammatory process in individual parts of the body - temperature changes, pain, swelling, hyperemia. 5. The method according to claim 1, characterized in that the state of tissue adaptation in the problem area is set based on changes in soft tissues in response to exposure.