1. Impulsive currents, application in physiotherapy Prof. Mysula I.R.

2. Types of impulsive current The Leduc’s Current - is one of the impulses of rectangular form  Frequency of impulses is 1-130 Hz, duration of every impulse is 0,2-2 ms  Activation the depression processes in a brain cortex cause the state similar to physiological sleep - electro-sleep

3. Types of impulsive current Tetanic current is one of the impulses of triangular form (with a sharp top)  Frequency of impulses is 100 Hz, duration of every impulse is 1-1,5 ms  Causes the muscles contraction. It is applied for muscle exercises in the case of muscle strength decrease.

4. Types of impulsive current The Lapec’s Current is one of the impulses of exponential form  Frequency of impulses is 8 -100 Hz, duration of every impulse is 2 - 60 ms  It is applied for the electro-gymnastics of muscles, frequency and duration of impulses used depends on the degree of muscles damage.

5. Effects in tissues depending on current’s frequency  1-10 Hz - stimulation of sympatic nerves  21-100 Hz - stimulation of parasympatic nerves  30 Hz - stimulation of the smooth muscles  80-150 Hz - stimulation of the strips muscles, decrease of pain  100 Hz - blocks conducting of impulses in sympatic nerves

6. Advantages of impulsive currents application  slow development of tissues adaptation to action of physical factor  specific action, that differs one factor from another  intensive therapeutic action with the minimum loading on an organism

7. Basic effects in tissues  Electro-stimulatory  Anaesthetic  Improvement of electric current conductivity in tissues  Trophic  Plastic  Increase the functional activity of CNS  Secretory

8. Electro-stimulatory effect  Nerve-muscle synaps is cholinergic  The production of acetylcholine is activated at current frequency 21-100 Hz with an optimum 50 Hz  Contraction of myofibrils in this diapason of current frequency

9. Anaesthetic Anaesthetic Theory of pain gate Melzack, Wall SG T + M Thin myelinic fibres Thick myelinic fibres + -

10. Improvement of electric current conductivity in tissues H 2 O  H + +OH - -+ KCl  K + +Cl - NaCl  Na + +Cl - MgSO 4  Mg ++ +SO 4 -- CaCO 3  Ca ++ +CO 3 -2 H 2 O  H + +OH - CathodeAnode CathodeAnode K+K+ K+K+ Na + K + Na + Ca ++ Mg ++ K + +OH -  KOH Na + +OH -  NaOH H + +Cl -  HCl H + +SO 4 -2  H 2 SO 4 H + +CO 3 -2  H 2 CO 3

11. Improvement of electric current conductivity in tissues Time of polarization depending on the level of structure organization:  for electronic polarization - 10 -16 - 10 -14 s  for ionic polarization - 10 -14 - 10 -12 s  for dipol polarization - 10 -13 - 10 -7 s  for macrostructural polarization - 10 -8 - 10 -3 s  for superficial polarization - 10 -3 – 1s

12. Trophic  Increase of blood stream in tissues  Metabolism activation  Improvement of trophic

13. Plastic Activation of albumin synthesis used for synthetic processes

14. Increase CNS functional activity  Receptors of muscles and skin are activating  Impulses from them by ascending ways are transmitted to the CNS

15. Secretory  Direct stimulation of endocrine glands  Stimulation through CNS

16. Indications for using of impulsive currents Antiinflamable and anaesthetic action  Paresises, paralyses.  Pain syndromes of different genesis  І-ІІ stage of arterial hypertension  Diseases of the urogenital system.  Diseases of digestion organs  Diseases of the respiratory system.  Arthrosis, rheumatic diseases of joints, periarthritic.  Vein stagnation.  Functional impotence.

17. Contra-indication for using of impulsive currents 1. General 2. Acute inflammatory processes 3. A few days after fractures of bones, haematomas 4. Сholelithiasis, nephrolithiasis (with the exception the localisation of concrements in the distal part) 5. Eye diseases 6. Unbearable of current

18. Basic methods of impulsive currents treatment 1. Electrodiagnostic, electro- stimulation of muscles. 2. Electro-sleep. 3. Diadynamotherapy. 4. Amplipulstherapy. 5. Interferenstherapy. 6. Fluctuorization.

19. Electrodiagnostics This method can define the functional state of muscles and nerves after the reaction on the dosed influence of electric current

20. Electrodiagnostics  Task - to detect the nerve regeneration (presence of complete or partial nerve damage).  At the partial of nerve damage muscle stimulation will be conducted through a nerve, at complete damage - directly through a muscle.

21. Electrodiagnostics Apparate for electrodiagnostics Button electrode

22. Electrodiagnostics Placing of motive points ( from Erba tables )

23. Electrostimulation  Applications of impulsive electric current in order to stimulate organs or systems activity.  It is administered only after 4 weeks from disease beginning (in absence of inflammation)

24. Electrostimulation of facial muscles

25. Film “Electrostimulation”

26. Electrostimulation Indications  paresises, paralyses  muscular atrophy (after immobilization)  atony of intestine, uterus, urinary bladder

27. Electrostimulation Contra-indication  General  spastic conditions of skeletal muscules and internal organs  hysteria

28. Electrosleep Neurotropic unpharmacological influence on CNS by the direct impulsive current of low frequency and small force  The form of impulses is rectangular  Frequency is 10-150 Hz  Duration of impulse is 0,2-2 mc  Strength of current is up to 10 mA

29. Electrosleep Electrode fixation for electrosleep a - middle cuff b – eye electrode c – electrode on mastoideus

30. Electrosleep It is possible to apply at the degenerative and functional brain changes  At degenerative 5-20 Hz  At functional changes current frequency is 60-120 Hz

31. Electrosleep Indications  neuroses, neuralgias, encephalitis, consequences of cranial-cerebral trauma, especially with sleeping disorders  І-ІІ stage of arterial hypertension  ischemic heart disease  hypothyreosis  diabetus mellitus  phantomic pain  tumor afer radical operations

32. Electrosleep Contra-indication  general  unbearabless of rectangular current  hysteria  damages of skin in the place of electrodes imposition  presence of metallic objects in a brain  eye diseases

33. Diadynamotherapy Method of electrotherapy at which direct impulsive currents with frequency 50 Hz, 100 Hz (or its combinations) influence on the human body.

34. Diadynamotherapy  50 Hz - stimulatory action.  100 Hz - anaesthetic actions, increase of tisues conductivity.

35. Diadynamotherapy

36. Film “Diadynamotherapy”

37. Diadynamotherapy Indications  inflammatory processes in muscles, joints, ligaments, nerves  atony of intestine  decrease of muscles strenth  vascular diseases (the Reyno syndrome, migraine, and others like that)  pain syndromes (with the exception of that included in contra-indications)

38. Diadynamotherapy Contra-indication  general  specific for galvanization  individual unbearablessnes of current  presence of purulent infection  fractures of bones  dislocations  hemorrhage  tromboflebitis  urolithiasis and cholelithiasis

39. Amplipulstherapy Using of sinusoidal alternative modulated current with small force in the impulsive mode for the medical purpose  Frequency - 5000 Hz  It is modulated by the current of low frequency in range from 10 to 150 Hz

40. Amplipulstherapy Advantages  good bearablesness by patients  absence of skin irritation in the influenced zone  deep penetration in tissues

41. Amplipulstherapy Unstraightened current modesStraightened current modes

42. Amplipulstherapy An stimulatory effect can be increase:  by decrease of modulation frequency to 10 Hz  by increase of pauses duration to 6 s  by increase of modulation depth to 100 %  by application of the straightened current

43. Film “Amplipulstherapy”

44. Fluctuorization Method of electrotherapy with using of sinusoid alternating current of small force and small tension, which is helter-skelter changing after amplitude and frequency within the limits of 100-2000 Hz

45. Fluctuorization

46. Indication  parodonthosis, alveolitis  inflammatory diseases of cranial nerves  diseases of muscle-bone apparatus

47. Fluctuorization Contra- indication: the same as for diadynamotherapy

48. Interferenstherapy Using with the medical purpose of interference currents, forming appear in tissues after imposition of two alternating currents with the same amplitude, but with different frequencies

49. Interferenstherapy