The method of electrotherapy

 

(57) Abstract:

The invention relates to medicine and is intended to perform electrotherapy. Procedures combine electrical stimulation of muscles with muscle relaxation and analgesia joints and painful areas of the cyclical movements of the patient and periodically register biomechanical parameters, depending on which corrects for movement of the patient during procedures. In modes muscle stimulation and analgesia joints choose the repetition rate of the electrical pulses 65 Hz ± 10%. In modes muscle relaxation and analgesia pain zones 130 Hz ± 10%. In the mode of stimulation of the muscles increases the strength of the electric current in the range from 10 to 100 mA, achieving a reduction of the relevant muscles. In modes muscle relaxation and analgesia joints and pressure zones select the magnitude of the electric current in the first sensations of the patient. During stimulation and muscle relaxation choose the size of the electrodes is equal to the diameter of the muscles and put them perpendicular to the direction of muscle fibers, when analgesia joints electrodes impose perpendicular to the axis of the joint, and when analgesia pain areas on the boundaries of the zone of pain. The method allows to increase the effectiveness of electrotherapy. 1 GII, traumatology, orthopedics and rehabilitation after injuries and lesions of the musculoskeletal system of different origin, as well as in sports training and aesthetic medicine.

There is a method of electrotherapy, which provide functional electrical stimulation of muscles of upper and lower extremities by submitting to the electrodes attached to the body of the patient, the electrical pulses, the parameters of which are set via a processor (US 5978712A, 1999).

When this occurs, the electrical stimulation of the muscles responsible for movement of the limbs alone. To achieve sufficient therapeutic effect choose the appropriate parameters of the stimulating pulses. However, the effectiveness of such stimulation is low.

Known methods of electrotherapy closest to the present invention is a method of electrotherapy, which provide multi-channel electrical stimulation of the muscle during cyclic movements of the patient by feeding the blend to the muscles of the electrodes of electrical impulses in the natural phases of excitation and contraction of muscles, the parameters of which are set in accordance with the phases of movement of the patient through necklac when walking the patient through submission to the pair of electrodes an electrical pulse current frequency 30-80 Hz when the voltage amplitude increase from 30 to 60 C. This allows you to provide artificial correction of movements in pathological walking through electric impulses to specific groups of muscles through eight stimulation.

However, this method is not sufficiently universal and also not effective enough. The scope of nosology, be treated in this way is limited.

The problem solved by the present invention is to provide a method of electrotherapy, devoid of the disadvantages of the prototype. Technical result provided by the invention, is to expand the functionality of a method of electrotherapy with simultaneous increase of its efficiency.

This is achieved by a method of electrotherapy, which carry out multichannel functional electrical stimulation of muscles during cyclic movements of the patient by feeding the blend to the muscles of the electrodes of electrical impulses in the natural phases of excitation and contraction of muscles, the parameters of which are set in accordance with the phases of movement of the patient through the overlay in the area of the respective joints of the angle sensors, when combined stimulation of muscles with muscle relaxation and analgesia meters, depending on which corrects for movement of the patient during the procedures, modes, muscle stimulation and analgesia joints select the pulse frequency 65 Hz ± 10%, and in modes muscle relaxation and analgesia pain zones 130 Hz ± 10%, in the mode of stimulation of the muscles increases the strength of the electric current in the range from 10 to 100 mA, achieving a reduction of the muscles, and in modes muscle relaxation and analgesia joints and pressure zones select the magnitude of the electric current by the first sensations of the patient. During stimulation and muscle relaxation choose the size of the electrodes is mainly equal to the diameter of the muscles and impose their predominantly perpendicular to the direction of muscle fibers, when analgesia joints electrodes impose predominantly perpendicular to the axis of the joint, and when analgesia pain areas on the boundaries of the zone of pain.

The above technical result is the whole set of essential features.

In the proposed method uses a combination of (full or partial) electrical muscle stimulation, muscle relaxation, analgesia joints, predominantly large, and painful areas of the cyclical movements of the patient, for example, is, biomechanical parameters, depending on which correction of the patient's movements. For this purpose on the body of the patient, record the set of electrodes, mainly 16 pairs, according to individual medical program, as well as the angle sensors, which are placed in areas of the respective joints, e.g. knee. The size of the electrodes, which in the natural phases of excitation and contraction of the muscles served stimulating and relaxing the electric current must correspond to the diameter of the stimulated muscles or muscles that are in the contracture. Such electrodes, it is expedient to impose perpendicular to the direction of muscle fibers. When analgesia pain zones electrodes placed on the boundaries of these areas, and if analgesia joints is perpendicular to the axis of the respective joint. This choice of the topology of the electrodes provides the greatest effectiveness. Optimal procedures conducive to achieving the above technical result is selected experimentally. In modes muscle stimulation and analgesia joints repetition frequency of electric pulses must be 65 Hz, and in the modes muscle relaxation and analgesia pain zones 130 Hz (with an allowable variation of ± 10% is of the appropriate muscles. In the case of muscle relaxation and analgesia joints and painful areas of the electric current must have a threshold value that is selected by the first sensations of his exposure to the patient. The procedure of the selection of the parameters of the pulses occurs with the active participation of the patient. The duration of the electrical pulses may be, for example, about 300 μs, and the maximum voltage is from 10 to 80 C. the Duration of the first treatment set, for example, 10 min, second to 20 minutes and then 30 minutes Total duration of the course is usually 15-20 procedures and is determined by the results of the analysis of the biomechanical parameters. This periodic check of these parameters during procedures, allows you to adjust the movement of the patient. Check biomechanical parameters may be, for example, before starting treatment and then every five procedures that allows the dynamics to observe the change of indicators of movements of the patient, to adjust their procedures and to judge the effectiveness of treatment. If, for example, walk used photographically and genigraphics methods and register such biomechanical parameters such as walking speed, step length, degree of lameness, the temporary page is realizatsii way under certain nosologies

1. When the consequences of acute insufficiency of cerebral circulation:

In the case of paresis of the muscles of the lower limb to stimulate the muscles, straightening the spine, straight abdominal muscles on the affected side is large and middle gluteal leading, quadriceps, and leg muscles. Relaksirutee in the presence of spasticity in the flexor muscles of the group - the flexors of the lower leg, the calf, the plantar muscles of the feet. When flaccid paralysis of these muscles are stimulated.

In the case of paresis of the muscles of the upper limb stimulates the trapezius muscle, the largest muscle of the back, big breast muscle, deltoid, triceps, extensor brush.

Relaksirutee in the presence of spasticity biceps muscle, the flexor brush. When flaccid paralysis of these muscles are stimulated.

2. When the lesions and injuries of large joints:

In the case of bilateral coxarthrosis (may be in combination with gonarthrosis) are two sides of the large and middle gluteal, quadriceps muscle, the flexor tibia, calf, Shin muscles. Relaksirutee leading muscle. Analiziruyutsya hip and knee joints.

In the case of unilateral coxarthrosis (can be combined with the rut is e muscles, the flexors of the lower leg, calf, Shin muscles. Relaksirutee leading muscle. Analiziruyutsya hip and knee joints.

In the case of shoulder blade periarteritis, injuries of the shoulder joint and upper limb stimulated trapezius, rhomboid muscles, the broadest muscle of the back, big breast muscle, deltoid, biceps, extensor brush, triceps, flexor brush. Analiziruetsya shoulder.

- In case of injuries of the ankle joint stimulates the calf, ankle, plantar muscles, the extensors of the toes. Analiziruetsya ankle.

- In case of injuries of the knee joint are stimulated large and middle gluteal, quadriceps, calf, Shin muscles. Analiziruetsya the knee.

- In case of injuries of the hip joint to stimulate the muscles, straightening the spine, straight abdominal muscles, big and middle gluteal, quadriceps muscle, the flexor tibia, causing the muscles. Analiziruetsya hip.

In the case of hip arthroplasty stimulated on both feet large and middle gluteal, look no further than the process of other joints (hip, knee) they analiziruyutsya.

3. With osteochondrosis:

In the case of osteochondrosis of the cervical-thoracic are two sides of the trapezius, rhomboid muscles, the latissimus, the pectoralis major, deltoid, biceps, triceps, flexor and extensor of the hand. Analiziruyutsya the zone of pain.

If nizhnespasskoe osteochondrosis, accompanied by a herniated disc and paresis of the extensor of the foot to stimulate the muscles, straightening the spine, straight abdominal muscles, big and middle gluteal, quadriceps muscle, the flexor tibiae, leading, calf, Shin muscles. Analiziruyutsya the zone of pain.

In the case of osteochondrosis operated on for disc herniation (hernia recurrence), to stimulate the muscles, straightening the spine, straight muscle of the abdomen, on both legs - large and middle gluteal, quadriceps muscle, the flexor tibiae, leading, calf, Shin muscles. Analiziruyutsya the zone of pain.

4. When kyphoscoliosis are two sides of the trapezius, rhomboid muscles, the latissimus, straight muscle of the abdomen.

Clinical examples:

1. Patient W., 39 years. Diagnosis - dorsopathy. The condition on the LASS="ptx2">

Within five years suffered negapatnam osteochondrosis. Repeatedly passed a course of conservative treatment. On MRI herniated disc 5 mm. In 1999 removed the herniated disc about nekupiruemy lumboischialgia right with paresis of the foot. After surgery he developed osteomyelitis. In 2001. repeated removal of herniated disc and install stabilizing systems about lumboischialgia left. After the operation the regression of pain, but remained paresis of both feet.

Objectively the presence of hypotension and malnutrition lumbar and gluteal muscles. Muscle strength - 3-4 points on both sides. Right violated roll of the foot, placing the foot on the outside edge. Mild spasticity in the right calf muscle.

Conducted 15 treatments (treatments). Walking stimulated rectus muscles of the abdomen, muscles, straightening the spine, right and left medium, and large gluteal muscles, right and left flexor tibiae, right and left quadriceps muscle, left calf, right and left crural muscles. Was relaxible right calf muscle. Was analgesically lumbosacral region. The distance between the electrodes and their size was selected based on the amount of muscle, and if analgesia is of the size of the painful area. The incentive is the frequency of 130 Hz. Temporary program was given with the help of knee sensors.

In the course of treatment strength has increased on average by two points. Walking speed increased by 0.4 km/h, stride length increased by 5 see Normalized roll both feet - factor structure of the roll has increased from 0.56 to 0.83 right and 0.7 on the left, which corresponds to the norm. Normalized tone right calf muscle. Decreased pain in the lumbar-sacral area. Thus was eliminated paresis stop that conservative was not resolved during the long conservative and subsequent surgical treatment.

2. Patient L., 51. Diagnosis - CVB. The consequences of myocardial infarction in 2001. Sensorimotor aphasia. The right-hand rough hemiparesis. Psychoorganic syndrome. The invalid of the first group.

Complaints about violations speech, weakness in the left extremities. CT brain - consequences of ischemic stroke in the basin of the left middle cerebral artery.

Objectively - wobbly gait, expressed torso to the left. Spasticity of the right calf and right plantar muscles. Range of motion in the right knee joint - 60, left 70. The strength of the muscles in his right leg - 3 points.

Conducted 15 healing from the middle gluteal muscle, right flexor tibiae, right quadriceps muscle, right Shin muscles. Edited the right gastrocnemius muscle, plantar muscles of the right foot. The distance between the electrodes and their size was chosen depending on the volume of the muscles. Stimulation was performed unipolar electric pulses at a frequency of 65-70 Hz, relaxation is at a frequency of 130 Hz. Temporary program was given with the help of knee sensors.

In resultate treatment muscle strength increased by an average of 1.5 points. Walking speed increased by 0.8 km/h, stride length increased by 12 see the Coefficient of rhythm walk increased from 0.66 to 0.75. Improved the structure of the re-rolling of the foot. Knee angle increased by 14. Significantly improved the patient's mood.

The proposed method treated a significant number of patients. Including 102 patients with degenerative disc disease, disc herniation (32 of them after surgical treatment), 138 patients with consequences of acute disorders of cerebral circulation, 20 patients with consequences of hip joints, 140 patients with coxarthrosis, etc. In all cases with a pronounced positive effect.

The proposed method is highly effective in the treatment of posledstvie, the kyphoscoliosis, osteochondrosis, accompanied by radiculopathy, lumbosacral, disc herniation, after operation in occasion of a hernia of a disk, the consequences of sprains, damaged ligaments, fractures and other injuries, as well as in sports training and aesthetic medicine. Its functionality beyond the capabilities of known similar ways, allowing for the combination of electrical stimulation of weakened and damaged muscles, elimination of contractures and spasticity, analgesia large joints and painful areas, with the possibility of correction movements of the patient during procedures, to develop in a variety of nosology close to normal motor stereotype.

The method allows to quickly and reliably restore walking, to improve the function of the spine, muscles of the trunk and arms.

1. The method of electrotherapy, which carry out multichannel functional electrical stimulation of muscles during cyclic movements of the patient by feeding the blend to the muscles of the electrodes of electrical impulses in the natural phases of excitation and contraction of muscles, the parameters of which are set in accordance with the phases of movement of the patient through the overlay in the area of soteriological muscles and analgesia joints and painful areas of the cyclical movements of the patient and periodically register biomechanical parameters, depending on which corrects for movement of the patient during the procedures, modes, muscle stimulation and analgesia joints choose the repetition rate of the electrical pulses 65 Hz ± 10%, and in modes muscle relaxation and analgesia pain zones - 130 Hz ± 10%, in the mode of stimulation of the muscles increases the strength of the electric current in the range from 10 to 100 mA, achieving a reduction of the muscles, and in modes muscle relaxation and analgesia joints and pressure zones select the magnitude of the electric current in the first sensations of the patient.

2. The method of electrotherapy on p. 1, characterized in that the stimulation and relaxation of the muscles choose the size of the electrodes is equal to the diameter of the muscles and put them perpendicular to the direction of muscle fibers, when analgesia joints electrodes impose perpendicular to the axis of the joint, and when analgesia pain areas on the boundaries of the zone of pain.

 

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SUBSTANCE: one should isolate and dissect the tendons of anterior tibial and long fibular muscles to dissect the tendon of posterior tibial muscle against the site of fixation and direct it towards plantar rear area in front of internal ankle through the tunnel in subcutaneous fiber, then one should subcutaneously direct dissected tendons of anterior tibial and long fibular muscles onto plantar rear area to suture them so to leave free the tendinous end of posterior tibial muscle which should be intraosseously fixed to median wedge bone that keeps the process of foot repulsion during walking.

EFFECT: higher efficiency of therapy.

5 dwg, 1 ex

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