Method for training vertical posture in patients having injured statodynamic functions

FIELD: medicine.

SUBSTANCE: method involves setting a patient in vertical posture with stabilogram and rheoencephalogram being concurrently recorded with frontomastoid and accipitomastoid leads being used retaining head position with stressed neck extensor muscles state and head position with relaxed neck extensor muscles state. Stabilogram parameters characterizing vertical posture stability and rheographic index of each of four brain basins. When combining better filling of cerebral basins with blood and higher standing stability, training is carried out in keeping head positions allowing better filling of cerebral basins. If better filling of cerebral basins with blood follows with no increased standing stability, the trainings are carried out in keeping head position with stressed neck extensor muscles state. The training sessions are given twice a day for 15 min during two weeks.

EFFECT: enhanced effectiveness of treatment.

2 cl, 3 tbl

 

The invention relates to medicine, namely to functional diagnostics, may be used to form a vertical posture in static-and-dynamic pathology.

In regulation poses important elements of the cervical-vestibular interaction, which provides the necessary installation of the body and head. To explore this interaction used stabilometry [Gurfinkel V.S. changing the direction vestibulomotor reactions in the process of habituation to prolonged static rotation of the head in humans / Ussuriiskii, Keepopen, Bensemann, Vushakov // Neurophysiology. - 1989. - T, No. 2. - S-217].

It is known that changing the position of the head accompanied by a change in the blood supply in the basins of the brain [Khabibullina A.B. Manual therapy of the vertebral-basilar disease / Manual therapy, 2001. No. 2. - P.4-17]. It is also known that the brain is very sensitive to ischemia. Therefore, the deterioration of crownpoint in the basins of the brain can affect vestibulomotor reaction and resistance [Khabibullina A.B., bachtadse M.A., Sidorskaya NV Dizziness as a symptom vertebrobasilar failure / Manual therapy, 2001. No. 2. - P.28-35]. Method stabilometry does not take into account the change in the blood supply to the brain and the influence of this factor on the stability in verticalmouse.

The objective of the invention is to provide a method of forming a vertical posture in patients with impaired static-and-dynamic functions with regard to the blood supply in the basins of the brain and reflex influences.

This object is achieved by the following sequence of actions. The patient is installed in a vertical position and training. Pre-standing survey conducted on computer stabilography with the relevant provisions of the head, at the same time registering rheoencephalogram using fronto-metodologi, occipito-metodologi lead. Assess the stability of the patient in these positions and the blood brain when forming the vertical posture. Recommend that patients without traumatic disease of the spinal cord workout with the position of the head to provide the best volume pools brain and greater stability. Patients with traumatic disease of the spinal cord and syndrome paraplegia recommend training in the pose head position "German horizontally, providing greater stability of the patient without regard to the blood supply to the brain. As the current head provisions used provisions: "the German horizontal and chin parallel to the floor".

The novelty of the method

1. Proposed JV is a method for forming a vertical posture in patients with disorders of static-and-dynamic functions.

2. Proposed standing to conduct examination of a patient on a computer stabilography with the relevant provisions of the head, at the same time registering rheoencephalogram using fronto-metodologi, occipito-metodologi leads.

3. Asked to evaluate the stability of the patient in these positions and the blood brain.

4. Offered to patients without traumatic disease of the spinal cord to conduct training in posture with head position that provides the best volume pools brain and greater stability of the patient.

5. Offered to patients with traumatic disease of the spinal cord and syndrome paraplegia conduct training in the pose head position "German horizontally, providing greater stability, without regard to the blood supply to the brain.

6. Proposed as relevant provisions of the head to use position: "chin parallel to the floor" and "German horizontally".

The proposed method is as follows. The subject register the stabile-gram when standing with the relevant provisions of the head, such as the position of the German horizontal and chin parallel to the floor, by means of computer stabilography company NMG (Moscow). The position of the German horizontal" involves muscle tension-roshiba the oil neck and activation symmetric tonic neck reflexes, what is important for the regulation of the vertical posture. Position the chin parallel to the floor and provides for the relaxation of muscles-extensors of the neck, so activating tonic neck reflex does not occur. At the same time register the subject rheoencephalogram using a computer rheoencephalography company NMG (Moscow) by the standard method using fronto-metodologi, occipito-metodologi leads. The study gives an idea about the volume in all the basins of the brain. This information is important because in the regulation of vertical posture involves all parts of the brain. When it receives the following parameters characterizing the stability of the vertical posture: deviation in the frontal and sagittal plane, the length and size of stabilogram and eographically index in each of the four pools brain characterizing the volume of these basins.

The result is characteristic of standing and blood in the basins of the brain in the process of standing with each position of the head. Comparing the results of studies that analyze the influence of the position of the head to maintain a vertical posture with regard to the blood supply in the basins of the brain in the moment standing. So differentially determine the role of reflex influences and CROs is napolnenija in the basins of the brain on sustainability.

The authors compared different groups of subjects, each group has compared the stability of the vertical posture with the volume pools brain when standing with different positions of the head.

Comparison of the results of the study showed a change in the blood supply in the basins of the brain and its impact on the stability of the patient. On the basis of the conducted research, the authors recommend that patients without traumatic disease of the spinal cord workout 2 times a day for 15 minutes, standing with head position that provides the best volume pools brain and better resistance, and patients with traumatic disease of the spinal cord - workout 2 times a day for 15 minutes, standing with the head in the position of the German horizontal, regardless of the blood supply to the brain. After 2 weeks of training produced a significant increase in the stability of the patients in each group.

Example 1. Investigated the standing patient And howling NI Diagnosed with arthritic disease. The patient spent stabilometry, placing the head in position "German the horizontal and the chin parallel to the floor". Simultaneously with the recording of stabilogram was registered rheoencephalogram by a standard method using fronto-metodologi, occipito-metodologi leads. The results of the study is s shown in table 1.

Table 1

Indicators of stabilometry and rheoencephalography patient And howling NI
The position of the headIndicators stabilogramGeographical index, pool artery
Deviation, planeLengthSquaresleepyspinal
frontsagittalleftrightleftright
"German horizontal"15,9423,21805,281162,120,770,690,510,48
"chin parallel to the floor"13,9319,17711,36838,770,710,770,540,59

When standing with the head in position chin parallel to the floor" eographically index in the basins of the right carotid and both vertebral arteries was higher than when standing with the head in position "German horizontally". That is, in this position, the blood in three of the four investigated Assenov was better. Indicators of stabilometry when standing with the head in position chin parallel to the floor" reflect the greater stability of the patient in this position: deviation in both planes, the length and size of stabilogram less than when standing with the head in position "German horizontally".

Conclusion. The patient And howling NI best volume pools brain and greater stability when standing with the head in position chin parallel to the floor than when standing with the head in position "German horizontally". She recommended workout 2 times a day for 15 minutes, standing with the head in position chin parallel to the floor". After 2 weeks of training has been a significant increase in the stability of the patient.

Example 2. Examined the standing of patient P-A.A. howling Diagnosed with osteochondrosis of the lumbar spine without exacerbation. The patient spent stabilometry, placing the head in position "German the horizontal and the chin parallel to the floor". Simultaneously with the recording of stabilogram was registered rheoencephalogram by a standard method using fronto-metodologi, occipito-metodologi leads. The results of the study are given in table 2.

Table 2

Indicators of stabilometry and rheoencephalography p is cienki P-howl AA
The position of the headIndicators stabilogramEographically index pool artery
Deviation, planeLengthSquaresleepyspinal
frontsagittalleftrightleftright
"German horizontal"7,187,56586,93170,550,931,051,151,04
"chin parallel to the floor"8,057,74745,55195,620,961,020,940,86

When standing with the head in the position of the German horizontal eographically index in the basins of the right carotid, both vertebral arteries is higher than when standing with the head in position chin parallel to the floor". In this position, the blood in three of the four surveyed better. Indicators of stabilometry when standing with the head in position "German horizontal" reflect the greater stability of the patient: deviation in both planes, the Lin and size of stabilogram less than when standing with the head in position chin parallel to the floor".

Conclusion. The patient P-A.A. howling best volume pools brain and greater stability when standing with the head in position "German horizontally than when standing with the head in position chin parallel to the floor". She recommended workout 2 times a day for 15 minutes, standing with the head in position "German horizontally". After 2 weeks of training has been a significant increase in the stability of the patient.

Similar results were obtained when examining other patients without conduction disorders in the spinal cord: the best volume in the basins of the brain combined with the higher stability when standing. These patients recommended workout 2 times a day for 15 minutes with the position of the head, providing a better blood supply in the basins of the brain. Such training was accompanied by a significant increase sustainability within 2 weeks of classes.

Example 3. Researched standing patient M-VA A.L. Diagnosis: traumatic disease of the spinal cord, the late period, the partial syndrome of conduction disturbances in the spinal cord from the level of L1, sluggish prepares. The subject held stabilometry, placing the head in position "German horizontal" and "chin to parallelisable". Simultaneously with the recording of stabilogram was registered rheoencephalogram by a standard method using fronto-metodologi, occipito-metodologi leads. The results of the study are given in table 3.

Table 3

Indicators of stabilometry and rheoencephalography patient M-VA A.L.
The position of the headIndicators stabilogramEographically index pool artery
Deviation, planeLengthSquaresleepySpinal
frontsagittalleftrightleftRight
"German horizontal"of 8.06a 12.7811,88321,890,60,640,450,4
"chin parallel to the floor"14,3225,671474,461154,540,720,50,50,51

When standing with the head in position chin parallel to the floor" neographics the s index in the basins of the left carotid and both vertebral arteries was higher than when standing with the head in position chin parallel to the floor". That is, in this position, the blood in three of the four surveyed better. Indicators of stabilometry when standing with the head in position chin parallel to the floor" reflect the lower stability of the patient in this position: deviation in both planes, the length and size of stabilogram much more than when standing with the head in position "German horizontally".

Conclusion. Patient M-VA A.L. best volume pools brain not accompanied by an increased stability when standing with the head in position chin parallel to the floor". Probably activate symmetric tonic neck reflexes that occur during insertion of the head in the position of the German horizontal", is more important to improve the stability of the patient, than the improvement of blood supply in the basins of the brain. The patient is recommended to workout 2 times a day for 15 minutes, standing with the head in position "German horizontally". After 2 weeks of training has been a significant increase in the stability of the patient.

Similar results were obtained when examining other patients with impaired conduction in the spinal cord syndrome paraplegia: activation of the symmetric tonic neck reflexes that occur when you the Denia head in position "German horizontal", accompanied by increased stability compared to standing, when the chin is parallel to the floor, regardless of the blood supply in the basins of the brain. Therefore, patients with traumatic disease of the spinal cord recommended workout 2 times a day for 15 minutes with his head in the "German horizontally". Such training was accompanied by a significant increase sustainability within 2 weeks of classes.

Conclusion. Conducting simultaneous registration stabilogram and rheoencephalography allows to estimate the influence of head position on the regulation of vertical posture with regard to the blood supply in the basins of the brain and reflex influences and to determine the direction of remedial measures.

The proposed method is effective for use in research and therapeutic purposes. Its use allows to evaluate the influence of blood in the basins of the brain on the stability of the vertical healthy posture, to compare the significance of this and other reflex factors in ensuring vertical posture sick people in different conditions, to determine the direction of the treatment effects and the effectiveness of treatment and, ultimately, to effectively form a vertical position when pathology.

The proposed method is used on the basis of the Federal state institution is Novokuznetsky scientific-production center of medical-social expertise and rehabilitation of disabled persons. In this way within six months diagnostics features maintain the vertical position of disabled people with impaired conduction in the spinal cord of patients with arthritic disease, cerebrovascular disease, other diseases involving violation of static-and-dynamic functions and blood in the basins of the brain. Based on the results of the survey changed tactics restore vertical position of persons with paraplegia, made adjustments in the formation of postural stereotypes patients with other pathologies. Correction of the position of the head with regard to the blood supply in the basins of the brain and reflex influences allows to obtain a noticeable improvement in stability of the vertical position of patients within 2 weeks of classes.

1. The method of forming a vertical posture in patients with disorders of static-and-dynamic functions, including the setting of the patient in an upright position, wherein at the same time register the stabile-gram and rheoencephalogram using fronto-metodologi, occipito-metodologi leads in position of the head with a strain of extensor muscle of the neck and head position when the relaxation of the extensor muscles of the neck, get the settings stabilogram characterizing the stability of the vertical posture, and eographically indec what each of the four pools brain and when combined with the best blood pools brain with higher stability when standing training is carried out in the head position, which provide the best blood pools brain, and if the best volume in the basins of the brain is not accompanied by increased stability when standing, training is carried out in the position of the head with a strain of extensor muscle of the neck; the exercise is carried out twice a day for 15 minutes for two weeks.

2. The method according to claim 1, characterized in that the best blood pools brain not accompanied by an increased stability when standing in patients with traumatic disease of the spinal cord and syndrome paraplegia.



 

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15 cl, 10 dwg

FIELD: medicine; medical engineering.

SUBSTANCE: method involves irradiating blood-carrying tissue area under control with luminous flow, receiving scattered luminous flow modulated with blood filling changes in blood vessels and capillaries of blood-carrying tissue and forming electric signal of pulse wave. Deviation signal of light-emitting and light-receiving transducers of optoelectronic converter relative to blood-carrying tissue area under control based on difference between the current and preceding values of impedance signal on the area under control. The signal being observed, prohibition signal is produced on pulse wave electric signal passage for excluding errors caused by motion artifacts from its following processing. The device has optoelectronic converter having light-emitting and light-receiving transducers and unit for producing pulse wave signal, which input is connected to light-receiving transducer output. Unit for forming deviation signal has two measuring electrodes connected to separate comparator inputs which output being deviation signal former output, is connected to control input of key. Information input of the key is connected to pulse wave signal former output.

EFFECT: improved noise immunity.

3 cl, 3 dwg

FIELD: medicine; medical engineering.

SUBSTANCE: method involves doing multi-channel recording of electroencephalogram and carrying out functional tests. Recording and storing rheoencephalograms is carried out additionally with multi-channel recording of electroencephalogram synchronously and in real time mode in carotid and vertebral arteries. Electroencephalograms and rheoencephalograms are visualized in single window with single time axis. Functional brain state is evaluated from synchronous changes of electroencephalograms, rheoencephalograms and electrocardiograms in response to functional test. The device has electrode unit 1 for recording bioelectric brain activity signals, electrode unit 2 for recording electric cardiac activity signals, current and potential electrode unit 3 for recording rheosignals, leads commutator 4, current rheosignal oscillator 5, synchronous rheosignal detector 6, multi-channel bioelectric brain activity signals amplifier 7, electrophysiological signal amplifier 8, demultiplexer 9, multi-channel rheosignal amplifier 10, multi-channel analog-to-digital converter 11, micro-computer 12 having galvanically isolated input/output port and personal computer 13 of standard configuration.

EFFECT: enhanced effectiveness of differential diagnosis-making.

11 cl, 6 dwg

FIELD: medicine.

SUBSTANCE: method involves recording rheogram from feet and legs lifted and fixed at an angle of 45є. Then, rheogram is recorded on inhaling from legs directed vertically downward. Functional blood circulation reserve index is calculated as product of results of dividing and subtracting rheographic indices recorded under conditions of lifted and lowered extremities that means under conditions of functional venous system relief and venous hypertension, respectively.

EFFECT: enhanced effectiveness in recognizing patient group suffering from severe lower extremities ischemia.

6 dwg

The invention relates to medicine, particularly cardiology and functional diagnostics

FIELD: medicine.

SUBSTANCE: method involves recording rheogram from feet and legs lifted and fixed at an angle of 45є. Then, rheogram is recorded on inhaling from legs directed vertically downward. Functional blood circulation reserve index is calculated as product of results of dividing and subtracting rheographic indices recorded under conditions of lifted and lowered extremities that means under conditions of functional venous system relief and venous hypertension, respectively.

EFFECT: enhanced effectiveness in recognizing patient group suffering from severe lower extremities ischemia.

6 dwg

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