Physiotherapy (physis - nature, Greek) - the science of the therapeutic use of environmental factors
in their natural or preformed (praeformo - transform, lat.) form.
Modern physiotherapy has a huge number of methods that are very diverse in physical nature,
physiological and therapeutic effect, methods of applying methods. Their use is constantly expanding, and
today it is difficult to name a disease in which physiotherapeutic methods could not be applied to the benefit of
patients.If at first therapeutic physical factors were used only for the purpose of aftercare of patients with
chronic diseases, now the scope of their application is much wider. The main areas of physical medicine are
currently:
- medical (actual physiotherapy);
- rehabilitation;
- prophylactic.
For therapeutic purposes, physical factors are used mainly in the subacute and chronic
course of diseases, to a lesser extent - in the acute stage of diseases of a therapeutic and surgical
profile. In recent years, due to the development and improvement of intraorgan physiotherapy
techniques, as well as resonant and biocontrolled options for exposure, physiotherapy has become
increasingly used in emergency situations, and even in patients with oncopathology. Physical factors
with therapeutic purposes can be used in patients of all age periods. Their appointment, selection and dosage
must necessarily be carried out taking into account the age and anatomical and physiological characteristics of
the patient's body.
Although it is difficult to find a disease in which the use of physical factors could not be beneficial for
patients, nevertheless, in certain conditions of the body and diseases, physiotherapy should be refrained from.
The second direction of using therapeutic physical factors is rehabilitation. It is closely related to the
previous one. At all stages of rehabilitation (rehabilitation therapy, readaptation and rehabilitation
itself), physical methods should be actively used - electrotherapy, massage, exercise therapy,
mechanotherapy, balneotherapy, etc. In neurological and orthopedic patients, physiotherapy is
generally considered the main means of medical rehabilitation.
A significant place in rehabilitation should be occupied by resorts with their wide arsenal of natural
and preformed factors.
The next direction of using physical factors is preventive. Physioprophylaxis is the improvement and
prevention of human diseases through the use of natural and artificially created physical factors. Distinguish
between primary and secondary physioprophylaxis. Primary physioprophylaxis is used to increase the
body's resistance to acute respiratory diseases, develop adaptive capabilities to adverse external
factors, increase the efficiency and hardening of healthy individuals, compensate for ultraviolet
deficiency, etc. Secondary physioprophylaxis is used in patients and is aimed at preventing
exacerbations or further progression of the disease, strengthening the body , faster recovery of his
life and ability to work. The most active and accessible means of physioprophylaxis are air, water, ultraviolet
rays, electromagnetic fields, etc.
Particular interest in physical factors is due not only to their wide therapeutic and prophylactic
possibilities, but also to the advantages that they have in comparison with other therapeutic agents.
One of the most important advantages of physical methods of treatment is the versatility of their
action, due to which the same factor can be used in a variety of diseases. An equally important advantage of
physiotherapy is its physiology.
Physical factors, being elements of the external environment, are stimuli familiar to the body, to which
unconditioned reflexes are developed in the process of individual development. Due to the physiological
nature, the action of physical factors is realized along the same anatomical pathways and mechanisms that
have developed in the process of evolution and interaction of the organism with the external environment.
Closely related to the previous ones are such advantages of physiotherapy as the normalizing
(homeostatic) nature of the action, as well as the ability to have a training effect, to stimulate compensatoryadaptive processes in the body.
Physical factors in therapeutic dosages, as a rule, do not have toxicity, do not cause side
effects and allergization of the body. This is one of the most important advantages of physiotherapy
over pharmacotherapy. At the same time, physical methods of treatment should not be opposed to
drug and other therapies. They should organically enter the treatment-and-prophylactic or
rehabilitation complex as one of the most important components. In addition, it is known that
physical factors can potentiate the action of drugs, weaken the side effects of some of them.
The advantage of physiotherapy is its long aftereffect. Its essence lies in the fact that changes in the
body, the therapeutic effect not only persist for a fairly significant period of time, but even increase after the end
of the course of treatment. Therefore, long-term results after physiotherapy are often better than immediate
ones. The aftereffect period can vary from several weeks (for drug electrophoresis,
Four diadynamic therapy, etc.) up to 4-6 months (mud therapy, balneotherapy, etc.).
The advantages of physical therapy include its good compatibility with other therapeutic agents. In
addition, physiotherapeutic methods can be widely and with high efficiency combined (combined) with each
other. The possibility of using physical factors in the form of general or local procedures, in a continuous or
pulsed mode, in the form of external or internal influences, makes it possible to reduce the adaptation of the
body to the treatment being carried out, and contributes to its individualization.
One of the important advantages of physical methods of treatment is their availability, comparative
cheapness. In this regard, physiotherapy can be considered a mass type of treatment.
Depending on the properties of the physical factor, the primary effect can be realized at the level of
afferent nerve endings, or a group of molecules that are susceptible to this factor, or its energy can have several
points of application. In response to exposure, local physicochemical changes in tissues and general reactions
by reflex and humoral mechanisms may occur. As a result, nonspecific and specific responses are formed.
Nonspecific action is characteristic of all physical factors. It manifests itself in the regulation of
the main physiological functions of the body that ensure homeostasis: the normalization of the activity
of various organs and systems, the mobilization of energy resources, the ability to choose the optimal
option for launching compensatory mechanisms. Consequently, physical factors can be considered
as a kind of adaptogens that enhance the body's resistance to various adverse effects. The specific
action depends on the nature of the physical factor, which causes the reactions of the organism peculiar only to
it. This action is realized in the form of a decrease in the severity or elimination of morphological changes caused
by the pathological process.
Nonspecific and specific action of physical factors are manifested simultaneously, causing a variety of
responses. The main thing in this action is a specific component. When choosing a dose of a physical factor, a
maximum manifestation of a specific action is achieved with a minimum of non-specific reactions.
Responses to the action of physical factors are individual. They are referred to as
balneophysioreactions, which depend both on the dose used and the general reactivity of the
organism. Physiological reactions are distinguished, pathological reactions are predominantly general
or predominantly local, as well as reactions in the form of an increase in the degree of activity of the
pathological process. In this regard, the appointment of physiotherapeutic procedures should be
etiologically and pathogenetically determined, strictly individual, treatment should carried out in the form
of a certain course of procedures. The treatment plan is drawn up in the form of a physiotherapy prescription,
which is entered into a special card of the patient being treated in the physiotherapy department or office. The
recipe should include:
1) the name of the physical factor;
2) area or zone of impact;
3) method of influence;
4) the dose of the physical factor (intensity of exposure);
5) the duration of the procedure;
6) the frequency of the procedures;
7) the number of procedures per course of treatment.
Classification of physical factors
Modern physiotherapy has a very wide and diverse arsenal of therapeutic methods in terms of physical
properties and physiological effects. They can be combined into groups according to the characteristic types and
forms of energy used and presented in the form of the following classification.
I. Electrical energy
1. Constant continuous electric current of low voltage and low strength (galvanization, drug
electrophoresis).
2. Low voltage impulse currents (electrosleep, diadynamic therapy, amplipulse therapy, interference
therapy, electrodiagnostics, electrical stimulation).
3. Alternating currents and alternating electromagnetic fields of high intensity:
a) high frequency electric current: darsonvalization, ultratonotherapy,
b) an electromagnetic field with a predominant magnetic component (inductothermy);
b) an electromagnetic field of ultrahigh frequency with a predominant electrical component (UHF
therapy);
c) electromagnetic fields of ultrahigh frequency (microwave therapy): decimeter range, centimeter
range.
4. Constant electric field of high intensity (franklinization).
II. Magnetic fields:
a) a permanent direction; b) variable direction of low frequency.
III. Light emission:
a) infrared, b) visible,
c) ultraviolet, d) laser (monochromatic, coherent).
I.Y. Hydrotherapy factors:
a) fresh water; b) mineral and medicinal waters; c) gas waters.
Y. Heat-healing factors:
a) healing mud; b) paraffin; c) ozokerite; d) naftalan;
YI. Mechanical energy:
a) fluctuations of infrasonic frequency (vibration); b) vibrations of ultrasonic frequency.
YI. Mechanical energy:
a) fluctuations of infrasonic frequency (vibration); b) vibrations of ultrasonic frequency.
YII. Artificial air environment:
a) air ions and hydroaeroions; b) aerosols and electroaerosols;
c) variable air pressure (barotherapy).
General contraindications to physiotherapy:
malignant neoplasms and suspicion of their presence, including hemoblastoses;
hormonally active tumors in women in the growth stage, or in a condition requiring surgical treatment
(mastopathy, endometriosis, uterine fibroids); cachexia; fibril body temperature;
pulmonary tuberculosis, if stabilization of the process is not achieved and there is no “cover” with at least
three tuberculostatic drugs; systemic lupus erythematosus; acute phase of myocardial infarction;
acute phase of cerebrovascular accident; severe atherosclerosis, primarily coronary and cerebral
vessels; aneurysm of the aorta and other large vessels;
persistent arterial hypertension with systolic blood pressure of 180 mm. rt. Art. and more;
complex and severe violations of the heart rhythm and conduction in the myocardium; epilepsy with frequent
seizures;
diseases with signs of severe organ failure (circulatory failure stage II - III, chronic renal failure, etc.); the
presence of large metal fragments in the impact zone,
if they are in the area of large vessels and nerve trunks; individual intolerance to this type of energy;
prolonged professional contact with this type of energy.