H. U. MAY
High Tone Power Therapy - HiToP®
Theory and Practice
Porto, March 2005
Introduction
Theory, part 1
"High Tone Therapy"
and
"High Tone Power therapy"
Simultaneous modulation
of frequency and amplitude
and
its advantages
"High Tone Power Therapy"
and the equipment to realise
this most advanced an most modern kind of
"High Tone Therapy",
HiToP®,
is the result of
the last step of developments
of
middle frequency therapy.
I will begin with the explanation of the reasons for the decision for
the development of a new sophisticated method within the
physical therapy, described as “electrical high tone frequency
alternating field therapy”, abbreviated in German
“Hochtontherapie”, in English “high tone therapy”, in Polish
“terapia energotonowa”, that means “energy tone therapy”.
The new method has been realised in Germany by gbo.
The result is the equipment HiToP® (High Tone Power Therapy).
High tone therapy is a purposeful new development in the field of
electrotherapy. It appears with the pretension to realise all effects
known and expected from the traditional low and middle frequency
therapy with higher efficacy. Including ranges of frequencies never
used until now and introducing the simultaneous modulation of
frequency and amplitude a completely novel method of electrotherapy has been created. Important aspects of this innovative
creation were to optimise the therapeutically width and to take
more into account the very interesting non-stimulatory effects.
Several clinical investigations
published recently (2002, 2003 and 2004)
in Poland
confirm the expectations
concerning the efficiency of high tone
therapy
in various injuries and/or diseases.
To understand correctly and completely the position
of the high tone therapy within the electrotherapy it
is required to be well acquainted with some terms of
the fields of physiology, related disciplines and
physical therapy.
However, neither all medical doctors nor all physical
therapists have been sufficiently educated during
their specific education's in both disciplines, or may
be they have forgotten some details.
Therefore I will try to repeat, to explain and to
comment some of the most important terms and
facts.
Terms:
The term “High tone therapy”
This term, abbreviated from
“electrical high tone frequency alternating field
therapy”
was proposed by medical doctors
just after the introduction of the first generation of
high tone therapy units
High tone therapy
High tone therapy is a purposeful new development in
the field of electrotherapy, basing on the principles of
the electric differential therapy (HANSJÜRGENS &
MAY, 1990).
By means of simultaneous modulation of frequency and
amplitude (SimulFAM®), either
a) along the threshold graph after it’s individual
determination (SimulFAMi) or
b) with crossing of this threshold graph with adjustable
crossing angles (SimulFAMx)
it is possible to generate alternatively either
a) selectively non-stimulatory effects or
b) non-stimulatory effects in combination with
stimulatory effects.
Electric differential therapy
Electric differential therapy (MAY & HANSJÜRGENS, 1988;
HANSJÜRGENS & MAY, 1990) can be considered
as a principle to classify currents used in electrotherapy and
as a principle to select the most suitable kind of current for the
pathological condition or symptom just to be treated.
For the selection of the best suitable current is decisive – like in
pharmacology – the best relation between efficacy and
tolerability, in other words: the therapeutic width.
Tolerance
We have to distinguish between local and systemic tolerance
for currents.
Local tolerance
The local tolerance is correlated with or described by
respectively
a) the value of the (“direct”) pain threshold,
b) the risk of chemical burning,
c) the risk of burning by heat,
d) the value of the (“indirect”) pain threshold caused by
intensive muscle contraction, measured as functions of
frequency and intensity,
for b and c additionally as functions of time.
Systemic tolerance
The systemic tolerance can be defined mainly by means of the
a) the value of the threshold for ventricular fibrillation or
b) the value of the threshold for cardiac arrest.
In cases of current applications including head and brain
thresholds for undesired sensations and/or generalised epileptic
seizures are important.
In cases of treatments of the trunk with high current intensities
above the motor threshold the thresholds of the muscles
responsible for respiration are important.
Effects
The electric differential therapy distinguishes between
stimulatory and non-stimulatory effects.
Stimulatory effects
Stimulatory effects are caused by generation of action potentials
in excitable structures (nerves, muscles, receptors).
The frequency of the triggered action potentials ranges between
> 0 and – for very short periods – 1000 Hz, defined in physiology
and physical medicine as the “low frequency range.
The application of stimulatory effects can be realised either
according the functional imitation principle or according
the functional fatiguing principle, depending on the values
of the frequencies of stimulation in relation to the fatiguing
frequency of the just stimulated excitable structure.
Important frequencies for therapeutically desired
special effects, basing on well known physiological
investigations regarding the discharge behaviour of excitable
structures - usable as border line frequencies between the
functional imitation principle and the functional fatiguing principle
Efferent nerve fibres
Sympathetic nerve fibres
Lipolysis
3 Hz
This frequency of 3 Hz is not a border line frequency between
imitation and fatiguing frequencies. The lipolytic effect of a
stimulation of sympathetic nerve fibres innervating fatty tissue
is decreased in case of using higher frequencies than 3 Hz
because of the simultaneously increasing vasoconstriction
(ROSELL, 1966).
Vasoconstriction
10 Hz
Motor nerve fibres
20 Hz
Afferent nerve fibres
100 Hz, however, not valid for
all groups of afferent fibres
Instructions regarding the meaning of the
principles of functional imitation and
functional fatiguing related to the stimulation
of the mentioned groups of nerve fibres
The principle of imitation can be used therapeutically
for all of the mentioned groups, the principle of fatiguing
mainly for sympathetic fibres, in few cases for motor
nerves as well.
To avoid undesired fatiguing effects during the initial
phase of a treatment in cases of applications of various
(low) modulation frequencies, please start every time
with the lowest frequency!
Stimulation of sympathetic nerve fibres:
Frequencies up to
3 Hz:
Frequencies up to 10 Hz:
Frequencies
for example
> 10 Hz,
100 Hz:
activation of the lipolysis
within the innervated area
mainly vasoconstriction
increasing with frequency
reduced lipolysis caused by
vasoconstriction and
product-inhibition
vasodilatation after
initial vasoconstriction
Stimulation of motor nerve fibres:
Frequencies up to 20 Hz:
Muscle exercise, re-education, strengthening with
individually designed and adjusted periods consisting in
phases of stimulation interrupted by pauses.
20 Hz is the physiological tetanising frequency, i. e. the
maximum discharge frequency in the efferent neurones of
the motor units during voluntarily initiated maximum
isometric contraction (HENNEMAN 1957; HENNEMAN et
al. 1965; SOMJEN et al 1965; MILNER-BROWN et al.
1973; FREUND, BÜDINGEN & DIETZ 1975; BÜDINGEN &
FREUND 1976)
Frequencies > 20 Hz:
muscle relaxation caused by fatiguing stimulation
Stimulation of afferent (somato-sensory) nerve fibres:
This group of nerve fibres is not homogeneous.
Therefore a frequency limit valid for all fibres does not exist.
Furthermore, there is no indication for purposeful fatiguing
stimulation of this group of fibres.
Nevertheless, 100 Hz can be accepted as the most useful
frequency to cause central pain relief according the imitation
principle by means of counter-irritation.
Non-stimulatory effects
These effects are defined as effects caused independently from
the generation of action potentials.
Non-stimulatory effects at the physical and chemical levels
of efficacy
Such effects are for instance movements
of freely movable charged particles, ions as carriers of the
electrical currents,
of water molecules (dipoles) and
of charges fixed in molecules as constituents of the tissue.
Results of these primary effects are
facilitation and acceleration of diffusion, that means
equilibration of concentration differences, and
the enhancement of the ability of water to act as an solvent.
End of Introduction, Theory , Part 1
Practice, part 1
Practice, part 1, High Tone Power Therapy - HiToP®
A. The 2 modes of application of the HiToP therapy
1. Whole body treatment
2. Regional (topical) treatments, mostly (a-e) with SimulFAMi,
only for stimulation of nerves and muscles with SimulFAMX (f-g)
a. Shoulders
b. Vertebral column and abdominal region
c. Hip
d. Knee
e. Ankle
f. Peripheral stimulation of sympathetic fibres causing vasoconstriction
(upper arm)
g. Stimulation of muscles (M. quadriceps femoris, M. triceps brachii,
calf-muscles, abdominal muscles)
The recommended whole body treatment carried out
besides the topic application has not only general effects
upon the mood and the general condition of the patient;
moreover, the superposition of the alternating electric fields
of the general treatment and the topical treatment causes
periodical changes of the directions of the vectors of the
local electric fields responsible for the electrochemical
shaking effect. This kind of interference is used for the
support of non-stimulatory effects and not for the
generation of stimulatory effects, realised in traditional
interferential current units, invented by NEMEC.
HiToP® allows the use of more than two electrodes per
channel. The purpose is to compensate the different
sensitivities of different body regions or to concentrate the
effects in particular areas respectively. Moreover, it is
possible to treat two different body regions in the same time
using only one channel
B. The 2 modes of SimulFAM
1. SimulFAMi - without stimulation of nerves and/or muscles
(ca. 80 % of the applications in practice)
2. SimulFAMX - for stimulation of nerves and/or muscles
(ca. 20 % of the applications in practice)
Only apparently complicated at the latest convincing
experiencing the feeling:
The variability of the "slope" of SimulFAMX and the
advantage of "paradoxical stimulation"
SimulFAMX and its stimulatory frequencies
The choice of the most suitable frequency
0.3 Hz
for activation of the muscle pump
(for instance for the prevention of venous
thrombosis and for the treatment of edema)
3 Hz
10 Hz
for lipolysis
for vasoconstriction (for example after
in juries and for the reduction of edema)
20 Hz
100 Hz
for tetanising stimulation of muscles
for central pain relief by means of counterirritation - only one of the 5 pain relieving effects
available in HiToP®
The modulation of frequency happens between two corner
frequencies, 212 Hz and 215 Hz.
The duration of one period of the “slow” threshold-adapted
modulation of frequency and amplitude, SimulFAMi, is 144 s
(2 min 24 s). Frequency and amplitude will be changed all
the time stepwise periodically in the same direction, either
both upstairs or both downstairs.
The frequency of the “fast” simultaneous modulation of
frequency and amplitude (SimulFAMx) can be varied
between 0,1 Hz and 200 Hz. In this case frequency and
amplitude can be changed periodically quickly either in the
opposite direction or in the same direction (upstairs or
downstairs).
Opposite changes lead to more or less brusque stimulation,
corresponding changes lead to softer stimulation
(paradoxical stimulation).
End of practice, part 1
Pictures
illustrating the theoretical background
of high tone power therapy
presented after the first part of practice
when the participants of the seminar
have acquired the first practical experience with HiToP®
Threshold current mA (eff)
Threshold graph of the current
sensation
Threshold curve
Frequency in Hz
Intensity
Intensität
Threshold Curve
lle
e
hw
c
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Horizontal
stimulation.
Vertical
stimulation.
Threshold threshould
Sensation
curve as a function
beim
Menschen
of
frequency
in Abhängigkeit
der frequency
Frequency
Frequenz
Intensität
Threshold Curve
®
SimulFAM i
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hw
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SimulFAM i
fmin
fmax
Frequenz
Intensität
Threshold Curve
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SimulFAM i
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SimulFAM i
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Threshold Curve
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SimulFAM i
Intensity
SimulFAM i
fmin
fmax
Frequency
Threshold Curve
®
SimulFAM i
Intensity
3 octaves in 72
steps of 1/4 tones
SimulFAM i
1 second each
fmin
fmax
Frequency
X
Intensität
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SimulFAM
SimulFAM X
fmin
fmax
Frequency
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Advantages of
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Advantages of
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Balanced relation between the
phases above threshold and
below threshold
fmin
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Frequenz
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Intensität
Advantages of
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SimulFAM
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Sensitive patient
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Advantages of
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SimulFAM
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Now Ifmax can be adjusted
via the modification knob
as x% of Ifmin.
Ifmax
fmin
fmax
Frequenz
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hw
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Intensität
Advantages of
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SimulFAM
X
Now Ifmax can be adjusted
via the modification knob
as x% of Ifmin.
fmin
fmax
Frequenz
Intensität
“Paradoxical” Stimulation via
®
lle
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SimulFAM X Schw
Now Ifmax can be adjusted
via the modification knob
as x% of Ifmin.
fmin
fmax
Frequenz
Intensität
“Paradoxical” Stimulation via
®
lle
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SimulFAM X Schw
Now Ifmax can be adjusted
via the modification knob
as x% of Ifmin until the
patient has the maximum
comfort
fmin
fmax
Frequenz
End of the presentation of pictures
Theory, part 2
Theory, part 2
History of High Tone Power Therapy - HiToP®
The purpose of this new development
The effects in the tissue
The effects in the healthy body
The use of HiToP® in medicine
Year of publication or introduction or start of the development
respectively, inventors and terms of the introduced currents and
methods
1935 KOEPPEN: (Hoch-)"Tonfrequenzströme", (high) tone frequency currents
1944 GILDEMEISTER: "Mittelfrequenzströme", middle frequency currents
1948 NEMEC: Interferenzströme, interferential currents, using amplitude
modulation (AM) caused by interference of two unmodulated
middle frequency currents between 4000 and 4100 Hz
1988 MAY & HANSJÜRGENS: Electric differential therapy
1995 HANSJÜRGENS & MAY: 1st generation of high tone therapy equipment,
using frequency modulation (FM) for "horizontal
stimulation" within 1 1/2 octaves up to 12300 Hz
2000 MAY:
2nd generation of high tone therapy equipment: High Tone Power
Therapy, HiToP®, using simultaneous modulation of frequency
and amplitude, SimulFAM®, within 3 octaves between 4096 Hz
and 32768 Hz, realised by gbo in Rimbach, Germany
The term "Tonfrequenzströme", "tone frequency currents", was created by
KOEPPEN 1935 in his scientific publication "Tonfrequenzströme in der
Medizin", "Tone frequency currents in medicine", and he still described
important advantages and special interesting effects appearing and rising with
increasing frequencies into the high tone frequency range.
Therefore, it is legitimate and more precise to use the term "High tone
frequency currents" instead of "tone frequency currents", because of the
absence of the special advantages within the lower tone frequency range.
KOEPPENS investigations concerning the high tone frequency currents did not
lead to any creations of equipment for electrotherapy.
GILDEMEISTER and his pupil SCHWARZ were physiologists.
GILDEMEISTER created the term "middle frequency currents" in his last paper,
published 1944 after his death 1943.
SCHWARZ published many papers concerning the physiological properties of
the middle frequency currents within the 40th and 50th of the 20th century.
Without the knowledge of the publications of KOEPPEN, GILDEMEISTER &
SCHWARZ interferential current as the first therapeutic application of middle
frequency currents was introduced by NEMEC after the second world war.
The next step was the differentiation of the therapeutic application
of middle frequency currents by the creation of the method of
"Electric Differential Therapy" (MAY & HANSJÜRGENS)
to distinguish between stimulatory and non-stimulatory effects related to "low frequency effects" and "middle frequency effects":
Unmodulated middle frequency currents can be used for nonstimulatory effects, and middle frequency currents modulated in
there amplitude within the low frequency range can be used for
stimulation of nerves and muscles; however, they contain
additional non-stimulatory effects.
In the first generation of high tone frequency treatment units,
developed by MAY, HANSJÜRGENS & FORSTER within the
middle of the last decade of the last century, the next (3rd)
important step into the direction of increase of efficacy and
significant reduction or even complete elimination of discomfort
was realised by the introduction of frequency modulation
(FM) - instead of amplitude modulation (AM).
"High Tone Therapy" is the abbreviation for "Electrical
High Tone Frequency Alternating Field Therapy".
As mentioned above, the first important step to reduce
the discomfort and the risks of electrotherapy,
furthermore to increase the efficacy of electrical currents
used for therapeutic purposes was the introduction of
middle frequency currents as the so called
"interferential current" by the inventor Hans NEMEC in
the middle of the last century. KÖCHERT and NEMEC
founded the company NEMECTRON, and the first
generations of interferential current treatment units,
named Nemectrodyn®, were more successful, and the
interferential current was more comfortable for the
patients than the other currents (Galvanic current and
low frequency currents) used in electrotherapy.
The aim of the development of the
HiToP® High Tone Power Therapy
The aim of this development was, to intensify and to combine
already known effects of the especially well tolerable currents,
the so called middle frequency currents.
Moreover, the equipment should indicate not only the current
intensity (amperage) in mA as a singular quantitative parameter of
the applied electricity:
Now additionally will be indicated the voltage in V,
the power in mW, the impedance in W
and the sum of the applied electrical energy in mWh.
Until now no other electrotherapy equipment offers such
completeness of indication of important electric
parameters.
Non-stimulatory effects at the
biochemical level of efficacy
Increase of the probability of “meetings” and
contacts between enzymes and substrates
Enzymes are biocatalysts.
The mediated biochemical reactions
are in all cases electrical events too,
facilitated by means of
alternating electrical fields.
Conformation changes of signal molecules as a
reason for the activation of the adenylatcyclase
In several papers changes of the intracellular
formation of cAMP (cyclic Adenosinemonophosphate,
one of the most important second messengers)
caused by middle frequency currents have been
published (KORENSTEIN 1984; BRIGHTON &
TOWNSEND 1986; NOSZVAY-NAGY 1988-1994).
Beneficial influences upon the trophism of the tissues,
anti-asthmatic, generally activating and
antidepressive effects - within the therapeutic level of
efficacy – could be explained by this
electro-biochemical effect.
Non-stimulatory effects
at the neurophysiological level of efficacy
Intensities of unmodulated middle frequency
currents distinctly above the threshold cause
in nerves and muscles partial depolarisation,
in nerves correlated with a block,
in muscles additionally with a physiological
contracture.
Below of these relatively high intensities a range
of intensities exists which is characterised by
some particularities:
Non-stimulatory effects at the therapeutic level of efficacy
1. Pain relief
a. symptomatic, immediate, transient
via distribution and thinning of mediators of pain and
inflammation
via blocking of afferent fibres involved in coding of pain
information
b. causal, longer lasting
by facilitation and/or activation of metabolic processes,
acceleration and abbreviation of healing processes
c. indirect
by anti-oedematous effects
via reversible physiological contractures
of the smooth muscles of the vessels including lymphatic
vessels
2. Acceleration and abbreviation of healing processes,
which are not accompanied by pain (s. 1 b)
3. Local anti-oedematous effects (explained under 1 c)
and diuretic effects
As I partially still mentioned above,
the most important fundamental facts for the purposeful
development of the high tone therapy equipment are originated
from the publications of the physiologists
Martin GILDEMEISTER (Straßburg, Leipzig),
Friedrich SCHWARZ (Leipzig, Posen, Jena),
Oscar A. M. WYSS (Zürich), and
of a pioneer of physical medicine,
Siegfried KOEPPEN (Halle, Wolfsburg),
furthermore from the electrotoxicological investigations of
GEDDES and co-workers (1969).
KOEPPEN already 1935 introduced the term
“Tonfrequenzströme”, English “tone frequency currents”,
GILDEMEISTER 1944 the term “Mittelfrequenzströme”, English
“middle frequency currents",
defined as alternating currents with frequencies
between ca. 1000 Hz and 100 kHz .
1. The principle of apolar “stimulation” is valid:
Using two electrodes (of the same size) under both electrodes are
generated the same effects at the same time.
Anodic or cathodic effects do not exist.
2. The law of “Alles oder nichts” (everything or nothing) is not valid.
With repetitions of tests of the thresholds the values increase.
3. There are no relations between the single phases of the middle
frequency current and the begin of the triggered action potentials.
4. Around the threshold single action potentials are triggered irregularly,
but this kind of ongoing activity disappears after a while
5. Intensities above the threshold trigger a “transient excitatory activity”,
abbreviated “tea”: immediately after the start of the establishment of
the alternating electrical field the firing rate has it’s highest values,
followed by decreasing discharge frequencies.
“Tea” is correlated at the psychophysical level of efficacy with a fading
tingling sensation.
“Tea” leads to fatigue of the involved excitable structures.
Monographs of WYSS (1975) and of his pupil SENN (1980)
contain comprehensive descriptions of the history and the
peculiarities of the middle frequency currents.
However, the descriptions of the pain relieving effects of
unmodulated and modulated middle frequency currents are
incomplete. The possibilities to use either the blocking or pseudoblocking effects of unmodulated middle frequency currents or the
counter-irritation principle (GAMMON & STARR 1941), caused by
the low frequency effects of modulated middle frequency currents
have not been mentioned. On the other hand, just the pain
relieving effect by means of unmodulated middle frequency
currents can be easily explained by the results of
neurophysiological investigations of WYSS and his pupils, for
instance the “reversible reactive partial depolarisation”, with other
words the “plateau effect” (KUMAZAWA & WYSS 1966). These
results, gained by means of intracellular recordings, could be
confirmed later by extracellular recordings (BOWMAN 1981).
The cited publications reveal
1.) that the local and systemic tolerability of
alternating currents above 50 Hz is increasing with
increasing frequencies and accordingly the
possibility of incoupling of electric power into the
body is increasing too with increasing frequencies
– without any local discomfort and without any
risks for the heart,
2.) that these currents, named “(high) tone
frequency currents” or “middle frequency currents”
have particular advantageous qualities in
comparison to the traditional low frequency
currents and direct current.
The frequency-correlated increase of the threshold of afferent
fibres of the sensory nervous system is also valid for the motor
fibres innervating the striated muscles (DALZIEL, 1941-1973), and
we can assume for the sympathetic fibres responsible for the
smooth muscles of the vasculature as well.
As I still mentioned above, originally, interferential therapy was
introduced by Hans NEMEC (1947/1950-1960) with the aim to
make the stimulating (stimulatory) effects of traditional
electrotherapy more comfortable: two unmodulated middle
frequency currents with slightly different frequencies should be
superimposed within the tissue to generate interferential beats, a
special kind of amplitude modulation. The low frequency of beat
generation or amplitude modulation respectively determines the
frequency of the neuronal responses, that means the frequency of
action potentials. Therefore, the differences between the two
middle frequencies have to be within the low frequency range, that
means mostly between > 0 Hz and 100 Hz.
In comparison to the interferential therapy and later introduced
other modifications of middle frequency therapy for the
development of high tone therapy (MAY, 2002) higher
frequencies and greater frequency ranges are included:
Interferential therapy mostly is using middle frequencies
around 4000 Hz, in some equipment moderately higher
frequencies but below 10000 Hz.
However, the newest version of high tone therapy equipment,
more exactly “high tone power therapy” equipment, HiToP®, are
able to generate frequencies up to 215 Hz (32768 Hz), and
between 212 Hz (4096 Hz) and 215 Hz 73 different frequencies
are available.
In comparison to NEMEC’s interferential therapy the highest
frequency in HiToP® equipment is more than eight times higher,
and the range of frequency modulation is more than 286 times
higher: 28672 Hz in comparison to 100 Hz.
In comparison to the interferential therapy and later introduced
other modifications of middle frequency therapy for the
development of high tone therapy (MAY, 2002) higher
frequencies and greater frequency ranges are included:
Interferential therapy mostly is using middle frequencies
around 4000 Hz, in some equipment moderately higher
frequencies but below 10000 Hz.
However, the newest version of high tone therapy equipment,
more exactly “high tone power therapy” equipment, HiToP®, are
able to generate frequencies up to 215 Hz (32768 Hz), and
between 212 Hz (4096 Hz) and 215 Hz 73 different frequencies
are available.
In comparison to NEMEC’s interferential therapy the highest
frequency in HiToP® equipment is more than eight times higher,
and the range of frequency modulation is more than 286 times
higher: 28672 Hz in comparison to 100 Hz.
For therapeutic purposes mostly the mentioned
73 frequencies in logarithmic steps between 212
Hz and 215 Hz are used. The factor is 2-24
corresponding a little bit less than 1,03. Because
of the great distance between the lower and the
upper corner frequency linear steps were not
suitable.
The “distances” between the neighbouring
frequencies of tones in our music are defined too
as logarithmic steps. The factor for the elevation
in half tone steps is 2-12.
The decision for the term “high tone frequency therapy”,
abbreviated “high tone therapy”, derived from relations to
tones or music respectively, resulted from the following
considerations:
1.) The term “high tone frequency” is more concrete than
“middle frequency”. The high tone frequency range (~ 1000 20 000 Hz) covers the low middle frequency range.
2.) The frequencies of the first generation of equipment varied in
the high tone frequency range only. The new generation,
HiToP®, includes even frequencies of the ultrasound range.
Nevertheless, the introduced term has not been changed
besides in Poland; there the term “energy tone therapy” is
preferred. Both terms are ingenious: “high” characterises the
means, namely the high tone frequencies as the agens for the
possibility for an easier application of more energy, “energy”
this purpose itself.
3.) The distances between the frequency steps correspond to
distances of quarter tone steps in music.
4.)
By means of frequency scanning the probability of
resonance phenomena within structures of the treated
tissue should be increased. Resonance plays an important part in music too.
5.)
The new term should emphasise the great difference to
traditional middle frequency units.
6.)
It is possible and useful to explain the modes of action of
HiToP® by an loud-speaker. It facilitates the
understanding of the physical realisation of the various
“programs”, SimulFAMi and the variations of SimulFAMx
using modulation frequencies between 0.1 and 200 Hz.
The demonstration of hearing emphasises the relation to
tones and the absence of similarity to a “current” as a
great river.”
Main differences between traditional
electrotherapy and high tone power therapy
(HiToP®)
1. Main differences in comparison to direct current (DC)
and low frequency currents with DC-components:
HiToP is without any risks of DC as chemical burning
caused by electrolysis.
Vasodilatation and acceleration of reabsorption of
topically applied substances in the treatment area,
known as DC-iontophoresis, can be achieved by HiToP
too, but by other mechanisms: vasodilatation via
fatiguing stimulatory effects upon sympathetic fibres,
and the acceleration of resorption via an electrochemical
shaking effect resulting in facilitation of diffusion.
2. Main differences in comparison to low frequency
currents:
HiToP has important advantages:
Great superiority concerning local and systemic tolerance,
very much greater spectrum of effects by additional
sophisticated utilisation of non-stimulatory effects.
3. Main differences in comparison to traditional middle
frequency equipment:
The most important difference or advantage respectively is
basing on the ability of HiToP to generate very much
(up to circa 50 times) more power without any
discomfort or systemic risks for the patient in
comparison to traditional middle frequency equipment.
HiToP offers 5000 mW as maximum output per
channel; this limit of the output is prescribed by law.
Additional advantageous differences:
The greater frequency range increases the
probability of resonance.
SimulFAMx, used for stimulation of nerves
including motor and sympathetic fibres, can be
adjusted as more brusque (“combined” or
“parallel” stimulation) or softer (“paradoxical”
stimulation) according the slope of the graph
representing the simultaneous modulation of
frequency and amplitude.
SimulFAMi can be used to minimise or avoid
stimulatory effects
The spectrum of indications - unbelievable large on the first view:
1. Pain (5 pain-relieving effects are available in HiToP®)
2. Chronic inflammations
3. Degenerative diseases, for example osteoarthritis
4. Diseases of nerves and muscles, for example symptoms resulting from central and peripheral
pathological affection of the nervous system as spasticity in cases of cerebral palsy or multiple sclerosis
5. Edema
6. Mental-emotional disturbances
7. Functional disorders of the abdominal organs (Constipation, meteorism,
dyskinesias, symptoms of CROHN's disease and colitis
8. Bronchial asthma
9. Itch
10. Sleeplessness
11. Functional arrhythmia of the heart
12. Metabolic disturbances and resulting diseases as for instance diabetic polyneuropathy
The 5 pain-relieving effects of HiToP®:
1. The electrochemical shaking effect
- present in all kinds of application
2. The real blocking effect
- caused by unmodulated alternating fields
distinctly above the sensation threshold
3. The pseudoblock - caused by unmodulated alternating fields
4. Counter-irritation - SimulFAMX 100 Hz
5. Indirect pain relief by edema reduction - SimulFAMX 10 Hz
Furthermore,
HiToP® can be used for the following aims of treatment:
1. Acceleration of healing processes
2. Rehabilitation in cases of peripheral or central neuronal lesions
or after immobilisation
3. Prevention of venous thrombosis
by means of calf muscle stimulation
4. Mobilisation of geriatric patients after long time of bed rest
Scientific explanations
of the manifold effects in question and answer
_______
Contraindications:
Pacemaker
Acute bacterial infections (local or systemic)
End of theory, part 2
Practice, part 2
Practice, part 2
Big tac,
bimanual gliding transcutaneous application of currents
using HiToP®
as especially comfortable electrical massage,
for the enhancement of the efficacy during the manual lymphdrainage,
for the detection of trigger points,
for the treatment of BELL's palsy,
for the manual-digital stimulation of acupuncture points,
for the massage of reflex-zones of hands and feet
End of practice, part 2
Results of the study of RHADES and SCHNEIDER
concerning low back pain
18 patients had been treated.
The range of motion could be improved by 5.3° (
statistically significant.
4.7°),
The distance of the fingers to the ground could be diminished by
3.7 cm ( 4.0) cm, (significant).
Pain relief after the end of the treatment series in 8 patients
(44%), later additionally in 3 patients (16.6%), together circa 60%.
Degree of pain relief:
Statistically high significant improvement from 6.25 (
3.44 ( 1.82) (NAS-Score).
1.73) to
Judgement of the efficiency
40%
30%
20%
10%
0%
very good
good
doctor
moderate
bad
patients
Fig.1 Judgement of the efficiency
Low back pain caused by problems of the lumbar part of the vertebral column
Mean value (°)
130
120
110
100
90
80
70
1st treatment
last treatment
bowing
follow-up examination
range of motion
Fig. 2 Effects upon bowing and range of motion