TEXTBOOK OF PHYSICAL AND REHABILITATION MEDICINE. PART 1
Physical and rehabilitation medicine (PHR) is an evidence-based core clinical specialty dedicated to its extension, evaluation, review, and application in practice. Globally, the physiotherapy community has always been divided by name - physiotherapy, physical therapy and others, even the definition of the specialty in many cases is different. Nowadays, with the development of medical care and the emergence of new surgical techniques and medications, life expectancy has increased significantly.
Medical rehabilitation is a suitable modern method not only after a number of severe diseases and disabilities, but also to improve the quality of life for each person, related to personal and environmental factors.
Physiotherapy for lumbar disc…
Contents TEXTBOOK OF PHYSICAL AND REHABILITATION MEDICINE:
- Introduction / 15
- SECTION 1. INTRODUCTION TO THE SPECIALTY
"PHYSICAL AND REHABILITATION MEDICINE"
Chapter 1. Essence of physical and rehabilitation medicine / 17
History of the specialty: where it comes from / 17
Definitions and concepts of the FRM specialty / 19
Rehabilitation for the disabled / 20
Epidemiological aspect of disability / 20
Damage through the ages / 20
The WHO model of functioning, disability and health / 21
Impairment, disability and disability / 22
FRM's approach to disability / 23
Scope of FRM / 24
FRM – main clinical specialty / 25
Principles of the FRM / 25
Multiprofessional rehabilitation team / 26
Clinical area and competence of FRM specialists / 27
Cooperation with other medical disciplines / 28
The FRM specialty in the health system and society / 28
Education and professional development / 29
FRM – evidence-based / 30
Chapter 2. The rehabilitation process / 31
Approach to solving the problem / 31
Diagnosis / 31
Functional assessment / 32
State assessment methods / 32
Determination of rehabilitation potential / 34
Determination of indications and contraindications / 35
Setting specific goals / 35
Development of a rehabilitation plan / 36
Funds used in FRM / 37
Rehabilitation in all areas of medicine and in various pathologies / 37
Summary TEXTBOOK OF PHYSICAL AND REHABILITATION MEDICINE / 40
Chapter 3. Basics of Therapeutic Modalities / 41
Classification of therapeutic modalities / 41
Electromagnetic energy / 42
Thermal energy / 44
Electric energy / 45
Sound energy / 46
Mechanical energy / 47
Reaction of tissues to impact with different types of energy / 48
Patterns in the impact of different types of energy / 50
Mechanisms of energy transfer / 50
Physical regularities in energy transmission / 51
Dose-dependent treatment / 53
Physiological and therapeutic effects / 54
Mixing and matching, compatibility and incompatibility
of therapeutic modalities / 55
Summary / 58
Book review / 58
Musculoskeletal Kinesiology…
- SECTION 2. THERAPEUTIC APPROACH TO TISSUE DAMAGE
AND ON PAIN MANAGEMENT in TEXTBOOK OF PHYSICAL AND REHABILITATION MEDICINE
Chapter 4. The tissue recovery process / 60
Impact of stress on tissues / 60
Theory of physical stress / 60
General adaptation syndrome / 61
Hypothesis of mechanotransduction / 62
The process of tissue damage / 63
Inflammation / 63
The process of tissue repair / 65
Inflammatory response phase / 65
Phase of fibroblastic recovery - proliferation / 69
Wound maturation and remodeling phase / 71
Chronic inflammation / 71
Factors affecting tissue healing / 72
Treatment in the different phases of recovery / 76
Role of progressive controlled mobilization in the maturation phase / 78
Summary / 79
Book review / 80
Chapter 5. Physiology, psychology and treatment of pain / 81
What is pain? / 81
Pain threshold and tolerance to it / 81
Types of pain / 82
Neuroanatomy and neurophysiology of pain / 83
Somatosensory system / 83
Pain mediators / 87
Mechanisms of pain transmission / 88
Hyperesthesia and hyperalgesia / 88
Neurophysiological theories of pain control / 89
Ascending mechanism of pain modulation / 89
Descending pain modulation / 90
Theory of neuromodulation of pain / 92
Overlap of pain control mechanisms / 94
Pain Assessment Tools / 94
Pain Management Approaches / 99
How the clinician should approach pain / 99
Pain relievers / 100
Summary / 102
Book review / 102
Physiotherapy for orthopedic and…
- SECTION 3. ELECTROTHERAPY
Chapter 6. Principles of electricity and electrotherapy / 103
Electricity / 103
Components of electric current / 104
Electric currents used in physiotherapy practice / 105
Generators of therapeutic currents / 107
Main current parameters / 107
Types of electrical circuits / 113
Methods of electrotherapy / 114
Passage of electric currents through biological tissues / 114
Application techniques and methods of application of electrical stimulation / 117
Electrodes / 118
Physiological responses to electrical stimulation / 121
Levels of impact of electric currents / 121
Muscular and nervous responses to electric current / 122
Membrane potential and resting potential / 122
Excitation of electroexcitable membranes / 124
The role of synapses / 127
The role of the peripheral and central nervous system –
adaptation and habituation / 129
Effects of changes in current parameters and their influence on
treatment protocols / 129
Selectivity of electrostimulation / 134
Therapeutic applications of electrical stimulation / 136
Types of electrostimulation - name game / 139
General contraindications and precautions in electrotherapy / 141
Summary / 142
Chapter 7. Currents for electrical stimulation used in practice / 144
From theory to practice / 144
High Voltage Impulse Current (HVPC) / 144
Characteristics of HVPC Stimulators / 145
Effects and clinical applications / 146
HVPC to stimulate wound healing / 146
HVPC for Pain Management / 147
HVPC for muscle re-education and influencing muscle spasm / 148
HVPC for Edema Management / 148
Specific methods of HVPC / 149
Microcurrent electrical therapy (MET) / 150
Characteristics of microcurrent electrical stimulation / 150
Mechanism of action / 151
Effects of microcurrents / 152
Analgesic effect / 152
Biostimulatory effect on the healing process / 152
Methods of application / 153
Treatment protocols / 153
Indications and contraindications / 154
Summary of HVPC and MES / 155
Transcutaneous electrical nerve stimulation (TENS) / 155
Essence of TENS / 155
TENS devices and parameters used in operation / 156
Types of TENS and mechanism of action / 158
Conventional or high-frequency TENS (impact on the sensory level) / 158
Electroacupuncture or low frequency TENS
(motor level of stimulation) / 159
Intense short-term TENS (harmful level) / 160
Burst-TENS / 160
Application techniques / 162
Conducting the treatment / 164
Advantages of TENS as a healing technique / 164
Clinical indications / 164
Scientific evidence in acute pain / 165
Scientific evidence in chronic pain / 166
Contraindications and warnings / 166
Summary / 166
Diadynamotherapy / 167
Types of diadynamic currents and their characteristics / 167
Physiological action / 168
Therapeutic effects / 169
Application techniques / 170
Indications and contraindications / 171
"2-5 current" or Träbert / 172 current
Current characteristics / 172
Summary of single-phase DDTs and Träbert current / 173
Interference current therapy / 174
Mechanism of interference / 174
Methods of interference / 176
Classical (four-pole) interference / 176
Bipolar interference / 178
Stereodynamic interference current / 179
Criteria for choosing the right parameters / 179
Physiological action and therapeutic effects / 181
Application techniques / 183
Types of electrodes / 183
Indications, contraindications and precautions / 184
Sinusoidally modulated currents / 185
Current characteristics / 185
Physiological and therapeutic action / 186
Comparison of monopolar CMT with diadynamic currents / 186
Application techniques and methods / 186
Indications and contraindications / 187
Currents of Kots / 187
Current characteristics / 188
Mechanism of action / 189
Therapeutic effects and clinical applications / 189
Summary / 190
Galvanotherapy / 190
Physical characteristics and physiological action of galvanic current / 191
Therapeutic effects / 193
Application techniques and methods / 194
Indications for galvanotherapy, contraindications and precautions / 195
Iontophoresis / 196
Essence of iontophoresis / 197
Basic principles of iontophoresis / 197
Factors Affecting Iontophoretic Transport / 198
Movement of ions in tissues / 201
Overcoming the skin barrier / 201
Penetration of ions into tissues / 201
Generators for iontophoresis / 202
Medicines used / 204
Advantages and disadvantages of the method / 205
Algorithm for conducting the procedure / 206
Treatment reactions and contraindications / 207
Summary / 207
Neuromuscular electrical stimulation (NMES) / 208
Kinesiological aspects / 209
Mechanism of action / 211
Parameters of NMES / 211
Application techniques / 212
Therapeutic effects / 213
Clinical Applications / 215
Conduct of the procedure / 216
Contraindications and precautions / 216
Muscle stimulation with medium-frequency alternating currents / 216
TENS for muscle stimulation / 217
Electrostimulation with neofaradic (tetanizing) currents / 218
Functional electrical stimulation (FES) / 218
Tonolytic effect of electrical stimulation / 219
Summary / 220
Chapter 8. Electrodiagnosis and electrostimulation of denervated muscles / 222
Electrodiagnostics / 222
Classical electrodiagnostics / 223
Research methodology / 223
Electrophysiological regularities / 224
Electrophysiological regularities in medium-frequency currents / 227
Degeneration reaction test / 228
Chronoximetry / 228
Construction of intensity-time curves / 230
Evaluation of intensity-time curves / 231
Accommodation coefficient and accommodation curves / 232
Electrophysiological syndromes in the case of damage to the neuromuscular apparatus / 233
Quantitative changes in excitability / 233
Qualitative changes in excitability / 234
Stages of the degenerative process / 234
Cutaneous electrosensitivity / 235
Nerve Conduction Tests / 235
Clinical electromyography / 235
Electrostimulation of denervated muscles / 236
Difference between hypotrophic and denervated muscle / 236
Current parameters / 238
Reinnervation of the nerve / 239
Summary / 239
Book review / 240
Kinesitherapy for degenerative changes...
- SECTION 4. ELECTROMAGNETIC ENERGY THERAPY
Chapter 9. High frequency and high voltage currents / 244
d'Arsonval currents / 245
Physiological reactions and therapeutic effects / 245
Apparatus, methods and algorithm / 246
Indications and contraindications / 247
Diathermy / 248
Classification of diathermy / 248
Mechanisms of endogenous heat formation in tissues / 248
Physiological effect of diathermy / 249
Thermal effects / 249
Non-thermal effects / 251
TECAR therapy / 251
Apparatus, mode of operation, methods and dosage / 251
Physiological effects and therapeutic action /253
TEXTBOOK OF PHYSICAL AND REHABILITATION MEDICINE
Indications and therapeutic protocols / 254
Short-wave diathermy / 256
Biophysical effects of short-wave diathermy / 256
Methods of short-wave diathermy / 257
Condenser field diathermy / 257
Induction method / 261
Pulsed short-wave diathermy / 263
Dosages in treatment with short-wave diathermy (continuous and pulsed) / 264
Physiological effects of short-wave diathermy / 265
Microwave diathermy / 265
Biophysical effects of microwave diathermy / 266
Device of the apparatus for microwave therapy / 267
Dosage / 269
Indications and contraindications for the use of diathermy / 269
Summary / 270
Book review / 271
Chapter 10. The pulsed magnetic field in therapy / 273
Origin and essence of magnetotherapy / 273
Physical characteristics / 274
Therapeutic window / 275
Methods of treatment / 276
Physiological and therapeutic action / 277
Available evidence / 278
High intensity magnetic therapy / 280
Summary / 281
Book review / 282
Chapter 11. Light therapy / 283
Properties of light / 283
Light sources / 285
Infrared and visible light therapy / 287
Physiological effects of infrared and visible rays / 287
Sources of infrared and visible rays / 289
Therapeutic use and contraindications / 291
Ultraviolet therapy / 291
Photochemical and biochemical action of UV radiation / 291
Therapeutic effects of ultraviolet irradiation / 294
Artificial sources of UV radiation / 297
Argon-mercury-quartz lamp / 298
Work rules / 299
Study of the biological sensitivity of the skin / 299
Individual and regional sensitivity / 299
Photosensitization / 300
Synergism and antagonism in the action between rays / 300
Dosage of ultraviolet irradiation / 300
Minimum erythema dose / 301
Biodose determination algorithm / 301
Types of dosages / 302
Methods of irradiation with UV radiation / 302
Clinical Applications / 303
Contraindications / 305
Summary / 305
Chapter 12. Laser therapy / 306
Basic characteristics of laser radiation / 307
Laser Generator Components / 308
Mechanism of laser beam generation / 309
Classification of laser types / 310
Parameters of laser therapy / 312
Depth of penetration of laser radiation / 313
Penetration depth according to wavelength / 313
Penetration depth depending on power / 314
Mode of operation and penetration depth of the laser beam / 314
Dosage of laser therapy / 314
Therapeutic window / 315
Methods of laser therapy / 316
Effects of laser therapy on tissues / 316
Mechanism of interaction of laser light with cells / 317
Physiological effects of the laser at the tissue level / 318
Therapeutic effects / 319
Indications, contraindications and precautions / 322
Work rules / 323
Consistency in using laser therapy
with other therapeutic modalities / 323
High-energy lasers in physical therapy practice / 323
Laser beam parameters and advantages over LLIT / 324
Photochemical and photobiological effects / 324
LEDs, Super Bright Diodes and Cluster Applicators / 326
Summary / 326
Book review / 327
Physiotherapy for fractures of…
- SECTION 5. SOUND ENERGY THERAPY
Chapter 13. Therapeutic ultrasound / 329
Devices for generating ultrasonic energy / 330
Physical characteristics of acoustic energy / 331
Propagation of ultrasound energy in tissues / 332
Reflection of the ultrasonic wave / 333
Penetration and absorption of ultrasound depending on the type of tissues / 335
Crystal Characteristics / 336
Effective radiation area / 336
Beam unevenness factor / 336
Therapeutic parameters / 338
Biophysiological effects of ultrasound / 342
Thermal effects / 343
Non-thermal effects / 344
Therapeutic effects of ultrasound / 346
Phonophoresis / 349
Mechanism of transfer of medicinal substances in tissues / 349
Factors determining the penetration of medicinal substances / 350
Application techniques and methods of ultrasound therapy / 351
Indications and contraindications / 353
Protocol for application of ultrasound therapy / 354
Combining ultrasound with other modalities / 356
Summary / 357
Book review / 358
Chapter 14. Extracorporeal shock wave therapy / 360
History of extracorporeal shock wave therapy / 360
Physical characteristics of extracorporeal shock waves / 361
Shock wave generators / 362
Types of shock waves / 363
Parameters of extracorporeal shock wave therapy / 365
Mechanism of action / 366
Therapeutic effects of shock wave therapy / 368
Clinical Applications / 370
Evidence-Based Practice / 374
Indications, contraindications and warnings / 374
Methodology of application / 376
Summary / 376
Book review / 376
Physiotherapy for orthopedic and…
- SECTION 6. THERMOTHERAPY
Chapter 15. Heat therapy and cryotherapy / 379
Terminology / 379
Heat transfer / 381
Thermoreceptors / 382
Heat therapy / 383
Mechanisms of action of heat / 383
Physiological effects / 384
Types of heat carriers and therapeutic techniques / 387
Moist Warm Packs / 387
Paraffin / 388
Fluid therapy / 391
Contraindications and warnings for thermal applications / 392
Cryotherapy / 393
Mechanism of action of cryotherapy / 393
Physiological effects / 395
Clinical applications of cryotherapy / 400
Precautions and contraindications / 401
Frostbite / 402
Cold-induced neuropathy / 403
Application techniques / 403
Ice applications / 403
Massage with ice blocks / 405
Cooling spray / 406
Immersion in cold water / 407
Contrast bath / 408
Cold Whirlpool / 408
Apparatus for cryotherapy / 408
Combined methods / 408
Comparison between heat and cold applications / 408
Summary / 409
Book review / 410
