What is the role and principle of physical therapy
The origin and development of physical therapy In primitive society, people hunted and chased wild animals, often tripped over thorns, causing soft tissue damage Injuries, so they instinctively use their hands to touch, massage, and relieve the pain. Fishermen in ancient Greece were sometimes injured by fish with electric dischargers on their backs while fishing, and later found that people who had joint pains got better or healed. It is constantly summed up in the long-term struggle between human beings and nature.
Physiotherapy has a long history in my country. As early as before the 2nd century AD, the book “Huangdi Neijing” had related records. Since the 1950s, my country has established the physiotherapy profession, and has carried out a lot of experimental work and achieved remarkable results.
The development of physiotherapy abroad first started before the 4th century AD, when the ancient Greek physician Hippocarates advocated the application of mineral springs, sunlight, seawater and other treatments. In the 17th century, the discovery of static electricity began to have artificial electrotherapy. In the 1930s, ultrasound was used to treat diseases.
Classification of modern physiotherapy using natural physical factors
For example: solar therapy, air bath therapy, forest therapy, thalassotherapy, climate therapy, etc.
Applying artificial physical factors
Applying motion and mechanical forces, electricity, light, sound, magnetism, heat, cold, water, etc.
Characteristics: Faster effect
For example, hot water bath for sweating, cold water bath for cooling down, some low-to-medium frequency electric therapy for acute sprain and contusion, often can make patients feel comfortable immediately.
Painless
The treatment works quickly, with immediate relief of pain and a feeling of comfort and lightness.
Less side effects and long-lasting effects
Physical therapy rarely causes physical discomfort. The effect of physiotherapy is long-lasting, and the treatment is repeated many times. Can produce stacking and cumulative effects of healing effects.
Classified Sound Therapy (Therapeutic Ultrasound)
Light Therapy (Infrared Light Therapy, Ultraviolet Light Therapy, Visible Light Therapy, Laser Therapy)
Hydrotherapy (contrast bath, whirlpool bath, bubble bath, etc.),
Electrotherapy (DC electrotherapy: iontophoresis, etc.; low frequency electrotherapy: including TENS, intermittent electrotherapy, etc.; medium frequency electrotherapy: that is, interference wave therapy; high Frequency electrotherapy or diathermy: including short-wave hyperthermia and microwave hyperthermia and magnetic therapy, etc.)
Cold therapy (ice compress, ice massage, etc.)
Hyperthermia (heat packs, waxes, diathermy, etc.)
Force (traction, pressure, impact, friction, etc.)
Magnetic (static magnetic field therapy, pulsed magnetic field therapy , low-frequency alternating magnetic field therapy, etc.)
Therapeutic effect and anti-inflammatory effect
A large number of clinical trials, a variety of physical therapy methods have anti-inflammatory effect. Skin, mucous membranes, muscles, joints and even internal organs, acute and chronic inflammation caused by various etiologies are all physiotherapy indications and can be treated with different physiotherapy methods.
Analgesia
Pain is a complex process, both a material phenomenon and a mental phenomenon. The application of physical factors for analgesia requires the identification of the cause and targeted treatment. Thermotherapy, direct current induction, and electrotherapy can be applied separately.
Antibacterial effect
Ultraviolet rays are known for their bactericidal properties and can kill Staphylococcus aureus, Pseudomonas aeruginosa, Bacillus anthracis, hemolytic streptococcus, etc. Effects
Sedation and insomnia
Physiotherapy with this effect includes electrosleep therapy, electrostatic therapy, magnetic field therapy, warm water baths, etc., all of which are It can enhance the diffusion inhibition of the cerebral cortex and relieve the tension of the whole body, thus producing obvious shock and hypnotic effects.
Neuromuscular excitation
Low-IF electrotherapy with various technical parameters, for the treatment of peripheral nerve palsy and muscle atrophy, or for the enhancement of muscle strength exercise.
Relief of spasticity
Physiotherapy for relief of spasticity includes short-wave, ultrashort-wave and microwave therapy for deep tissue, as well as superficial tissue. Paraffin therapy, infrared therapy, etc. The main mechanism of physiotherapy and spasmolysis is that heat energy reduces γ efferent nerve fibers in muscle spindles, which weakens stretch reflexes and decreases muscle tone.
Softens scars and disperses adhesions
Paraffin therapy, ultrasound therapy, iodine iontophoresis therapy can change the elasticity of connective tissue and increase extensibility, and are often used in the treatment of Postoperative scars and tissue adhesions can significantly soften scars and dissipate adhesions.
Accelerates wound healing
The application of low-dose ultraviolet radiation can prevent and control wound infection, while stimulating the growth of granulation tissue and accelerating epithelial bypass and wound healing process.
Accelerate callus formation
Weak DC cathode, TENS, interference electrotherapy and pulsed magnetic field can promote bone growth and accelerate fracture healing.
Enhancing the body’s immune mechanism
Experiments have shown that physical factors such as ultraviolet, infrared, and magnetic fields can enhance and regulate the body’s immunity.
Desensitization
The mechanism of desensitization is that ultraviolet rays can decompose proteins to form histamine, and small doses of histamine continue to enter the blood, which can stimulate the Aminase is produced, and when sufficient histamine is present, it breaks down excess histamine, thereby desensitizing. UV radiation also promotes adrenal function and enhances calcium absorption, which are also beneficial in reducing allergic reactions.
Anti-cancer effect
In recent years, the application of heating, cryogenic freezing, laser photosensitive effect, laser gasification carbonization, and focused ultrasound in the treatment of cancer has achieved good results. progress.
Commonality and characteristics of the effect on the body
The commonality of the effect of physical therapy on the body
1. In terms of physiological effects
(1) Change the proportion of ions and the content of trace elements in tissue cells and body fluids
(2) Change the molecular structure of certain substances in the body
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(3) Affect the activity of various enzymes
(4) Regulate substance metabolism
(5) Produce biologically highly active substances in the body
(6) Enhance blood and lymph circulation
(7) Change the permeability of biofilms, blood vessels, skin, mucous membranes and other tissues
(8) Cause changes in tissue temperature
(9) Regulate the function of the neuro-endocrine information control system
(10) Strengthen the function of the monocyte-phagocyte system, etc.
2. Performance in therapeutic effect
(1) Promote the elimination of dysfunction of the neuro-endocrine information control system.
(2) Improve the functional level of the body or some systems and organs
(3) Improve the blood circulation and nutrition of tissues and organs, and promote tissue repair and regeneration.
(4) Improve local or systemic resistance
(5) Analgesic effect
(6) Anti-inflammatory and swelling effect
(7) Relieves spasm
(8) Desensitization or sensitization
(9) Enhances the body’s adaptability
(10) Improves drugs Penetration into tissues and organs, etc.
Characteristics of the effect of physiotherapy on the body
After physiotherapy acts on the body, it can cause both common effects and specific effects. The specific effect of physical therapy is based on the relative selectivity of different physical factors to different cells, tissues and organs. This is because the properties of physical energy are different and the sensitivity to tissue cells is different. The specific effect of physiotherapy can only be manifested most obviously when a small dose is used, and its specific effect can be masked when a large dose is used due to molecular Brownian motion.
Clinical physical therapy diseases Nervous system diseases
such as cerebrovascular disease (Cerebrovascular Disease CVD or Cerebrovascular Accident CVA), brain lesions (such as Parkinson’s disease) Symptoms, etc.), brain trauma, myelopathy, spinal cord injury, peripheral nerve disease or injury caused by limb dysfunction.
Bone and muscular disorders
Arthritis (including degenerative and rheumatoid arthritis), ankylosing spondylitis, soft tissue injuries, Fractures, amputations, neck, shoulder, waist and leg pain, scoliosis and sports injuries, etc.
Cardiopulmonary Dysfunction
Treatment and training before and after thoracic, abdominal and cardiac surgery, and treatment of respiratory diseases such as chronic obstructive respiratory disease ( Chronic bronchitis, asthma, emphysema), pleurisy, pneumonia and bronchiectasis, etc.
Diseases of digestive system, genitourinary system
Gastritis, gastroduodenal ulcer, gastrointestinal spasm, cholecystitis, pyelonephritis, cystitis , pelvic inflammatory disease, prostatitis, etc.
Tissue Physical Therapy
The condition is usually treated for the skin or related organs. Common clinical conditions are burns and root skin open wound problems. Treatment methods include debridement of wounds, scars, maintenance of joint mobility, and wound dressing and dressing.
Others in need:
Exercise before and after childbirth, lymphedema, diabetic lower extremity pain and ulcers, geriatrics, Patients who are bedridden or undergoing cardiac surgery can be educated to avoid complications.
In the process of physical therapy, physical therapists not only focus on the control of pain, but also focus on the functional recovery of the patient, and provide education and corrections according to the patient’s daily habits and work needs , reduce the crises that damage health, and comprehensively pave the way for the sick.
Apply the basic principles to make the diagnosis clear and save lives
Without a correct diagnosis, there will be no correct treatment. Careful analysis of what causes this symptom can only be treated with the correct physiotherapy method.
Comprehensive therapy, with a holistic concept
1. Combined application of various physical therapy.
Comprehensive treatment can often do more with less. For example, the pathogenesis and pathogenesis of shoulder-hand syndrome after stroke are still not very clear. At present, most scholars believe that the occurrence of this complication is related to the incorrect movement pattern of stroke patients, which leads to shoulder and wrist joint injuries and upper limb fluid reflux. Obstruction and vascular motor dysfunction after central nervous system injury. In addition, the loss of the nerves supplying the shoulder muscles after stroke, resulting in decreased muscle strength, muscle tension or spasm of the affected limb, resulting in structural instability of the shoulder joint, is also an important cause of shoulder pain. Interfering with low-frequency treatment of the shoulder joint can stimulate the supraspinatus and deltoid muscles in the middle and rear, activate the nerve fibers of these two groups of muscles, make them contract rhythmically, accelerate the return of body fluids, enhance local metabolism, and increase muscle nutrition. It can effectively improve the muscle tension, thereby pulling the humeral head back to the normal anatomical position, and relieve the pain symptoms caused by nerve entrapment. In addition, according to the analgesic mechanism of low and medium frequency currents acting on the human body, interfering with low frequency currents stimulates the thick fibers that conduct non-painful substances with comfortable intermediate frequency currents, interferes and blocks the conduction of pain sensation, and at the same time promotes enkephalins and endorphins in the body. The release of endogenous morphine-like substances can achieve analgesic effect, thereby relieving shoulder pain. The magnetic field acts on the organism to reduce the excitability of peripheral nerves, promote blood circulation, accelerate the absorption and dissipation of inflammatory exudates, and promote wound healing. The synergistic effect of heat and heat further enhances its efficacy. Electroacupuncture therapy has the characteristics of holistic and bidirectional regulation, and it is unique in the treatment of stroke patients with hemiplegia. Shoulder-hand syndrome often occurs in the flaccid stage after stroke, and the treatment in the flaccid stage should focus on promoting the production of active muscle tension. At this time, acupuncture can be used to acupuncture the yin meridian of the upper limb and the yang meridian of the lower limb to induce the flexor muscles of the upper limbs and the extensor muscles of the lower limbs on the paralyzed side, enhance muscle tension, and promote joint movement. To sum up, the combination of various physical factors has a positive and significant effect on the treatment of shoulder-hand syndrome after stroke, and active treatment of shoulder-hand syndrome is very important for the comprehensive recovery of stroke patients and their return to family and society. significance.
2. Physical therapy and drug combination
Physical therapy and drug combination therapy can promote drug absorption and improve the body’s sensitivity to drugs. Examples of clinical use: The pathogenesis of cervical insomnia is still not fully elucidated. For the treatment of insomnia, in addition to giving treatment from the spiritual aspect, it is also necessary to pay attention to whether the patient has cervical spondylosis involved in the disease. It has been reported in the literature that frontal-occipital direct current can relieve local muscle spasm and dilate blood vessels, thereby relieving cerebral vasospasm and increasing cerebral blood flow. In this study, psychological counseling combined with estazolam combined with Danshen injection direct current iontophoresis was used to treat cervical insomnia. The clinical efficacy of the treatment group was better than that of the control group, and after stopping taking estazolam tablets, the control group had more obvious rebound insomnia. The results show that the direct current iontophoresis of Danshen injection has a good clinical effect in the treatment of cervical insomnia, and can significantly reduce the side effects of sleeping pills.
