Physical offices. What is a physiotherapy office? Need help studying a topic?

Ministry of Education and Science of Ukraine

Open International University of Human Development “Ukraine”

Gorlovka branch

TEST

discipline: Fundamentals of physiotherapy

TOPIC: “Organization of physiotherapeutic care

to the population"

Completed:

Milyaeva Anastasia Valentinovna

1. Design, equipment and equipment of a physiotherapy room

1.1 Safety and health instructions for the physiotherapy department (office)

2. Organization of the work of the physiotherapy room

3. General rules carrying out physiotherapeutic procedures

1. Design, equipment and equipment of a physiotherapy room

To provide physiotherapeutic assistance, physiotherapy departments (offices) are organized in all treatment and preventive, sanatorium and resort institutions and rehabilitation centers.

Depending on the capacity of the treatment and prevention institution, it can either use separate devices for physiotherapy, or create physiotherapy rooms or physiotherapy departments. Physiotherapeutic rooms are designed to provide basic types of electrical, light and heat treatment. Physiotherapeutic departments are created on the basis of large multidisciplinary hospitals, clinics, rehabilitation centers, sanatoriums and are capable of providing the entire volume of physiotherapeutic care. They also usually include reflexology, massage and manual therapy rooms.

According to this standard, the area of ​​electrotherapy and light therapy rooms must be at least 6 m2 per couch, and if there is one couch, at least 12 m2. The room for abdominal procedures is allocated separately; the area for one gynecological chair is 18 m2. The floor should be wooden or covered with special linoleum that does not generate static electricity. The walls of the premises are painted with light-colored oil paint to a height of 2 m; for the rest of the walls and ceiling, adhesive paint is used. Wall cladding with ceramic tiles is prohibited.

For medical procedures, cabins are equipped, the frames of which are made of plastic or well-polished wooden racks or metal (nickel-plated or oil-painted) pipes. In the latter case, metal structures must be isolated from stone walls and floors by installing flanges made of insulating material. Dimensions of cabins: height - 2 m, length - 2.2 m, width - 1.8-2.0 m. Only one stationary physiotherapy device should be installed in each cabin; There may be several small portable devices. Stationary devices for UHF and microwave therapy are located in specially equipped shielded rooms or cabins.

The electrotherapy room must have a special insulated box with an area of ​​at least 8 m2 for preparatory work, storage and processing of pads, preparation of medicinal solutions, etc., equipped with a drying hood, washing sinks, a work table, a medical cabinet, and disinfection boilers. , washing machine.

In each room for electrolight therapy, in an easily accessible place, a group panel is installed with a common switch or starter with a designated “on-off” position. In each treatment cabin, a starting panel is installed to connect devices at a height of 1.6 m from the floor level. Wires used to connect devices to the network must be made of flexible cable. Wires extending from the device to the patient must have high-quality insulation, and its integrity must be checked before each use. Electrical wiring and starting devices in areas associated with the conduct of water procedures, are made of special materials that ensure tightness. Each of the premises used for procedures has certain requirements. They relate to the size of the room, supply and exhaust ventilation devices, placement of devices, etc. All devices with electrical safety class 01 and I are subject to mandatory grounding (grounding).

Safety instructions should be posted in a visible place in the office.

1.1 Safety and health instructions for the physiotherapy department (office)

1. Before starting work, the nurse must check the serviceability of all therapeutic devices and grounding wires. If defects are detected, she must inform the doctor about this and make a record of the detected defects in the control and technical journal. Until the defect is eliminated, it is prohibited to carry out procedures on a faulty device.

2. Metal grounded housings of devices during procedures with contact application of electrodes should be installed out of reach of the patient.

3. It is prohibited to use radiators of the heating system, water pipes and sewer pipes as grounding. They should be covered with wooden casings painted with oil paint.

4. Before turning on the device, check that all switches are in their original positions. Changing the impact parameters or turning off the device is only permissible when the amplitude or intensity knobs are in the zero position.

5. It is strictly forbidden to troubleshoot, change fuses or wipe the panels of devices connected to the network. Non-working devices must not be left connected to the network.

6. When carrying out ultraviolet and laser irradiation It is necessary to protect the eyes of patients and medical personnel with dark-colored glasses and side protective (leather or rubber) frames. Do not look towards the primary and reflected laser beam.

7. The mercury-quartz irradiator and the Sollux lamp must be installed on the side of the patient to avoid dangerous falling of hot glass fragments or parts of the lamp (irradiator) in case of accidental breakdowns. The Sollux lamp must be equipped with safety wire mesh with a window with a diameter of 4-5 mm in the outlet of the reflectors.

8. It is prohibited to carry out UHF therapy if the total gap between the tissues and the capacitor plates is more than 6 cm.

9. Before taking a bath (shower), it is necessary to measure her (his) temperature using a thermometer.

10. When heating paraffin (ozokerite) and carrying out thermotherapy procedures, it is necessary to prevent water from getting into it to avoid burns for patients.

11. When carrying out gas baths, it is necessary to protect gas cylinders from impacts and falls. Do not touch oxygen cylinders with objects containing grease or oil.

12. Hydrogen sulfide baths must be carried out in isolated compartments with supply and exhaust ventilation.

14. During the procedures, the nurse has no right to leave the physiotherapy room. She is obliged to constantly monitor the operation of the devices and the condition of the patients.

15. At the end of the working day, all switches, device switches, as well as socket plugs must be disconnected from the network.

16. Nursing personnel who do not have specialization in physiotherapy are not allowed to perform procedures.

17. Repair of physiotherapeutic equipment by random persons is strictly prohibited.

2. Organization of the work of the physiotherapy room

The work of the physiotherapy department (office) is supervised by the head of the department (office), who supervises the therapeutic and preventive work of the staff, ensures the organization of the work of the department (office), equipping it with equipment, is responsible for the correctness of prescriptions and the implementation of treatment procedures, and is responsible for the safety of work on physiotherapy equipment, monitors the proper maintenance of medical records.

The choice of physiotherapeutic method, area of ​​influence, dosage, frequency of exposure and number of procedures are the prerogative of the attending physician, which he makes an appropriate entry in the medical history or outpatient card. A physiotherapist (rehabilitation doctor) has the right to cancel the attending physician’s prescriptions if they are made without due consideration of contraindications, are incompatible with the physiotherapy already being carried out, or contradict other basic principles of the therapeutic and prophylactic use of physical factors. In this case, assigning the optimal therapeutic complex carried out by a physiotherapist (rehabilitation doctor) together with the attending physician.

After examining the patient, the physiotherapist (rehabilitation doctor) makes a detailed entry in the medical history (outpatient card), which indicates the name of the procedure, area of ​​influence, technique, dosage and number of procedures. Based on the appointment, a procedural card of the patient being treated in the physiotherapy department (office), form No. 44u, is filled out. In it, the method and parameters of the impact are indicated for the nurse, and the localization of the impact is graphically marked on the silhouette diagram of the person. In this card, the nurse makes notes on the implementation of each procedure, the actual dosage of the physical factor and the duration of exposure are noted. After completion of the course of treatment, the procedural card is stored for a year. The physiotherapy department (office) must also have the following documentation: a logbook for registering primary patients, a diary for the daily work of a nurse, a logbook for introductory briefing upon hiring, a logbook for on-the-job briefing, a technical maintenance logbook, a passport of the physiotherapy department (office).

Physiotherapeutic procedures are carried out only by paramedical workers who have undergone special training and having a certificate of completion of specialization courses in physiotherapy. Some procedures are carried out only by a physiotherapist (rehabilitation doctor). The nurse must prepare the patient for the procedure: briefly introduce its essence and report possible sensations during the treatment process, instruct about the rules of behavior during the procedure, help take the necessary body position, provide, if necessary, protection for the eyes or other parts of the body that are not subject to influence. During the procedure, the nurse must be in the treatment room, monitor the patient’s condition, and if it worsens, stop the treatment and call a physiotherapist (rehabilitation doctor). She must strictly follow safety rules, know and be able to provide emergency medical care to patients in situations where it is necessary. The responsibilities of the nurse also include keeping records and reporting on the work done. Every 5 years, a physical therapy nurse must undergo advanced training in her specialty.

Since unequal time is spent on performing various procedures, so-called conventional procedural units (CU) have been introduced to account for the work of a physical therapy nurse. According to the current situation, for 1 USD A job has been accepted that requires 8 minutes to prepare and complete. So, for example, galvanization, UHF therapy, decimeter wave therapy, magnetic therapy are estimated at 1 USD, ultrasound therapy, treatment with dia-dynamic currents - 2, electrosleep - 3, underwater shower-massage - 4 USD . etc. The standard workload for a nurse is 15,000 USD. per year (approximately 50 USD per day for a 6-day work week and 60 USD for a 5-day week).

Preventive inspection of physiotherapy equipment is carried out twice a month, and a corresponding entry is made in the technical maintenance log.

3. General rules for conducting physiotherapeutic procedures

1. Each treatment room must have a work schedule posted in a visible place, which indicates:

a) the time the doctor sees patients;

b) time of procedures in the office;

c) time of procedures in the ward;

d) if the office is designed to serve inpatient and outpatient patients, the hours of reception of these groups of patients are indicated.

2. Each patient should be allocated certain time to carry out the procedure. The order of procedures is determined by the time specified in the procedure card.

4. Before the first procedure, the nurse familiarizes the patient in detail with the rules of behavior during and after the procedure and the nature of the sensations that he will experience during the procedure. Before each following procedure It is necessary to briefly remind patients of these rules.

5. Where possible, procedures should be performed on patients in a supine position. At the end of the procedure, patients, especially older ones, should slowly move to a vertical position to avoid dizziness.

6. When performing any procedure, the patient should be given a comfortable position. To prevent pain, numbness, and cramps in patients during the procedure, place sandbags under the lower back and knee joints. Patients with cardiac dysfunction and lung disease are given an elevated position of the head and chest during the procedure.

7. To fix the electrodes, it is advisable to allocate bandages for each patient and put them in the closet in special slots indicating the patient’s name. If there is a shortage of bandages, it is necessary to allocate bandages for the face and limbs and store them separately.

8. Patients with infectious diseases ( fungal infections etc.) must be served at specially allocated times with the obligatory use of individual linen.

9. During procedures, wires should not be left directly on the patient’s body.

10. After the procedure, patients should rest for 20-30 minutes.

References

1. Pankov E.Ya. Physical factors and recovery processes. - Kharkov, 1989. - 48 p.

2. Technique and methodology of physiotherapeutic procedures / Ed. V. M. Bogolyubova.-- M.: Medicine, 1983.--352 p.

3. Physiotherapy: Transl. from Polish /Ed. M. Weiss and A. Zembatogo.-- M.: Medicine, 1985.--496 p.

4. Physical rehabilitation: Textbook for academies and institutes of physical culture / Under the general editorship. prof. S.N. Popova. - Rostov n / D: publishing house "Phoenix", 1999. - 608 p.

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Physiotherapy (Klyachkin L.M., Vinogradova M.N.) - 1995

PREFACE

In the time that has passed since the publication of the first edition of the textbook (1988), physiotherapy has been enriched with new theoretical concepts and practical methods. This necessitated the need to reissue the textbook, in the preparation of which the authors took into account the comments and wishes of reviewers and readers. The content of the textbook has been significantly modernized and reflects the current level of development of physiotherapy.

When revising the textbook, ideas on the theory of action of physical factors were expanded and clarified. Information about modern equipment has been added and information about outdated equipment has been eliminated. A description of such modern methods as millimeter wave therapy, fluctuarization, electrotonotherapy is included, and the section devoted to sanatorium treatment has been expanded. Data is included on the features of physiotherapy in children, as well as the features of the use of its methods in obstetrics and gynecology. Some illustrations have been updated.

The textbook examines the subject and tasks of physiotherapy, the basics of organizing physiotherapy departments (offices), the responsibilities of their staff, safety rules, characterizes the main natural and modified therapeutic physical factors, and sets out methods for performing procedures. Practical information, on which the main emphasis is placed, is based on the foundation of modern theoretical concepts, given in a volume that corresponds to the level of training of students. The volume of textbook sections is proportional-3

is allocated to the educational time that the discipline program allocates for working on relevant topics.

Each section ends with methodological recommendations, including the definition of goals, educational objectives of classes, the logical structure of their implementation, indicative principles and algorithms of actions for performing procedures, control questions, tests and situational tasks for self-monitoring of knowledge acquisition.

INTRODUCTION

The methods, methods and means of treating human diseases are extremely diverse. Along with drugs, there are also many non-drug means of influencing the human body. The main place among them is occupied by healing physical factors, both natural - climate, air, sun, water (including mineral), and preformed, i.e. based on the use of various types of physical energy in a transformed form. The rational use of physical non-drug factors significantly increases the effectiveness of complex treatment and rehabilitation of patients, reduces the period of temporary disability, reduces disability, accelerates return to active life and creative work. These factors have certain advantages over drugs, since they are relatively free from allergic and toxic side effects. However, physical methods are no less active, sometimes they can even be considered potent, and if used incorrectly, they can be dangerous for the patient. Therefore, a paramedic or nurse must clearly understand the mechanism of action of physical factors on the human body and be fluent in the methodology for dispensing procedures.

Advances in science and the introduction of the results of scientific and technological progress into healthcare practice contribute to the creation of new medical devices and place increasingly high demands on the work of medical personnel.

The field of clinical medicine that studies the healing properties of physical factors and develops methods of using them for the treatment and prevention of diseases, as well as medical rehabilitation, is called physiotherapy.

Natural factors have been used for treatment since

ancient times (water and heat therapy, massage, etc.). However, only the development of the natural sciences (physics, physiology and biology) served as the basis for physiotherapy. Thus, the discovery of the phenomenon of electromagnetic induction in the 19th century. marked the beginning of electrotherapy. At the same time, other branches of physiotherapy emerged and improved. Of great importance for its development were the works of outstanding domestic physiologists I. M. Sechenov, I. P. Pavlov, as well as the works of the founders of domestic clinical medicine S. P. Botkin, G. A. Zakharyin, G. A. Ostroumov and others. Fundamentals physiotherapy in our country was founded by the works of A. E. Shcherbak, A. V. Rakhmanov, S. A. Brushtein. In subsequent years, A. P. Parfenov, A. N. Obrosov, K. N. Zavadovsky, E. I. Pasynkov, N. S. Molchanov, A. I. Nesterov, A. P. Speransky made a great contribution to its development etc.

Physiotherapy has become an integral and important element of the medical care system for the population. Every year the arsenal of treatment methods used is expanding, and the technical equipment of physiotherapy departments and offices is growing. At the same time, the responsibility of medical personnel increases, including nurses, whose responsibilities include directly carrying out procedures as prescribed and under the supervision of doctors.

Physiotherapeutic procedures have a variety of effects on the human body. As a result of their use, pain syndromes disappear or are reduced, the secretory and motor functions of organs are normalized, the activity of inflammatory processes is reduced, the trophism of organs and tissues is improved, and reparative processes are enhanced. These clinical effects are based on the normalizing effect of physiotherapeutic procedures on metabolism, redox processes, neurohumoral regulation of the functions of internal organs, blood and lymph circulation in them. In general, they have a powerful sanogenetic effect and help mobilize the body’s defenses.

The mechanism of this action is very complex. The main aspects of this mechanism can be explained on the basis of the teachings of I.P. Pavlov. Physical factors cause irritation of receptors in the skin and underlying tissues. In response to this irritation, complex reflex-type reactions arise. They may be predominantly

local, i.e. localized in the affected area. More complex reactions associated with the involvement of the autonomic nervous system are segmental in nature, similar to somatosympathetic reflexes that cause vascular and metabolic (trophic) changes in a particular organ. Finally, the spread of excitation from the zone of influence to the higher parts of the central nervous system affects all systems of the body.

Along with the neuro-reflex mechanism, there is also a humoral mechanism of action of physiotherapeutic procedures, which leads to the formation of biological active substances, histamine, as well as neurotransmitters - norepinephrine, dopamine and acetylcholine, as a result of which the release of hormones from the pituitary gland, adrenal glands, thyroid and other endocrine glands, which contribute to the implementation of the physiological and therapeutic effects of physiotherapeutic procedures, increases.

As a result of neurohumoral responses to the action of physical factors, long-term readaptation (restructuring) of the body occurs, i.e., activation of its protective forces as a result of optimal adaptation to the therapeutic stimulus. The general biological effect of physical factors, both natural and preformed, is to mobilize the protective and adaptive reactions of the human body.

The skin plays an important role in the mechanism of action of physical factors. It performs not only barrier and receptor functions, but also promotes the accumulation, redistribution and transformation of effects with their subsequent transfer to internal organs.

In recent years, it has become clear that physical factors are capable of purposefully changing the body’s immune response and correcting its immune reactivity.

Currently, it is believed that physical factors have both nonspecific and specific effects, which depend on the area of ​​influence, its duration and intensity, and mainly the nature of the physical factors.

Many of the effects of physiotherapeutic procedures can be explained on the basis of the theory of functional systems, developed by the Soviet physiologist Academician P.K. Anokhin. A functional system is a collection of nerve centers and peripheral organs, the combined activity of which is involved in the formation

the body’s response, for example, normalization of blood pressure, gastric juice secretion, tissue trophism, muscle contraction, etc., which determines in each case the structure of a particular functional system and the activity of the nerve centers that regulate them. The essence of the system’s action is that the body’s reaction to a stimulus, including a physiotherapeutic procedure, does not end with a reflex response of the effector apparatus (for example, a muscle or gland), but continues further. Thanks to the feedback of the peripheral organ with the nerve centers, the latter evaluates the result and its compliance ultimate goal. If the goal is not achieved, then the system further searches for the desired reaction, turns on other organs, and promotes changes in their structure and function in order to adequately adapt to the environmental factor. Within the framework of the systems approach, the Pavlovian reflex principle was further developed. This approach helps to better understand the mechanism for achieving beneficial results when using physiotherapeutic procedures.

Physiotherapeutic procedures are included in the complex treatment of a number of diseases, mainly in the phase of beginning or complete remission. However, in recent years, physiotherapeutic methods have been used in the acute phase of the pathological process. Physiotherapy methods have a mainly pathogenetic, rather than etiological, impact, so the indications for them are determined not so much by the name of the diseases (their list would be too broad), but by the direction of their pathogenesis, the predominance of inflammatory, dystrophic or functional processes in it. Further clarification of the indications for the use of certain specific methods of physiotherapy is given in the relevant sections of the textbook.

This determines the breadth of the range of indications for the use of physical factors. The most common contraindications to their use are severe conditions of the body, severe exhaustion, a tendency to bleeding, malignant neoplasms, blood diseases, severe cardiovascular and respiratory failure, as well as impaired liver and kidney function.

Compatibility and consistency of procedures are important. Within one day

It is customary to perform no more than two procedures, provided that one of them has a predominantly local effect.

You should not prescribe simultaneously procedures that have an antagonistic effect - calming and stimulating, and also use two different baths, two thermal treatments, and different types of high-frequency electrical procedures on the same day.

The therapeutic possibilities of modern physiotherapy are very great, but, like everyone active method treatment, it requires a qualified and careful approach with strict adherence to the principle of individualization of each patient.

Chapter 1

ORGANIZATION OF WORK OF THE PHYSIOTHERAPY DEPARTMENT (OFFICE)

The modern physiotherapeutic department (PTD) includes a number of rooms: electrical and light therapy, ozokerito- and paraffin therapy, therapeutic massage, a hydropathic clinic with baths and showers, an inhalation room, etc. They are equipped in accordance with sanitary and hygienic standards and are equipped with a variety of medical equipment. In addition, the FTO has doctors’ offices, utility rooms, and rest rooms for patients. Such departments are created in large hospitals, clinics, and sanatoriums, which also have rooms and equipment for balneotherapy and mud therapy.

Medical institutions with relatively low capacity and capacity (some local hospitals) have a physiotherapy room. Its capabilities are more modest; it is located in one or two rooms with utility rooms. The rooms are dry, well lit, with an area of ​​32-38 m2, s wooden floor covered with oil paint or linoleum. The walls are painted with oil paint to a height of 2 m. Central heating radiators, water and sewer pipes must be covered with wooden casings painted with oil paint, current-carrying wires must be well insulated. In Fig. Figure 1 shows a plan of a physiotherapy room in a rural outpatient clinic. These offices are equipped with wooden couches and chairs. Metal structures of the cabin must be insulated. The physiotherapy room also houses a nurse's workplace.

A group electrical panel with a common switch is installed in the office, and switchboards are installed to connect individual devices. In addition, a “kitchen corner” is equipped with a sink for rinsing the electrode pads and a sterilizer is installed for boiling them.

10

Rice. 1. Plan of a physiotherapy room for a rural medical outpatient clinic (standard project 254-4-7).

1 - couch for light therapy; 2 - couch for electrotherapy; 3 - bedside table; 4 - single-bed table; 5 - semi-rigid chair; 6 - hanger; 7 - pedal bucket; 8 - apparatus for galvanizing; 9 - device for UHF therapy; 10 - apparatus for diadynamic therapy; 11 - portable ultraviolet irradiator;

12 - Sollux irradiator.

Safety instructions must be posted in a visible place in the office. It is also necessary to have an emergency first aid kit.

Larger rooms and specialized in types of physiotherapy are equipped with cabins with an area of ​​2.2 x 1.8 m. The partitions between the cabins are up to 2 m high. The cabin is equipped with an apparatus, a couch for the patient, a hanger for his clothes, and a chair.

The physiotherapist, head of the department (office), manages all the work of the staff, plans and ensures the work of the department, receives patients, monitors the correctness of the prescriptions of physiotherapeutic procedures, enters them into the procedural card, checks the correctness of their implementation, advises patients, organizes and provides advanced training personnel, is responsible for all work of the unit.

Physiotherapeutic assistance is also provided in the conditions of a paramedic-midwife station, where a physiotherapeutic station is created, equipped with the most simple equipment.

The work of the physiotherapy department (office) is characterized by two indicators. The first of them reflects the coverage of patients with physiotherapy; it is determined by the percentage ratio of the number of patients treated in physical therapy to the total number of patients treated in

hospital, or the number of initial visits to the clinic. Average coverage figures are: for hospitals - at least 55%; for clinics - 25%; in sanatoriums - 70%; in specialized hospitals - 100%. The second indicator is the number of procedures per patient treated in the medical technical department. On average, this figure for clinics is 10-12, for hospitals - 13-14.

Responsibilities of a nurse

A nurse in a physiotherapy department (office) must have a secondary medical education and complete specialization courses in physiotherapy. She is responsible for the correct conduct of physiotherapeutic procedures, monitors the condition of patients during the procedure and the operation of the equipment, and ensures the sanitary condition of the office. During her work, she must strictly adhere to safety regulations and be able to provide emergency medical care to the patient in necessary cases. The nurse organizes the work of junior medical staff in the office, in particular in preparing pads for electrophoresis, baths, paraffin, changing linen, and maintaining cleanliness and order in the office.

The nurse receives the necessary information about the procedures prescribed for the patient from the doctor’s notes on the procedure card (Form 44 y). There, on the silhouette diagram of the human body, the doctor graphically marks the area of ​​influence (Diagram 1).

The nurse must carefully read the assignment made and strictly follow it.

Having received the patient, the nurse prepares him for the procedure: introduces him to the necessary extent with the medical prescription, instructs him on the rules of behavior during the procedure, helps him take the necessary body position, provides protection for the eyes and areas of the body that are not subject to influence, and informs about the sensations during the procedure. After this, she applies the electrodes or sets the device in the working position, starts the signal clock and turns on the device.

Before the first and each subsequent procedure, the nurse must inquire about the patient’s well-being and examine the area of ​​the procedure, reporting any violations to the physiotherapist.

During the procedure, the nurse should not leave the office; she must constantly monitor the operation of the device and the patient’s condition. After the procedure is completed, the nurse turns off the device, removes the electrodes, sends the patient to the rest room and makes a note in the procedure chart.

At the end of the office work, the nurse must turn off all devices, turn off the general network switch, close the windows and all water taps.

The responsibilities of the nurse also include keeping records of the work done and reporting on it. She must monitor the condition and safety of medical equipment, promptly prescribe and receive the necessary medications and solutions from the pharmacy.

Different procedures require different amounts of time, so conventional units are used to record the work of a nurse. By order of the Ministry of Health of the USSR No. 1440 of December 21, 1984 “On approval of conventional units for performing physiotherapeutic procedures, time standards for massage, regulations on physiotherapeutic units and their personnel,” work that requires 8 minutes to complete and prepare is accepted for one conventional unit . So, for example, one conventional unit evaluates procedures such as galvanization, UHF therapy, exposure to decimeter waves (UHF), two units - the procedure for exposure to diadynamic currents (DDT), sinusoidal modulated currents (SMC), determination of the biodose for UV irradiation , three units - electrosleep procedure, four units - underwater shower-massage. The work rate of a nurse is 15 thousand conventional units per year or about 60-65 conventional units per working day (b"/2 hours)..

One of the most experienced nurses in the department is appointed to the position of senior nurse. She completely performs all the work of a nurse and at the same time supervises the work of all secondary and junior staff, ensuring its arrangement, drawing up a work schedule. She monitors the work of personnel and the serviceability of equipment.

The work of a paramedic at paramedic-midwife stations, which are outpatient institutions that provide pre-medical care to the population under methodological guidance, has significant differences.

local doctor. The paramedic, in addition to other types of medical care, must conduct physiotherapeutic procedures and therapeutic massage.

Safety regulations

Carrying out physiotherapeutic procedures is associated with increased danger for patients, and sometimes also for the staff of physiotherapy departments and offices. Only solid knowledge and strict compliance by personnel with safety regulations can prevent complications and accidents during procedures.

The nurse should be well acquainted with the basic situations requiring emergency care, possible reasons their occurrence and consequences. Such cases include electrical trauma, burns, anaphylactic shock, severe balneological reactions, up to critical exacerbations of the underlying disease.

Electrical injury, or electric shock, poses the greatest danger. It can arise from errors during electrotherapeutic procedures or accidental contact with current-carrying parts of devices. A nurse can also be exposed to electric current if she simultaneously touches the body of the device and the electrode when the grounding is broken. The possibility of electrical injury may occur if the power cord is faulty,

twisting.

Depending on the method of protection against electric shock, all devices are divided into 4 classes:

devices of classes 01 and I have protective grounding, class U - protective insulation, class III - powered by isolated current source low voltage. In class I devices, the plug has a grounding contact - a pin and they cannot be plugged into a regular socket without grounding. In Class II devices, protective insulation eliminates the possibility of voltage occurring on accessible metal parts, which is especially important for portable equipment plugged into regular sockets outside the PTO.

Electrical injury occurs when electric current passes through the human body during grounding or a short circuit. Grounding occurs when a person comes into contact with one pole of the device and at the same time

concerns water pipes or a heating radiator. A short circuit is characterized by the connection of both poles of an electrical circuit through the human body. In both cases, a large current passes through the human body.

To prevent possible electrical injuries, the nurse before starting work. is obliged to check the serviceability of all physiotherapeutic devices and grounding wires. If defects are detected, she must inform the doctor about this and make a record of the detected defects in the control and technical journal. Until the malfunction is resolved, operation of this device is prohibited.

When carrying out procedures with contact application of electrodes, metal grounded housings of devices should be installed out of reach of the patient. It is prohibited to use radiators of the heating system, water supply and sewerage pipes as grounding conductors.

When injured by an electric current, pain and convulsive muscle contractions occur, a sharp blanching of visible skin. Convulsions do not allow the victim to release the wire from his hands, so the effect of the electric current continues. In severe cases, loss of consciousness, respiratory arrest, cessation of cardiac activity, and dilated pupils are noted. These signs indicate the onset of clinical death. It is necessary to immediately release the victim from the action of the current - open the electrical circuit, turn off the switch. If this is not possible, then the victim should be pulled away from the power source. In this case, the rescuer must wear rubber gloves or wrap his hands in a dry cloth and stand on a rubber mat. If current flows through wires, then their should be cut with wire cutters with insulated handles.

Resuscitation measures must begin immediately. A doctor should be called, but without waiting for his arrival, the nurse should begin to carry out artificial respiration using the mouth-to-mouth method, closed heart massage, and give an injection of cordiamine. When the doctor arrives, she must act according to his instructions.

Burns can be thermal (heat), electrical, or chemical, depending on the procedure. To prevent burns, the mercury-quartz irradiator and the Sollux lamp must be installed

directly above the patient, and from the side, to avoid contact with hot glass shards or parts of the lamp in case of accidental accidents. The outlet openings of the reflectors of Sollux lamps must be covered with safety wire mesh.

It is prohibited to carry out UHF therapy procedures without careful consideration. setting the therapeutic circuit in resonance with the technical circuit of the device and with a total chachor under both condenser plates of more than 6-10 cm.

When heating the paraffin, it is necessary to prevent water from entering it.

Before carrying out water and other thermal therapeutic procedures, it is necessary to ensure each time that the temperature of the treatment environment corresponds to the prescribed temperature and does not exceed the critical limit (for water 38-40° WITH, for paraffin 50-55° C).

Burns during physiotherapeutic procedures rarely pose a threat to the patient’s life, but nevertheless require assistance. It lies first of all V termination of the source that caused the burn. In case of thermal burns, it is advisable to immediately moisten the burned part of the body. cold water, treat with alcohol, then cover the burn area with a sterile bandage and refer the patient to a doctor. No medications in any form (except for moistening the burned area with alcohol), including oils and ointments, should not be used before the doctor arrives, as this may interfere with further treatment burn.

The occurrence of burns may be facilitated by a general or local decrease in the sensitivity of the patient’s skin, of which the attending physician must notify the physiotherapist. Epilepsy seizures are very dangerous in this regard. during which the patient’s risk of electrical injury or burns sharply increases.

Anaphylactic shock occurs when exposed to drugs to which the patient has increased individual sensitivity (intolerance). In such cases, a severe anaphylactic reaction can occur when using these drugs even in small quantities, including during electrophoresis and inhalation.

To prevent the occurrence of such reactions, it is necessary to find out from the patient how he tolerates certain medications, especially antibiotics.

In doubtful cases, the patient should undergo drug sensitivity tests in the department and inform the physiotherapist that the patient does not have hypersensitivity to the prescribed drugs.

Anaphylactic shock is manifested by suffocation, anxiety, itching, loss of consciousness (coma), a drop in blood pressure, sudden paleness of the skin, and dilated pupils. Possible death within minutes. If anaphylactic shock develops, the nurse should immediately stop the procedure, lay the patient down, inject subcutaneously 0.5 ml of a 0.1% solution of adrenaline hydrochloride and immediately call a doctor. Further emergency care measures are carried out as directed by the doctor. They include repeated intravenous injections lredni-zolongemisuccinate (50 mg), 10 ml of 2.4% aminophylline solution, subcutaneously - 2 ml of cordiamine. Further treatment is carried out in the intensive care unit, where the patient is given intravenous drips of corticosteroid hormonal drugs, anti-shock plasma substitutes (polyglucin), and prescribed antihistamines(diphenhydramine, suprastin).

With intensive physiotherapeutic procedures (especially thermal ones) in patients suffering from cardiac and pulmonary disorders, symptoms of exacerbation of the disease may develop (hypertensive crisis, impaired cerebral circulation, attack of angina, bronchial or cardiac asthma). In these cases, it is necessary to stop the prescribed procedures and begin using appropriate medications. Adverse reactions can also occur when mutually exclusive procedures are prescribed.

The operation of physiotherapeutic devices must be under constant technical supervision. Only persons with qualified special education. At least once every two weeks, a preventive inspection of all electric light therapy devices should be carried out and any identified malfunctions should be eliminated. Allowing random persons to repair physiotherapy equipment is strictly prohibited.

In order to protect the health of medical personnel of physiotherapeutic institutions, whose work involves

with harmful working conditions, the legislation provides for certain benefits: shortened working hours, additional leave, increased salary, free milk, etc. Such benefits are used, in particular, by nurses working with UHF and microwave generators in rooms for taking hydrogen sulfide baths and mud, busy preparing radon baths.

All physiotherapy staff undergo mandatory medical examinations upon entry to work and annually thereafter.

For staff rest and meals, the staff of physiotherapeutic institutions are allocated a separate room. It is also provided with protective clothing.

The physiotherapy department (office) is a structural unit of the hospital and is intended for the rational use of scientifically based physical therapeutic factors V complex therapy and rehabilitation of patients.

A qualified physiotherapist with experience in the specialty and organizational skills is appointed to the position of head of the department (office). The head of the department (office) is directly subordinate to the deputy head of the hospital for medical affairs and organizes the physiotherapeutic treatment of patients.

The head and staff of the department (office) in their activities are guided by current legislation, orders, instructions and guidelines, and other regulations.

The physiotherapy department should have rooms:

1. Electro-light and heat treatments;

2. Inhalator;

3. Therapeutic massage room;

4. Expected;

5. Rest room;

6. Material.

If possible, water and mud therapy rooms are also equipped.

The hardware and material support of the physiotherapy department (office) is carried out in accordance with the equipment sheet, as well as taking into account the possibility of ensuring the implementation of the recommended approximate list of physiotherapeutic treatment methods.

In accordance with the rules for the design, operation and safety of physiotherapy departments, the requirements of sanitary standards and regulations, the physiotherapy department must have premises for electrophototherapy, massage, laser therapy, hydrotherapy, heat therapy, and inhalation. If it is not possible to allocate the required number of premises, the organization of the work of the physiotherapy department in the available space should provide those types of physiotherapy that are most often in demand in the treatment of patients with underlying diseases in a given hospital.

For most physiotherapeutic treatment methods, a cabin system for placing equipment is acceptable.

Physiotherapy is prescribed by the attending physician to each patient individually, taking into account his general condition and the characteristics of the course of the disease. When prescribing physiotherapeutic treatment, the medical history indicates the name of the procedures, scope of application, dosage, frequency and number of procedures.

Patients who have been fully examined and have a clear diagnosis should be accepted for physiotherapeutic treatment. Patients are allowed to undergo physical procedures only after they have been examined by a physiotherapist and have filled out a procedural card. He is responsible for the correctness and validity of the physiotherapeutic procedures prescribed to the patient. If necessary, the physiotherapist, in agreement with the attending physician, can make changes to his prescriptions, revise the dosage and number of procedures.

With a procedural card, the patient is sent to the treatment room, where the nurse registers him in the patient register in the outpatient clinic, which notes the date, name, age, diagnosis of the patient, medical record number, name of the attending physician, and prescribed treatment by physical factors.

Physiotherapeutic procedures, in accordance with the instructions in the procedural card, are performed by nurses with special training, under the supervision of a physiotherapist.

Physiotherapeutic procedures must be administered to patients 1.5-2 hours after eating, always at the same time. During the procedure, the patient is prohibited from sleeping, reading, touching devices, or adjusting the dose of exposure. After the procedure, the patient is recommended to rest for 30-40 minutes in the hall or rest room of the department. Patients should be reminded of these rules during return visits. The patient should also be familiarized with the nature of the sensations that arise during physiotherapeutic treatment. If the patient does not tolerate the prescribed procedure, the nurse should inform the physiotherapist about this.

The physiotherapist notes in the procedural chart the patient’s body’s response to the effects of physical treatment methods and their effectiveness. At the end of the course of physiotherapeutic treatment, a similar entry is made in the medical record.

Procedural records are stored in the physiotherapy department or hospital archives.

Medical staff is obliged to check the condition of physiotherapeutic equipment daily before starting work. If a malfunction is detected, the device must be turned off and an entry about this must be made in the control and technical log.

Physiotherapy staff should be trained in first aid for electrical shock, heat stroke and other conditions that may occur during physiotherapy. In the department, in a place accessible to staff, there should be a first aid kit with medications for emergency medical care. The department should also contain instructions on how to comply with safety regulations when working with physiotherapy equipment.

Safety instructions for persons administering physiotherapeutic procedures are carried out upon hiring, then again - once every six months and are recorded in a special journal in the physiotherapy department.

Maintenance and repair of physiotherapeutic equipment is carried out by engineering and technical personnel of repair shops medical equipment. Preventative inspections of equipment are carried out at least once every two weeks, recording of hourly operation of equipment is carried out quarterly.

An approximate list of physiotherapeutic treatment methods used in the physiotherapy department (office):

1. Electrophototherapy;

2. Ultrasound therapy;

3. Magnetic therapy;

4. Laser therapy;

5. Heat therapy;

6. Inhalations;

7. Hydrotherapy;

8. Massage.

The department's offices are equipped in accordance with sanitary rules and regulations.

The room for electrolight therapy is organized on the above-ground floors and is equipped with reliable grounding. Pipes, water heating radiators and all metal objects connected to the ground must be covered with protective insulating grilles or other devices that prevent accidental contact of the patient with them. Electrical fittings (boards, sockets, switches) are made of non-conducting material. The switchboards must be connected to the cabinet's main switchboard, which has a common switch.

A cabin system for dispensing procedures is organized in the department's offices. The cabin must have the following dimensions: rack height - 2.0 m, length - 2.2 m, width - 1.8 m. No more than one device can be placed in the cabin. Along with the apparatus, a wooden couch, chair, and hanger are placed in the cabin. In the office outside the cubicles there is a nurse's table on which the procedure charts and electric procedure clock are located.

Electrophototherapy includes procedures associated with the therapeutic effects of various types of electromagnetic energy (low-voltage currents, pulsed currents of low frequency and low voltage, currents and fields of high, ultra-high and ultra-high frequencies, electrosleep, etc.).

Laser therapy is carried out in a separate room or cabin with an area of ​​at least 12 m² per couch, which has protective grounding and proper insulation. The laser installation must be placed indoors to prevent exposure to direct beam laser into the eyes of service personnel and patients. The walls and ceiling must have a matte finish. In this case, the walls are painted with oil paint in a color that promotes maximum absorption of reflected rays. The floors are covered with dark-colored linoleum. Sheets and curtains are made from material that has light-absorbing properties. Covering walls with tiles and using devices and objects with a mirror surface is prohibited. A laser danger sign is installed on the doors of the premises.

For massage, separate rooms (offices) are allocated at the rate of 12 m² per workplace. The massage room must be equipped with a washbasin with cold and hot water. If there are several masseuses, the workplace of each of them is equipped in cabins with the help of fabric curtains. Special massage tables are used for massage.

If possible, the department organizes thermotherapy and hydrotherapy rooms.

Thermal therapy is intended for the thermal effect on the body of peloids (silt mud, sapropels, peats) and peloid-like substances (paraffin, ozokerite). To carry out thermal therapy, the following premises are required: a locker room, a treatment room, electromud therapy rooms, a shower room, a room for treatment with mud tampons, a mud kitchen, a room for washing sheets and tarpaulins, a drying chamber, mud peat storage, a rest room for patients, a room for staff with a shower and individual wardrobes, toilet rooms, utility rooms.

Hydrotherapy (hydrotherapy) is intended for external use of water for therapeutic and preventive purposes. Hydrotherapy methods using various devices and devices require special equipment of premises, the size of which is determined by the volume and nature of the clinic’s work and the number of hydrotherapy installations. The hydropathic clinic includes: a bathroom, a pool for underwater traction, a shower room, rooms for medicinal irrigation (intestinal, gynecological, etc.), rooms for wrapping, staff rooms, utility rooms.

Inhalation therapy with aerosol drugs and others medicinal mixtures performed for patients with respiratory diseases. To carry it out, a room is allocated with an area of ​​4 m² per inhalation device. The office must be equipped with supply and exhaust ventilation. Carrying out inhalations in the electrolight therapy room is prohibited.

In this material:

The effectiveness of physiotherapy when skillfully combined with medication and other types of treatment has been proven by many scientists and practicing medical professionals. A specialist physiotherapist is not a deceiver or a fraudster, and, unlike most practitioners of traditional and alternative medicine specialists, his procedures provide truly effective assistance to the human body. Among other things, a physiotherapist compares favorably with specialists in traditional and alternative means of treatment by having a higher medical education and experience working in medical institutions.

Description of the project and its advantages

A business plan for a physiotherapy office includes a description of the main stages of organizing a business, requirements for the selected premises, purchased equipment and hired personnel, as well as recommendations for the effective implementation of advertising and marketing activities and financial analytics of the business project.

The advantages of running a business based on providing physiotherapeutic assistance to the population are due to the demand for private physiotherapy offices in many cities and regions of the country. Such private offices compare favorably with physiotherapy departments that are part of local medical institutions, clinics and hospitals in the quality of treatment provided, level of service and qualifications medical specialists, as well as the presence of modern professional medical equipment.

At the same time, in practice, there are often cases of opening private physiotherapy departments as full-fledged small clinics, providing, unlike a physiotherapy office, wide range procedures and services, but in this case there is a need to prepare additional documents, rent large premises, and form a large staff of qualified employees. As a result, there is a high level of initial capital investments, operating expenses, long payback periods and slow movement towards the project’s break-even point. A profitable option is to open a physiotherapy office (PTK).

What services does the physiotherapy office provide?

This medical field includes the following industries and services:

• diadynamic therapy, based on treatment using directed electric current;
• laser therapy, in which directed beams of laser light energy have a therapeutic effect;
• electromyostimulation, which affects muscles and nerve endings to return them to working condition;
• amplipulse therapy, which is similar in principle to the effect of diadynamic therapy, affecting the body with the help of low-frequency currents;
• heat therapy, which includes a variety of methods and techniques for the therapeutic effects of heat on the human body;
• micropolarization, which is similar in principle to electrical myostimulation, but has a direct effect on the human central nervous system using electrical impulses;
• cryotherapy, in which the body is exposed to cold rather than heat, as is the case with heat therapy;
• halotherapy, which involves injecting purified sodium chloride into the lungs in a specially equipped room;
• iontophoresis and phonophoresis, which are galvanic and ultrasonic effects on a drug applied to human body for more effective and deep penetration of the therapeutic agent into the tissue.

In addition to the industries mentioned, physiotherapy traditionally includes water and mud therapy procedures, as well as physical therapy and health massages.

Business organization

Registration, package of documents

To open a private office and provide physiotherapeutic services to the population, it is mandatory to go through the state registration procedure, registering as a legal entity or individual entrepreneur, and also be asked to register with the tax authority.

At the start of a business project you will need the following documents:

• certificate of state registration as a legal entity or registration of a business in the form of an individual entrepreneur;
• documents related to the rental of premises for a private physiotherapy room;
• certificates of fire safety of the premises, as well as its compliance with sanitary and epidemiological standards and requirements, obtained from the relevant authorities;
• evidence of payment of the fee for obtaining a license to carry out medical activities;
• list of services provided by the organization;
• proof of registration with the local tax authority.

Choosing a business format

The option of providing physical therapy services to the population in the form of a private office, rather than a full-fledged physical therapy clinic, is obviously popular, due to the significant savings in initial capital investments and the absence of the need for complex procedures for selecting and leasing a large premises, forming a large staff, state registration and tax deductions.

Search for premises

A spacious, bright room is suitable, the area of ​​which will directly depend on the range of physiotherapeutic services provided, the number of rooms and the necessary medical equipment for treatment and diagnosis. The premises must be rented; attention should be paid to residential areas, since the basis in this case is taken simultaneously by two factors: increased human traffic and the convenience of the location of the office for potential clients.

A special option for opening a private physiotherapy office is a partnership with a medical institution or health resort, provided that the physiotherapy office is opened in a separate room provided on the territory of the hospital or clinic. Thus, not only time and money are saved on searching and renting premises, but also the first clients appear.

Purchase of equipment

Depending on the specific types of physical therapy services provided and the number of clients served at the same time, certain medical equipment will be needed, as well as modern hospital furniture. This item of initial investment does not imply the opportunity to save money and purchase used equipment and furniture, since the general population makes a choice in favor of private medical offices and institutions, largely due to the quality and high cost of medical equipment, as well as the service of the health services provided.

Staff

A small private physical therapy office will need several physical therapists with higher medical education and experience in their chosen field of treatment services, as well as a receptionist who will take calls. Management functions are carried out directly by the entrepreneur, while it is recommended to entrust accounting to specialist outsourcers, and contact third-party representatives for legal services as needed. You will also need an advertising and marketing department that will take care of attracting and retaining a stable flow of customers.

Advertising of physiotherapy services

As usual, pay attention to advertising in local print media mass media, on thematic forums and in popular social networks, also by posting advertisements and distributing leaflets in high-traffic areas. Collaborate with doctors from local medical institutions and clinics who will recommend your physical therapy office to patients if necessary. Traditional word of mouth will do most of the marketing work for you.

Financial indicators of the project: payback and profitability

Start-up investments are formed through acquisition necessary equipment, as well as procedures related to state registration of a legal entity or individual entrepreneur and the preparation of related documents. The amount of current office expenses is directly affected by employee salaries, rent for office space, as well as tax payments, routine repairs and depreciation of equipment, and replenishment of consumables.

On average, the starting investment in a business project is about 500 thousand rubles, and current monthly expenses range from 150 to 200 thousand rubles. With such indicators, payback will occur within the first year of operation of the office, and the profitability of the project will exceed 30%.

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It is necessary to distinguish between a physiotherapy department, where all the main types of physiotherapy are presented (electrical, light, water, heat therapy), and a physiotherapy room, which has only a part of the devices. In the latter case, one or two or three rooms (usually adjacent) can be allocated for a physiotherapy room.

The organization of a physiotherapy room (department) provides for the rational placement and arrangement of equipment, taking into account the ease of its operation and safety during procedures. The opening and operation of a physiotherapy department (office) is permitted only if it complies with the safety and sanitation rules approved by the USSR Ministry of Health and the Central Committee of the Health Workers' Trade Union.

The height of the premises of the physiotherapy room must be at least 3 m. The area of ​​​​the premises for the physiotherapy room is determined at the rate of at least 6 m 2 per treatment couch. The area of ​​the combined electric light therapy room must be at least 24 m2; if there are 4 or more low-power UHF generators, a separate room with an area of ​​also 24 m2 is allocated for them. The ratio of window area to floor area is at least 1: 6. The lowest artificial illumination at the level of 0.8 m from the floor with incandescent lamps is 75 lux, with fluorescent lamps - 150 lux.

The floor should be wooden. Walls to a height of 2 m are painted with light oil paint; the rest of the walls and ceiling are adhesive. Wall cladding with ceramic tiles is not permitted.

The physiotherapy room must have supply and exhaust ventilation with air heating, as well as transoms; the air temperature in the room should not be lower than 20°. The physiotherapy room must be equipped with a washbasin. Treatment areas (cabins) are separated from each other by curtains on a metal, plastic or polished wooden frame, attached to the ceiling at a height of 2 m. The metal structures of the cabins are insulated from the stone walls by placing 40 mm thick wooden socket boxes under the flanges, impregnated with paraffin and painted with oil paint.

Dimensions of cabins for electrolight therapy procedures: length 2-2.2 m, width (for all floor-standing and ultrasonic devices) - 2 m, for others - 1.6 m. Only one floor-standing device is installed in each cabin. In the physiotherapy room, where there are devices for galvanization, electrophoresis of medicinal substances, treatment with low-frequency currents and devices for light therapy, a special insulated box (8 m2) is allocated for work on preparing the treatment procedure (boiling electrode pads, drying them, wetting with solutions of medicinal substances etc.) with a drying cabinet and exhaust ventilation.

The electrical equipment of the physiotherapy room must be carried out in accordance with the “Rules for the design, operation and safety of physiotherapy departments (offices)”. Each office must have an independent electrical input from the main switchboard, laid with copper wire with a cross-section of at least 6 mm 2, and a group switchboard with a common switch or starter that has clearly marked “on” and “off” positions. The switch is installed at a height of 1.6 m from the floor level. A mains voltmeter with a phase switch is mounted on the switchboard. The group board is mounted from fuses or maximum current circuit breakers of 15 I with the number of groups corresponding to the number of installed devices, also taking into account sterilizers and electric stoves. In the booths for connecting devices, starter shields made of insulating material are installed at a height of 1.5 m from the floor level. A three-pole switch (starter) for 15-25 A is mounted on them, clearly marked “on”, “off”, four terminals in an insulating frame, of which two left ones are for connecting devices, the rest are for protective grounding of the device, one plug socket with self-catering.

Only portable equipment may be connected to the socket outlets. The line from the group to the starting panels is laid with copper wire with a cross-section of at least 2.5 mm 2. All starting devices are installed only in a protected form.

It is prohibited for personnel to remain in the direct radiation zone in front of a remotely located emitter of devices for microwave or decimeter wave therapy. The operation of such devices is carried out in specially designated rooms or in common rooms, subject to shielding using a metal mesh or chambers made of a metal mesh, shields coated with substances that absorb electromagnetic vibrations, cabins or screens made of cotton fabric with microwire.

Physiotherapy: types of procedures

Physical therapy (PT), also known as physical therapy, is a physical medicine and rehabilitation specialty that uses mechanical force and movement to address impairments and promote mobility, function, and quality of life through assessment, diagnosis, prognosis, and physical intervention.

Why is physiotherapy needed?

Physiotherapy is a professional medical specialty performed by physical therapists.

Physiotherapists use their knowledge and skills to improve a range of conditions related to different body systems, such as:

• neurological (stroke, multiple sclerosis, Parkinson's disease);
• musculoskeletal (back pain associated with whiplash, sports injuries, arthritis);
• cardiovascular (chronic heart disease, rehabilitation after a heart attack);
• respiratory (asthma, chronic pulmonary obstruction, cystic fibrosis).

You can benefit from physical therapy at any time in your life.

Classification of physiotherapy

Modern science is exploring a large number of types of energy. The main component of many procedures is a natural factor of physical origin.

With its use, the main physical procedures are distinguished:

1. The use of different electrical options: (various medications with electrophoresis, galvanization procedures, electrosleep, diadynamometry, impulse therapy, electrical analgesia, ultratonotherapy).
2. Use of heated preparations on the patient's skin: ozokerite, Naftalan, treatment with paraffin, therapeutic mud, clay and sand.
3. Use of various magnetic fields: inductothermy, magnetotherapy.
4. The use of electromagnetic fields of excessively high frequency: terahertz, decimeter, centimeter and extremely high frequency therapy.
5. Consumption of fresh water, artificial and natural waters: balneotherapy, hydrotherapy.
6. Mechanical vibrations: vibration therapy, ultraphonotherapy.
7. Using an electric field: ultra-high-frequency procedure, infective therapy, franklinization.
8. Electromagnetic vibrations of the optical range: visible, infrared, ultraviolet and laser radiation.
9. Applied modified or special air environment: aeroionotherapy, inhalation therapy, climatotherapy, barotherapy.
10. Combined procedures are based on the use of various therapeutic factors from one or two different groups: magnetic laser therapy, vacuum-darsonvalization, inductothermoelectrophoresis, etc.

Types of physiotherapeutic procedures

The type of procedure is selected by specialists for each patient individually. Based on: the general condition of the body, immune activity, concomitant diseases, allergies, as well as the main pathology with which the patient came in. There are a large number of physiotherapeutic procedures.

Electrotherapy

This procedure is a form medical treatment, which uses small electrical impulses to restore tissue, stimulate muscles and tissue.

The benefits of electrotherapy include a more advanced healing process, improved circulatory system and increased muscle tone.

The effectiveness of electrotherapy provides: reduction of pain, increase in strength, range of motion, muscle tone and absorption rate.

The reason for using this method is that injuries that cause swelling respond well to electrotherapy. These include sprained ankles and overuse injuries such as tennis or golfer's elbow.

Magnetotherapy

Magnetotherapy is a procedure that is a natural phenomenon and is based on the application of certain magnetic fields on the human body. Magnetic therapy is used to treat pain, reduce inflammation and swelling.

Clinical studies have shown that it is necessary to treat osteoporosis with magnetotherapy and use it for regeneration of superficial tissues and bone fractures. The procedure is used in orthopedics and sports.

The low-intensity and low-frequency magnetic field itself is not used, but a set of several factors that optimize the method of application to produce therapeutic results:

• selection of magnetic field and waveform;
• choice various methods transmission of magnetic field into tissue;
• manual or automatic;
• method of application, contact - general or local;

Therapeutic expectations can be summarized as follows: non-abrasive and painless treatment, contracture reduction and muscle relaxation, analgesic, anti-inflammatory and drainage effect, tissue repair, even deep.

Shock wave therapy

Shock wave therapy is a procedure using a multidisciplinary device necessary for the treatment of tendons, muscles, joints, orthopedics, to stimulate bone healing, in physiotherapy, for immediate pain relief, in sports medicine, stone crushing, in urology.

Its main assets are lightning-fast pain relief and restoration of mobility. Together with non-surgical therapy without the need for painkillers, it is an ideal therapy for accelerating recovery, as well as treating various symptoms causing various kinds pain.

These processes are used simultaneously and are necessary for the treatment of acute and chronic pathologies.

Laser therapy

Laser therapy is a therapy that uses the necessary wavelength of light to interact with cells and speed up the healing process.

It can be used by patients suffering from various acute, subacute, chronic diseases to help eliminate pain, swelling, reduce vascular contractions and increase functionality.

During this time, non-thermal light photons emitted by the device penetrate the skin, subcutaneous tissue and reach the required organ. After passing through the skin, at the moment it reaches the desired organ, it penetrates the tissue cells.

When cells absorb these photons of light, their metabolic process is enhanced and their regenerative ability is activated. As a result, swelling, signs of inflammation, pain subsides and enhanced wound healing occurs due to an increase in intracellular metabolism.

Balneotherapy

Balneotherapy is the treatment of diseases through bathing. Balneotherapy may include hot or cold water, massage through moving water, relaxation or tension. Most mineral waters are rich in essential minerals: silica, sulfur, selenium and radium.

Healing clays are also used in balneotherapy. Balneotherapy is used for patients with a large number of diseases.

The most serious pathologies include: fibromyalgia, depression, anxiety, insomnia, osteoarthritis, rheumatoid arthritis, psoriatic arthritis, syndrome chronic fatigue, spasticity, stroke, acne, dermatitis, psoriasis and cardiovascular diseases.

Other benefits of balneotherapy include pain reduction, increased collateral circulation, increased cellular fluids, muscle relaxation, and numerous healing benefits from the absorption of minerals and botanicals.

Climatotherapy

Climate therapy is the temporary or permanent movement of a patient to a region with a climate more favorable for recovery or management of a condition.

For example: The partial pressure of oxygen is lower at high altitude, so a person with sickle cell disease may move to a lower altitude to reduce the number of sickling crises. There are also possible therapeutic benefits for patients with psoriasis, especially in the Dead Sea region.

Detensor therapy

Detensor therapy treatment works by canceling the force of gravity and it only takes the pressure off the compressed discs and in return the body relaxes. The system consists of a traction device, a bed system and a therapy mat for systematic traction treatment.

This treatment is very important because it can be applied to the patient without weights, belts, etc. This method made primarily for people who experience pain when degenerative disease disc, herniated discs, sciatic nerve, bone spurs, or something like a pinched nerve in the neck.

Since proper spinal alignment, decompressed joints, and pain relief are the result of spinal decompression, the therapy stretches the bones and muscles of the back so they can resist the effects of gravity.

Ultraviolet irradiation

Ultraviolet germicidal irradiation is a disinfection method that uses short-wave ultraviolet (UV-C) light to kill or inactivate microorganisms by destroying nucleic acids and destroying their DNA, rendering them unable to perform vital functions.

UV irradiation is used in a variety of applications in the treatment of many skin diseases, including psoriasis and vitiligo.

Mechanotherapy

Mechanotherapy is a treatment through a series of manual and instrumental techniques that primarily use pressure, smoothing and stretching to prevent pain and improve blood circulation and cellular metabolism.

Mechanotherapy includes all therapeutic, underwater and mechanical massages and training. Mechanotherapy uses many other relaxing techniques such as traditional manual massage, manual lymphatic drainage and foot reflexology massage to combat muscle strain caused by forced posture, which is typical for most patients.

Peloid therapy

Peloid is mud or clay used therapeutically, as part of balneotherapy, or therapeutic bathing.

Peloids consist of humus and minerals formed over many years as a result of geological and biological, chemical and physical processes.

Numerous peloids are available today, of which the most popular are: peat masses, various medicinal clays mined in various places around the world, and various plant substances.

The most common treatments are peloid wraps, mud baths and peloid sets, applied locally to the part of the body being treated.

Peloids are widely used in cosmetology. They are used as a face mask. Applying peloid masks once a week helps revitalize the skin, tighten it and bind fluids in the skin layers. Regular use of peloids leads to the disappearance of wrinkles and prevents the appearance of new wrinkles.

Thermotherapy is the use of heat in therapy to relieve pain and heaviness. It can take the form of hot cloth, hot water bottle, ultrasound, heating pad, hydrocollator packs, whirlpool baths, cordless heat therapy wraps.

Therapeutic effect includes increased extensibility of collagen tissues, decreased joint stiffness, pain reduction, relief muscle spasms, reducing inflammation and swelling. Increased blood flow to the affected area provides proteins, nutrients and oxygen for better healing.

It may be useful for people with arthritis and stiff muscles, deep skin tissue damage. Heat can be effective in treating conditions such as rheumatoid arthritis. Thermotherapy is most often used for rehabilitation purposes.

Phototherapy

Light therapy or phototherapy consists of exposure to daylight or specific wavelengths of light using polychromatic polarized light, lasers, LEDs, fluorescent lamps, or very bright full-spectrum lamps.

Light is administered for a set time and, in some cases, at a specific time of day. Phototherapy deals with the treatment of skin diseases, mainly psoriasis, acne vulgaris, eczema and neonatal jaundice.

Effectiveness of physiotherapy

The advantages of physiotherapeutic methods are their natural effects on the human body, and are considered as a replacement for drugs or surgical interventions. Basically, a combination of drugs and physiotherapy is used to treat the disease.

Together with other types of therapies, physical factors have their own advantages:

• increase the range of interventions of different treatment methods, reducing recovery time;
• do not cause allergies to medications;
• increase the impact of medicinal drugs;
• there is no addiction or dependence on medications;
• there are no side effects on other systems and organs;
• provide painless treatment;
• no invasive treatments are used;
• prolong periods of remission.

Contraindications

There are these contraindications to the inability to undergo physiotherapy:

• malignant tumors, leukemia, myeloid leukemia, cachectic conditions;
• III stage of hypertension, atherosclerotic damage to the arteries of the head, decompensated cardiovascular pathologies, deterioration of blood clotting;
• seriously ill patients, hectic fever;
• active tuberculosis, epileptic seizures, convulsions;

Design and equipment of a physiotherapy room

The premises are allocated no lower than the 1st floor. It should be dry (humidity not higher than 70%), warm (temperature not lower than +20 ° C), bright, spacious (the area of ​​the office is allocated at the rate of 6 m 2 per 1 stationary device, but not less than 24 m), supply air is required exhaust ventilation, only hidden electrical wiring, walls to a height of 2 m are covered with oil paint, floors are covered with linoleum.

All metal grounded objects are protected by wooden casings. A panel with a common switch is installed at a height of 1.6 m from the floor.

The following cabins are equipped according to the number of stationary devices:

There is a separate service cabin for preparation for procedures. A table for the nurse is placed outside the service cabin. On the table there are: a file cabinet with patient cards and a procedural electric clock. The nurse's desk contains a stopwatch, a measuring tape, rubber gloves, and safety glasses.

The equipment is placed strictly according to the plan approved by the manager. All devices mounted in metal enclosures must be grounded. It is necessary to carry out a preventive inspection of the equipment at least once every 7 days. A preventive examination is carried out by a physical technician. Monitoring compliance with the frequency of preventive examinations is carried out by a nurse, about which a special entry is made in the journal. The devices must be protected from dust, dampness and overload. Maintenance of the equipment is the responsibility of the nurse.

Medical card

A bad doctor treats a disease, a good doctor treats the cause of the disease.

Physiotherapeutic procedures

Many parents consider physiotherapeutic procedures not very effective and do not take them seriously - they violate the schedule and conditions of implementation, or even completely interrupt the course of treatment prescribed by the doctor. The name of the method comes from two ancient Greek words - “physio”, which means “nature”, and “therapy” - treatment. You can’t say more precisely: natural factors - water, air, sunlight, warm, cold, electromagnetic radiation help the body get rid of diseases without medications and side effects. The choice of techniques is large: some have been known since time immemorial, that is, time-tested, others have appeared recently.

What is physiotherapy

Physiotherapy is a separate medical specialty; in order to obtain it, you need to master knowledge from the field of physics and chemistry, which is not taught to representatives of other areas of medicine. Only those who have undergone the necessary training are able to correctly prescribe the procedure; other doctors do not have full information. Many clinics have physiotherapy departments or physiotherapists. By visiting their offices more often, parents will be able to learn more about non-drug methods of preventing and treating diseases.

The unpopularity of physical therapy among parents is due to several circumstances, for example, mothers are able to refuse inhalations, fearing that nebulizers are a carrier of infection because they are not properly sterilized. Often such suspicions are unjustified: each little patient receives “his own” nozzle, and the used one is sent for disinfection. The second argument: physiotherapeutic procedures are difficult to comply with, since they require a strict regime - preparation “before” and compliance with certain rules “after”. In order for the baby to get the maximum benefit from the manipulation, he must be well-fed, rested, and calm. Taking into account the biorhythms of children, it is better to carry out treatment in the first half of the day, 1 hour after feeding. At the end of the session, the baby needs to rest - lie down in the crib, or better yet, sleep. The younger the child, the more difficult it is to follow these requirements.

Technological progress offers an excellent way out of this situation: by creating a home physiotherapy office using portable devices, you can solve both the first and second problems. The algorithm is this: get a doctor’s prescription, purchase the device, master it and use it, following the rules.

How does physiotherapy work?

All natural factors influence the child’s body to one degree or another - they change body temperature, blood pressure, breathing and heart rate, and cause muscles to tense or relax. This observation formed the basis of physiotherapy and prompted the ancient aesculapians to conduct experiments. For example, this - if the sun's rays or hot baths are useful for a healthy person, then why not treat a sick person with their help? The guesses were confirmed, and doctors began to take advantage of the discovery. Modern doctors do not stop at what their predecessors achieved and continue to develop methods of physiotherapy. The achievements of the founders of medicine are replenished, but many of the rules for conducting sessions discovered by them remain unshakable.

The most important thing is that physiotherapeutic procedures are always prescribed during the recovery period, when the crisis has passed and the patient is on the mend. At the height of the illness - at elevated temperature and acute manifestations - physiotherapy can be harmful, since the body is disoriented, and any intrusion into its work will be perceived inadequately. So, heating with any of the devices will cause heat stroke and dehydration.

What are the types of physiotherapeutic procedures?

The range of physiotherapeutic procedures is very diverse. Methods are divided into groups according to sources of influence: light, heat and radiomagnetic devices, water and air. Many of them are interchangeable. Children are most often prescribed the simplest ones.

UHF stands for Ultra High Frequency. The method is used for treatment and prevention inflammatory processes. A protective barrier is formed around the lesion - the walls of the capillaries are compacted, as a result, blood flow improves and swelling goes away, ulcers and ulcers dry out.

Magnetic therapy involves warming tissues, after which all processes in them are activated. At the same time, metabolism, blood circulation, protein and hormone synthesis are improved, spasms are relieved, and blood pressure decreases. blood pressure And painful sensations. It is used for neuroses, rhinitis, sinusitis, atopic dermatitis, and dyskinesias of the digestive system.

Light therapy is exposure to any light sources, including lasers. It is prescribed to frequently ill children to improve the functioning of the immune system and metabolism. You can “shine” the whole body, small areas and individual organs, for example, the ear, nose or knee.

Phototherapy is a type of light therapy that helps babies cope with newborn jaundice in the first days after birth. Under light energy, emanating from, for example, fluorescent lamp blue light, toxic, dangerous forms of bilirubin (excess bilirubin causes jaundice) are converted into safe forms.

Ultraviolet radiation is also a type of light. It protects children from rickets. And since ultraviolet rays have a detrimental effect on dangerous microbes, they also help with purulent inflammations and allergies, disinfect indoor air and water in swimming pools.

Electrophoresis - using current through the skin or mucous membranes, medications are introduced into the body, which immediately reach the target, bypassing the gastric tract and respiratory organs, and thus pain is often relieved.

From massage and physical therapy Babies of all ages benefit from birth. These methods help babies quickly cope with the “shortcomings” of nature and grow healthy and strong.

Kinesiotherapy is a combination of morning and therapeutic exercises, stay on fresh air, sports and applied exercises and outdoor games. In newborns born prematurely and small children with neurological problems their own activities - for these categories of children, special bed-baths with a porous bottom, filled with glass microbeads and simulating intrauterine living conditions, have been created. A filter sheet separates the baby’s body from them, and the baby calmly floats in the “dry liquid”.

Physical office what procedures

Treatment of any disease should not only be effective, but also as safe as possible, without unpleasant consequences or side effects. “Do no harm” is precisely the principle on which all modern medical techniques. Physiotherapy is one of the long-known, absolutely safe, and therefore extremely popular techniques. The main feature, or rather, the advantage of the technique is that such a course of treatment eliminates the use of chemicals and medicines. The name physiotherapy itself suggests that treatment is carried out using physical factors affecting the patient’s body. There are many such physical factors - ultrasound, currents, laser, magnetic field, various types radiation (ultraviolet, infrared), massage and others. So, physiotherapy has a big advantage - high efficiency combined with safety of use.

The undoubted advantage of physiotherapy over other treatment methods is its high efficiency coupled with safety. Physiotherapy awakens the body's internal reserves, strengthens the immune system and thereby shortens the treatment time, accelerates the healing of wounds and inflammation, activates the most important biochemical processes in the body, tuning the body's natural forces for recovery. As an independent method of treatment, physiotherapy is effective in initial stages development of the disease. Physiotherapy is an excellent means of preventing many diseases. Most often it is used as an additional method in general course treatment.

Physiotherapy is prescribed to each patient strictly according to individual indications, since the nature of the disease, its stage, the person’s age and other factors play a role. The occurrence of side effects after the use of physiotherapeutic techniques is practically excluded. Often, physical therapy helps to cope with diseases that for a long time were not treatable using traditional methods.

Methods of hardware physiotherapy:

Inductothermy is a method of electrotherapy, the active factor of which is a high-frequency alternating magnetic field.

UHF therapy A method of electrotherapy based on the effect on the patient’s body of a predominantly ultra-high-frequency electromagnetic field (UHF e.p.). Physical action e. UHF consists of the active absorption of field energy by tissues and its conversion into thermal energy, as well as the development of an oscillatory effect characteristic of high-frequency electromagnetic oscillations. The main heat generation occurs in tissues that do not conduct electrical current well (nervous, bone, etc.). E.p. UHF has an anti-inflammatory effect by improving blood and lymph circulation, tissue dehydration and reducing exudation, activates the functions of connective tissue, stimulates the processes of cell proliferation, which makes it possible to limit the inflammatory focus to a dense connective capsule. E.p. UHF has an antispastic effect on the smooth muscles of the stomach, intestines, gall bladder, accelerates regeneration nerve tissue, enhances the conduction of impulses along the nerve fiber, reduces the sensitivity of the terminal nerve receptors, i.e. promotes pain relief, reduces the tone of capillaries and arterioles, lowers blood pressure, and causes bradycardia. Treatment is indicated for various acute and chronic inflammatory processes of internal organs (bronchitis, cholecystitis, pneumonia), musculoskeletal system, ear, throat, nose (sore throat, otitis), peripheral nervous system (neuritis), female genital area, degenerative processes

Magnetotherapy A new direction of physiotherapy based on the effect of a low-frequency alternating magnetic field on the entire body or part of it. Computer support of the devices allows for continuous monitoring and development of an individual program for each patient.

Magnetotherapy has an analgesic, antispasmodic effect, lowers blood pressure, activates repair and regeneration processes, has a powerful anti-inflammatory and anti-edematous effect, due to the normalization of the tone of blood and lymphatic vessels and rheological properties blood improves microcirculation and peripheral blood and lymph flow, activates the activity of the sympathoadrenal and hypothalamic-pituitary-adrenal systems, improves the functioning of the autonomic nervous system and endocrine system, and restores immunity. The general effect of magnetic therapy is manifested by an improvement in the psychophysical and emotional state, and normalization of sleep.

A wide range of indications for treatment and the versatility of the effect on the body, as well as a small number of contraindications, make it possible to use devices for general magnetic therapy not only for the treatment of diseases, but also in the process of rehabilitation, as well as for the prevention of diseases (including immune-related and oncological ones). Contraindications: pregnancy; circulatory failure stages II B – III; systemic diseases blood; the presence of foreign magnetic bodies (for example, pacemakers); acute infectious diseases; hemorrhagic vasculitis and other pathological processes accompanied by increased bleeding.

Ultrasound therapy has a mechanical, physico-chemical and weak thermal effect on the body. The mechanical action of ultrasound, caused by variable acoustic pressure, causes microvibration, a kind of “micro-massage” of tissues. Thanks to the physicochemical effects of ultrasound, the intensity of tissue redox processes increases, the formation of biologically active substances increases - heparin, histamine, serotonin, etc. Ultrasound has a pronounced analgesic, antispasmodic (eliminating spasms), anti-inflammatory, antiallergic and general tonic effect. It stimulates blood and lymph circulation, restoration processes, and improves tissue nutrition. Ultrasound therapy has found wide application in the clinic of internal diseases, for diseases of the joints, skin, ear, throat, and nose.

Phonophoresis (syn.: sonophoresis, ultraphonophoresis) is a treatment method that consists of a combined effect on certain areas of the patient’s body with ultrasound and solutions, emulsions or ointments applied to their surface. It is used for diseases of the joints and spine, urological and gynecological diseases.

Laser therapy is a relatively new method of therapy. The history of its use goes back a little over 30 years. The priority in the development of all laser technology in general - be it in the field of space research or in medicine - belongs to Soviet scientists. The first lasers were used in surgery. Currently, laser treatment methods occupy one of the leading places in the list of the most promising areas modern medicine. Currently, laser therapy, being a special branch of medicine, is successfully used in almost all its areas and is officially recognized by all developed countries.

When used externally, laser treatment occurs by exposing certain areas and points of the body to the emitting terminal. Light penetrates tissue to a great depth and stimulates metabolism in affected tissues, activates healing and regeneration, and overall stimulation of the body as a whole occurs. With intravenous laser therapy, through a thin light conductor that is inserted into a vein, a laser beam affects the blood. Intravascular action of low-intensity radiation allows you to influence the entire blood mass. This leads to stimulation of hematopoiesis, strengthened immunity, increased transport function blood, and also helps to increase metabolism.

Drug electrophoresis(Greek phoresis - carrying) - an electropharmacotherapeutic method of combined effects on the body of direct current and medicinal substances administered with its help. Pharmacological activity of medicinal substances increases against the background of direct current, since they are introduced into tissues in ionic form. Deposition of medicinal substances in the skin ensures their long-term reflex and focal effects on the body (for a day or more). The side effects of drugs are reduced, since they enter the body in small quantities, bypassing gastrointestinal tract. At the same time, the concentration of the drug in the pathological focus increases and can be several times higher than the concentration during parenteral administration of drugs. Medicinal electrophoresis has an anti-inflammatory, absorbable, local anesthetic effect on the body, improves blood supply to tissues and conductivity of peripheral nerve fibers, reduces pathological impulses from the periphery, normalizes the functional state of the central and autonomic nervous systems.

Electrical stimulation A method of electrotherapy using various pulsed currents to change the functional state of muscles and nerves. Electrical stimulation supports contractility muscles, enhances blood circulation and metabolic processes in tissues, creates a flow of nerve impulses entering the central nervous system, which in turn has a positive effect on the restoration of motor functions, and prevents the development of atrophies and contractures. Electrical stimulation is most widely used in the treatment of diseases of the nerves and muscles. Such diseases include various paresis and paralysis of skeletal muscles, both flaccid, caused by disorders of the peripheral nervous system and spinal cord (neuritis, consequences of polio and spinal injuries with damage to the spinal cord), and spastic post-stroke, as well as hysterogenic. Electrical stimulation is indicated for aphonia due to paresis of the laryngeal muscles, paretic condition of the respiratory muscles and diaphragm. It is also used for muscle atrophy, both primary, which developed as a result of injuries to peripheral nerves and the spinal cord, and secondary, resulting from prolonged immobilization of the limbs due to fractures and osteoplastic operations. Electrical stimulation is also indicated for atonic conditions of the smooth muscles of internal organs (stomach, intestines, bladder, etc.). It is used for atonic bleeding, to prevent postoperative phlebothrombosis, to prevent complications during prolonged physical inactivity, and to improve the fitness of athletes. Contraindications for electrical stimulation are varied. It is impossible, for example, to perform electrical stimulation of the muscles of internal organs in case of cholelithiasis, kidney stones, acute purulent processes in organs abdominal cavity, with a spastic condition of the muscles. Electrical stimulation of facial muscles is contraindicated in case of early signs of contracture or increased excitability of these muscles. Electrical stimulation of the muscles of the limbs is contraindicated in cases of ankylosis of the joints, dislocations until they are reduced, and bone fractures until they are consolidated.

Sinusoidal modulated currents - SMT This original domestic method is based on physiological action amplitude pulsations of alternating currents with a frequency of kHz. CMT has a pronounced analgesic effect associated with the direct effect of current on nerve receptors and muscle formations. Exposure to a series of low-frequency oscillations in an orderly manner leads to the extinction of pain. The duration of the analgesic effect is due to the neurohumoral mechanism: the release of morphine-like peptides - mediators of the nervous system - into the central nervous system. Another mechanism of pain relief is improving blood circulation and reducing tissue swelling.

Shock wave therapy (SWT). The therapeutic effect of shock wave therapy on body tissue is based on the so-called microcavitation effect, which occurs when sound waves pass through the boundaries of tissues of different densities, for example, between bone and soft tissues (muscles, ligaments, fascia, etc.) , between cartilage and softer tissues, as well as between soft tissues of different densities (scars and muscles, fascia and muscles, etc.). During shock wave therapy, due to the microvibration that occurs, the process of loosening calcium microcrystals in places of their excess deposition, as well as fibrous and scar tissue in places of damage, inflammation and other painful changes occurs. Percussion sound wave, penetrating into trigger zones, causes activation of regeneration processes. The concept of the shock wave effect when orthopedic diseases is based on the fact that the shock wave stimulates and activates revascularization and other adaptive capabilities for restoring normal tissue structure. In addition, the shock wave helps to block the transmission of impulses by pain receptors and thus reduce sensitivity and pain.

SWT has proven effective in treating many different musculoskeletal conditions including plantar fasciitis (heel spurs), epicondylitis, tendinitis and nonunion. In all situations, shockwave therapy is considered an atraumatic alternative. surgical methods treatment.

Effects of shockwave therapy on tissues: increased metabolism in target tissues; destruction of calcium deposits and further resorption (around the inside of the tendons); reducing the activity of inflammatory processes; reduction of pain; increasing the strength of fabrics.

Indications for shock wave therapy (SWT): calcific tendinosis of the supraspinatus tendon (supraspinatus syndrome), a disease of the tendon of the supraspinatus muscle, accompanied by its calcification; Syndrome of the apex and proper patellar ligament; traumatic injury ligamentous apparatus of the knee; trochanteroperiostosis - a disease of the capsule and tendon hip joint, trochanteritis - inflammation of the hip joint; Achilles' tendonitis, Achilles tendon pain and inflammation; Dupuytren's syndrome - chronic traumatic overstrain of the muscles and tendons of the anterior edge tibia; radial epicondylitis, inflammation of the head of the radial bone at the site of attachment of muscles and ligaments; heel spur; glenohumeral periarthrosis - a disease of the periarticular soft tissues (muscles, ligaments and tendons) of the shoulder joint; deforming osteoarthritis - degenerative-dystrophic (age-related) disease of the joints; Post-traumatic arthrosis; sprains and micro-tears of muscles; ligamentosis (ligament diseases) of various localizations; SIJ (sacroiliac joint) blocks; trigger and muscle-tonic pain in osteochondrosis; delayed consolidation of fractures; muscle contractures in cerebral palsy; "diabetic foot"

There are very few contraindications to UVT: oncological diseases; pregnancy; acute infectious diseases; Shock wave therapy is not performed for bleeding disorders; the patient has a pacemaker; the patient is taking anticoagulants.

SWT allows the doctor to carry out targeted effects on the site of the disease without injuring other tissues. The course of treatment usually consists of 4-10 sessions. each, carried out once within 5-7 days.

Indications for therapeutic massage: headaches; pain in the back, lower back, neck; osteochondrosis; bruises, sprains of muscles, tendons and ligaments; fractures at all stages of healing; functional disorders after a fracture and dislocation (joint stiffness, muscle changes, scar tissue adhesions); arthritis in the subacute and chronic stages; neuralgia and neuritis; radiculitis; paralysis; chronic failure heart muscle; angina pectoris; hypertension; arterial hypotension; rehabilitation period after myocardial infarction; chronic gastritis; impaired motor function of the large intestine; bronchitis; pneumonia; bronchial asthma; peptic ulcer of the stomach and duodenum (beyond exacerbation).

General classic massage(general massage is a massage of the whole body, otherwise it is a wellness, preventive massage): active agent promoting health, maintaining body activity, preventing diseases, caring for normal skin.

Indications for general massage: for mental and emotional disorders; general poor health; muscle tension; headaches and occipital pain; back pain; apathy, bad mood; digestive problems, lack of appetite; sleep disorders, night restlessness.

Anti-cellulite massage - a type of massage aimed at combating cellulite, improves the inflow and outflow of blood, lymph, and intercellular fluid throughout the body. Anti-cellulite massage helps remove toxins, improves metabolic processes in the body, and helps burn your own fat.

Contraindications are given in a generalized form: for acute febrile conditions and high temperature; bleeding and tendency to it; blood diseases; purulent processes any localization; various diseases of the skin, nails, hair; for any acute inflammations blood and lymphatic vessels, thrombosis, severe varicose veins; atherosclerosis of peripheral vessels and cerebral vessels; aortic and cardiac aneurysm; allergic diseases with skin rashes; diseases of the abdominal organs with a tendency to bleeding; chronic osteomyelitis; tumors; mental illness with excessive agitation; circulatory failure of the 3rd degree; during hyper- and hypotonic crises; acute ischemia myocardium; severe sclerosis of cerebral vessels; acute respiratory disease (ARI); in case of disorder intestinal functions(nausea, vomiting, loose stool); Pulmonary heart failure of the 3rd degree.

Massage works not only on a physical, but also on a psychological level. It fills the body with energy, helps us feel better about ourselves, and makes us optimistic. Massage, affecting vital organs, returns the body's ability to heal itself.