The origin and development of physical therapy in primitive society, people often stumble over thorns when hunting wild animals, causing soft tissue injury, so they instinctively touch, press and rub with their hands to relieve pain. In the process of fishing, fishermen in ancient Greece were sometimes injured by fish with secretions on their backs, and later found that people with joint pain improved or recovered. In the long-term struggle between mankind and nature, we constantly sum up.
Physical therapy has a long history in China. As early as the 2nd century AD, it was recorded in the book Huangdi Neijing. Since 1950s, our country has set up physiotherapy specialty, and has done a lot of tentative work, which has made remarkable achievements.
The development of physical therapy in foreign countries first began before the 4th century. Hippocarates, an ancient Greek doctor, advocated the application of mineral springs, sunlight and seawater to treat diseases. In the17th century, it was found that static electricity began to have artificial electrotherapy. In the 1930s, ultrasound was used to treat diseases.
The classification of modern physical therapy applies natural physical factors.
For example: solar energy therapy, air bath therapy, forest therapy, seawater bath therapy, climate therapy, etc.
Applying artificial physical factors
Apply motion and mechanical force, electricity, light, sound, magnetism, heat, cold, water, etc.
It is characterized by quick response.
For example, some low-intermediate frequency electrotherapy such as sweating in hot water bath, cooling in cold water bath and acute sprain and contusion can often make patients feel comfortable immediately.
painless
Physical therapy takes effect quickly, the pain is relieved immediately, and there is a feeling of comfort and lightness.
Has little side effect and lasting curative effect.
Physical therapy rarely causes physical discomfort. Physical therapy has a lasting effect and repeated treatment. Can produce the superposition and accumulation of therapeutic effects.
Classified sound therapy (ultrasonic therapy)
Phototherapy (infrared phototherapy, ultraviolet phototherapy, visible light therapy, laser therapy)
Hydrotherapy (contrast bath, whirlpool bath, bubble bath, etc. ),
Electrotherapy (DC electrotherapy: iontophoresis, etc. ); Low-frequency electrotherapy: including TENS and intermittent electrotherapy. Intermediate frequency electrotherapy: that is, interference wave therapy; High-frequency electrotherapy or diathermy: including short-wave hyperthermia, microwave hyperthermia and magnetic therapy. )
Cold therapy (ice compress, ice massage, etc. )
Hyperthermia (hot compress, wax therapy, diathermy, etc. )
Force (traction, pressure, impact, friction, etc.). )
Magnetic therapy (static magnetic field therapy, pulsed magnetic field therapy, low frequency alternating magnetic field therapy, etc.). )
Therapeutic effect and anti-inflammatory effect
A large number of clinical trials show that various physical therapy methods have anti-inflammatory effects. Acute and chronic inflammation of skin, mucosa, muscles, joints and even internal organs caused by various reasons are indications of physiotherapy, and different physiotherapy methods can be used for treatment.
abirritation
Pain is a complicated process, which is both a material phenomenon and a spiritual phenomenon. If physical factors are used to treat analgesia, it is necessary to find out the reasons and carry out targeted treatment. Hyperthermia, direct current introduction and electrotherapy can be used for treatment respectively.
Antibiotic action
Ultraviolet ray is famous for its sterilization, which can kill Staphylococcus aureus, Pseudomonas aeruginosa, Bacillus anthracis and hemolytic streptococcus.
Sedation and insomnia
Physical therapy with this effect includes electric sleep therapy, electrostatic therapy, magnetic field therapy, warm water bath and so on. These therapies can enhance the diffusion inhibition of cerebral cortex, relieve the whole body tension, and thus produce obvious shock and hypnosis.
Excite neuromuscular
Use low-intermediate frequency electrotherapy with various technical parameters to treat peripheral nerve paralysis and muscle atrophy or enhance muscle strength exercise.
Relieve spasm
Physical therapy methods that can relieve spasm include short wave, ultrashort wave and microwave therapy for deep tissue, paraffin therapy and infrared therapy for shallow tissue. The mechanism of physical therapy for spasticity mainly lies in that heat energy reduces γ efferent nerve fibers in muscle spindle, and weakens stretch reflex and muscle tension.
Soften scars and eliminate adhesion.
Paraffin therapy, ultrasonic therapy and iodine iontophoresis can change the elasticity of connective tissue and increase its ductility. They are often used to treat postoperative scar and tissue adhesion, and have obvious effects on softening scar and dissipating adhesion.
Accelerate wound healing
The application of low-dose ultraviolet rays can not only prevent and control wound infection, but also stimulate the growth of granulation tissue and accelerate the process of epithelial bridging and wound healing.
Accelerate the formation of callus
Weak DC cathode, TENS, interference current therapy and pulsed magnetic field can all promote bone growth and accelerate fracture healing.
Enhance the body's immune mechanism
Experiments show that physical factors such as ultraviolet rays, infrared rays and magnetic fields can enhance and regulate the body's immunity.
desensitize
The mechanism of desensitization is that ultraviolet rays can decompose protein into histamine, and a small dose of histamine continuously enters the blood, which can stimulate the production of histaminase. When the amount of histamine enzyme reaches enough, it can decompose excess histamine, thus playing a desensitization role. Ultraviolet radiation can also promote adrenal function, enhance calcium absorption, and help reduce allergic reactions.
Anticancer effect
In recent years, progress has been made in the treatment of cancer through heating, low temperature freezing, laser photosensitive effect, laser gasification and carbonization, and focused ultrasound.
* * * and the characteristics acting on the body.
* * * Physical therapy for the body.
1, physiological performance
(1) Change the proportion of ions and the content of trace elements in tissues, cells and body fluids.
(2) causing changes in the molecular structure of some substances in the body
(3) affecting the activities of various enzymes
(4) regulating substance metabolism
(5) producing bioactive substances in vivo.
(6) promoting blood and lymphatic circulation
(7) Change the permeability of biomembrane, blood vessel, skin, mucosa and other tissues.
(8) causing tissue temperature change
(9) regulating the function of neuroendocrine information control system
(10) enhances the function of monocyte-phagocyte system.
2. Performance in treatment.
(1) Promote the elimination of dysfunction of neuroendocrine information control system.
(2) Improve the functional level of the body or some systems and organs.
(3) Improve blood circulation and nutrition of tissues and organs, and promote tissue repair and regeneration.
(4) improve local or systemic resistance
(5) Analgesic effect
(6) Anti-inflammatory and detumescence effects
(7) relieve spasm
(8) Desensitization or sensitization
(9) Enhance the adaptability of the body.
(10) Improve the penetration of drugs into tissues and organs.
Characteristics of physical therapy
After physical therapy acts on the body, it can cause homosexual effect and specific effect. The specific effect of physical therapy is based on the relative selectivity of different physical factors to different cells, tissues and organs, because different physical properties have different sensitivities to tissues and cells. The special effect of physical therapy can only be most obvious when a small dose is used, and its special effect will be covered up when a large dose is used because of molecular Brownian motion.
Clinical physiotherapy diseases nervous system diseases
Such as cerebrovascular diseases (cerebrovascular diseases), brain diseases (such as Parkinson's disease), brain trauma, spinal cord diseases, spinal cord injuries and peripheral nerve diseases or injuries.
Diseases of skeletal and muscular systems
Arthritis (including degenerative arthritis and rheumatoid arthritis), ankylosing spondylitis, soft tissue injury, fracture, amputation, neck, shoulder, back and leg pain, scoliosis and sports injury.
Cardiopulmonary dysfunction disease
Treatment and training before and after chest, abdominal cavity and heart surgery, treatment of respiratory diseases, such as chronic obstructive respiratory diseases (chronic bronchitis, asthma, emphysema), pleurisy, pneumonia and bronchiectasis.
Diseases of digestive system and urogenital system
Gastritis, gastroduodenal ulcer, gastrointestinal spasm, cholecystitis, pyelonephritis, cystitis, pelvic inflammatory disease, prostatitis, etc.
Skin tissue physiotherapy
Usually, the treatment conditions are directed at the skin or related organs. The common clinical diseases are burns and open wounds of root skin. Treatment methods include debridement of wounds and scars, maintenance of joint mobility, wound dressing and dressing change.
Other people in need:
Such as exercise before and after delivery, lymphedema, diabetic lower limb pain and ulcer, senile diseases, patients who need bed rest or heart surgery can be educated first to avoid complications.
In the process of physical therapy, physiotherapists not only pay attention to pain control, but also pay attention to patients' functional rehabilitation, educate and correct patients' daily habits and work needs, reduce the crisis of damaging health, and lay a healthy road for patients in an all-round way.
The basic principle of application is clear diagnosis and saving lives.
Without correct diagnosis, there is no correct treatment. Careful analysis of what causes this symptom can only be treated by correct physical therapy.
Comprehensive treatment, with a holistic concept.
1, combined application of various physical therapies.
Comprehensive treatment often gets twice the result with half the effort. For example, the etiology and pathogenesis of shoulder-hand syndrome after stroke are still unclear. At present, most scholars believe that the occurrence of this complication is related to the injury of shoulder and wrist joint, the obstruction of upper limb body fluid reflux and the dysfunction of vascular movement after central nervous system injury in stroke patients. In addition, the loss of nerves that control shoulder muscles after stroke leads to the decrease or spasm of muscle strength and muscle tension of the affected limb, and the instability of shoulder joint structure, which is also an important cause of shoulder joint pain. Interventional low-frequency therapy can stimulate the middle and posterior parts of supraspinatus and deltoid muscles, activate nerve fibers of these two groups of muscles, make them contract rhythmically, promote the accelerated return of body fluids, enhance local metabolism, increase muscle nutrition, and effectively improve muscle tension, thus pulling the humeral head back to the normal anatomical position and relieving the pain symptoms caused by nerve entrapment. In addition, according to the analgesic mechanism of low-frequency and intermediate-frequency currents, interfering with low-frequency currents stimulates crude fibers that conduct non-painful substances with comfortable intermediate-frequency currents, which interferes with and blocks the transmission of pain, promotes the release of endogenous morphine-like substances such as enkephalins and endorphins in the body, and achieves analgesic effect, thus relieving shoulder pain. The effect of magnetic field on organisms has biological effects such as reducing the excitability of peripheral nerves, promoting blood circulation, accelerating the absorption and dissipation of inflammatory exudates, and promoting wound healing. It has good analgesic, spasmolytic, anti-inflammatory and repairing effects, and the synergistic effect of mechanical vibration and warmth enhances its curative effect. Electroacupuncture treatment has the characteristics of integrity and two-way adjustment, which is unique in treating stroke patients with hemiplegia. Shoulder-hand syndrome often occurs in flaccid paralysis after stroke, and the treatment of flaccid paralysis should focus on promoting the production of active muscle tension. At this time, acupuncture can be used to induce upper limb flexors and lower limb extensors to enhance muscle tension and promote the same movement. To sum up, the comprehensive effect of various physical factors has a positive and significant effect on the treatment of shoulder-hand syndrome after stroke, and active treatment of shoulder-hand syndrome is of great significance to the comprehensive rehabilitation of stroke patients and their return to family and society.
2, physical therapy and drug synthesis
Physical therapy and comprehensive drug therapy can promote drug absorption and improve the body's sensitivity to drugs. Examples of clinical use: The pathogenesis of cervical insomnia has not been fully clarified. For the treatment of insomnia, besides psychotherapy, we should also pay attention to whether the patient has cervical spondylosis to participate in the onset. It is reported in literature that frontoccipital DC can relieve local muscle spasm and dilate blood vessels, thus relieving cerebral vasospasm and increasing cerebral blood flow. In this study, psychological counseling combined with estazolam combined with Danshen injection was used to treat cervical insomnia. The clinical effect of the treatment group is better than that of the control group, and the control group has obvious rebound insomnia after stopping the drug. The results show that the direct current iontophoresis of Danshen injection has a good clinical effect on cervical insomnia and can obviously reduce the side effects of sleeping pills.