Diadynamic currents

The purpose of the class: to study the biophysical basis of AC action; physical
characteristics of diadinamotherapy; diadinamotherapy apparatus; methods and techniques of
procedures.

Formed competencies:

PC-5-is able to work with medical and technical equipment used in working with
patients, own computer equipment, receive information from various sources, work with
information in global computer networks, apply the capabilities of modern information
technologies to solve professional problems.

SLK-2-is able and ready to reveal the natural-scientific essence of the problems arising in
the course of professional activity of the doctor.

Introductions

Diadynamic currents (Bernard currents) - the impact of a constant electric current in the
direction of low voltage (60-80 V) and low power (up to 50 mA) in the pulse mode. Pulses of
semi-sinusoidal shape with a frequency of 50 or 100 Hz.

Two types of diadynamic currents (50 Hz and 100 Hz) are used for the following fixed
types of modulation:

1) single-Period continuous current (OH);

2) two-half-Period continuous current (DN);

3) Current. modulated by short periods (CP);

4) long period modulated current (DP);

5) single-Period rhythmic current (OR).

6) single-Period wave current (S).

7) two-half-Period wave current (DV).

Single-period continuous-semi-sinusoidal current frequency of 50 Hz has a pronounced

irritating and myostimulating effect, up to tetanic muscle contraction, causes a large unpleasant
vibration in the patient.

Two-half-period continuous-semi-sinusoidal current with a frequency of 100 Hz has a

pronounced analgesic and vasoactive effect, causes fibrillar muscle twitching, shallow and
diffuse vibration.
 One-half rhythmic-intermittent one-half-periode current, sending which with pauses of
equal duration (1:1 or 1.5: 1.5 s) has the most pronounced myostimulatory effect during the
current parcels, which are combined with a period of complete relaxation of muscles during the
pause.

Short-period modulated current is a sequential combination of one-half continuous and

two-half continuous currents following equal parcels (1-1. 5 s). This alternation significantly
reduces adaptation to them. This current at the beginning of exposure has a neuromyostimulating
effect, and after 1-2 minutes causes analgesia. Its inclusion causes the patient periodic sensations
of large and soft gentle vibration.

Current-modulated long-period - the simultaneous combination of parcels half-wave

continuous current with a duration of 4 and full-wave continuous current with a duration of 8 s.
the current pulses of half-wave continuous for 4 are complemented by a smoothly increasing and
decreasing (for 2 s) pulses of current, continuous full-wave. Such currents decreases
neuromyostimulating effect and gradually increase the analgesic, vasoactive and trophic effects.
The patient's sensations are similar to the previous mode of exposure.

Half-wave rectified wave half-wave packages continuous current frequency of 50 Hz

duration of 4-8 s, with a gradual increase and decrease in amplitude, followed by pauses of 2-4 s.
Has a pronounced neuromyostimulating effect.

Two-half-period wave-sending of two-half-period continuous current with a frequency of

100 Hz lasting 4-8 s, with a gradual increase and decrease in amplitude, followed by pauses
lasting 2-4 s. it Has a pronounced neurotrophic and vasoactive effect.

To reduce the habituation of the patient to the pulse current, 2-3 types of diadynamic
currents are usually used in the formulation. Depending on the purpose of exposure and the
expected effect, a combination of base currents and their modulations is used.

Apparatus:

- SNIM (sinusoidal low frequency pulse modulated);

-«Tone»;

- "Diadynamic»;

"Neuroton."

Procedure.

When conducting procedures diadinamoterapy use flat electrodes of different sizes, used
for galvanization, small and medium Cup electrodes, as well as cavity (rectal and vaginal). Flat
electrodes are placed on the body of the patient longitudinally or transversely and fixed with
rubber bandages or sandbags. At the same time, they strive to achieve good contact of the
electrode with the tissues of the patient. Calyx cavity electrodes are treated hydrophilic spacers.
The distance between the electrodes should not be less than their transverse size. Electrodes
should be placed on the surface of the skin in the area of the painful focus, and when using local
electrodes to move them along the nerves involved in the pathological process. An active
electrode connected to the cathode is applied to the pain focus, which most effectively forms the
dominant of rhythmic irritation, contributing to the relief of acute pain. In the figurative
expression of P. Bernard, " the Doctor should chase the cathode for pain." The current supplied
to the patient is dosed according to the force, which depends on the shape and size of the
electrodes and ranges from 2-5 to 15-20 mA. In addition, during the procedures, the nurse should
focus on the feelings of the patient. The current is gradually increased to a feeling of distinct
vibration or a sense of sliding of the electrode. When a burning sensation under the electrodes or
pronounced hyperemia after the procedure, the current strength during subsequent procedures is
reduced.

Basic biophysical processes:

the same as when galvanizing. Movement of ions in one direct this occurs during the period
when there is an electric current.

Main physiological reactions and therapeutic effect:

the same as when galvanizing. Pulsed electric current with a frequency of 50 Hz causes
burning, tingling, a feeling of large vibration, painful and irritating. An electric current with a
frequency of 100 Hz causes a feeling of fine vibration, which is carried much easier.

The main action of diadynamic currents is anesthesia. The mechanism of this action is
considered from the standpoint of the doctrine of N.E. Vvedensky about the peculiarities of the
tissue response to a monotonous stimulus. In the first phase of exposure there is excitement,
when getting used to the excitement comes the phase of inhibition, then-the phase of parabiosis.
The braking phase caused by the action of diadynamic currents continues for 2-4 hours after the
end of the procedure, and the parabiotic phase is very short-lived. Reduction of excitability and
functional mobility of nerve receptors leads to anesthesia.

When alternating exposure to currents with a frequency of 50 and 100 Hz, addiction to
the stimulus does not occur. Irritation from the receptors of the neuromuscular apparatus enters
the Central nervous system. In accordance with the teachings of AA Ukhtomsky in the cerebral
cortex is formed dominant rhythmic stimulus, which suppresses the pain dominant.

In the zone of influence appears hyperemia of the skin, improves blood and lymph
circulation, trophic tissues. The effect is mainly on the surface receptors. Before the procedure,
you should find pain points, pain distribution zones and apply electrodes to these areas. The
above reactions are expressed to a greater extent under the cathode, so the pain zones should be
affected by the negative pole.

Diadynamic currents can be used for electrical stimulation of muscles, including for the
effect on the smooth muscles of internal organs in their hypomotor dyskinesia with a single-half-
period rhythmic current (the former name is the rhythm of syncope).
 Diadynamic currents, being direct currents, have an introducing ability, which justifies
their use in the methods of administration of drugs (diadinamophoresis).

Yielding to the galvanic current in the amount of input into the organism of the medicinal
substance, they provide its deeper penetration, often potentiate its action. In this regard,
diadinamophoresis is preferable to use for the treatment of deep-localized processes, in the
clinical picture of which pain syndrome and vegetative-vascular disorders prevail.

The main indications for the use of

1. Pain syndrome with peripheral nerve damage (osteochondrosis, neuritis, neuralgia,

polyneuropathy).

2. Pain syndrome in injuries: bruises, sprains and muscles.

3. Pain syndrome in degenerative-dystrophic lesions of the joints and spine.

4. Local autonomic vascular disorders: migraine, Raynaud's syndrome, paresthesia, etc.

5. Dyskinesia of internal organs of hypomotor type.

6. Diseases of ENT organs (laryngitis, sinusitis, rhinitis).

The main contraindications to the use of

1. Acute stages of inflammation, especially purulent.

2. Non-fixed bone fractures, dislocations of joints (before reduction), complete ruptures

of ligaments and muscles.

3. Thrombophlebitis (in the area of the expected impact).

4. The presence of stones in the gallbladder and urinary tract (if it is expected to affect
the relevant areas).

5. Hypertension stage 2 - 3.

6.Tendency to bleed.

Dosage:

1) electric current (up to 50 mA):

2) according to the patient's sensations (slight tingling, burning, vibration or rhythmic

muscle contraction);

3) the duration of the procedure (the impact on one field is not more than 7 minutes;
during one procedure, the impact is not more than three fields);
 4) the multiplicity of procedures (twice a day with a break of at least 4 hours, daily, every
other day);

5) the number of procedures per course of treatment (no more than 10).

If necessary, repeat the course in 2 weeks.

The second and third courses of treatment is advisable to appoint only in the presence of
positive dynamics in the patient's condition.