Physiotherapy for chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease is a widespread and progressive inflammatory-dystrophic lesion of the bronchopulmonary system, characterized by a decrease in the maximum air flow during exhalation and a slowdown in forced emptying of the lungs with a long course. In the previously existing terminology, some types of chronic bronchitis were attributed to this disease. The symptom complexes that determine the diagnosis of COPD include inflammation of the bronchial mucosa, tonic contraction of the bronchial smooth muscles and impaired drainage function of the respiratory tract. Consequently, physiotherapy methods should have a corresponding pathogenetic determinacy of the impact of a particular physical factor.

In case of exacerbation of COPD, treatment of patients should be carried out in hospital conditions (in a hospital or a hospital) with full dynamic diagnostic control and with the appointment of a full range of therapeutic measures. The list of physiotherapeutic procedures at the hospital stage includes the following methods:

• inhalation therapy with antibacterial and bronchodilators;
• medicinal electrophoresis with medications corresponding to the stages of the pathological process;
• ultrasound exposure;
• exposure to a pulsating low-frequency magnetic field;
• appropriate methods of light therapy or laser (magnetic laser) therapy;
• chest massage;
• some hydro- and balneotherapy procedures according to traditional application options.

The sequence and alternation of physiotherapeutic procedures are also determined by the stages of the pathological process in a particular patient, and the combination of procedures must correspond to the general principles of combined action.

At this stage, the family doctor monitors the patient and, if necessary, together with the hospital doctors, makes appropriate adjustments to the treatment prescriptions based on a full knowledge of the characteristics of the patient's body and his reaction to taking certain medications and physiotherapy procedures.

If psychological rehabilitation of the patient is required as an addition to the activities carried out at the hospital stage, the family doctor should recommend methods of influencing the frontal lobes of the brain using the Azor-IK device. The methods of performing the procedures depend on the mental status of the patient. If the patient has psychoemotional arousal, the impact is carried out using the inhibitory method, and in a depressive state - using the stimulating method. The procedures are carried out with two fields simultaneously on the projection of the frontal lobes of the patient's head, contact, stable. The modulation frequency of the EMI for the inhibitory option is 2 Hz, for the stimulating option 21 Hz. The exposure time per field is 20 minutes, for a course of 10-15 daily procedures 1 time per day in the morning (before 12 noon).

In the inter-relapse period of the disease, it is rational to carry out measures using physical factors, the impact of which ensures the maintenance of normal tone of the smooth muscles of the bronchi and the normal rhythm of functioning of the ciliated epithelium of the bronchi, and also prevents the progression of dystrophic processes in the bronchopulmonary system.

Pathogenetically conditioned methods of physiotherapy at home in the inter-relapse period for this pathology include laser (magnetic laser) therapy using red (wavelength 0.63 μm) or infrared emitters (wavelength 0.8 - 0.9 μm).

The technique is contact and stable. The matrix emitter is applied to the exposed skin of the body in two fields: - to the area of the middle third of the sternum; II - to the interscapular region along the line of the spinous processes of the vertebrae. Using devices with an irradiation area of about 1 cm2, the interscapular region is affected by four fields paravertebrally, two fields on the right and left at the level of Thv - ThVn.

The recommended PPM of the ILI is 5-10 mW/cm2. With the possibility of frequency modulation of the NLI, the optimal frequency is 10 Hz. However, exposure in the continuous (quasi-continuous) radiation generation mode is also effective. Magnetic nozzle induction is 20-150 mT. The duration of exposure to one field is 5 minutes, once a day in the morning (before 12 noon), for a course of treatment 7-10 procedures daily.

An alternative method of laser (magnetic laser) therapy is information-wave exposure using the Azor-IK device. The procedures are carried out using a contact, stable method, only on the exposed areas of the patient's body. The fields of exposure are similar to those in laser therapy; the modulation frequency of the EMI is 10 Hz, the exposure time for one field is 20 minutes, for a course of 10-15 procedures daily once a day in the morning.

Repetition of anti-relapse courses of laser (magnetic laser) or information-wave therapy can be carried out once every 3 months. It is desirable that these courses coincide with the spring and autumn periods, i.e. with the seasonality of possible exacerbation of the disease.

One of the effective methods that helps restore the tone of the smooth muscles of the bronchopulmonary system is to perform daily procedures in the evening (1 hour after dinner) on the Frolov breathing simulator (TDI-01) according to the methods attached to this device. The duration of the procedures is at least 1 month with periodic (1 time in 3 months) repetitions of a similar course.

It is possible to carry out the procedures sequentially on the same day at home for COPD (the interval between procedures is at least 30 minutes):

• laser (magnetic laser) therapy + psychological rehabilitation procedures using the Azor-IK device + procedures on the Frolov breathing simulator;
• information-wave impact using the Azor-IK device + psychological rehabilitation procedures using the Azor device

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