What is physical therapy and how does it affect a person?

Physiotherapy is the study of the principles of using external physical factors on the human body for therapeutic, preventive and rehabilitation purposes.

The use of physiotherapy in the elderly

When solving the problem of treating various diseases in elderly and senile people, certain difficulties arise. That is why a doctor needs knowledge in the field of gerontology and geriatrics. Gerontology is the science of aging organisms, and geriatrics is a field of clinical medicine that studies diseases of elderly (men from 60, women from 55 years) and senile (75 years and older) people, developing methods for diagnosing diseases, preventing and treating them. Geriatrics is a section of gerontology.

Aging of the organism is a biochemical, biophysical, physicochemical process. It is characterized by such processes as heterochronicity, heterotopicity, heterokineticity and heterocatephticity.

Heterochrony is the difference in the time of onset of aging of individual cells, tissues, organs, and systems.

Heterotopy is the unequal severity of age-related changes in different structures of the same organ.

Heterokinetics is the development of age-related changes in the structures and systems of the body at different rates.

Heterokatephtennost is the multidirectionality of age-related changes associated with the suppression of some and activation of other life processes in the aging organism.

Most researchers agree that the aging process begins at the molecular level, and that changes in the genetic apparatus are of primary importance in the molecular mechanisms of aging. It is assumed that the primary mechanisms of aging are associated with shifts in the implementation of genetic information. Aging and old age are different concepts; they relate to each other as cause and effect. And a great many causes accumulate during the life of an organism. Shifts in the implementation of genetic information under the influence of endogenous and exogenous causal factors lead to uneven changes in the synthesis of various proteins, a reduction in the potential capabilities of the biosynthetic apparatus, and the appearance of proteins that were possibly not synthesized before. The structure and function of cells are disrupted. Of particular importance in this case are shifts in the state of cell membranes, on which the most important and extremely active biochemical and physicochemical processes occur.

As a field of clinical medicine, geriatrics is characterized by several important features, the main ones being the following:

• the multiplicity of pathological processes in elderly and senile patients, which requires a detailed study of the patient's body, a good knowledge of not only the age-related characteristics of the course of certain diseases, but also the symptoms of a very wide range of various pathologies.
• the need to take into account the peculiarities of the development and course of diseases in elderly and old people, caused by the new qualities of the aging organism.
• in old and senile age, the recovery processes after illnesses occur slowly, less perfectly, and this causes a protracted rehabilitation period and often less effective treatment. Finally, the peculiarities of the psychology of an aging person leave a special imprint on the interaction between the doctor and the patient, on the results of treatment.

The main features of the use of physiotherapeutic interventions in geriatrics:

• the need to use low and ultra-low output power of the external physical factor acting on the body, i.e. low intensity of impact;
• the need to reduce the time of exposure to the therapeutic physical factor;
• the need to use fewer physiotherapy treatment fields per procedure and fewer procedures per course of treatment.

When combining physiotherapy with medication in elderly and senile individuals, it should be taken into account that the effect of medication in this group may be:

• toxic manifestations due to the cumulative effect;
• undesirable biological effects of drugs on the body;
• unwanted interactions in the body between certain drugs;
• persistent hypersensitivity to the drug, caused in many cases by taking this drug in previous years.

In this regard, it is necessary to remember the possibility of increasing the negative effect on the body of taking the appropriate medications against the background of physiotherapy in older age groups. Knowledge of the basic provisions of gerontology and geriatrics, taking into account new concepts of physiotherapy, will help to avoid unjustified complex treatment of elderly and senile patients with various pathologies.

Principles of Physiotherapy

The following principles of physiotherapy are currently substantiated:

• the unity of the etiological, pathogenetic and symptomatic direction of the influence of therapeutic physical factors;
• individual approach;
• course impact of physical factors;
• optimality;
• dynamic physiotherapeutic and complex impact of therapeutic physical factors.

The first principle is implemented due to the capabilities of the physical factor itself to carry out or generate the corresponding processes in tissues and organs, as well as by selecting the necessary factor of influence to achieve the goals of either prevention, treatment, or rehabilitation. In this case, it is important to take into account the corresponding localization of the action of this factor on the patient's body (topography and area of the fields of influence); the number of fields per procedure; the PPM of the acting factor per field and the total dose of the effect of this factor per procedure, as well as a certain duration of the course of physiotherapy.

The principle of individualization of physiotherapy is associated with compliance with indications and contraindications for the impact of certain external physical factors, taking into account the individual characteristics of the body, with the need to obtain appropriate clinical effects from physiotherapy in a competitive patient.

The principle of a course of physical factors for the purposes of prevention, treatment and rehabilitation is based on the chronobiological approach to all processes in the human body. Thus, in the case of a local acute inflammatory process, the course of daily physiotherapeutic procedures can be 5-7 days (this is the average duration of the acute pathological process, corresponding to the circoseptane rhythm of the functioning of the body's systems). In the case of chronic pathology, the duration of the physiotherapy course reaches 10-15 days (this is the average duration of acute-phase reactions during an exacerbation of a chronic pathological process, corresponding to the circodiseptane rhythm). This principle corresponds to the provisions of synchronizing the effect of regular repetition and periodicity of physiotherapeutic procedures.

The principle of optimal physiotherapy is based on taking into account the nature and phase of the pathological process in the patient's body. But it is necessary to remember first of all about the optimality and sufficiency of the dose of exposure and synchronization of the rhythm of the factor's action with the normal rhythms of the functioning of the body's systems.

The principle of dynamism of physiotherapeutic effects is determined by the need to correct the parameters of the acting factor during treatment based on constant monitoring of changes in the patient's body.

The impact of physiotherapy on the body

Complex impact of external physical factors for therapeutic, preventive and rehabilitation purposes is carried out in two forms - combination and combination. Combination is the simultaneous impact of two or more physical factors on the same area of the patient's body. Combination is a sequential (different-time) impact of physical factors that can be used on the same day with the following options:

• sequential, close to combined (one effect follows another without interruption);
• with time intervals.

Combination includes exposure to the relevant factors on different days (using the alternation method) during one course of physiotherapy, as well as alternating courses of physiotherapeutic procedures. The basis of the approach to the complex use of exposure to external physical factors is knowledge of the direction of the influence of the relevant factors on the body, as well as the result in the form of synergism or antagonism of the action of certain physical factors on the body and the resulting biological reactions and clinical effects. For example, combined exposure to EMR and alternating electric current or alternating electric and magnetic fields, which reduce the depth of penetration of EMR into tissues by changing the optical axis of the dipoles of biosubstrates, is inappropriate. Thermal procedures increase the reflection coefficient of EMR by tissues. Therefore, exposure to EMR on the body should be carried out before heat treatment procedures. When cooling tissues, the opposite effect is observed. It is necessary to remember that after a single exposure to an external physical factor, the changes in tissues and organs caused by this exposure disappear after 2-4 hours.

Nine principles of physiotherapy have been defined, the main ones of which fully correspond to the principles listed above, while others require discussion. Thus, the validity of the principle of nervism should be assessed from the standpoint of theoretical and experimental justifications given in Chapter 3 of this publication. The principle of adequacy of exposure is essentially an integral part of the principles of individualization and optimality of physiotherapy. The principle of small dosages fully corresponds to the concept of the sufficiency of the dose of exposure, substantiated in Section 4 of this manual. The principle of varying exposures practically corresponds to the principle of dynamism of treatment with physical factors. The principle of continuity deserves attention, which reflects the need to take into account the nature, effectiveness and duration of previous treatment with physical factors, taking into account possible combinations of all treatment, preventive and rehabilitation measures, as well as the patient's wishes.

Physiotherapy is almost always carried out against the background of patients taking appropriate medications (chemical factors). The interaction of external chemical factors with a whole multicellular organism occurs through the formation of chemical bonds of exogenous substances with appropriate biological substrates, which initiate subsequent various reactions and effects.

Pharmacokinetics of a drug in a living organism is a change in the concentration of a pharmacological substance in various environments of the organism over time, as well as the mechanisms and processes that determine these changes. Pharmacodynamics is a set of changes that occur in the organism under the influence of a drug. During the primary interaction of a chemical factor (drug) with the organism, the following reactions most often occur.

With a high chemical affinity between a pharmacological substance and the natural metabolic products of a given biological object, chemical reactions of a substitution nature occur, causing corresponding physiological or pathophysiological effects.

With a distant chemical affinity of a pharmaceutical with metabolic products, chemical reactions of a competing nature occur. In this case, the drug occupies the point of application of the metabolite, but cannot perform its function and blocks a certain biochemical reaction.

In the presence of certain physical and chemical properties, drugs react with protein molecules, causing a temporary disruption of the function of the corresponding protein structure, the cell as a whole, which may cause cell death.

Some drugs directly or indirectly change the basic electrolyte composition of cells, i.e. the environment in which enzymes, proteins and other elements of the cell perform their functions.

Distribution of drugs in the body depends on three main factors. The first is the spatial factor. It determines the routes of entry and distribution of chemical factors, which is associated with the blood supply to organs and tissues, since the amount of an exogenous chemical substance entering an organ depends on the volumetric blood flow of the organ, referred to a unit of tissue mass. The second is the time factor, which is characterized by the rate of entry of the drug into the body and its excretion. The third is the concentration factor, which is determined by the concentration of the drug in biological environments, in particular in the blood. A study of the concentration of the corresponding substance over time allows us to determine the resorption period, the achievement of its maximum concentration in the blood, as well as the elimination period, the excretion of this substance from the body. Elimination rates depend on the chemical bonds that the drug enters into with biological substrates. Covalent bonds are very strong and difficult to reverse; ionic, hydrogen and van der Waals bonds are more labile.

Therefore, before entering into a chemical reaction with biological substrates, a medicinal product, depending on the route of entry and other direct and indirect causes, must undergo certain stages, the time period of which can be many times greater than the speed of the chemical reaction itself. Plus, it is necessary to add a certain period of time of interaction of the medicinal product itself and its decay products with certain biological substrates until the complete cessation of action in the body.

It should be noted that the action of many drugs lacks strict selectivity. Their intervention in life processes is based not on specific biochemical reactions with certain cellular receptors, but on interaction with the entire cell as a whole, caused by the presence of these substances in the biological substrate even in small concentrations.

The main features of the influence of the simultaneous action of external physical and chemical factors on structures and systems, primarily at the cellular level, are the following established factors. Physical factors have global and universal action in the form of a change in the electrical status of a cell, a group of cells in the area of action. Chemical factors, including drugs, have an intended effect on certain structures, but, in addition, participate in a number of non-specific biochemical reactions, which are often difficult or impossible to predict.

Physical factors are characterized by the colossal speed of interaction of the factor with biological substrates and the possibility of immediate termination of the effect of this factor on the biological object. A chemical factor is characterized by the presence of a temporary, often long interval from the moment of introduction of the substance into the body until the beginning of certain reactions. At the same time, the fact of completion of the interaction of a given chemical substance and its metabolites with biological substrates cannot be accurately determined, much less predicted.

When external physical factors and drugs act simultaneously on the body, it should be remembered that the pharmacokinetics and pharmacodynamics of many drugs undergo significant changes. Based on these changes, the effect of either a physical factor or a drug may be strengthened or weakened. It is possible to reduce or strengthen undesirable side effects from taking drugs against the background of appropriate physiotherapy. Synergism of chemical and physical factors can develop in two forms: summation and potentiation of effects. Antagonism of the combined action of these factors on the body is manifested in a weakening of the resulting effect or the absence of the expected effect.

Generalized clinical and experimental data indicate that with the simultaneous impact on the body of certain physical factors and appropriate drug therapy, the following effects occur.

Galvanization reduces the side effects of medications such as antibiotics, immunosuppressants, some psychotropic drugs, non-narcotic analgesics, and the effect of taking nitrates is enhanced by this method of physiotherapy.

The effect of electrosleep therapy increases against the background of taking tranquilizers, sedatives, psychotropic drugs, at the same time, the effect of nitrates increases during electrosleep therapy.

With transcranial electroanalgesia, there is a clear increase in the effect of analgesics and nitrates, and the use of sedatives and tranquilizers enhances the effect of this method of physiotherapy.

With diadynamic therapy and amplipulse therapy, a reduction in side effects from taking antibiotics, immunosuppressants, psychotropic drugs and analgesics has been recorded.

Ultrasound therapy reduces unwanted side effects that occur when taking antibiotics, immunosuppressants, psychotropic drugs and analgesics, but at the same time, ultrasound therapy enhances the effect of anticoagulants. It should be remembered that a caffeine solution previously exposed to ultrasound, when administered intravenously into the body, causes cardiac arrest.

Magnetotherapy enhances the effect of immunosuppressants, analgesics and anticoagulants, but against the background of magnetotherapy, the effect of salicylates is weakened. Particular attention should be paid to the detected antagonism effect with the simultaneous administration of steroid hormones and magnetotherapy.

The effect of ultraviolet radiation is enhanced by taking sulfonamides, bismuth and arsenic agents, adaptogens and salicylates. The effect of this physical factor on the body enhances the effect of steroid hormones and immunosuppressants, and the introduction of insulin, sodium thiosulfate and calcium preparations into the body weakens the effect of ultraviolet radiation.

Laser therapy has been shown to enhance the effect of antibiotics, sulfonamides and nitrates, and increase the toxicity of nitrofuran drugs. According to A.N. Razumov, T.A. Knyazeva and V.A. Badtieva (2001), exposure to low-energy laser radiation eliminates tolerance to nitrates. The effectiveness of this method of physiotherapy can be reduced to almost zero when taking vagotonic agents.

When taking vitamins, an increase in the therapeutic effect of electrosleep therapy, inductothermy, UHF, SHF and ultrasound therapy was noted.

Hyperbaric oxygen therapy (oxygen barotherapy) changes the action of adrenaline, nonachlazine and euphyllin, causing a beta-adrenolytic effect. Narcotic and analgesic drugs exhibit synergism in relation to the action of compressed oxygen. Against the background of oxygen barotherapy, the main effect of serotonin and GABA on the body is significantly enhanced. The introduction of pituitrin, glucocorticoids, thyroxine, insulin into the body during hyperbaric oxygenation increases the adverse effect of oxygen under increased pressure.

Unfortunately, at the level of modern knowledge in the field of physiotherapy and pharmacotherapy, it is theoretically difficult to predict the mutual influence of physical factors and drugs on the body when they are used simultaneously. The experimental path of studying this process is also very thorny. This is due to the fact that information about the metabolism of chemical compounds in a living organism is very relative, and the pathways of metabolism of drugs are studied mainly on animals. The complex nature of species differences in metabolism makes it extremely difficult to interpret experimental results, and the possibility of using them to assess metabolism in humans is limited. Therefore, a family doctor must constantly remember that prescribing physiotherapy to a patient against the background of appropriate drug therapy is a very responsible decision. It must be made with knowledge of all possible consequences with a mandatory consultation with a physiotherapist.

Physiotherapy and childhood

In the daily practice of a family doctor, one often has to deal with members of the ward family of different childhood ages. In pediatrics, physiotherapy methods are also an integral part of the prevention of diseases, treatment of children with various pathologies and rehabilitation of patients and disabled people. The response to physiotherapy is determined by the following features of the child's body.

Skin condition in children:

• the relative surface area of the skin in children is larger than in adults;
• in newborns and infants, the stratum corneum of the epidermis is thin, and the germinal layer is more developed;
• baby's skin contains a lot of water;
• sweat glands are not fully developed.

Increased sensitivity of the central nervous system to influences.

The spread of irritation from the impact on adjacent segments of the spinal cord occurs faster and wider.

High tension and lability of metabolic processes.

The possibility of perverted reactions to the influence of physical factors during puberty.

The features of physiotherapy for pediatric patients are as follows:

• in newborns and infants, it is necessary to use an ultra-low output power of the external physical factor acting on the body; with the age of the child, a gradual increase in the intensity of the acting factor and the achievement of this intensity, similar to that of adults, by the age of 18;
• For newborns and infants, the smallest number of fields of action of the therapeutic physical factor are used per procedure, with a gradual increase in them as the child ages.
• The possibility of using various physiotherapy methods in pediatrics is predetermined by the corresponding age of the child.

V. S. Ulashchik (1994) developed and substantiated recommendations for the possible use of one or another method of physiotherapy in pediatrics depending on the age of the child, and many years of clinical experience confirmed the viability of these recommendations. Currently, the following age criteria for the appointment of physiotherapeutic procedures in pediatrics are generally accepted:

• methods based on the use of direct current: general and local galvanization and medicinal electrophoresis are used from the age of 1 month;
• methods based on the use of pulsed currents: electrosleep therapy and transcranial electroanalgesia are used from 2-3 months; diadynamic therapy - from the 6th-10th day after birth; short-pulse electroanalgesia - from 1-3 months; electrical stimulation - from 1 month;
• methods based on the use of low-voltage alternating current: fluctuation and amplipulse therapy are used from the 6th to the 10th day after birth; interference therapy - from the 10th to the 14th day after birth;
• methods based on the use of high-voltage alternating current: darsonvalization and local ultratonotherapy are used from 1-2 months;
• methods based on the use of the influence of an electric field: general franklinization is used from 1-2 months; local franklinization and UHF therapy - from 2-3 months;
• methods based on the use of the influence of a magnetic field: magnetotherapy - the effect of constant, pulsed and alternating low-frequency magnetic fields is used from 5 months; inductothermy - the effect of an alternating high-frequency magnetic field - from 1-3 months;
• methods based on the use of electromagnetic radiation in the radio wave range: UHF and SHF therapy are used from 2-3 months;
• methods based on the use of electromagnetic radiation of the optical spectrum: light therapy with infrared, visible and ultraviolet radiation, including low-energy laser radiation of these spectra, are used from 2-3 months;
• methods based on the use of mechanical factors: massage and ultrasound therapy are used from 1 month; vibration therapy - from 2-3 months;
• methods based on the use of artificially altered air environment: aeroionotherapy and aerosol therapy are used from 1 month; speliotherapy - from 6 months;
• methods based on the use of thermal factors: paraffin, ozokerite therapy and cryotherapy are used from 1-2 months;
• methods based on the use of water procedures: hydrotherapy is used from 1 month;
• methods based on the use of therapeutic mud: local peloidotherapy is used from 2-3 months, general peloidotherapy - from 5-6 months.

The implementation of the principles of individualization and optimality of physiotherapy based on biological feedback is very tempting and promising. To understand the complexity of solving this problem, it is necessary to know and remember the following fundamental principles.

Control is a function that has developed in the process of evolution and underlies the processes of self-regulation and self-development of living nature, the entire biosphere. Control is based on the transmission of various types of information signals within the system. Signal transmission channels form direct and feedback connections in the system. It is believed that direct communication takes place when signals are transmitted in the "direct" direction of the elements of the channel chain from the beginning of the chain to its end. In biological systems, such simple chains can be distinguished, but only conditionally. Feedback plays the main role in control processes. Feedback in general is understood as any transmission of signals in the "reverse" direction, from the system's output to its input. Feedback is a connection between an impact on an object or bio-object and their reaction to it. The reaction of the entire system can enhance the external impact, and this is called positive feedback. If this reaction reduces the external impact, then negative feedback takes place.

Homeostatic feedback in a living multicellular organism is aimed at eliminating the influence of external action. In the sciences studying processes in living systems, there is a tendency to represent all control mechanisms as feedback loops covering the entire bio-object.

In essence, devices for physiotherapeutic effects are an external control system for a biological object. For effective operation of control systems, constant monitoring of the parameters of the controlled coordinates is necessary - the coupling of technical external control systems with the biological systems of the body. Biotechnical system (BTS) is a system that includes biological and technical subsystems, united by unified control algorithms for the purpose of the best performance of a specific deterministic function in an unknown, probabilistic environment. An obligatory component of the technical subsystem is an electronic computer (EC). Unified control algorithms of BTS can be understood as a single knowledge bank for a person and a computer, including a data bank, a bank of methods, a bank of models and a bank of tasks to be solved.

However, for an external control system (a device for physiotherapeutic influence, a device for dynamic registration of the corresponding parameters of biosystems and a computer), operating on the principle of feedback with a bioobject according to uniform algorithms, the possibility of full automation of all processes is excluded for the following reasons. The first reason is that a living biosystem, especially such a complex one as the human organism, is self-organizing. Signs of self-organization include movement, and always complex, non-linear; openness of the biosystem: the processes of exchange of energy, matter and information with the environment are independent; cooperativity of the processes occurring in the biosystem; non-linear thermodynamic situation in the system. The second reason is due to the discrepancy between the individual optimum of the functioning parameters of the biosystem and the average statistical data of these parameters. This significantly complicates the assessment of the initial state of the patient's organism, the choice of the necessary characteristics of the acting information factor, as well as the control of the results and the correction of the parameters of influence. The third reason: any data bank (methods, models, tasks to be solved), on the basis of which the algorithm of BTS control is built, is formed with the obligatory participation of mathematical modeling methods. A mathematical model is a system of mathematical relations - formulas, functions, equations, systems of equations, describing certain aspects of the studied object, phenomenon, process. The optimal is the identity of the mathematical model of the original in the form of equations and the state between the variables in the equation. However, such identity is possible only for technical objects. The involved mathematical apparatus (coordinate system, vector analysis, Maxwell and Schrödinger equations, etc.) is currently inadequate to the processes occurring in a functioning biosystem during its interaction with external physical factors.

Despite certain imperfections, biotechnical systems are widely used in medical practice. For biological feedback when exposed to an external physical factor, changes in the parameters of the indicators of physical factors generated by the human body may be adequate.

When a closed electrical circuit is created between different areas of human skin, an electric current is recorded. In such a circuit, for example, between the palmar surfaces of the hands, a direct electric current of 20 μA to 9 mA and a voltage of 0.03-0.6 V is determined, the values depending on the age of the patients being examined. When a closed circuit is created, human tissues and organs are capable of generating alternating electric current with different frequencies, which indicates the electrical activity of these tissues and organs. The frequency range of an electroencephalogram is 0.15-300 Hz, and a voltage of 1-3000 μV; electrocardiogram - 0.15-300 Hz, and a voltage of 0.3-3 mV; electrogastrogram - 0.05-0.2 Hz at a voltage of 0.2 mV; electromyogram - 1-400 Hz at a voltage of current from units of μV to tens of mV.

The method of electropuncture diagnostics is based on measuring skin conductivity in biologically active points corresponding to acupuncture points of oriental reflexology. It has been determined that the electric potential in these points reaches 350 mV, the tissue polarization current varies from 10 to 100 μA. Various hardware complexes allow us to judge with a certain degree of reliability the adequacy of the impact of various external factors on the body.

Experimental data indicate that human tissues generate a long-term electrostatic field with an intensity of up to 2 V/m at a distance of 10 cm from their surface. This field is generated by electrochemical reactions occurring in a living organism, by quasi-electret polarization of tissues, by the presence of an internal electrotonic field, triboelectric charges and charge oscillations induced by the action of the atmospheric electric field. The dynamics of this field is characterized by slow aperiodic oscillations when the subjects are at rest and by sharp changes in the value and sometimes the sign of the potential when their functional state changes. The generation of this field is associated with tissue metabolism, not with blood circulation, since in a corpse it is recorded for 20 hours after death. The electric field is measured in a shielding chamber. A metal disk connected to the high-resistance input of the amplifier is used as a field sensor. The potential of the electric field near the human body relative to the walls of the chamber is measured. The sensor can measure the intensity of the area covered by this sensor.

A constant and variable magnetic field is recorded from the surface of the human body, the induction value of which is 10-9-1012 T, and the frequency is from fractions of a hertz to 400 Hz. Magnetic fields are measured by induction-type sensors, quantum magnetometers and superconducting quantum interferometers. Due to the extremely small values of the measured quantities, diagnostics are carried out in a shielded room, using differential measurement circuits that weaken the effect of external interference.

The human body can generate electromagnetic radiation in the radio frequency range with a wavelength of 30 cm to 1.5 mm (frequency 109-1010 Hz) and the infrared part of the optical spectrum with a wavelength of 0.8-50 μm (frequency 1012-1010 Hz) into the external environment. The recording of this physical factor is carried out using complex technical devices that selectively perceive only a certain spectrum of electromagnetic radiation. Even greater difficulties are presented by the precise determination of the energy parameters of this radiation.

The method of gas-discharge visualization (the method of S.D. and V.Kh. Kirlian) deserves attention. It is based on the following effects. The human epidermal space has the ability to generate electromagnetic radiation of the optical spectrum when the skin area is placed in an electric field with a frequency of 200 kHz and a voltage of 106 V/cm or more. Registration of the dynamics of the gas-discharge image of human fingers and toes allows:

• to judge the general level and nature of physiological activity;
• carry out classification according to the type of glow;
• evaluate the energy of individual body systems in accordance with the distribution of glow characteristics across energy channels;
• monitor the impact of various influences on the body.

Registration of mechanical vibrations of organs and systems is possible both from the body surface and from the corresponding organs. Pulsed acoustic waves recorded from the skin have a duration of 0.01 to 5 10-4 s and reach an intensity of 90 decibels. The same methods are used to register ultrasonic vibrations with a frequency of 1 - 10 MHz. Phonography methods allow one to determine the sounds of cardiac activity. Echography (ultrasound diagnostic methods) gives an idea of the structure and functional state of parenchymatous organs.

Changes in the temperature (thermal factor) of the skin, as well as the temperature of deeper tissues and organs, are determined by thermal imaging and thermal mapping methods using appropriate equipment that perceives and records the body's radiation of electromagnetic waves in the infrared spectrum.

Of the listed methods of recording physical factors generated by the body, not all are suitable for implementing feedback for the purpose of monitoring and optimizing physiotherapeutic effects. Firstly, bulky equipment, complexity of diagnostic methods, and the lack of the ability to create a closed circuit of the biotechnical system do not allow the use of many methods of recording electric and magnetic fields, electromagnetic radiation, mechanical and thermal factors. Secondly, the parameters of physical factors generated by a living organism and being objective indicators of its endogenous information exchange are strictly individual and extremely variable. Thirdly, the external technical device for recording these parameters itself affects their dynamics, and this affects the reliability of the assessment of the physiotherapeutic effect. Determining the patterns of the corresponding dynamics is a matter for the future, and solving these problems will contribute to the optimization of the means and methods of biological feedback in physiotherapeutic effects.

The methodology of physiotherapy depends on the purpose for which it is carried out - for the prevention of diseases, for the treatment of a specific pathology, or as part of a complex of rehabilitation measures.

Preventive measures using the influence of external physical factors are aimed at activating the weakened activity of certain functional systems.

When treating a corresponding disease or pathological condition, it is necessary to break the emerging pathological control circuit of certain processes in the biosystem, erase the “engram” of pathology, and impose on the biosystem its inherent rhythm of functioning in the norm.

During rehabilitation, a comprehensive approach is necessary: suppression of the activity of the still existing pathological control circuit and activation of normally, but not fully functioning systems responsible for compensation, restitution and regeneration of damaged biological structures.