What is physiotherapy and how does it affect a person?

Physiotherapy is a teaching about the principles of application of external physical factors in medical-prophylactic and rehabilitation purposes to influence the human body.

The use of physiotherapy in old age

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

Aging of the body is a process of biochemical, biophysical, physico-chemical. It is characterized by such processes as heterochronicity, heterotopy, heterokineticity and heterocathepticity.

Heterochronicity - the difference in the time of onset of aging of individual cells, tissues, organs, systems.

Heterotopy is a different expression of age changes in different structures of the same organ.

Hetero kineticity is the development of age-related changes in the structures and systems of the organism at different rates.

Heterocathetenness is a different direction of age-related changes associated with the suppression of some and the activation of other vital processes in the aging organism.

The majority of researchers are unanimous in that the aging process starts at the molecular level, that the changes in the genetic apparatus play a leading role in the molecular mechanisms of aging. It is suggested 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 a cause for consequence. And a great number accumulates in the process of vital activity of the organism. Shifts in the implementation of genetic information under the influence of endogenous and exogenous causative factors lead to an uneven change in the synthesis of various proteins, a reduction in the potential of the biosynthetic apparatus, the appearance of possibly previously synthesized proteins. The structure and function of cells is disturbed. Of particular importance in this case are the shifts in the state of cell membranes on which the most important and extremely active biochemical and physico-chemical processes occur.

As a field of clinical medicine, geriatrics is characterized by several important features, the main of which are as follows:

• 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 features of the course of certain diseases, but also the symptoms of a very wide spectrum of various pathologies.
• the need to take into account the features of development and course of diseases in the elderly and old people, due to the new qualities of the aging organism.
• in the elderly and elderly, the processes of recovery after the transferred diseases are slower, less complete, and this causes a prolonged period of rehabilitation and often less effective treatment. Finally, the features of the psychology of an aging person impose a special imprint on the interaction of the doctor and patient, on the results of treatment.

The main features of the application of physiotherapeutic effects in geriatrics:

• the necessity of using a small and ultra-low output power of an external physical factor acting on the body, that is, a low intensity of impact;
• the need to reduce the time of exposure to the therapeutic physical factor;
• the need to use fewer fields of physiotherapy in one procedure and fewer procedures for treatment.

When combining physiotherapy with the use of medicines in elderly and senile patients, it should be borne in mind that in the operation of medicines in this contingent there is the possibility:

• toxic effects due to the cumulative effect;
• undesirable biological effects of drugs on the body;
• undesirable interaction in the body between some drugs;
• a hypersensitivity to the drug, caused in many cases, the use of 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 appropriate medicines against the background of physiotherapy in people of older age groups. Knowledge of the main provisions of gerontology and geriatrics, taking into account new concepts of physiotherapy, will allow to avoid unreasonable complex treatment of elderly and senile patients with various pathologies.

Principles of physiotherapy

At present the following principles of physiotherapy are grounded:

• unity of etiological, pathogenetic and symptomatic orientation of influence by medical physical factors;
• individual approach;
• course exposure by physical factors;
• optimality;
• dynamic physiotherapeutic and complex effects by therapeutic physical factors.

The first principle is realized due to the possibilities of the physical factor itself to carry out or generate the corresponding processes in tissues and organs, and also by choosing the necessary factor of influence to achieve the goals either of prevention, treatment or rehabilitation. It is important to take into account the appropriate localization of the effect of this factor on the patient's body (topography and area of the impact fields); number of fields per procedure; MRP of the acting factor on one field and the total dose of the effect of this factor in one procedure, as well as the specific duration of the course of physiotherapy.

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

The principle of the course effect of physical factors for prevention, treatment and rehabilitation is based on the chronobiological approach to all processes in the human body. So, with a local acute inflammatory process, the course of daily physiotherapy can be 5-7 days (this is the average duration of an acute pathological process that corresponds to a circusseptic rhythm of functioning of the body's systems). With chronic pathology, the duration of the course of physiotherapy reaches 10-15 days (this is the average duration of acute phase reactions in the exacerbation of a chronic pathological process, corresponding to a circadian rhythm). This principle is consistent with the provisions for synchronizing the effects of regular frequency and the frequency of physiotherapy.

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

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

The impact of physiotherapy on the body

The complex effect of external physical factors in the treatment and prevention and rehabilitation purposes is carried out in two forms - combination and combination. A combination is the simultaneous action of two or more physical factors on the same area of the patient's body. Combination represents a sequential (time-dependent) impact by physical factors that can be applied in one day with options:

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

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

9 principles of physiotherapy are determined, the main ones of which fully correspond to the principles listed above, others require discussion. Thus, the validity of the principle of nervism should be evaluated from the position of the theoretical and experimental justifications given in Chapter 3 of this publication. The principle of adequacy of impact is inherently part of the principles of individualization and optimality of physiotherapy. The principle of small dosages is fully consistent with the concept of the adequacy of the dose of exposure justified in section 4 of this manual. The principle of variation of impacts practically corresponds to the principle of dynamism of treatment by physical factors. The principle of continuity deserves attention, which reflects the need to take into account the nature, effectiveness and prescription of the previous treatment by physical factors, taking into account possible combinations of all the medical, preventive and rehabilitation measures being carried out, as well as the wishes of the patient.

Physiotherapy is almost always performed against the background of patients taking appropriate medications (chemical factors). The interaction of external chemical factors with an integral multicellular organism occurs through the formation of chemical bonds of exogenous substances with the corresponding biological substrates that initiate subsequent different reactions and effects.

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

With a large chemical affinity of a pharmacological substance with natural metabolic products of a given biological object, chemical reactions of a substitutionary nature occur that cause the corresponding physiological or pathophysiological effects.

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

In the presence of certain physicochemical properties, drugs react with protein molecules, causing a temporary disruption of the function of the corresponding protein structure, the cell as a whole, which can be the cause of cell death.

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

The distribution of drugs in the body depends on three main factors. The first is the spatial factor. Determines the ways of receipt and distribution of chemical factors, which is related to the blood supply of organs and tissues, since the amount of exogenous chemical that enters the organ depends on the volume blood flow of the organ referred to a unit of tissue mass. The second - the time factor is characterized by the rate of drug intake into the body and its excretion. The third - the concentration factor is determined by the concentration of the drug substance in biological media, in particular in the blood. The study of the concentration of the relevant substance in time allows us to determine the period of resorption, the maximum concentration in the blood, as well as the period of elimination, removal of this substance from the body. The parameters of elimination depend on the chemical bonds that the drug enters with biological substrates. Covalent bonds are very strong and difficult to reconvert; ionic, hydrogen, and van der Waals bonds are more labile.

Consequently, before entering into a chemical reaction with biological substrates, the drug, depending on the pathway and other direct and indirect causes, must go through certain stages, the time period of which can many times exceed the speed of the chemical reaction itself. Plus, it is necessary to add a certain period of time for the interactions of the drug itself and the products of its decay with one or other biological substrates to the complete cessation of action in the body.

It should be noted that in the action of many drugs there is no strict selectivity. Their interference in life processes is not based on specific biochemical reactions with specific cellular receptors, but on interaction with the whole cell as a whole, caused by the presence of these substances in the biological substrate, even in small concentrations.

The main factors influencing the simultaneous impact of external physical and chemical factors on structures and systems, primarily at the cell level, are the following established factors. Physical factors have the globality and universality of action in the form of a change in the electrical status of the cell, a group of cells in the site of exposure. Chemical factors, including drugs, have an effect on the intended use of certain structures, but, in addition, participate in a number of nonspecific biochemical reactions, which are often difficult or impossible to predict.

For physical factors, there is a colossal rate of interaction between the factor and biological substrates and the possibility of an immediate cessation of the effect of this factor on a biological object. The chemical factor is characterized by the presence of a temporary, often a long interval from the moment of introduction of the substance into the body before the beginning of certain reactions. At the same time, the fact of the completion of the interaction of a given chemical substance and its metabolites with biological substrates can not be accurately determined, the more predictable.

With the simultaneous effect on the body of external physical factors and medicines, it should be remembered that the pharmacokinetics and pharmacodynamics of many medications undergo significant changes. On the basis of these changes, the effect of either a physical factor or a drug may be enhanced or weakened. It is possible to reduce or increase unwanted side effects from taking medications on the background of appropriate physiotherapy. Synergism of chemical and physical factors can develop in two forms: summation and potentiation of effects. The antagonism of the joint effect on the organism of these factors is manifested in the weakening of the net effect or the absence of the expected action.

Generalized clinical and experimental data indicate that the following effects occur when the physical effects of certain physical factors and the corresponding drug therapy are simultaneous.

When galvanizing, the side effects of such drugs as antibiotics, immunosuppressants, certain psychotropic drugs, non-narcotic drugs are reduced, and the effect of nitrate intake is enhanced against this method of physiotherapy.

The effect of electro-therapy increases with the use of tranquilizers, sedatives, psychotropic drugs, at the same time. The effect of nitrates during electro-therapy is increased.

In transcranial electroanalgesia, the effect of analgesics and nitrates is clearly seen, and the use of sedatives and tranquilizers enhances the effect of this method of physiotherapy.

With diadynamic therapy and amplipulse therapy, there was a decrease in side effects when taking antibiotics, immunosuppressants, psychotropic drugs and analgesics.

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 solution of caffeine, previously exposed to ultrasound, when administered intravenously to the body causes a cardiac arrest.

Magnetotherapy enhances the action of immunosuppressants, analgesics and anticoagulants, but against the background of magnetotherapy, the effect of salicylates is weakened. Especially it is necessary to pay attention to the detected effect of antagonism with simultaneous reception of steroid hormones and magnetotherapy.

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

With laser therapy, the effect of antibiotics, sulfonamides and nitrates has been increased, the toxicity of nitrofuran drugs has increased. According to A.N. Razumova, T.A. Knyazeva and V.A. Badtieva (2001), the effect on the body of low-energy laser radiation eliminates tolerance to nitrates. The effectiveness of this method of physiotherapy can practically be reduced to zero on the background of the acceptance of vagotonic drugs.

With the intake of vitamins, the therapeutic effect of electro-therapy, inductothermy, DMV-, CMV- and UZ-therapy has been increased.

Hyperbaric oxygen therapy (oxigenobarotherapy) changes the effect of epinephrine, nonahlazine and euphyllin, causing a beta-adrenolytic effect. Narcotic and analgesic agents exhibit synergism with respect to the action of compressed oxygen. Against the background of oxigenobarotherapy, the main effect on the body of serotonin and GABA is greatly 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 interaction of physical factors and drugs with the body at the same time. The experimental way of investigating this process is also very thorny. This is due to the fact that information on the metabolism of chemical compounds in the living body is very relative, and the ways of metabolism of drugs are studied mainly in animals. The complex nature of the species differences in metabolism makes it extremely difficult to interpret the experimental results, and the possibility of using them for assessing metabolism in humans is limited. Consequently, the family doctor must constantly remember that the appointment of a physiotherapeutic treatment to the patient against the background of appropriate drug therapy is a very responsible decision. It should be taken with knowledge of all possible consequences with obligatory consultation with the physiotherapist.

Physiotherapy and children's age

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

Skin condition in children:

• the relative surface of the skin is greater in children than in adults;
• in newborns and infants the horny layer of the epidermis is thin, and the embryonic layer is more developed;
• in the skin of the child a large water content;
• sweat glands completely not developed.

Increased sensitivity of the CNS to the effect.

The spread of stimulation from exposure to adjacent segments of the spinal cord is faster and wider.

Great tension and lability of metabolic processes.

The possibility of perverse reactions to the effect of a physical factor during puberty.

The peculiarities of physiotherapy in children are as follows:

• in newborns and infants, the use of an ultra-low output power of an external physical factor acting on the body is necessary; with the child's age, a gradual increase in the intensity of the active factor and the achievement of this intensity, similar to adults, by the age of 18;
• in newborns and infants, the least number of fields of exposure to a curative physical factor is used in one procedure with a gradual increase with the age of the child.
• the possibility of using different methods of physiotherapy in pediatrics is predetermined by the child's appropriate age.

BC Ulaschik (1994) developed and justified recommendations on the possible use of a particular method of physiotherapy in pediatrics depending on the child's age, 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 effects: general and local galvanization and drug electrophoresis are used from the age of 1 month;
• methods based on the use of impulse currents: electro-therapy and transcranial electroanalgesia are used from 2-3 months; diadynamic therapy - from the 6th to the 10th day of birth; short-pulse electroanalgesia - from 1-3 months; electrostimulation - 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 of birth; interference therapy - from the 10th to the 14th day of birth;
• methods based on the use of high-voltage alternating current: darsonvalization and ultratonoterapiyu local apply from 1 to 2 months;
• methods based on the use of the electric field: franklinizatsiyu general apply from 1 to 2 months; local and UHF therapy - from 2-3 months;
• methods based on the use of magnetic field effects: magnetotherapy - the effect of a permanent, pulsed and alternating low-frequency magnetic field is applied from 5 months; inductothermy - the effect of a variable high-frequency magnetic field - from 1 to 3 months;
• methods based on the use of electromagnetic radiation from the radio wave: DMV- and CMV-therapy is used from 2-3 months;
• methods based on the use of electromagnetic radiation from the optical spectrum: light treatment of infrared, visible and ultraviolet radiation, including low-energy laser radiation of these spectra used from 2-3 months;
• methods based on the use of mechanical factors: massage and ultrasound therapy is used from 1 month; vibrotherapy - from 2-3 months;
• methods based on the use of an 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, ozokeritotherapy and cryotherapy are used from 1 to 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 pelotherapy is used from 2-3 months, peloid therapy is general - from 5-6 months.

It is very tempting and promising to implement the principles of individualization and optimality of physiotherapy on the basis of reverse biological communication. To understand the complexity of solving this problem, it is necessary to know and remember the following basic settings.

Management is a function that evolved in the process of evolution and underlies the processes of self-regulation and self-development of living nature, the entire biosphere. Management is based on the transmission within the system of various kinds of information signals. The signal transmission channels form direct and feedback links in the system. It is believed that a direct connection occurs when the signals are transmitted along the "direct" direction of the elements of the chain of the channel from the beginning of the chain to its end. In biological systems, such simple chains can be isolated, but also conditionally. In the management processes, the main role is played by feedbacks. By feedback in the general case is meant any signal transmission in the "reverse" direction, from the output of the system to its input. The Reverse I connection is the relationship between the impact on an object or a bioobject and their reaction to it. The reaction of the whole system can exacerbate the external effect, and this is called positive feedback. If this reaction reduces the external effect, then there is a negative feedback.

Homeostatic feedbacks in a living multicellular organism are aimed at eliminating the influence of external influence. In the sciences studying processes in living systems, there was a tendency to represent all control mechanisms as feedback loops covering the entire bioobject.

At its core devices for physiotherapeutic effects are an external control system for the bioobject. For the effective operation of control systems, constant monitoring of the parameters of the controlled coordinates is required - the docking of technical external control systems with the biological systems of the organism. Biotechnical system (BTS) - a system that includes biological and technical subsystems, united by unified control algorithms with the aim of best performing a specific deterministic function in an unknown, probabilistic environment. An obligatory component of the technical subsystem is an electronic computer (computer). Under the uniform control algorithms of the BTS, one can understand a single knowledge bank for a person and a computer, including a data bank, a method bank, a model bank, and a bank of solved problems.

However, for the external control system (the device of physiotherapeutic influence, the device for dynamic registration of the corresponding parameters of biosystems and the computer), operating on the principle of feedback from a bioobject according to unified algorithms, the possibility of full automation of all processes is excluded for the following reasons. The first reason is that a living biosystem, especially so complex as a human body, is self-organizing. The signs of self-organization include movement, and, always, a complex, nonlinear one; open biosystem: the processes of energy, substance and information exchange with the environment are independent; cooperativeness of processes occurring in the biosystem; nonlinear thermodynamic situation in the system. The second reason is due to the non-coincidence of the individual optimum of the parameters of the functioning of the biosystem with the average statistical data of these parameters. This makes it very difficult to assess the initial state of the patient's body, to select the necessary characteristics of the current information factor, as well as to control the results and correct the parameters of the impact. The third reason: any data bank (methods, models, solved problems), on the basis of which the BTS control algorithm is built, is formed with the obligatory participation of methods of mathematical modeling. The mathematical model is a system of mathematical relations - formulas, functions, equations, systems of equations describing certain aspects of the object, the phenomenon, the process. 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 an identity is possible only for technical objects. The attracted mathematical apparatus (coordinate system, vector analysis, Maxwell and Schrödinger equations, etc.) is currently inadequate to the processes occurring in the functioning biosystem in its interaction with external physical factors.

Despite certain imperfections, biotechnical systems are widely used in medical practice. For biologically feedback under the influence of an external physical factor, changes in the parameters of the indices of precisely the physical factors generated by the human body can be adequate.

When creating a closed electrical circuit between different parts of the human skin, an electric current is recorded. In such a chain, for example between the palmar surfaces of the hands, a constant electric current of 20 μA to 9 mA and a voltage of 0.03-0.6 V, the values of which depend on the age of the patients being studied, is determined. When creating a closed circuit, tissues and human organs are able to generate an alternating electric current with a different frequency, which indicates the electrical activity of these tissues and organs. The frequency range of the electroencephalogram is 0.15-300 Hz, the voltage is 1-3000 μV; the electrocardiogram is 0.15-300 Hz, and the voltage is 0.3-3 mV; electrogastrograms - 0.05-0.2 Hz at a current voltage of 0.2 mV; electromyograms - 1-400 Hz at a current voltage from a few μV to tens of mV.

The method of electropuncture diagnostics is based on measurement of skin electrical conductivity in biologically active points corresponding to acupuncture points of eastern reflexotherapy. It is determined that the electric potential at these points reaches 350 mV, the polarization current of the tissues varies from 10 to 100 μA. Various hardware systems allow to judge with certain confidence a certain adequacy of the effect on the body of various external factors.

Experimental data indicate that the tissues of the human body generate a long-term electrostatic field with a strength of up to 2 V / m at a distance of 10 cm from their surface. This field arises from electrochemical reactions taking place in a living organism due to the quasi-electrified polarization of tissues, due to 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 in the quiet state of the subjects and abrupt changes in the magnitude, and sometimes also in the sign of the potential, when their functional state changes. Generation of this field is associated with tissue metabolism, and not with blood circulation, since the corpse is recorded within 20 hours after death. The electric field is measured in a shielding chamber. A metal disk connected to the high-impedance input of the amplifier is used as the field sensor. Measure the potential of the electric field near the human body relative to the walls of the chamber. The sensor can measure the intensity of the area that is covered by this sensor.

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

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

The method of gas-discharge imaging (the method of SD and VK Kirlian), which is based on the following effects, deserves attention. The human tadpole has the ability to generate electromagnetic radiation from the optical spectrum when the skin 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 a gas-discharge image of the fingers and toes of a person allows:

• to judge about the general level and nature of physiological activity;
• to carry out classification by type of luminescence;
• evaluate the energy of individual systems of the body in accordance with the distribution of luminescence characteristics through energy channels;
• to monitor the impact on the body of various effects.

Registration of mechanical vibrations of organs and systems is possible both from the surface of the body and from the corresponding organs. The pulsed acoustic waves, fixed from the skin, have a duration from 0.01 to 5 10-4 s and reach an intensity of 90 decibels. The same methods recorded ultrasonic vibrations with a frequency of 1 - 10 MHz. Methods of phonography allow you to determine the tone of the heart activity. Echography (methods of ultrasound diagnosis) gives an idea of the structure and functional state of the parenchymal 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 senses and records the radiation of the body by electromagnetic waves of the infrared spectrum.

Of the listed methods of recording the physical factors generated by the body, not all are suitable for implementing feedback in order to control and optimize physiotherapeutic effects. First, the cumbersome apparatus, the complexity of the diagnostic techniques, the lack of the possibility of creating a closed loop 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 are objective indicators of its endogenous information exchange are strictly individual and extremely variable. Thirdly, the external technical device of registration of these parameters influences their dynamics, and this affects the reliability of the evaluation of the physiotherapeutic effect. Determination of the laws of the corresponding dynamics is a matter of the future, and the solution of these problems will help optimize the means and methods of feedback biofeedback under physiotherapeutic influence.

The methodology of physiotherapy depends on the purpose for which it is carried out - in order to prevent the occurrence of diseases, to treat a specific pathology or in 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.

In the treatment of an appropriate disease or pathological condition, it is necessary to break the emerging pathological control loop of certain processes in the biosystem, to erase the "enramma" of pathology, to impose on the biosystem the characteristic rhythm of functioning in the norm.

Rehabilitation requires a comprehensive approach: suppression of the activity of the still existing pathological contour of control and activation of normally functioning but not fully functioning systems responsible for compensation, restitution and regeneration of damaged biological structures.