Physical factors in physiotherapy

Classification of physical factors

Modern clinical practice employs a wide range of both natural and artificially created physical factors. They are classified according to the nature of the acting agent:

• Electro- and magnetotherapy: includes the use of electric current (high and low voltage, direct and alternating), as well as the therapeutic effect of electric, magnetic, and electromagnetic fields.
• Mechanotherapy: is based on the application of mechanical energy, specifically ultrasonic vibrations that penetrate tissues.
• Phototherapy: the therapeutic effect of electromagnetic radiation in the visible range.
• Aero- and hydrotherapy: the use of air ions and water, as well as the inhalation of medicinal substances.
• Oxygen therapy: saturation of the body with oxygen supplied under increased pressure.
• Balneotherapy: external application of natural and artificially prepared mineral waters.
• Heat and peloidotherapy: the use of heat transfer agents (paraffin, ozokerite) and medicinal muds. This method is especially in demand in the treatment of diseases of the skeletal system.

Application in pulmonology (using tuberculosis as an example)

It is strongly recommended to include hardware physiotherapy methods in the comprehensive rehabilitation program for patients with pulmonary tuberculosis. At the same time, it is worth noting that specialized diet therapy in this specific case is not indicated.

The choice of specific physical factors for the treatment of tuberculosis must strictly and implicitly be based on the mechanisms of their therapeutic effect on the respiratory system. Proven effective methods include:

• Aerosol therapy (inhalation administration of drugs).
• Application of sinusoidally modulated currents (SMC).
• Application of ultra-high frequency (UHF) electric field.
• Magnetotherapy.
• Laser therapy (strictly using low-intensity laser radiation).
• Ultrasound therapy.
• Drug iontophoresis.

In addition to the above, other physiotherapeutic methods are permitted if they have proven clinical efficacy.

Physiotherapy in traumatology and orthopedics

Physical factors hold a special place in traumatology, particularly in the postoperative period during surgical treatment of ununited fractures (pseudarthrosis) of long tubular bones. The prescription of procedures requires a mandatory preliminary examination and detailed consultation with a physical therapist.

The role of physiotherapy increases significantly during the recovery period, immediately after the cessation of rigid limb immobilization. The application of physical factors to the targeted tissues of the operated area pursues the following goals:

1. Active stimulation of bone tissue reparative regeneration processes.
2. Improvement of local tissue trophism.
3. Normalization of microcirculation in the injury zone.
4. Reduction of soft tissue edema severity.
5. Acceleration of hematoma resorption processes.
6. Achievement of a sustained analgesic effect.

Prescription principles and selection criteria

In general, the use of physiotherapeutic treatment methods is recommended for adult patients as part of medical rehabilitation programs, provided there are no absolute contraindications. In the early postoperative period, specialists face four fundamental tasks: achieving analgesic, anti-inflammatory, anti-edematous, and reparative-regenerative effects. A wide arsenal of modern physiotherapeutic methods is used to achieve them.

The criteria for choosing a specific physical factor and treatment method are always strictly individual. In musculoskeletal disorders, the physician relies on:

• The current stage of bone tissue reparative regeneration.
• The nature of the sustained fracture.
• The method of bone fragment fixation chosen by surgeons.
• The patient's mobility level (the physical ability to regularly visit the physiotherapy department).
• The technical equipment level of a particular rehabilitation department.

A crucial condition for successful treatment is taking into account comorbidity factors—the presence of concomitant diseases in the patient that may act as a limitation to the use of certain preformed physical factors.

Class and exam questions

What else to study on this topic

• Mechanisms of the therapeutic effect of sinusoidally modulated currents (SMC).
• Features of UHF therapy application in pulmonological practice.
• The effect of low-intensity laser radiation on microcirculation and tissue trophism.
• Physiological basis of peloidotherapy in skeletal system diseases.
• The impact of comorbidity on the choice of medical rehabilitation methods.

Other topics in the "Additional Topics" section

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.