Massage with mechanized devices

In practice, from the hardware types of massage, the most widely used are vibratory, pneumatic, hydromassage, ultrasound and baromassage, as well as various combinations thereof.

Vibrating massage. Vibration therapy, as one of the oldest methods of apparatus physiotherapy, developed in accordance with the technical capabilities of a particular period. Initially, the vibrators were driven manually: by the type of a foot sewing machine or even using tuning forks of various designs.

The principles of excitation of vibration can be:

1) electromotive - through the eccentric;

2) electromagnetic - when passing an alternating electric current through an electromagnet;

3) pneumatic - due to variable air pressure;

4) hydraulic - due to the variable pressure of the water created by the compressor.

In modern devices for vibrating massage electric motors are most often used. The determining signs of vibration are the amplitude and frequency of oscillations.

The oscillation amplitude of the

is the amount of deviation of a point from a stable position( in mm).The bigger it is, the deeper the tissue penetrate the vibrations, since the fatty tissue is a shock absorber for them. The amplitude of the oscillations depends on the degree of pressing of the vibrating tip to the patient's body, this is one of the difficulties in selecting the correct dosage.

The oscillation frequency is the amount of movement of the point through the position of the steady state per unit time. It is measured in hertz. Hertz is one complete swing in 1 s. Practically used frequencies of the audio range from 16 to 2000 Hz.

The transfer of vibrations from the apparatus to the body of the massaged occurs through the differently shaped and hard vibrator heads. For vigorous and deep impact on the fabric, solid vibrators( metal, plastic, ebonite) are used;for a more gentle and superficial impact - soft( rubber, spongy).

By the degree of the spread of vibration there are general actions and local ones.

Apparatuses of general action due to high costs, cumbersomeness and heaviness are currently not widely used.

The devices intended for local action have received much more use. This is explained by the following: firstly, they are cheap, portable, convenient to operate, and secondly, local vibration has not only local but also reflex action, affecting the organs and systems located far from the vibrating site.

The physiological impact of vibration massage is very diverse and depends on the frequency, amplitude and duration of vibration( A. Ya. Kreimer).The vascular, muscular and nervous( in particular vegetative) systems are the most sensitive to the action of the vibrational stimulus. In the mechanism of the therapeutic effect of vibration, their analgesic effect is of great importance in connection with the development of protective inhibition in cortical cells. However, the anesthetic effect at the site of exposure is more pronounced when vibration acts at a frequency of 100 Hz than 50 Hz.

Fig.118. Vertical impact of vibration.

Under the influence of mechanical vibrations, a sensation of heat appears at the site of exposure, local hyperemia( reddening) is detected and the temperature rises( and more so with an increase in the frequency of vibration used or the duration of the procedures).After the first procedure, the absorption of oxygen by muscle tissue increases and work capacity, the redox processes and the pituitary-adrenal gland system become more active.

The nature of the body's response to vibrational action depends not only on the frequency and amplitude of mechanical vibrations, the duration of the procedure, but also on the localization of the effect. For example, at a frequency of 100 Hz, the increase in arterial pressure and the increase in heart rate are more frequent, and at lower frequencies - lowering of arterial pressure and a decrease in the pulse.

Vibromassage can be carried out in a labile and stable manner. The labile technique consists in the fact that the vibrator constantly moves without detachment from the skin of the massaged area, mainly along the course of the lymph flow, that is, to the nearest lymph nodes. When performing a stable technique, the vibrato is in the same place for 3 seconds or more( up to several minutes).

The main variants of the arrangement of vibratoids are the following: vertical( Figure 118), horizontal( Figure 119) and vertical-horizontal( Figure 120) with respect to the massed areas.

Fig.119. Horizontal exposure to vibration.

Fig.120. Vertical-horizontal impact of vibration.

The choice of this or that vibrato depends on the shape and extent of the massed surface. They can be flat with an adjacent surface, concave, ball and shock.

The methods of vibrating massage in the form of motion are divided into the following:

1) rectilinear - the movements are made strictly along the straight line of the massaged area and mainly along the lymph flow( Fig. 121, a);the pressure exerted by the hand on the vibrator is minimal in this case, the vibrations spread to the skin and subcutaneous tissue( imitation of the manual reception "stroking");

2) zigzag( Fig. 121, b) - hand holding the vibrator, additionally performs shaking from side to side;

3) spiraling( Fig. 121, c) - the pressure on the vibrator can be of average strength( 2-4 kgf), when the vibrations spread to the skin and muscles( imitation of manual reception "grinding"), and large( up to 9 kgf)vibration penetrates through all tissues to the bone system( imitation of manual reception "kneading");

4) circular - are used most often in some local area to eliminate hypertonic muscle( Fig. 121, d);

5) dashed - produced by 2-3 forward-backward movements( Fig. 121, d);

6) transverse - used for massaging large regions of space: back and back surface, lower extremities( Fig. 121, e).

Fig.121. Variants of movements of hardware attachments.

and - rectilinear;b - zigzag shape;c - spiraling;g - circular;d - dashed;e - transverse.

Fig.122. Vibrating massage in the thigh area with a spiral movement of the EMA-2 apparatus nozzles.

Fig.123. Electro-massage apparatus "Elvo" with attachments.

is flat;b - with spherical projections;in - bell-sucker;g - spike-shaped.

Vibromassage can be performed daily, every other day or 2-3 times in a row, followed by a one-day break. The optimal exposure time to one area is from 3 to 5 minutes. The number of massage sessions is determined individually and depends on the general state of the organism and its response to the effect of vibration( usually 10-15 sessions).

For local vibration in our country the following devices are produced: EMA-2 designs by NN Vasiliev, VMP-1, VM-1, Bodrost, Elvo, TEM-1, Sport, Tonus, mechanicalMG Babia, etc.

The principle of the EMA-2 electromassage device is that the pressure drops from the cylinder of the device through rubber hoses are transferred to two shock or rubber nozzles with a frequency of up to 50 Hz. The labile technique and all the main "variants of the arrangement and movement of vibrododes along the massed area are used mainly."

When pressing vibrators to a massaged surface with a force of 0.2-1.0 kg and moving them at a speed of 3-4 cm / s, The pressing with a force of 2-4 kg and a speed of 5-10 cm / s simulates grinding, and with a force of 5-9 kg and a speed of 2-3 cm / s - mashing( Figure 122).

In a general massage session by regionsbody is recommended such a sequence: the back, including the collar area( 3 min), by(2 min), thigh( 3 min) and shin( 2 min) of one limb, then the other, the front surface of one lower limb from the bottom upwards( 4 min), then the other, the chest( 1 min), one upper limb from abovedown( 3 min), then the other one. On the indications, the general massage session ends with a massage of the abdomen area.

The scheme of the sequence of the general massage session on the areas of the body with the help of EMA-2 is also used for massage performed by other apparatuses.

Combination massage, that is, a combination of manual massage with vibrating massage, is also effective. The technique is as follows: after manual stroking, rubbing, kneading, vibration is applied for 1-3 minutes in one area. The session ends with other methods of manual massage. Mechanical vibration, having a strong reflex action, significantly supplements and deepens the physiological effect of manual massage.

Vibration instruments for massage - VMP-1 model( 50 Hz with adjustable amplitude of 0.2-2 mm), vibro massager BM-1( 57 Hz and 0.11-0.07 mm, respectively) and "Cheerfulness"( 50 and 100Hz) - are used not only with cosmetic, but also with therapeutic purposes, taking into account the above guidelines.

The new ELVO electric vibratory massager is effective for self-massage and easy to use( Fig. 123).Vibration with a frequency of 100 Hz and an amplitude of 4 mm is transmitted to the massaged area through four removable attachments: flat, with spherical protrusions, with bell-suckers for massage of the back, abdomen and extremities and spike( for neck and head massage).

The PEM-1( Elmaz) electromassage unit is less convenient, although it has an adjustable vibration frequency of 50 and 100 Hz( Figure 124).With the help of this device, despite its portability and accessibility, you can use only a stable technique and carry out massage on one area of ​​the body. Changing the positions of the patient creates additional difficulties for the masseur, as well as for the massaged.

Fig.124. Electromassage apparatus of the Elmaz type.

1 - vibrating platform;2 - vibration frequency controller.

In the "Sport"( AM-2) and "Tonus"( AM-1) automatic scooters, vibration with a frequency of 45-50 Hz and an amplitude of 12 mm and 2-3 mm acts on the massaged area through a wide massage belt. The amplitude of vibration is regulated by the massed tension of the belt itself, equal to an average of 7-8 kgf.

Similar devices abroad have become widely used in the form of automatons, for example in Vienna, in the Exhibition and Leisure Park, and in South and North America hotels, in the sanatoriums of Japan. The general self-massage session for 10-15 minutes with these devices begins in the standing position from the back and waist region - 3 min( Figure 125), then the gluteal region - 2 min and the thigh - 3 min( Figure 126).The shin and foot( Figure 127) are massaged for 2 minutes in a sitting position, after which the mass, which is massaged for 1-2 minutes, shifts the vibrating belt to the upper shoulder girdle. At the same time, the upper extremities are massaged in the sitting position - 3 min( Figure 128).Naturally, time for self-massage increases, if the limbs are massaged separately.

Fig. G26.Massage the gluteal region and thighs.

Fig.127. Massage of the lower leg.

Fig.125. Massage of the back and waist area with the help of the "Sport" or "Tonus" automozers.

The stationary mechanical apparatus MG Babiya is capable of transmitting not only vibration in horizontal and vertical directions, but also simulating the basic techniques of manual massage: stroking, grinding and kneading. The general massage session lasting 12-15 minutes, but not more than 5 minutes in each area, accelerates the restoration of efficiency, especially when exposed to a tired muscular system. The methods of therapeutic application of mechanical massage are constructed depending on the nature of the pathological process and its localization.

Recently, vibration massage has been used in the form of hydro vibrating massage( combination of vibration and water environment) or in the form of pneumatic vibration massage( combination of vibration with sucking air action).

hydro vibribration massage is a new kind of massage, its essence consists in transferring mechanical vibrations to tissues through the water layer with the help of the "Wave" apparatus( Fig. 129).Vibrational water waves are sent to the desired area of ​​the body at a frequency of 10-200 Hz for 12-15 minutes. Baths can be fresh, mineral, coniferous, etc., that is, chemical influence is added to the mechanical and hydrothermal influence. Currently hydrovibromassage is used in the treatment of diseases, in particular the peripheral nervous system, trauma.

Fig.129. Apparatus for hydro vibrating massage of the "Volna" type.

Pneumatic vibrating massage is carried out with the help of the EMA-2 apparatus, in which the vibration effect is carried out through the funnel-shaped nozzle by squeezing and thinning the air coming from the cylinder of the apparatus. With massage, the nozzles move rectilinearly, imitating manual stroking, zigzag rubbing and circular kneading.

The general session of pneumovibromassage is performed for 25-30 minutes according to the scheme: back - 3 min, buttocks - 2 min, hip - 2 min, shin - 1 min of one limb, then another;shin and hip of the forelimb - 3 min, chest - 2 min, arms - 4 min.

Thermovibrating massage with the help of a device of the type "Wizard", developed by Tomsk Research Institute of balneology, which will simultaneously act mechanical vibrations with a frequency of 10 to 100 Hz and a temperature factor of 20 to 50 "C.

In addition to these devices, the industry produces stationary, which are usedin recovery centers and in physiotherapy departments

Pneumatic massage The operation of air massage machines is based on the principle of creating an increased or reduced air pressure( Figure 130).

They consist of an air compressor and a pump, mainly used in medical practice in the form of vacuum pneumomassage. The mechanism of action is that the skin drawn into the nozzle( bank) creates congestion and causes local hemorrhages. The products of tissue and blood decay have a stimulatingaction on the body of the massaged

In the absence of the apparatus, the so-called canned massage can be used with the same effect. The medical bank is installed on the skin treated with cream so that the skin is drawn into the skin no more than 1 cm. Then the can is moved smoothly. When it detaches the can, it is set again. It is used mainly in the back area. The procedure is 5-7 minutes, the frequency is every other day or, with good tolerability, every day.

Hydromassage. There are several ways to hold a whirlpool: hands under water, a water jet in the air, a water jet under high pressure water.

Hand massage under water is a combination of hand massage with a thermal water procedure in the form of a bath or a rain shower made of plain or mineral water.

With water jet massage in the air, the uses thermal and mechanical stimulation( Figure 131).This type of massage is used in physiotherapy practice in the form of a Charcot shower or a jet shower( a jet of water at a pressure of 1.5-3 atm is fed into the hose to the tip with a diameter of 1 -1.5 cm, this water jet with a temperature of 20-30 "C per3-4 m distance is carried out on the body massaged from the bottom up for no more than 3 minutes), Scottish or contrast shower( during the procedure, the water temperature varies all the time - from 40 to 20 ° C), a circular shower( a water jet affects the mass being massagedall sides)

130. Pneumomassage in the back area

R131. Hydromassage with a water jet in the air( Sharko shower)

With underwater massage under high pressure, centrifugal pumps are used to increase the pressure of the water jet to 12 atm. The hydromassage is carried out in special micro-pools with a size of 210.8 m with the help of Tangentor devices"And" Universal ", Germany. The temperature of fresh or mineral water is 34-38" C.The nozzles have holes of various diameters, and therefore the jet of water affects the body tissues differently( Fig. 132).The intensity of the whirlpool is achieved by removing or approaching the water jet or increasing the angle of inclination of the handle of the tip to the massaged part of the body, and also depends on the duration of the session and the water temperature. It is necessary to take into account the sensitivity of individual parts of the body to pressure and temperature. The optimal pressure for back massage is 2-5 atm, hips 2-4 atm, duration of the general session is 15-35 min, 6-10 procedures are prescribed for the whole course. Begin a massage with

Fig.132. Types of nozzles( a) for underwater hydromassage and their effect on massaged tissues( b).

Hydromassage enhances blood circulation to the skin and hemodynamics in general, increases diuresis and metabolism, activates trophic functions, promotes rapid resolution of hemorrhages and effusions, accelerates the recovery processes.

Ultrasonic massage. This massage is performed using ultrasound physiotherapy equipment, which includes a high frequency generator and a piezoelectric transducer( Figure 133).Ultrasonic vibrations are not carried out through the thinnest 0.001 mm air layer, so a close fitting of the head of the apparatus to the body of the massaged is necessary, for which vaseline, lanolin or therapeutic oils are used. The operating frequency of the apparatus is from 880 to 2950 kHz, the head area is 1.5 cm2, the intensity of ultrasonic radiation is 0.05-3 W / cm2.The duration of exposure to one area is 2-5 minutes.

the distance of the ejection of water jet from the surface of the body massaged at least 15 cm. Massage manipulations are performed in a circular motion clockwise from the periphery to the center.

Usually use a labile technique of exposure: the ultrasonic head slowly produces longitudinal and circular motions.

The mechanism of ultrasonic vibration on the body tissues is complex, it distinguishes between mechanical, thermal and chemical effects. The mechanical effect is associated with the direct influence of oscillations, causing successive thickening and rarefaction of tissue particles, that is, with micro-massage;thermal - directly proportional to the magnitude of the vibrational energy absorbed in a particular tissue;chemical - is associated with a change( under the influence of vibrations) of the intensity of oxidative processes.

Baromassage. It is carried out with the help of the apparatus of VA Kravchenko( Figure 134).The air is pumped into the chamber and sucked air from it. The minimum pressure achieved in the chamber is 500 mm Hg. The maximum - 850 mm Hg. The temperature does not exceed 40 ° C.Dosage is carried out by the manometer of the device.

Fig.133. Ultrasonic massage of the back area

Baromassage is carried out by a 3-time alternation of decompression up to 1000 or 3000 m depending on the pump power and compression - up to 500-600 m. The duration of the massage in the first case is 20-25 min, in the second - 6-7 min.

Decompression causes increased blood flow to the massaged area due to the expansion of arterioles and capillaries, an increase in skin temperature by 1.5-3 ° C, an increase in the amount of oxygen entering the tissues and respiratory activity of the cells in the decompression zone, and improvement of metabolic processes.