Scenar Therapy: A Comparison with Other Forms of Electrotherapy
Based on material from a
lecture by Y. Grinberg
SCENAR therapy is a form of electrotherapy. Other forms include electro-stimulation,
therapy with electro-sleep, dia-dynamic current, interference
therapy, therapy with sinusoidal modulated current, fluctuation and impulse
electro-therapy.
The
effects of electrical therapy may be divided into 3 groups, local (regional),
segmental and generalised.
Local reactions
include:
- activation of afferent sensory
nerves
Electrical
impulses stimulate receptors and nerve endings. Afferent impulses travel to the
central nervous system and give rise to the various segmental and general
reactions.
- influence on local blood flow
Impulses
can regulate the micro-circulation by stimulating contraction or relaxation of
the smooth muscle of the vascular wall, in particular the arterioles,
capillaries and venules with a resultant change in
local blood flow. This effect occurs through a combination of axon-reflexes,
bioactive substances (kinins, prostaglandins,
substance P, cytokines) and mediators (acetylcholine
and histamine). These chemical compounds are often filtered from the blood
through the endothelium/vessel wall into the interstitial space and may accumulate
in the superficial layers of the skin and various tissues.
- release of endogenous regulators of
inflammation and the immune response.
It
has been found that there is a reduction in secretion of mediators of
inflammation from the cell. Components of the complement system are suppressed
by synthesis of macrophages and there is a change in the metabolism of the
tissues. What this amounts to is a slowing down of the process of inflammation.
Segmental reactions:
These
appear at areas where the electrical impulses are applied and are essentially
spinal reflexes. Afferent impulses from sensory nervous fibres activate, via interneurones, motor neurones in the anterior horns of the
spinal cord. Efferent impulses then pass back to the area receiving the impulses
as well as to the organs corresponding to these segments of the spinal cord.
The interaction between visceral and somatic afferent impulses takes place at
the spinal level, and impulses are then sent to the bulbar and cortical
structures.
Generalised reactions:
These
occur as a result of transmission of ascending afferent impulses to the higher
centres of the brain. Visceral and somatic afferent impulses converge within
the central nervous system and are processed and the resultant efferent
impulses cause a general response from the whole system. General reactions also
occur as a result of direct stimulation of the glands of internal secretion and
of the cerebral cortex.
As an example of general
mechanisms of electro-therapy, let us look at DDC (Dia-Dynamic
Current or
P. Bernard current).
DDC
is made up of impulses half-sinusoidal in shape with a frequency of 50 – 100
Hz with delayed exponent background. DDC excites myelinated cutaneous nerves, which are sensitive to this
current. Ascending afferent impulses go towards the substantia gelatinosa in the posterior horns of the spinal cord
and then along paleo-spinal-thalamic,
neo-spinal-thalamic and spinal-reticular-thalamic tracts and activate opioid and serotonin-ergic systems of the brain stem.
This
gives pain relief in three ways. Firstly, a new dominant focus is formed in the
cortex, which causes de-localisation of the previously dominant focus of pain
and activates the parasympathetic nervous system. Secondly, a change in
sensitivity and a decrease in lability occur in the
thick A and thinner C nerve fibres. The faster A-fibres
depolarise the substantia gelatinosa and pain impulses arriving via the C-fibres are prevented from
continuing (Gate theory). Thirdly, activated cortical and sub-cortical
centres produce descending efferent impulses, which increase the blood flow and
stimulates local humoral mechanisms, viz., the
production and release of endorphins, increase in activity of enzymes, such as
acetyl cholinesterase, histaminase and kinases.
When
impulses are applied to the paravertebral zones, DDC
reduces activity of the Renshaw cells and so restores
the ability of the nervous system to damp down the transmission of pain
impulses.
Direct
action on the affected areas results in rhythmical contraction of a large
number of the myofibrils of the skeletal muscles and smooth muscles of the
blood vessel walls. This subsequently increases blood flow and opens anastomoses and collateral vessels. Metabolism in tissues
speeds up and the temperature in the area increases. The improved blood flow
allows redistribution of the ions and water in the interstitium,
promotes removal of the products of lysis in tissues,
permits rehydration of the tissues and helps to
reduce oedema. Reduction of the peri-neural oedema improves
conductivity and excitability of the nerves. These metabolic processes take
place at the areas stimulated by the impulses and also at the tissues and
organs that are innervated from the same segment of the spinal cord.
Based
on the above, DDC should be an effective therapy. However, practically, there
are many restrictions and contra-indications to this method. One of the
limitations of the effectiveness of this therapy is the adaptation of treated
tissues, mentioned by author P. Bernard himself. Another reason is the
essential energetic component in such current. To be non-damaging, the impulse
must be a bi-polar, rectangular impulse, where the duration of each phase is
not more than 100microseconds. In DDC, one half-period of a 50Hz impulse lasts 10milliseconds, i.e. 50 times longer then that
required to be non-damaging. Shortening the time would mean using an impulse of 5kHz, which is obviously unacceptable!
It
is generally accepted that the extent of the response of the organism depends
on the area which absorbs most of the electromagnetic energy. In modern
electro-therapy there is a tendency to attempt to achieve bigger therapeutic
effect using lower electro-magnetic energy by increasing the “informational
aspect” and reducing the “energy component” of the input. For this reason, the
shape (type) of the impulse signal is important.
There
are a number of ways of improving the effectiveness of electro-therapy:
- impulses should be
physiological;
- there needs to be less
habituation to these impulses;
- impulses are more effective if
variable;
- they need to be more
concentrated in order to reduce the general load and cause more specific
changes in the organism;
- if the impulses affect deeper
structures in the organism, their effect is more profound.
In
order to achieve greater therapeutic effect, the action should be applied by
means of electro-magnetic fields and current. To be non-damaging to nerves, the
impulses should last not more then 200microseconds. The time of the
relative and absolute refraction phase determines the frequency of repetition
of these impulses. In pathological states, these values can differ considerably
from values in normal states. For skeletal muscles, the absolute refractory
phase is 2.5 milliseconds and for motor neurones the time is <1millisecond.
Consequently the time between impulses needs to be longer than these times. As
mentioned, the times may vary with the pathology and the frequency of the
impulses may need to be varied from single units to hundreds of hertz to accommodate
this. In order to excite the nerves, the duration of the impulses and amplitude
must be varied considerably.
Practically,
these parameters are similar to Short-impulse Electro-Analgesia (SEA) where
mono- and bi-polar impulses are used, often formed in bundles and lasting 20-500 microsecs at frequencies 2-400Hz
As
in DDC, SEA causes rhythmical excitement of the myelinated nerves. These afferent impulses go towards the substantia gelatinosa of the spinal cord. Inhibitory interneurones in the lateral horns of the spinal cord
reduce the amount of substance P produced. This also reduces the possibility
for the transmission of impulses from afferent sensory conductors of the
lateral horns (A and C-fibres) to neurones of the reticular
formation and supra-spinal structures. Excitement of the interneurones of the posterior horns of the spinal cord
causes a release of opioid substances.
Serotonin is released from the lateral nucleus of the mes-encephalon
and from the peptide-ergic ventral nucleus of the
hypothalamus. As in DDC, fibrillation of the smooth muscles in the arterioles
and superficial skin muscles stimulates the utilisation of the allogenic substances and mediators, which are released in
response to pain. Increase in local blood flow stimulates local metabolic
processes and defensive reactions in the tissues. Reduction of the peri-neural oedema improves excitability and conductivity
of the skin conductors and promotes restoration of suppressed tactile
sensitivity.
Why
does SEA therapy, which seems to be optimal when we look at its mechanism, work
mainly for analgesia and not have wider applications?
1. This method
has a strict specific administration. Because of the type of current, it has
effects on the symptoms rather than a physiological action.
2. Habituation
of the organism to the impulses. Adaptation is an active response of the
organism to changes in the environment. When using electrotherapy, in order to
reduce adaptation to electrical impulses, various types of modulation,
frequency and wave forms are used. However, it is known that the nervous system
builds up a model of the external stimuli by modifying its own elements. As a
result, the nervous system blocks all signals, which are within fixed
parameters of intensity, time, and space. Only those signals that are outside
these parameters will cause a dynamic reaction.
3. In SEA
therapy, the choice of amplitude of the current is determined by the patient’s
sensations (as with other methods of electrotherapy). So excitement of some of
the fibres can be a coincidence. With some devices, because of the patient’s
subjective sensation, the impulses applied were only sufficient to stimulate
sensitive fibres and this determined the extent of the action on the organism.
4. Insufficient
theory exists to support this modality and the methods used were restricted to
studying pain relief.
SCENAR is close to SEA. What determines its significant effectiveness?
1. The “force-duration”
curve and strength of the acting stimuli differ from previous therapies.
The difference between SCENAR and DDC and SEA lies in the quality of action : SCENAR action causes obvious
physiological effects. In particular, it excites motor and sensory fibres,
increases the speed of blood flow, activates local humoral mechanisms, promotes the removal of the products of lysis from the cell, etc.
2. Almost
complete absence of adaptation of the organism to SCENAR action. Due to
bio-feedback, each subsequent impulse is different from the previous one. For
example, towards the end of the session, the power of action may be felt to be
increasing by the patient, but not usually decreasing.
3. Non-damaging
regime of action, technically (short excitatory impulses, bio-feedback, SCENAR-expertise)
and methodology (individually-dosing regime of action, therapy based on rules).
4. High level
of methodology. Various methods for treatment of certain diseases have been
developed as well as combination with general zones (including the three
pathways on the back, six points of the face etc.). Specific methods of action
are used for individually-dosed regimes and according to various rules.
5. SCENAR can
be used as a diagnostic and therapeutic tool at the same time, because there
are different reactions from healthy and pathological tissue. Using the
techniques now available we can assess the effectiveness of the procedures.
6. The successful
construction of the family of SCENAR devices makes it possible in one
session to combine the various effects of electro-analgesia, DDC, SEA and so
on. The size of the active electrode is about 1cm², which is quite small.
Therefore during the treatment we can achieve effects which are similar to the
effects of electro-acupuncture. Acupuncture points and reflective zones are at
areas of higher innervation (close proximity to
nervous trunks, above nervous plexus, lymphatic and blood vessels, at places
where a nerve exits/enters the bones). With the high conductivity of these
areas, the main energy of action can be applied to them, even though the size
of the electrode is bigger than the zones. We can suggest that SCENAR-therapy
smoothes away the differences between physiotherapy (electrotherapy) and
acupuncture, where general mechanisms and actions are similar to each other.
With
all this in mind, wherever other electrotherapies are effective, SCENAR therapy will also be useful and,
indeed, it has been found to be
very useful when other electrotherapies have failed. The peculiarities of SCENAR-therapy
mean that there are few contra-indications.
The
table below shows the indications and contra-indications for electrotherapy.
The recommendations for SCENAR-therapy are based on the experience of
the founders of SCENAR therapy in
Russia
: Dr Y.Gorfinkel and Dr. A. Revenko.
Abbreviation used in the table 1/2
DDC – Dia-Dynamic
Current;
TE – Trans-cranium Electro-Analgesia;
EST – Electro-Sleep Therapy;
SEA – Short impulse Electro-Analgesia;
ES – Electro Stimulation;
EP – Electro-Puncture;
AT – Ampli-pulse Therapy;
IT – Interference Therapy;
F – Fluctuorisation;
Sc – SCENAR therapy.
Table
1 Indication to
Electro-therapy
Disease |
DDC |
TE |
EST |
SEA |
ES |
EP |
AT |
IT |
F |
Sc |
Diseases of Peripheral Nervous System (neuritis, radiculitis, sympath-algia, trauma of the spinal cord) |
+ |
- |
- |
- |
- |
+ |
+ |
+ |
+ |
+ |
Acute traumas of the Musculo-skeletal System
(ligament injury, bruises, myalgia) |
+ |
- |
- |
- |
- |
- |
- |
+ |
- |
+ |
Peri-arthritis |
+ |
- |
- |
- |
- |
- |
+ |
+ |
- |
+ |
Muscular Atrophy |
+ |
- |
- |
- |
- |
- |
- |
- |
- |
+ |
Hypertonic Disease (I,II stages) |
+ |
- |
+ |
- |
+ |
- |
+ |
+ |
- |
+ |
Bronchial Asthma |
+ |
- |
+ |
- |
- |
+ |
+ |
- |
- |
+ |
Vascular Diseases (Raynaud’s, atheroscleriosis of the extremities, varicose veins,
endarteritis obliterans) |
+ |
- |
+ |
- |
- |
- |
+ |
+ |
- |
+ |
Cholecystitis |
+ |
- |
- |
- |
- |
- |
- |
- |
- |
+ |
Dyskinesia of the Bile Ducts |
+ |
- |
- |
- |
- |
- |
+ |
+ |
- |
+ |
Atonic and Spastic Colitis |
+ |
- |
- |
- |
- |
- |
+ |
+ |
- |
+ |
Pancreatitis |
+ |
- |
- |
- |
- |
- |
- |
- |
- |
+ |
Rheumatoid Arthritis |
+ |
- |
- |
- |
- |
- |
+ |
+ |
- |
+ |
Enuresis |
+ |
- |
+ |
- |
+ |
- |
+ |
+ |
- |
+ |
Deforming Osteoarthrosis |
+ |
- |
- |
- |
- |
- |
- |
- |
- |
+ |
Ankylosing spondylitis (Bechterev Disease) |
+ |
- |
- |
- |
- |
- |
- |
- |
- |
+ |
Chronic inflammation of the ovaries and tubes |
+ |
- |
- |
- |
- |
- |
- |
- |
- |
+ |
Adhesions |
+ |
+ |
- |
- |
- |
- |
- |
- |
- |
+ |
Neurasthenia |
+ |
- |
+ |
- |
- |
- |
- |
-- |
- |
+ |
Consequences of trauma to the brain, encephalopathy |
_ |
- |
+ |
- |
- |
- |
- |
- |
- |
+ |
Reactive and asthenia conditions |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
+ |
Tiredness |
- |
+ |
+ |
- |
+ |
- |
- |
- |
- |
+ |
Disturbance of sleep |
- |
+ |
+ |
- |
- |
- |
- |
- |
- |
+ |
Atheroscleriosis of the brain vessels at the
initial stage |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
+ |
Ischaemic Heart Disease |
- |
+ |
+ |
- |
- |
- |
- |
- |
- |
+ |
Neuro-circulatory Dystonia |
- |
- |
+ |
- |
+ |
- |
- |
- |
- |
+ |
Stomach and Duodenum Ulcer |
- |
+ |
+ |
- |
- |
- |
+ |
+ |
- |
+ |
Neuro-dermatitis |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
+ |
Eczema |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
+ |
Diseases of the mouth (stomatitis, para donthosis, peri-odontitis) |
- |
- |
+ |
- |
- |
- |
- |
- |
+ |
+ |
Juvenile bleeding from the uterus |
- |
- |
- |
+ |
- |
- |
- |
- |
- |
+ |
Hysterical Aphonia |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
+ |
Alarming Conditions |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
+ |
Pain syndrome in conjunction with cranial nerves (neuralgia, migraines, neuro-sensorial deafness) |
- |
+ |
- |
- |
+ |
- |
- |
- |
- |
+ |
Pain syndrome in conjunction with spinal nerves (spondylosis,
trapped nerve, autonomic pain) |
- |
+ |
- |
- |
+ |
- |
- |
- |
- |
+ |
Phantom limb pain |
- |
+ |
- |
+ |
+ |
- |
- |
- |
- |
+ |
Neuro-circulatory dystonia |
- |
+ |
- |
- |
- |
- |
- |
- |
- |
+ |
Itching Dermatoses |
- |
+ |
- |
- |
- |
- |
- |
- |
- |
+ |
Anaesthesiology for operative intervention |
- |
+ |
- |
- |
- |
- |
- |
- |
- |
+ |
Meteorological reaction |
- |
+ |
- |
- |
- |
- |
- |
- |
- |
+ |
Psycho-emotional stress |
- |
- |
- |
- |
- |
- |
- |
- |
- |
+ |
Pain syndrome (from the spinal column) |
- |
- |
- |
+ |
- |
- |
- |
- |
- |
+ |
Cephalgia |
- |
- |
- |
+ |
- |
- |
- |
- |
- |
+ |
Pain from Herpes Zoster |
- |
- |
- |
+ |
- |
- |
- |
- |
- |
+ |
Analgesia at general and combinative anaesthesia |
- |
- |
- |
+ |
+ |
- |
- |
- |
- |
+ |
Primary muscular atrophy at damage of the peripheral motor nerves
(poliomyelitis, poli-neuritis, plexitis, radiculo-neuritis, traumatic neuritis, osteochondrosis with pain syndrome, cerebral paralysis) |
- |
- |
- |
- |
+ |
- |
- |
- |
- |
+ |
Sluggish paralysis with pain syndrome and trophic disturbance |
- |
- |
- |
- |
+ |
- |
- |
- |
- |
+ |
Secondary muscular atrophy due to prolonged immobilisation (after bone
fracture, hypodynamia, traumatic injury of the
joints) |
- |
- |
- |
- |
+ |
- |
- |
- |
- |
+ |
Hysteria with paralysis and paresis |
- |
- |
- |
- |
+ |
- |
- |
- |
- |
+ |
Sexual neurosis |
- |
- |
- |
- |
+ |
- |
- |
- |
- |
+ |
Atonia of the smooth muscles of the
internal organs (stomach, intestine, gall bladder, urinary bladder) |
- |
- |
- |
- |
+ |
- |
- |
- |
- |
+ |
Ischaemic Stroke |
- |
- |
- |
- |
+ |
- |
- |
- |
- |
+ |
Vegetative-circulate dysfunction |
- |
- |
- |
- |
- |
- |
- |
- |
- |
+ |
Diseases of the Central Nervous System with motor,
vegetative-circulate and trophic disturbance |
- |
- |
- |
- |
- |
- |
+ |
- |
- |
+ |
Functional Impotence |
- |
- |
- |
- |
- |
- |
+ |
- |
- |
++ |
Inflammation of the pelvic organs |
- |
- |
- |
- |
- |
- |
+ |
+ |
- |
+ |
Angiospasm |
- |
- |
- |
- |
- |
- |
- |
- |
+- |
+ |
Sub-acute and chronic diseases of the mouth and superficial tissues
(abscess, alveolitis,etc.) |
- |
- |
- |
- |
- |
- |
- |
- |
+- |
+ |
Diseases of the peripheral nervous system with pain syndrome (causalgia, myalgia, glossalgia, neuralgia of the trigeminal, glosso-pharyngeal and other nerves), pain after tooth
extraction |
- |
- |
- |
- |
- |
- |
- |
- |
+ |
+ |
Arthrosis, Arthritis (temporal-mandibular joint) |
- |
- |
- |
- |
- |
- |
- |
- |
+ |
+ |
Salpingo-oforitis |
- |
- |
- |
- |
- |
- |
- |
- |
+ |
+ |
Table
2 Contra-indication to
Electro-Therapy
Diseases |
DDC |
TE |
EST |
SEA |
ES |
EP |
AT |
IT |
F |
Sc |
Cancerous tumour |
+ |
+ |
+ |
- |
+ |
+ |
+ |
+ |
+ |
- |
Systemic blood diseases |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
- |
Cachexia |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
- |
Hypertonic disease III stage |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
- |
Severe atheroscleriosis |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
- |
Cardio-vascular disease at de-compensated stage |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
- |
Bleeding diatheses |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
- |
General severely ill patient |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
- |
Fever (>38) |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
- |
Active TB |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
- |
Epilepsy with frequent seizures |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
- |
Hysteria with frequent seizures |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
- |
Psychosis with psycho-motor excitement |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
+ |
- |
Bone fracture with non-mobilised bone fragments |
+ |
- |
- |
- |
- |
- |
+ |
+ |
- |
- |
Renal calculus and gall stone disease |
+ |
- |
- |
- |
- |
- |
+ |
+ |
- |
- |
Thrombo-phlebitis |
+ |
- |
- |
- |
- |
- |
+ |
+ |
- |
- |
Acute pain visceral origin (angina, heart attack, renal colic, labour,
surgical intervention) |
+ |
- |
+ |
+ |
- |
- |
- |
- |
- |
- |
Increase sensitivity to electrical current |
+ |
+ |
- |
- |
- |
- |
+ |
- |
- |
- |
Psychosis |
+ |
+ |
- |
- |
- |
-+ |
- |
- |
- |
- |
MS |
+ |
- |
- |
- |
- |
- |
+ |
- |
- |
- |
Traumas of the brain |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
- |
Epilepsy |
- |
+ |
+ |
- |
- |
- |
- |
- |
- |
- |
Infectious diseases of the CNS |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
- |
Di-encephal syndrome |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
- |
Thalamic pain |
- |
- |
+ |
- |
- |
+ |
- |
- |
- |
- |
Arrhythmia |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
- |
Drug addiction |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
- |
Skin lesions at the place of application of the electrodes |
- |
- |
+ |
- |
- |
- |
- |
+ |
- |
- |
Hysteria |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
- |
De-compensated heart failure |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
- |
Inflammation of the eyes |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
- |
Glaucoma, myopia, hyper-metropia (more then
4D) |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
- |
Arachnoiditis |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
- |
Encephalitis |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
- |
Weeping dermatitis on the face |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
- |
Neurosis |
- |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
Psychogenic ischaemic pain |
- |
- |
- |
+ |
- |
- |
- |
- |
- |
- |
Acute inflammation process |
- |
- |
- |
- |
+ |
+ |
+ |
+ |
- |
- |
Spastic paralysis and paresis |
- |
- |
- |
- |
+ |
- |
- |
- |
- |
- |
Increased electro-excitability |
- |
- |
- |
- |
+ |
- |
- |
- |
- |
- |
Pathological muscle contractions |
- |
- |
- |
- |
+ |
- |
- |
- |
- |
- |
Earlier sign of contracturae |
- |
- |
- |
- |
+ |
- |
- |
- |
- |
- |
Ankylosis in the joints |
- |
- |
- |
- |
+ |
- |
- |
- |
- |
- |
Nervous sutures or vascular sutures, during the first month after
operation |
- |
- |
- |
- |
+ |
- |
- |
- |
- |
- |
Thrombosis of the veins |
- |
- |
- |
- |
+ |
+ |
+ |
+ |
- |
- |
Spastic state of the intestine |
- |
- |
- |
- |
+ |
- |
- |
- |
- |
- |
Haemorrhagic stroke |
- |
- |
- |
- |
+ |
- |
- |
- |
- |
- |
Chronic infectious diseases |
- |
- |
- |
- |
- |
+ |
- |
- |
- |
- |
Acute coronary insufficiency |
- |
- |
- |
- |
- |
+ |
- |
- |
- |
- |
Acute and sub-acute inflammation diseases of the internal organs |
- |
- |
- |
- |
- |
- |
+ |
+ |
- |
- |
Lymphostasis |
- |
- |
- |
- |
- |
- |
+ |
- |
- |
- |
Varicose veins |
- |
- |
- |
- |
- |
- |
+ |
- |
- |
- |
Post-thrombosis disease |
- |
- |
- |
- |
- |
- |
+ |
- |
- |
- |
Implanted pacemakers (when action applied at distance of > 50cm
from the pacemaker) |
- |
- |
- |
- |
- |
- |
- |
+ |
- |
- |
Internal fracture with haemarthrosis at
early stage (2 weeks) |
- |
- |
- |
- |
- |
- |
- |
+ |
- |
- |
Thrombo-obliterative processes |
- |
- |
- |
- |
- |
- |
+ |
- |
+ |
- |
Vibration disease |
- |
- |
- |
- |
- |
- |
- |
- |
+ |
- |
Aneurysm of the arteries |
- |
- |
- |
- |
- |
- |
- |
- |
+ |
- |
Neurosis of persistent conditions |
- |
- |
- |
- |
- |
- |
- |
- |
|
|
EFFECTIVENESS OF SCENAR
THERAPY. PHYSIOLOGICAL ASPECTS
Ya.Z.
Grinberg.
This article [1,2] discusses the peculiarities of SCENAR therapy (SCENAR
action) which sets it apart from other methods of electro-therapy.
The main area
of focus was the difference between the SCENAR signal and signals normally used
in electro-therapy.
Therapeutic
mechanisms have in general been observed in the light of what is known in
physiotherapy [3,4]. It has been found
that due to the fact that SCENAR action activates tissues in the somatic or
autonomic nervous system, it is possible to achieve a considerable therapeutic
effect compared with other methods of electro-therapy.
So how
and by which physiological mechanisms is that effect achieved? This paper
aims to provide an answer to this question on the basis of modern ideas about
the functions, structure and chemical reactions involved in providing the
passage of excitation within the nervous system.
First,
however, let us recall:
The
peculiarities of SCENAR action [1,2]
1. High amplitude and, at the same time,
non-damaging (short) action. [1,2]
2. Absence (or almost complete absence)of adaptation process. Due to biofeedback, each new
impulse differs from the previous one.
3. Neutralisation of
the possible effect of accommodation (powerful first peak of the action
signal).
The methodological peculiarities in SCENAR therapy
1. Moving the device over the skin surface
at the time of action.
2. Activation of numerous areas connected to
the mass of nerve endings.
3. Choice of special zones (of small
asymmetry, etc.)
SCENAR action
applies electrical current on the skin surface. The degree of excitation
of the nerve tissue depends on the type of nerve fibres that it consists of. According to classification by Gasser and Erlanger,
there are various types of nerve conductors [3] which differ by their
diameters, speed of action and presence of myelin cover. These are:
- Fibres of type A: A alpha (15-20; 90-120); A beta (10-15; 50-100); A gamma (5-10
; 5-30); A sigma
(1-10; 5-30);
- Fibres of type B: (1-3; 3-15); and
- Fibres of type C: (0,5-1;
0,6-20).
The figures in
brackets indicate the diameter is in mkm and the
speed of passage of an impulse in M/c. Of the fibres listed, type C are non-myelinated.
It is known
that C-fibres have a high threshold of
excitement. There is an existing rule (for
the fibre), according to which the value of the
threshold of electrical excitation is in inverse proportion to the diameter of
the fibre. [6]
The force of
current required to activate C-fibres should
therefore be 15-40 times higher than for A alpha-fibres. However, it should be noted that during the
action, current from the electrode flows through the tissues . The current should be proportional to
the volume of the conductor (all other conditions being equal) and at set length
to the square of the conductor. Thus, the force of current in C-fibres should be 225-1600 times less than in A-fibres. Correspondingly, the force of current
necessary to excite C-fibres should be at a level
equal to the critical membranous potential, so as to keep the corresponding
proportion: - in this instance at most 16OO times higher. (A-fibres have a diameter of equal to 20 mkm;
that of C-fibres is 0.5 mkm).
It should be
recalled here that the SCENAR generates a high amplitude current impulse.
Accordingly, the potential for exciting thin fibres,
including C-fibres, is considerably higher than with
other methods of electro-therapy.
Quantity
correlation between the fibres mentioned is also
essential. To give a few examples [7,8]:
The
cranial cervical sympathetic node has been the subject of considerable
study. The following shows numbers of nerve cells found
:
- in rats
: 42,OOO
- in guinea-pigs: 16,OOO
- in cats
: 1OO,OOO
- in man
: 911,OOO nerve cells
Of all the
types of fibres, 80% relate to sensory fibres, particularly in cats. 20% of fibres are myelinated and the rest – i.e. C-type fibres – are thin, non-myelinated,
with a diameter of 1-2 mkm.
In the study of
celiac nerves in cats, it was established that out of approximately 13,500 fibres, nearly ll,000 were non-myelinated. The presence of B-afferents was
discovered which were small in diameter and had a correspondingly high
threshold of excitement. B-fibres and also
pelvic nerves were discovered in the parasympathetic vagus. The quantity of C-fibres in these nerve tracts
was, 90% and 50% respectively. Hence thin, non-myelinated or weakly-myelinated fibres make up the biggest part of the main nerve tracts.
Let us take a
further look at the modern concept of chemical passage. The basis for
this was established at the beginning of the 20th century. It
was demonstrated that the passage of the signal in the neuro-effector connections was due to the release of acetylcholine or adrenaline in the nerve endings.
Up to the l950’s, two groups of chemical compounds were known as neuromediators (NM), namely:
- amines : acetylcholine (AC), noradrenaline (NA), adrenaline, dopamine, serotonin; and
- amino acids : glicin, glutamin, asparginate acid
and gamma-aminobutyric acid.
A third group
of neuromediators (purine/neucleitides) was discovered in the l960’s.
In the
mid-l950’s, it was suggested that a peptide – compound P (CP) - had a role of neuromediator. Since then, neuropeptides (NP) have been established as the most numerous group of neuromediators.
The co-existence of the representatives of various groups of compounds was
traced in the same neurones of the central and
peripheral nervous systems [9] i.e. - a few classical NM, classical NM +
NP. Purines were subsequently added to this
combination.
In the context
of the subject under discussion, we above all are interested in the properties
that can influence the therapy. The bioactive properties of the classical
NM are widely known [3,6]. We will therefore
focus to the properties of NP.
Table 1 [9,10] sets out the most general characteristics of the
bioactivity of neuropeptides.
The following
are the abbreviations used for neuropeptides (NP) :
CCK – choliecystokinin;
VIP – vasoactive intestinal peptide;
ACTH –
adrenal-corticotrophin;
CGRP – Ca-gene relative peptide.
Analysis of the
table shows that each of the NP represented (or group of NP) does not
completely match the bioactivities listed but has a clearly expressed specific
property or complex of properties. Some physiological functions are under
control of not only one but a whole range of NP, where each NP has evolved into
a “package of programmes” for triggering or
modulating a certain set of functions. NP, together with the other humor
regulators, form a functional continuity (or
continuum) assuring compatibility of biological activities.
Table 2 sets out a list of given functions
on which neuropeptides have their main influence.
At this point, it makes sense to move from the notion of NP to the notion of
regulative peptide (RP), which is used as a synonym when referring to given
properties of NP. The concept of RP [9] is slightly wider, as a whole range of
RP is produced by neurones. Persistence in the search for peptide-producing
neurones (previously considered to be non-neurones) has in many cases been
rewarded with success. The next important peculiarity of NP is its long life
span in the liquids of the organism. If the average duration of the
effective concentration of AC is split seconds (l0-2), for catecholamines, serotonin, histamine and GABA from 10-1 to 5 seconds,
then for small peptides it will be tens of minutes and, for medium and large
peptides, tens of hours.
Another
peculiarity of the NP which differentiates it from regular NM is the fact that
its breakdown is not just a simple act of decomposition of the regulator but
the creation, or synthesis, of a new bioactive compound. The end activity of
the chemical compounds resulting from the cascade reaction breakown of the original NP, differs from the activity of the
starting NP and this is a valuable difference: the formation of complex chains
and cascades is taking place. Each of the peptides studied demonstrated
the ability to induce certain other NP to appear in the blood and interstitial
liquor of the organism. Each of the peptides mentioned, in turn, is
capable of the same inducing effect. The long-lasting effects of NP with
a short life-span may be explained by the existence of such regulative chains.
It seems
logical, therefore, that the likelihood of chains and cascades appearing essentially increases if the dosage of NP exceeds a
certain threshold, i.e. when the effective dose of NP is being released.
Distant effect
is a logical continuation of the aforementioned peculiarities (formation and
duration of the complex chains and cascades). NP come from the synapse
area and act on the less remote receptors. The
majority of NP is recognized as regulators, transferred by blood and/or CSLiquid in any area of the organism. For some
distantly-acting NP, special carrier-proteins are described, which stabilise them in the process of transportation. With
distant action of NP, the ability of the NP to induce the release of other NP
is an important property.
The next
important property of NP, which differentiates them from regular NP, is
connected to their high numbers and therefore to the possibility of many new
functional combinations in the synapse and intersynapsis interactions.
Finally, it
should be noted that exhaustive study of each NP always leads to the discovery
of its action on the genome activity. The triggering or increase of the
activity of given genes under the influence of NM, especially RP, is an typical process. The process can even be caused by
the mediators, whose action is so short and seems to
be focused on quick synaptic reactions.
To sum up.
There are biologically-active compounds in the organism consisting basically of
RP. Together with other humor regulators, they ensure
compatible biological activity. RP are characterised by their ability to
create complex regulative chains and cascades, their long life-span, their
distant effect and action on the genome activity.
The last
question to be cleared up is related to the localisation of NP. The short answer to this question is: NP are present in all parts of the central and peripheral nervous system, somatic and
autonomic. (Refer to the list of various NP that co-exist with each other
[9]) cerebral pons, cerebrum, cortex of hemispheres,
striatum, cerebro-spinal ganglions, parasympathetic neurones, sympathetic neurones, enthral ganglions, spinal cord, peripheral vegetative
nerves, retina cells, preganglion sympathetic nerves, hypocampus formation, medullar of the adrenal glands,
hypothalamus hypocampus, cerebral trunk, olivo-cochlear neurones, suture
nucleus, blue macular, primal afferent neurones.)
Let us examine
the modern idea of chemical reactions involved in the passage of excitation in the peripheral autonomic reflex [7]
.The main mediator in the pre-ganglion sympathetic and parasympathetic
structures is AC. In the post-ganglion, AC prevails in the
parasympathetic structures and NA in the sympathetic. In the
post-ganglion sympathetic pathways, together with adrenergic cells,
there is a certain quantity of cells which are choilinergic.
Classical mediators, as mentioned earlier, exist in combination with various
peptides. These are: vasopressin (VP), CHRP, Bom/HRP,
VIP, SOM, pancreatic peptide (PP), RFLH, NT, neurotensin A (AT), galonino-like peptide (GAL), petid-gystidin-siolicin (PGI), gastroliberin (GLB), ENK, CCK, NPU and others.
It is always a
surprise to researchers studying the distribution of visceral fibres innervating the internal organs (vagus,
celiac, pelvic nerves) to find that there is a prevalence of sensory fibres over motor fibres [8]. In the vagus nerve, the ratio is 9:1; in
the celiac nerve – 3:1 and in the pelvic nerve – 1:1. The efferent
sensory fibres transfer information about the condition of an object and create their own
local control for the object. In response to adequate stimulation or
irritation by electrical current, bioactive compounds are released (mainly RP)
which act specifically on the surrounding tissue and beyond, as follows from
the above. The process of effective regulation by sensory endings is seen
especially clearly in regulation of the immune process, the inflammatory trophic process, healing of wounds [7] and in regulation of
the gastro-intestinal mechanism, where ulcer formation is prevented [8].
Traditionally, neurosecrete cells were studied mainly through the hypothalamo-hypofisis-adrenal connections. Today, it
is clear that large quantities of neuosecrete cells
are spread around the various parts of the
nervous system and their activity is closely connected to the production of the
peptide regulators.
Based on these
explanations, let us look at some postulates and reports received on the
practical effects of SCENAR therapy.
SCENAR treats everything. (Ref
also “The Principle of Universality “ [4]).
This statement
very often makes medical doctors and scientists wary when first faced with the
device and treatment method. Results from SCENAR therapists (at present
the device is being used by medical doctors in over 30 specialities),
publications of compilations of SCENAR therapy, multiple trials, including
trials at five departments of I.M.Sechenev MMA (ref.
Supplement to the second compilation) have, to a considerable degree, served to
reassure them.
The main modality
of SCENAR therapy. This phenomenon is explained as follows:
Due to the
peculiarity of its action, SCENAR activates thin peptide-containing fibres to a higher degree than other methods of influence.
This enables the effective dosage of RP to be created and, consequently, RP with
other humoral factors which are also subjected to the
essential influence of RP, thus creating a regulator continuum - i.e. a full set of biological activities which are
capable of managing practically any disease.
There are
numerous publications describing the influence of RP on regulation of vessel
tone [7], heart rhythm [11], respiratory system [13], degree of epileptic
activity [14], integrative brain action [15] and pain mechanism [16] (see
below).
SCENAR –
regulator. This
statement is repeatedly corroborated by practice. Regardless of the
direction of the disease (a characteristic example: hypertonia – hypotonia), the same zones of action are used for
the therapy. This is natural, as SCENAR only activates the release of
regulative peptides stored in the body and which, as a result of genetic programming , substantiates the therapy. In common
electrotherapy this, as a rule, cannot be achieved due to limitations connected
to its peculiarity [1] and also bearing in mind the main functions of the afferent
fibres of the A-type which are involved in high-speed transference of chemical
supply. NP are not suited as chemical mediators
to the process of transferring the impulse to A-type fibres endings [8].
Therefore, when they are activated - which is a
characteristic of the common methods of electrotherapy - the likelihood of
peptic chains and cascades appearing is small, compared to SCENAR therapy.
Treatment of children is better. Practice
has time and again corroborated this statement. It is relatively simple
to explain in the light of the above. Myelinisation of fibres is complete by the age of 11/2 – 2 years. The
quantity of endocrine cells in the foetus and neonate is considerably higher
than in adults.
Here, I would
like to mention the successful experience of SCENAR use in the treatment of
respiratory asphyxia in neonates, practically with a single touch of the
device. This took place at the 2nd City Hospital in Tanganrog.
It is known that more than 10 RP synthesize in the neuroendrocrine cells of the lungs [12].
False, true
SCENAR complications. It is
characteristic that, following treatment of osteochondrosis,
for example, women unexpectedly become pregnant. There have been numerous
positive results in the treatment of infertility. The explanation for
this effect is obvious, as 30 NM take part in the functioning of the
reproductive system [13]. They also provide a chemical structure for an
autonomic reflex [7]. Here, I should also make a reference to the effect
of the distant properties of RP.
Absence of
contra-indications. This
statement claims that SCENAR therapy is different from other methods of
electrotherapy [1] which, to a great extent, can be ascertained from the
reaction of the organism to the introduction of RP.
It is known
that the pharmacological (physiological) effect depends on the functional
status of the system being tested. When introducing moderate dosages of
RP into a “normally”-functioning organism, i.e. in equally balanced relations,
the exogenous factor will be subject to intensive influence and these peptides
will be destroyed, in order to conserve homeostasis. In pathological
conditions, the opposite is true: balanced relations between chemical and
physiological systems, cells, tissues and the organism are disrupted. The
links which are susceptible to the corrective action of the regulator, are revealed.
Pain-killing
effect. The success of SCENAR action in
analgesia is well known (ref. [18]). According to the existing
concept [16], regulation of pain sensation in the organism is based on the
mechanism of interaction between nociceptive and
anti-nociceptive endogenous systems. They form
a functional variable pain
threshold. Both these systems have a multiple chemically- heterogeneous
make-up, and both have in their basis neuro-chemical reactions. Some of the reactions are
called peptide-ergic reactions. Besides opioid peptides, there is: neurotensin,
AT-2, CHRP, SP, BOM, SOM, CCK and others involved in the mechanism regulating
pain sensation. Peptic mechanisms possess a certain selectivity, confirmed by the activity of extremely small dosages of certain
peptides. The pain sensitivity mechanisms occur through interaction of
the functions of various peptides. As mentioned earlier, it is clear to
see how complicated it is to develop medical drugs for anaesthesia. The
optimal solution can only provided by the organism itself, which only needs a
little help.
The experience
acquired from the application of SCENAR therapy shows that this treatment
tackles all three tasks involved in combating pain:
- anaesthesia without a change
in the general pain sensation;
- therapy; and
- reduction in intake of narcotic drugs (refusal of these).
Participation
of the peptic mechanisms in this process confirms, from the effect of the
increase of pain (aggravation), the obvious improvement of the functional
condition (via aggravation to recovery). A patient expresses anxiety and
the SCENAR therapist endeavours to persuade him/her to hang on. This effect promotes essential progress
in the distribution of RP. The restoration of the function occurs against a
background of change in the RP which are
responsible for anaesthesia, which consequently leads
to an increase in pain sensitivity.
When treating one disease – cures another
as well. This is a phenomenon familiar to all SCENAR
therapists and is easily explained as follows: a regular continuum of
biological activity and distant effect of RP. Positive results
achieved after a single SCENAR session [17] are connected to the long duration
of RP and their ability to form new biological compounds on decomposition.
Quick effect,
acceleration of recovery. (Ref. Reply from I.M.Sechenev MMA,
compilation 2). Fast action of RP (different from that of steroid
hormones) is due to activation of earlier synthesised ferments and proteins
[15]. This property is used in certain peptic drugs for the correction of
functions in extreme conditions.
Let us list
briefly some of the SCENAR “fairy tales”:
- Restoration
of the reproductive function;
- Treatment of
a brain tumour by action on the appendages (uterine
or epididymis): distant property of RP;
- Treatment of ileus. Essential influence of CCK, BOM, VIP on
the secretion of the grastro-intestinal tract (ref.
[19] in this compilation);
- Emergency
effects (ref above: fast effects);
-
Reversal of Growth retardation. CCK stimulates excretion of the growth
hormone;
-
Reversal of Mental development retardation.
Essential stimulation of VAZ, ACTH and alphamelanotropin on ability to study and memory;
- Correction of disturbance in motor activity and tactile
sensitivity. Effective application of the device in this case follows
from analysis of the table.
- There are
positive cases of treatment of epilepsy. It is know that black substance, neuromediators and peptidergic systems of the brain halt epileptic activity [14].
In conclusion, let us examine
to what extent certain SCENAR techniques correspond to what has been stated.
- Action on the
projection of the lesion of the injury. In this case, distant effects
occur more quickly and a fast therapeutic effect can be expected to take place
in practice.
- Action on the
three pathways, 6 points, collar zone, projection of the gastro-intestinal
tract, active points and zones activates a great number of nerve cells
containing practically the whole range of RP, leads to the desired effect.
The fact that SCENAR therapy is based on the
mechanisms of peptide activation makes it possible to look upon the system
“organism-device” as a generator of Regulative Peptides.
Reference
1. Grinberg Ya.Z. SCENAR therapy: the effectiveness from the
point of view of methods of
electrotherapy. SCENAR therapy and SCENAR expertise. Compilation of articles, issue 2, p 18-33. Tangarog, 1996.
2, Grinberg Ya.Z. Question of the
substantiation of the effectiveness of SCENAR therapy. SCENAR therapy and SCENAR expertise. Compilation of articles, issue 3, p.17-23. Tangarog, 1997.
3. Bogolubov V.M., Ponomarento G.N. General
physiotherapy. M.; compilation 1996 – 480 pp.
4. Revenko A.N. Adaptation –adaptive regulation (SCENAR). Theoretical and
practical substantiation.
5. Gorfinkel Yu.V. Theoretical and practical
basis for the increase in effectiveness of SCENAR therapy. SCENAR therapy and SCENAR expertise. Compilation of articles, issue 2.
6. Nozdrachev A.D. Physiology
of the nervous system. L.: “Medicine”, 19238, p.296.
7. Nozdrachev A.D. Chemical structure of the peripheral autonomic (visceral) reflex. Usp.physiol.
science, 1996, v.27, No.2, p.28-60.
8. Nozdrachev A.D. Axon-reflex. New point of view
in the old area. I.M.Sechenev Physiol.magazine, 1992, v.11, p.135-142.
9. Ashmarin I.P., Kamenskaya M.A. Neuropeptides in the synaptic passage. Results of science and technique. Ser. “Physiology of humans and animals”, v.34, 1988, p. 183.
10. Ashmarin I.P., Obuchova M.F. Content
of regulative peptides in the brain cortex and their central activity. M. “Highest nervous activity”, v.35, No.2, p. 211-221.
11. Osadchyi O.E., Pokrovskyi V.M. Peptidergic mechanism in the parasympathetic regulation of the cardiac rhythm. UFN, v.24, No.3, 1993, p. 71-85.
12. Belyakov N.A., Solovieva I.E., Meshkova M.E. Regulative
peptides in the lung. UFN, v.23, No.2,
1992, p.74-87.
13.
Babichev V.N. Neuroendocrine regulation of the secretion of gonadotrophins and prolactin and the role of neuromediators in it. UFN, v.26, No.2, 1995, p.44-59.
14. Shandra A.A., Godlevskyi L.S., Tkachenko I.V., Servetskyi K.L. The role of black substance in mechanisms stopping epileptic activity. UFN, v.26,
No.2, 1996, p.90-102.
15. Malyshenko N.M., Popv N.S. Hormones and neuropeptides in the integrative
processes. UFN, v.21, No.2, 1990, p.94-106.
16. Kaluzhnyi L.P., Heterogeneity of nociceptive and anti-nociceptive peptic mechanisms and their
correlation with the genesis of pain. UFN, v.21, No.4, p.68-84.
17. Zavitaev Y.A. SCENAR examples of single SCENAR application. SCENAR therapy
and SCENAR expertise. Compilation of articles, issue 2,c.81-82. Tangarog 1996
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