alexander tarakanov new possibilities of transcutaneous ......scenar de-p2 this commutator in set...

New possibilities of transcutaneousNew possibilities of transcutaneous neuroadaptive electronic regulation

in clinical praxis. A Development perspectivep p p

A V TarakanovA.V.TarakanovM.D., Professor, Rostov State Medical University, Russia

PROGRAMPROGRAM

of clinical studies of the SCENAR device (self controlled electronicdevice (self-controlled electronic

neuroadaptive regulator)

Purposes:p1. Study unification.2. Possibility of performance of the controlled

studies by different doctors and SCENAR ytherapeutists.

3 Search for the new aspects of the SCENAR3. Search for the new aspects of the SCENAR therapy application.

4. Fund establishment for scientific investigations and grants assignmentinvestigations and grants assignment.

SCENARSuper ProSuper Pro

M l Automatic regimeManual mode

Automatic regime and presets

Automatic regimeAcute pain(condition)

g

cosmetologyPresets

rubbingti l timyostimulation

tonus improvementapplication of nutrients

sportsbefore trainingafter training

rehabilitation

SCENAR DE-P2Thi i i h l i i l ( ll f i l d l SCENARThis commutator in set with any electronic stimulator (all professional and personal SCENAR devices) and others) are designed for the program control of the influence transfer on the skin tissues of patient using the included to the set outer multielectrodes. In the commutator 34 trajectories of influence transfer are released and 4 types of multielectrodes.

Outer electrodes

M lti l El t d Combined zone electrode “Revolver”Multiple Electrode Combined zone electrode Revolver

The abovementioned electrodes are included to the delivery volume. 

RITM OKB ZAO has developed a blanket with two screens. It’s distinctive feature lies in strong protection from the externaldistinctive feature lies in strong protection from the external electromagnetic fields. Moreover, this new healing blanket

possesses the increased wear resistance.

healing multilayer blanket healing multilayer blankethealing multilayer blanket healing multilayer blanketwith two screens

Patient selection for the SCENAR therapy has principal differences and sense…

Indications for the SCENAR therapyIndications for the SCENAR therapy(discussion)

Tarakanov A. V.a a a oCherchago A. Ya.

1. Patients with insufficient effect or absent effect after the conventionalabsent effect after the conventional

treatment.

Complication after lyposuction, the process continues over 4 months

05.02.2008

15.02.2008

27.02.008

BEFORE TREATMENT AFTER TREATMENT (4 MONTHS)BEFORE TREATMENT AFTER TREATMENT (4 MONTHS).

Dermatological chair of the RostovDermatological chair of the Rostov State Medical University

Patient S-w, 48 years.Diagnosis: arterial hypertension grade 2. Impossibility ofmedication selection over the last two years.

Effect of the SCENAR therapy in course of 1,5 months.

250 Mm Hg.

150

200

100

0

50

0

утро АД сист утро АД диаст.Morning systolic BP

Morning diastolic BP

2. Impossibility of the conventional therapy d ticonduction

(i l ti b f di ti(isolation, absence of medications,

absence of specialists etc.).

Analgesiag

The pronounced effect of electronicstimulation of the biologically active points andzones in comparison with acupuncture, occursdue to the conduction of electric current allowingf ff ffor more efficacious impact on receptors, even iflocalization of the point is not precisely.

By selection of stimulation frequency, it is recommended to be guided by data on labilityrecommended to be guided by data on lability

of the other electroexcitable tissues

Thus, in 1 sec. the nerve trunk is capable ofd i 500 i l di t th i it tireproducing over 500 impulses according to the irritation

rhythm, the motor nerve endings - up to 150, themuscle itself (after curare) — up to 250muscle itself (after curare) up to 250.

These data are important for the right selection ofelectric signals by nervous system affection.electric signals by nervous system affection.

By somatic and nervous system affection, in thelast case the use of low-frequency currents is moreq yefficatious.

By high-frequency currentsy g ythe pain is more quickly ameliorated, but

stable results are achieved in case ofstable results are achieved in case of application of low-frequency currents.

500-350…… 90-60……….15-7 Нz

Stimulation energy for development of sensation pain and pain tolerancesensation, pain and pain tolerance

90

100Energy, relative

80

90 units

60

70

40

50

20

30

0

10

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57

непереносимая боль боль тактильное ощ.Unbearable pain pain Tactile sensation

3. SCENAR therapy as complementary py p ymethod for conventional treatment effect

accelerationacceleration.

Zones of muscle hyper- and hypotensionyp yp

4. Comorbid patients

(threat of polypragmasia!!! ).(t eat o po yp ag as a )

Comorbidity -Comorbidity(lat. со - together, morbus - disease).

Comorbidity –A combination of two and/or more chronic

diseases, connected with each other pathogenetically or coinciding in time in one patient independently of activitycoinciding in time in one patient independently of activity of each of them.

H.C. Kraemer and M. van den Akker

5. Patients, unsatisfied with life quality after

the conducted conventional treatment.

Index of vital functions affection during neck pains (H.Vernon, J.Mior, 1989)

Evaluation by 10 categories:1. Pain intensity2. Self-service3 L d lifti

4,0

3. Load lifting4. Reading5 Headache

3,0

3,5

5. Headache6. Attention concentration7 Work 1 5

2,0

2,5

7. Work8. Car driving9 Sleep 0,5

1,0

1,5

9. Sleep10. Rest 0,0

,

I II III IV V VI VII VIII IX X

до лечения после леченияBefore After treatmentдо лечения после лечения

Kusmova R., Tarakanov А.А., Tarakanov А.V.

treatment

Cella D. F. Quality of life (QoL)

There exist different terms for descriptionThere exist different terms for descriptionof life quality. Nevertheless it is generallyaccepted that quality of life is some kindaccepted that quality of life is some kind of multidimensional term showing the influence of disease and treatment on patient’s well beingthe influence of disease and treatment on patient s well-being. Patient’s quality of life characterizes how physical, emotional and social well-being of the patient changes under the influence of g p gdisease or it’s treatment. [Cella Bayu and Bohomi AE, 1995]. In some cases this term includes also economic and spiritual aspects of patient’s functioning

36-Item Short Form Survey f th RAND M di lfrom the RAND Medical

Outcomes Study

As part of the Medical Outcomes Study (MOS) a multiAs part of the Medical Outcomes Study (MOS), a multi-year, multi-site study to explain variations in patient outcomes RAND developed the 36 Item Short Formoutcomes, RAND developed the 36-Item Short Form Health Survey (SF-36). SF 36 i t f i h t d ilSF-36 is a set of generic, coherent, and easily administered quality-of-life measures. These measures rely upon patient self-reporting and are now widely utilized by managed care organizations and by Medicare for routine monitoring and assessment of care outcomes in adult patients.

7. If it is impossible to determine precise p p

diagnosis, there is no diagnosis in the presence of g g

complaints with projection on skin surface (therapy j ( y

alternative ex juvantibus).

01 02 06 03 05 0601.02.06. 03.05.06.

Abdominal pain(for diagnosis precision)SPASTIC (for diagnosis precision)SPASTIC

In case of smooth muscle spasms in digestive or biliary tract

PERITONEALin case of pathological process inin case of pathological process in

peritoneum(inflammation – antibiotics…)

DISTENSION PAINBy hollow abdominal cavity organs

distension(swelling, constipation…)

VASCULARBy abdominal cavity organs

ischemiaischemia

(atherosclerosis, thrombosis…)

8. In case of the absence of compliance

to the medication therapy; patient’s

illi t i di tiunwillingness to receive medications.

9. By contraindications to conventional treatmenttreatment

I will vaccinate you anywayI will vaccinate you anyway…Choose between life or health…

10. SCENAR application for non-medical10. SCENAR application for non medical

purposes.

Evaluation criteria

Performance and safety criteria of the performed therapy

1. Primary performance criteria(direct performance criteria by the “principal complaint”

and adherence to this treatment method).

2. Quantitative (changes in relation to norm and initial value)

SCENAR therapy must not contradict conventionalSCENAR therapy must not contradict conventional treatment methods.

3 S d f it i3. Secondary performance criteria(surrogate criteria based on hypotheses about the SCENAR mechanism of action: subcellular to the level of physiological systems, incl. laboratory studies)

4. Additional performance criteria:Subjective quantitative patient’s and doctor’s– Subjective quantitative patient s and doctor s evaluation of treatment methodD i f i l d t ti l l– Dynamics of social adaptation level.

5. Safety criteria:y

) ibl ti ff ti d b dа) possible tissue affections and body reactions due to correct technology i l t tiimplementation;

b) possible tissue affections and body reactions due to the most probable infringements of technology implementation of intervention’s performance;

c) self-confidence of SCENAR therapeutist) pand danger to «miss» a severe disease.

11 Treatment for animals11. Treatment for animals.

Treatment for animals

Treatment for animalsTreatment for animals

Non-specific effects of SCENAR and healing multilayer blanket.

Sl l tiSleep regulation

Value Points1. Time of falling asleep

мгновенно: 54

Severity and structure of the disturbances were estimatedнедолго

среднедолгоочень долго

4321

2. Sleep duration:l 5

disturbances were estimated using questionnaire points of subjective sleep values,

very longlongmiddleshort

very short

54321

3 Q tit f ki t i htThis questionnaire contains 6 

i d h f h3. Quantity of waking up at night:norarelynot frequentlyfrequentlyvery frequently

54321

questions, and each of them characterizes definite sleep periods,y q y

4. Sleep quality:perfectgoodmoderatebad

5432

periods,the answers are estimated on 5‐

point scale.very bad 1

5. Quantity of dreams while sleeping:noat timesmoderately

543

Maximal sum of scores– 30 points.22 and more points – the valuesmultiple

and anxious21

6. Quality of morning awakening:perfectgood

54

22 and more points  the values characteristic for healthy subjects, 

19‐21 points – borderline value, andL th 19 i t i f t ll b imoderate

badvery bad

321

Sum value

Less than 19 points – sign of not well‐being.

Clinical performance ofClinical performance of Zopiclone and the SCENAR therapy

Субъективная оценка сна

22 7 23 125

Subjective sleep evaluation

16,3 16,6

22,7 23,1

15

20

25

лах

* *

10

15

оценка

в балл

poin

ts

0

5

зопиклон СКЭНАР Zopiclone SCENAR

до лечения после лечения

* Р < 0,05

Before treatment

After treatment

Results, healing multilayer blanketg y

*p<0,05p

sum

Before treatment

After treatment

Results, healing multilayer blanket -carpet

25 0*p<0,05

20,0

25,0

17 6

22,5

15,0

17,6

10,0*p<0,05 *p<0,05

5,0 3,1 2,9 2,9 3,0 3,1 2,53,9 3,6 3,9 3,7 3,8 3,6

0,01 2 3 4 5 6 суммаsum

до лечения после леченияBefore treatment

After treatment

Results, healing multilayer blanket -carpetcarpet

*p<0,05

l b di l h li ltilsum

Placebo remedial multilayer blanket

healing multilayer blanket ‐ carpet

E i ll f di t ib t !!!!!Especially for distributors !!!!!

Assign money for investigations!!!Assign money for investigations!!!

ФОРМУЛА СЧАСТЬЯFORMULA FOR HAPPINESS

НЕТ.У ВАС ЕСТЬ ПРОБЛЕМЫ?DO YOU HAVE ANY PROBLEMS? No

Right now I haveДАY have

SCENARf i

ДА.Yes..

professional as

No,

o a aswell

МОЖЕТЕ ЛИ ВЫ ЕЕ РЕШИТЬ?

ДА.CAN YOU SOLVE IT? Yes.