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.