Kein Folientitel

1
H. U. MAY High Tone Power Therapy -
HiToP Theory and Practice Porto, March 2005
2
Introduction Theory, part 1 "High Tone Therapy"
and "High Tone Power therapy" Simultaneous
modulation of frequency and amplitude and its
advantages
3
"High Tone Power Therapy" and the equipment to
realise this most advanced an most modern kind
of "High Tone Therapy", HiToP, is the result
of the last step of developments of middle
frequency therapy.
4
I will begin with the explanation of the reasons
for the decision for the development of a new
sophisticated method within the physical therapy,
described as electrical high tone frequency
alternating field therapy, abbreviated in German
Hochtontherapie, in English high tone
therapy, in Polish terapia energotonowa, that
means energy tone therapy. The new method has
been realised in Germany by gbo.The result is
the equipment HiToP (High Tone Power
Therapy). High tone therapy is a purposeful new
development in the field of electrotherapy. It
appears with the pretension to realise all
effects known and expected from the traditional
low and middle frequency therapy with higher
efficacy. Including ranges of frequencies never
used until now and introducing the simultaneous
modulation of frequency and amplitude a
completely novel method of electro-therapy has
been created. Important aspects of this
innovative creation were to optimise the
therapeutically width and to take more into
account the very interesting non-stimulatory
effects.
5
Several clinical investigations published
recently (2002, 2003 and 2004) in Poland
confirm the expectations concerning the
efficiency of high tone therapy in various
injuries and/or diseases.
6
To understand correctly and completely the
position of the high tone therapy within the
electrotherapy it is required to be well
acquainted with some terms of the fields of
physiology, related disciplines and physical
therapy. However, neither all medical doctors
nor all physical therapists have been
sufficiently educated during their specific
education's in both disciplines, or may be they
have forgotten some details. Therefore I will
try to repeat, to explain and to comment some of
the most important terms and facts.
7
Terms The term High tone therapy This term,
abbreviated from electrical high tone
frequency alternating field therapy was
proposed by medical doctors just after the
introduction of the first generation of high tone
therapy units
8
High tone therapy High tone therapy is a
purposeful new development in the field of
electrotherapy, basing on the principles of the
electric differential therapy (HANSJÜRGENS MAY,
1990). By means of simultaneous modulation of
frequency and amplitude (SimulFAM), either a)
along the threshold graph after its individual
determination (SimulFAMi) or b) with
crossing of this threshold graph with adjustable
crossing angles (SimulFAMx) it is possible
to generate alternatively either a) selectively
non-stimulatory effects or b) non-stimulatory
effects in combination with stimulatory
effects.
9
Electric differential therapy Electric
differential therapy (MAY HANSJÜRGENS, 1988
HANSJÜRGENS MAY, 1990) can be considered as
a principle to classify currents used in
electrotherapy and as a principle to select the
most suitable kind of current for the
pathological condition or symptom just to be
treated. For the selection of the best suitable
current is decisive like in pharmacology the
best relation between efficacy and tolerability,
in other words the therapeutic width.
10
Tolerance We have to distinguish between local
and systemic tolerance for currents. Local
tolerance The local tolerance is correlated with
or described by respectively a) the value of the
(direct) pain threshold, b) the risk of
chemical burning, c) the risk of burning by
heat, d) the value of the (indirect) pain
threshold caused by intensive muscle contraction,
measured as functions of frequency and intensity,
for b and c additionally as functions of time.
11
Systemic tolerance The systemic tolerance can be
defined mainly by means of the a) the value of
the threshold for ventricular fibrillation or b)
the value of the threshold for cardiac
arrest. In cases of current applications
including head and brain thresholds for undesired
sensations and/or generalised epileptic seizures
are important. In cases of treatments of the
trunk with high current intensities above the
motor threshold the thresholds of the muscles
responsible for respiration are important.
12
Effects The electric differential therapy
distinguishes between stimulatory and
non-stimulatory effects. Stimulatory
effects Stimulatory effects are caused by
generation of action potentials in excitable
structures (nerves, muscles, receptors). The
frequency of the triggered action potentials
ranges between gt 0 and for very short periods
1000 Hz, defined in physiology and physical
medicine as the low frequency range. The
application of stimulatory effects can be
realised either according the functional
imitation principle or according the functional
fatiguing principle, depending on the values of
the frequencies of stimulation in relation to the
fatiguing frequency of the just stimulated
excitable structure.
13
Important frequencies for therapeutically desired
special effects, basing on well known
physiological investigations regarding the
discharge behaviour of excitable structures -
usable as border line frequencies between the
functional imitation principle and the functional
fatiguing principle Efferent nerve fibres
Sympathetic nerve fibres Lipolysis
3 Hz This frequency of 3 Hz is not a
border line frequency between imitation and
fatiguing frequencies. The lipolytic effect of a
stimulation of sympathetic nerve fibres
innervating fatty tissue is decreased in case of
using higher frequencies than 3 Hz because of the
simultaneously increasing vasoconstriction
(ROSELL, 1966). Vasoconstriction 10 Hz
Motor nerve fibres 20 Hz Afferent nerve
fibres 100 Hz, however, not valid for
all groups of afferent fibres
14
Instructions regarding the meaning of the
principles of functional imitation and
functional fatiguing related to the stimulation
of the mentioned groups of nerve fibres The
principle of imitation can be used
therapeutically for all of the mentioned
groups, the principle of fatiguing mainly for
sympathetic fibres, in few cases for motor nerves
as well. To avoid undesired fatiguing effects
during the initial phase of a treatment in cases
of applications of various (low) modulation
frequencies, please start every time with the
lowest frequency!
15
Stimulation of sympathetic nerve
fibres Frequencies up to 3 Hz activation
of the lipolysis within the innervated area
Frequencies up to 10 Hz mainly
vasoconstriction increasing with frequency
reduced lipolysis caused by
vasoconstriction and product-inhibition
Frequencies gt 10 Hz, for example
100 Hz vasodilatation after initial
vasoconstriction
16
Stimulation of motor nerve fibres Frequencies
up to 20 Hz Muscle exercise, re-education,
strengthening with individually designed and
adjusted periods consisting in phases of
stimulation interrupted by pauses. 20 Hz is the
physiological tetanising frequency, i. e. the
maximum discharge frequency in the efferent
neurones of the motor units during voluntarily
initiated maximum isometric contraction (HENNEMAN
1957 HENNEMAN et al. 1965 SOMJEN et al 1965
MILNER-BROWN et al. 1973 FREUND, BÜDINGEN
DIETZ 1975 BÜDINGEN FREUND 1976) Frequencies
gt 20 Hz muscle relaxation caused by
fatiguing stimulation
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Stimulation of afferent (somato-sensory) nerve
fibres This group of nerve fibres is not
homogeneous. Therefore a frequency limit valid
for all fibres does not exist. Furthermore,
there is no indication for purposeful fatiguing
stimulation of this group of fibres. Nevertheles
s, 100 Hz can be accepted as the most useful
frequency to cause central pain relief according
the imitation principle by means of
counter-irritation.
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Non-stimulatory effects These effects are
defined as effects caused independently from the
generation of action potentials. Non-stimulatory
effects at the physical and chemical levels of
efficacy Such effects are for instance movements
of freely movable charged particles, ions as
carriers of the electrical currents, of water
molecules (dipoles) and of charges fixed in
molecules as constituents of the tissue.
Results of these primary effects
are facilitation and acceleration of diffusion,
that means equilibration of concentration
differences, and the enhancement of the ability
of water to act as an solvent.
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End of Introduction, Theory , Part 1
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Practice, part 1
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Practice, part 1, High Tone Power Therapy -
HiToP A. The 2 modes of application of the
HiToP therapy 1. Whole body treatment
2. Regional (topical) treatments, mostly (a-e)
with SimulFAMi, only for stimulation of
nerves and muscles with SimulFAMX (f-g)
a. Shoulders b. Vertebral column and
abdominal region c. Hip d.
Knee e. Ankle f. Peripheral
stimulation of sympathetic fibres causing
vasoconstriction (upper arm) g.
Stimulation of muscles (M. quadriceps femoris, M.
triceps brachii, calf-muscles, abdominal
muscles)
22
The recommended whole body treatment carried out
besides the topic application has not only
general effects upon the mood and the general
condition of the patient moreover, the
superposition of the alternating electric fields
of the general treatment and the topical
treatment causes periodical changes of the
directions of the vectors of the local electric
fields responsible for the electrochemical
shaking effect. This kind of interference is used
for the support of non-stimulatory effects and
not for the generation of stimulatory effects,
realised in traditional interferential current
units, invented by NEMEC. HiToP allows the
use of more than two electrodes per channel. The
purpose is to compensate the different
sensitivities of different body regions or to
concentrate the effects in particular areas
respectively. Moreover, it is possible to treat
two different body regions in the same time using
only one channel
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B. The 2 modes of SimulFAM 1. SimulFAMi
- without stimulation of nerves and/or muscles
(ca. 80 of the applications in
practice) 2. SimulFAMX - for stimulation
of nerves and/or muscles (ca. 20 of
the applications in practice)
Only apparently complicated at the latest
convincing experiencing the feeling
The variability of the "slope" of
SimulFAMX and the advantage of
"paradoxical stimulation"
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SimulFAMX and its stimulatory frequencies The
choice of the most suitable frequency 0.3 Hz for
activation of the muscle pump (for instance
for the prevention of venous thrombosis and
for the treatment of edema) 3 Hz for
lipolysis 10 Hz for vasoconstriction (for
example after in juries and for the reduction
of edema) 20 Hz for tetanising stimulation of
muscles 100 Hz for central pain relief by means
of counter- irritation - only one of the 5 pain
relieving effects available in HiToP
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The modulation of frequency happens between two
corner frequencies, 212 Hz and 215 Hz. The
duration of one period of the slow
threshold-adapted modulation of frequency and
amplitude, SimulFAMi, is 144 s (2 min 24 s).
Frequency and amplitude will be changed all the
time stepwise periodically in the same direction,
either both upstairs or both downstairs. The
frequency of the fast simultaneous modulation
of frequency and amplitude (SimulFAMx) can be
varied between 0,1 Hz and 200 Hz. In this case
frequency and amplitude can be changed
periodically quickly either in the opposite
direction or in the same direction (upstairs or
downstairs). Opposite changes lead to more or
less brusque stimulation, corresponding changes
lead to softer stimulation (paradoxical
stimulation).
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End of practice, part 1
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Pictures illustrating the theoretical
background of high tone power therapy presented
after the first part of practice when the
participants of the seminar have acquired the
first practical experience with HiToP
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Threshold graph of the current sensation
Threshold current mA (eff)
Threshold curve
Frequency in Hz
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Threshold Curve
Threshold
Intensity
Sensation threshould beim Menschen in
Abhängigkeit der frequency
Threshold curve as a function of frequency
Frequency
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Threshold CurveSimulFAM i
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Threshold CurveSimulFAM i
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Threshold CurveSimulFAM i
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Threshold CurveSimulFAM i
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Threshold CurveSimulFAM i
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Threshold CurveSimulFAM i
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Threshold CurveSimulFAM i
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Threshold CurveSimulFAM i
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Threshold CurveSimulFAM i
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Threshold CurveSimulFAM i
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Threshold CurveSimulFAM i
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Threshold CurveSimulFAM i
Intensity
SimulFAM
i
f
f
Frequency
min
max
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Threshold CurveSimulFAM i
3 octaves in 72 steps of 1/4 tones 1 second each
Intensity
SimulFAM
i
f
f
Frequency
min
max
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SimulFAM X
t
ä
t
i
s
n
e
t
n
I
SimulFAM X
f
f
Frequency
max
min
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SimulFAM X
45
SimulFAM X
46
SimulFAM X
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SimulFAM X
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SimulFAM X
49
SimulFAM X
50
SimulFAM X
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SimulFAM X
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SimulFAM X
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SimulFAM X
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SimulFAM X
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SimulFAM X
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SimulFAM X
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SimulFAM X
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Advantages of SimulFAM X
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Advantages of SimulFAM X
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Advantages of SimulFAM X
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Advantages of SimulFAM X
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Advantages of SimulFAM X
Sensitive patient
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Advantages of SimulFAM X
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Advantages of SimulFAM X
Now Ifmax can be adjusted via the modification
knob as x of Ifmin.
Ifmax
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Advantages of SimulFAM X
Now Ifmax can be adjusted via the modification
knob as x of Ifmin.
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Paradoxical Stimulation via SimulFAM X
Now Ifmax can be adjusted via the modification
knob as x of Ifmin.
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Paradoxical Stimulation via SimulFAM X
Now Ifmax can be adjusted via the modification
knob as x of Ifmin until the patient has the
maximum comfort
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End of the presentation of pictures
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Theory, part 2
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Theory, part 2 History of High Tone Power
Therapy - HiToP The purpose of this new
development The effects in the tissue The effects
in the healthy body The use of HiToP in medicine
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Year of publication or introduction or start of
the development respectively, inventors and terms
of the introduced currents and methods 1935
KOEPPEN (Hoch-)"Tonfrequenzströme", (high) tone
frequency currents 1944 GILDEMEISTER
"Mittelfrequenzströme", middle frequency
currents 1948 NEMEC Interferenzströme,
interferential currents, using amplitude
modulation (AM) caused by interference of two
unmodulated middle frequency currents
between 4000 and 4100 Hz 1988 MAY HANSJÜRGENS
Electric differential therapy 1995 HANSJÜRGENS
MAY 1st generation of high tone therapy
equipment, using frequency
modulation (FM) for "horizontal
stimulation" within 1 1/2 octaves up to 12300
Hz 2000 MAY 2nd generation of high tone
therapy equipment High Tone Power
Therapy, HiToP, using simultaneous modulation of
frequency and amplitude, SimulFAM,
within 3 octaves between 4096 Hz and
32768 Hz, realised by gbo in Rimbach, Germany
72
The term "Tonfrequenzströme", "tone frequency
currents", was created by KOEPPEN 1935 in his
scientific publication "Tonfrequenzströme in der
Medizin", "Tone frequency currents in medicine",
and he still described important advantages and
special interesting effects appearing and rising
with increasing frequencies into the high tone
frequency range. Therefore, it is legitimate and
more precise to use the term "High tone frequency
currents" instead of "tone frequency currents",
because of the absence of the special advantages
within the lower tone frequency range. KOEPPENS
investigations concerning the high tone frequency
currents did not lead to any creations of
equipment for electrotherapy. GILDEMEISTER and
his pupil SCHWARZ were physiologists.
GILDEMEISTER created the term "middle frequency
currents" in his last paper, published 1944 after
his death 1943. SCHWARZ published many papers
concerning the physiological properties of the
middle frequency currents within the 40th and
50th of the 20th century. Without the knowledge
of the publications of KOEPPEN, GILDEMEISTER
SCHWARZ interferential current as the first
therapeutic application of middle frequency
currents was introduced by NEMEC after the second
world war.
73
The next step was the differentiation of the
therapeutic application of middle frequency
currents by the creation of the method of
"Electric Differential Therapy" (MAY
HANSJÜRGENS) to distinguish between stimulatory
and non-stimulatory effects - related to "low
frequency effects" and "middle frequency
effects" Unmodulated middle frequency currents
can be used for non-stimulatory effects, and
middle frequency currents modulated in there
amplitude within the low frequency range can be
used for stimulation of nerves and muscles
however, they contain additional non-stimulatory
effects. In the first generation of high tone
frequency treatment units, developed by MAY,
HANSJÜRGENS FORSTER within the middle of the
last decade of the last century, the next (3rd)
important step into the direction of increase of
efficacy and significant reduction or even
complete elimination of discomfort was realised
by the introduction of frequency modulation (FM)
- instead of amplitude modulation (AM).
74
"High Tone Therapy" is the abbreviation for
"Electrical High Tone Frequency Alternating Field
Therapy". As mentioned above, the first important
step to reduce the discomfort and the risks of
electrotherapy, furthermore to increase the
efficacy of electrical currents used for
therapeutic purposes was the introduction of
middle frequency currents as the so called
"interferential current" by the inventor Hans
NEMEC in the middle of the last century. KÖCHERT
and NEMEC founded the company NEMECTRON, and the
first generations of interferential current
treatment units, named Nemectrodyn, were more
successful, and the interferential current was
more comfortable for the patients than the other
currents (Galvanic current and low frequency
currents) used in electrotherapy.
75
The aim of the development of the HiToP High
Tone Power Therapy The aim of this development
was, to intensify and to combine already known
effects of the especially well tolerable
currents, the so called middle frequency
currents. Moreover, the equipment should
indicate not only the current intensity
(amperage) in mA as a singular quantitative
parameter of the applied electricity Now
additionally will be indicated the voltage in V,
the power in mW, the impedance in W and the sum
of the applied electrical energy in mWh. Until
now no other electrotherapy equipment offers such
completeness of indication of important electric
parameters.
76
Non-stimulatory effects at the biochemical level
of efficacy Increase of the probability of
meetings andcontacts between enzymes and
substrates Enzymes are biocatalysts. The
mediated biochemical reactions are in all cases
electrical events too, facilitated by means of
alternating electrical fields.
77
Conformation changes of signal molecules as a
reason for the activation of the
adenylatcyclase In several papers changes of the
intracellular formation of cAMP (cyclic
Adenosinemonophosphate, one of the most important
second messengers) caused by middle frequency
currents have been published (KORENSTEIN 1984
BRIGHTON TOWNSEND 1986 NOSZVAY-NAGY
1988-1994). Beneficial influences upon the
trophism of the tissues, anti-asthmatic,
generally activating and antidepressive effects -
within the therapeutic level of efficacy could
be explained by this electro-biochemical effect.

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Non-stimulatory effectsat the neurophysiological
level of efficacy Intensities of unmodulated
middle frequency currents distinctly above the
threshold causein nerves and muscles partial
depolarisation,in nerves correlated with a
block,in muscles additionally with a
physiological contracture. Below of these
relatively high intensities a range of
intensities exists which is characterised by
some particularities
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Non-stimulatory effects at the therapeutic level
of efficacy 1. Pain relief a.
symptomatic, immediate, transient
via distribution and thinning of mediators of
pain and inflammation via
blocking of afferent fibres involved in coding of
pain information b. causal,
longer lasting by facilitation and/or
activation of metabolic processes,
acceleration and abbreviation of healing
processes c. indirect by
anti-oedematous effects via reversible
physiological contractures of the smooth
muscles of the vessels including lymphatic
vessels
80
2. Acceleration and abbreviation of healing
processes, which are not accompanied by pain
(s. 1 b) 3. Local anti-oedematous effects
(explained under 1 c) and diuretic effects
81
As I partially still mentioned above, the most
important fundamental facts for the purposeful
development of the high tone therapy equipment
are originated from the publications of the
physiologists Martin GILDEMEISTER (Straßburg,
Leipzig), Friedrich SCHWARZ (Leipzig, Posen,
Jena), Oscar A. M. WYSS (Zürich), and of a
pioneer of physical medicine, Siegfried KOEPPEN
(Halle, Wolfsburg), furthermore from the
electrotoxicological investigations of GEDDES and
co-workers (1969). KOEPPEN already 1935
introduced the term Tonfrequenzströme, English
tone frequency currents, GILDEMEISTER 1944 the
term Mittelfrequenzströme, English middle
frequency currents", defined as alternating
currents with frequencies between ca. 1000 Hz and
100 kHz .
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1. The principle of apolar stimulation is
valid Using two electrodes (of the same
size) under both electrodes are generated
the same effects at the same time. Anodic or
cathodic effects do not exist. 2. The law of
Alles oder nichts (everything or nothing) is
not valid. With repetitions of tests of the
thresholds the values increase. 3. There are
no relations between the single phases of the
middle frequency current and the begin of
the triggered action potentials. 4. Around the
threshold single action potentials are triggered
irregularly, but this kind of ongoing
activity disappears after a while 5.
Intensities above the threshold trigger a
transient excitatory activity,
abbreviated tea immediately after the start
of the establishment of the alternating
electrical field the firing rate has its highest
values, followed by decreasing discharge
frequencies. Tea is correlated at the
psychophysical level of efficacy with a fading
tingling sensation. Tea leads to fatigue
of the involved excitable structures.
83
Monographs of WYSS (1975) and of his pupil SENN
(1980) contain comprehensive descriptions of the
history and the peculiarities of the middle
frequency currents. However, the descriptions
of the pain relieving effects of unmodulated and
modulated middle frequency currents are
incomplete. The possibilities to use either the
blocking or pseudo-blocking effects of
unmodulated middle frequency currents or the
counter-irritation principle (GAMMON STARR
1941), caused by the low frequency effects of
modulated middle frequency currents have not been
mentioned. On the other hand, just the pain
relieving effect by means of unmodulated middle
frequency currents can be easily explained by the
results of neurophysiological investigations of
WYSS and his pupils, for instance the reversible
reactive partial depolarisation, with other
words the plateau effect (KUMAZAWA WYSS
1966). These results, gained by means of
intracellular recordings, could be confirmed
later by extracellular recordings (BOWMAN 1981).
84
The cited publications reveal 1.) that the local
and systemic tolerability of alternating currents
above 50 Hz is increasing with increasing
frequencies and accordingly the possibility of
incoupling of electric power into the body is
increasing too with increasing frequencies
without any local discomfort and without any
risks for the heart, 2.) that these currents,
named (high) tone frequency currents or middle
frequency currents have particular advantageous
qualities in comparison to the traditional low
frequency currents and direct current.
85
The frequency-correlated increase of the
threshold of afferent fibres of the sensory
nervous system is also valid for the motor fibres
innervating the striated muscles (DALZIEL,
1941-1973), and we can assume for the sympathetic
fibres responsible for the smooth muscles of the
vasculature as well. As I still mentioned
above, originally, interferential therapy was
introduced by Hans NEMEC (1947/1950-1960) with
the aim to make the stimulating (stimulatory)
effects of traditional electrotherapy more
comfortable two unmodulated middle frequency
currents with slightly different frequencies
should be superimposed within the tissue to
generate interferential beats, a special kind of
amplitude modulation. The low frequency of beat
generation or amplitude modulation respectively
determines the frequency of the neuronal
responses, that means the frequency of action
potentials. Therefore, the differences between
the two middle frequencies have to be within the
low frequency range, that means mostly between gt
0 Hz and 100 Hz.
86
In comparison to the interferential therapy and
later introduced other modifications of middle
frequency therapy for the development of high
tone therapy (MAY, 2002) higher frequencies and
greater frequency ranges are included Interferent
ial therapy mostly is using middle frequencies
around 4000 Hz, in some equipment moderately
higher frequencies but below 10000 Hz. However,
the newest version of high tone therapy
equipment, more exactly high tone power therapy
equipment, HiToP, are able to generate
frequencies up to 215 Hz (32768 Hz), and between
212 Hz (4096 Hz) and 215 Hz 73 different
frequencies are available. In comparison to
NEMECs interferential therapy the highest
frequency in HiToP equipment is more than eight
times higher, and the range of frequency
modulation is more than 286 times higher 28672
Hz in comparison to 100 Hz.
87
In comparison to the interferential therapy and
later introduced other modifications of middle
frequency therapy for the development of high
tone therapy (MAY, 2002) higher frequencies and
greater frequency ranges are included Interferent
ial therapy mostly is using middle frequencies
around 4000 Hz, in some equipment moderately
higher frequencies but below 10000 Hz. However,
the newest version of high tone therapy
equipment, more exactly high tone power therapy
equipment, HiToP, are able to generate
frequencies up to 215 Hz (32768 Hz), and between
212 Hz (4096 Hz) and 215 Hz 73 different
frequencies are available. In comparison to
NEMECs interferential therapy the highest
frequency in HiToP equipment is more than eight
times higher, and the range of frequency
modulation is more than 286 times higher 28672
Hz in comparison to 100 Hz.
88
For therapeutic purposes mostly the mentioned 73
frequencies in logarithmic steps between 212 Hz
and 215 Hz are used. The factor is 2-24
corresponding a little bit less than 1,03.
Because of the great distance between the lower
and the upper corner frequency linear steps were
not suitable. The distances between the
neighbouring frequencies of tones in our music
are defined too as logarithmic steps. The factor
for the elevation in half tone steps is 2-12.
89
The decision for the term high tone frequency
therapy, abbreviated high tone therapy,
derived from relations to tones or music
respectively, resulted from the following
considerations 1.) The term high tone
frequency is more concrete than middle
frequency. The high tone frequency range ( 1000
- 20 000 Hz) covers the low middle
frequency range. 2.) The frequencies of the
first generation of equipment varied in
the high tone frequency range only. The new
generation, HiToP, includes even
frequencies of the ultrasound range.
Nevertheless, the introduced term has not been
changed besides in Poland there the term
energy tone therapy is preferred. Both
terms are ingenious high characterises the
means, namely the high tone frequencies as the
agens for the possibility for an easier
application of more energy, energy this
purpose itself. 3.) The distances between the
frequency steps correspond to distances of
quarter tone steps in music.
90
4.) By means of frequency scanning the
probability of resonance phenomena within
structures of the treated tissue should be
increased. Resonance plays an im- portant part
in music too. 5.) The new term should
emphasise the great difference to traditional
middle frequency units. 6.) It is possible and
useful to explain the modes of action of HiToP
by an loud-speaker. It facilitates the
understanding of the physical realisation of
the various programs, SimulFAMi and the
variations of SimulFAMx using modulation
frequencies between 0.1 and 200 Hz. The
demonstration of hearing emphasises the relation
to tones and the absence of similarity to a
current as a great river.
91
Main differences between traditional
electrotherapy and high tone power therapy
(HiToP) 1. Main differences in comparison to
direct current (DC) and low frequency currents
with DC-components HiToP is without any risks
of DC as chemical burning caused by
electrolysis.Vasodilatation and acceleration of
reabsorption of topically applied substances in
the treatment area, known as DC-iontophoresis,
can be achieved by HiToP too, but by other
mechanisms vasodilatation via fatiguing
stimulatory effects upon sympathetic fibres, and
the acceleration of resorption via an
electrochemical shaking effect resulting in
facilitation of diffusion.
92
2. Main differences in comparison to low
frequency currents HiToP has important
advantages Great superiority concerning
local and systemic tolerance, very much greater
spectrum of effects by additional sophisticated
utilisation of non-stimulatory effects. 3. Main
differences in comparison to traditional middle
frequency equipment The most important
difference or advantage respectively is basing on
the ability of HiToP to generate very much (up
to circa 50 times) more power without any
discomfort or systemic risks for the patient in
comparison to traditional middle frequency
equipment. HiToP offers 5000 mW as maximum output
per channel this limit of the output is
prescribed by law.
93
Additional advantageous differences The greater
frequency range increases the probability of
resonance. SimulFAMx, used for stimulation of
nerves including motor and sympathetic fibres,
can be adjusted as more brusque (combined or
parallel stimulation) or softer (paradoxical
stimulation) according the slope of the graph
representing the simultaneous modulation of
frequency and amplitude. SimulFAMi can be used
to minimise or avoid stimulatory effects
94
The spectrum of indications - unbelievable large
on the first view 1. Pain (5 pain-relieving
effects are available in HiToP) 2. Chronic
inflammations 3. Degenerative diseases, for
example osteoarthritis 4. Diseases of nerves and
muscles, for example symptoms resulting from
central and peripheral pathological
affection of the nervous system as spasticity in
cases of cerebral palsy or multiple sclerosis 5.
Edema 6. Mental-emotional disturbances 7.
Functional disorders of the abdominal organs
(Constipation, meteorism, dyskinesias,
symptoms of CROHN's disease and colitis 8.
Bronchial asthma 9. Itch 10. Sleeplessness 11.
Functional arrhythmia of the heart 12. Metabolic
disturbances and resulting diseases as for
instance diabetic polyneuropathy
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The 5 pain-relieving effects of HiToP 1. The
electrochemical shaking effect - present in
all kinds of application 2. The real blocking
effect - caused by unmodulated alternating
fields distinctly above the sensation
threshold 3. The pseudoblock - caused by
unmodulated alternating fields 4.
Counter-irritation - SimulFAMX 100 Hz 5. Indirect
pain relief by edema reduction - SimulFAMX 10
Hz
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Furthermore, HiToP can be used for the
following aims of treatment 1. Acceleration of
healing processes 2. Rehabilitation in cases of
peripheral or central neuronal lesions or
after immobilisation 3. Prevention of venous
thrombosis by means of calf muscle
stimulation 4. Mobilisation of geriatric patients
after long time of bed rest
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Scientific explanations of the manifold effects
in question and answer _______ Contraindications
Pacemaker Acute bacterial infections (local or
systemic)
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End of theory, part 2
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Practice, part 2
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Practice, part 2 Big tac, bimanual gliding
transcutaneous application of currents using
HiToP as especially comfortable electrical
massage, for the enhancement of the efficacy
during the manual lymph-drainage, for the
detection of trigger points, for the treatment of
BELL's palsy, for the manual-digital stimulation
of acupuncture points, for the massage of
reflex-zones of hands and feet
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End of practice, part 2
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Results of the study of RHADES and
SCHNEIDER concerning low back pain 18 patients
had been treated.The range of motion could be
improved by 5.3 (? 4.7), statistically
significant. The distance of the fingers to the
ground could be diminished by 3.7 cm (? 4.0) cm,
(significant). Pain relief after the end of the
treatment series in 8 patients (44), later
additionally in 3 patients (16.6), together
circa 60. Degree of pain reliefStatistically
high significant improvement from 6.25 (? 1.73)
to 3.44 (? 1.82) (NAS-Score).
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Fig.1 Judgement of the efficiency
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Fig. 2 Effects upon bowing and range of motion