Mototherapy

MOTOTHERAPY (from Lat. motus-movement and Gr. therapeia-treatment), literally treatment by movement; this term appeared in the USSR relatively recently, beginning approximately from 1923, that is, from the moment when the movement in favor of applying individual means of physical culture for the purposes of therapy of various diseases began here. Proceeding from the very concept of M., all various kinds of movements applied for therapeutic purposes should be included in the composition of this discipline, starting from the simplest gymnastic analytical exercises, which characterize massage, as well as individual kinds of medical gymnastics, and ending with complex synthetic movements, which constitute the content of physical culture or labor processes. To this must be added that the composition of M. also includes all kinds of movements applied with the aid of apparatus (massage devices for producing vibrations or other massage manipulations, mechanotherapy in the narrow sense of the word, Zander gymnastic apparatus, Krückenberg apparatus, etc.). If one compares the content of the concept of M., as it was first defined by Georgi, with what we have in this field at present, then it should be stated that enormous changes have occurred here; this evolution can be observed in any department of M. First of all, the methods of applying massage have changed significantly, and especially great successes have been achieved in the mechanization of the field of massage. Thanks to a number of special devices, it became possible to perform massage where, due to anatomo-topographical conditions, this was or extremely difficult (massage at the exit of the sciatic nerve, supra- and infraorbital nerve) or completely inaccessible (nasal cavity, ureters). Thanks to the introduction of devices allowing one to vary with great precision the force and frequency of the movements produced, it became possible to exert various physiological effects on tissues and organs of the human body during massage; at the same time, the energy of the worker is saved to a significant extent. At present there is a large independent department of the so-called vibratory massage, or seismotherapy, to which an extensive special journal literature is devoted and about the application of which there are dozens of manuals. Even greater differentiation and development are observed in medical gymnastics. From this department of M., a number of large independent subdepartments have gradually been distinguished, for example, respiratory gymnastics, corrective gymnastics, coordination gymnastics, etc. In relation to coordination gymnastics, it can be said that the history of its origin is quite old. The merit in the creation of coordination gymnastics belongs to the Swiss physician Frenkel. Further scientific substantiation of this method belongs to Jacob, Eulenburg, Grasset, Foerster, and others. These works served to distinguish the system of coordination exercises into an independent department under the name of coordination gymnastics, the indications for the application of which at present are increasingly deepening and expanding. At present there is medical gymnastics for children, medical gymnastics for infants (Speransky, Medovikov). In recent times, a new large and extremely important department of physical culture has joined M. We are indebted to Bier, Kohlrauch, Kisch for the wide propaganda of the application of physical exercises for therapeutic purposes, and in our USSR to N. A. Semashko, V. A. Gorinevsky, and others. At present, a new kind of M. - labor process - is entering practice. The scientific development of the question of the application of labor process for therapeutic purposes, the so-called labor therapy, as well as clinical substantiation of this method, belongs in the West to Schwartz, Faslem, and in the USSR to Bekhterev, Krummiller, Ilon, and others. The idea of applying the labor process is not new, and it was first applied to the mentally ill. In Russia this method began to be applied from 1873 in the Kolmogorov hospital near Novgorod. At present, labor therapy represents a large department of M., having behind it a significant literature. The indications for the application of labor therapy are becoming wider and wider every year. Analyzing the character of the effect of each of the individual motor means included in the composition of M., it is necessary to point out that a sharp difference exists among them, and while some of them, for example massage or medical gymnastics, mainly exert a selective effect on individual parts or organs of our body, others - physical exercises in the broad sense of this word, as well as labor processes - exert an effect on the whole organism as a whole; in other words, in some cases we have predominantly a local effect, and in other cases the general effect on the organism comes to the fore. Such a difference is naturally relative due to the organic unity which the entire human organism represents as a whole. A significant difference is also observed between the individual motor means included in the composition of M. in terms of the choice of muscular movements. In some cases the choice of movements is limited (medical gymnastics), in others it is extremely wide (physical culture). While in medical gymnastics the movements in most cases are stereotyped and artificial, and also devoid of any emotionality, physical culture exercises, if they are applied for therapeutic purposes, give an extremely diverse set of movements and a specific charge for the whole organism. Labor movements exert a completely special character of effect on the organism. Here we have the involvement of the most various muscular groups (depending on the type of work). Labor movements to a large extent exercise individual neuro-muscular functions, and the wealth of these neuro-muscular functions in turn varies depending on this or that type of work; these movements develop muscle sense, coordination of the visual-motor apparatus, firmness and precision of the hand, subtlety of sensation through the instrument, muscle-joint sense, coordination of movements of the hands, trunk, and legs. In addition to the aforementioned psycho-physical functions, attention, constructive abilities, the ability to analyze, etc., participate in all these works. In relation to indications for the application of M., the path which it has gone through in the field of treatment of joint diseases over the last 50 years is extremely instructive. On this path the following 3 stages are clearly distinguished: the first - complete prohibition of movements regardless of the etiology of joint lesions, on the basis of which the exclusively strict principle of immobilization was laid down. The second stage is characterized by the prohibition of movements in the acute stage and the admission of them in the chronic stage. Finally, on the third stage the principle of wide application of massage, active and passive movements, both in the chronic and acute stages, in a number of joint lesions is put forward: exudative or adhesive chronic arthritis, genuine dry arthritis, etc. Even further, Munk considers it necessary to apply movements as early as possible in acute joint diseases; in order to eliminate painfulness when applying movements, he uses various analgesic means: injections of morphine, 2% cocaine, etc. In the same way, at present the limits for the application of M. in diseases of the lungs, heart, and other internal organs have been significantly expanded. In this case, the presence of organic disorders, for example heart defect or pulmonary tuberculosis, is by no means an absolute contraindication for the application of M. As for disorders of metabolism (gout, obesity, diabetes), in these diseases M. is applied with especially great practical success. Lit.-see literature to articles Gymnastics and Massage.