About some results experienced by the introduction of the ... - Detensor

About some results experienced by the introduction of the
therapy-system Detensor¹ within the frame of rehabilitative
procedures for neurologic disorders
Candidate of medical sciences A.I. Romanov, T.S. Rakova, V.I. Schmyriov, O.V.
Balakirewa, K.L. Kienlein Dr. h.c. Russian Academy of Sciences
Rehabilitation Center of the Administration of the Russian Federation
The therapy system DETENSOR was developed in 1980 by Dr. h. c. K.L. Kienlein
(Germany). It is applied successfully in foreign countries at internal and orthopaedic
clinics for long term distention of the spinal column.
The principal of the Detensor-therapy utilizes inclined ribs, consisting of a material
which changes it’s firmness according to body weight. The recumbent patient on the
system produces optimally directed traction forces leading in their entirety to the relief
of the kinematic system of the spine. The spine itself is placed in an anatomically and
functionally favorable position.
The system consists of a mattress and a therapy mat. The mattress for sleep
generates a distention of 5-10% body weight, the therapeutic mat averages from 18-
25%.
Important advantages of the system consist of a pleasing design, absent complicated
hardware as straps, weights et al, that might create a stress upon the patient. A
uniform long term distention is further possible. Torsional movement during the
distention procedure are not only possible but indicated. I contrast to the classical
devices (as Glisson sling, suspension slings etc., which were used prior to the
development of the DETENSOR), this method does not lead to excessive distention.
Consequently it excludes possible traumatization extending the range of application
of the DETENSOR-system.
The DETENSOR-therapy was introduced in the rehabilitation center within the frame
of cure and rehabilitative produced which consisted of neurologists, physiatrists and
intermediate medical service personnel.
Rooms n the neurology department of the rehabilitation center were equipped with
the DETENSOR and implemented by a consulting service responsible for compiling
DETENSOR-therapy concepts and corrections during different phases of
rehabilitation. It is intended to combine this with rational psychotherapy, music
therapy as well as reflex zone therapy.
¹ Detensor is a registered trademark
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The treatment was carried out on the basis of methodic recommendations by Dr. K.L.
Kienlein and the associated consultant for DETENSOR-therapy, O.V. Balakirewa,
both having conducted frequent seminars at the rehabilitation center.
The DETENSOR-system was used from December to June 1995 in the neurology
department of the rehabilitation center on 61 patients with vertebral pain syndrome of
differing regions. Regressions of pain was determined in 32 patients during an
average of 5 treatments, 19 patients after 10 treatments and 9 patients after 15
treatments. Distinctively positive developments of the pain syndrome and muscle
tonus were found. The therapeutic effect of a singular treatment could be maintained
for a few hours when following the recommendations for static and dynamic loading.
Changes in clinical data as haemodynamic parameters as well as theographic
changes were evaluated. Further, the therapeutic progress was examined
radiolodically.
Several patients are introduced who had undergone DETENSOR treatment:
Patient A, 32 years: Diagnosis: Nerveroot syndrome L5-S1, diskal prolaps left
prosterior L5-S1. Spinal osteochondrosis, frequent recividation.
Admission to rehabilitation center with severe signs of neurologic deficits which had
not been improved by prior cure and rehabilitative procedures including medication
and physiotherapy. The patient declined any operative intervention. The patient was
accommodated in a room equipped with the DETENSOR-system. Minimal
medication (vitamin therapy, biostimulators, short diuretic therapy) mat (30-40 min. 3
times daily) and on the mattress (twice daily reaching a total time of 10-12 hours) as
well as rational therapeutic gymnastics, led to a complete recovery from the signs of
neurological deficits within 17 days of in-patient care.
Patient P, 58 years, was admitted at the rehabilitation center in a state of progressive
(9 months) rediculopathy in the region L4-S2 in spite of prior unsuccessful therapy
attempts. Computertomography of the lumbo-sacral region revealed a protruded disk
L4-L5, L5-SI, with nerveroot compression and edema in the investigated ranges l3-
S1. Under DETEMSOR-therapy in combination with physiotherapeutic treatment
(swimming, Bischofit baths) and minimal medication (vasoactive and diuretic
preparations in short-term treatment, vitamincompounds and antidepressants). A
considerable regression of the pain syndrome after 15 days of treatment was
observed with regeneration of muscle mass of the affected extremities as well as in
the posture.
Patient Z., 46 years with onset of cerebral vascular insufficiencies, with vertebral
basilar syndrome and osteochondrosis of the cervical spine in the background. Aside
from the common ailments, the patient exhibited an instable gait, inhibited
articulation, bradylalia, as well as pronounced mobility restrictions in the cervical
region upon admission at the rehabilitation center. DETENSOR-therapy with the
therapy mat was carried out 3x daily for 40 minutes in combination with rational
psychotherapy and therapeutic gymnastics. Further, a balneologic treatment as well
as medicative therapy (small dosages of tranquilizer and vitamin preparations) were
administered. DETENSOR-therapy was included in these cure and rehabilitative
procedures during 5 days. A perseptible improvement of the condition could be
observed from the first treatment on. The 5 th treatment led to a complete regression
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of headaches (paroxysms and background pain), active and passive mobility in the
cervical region had increased. After 15 days, the signs of neurological deficit had
subsided.
During the reported time period, the DETENSOR-therapy was applied to 9 patients
14-20 days following spinal surgery (post laminectomy syndrome). In comparison to
previous observations, the duration of the rehabilitation period was reduced by 35-
40%, which agreed with the statements of Dr. h. c. K. L. Kienlein.
Use of the DETENSOR-therapy produced also positive results in the treatment of
spinal insults (apparently accelerating rehabilitation by inclusion of the DETENSORtherapy).
According to our opinion, it was meaningful to prescribe the use of the DETENSORtherapy
in the postoperative period of patient N., 63 years, upon renewed removal of
a gigantic sundial like neurofibroma of stage Th 4-6 with pronounced postoperative
signs of neurological deficits (sensory deprivation), differing but severe pain
syndromes, postoperative complications in form of ventile pneumothorax, reactive
pleuritis, relaxation of diaphragm cupola, as well as compensation. For this patient,
the DETENSOR-therapy was performed for 20 days on the mattress. Further,
minimal doses of vasoactive preparations were adminstered. Under this cure and
rehabilitation treatment, the pain syndromes steadily regressed after 5 days of
DETENSOR-therapy, after 9-10 days the shooting pains had vanished completely.
Comparing this with the rehabilitative treatments after the first operation, an
equivalent effect, as in this case, could be reached four times faster without
administration of analgesics.
Use of the DETENSOR-system led to positive development of sleep disorders with
slight doses of soporifics, where the latter could be terminated in 17% of the cases.
Nocturnal snoring ceased in 4 of the observed patients of middle age. In 87% of the
cases, the DETENSOR-therapy led to regulation of the arterial B.P. at the adapted
level in the first treatments. This occurred not only at high arterial B.P. but also in
cases of hemodynamic insufficiencies of the cure and rehabilitative procedures
permitted the reduction for the dosage of B.P. depressants. The results became
stabilized during long term therapy on the DETENSOR (over 14 days).
Following the instructions for the DETENSOR-therapy and considering the character,
the body weights and individualities of the medical history, the following side effects
were registered: Short term vertigo in 0.5% of the cases in the first treatment and in
0.09% of the cases in the second treatment.
The experiences of the DETENSOR-therapy in the practice of treatment at the
rehabilitation center prove the collective possibilities of the method in the treatment of
vertebral disorders as well as general somatic changes. According to our opinion, the
DETENSOR—therapy is capable of reducing myohypertonicity to reestablish spinal
mobility and a comfortable psycho-emotional state by gentle distention effects under
the conditions of long term relaxation. Based on the above mentioned information
and the assumed improvement of segmental innervation in connection with a
corrected muscle tonus determine amongst others, the positive course of somatic
processes accompanied by maximally agreeable conditions for the metabolism in the
elimination of neurotrophic changes.
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