Functional research methods are methods of studying the work of the body, i.e. functioning of its organs and systems, according to several manifestations. Among them are electrical (ECG, EEG, EMG, etc.); sound (phonocardiography, phonopneumography for example); kinetic (registration of motor activity of the system); mechanical (sphygmography, spirometry, etc.).
Electrical manifestations are based on the fact that during the work of any organ, biopotentials arise, which are recorded by devices. Sound - on the same principle.
Although functional research methods are auxiliary, they allow to detect pathologies at an early stage when there are no clinical manifestations yet. They help to control the effectiveness of the therapy and can predict the outcome of the process. The number of functional research methods for each branch of medicine is huge, and it is impossible to describe them in one article, even briefly listing them. After all, this is almost the entire arsenal of modern medicine.
Functional diagnostics
There is also the concept of functional diagnostics - it is based on the fact that the work of the bodyat rest and load is always different, and, having the initial static data, it is possible to diagnose a particular pathology by the nature of the recovery period. Functional diagnostic methods of research - the study of the reaction of the system to any dosed effect obtained during a functional study, in other words. It operates with concepts such as functionality and functional ability.
The first is defined at rest and is a static concept. Here you can add, for example, all anthropometric data, homeostasis, VC (vital capacity of the lungs), conduction of the heart, etc. Having a high growth, for example, there is an opportunity to play basketball. But to become such a player, one must be able to use this growth, that is, to train. Then the functionality goes into functionality.
What does such functional diagnostics give?
This is the key to understanding the pathogenesis of diseases, it determines the adaptive capabilities of the organism as a whole or its individual organs and systems. This is primarily the heart and blood vessels, the nervous and respiratory systems, the neuromuscular apparatus.
The essential feature of this branch of medicine is that it does not give the same standard for everyone. Each organism works in its own way. At the same time, each person is given different loads in different conditions and the results of repeated examinations are compared.
In addition, the functional characteristics of a person change with age - from the development of a child to old age. These are the stages that are natural for a person, and theseprocesses are ongoing. But they are not simultaneous and uneven. Changes in the elderly and senile age are already irreversible.
The old age includes the period from 55 to 75 years (for women), from 60 to 75 years (for men). This is followed by the older, or senile, age (75-90 years). After 90 years - these are centenarians. Many theories of aging have been created, but all of them recognize the role of age-related mutations in the gene apparatus of the cell. It is impossible to reverse the process, but you can slow down its intensity: physical activity, nutrition, lifestyle.
Most famous systems research methods
The most popular research methods are:
- Spirography (residual lung volume), spirometry, pneumotachometry (air flow volumetric velocity), oximetry, peak flowmetry (peak expiratory flow) are used to study the respiratory organs.
- Functional research methods in cardiology - sphygmography, mechano-, ballisto-, seismo-, electro-, poly-, phonocardiography, rheography, impedanceography, plethysmography, pulsometry, etc.
- Pathologies of the gastrointestinal tract are detected by methods such as duodenal sounding, ultrasound, esophagoscopy, colonoscopy, examination of gastric juice, bile, etc.
- The brain is examined using EEG.
- Study of kidney function - tests to determine their concentration ability - Zimnitsky test, for breeding, Kukotsky, Nechiporenko, etc.
- Determination of clearance - determination of glomerular filtration rate.
- Ophthalmology - detection of visual acuity without glasses.
- Dentistry - here the entire work of the lower jaw is studied and the electrical efficiency of the muscles is assessed, etc.
Do not list all sections.
The study of the cardiorespiratory system is of primary importance in functional research methods, since it is the central link in the chain of oxygen delivery to the muscles. What are its indicators? Those that determine the performance of the heart: the value of cardiac output, the frequency and strength of contractions, the gas composition of the blood, etc. Some studies in dentistry will also be considered.
Functional trials
Functional tests of the cardiovascular system provide additional information about the overall physical fitness of the heart and determine the reserve capacity of the body. The examination is carried out at rest and then after exercise as a response to physical stress. The loads are dosed.
Orthostatic test
The subject lies motionless for 3 minutes. His pulse rate is determined, his blood pressure is measured, then he is offered to stand up calmly. Again measure the same indicators. Normally, the difference in pulse should not exceed 10-14 beats / min, and the pressure changes by no more than 10 mm Hg. st.
Wedge orthostatic test (COP)
This test is carried out with the transfer of the patient from a vertical to a horizontal position, i.e. in reverse order. The same parameters are measured. Normal heart rateslows down by 4-6 beats per minute; pressure fluctuations are similar to the first sample. These tests give a small load, they do not so much show the capabilities of the heart as the excitability of the central nervous system.
Genchi test with breath holding
It is carried out on exhalation: after a normal (not excessive) exhalation, hold your breath. A he althy one can delay it for 20-25 seconds. In the presence of deviations in the state of the heart, the time is halved. Here, the patient's willpower may matter, and the practical value of such a test will be small.
Electrocardiography (ECG)
Reveals the electrical activity of the myocardium and evaluates all the physiological capabilities of the myocardium:
- Automatism, conduction and excitability.
- Depolarization of the chambers of the heart, as well as ventricular repolarization.
- Gives a picture of the rhythm of the heart.
Phonocardiography (PCG)
Records tones and noises of the working heart graphically - shape, frequency, amplitude. This makes it possible to clarify auscultatory data: sound symptoms are objective and accurate. Used in combination.
Polycardiography (PCG)
Method of synchronous simultaneous registration of ECG, FCG and sphygmogram of the carotid artery, the structure of the phase of the heart cycle is assessed. Sphygmogram of the carotid artery helps to accurately calculate the phases of the left ventricular systole and analyze the diastole.
Variational pulsography (VPG)
Analyzes the distribution of cardio interval values. It shows the predominance of para- or sympathetic regulation.rhythm.
Impedansography (IG)
Impedance is the total resistance, which is the sum of the ohmic resistance of liquid media to alternating current and the capacitive resistance of the skin (at the point where the electrode touches the body). The general and peripheral blood circulation is determined by registering fluctuations in the electrical resistance of tissues during their blood supply.
Normally, they occur gradually and synchronously with the contractions of the heart. For research, a high-frequency and low-power current is used. Impedanceography makes it possible to study the hemodynamics of any part of the body, as well as to determine the stroke volume (SV).
Echocardiography (EchoCG)
Myocardium and blood in the chambers of the heart have different acoustic density, and a picture of the internal structures of the beating heart of the contracting myocardium, valve leaflets, etc.
Ultrasound of the heart is based on the property of ultrasound to reflect differently from structures with different acoustic density. The sound goes through a whole chain of transformations - reflection, perception, amplification and transformation into an electrical signal that is fed to the recorder.
Doppler ultrasound (USDG)
The ultrasound method is focused on the study of blood flow, its time and speed indicators. The principle is that the frequency of the ultrasound sent by the transducer changes in direct proportion to the linear velocity of the blood flow, and the reflected ultrasound is recorded on the same transducer.
Methods in dentistry
Functional research methods in dentistry are in demand because they significantly expand the possibilities of diagnosing diseases in almost all its sections, made it possible to objectively evaluate the results of treatment, predict the outcomes of pathologies.
The movements of the lower jaw, the electrical activity of the muscles, the state of blood flow in the tissues, etc. are studied. Kinesiology studies the dysfunction of the TMJ by drawing a graph of the trajectory of the point of the central lower incisor or head.
The lower jaw is multifunctional, it provides a person with the ability to speak, chew, swallow, sing, etc. This is possible due to its ability to move in 3 directions: vertical (up and down), sagittal (forward and backward) and transversal (to the right and to the left). But the movements of the lower jaw do not occur on their own, they depend on the dentition, bite, TMJ (temporomandibular joints), periodontal, and also on the strength of the muscles that are attached to it. Therefore, the study of its movements allows you to study each of these components in the norm and in diseases.
Masticography
The method of mastication was developed by I. S. Rubinov back in 1940. Its disadvantage was that it revealed the work of the lower jaw only in the vertical plane (opening and closing the mouth). Today, the methods are more advanced: modern functioniographs allow you to register movements in all 3 dimensions, determine the speed of its movement and simultaneously register electromyograms.
Periotestmetry
The method gives an indirect assessment of functionalcapabilities of the periodontium under the influence of external forces. It converts an electrical impulse into a mechanical one. During examination, the tooth is percussed with a special sensor at high speed (every 250 ms) at the level between the cutting edge of the tooth and its equator (the most convex part).
After that, the response is registered by the device's microprocessor. It depends on the elasticity and endurance of the dental ligamentous apparatus. With a he althy periodontium, the data range from -5 to +10 units. With periodontal diseases, they increase: from +10 to +30 or more units.
Electromyography description
What is electromyography? This is a study of skeletal muscle movements based on the registration of their biopotentials. The technique is used to diagnose and assess the functional state of the masticatory muscles in case of injuries and inflammations, after reconstructive operations in the maxillofacial region, TMJ diseases, in orthopedic dentistry.
What is electromyography? An objective method for studying the neuromuscular system by recording the electrical potentials of the masticatory, temporal, facial, tongue and floor of the mouth muscles. Examine the state of rest and under load - with maximum tension, chewing, swallowing, speech and protrusion of the lower jaw forward.
Rheography, or impedanceography, which has already been mentioned, is used in dentistry to assess the functional state of the dental pulp, periodontal tissues, oral mucosa with fixed, removable and clasp prosthetics (a type of removable prosthetics).
Radioisotope diagnostics
Based on the fact that radioactive isotopes accumulate in affected organs and tissues. They are selectively absorbed by them, with the help of this method it is possible to carry out radiosialography (quantitative characteristics of the work of the salivary glands), radioscanning of the salivary glands and periodontium, radiometry and determine the nature of the healing of fractures of the jaws, tumors of the maxillary fossa.
Intravital microscopy, or contact biomicroscopy, is a morphological and functional method for studying the blood supply to periodontal tissues and oral mucosa. To do this, devices with luminescence are used to examine the studied tissues in polarized reflected light.
Axiography
Displacement of the axis of the articular head of the lower jaw in the sagittal and vertical planes forms a path characterized by distance and a trajectory that looks like a curve that forms with the Frankfurt plane (orbital-ear horizontal) the angle of the lateral articular path, or Bennett angle. When projected onto a horizontal plane, this is the angle between the anterior and lateral movements of the articular head. It averages 17°.
Axio-or condylography is used to record and measure the articular path. Those. axiography in dentistry - registration of movements of the lower jaw. A graphic recording of the trajectory is made using an axiograph. The results of the study are displayed on a computer monitor. This allows you to reproduce, increase each movement of the joint, superimpose it on another and compare with the norm.
Price of axiography ranges from 2800 to 5300 rubles. Without her todayorthodontic treatment is not possible. It applies:
- for TMJ dysfunctions;
- pain in the jaw when moving;
- crunch or click in the jaw when moving;
- choosing braces, plates or other orthodontic appliances.
The price of axiography is great. But the significance of the study cannot be overestimated.
Chew test
Evaluation is based on 3 indicators. This is the effect, efficiency and chewing ability.
Technique of functional chewing test: the essence of the experiment is explained to the patient. Then they are offered to chew them in pre-prepared portions. A serving is 5g of almonds.
Chewing starts and stops after the signal. After 50 seconds, the entire mass is spit out into the basin.
Then they offer to rinse your mouth with boiled water and spit it into a basin - 2 times.
The mass is collected, dried and weighed to the hundredth of a gram. Then, according to a special formula, the amount of loss of chewing efficiency is determined.
Persin method (Karl Pearson) is used to count chewing movements. Its essence is that the movement of the circular muscle of the mouth is being studied.
Ultrasonic osteometry
Acoustic method - comparison of the delay time of ultrasonic pulses measured in the same areas of the damaged and intact bone. During fractures, the speed of sound conduction decreases by 200-700 cm/s.
All functional research methods are auxiliary and should be combined with clinicaldata.
