Functional research methods are methods of studying the work of the body, i.e. the functioning of its organs and systems, according to several manifestations. Among them - electric (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 operation of any organ, biopotentials arise, which are recorded by devices. Sound - on the same principle.
Although functional research methods and auxiliary, but they allow you to identify pathologies at that early stage, when there are no clinical manifestations. They help 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 it. 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 organ’s work at rest and load is always different, and having the initial static data, one or another pathology can be diagnosed by the nature of the recovery period. Functional diagnostic methods of research - the study of the response of the system to any dosed effect obtained during a functional study, in other words. She operates with concepts such as functionality and functional ability.
The first is determined at rest and is a static concept. Here you can add, for example, all anthropometric data, homeostasis, VC (vital capacity of the lungs), cardiac conduction, etc. Having high growth, for example, you can go in for basketball. But in order to become such a player, one must be able to use this growth, that is, to train. Then the functionality goes into functionality.
What gives such a functional diagnosis?
This is the key to understanding the pathogenesis of diseases, it determines the adaptive capabilities of the body as a whole or its individual organs and systems. This is primarily the heart and blood vessels, nervous and respiratory systems, neuromuscular apparatus.
An essential feature of this section 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 - starting with the development of the child and ending with old age. These are stages that are natural for a person, and these processes occur continuously. But they are not simultaneous and uneven. Changes in old and old age are already irreversible.
To advanced age include the period from 55 to 75 years (for women), from 60 to 75 years (for men). The following is the senior, or senile, age (75-90 years). After 90 years, they are centenarians. Many theories of aging have been created, but they all recognize the role of age-related mutations in the cell’s gene apparatus. It is impossible to reverse the process, but it is possible to slow down its intensity: motor activity, nutrition, lifestyle.
The most famous research methods for systems
The most popular research methods are:
- Spirography (residual lung volume), spirometry, pneumotachometry (volumetric velocity of an air stream), oximetry, peak flowmetry (peak expiratory flow rate) are used to study respiratory organs.
- Functional research methods in cardiology - sphygmography, mechano-, ballistic-, seismo-, electro-, poly-, phonocardiography, rheography, impedanceography, plethysmography, heart rate monitoring, etc.
- Gastrointestinal pathologies are detected by such methods as duodenal sounding, ultrasound, esophagoscopy, colonoscopy, examination of gastric juice, bile, etc.
- The brain is examined using EEG.
- The study of the kidneys - 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 all the work of the lower jaw is studied and the electrical efficiency of the muscles, etc. is assessed.
All sections can not be listed.
The study of the cardiorespiratory system is of primary importance in functional research methods, since it is this system that is the central link in the chain of oxygen delivery to muscles. What are her indicators? Those that determine the performance of the heart: the amount 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 Tests
Functional tests of the cardiovascular system provide additional information about the general physical fitness of the heart and determine the reserve capabilities 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 examined person lies motionless for 3 minutes. They determine the pulse rate, measure the pressure, and then offer to calmly stand up. Again measure the same indicators. Normally, the difference in heart rate should not exceed 10-14 beats / min, and the pressure does not change by more than 10 mm RT. Art.
Wedge-orthostatic test (CPC)
This test is carried out with the patient moving from a vertical to a horizontal position, i.e. in reverse order. Measure the same parameters. Normally, the heart rate slows down by 4-6 beats per minute; pressure fluctuations are similar to the first test. These samples 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 the usual (not excessive) exhalation, hold the breath. Healthy can hold it for 20-25 seconds. In the presence of deviations in the state of the heart, time is halved. Here the patient's volitional effort may be of importance, and the practical value of such a test will be small.
Electrocardiography (ECG)
Detects the electrical activity of the myocardium and evaluates all the physiological capabilities of the myocardium:
- Automatism, conductivity and excitability.
- Depolarization of the heart chambers, as well as ventricular repolarization.
- Gives a picture of the rhythm of the heart.
Phonocardiography (FCG)
Records tones and noises of a working heart graphically - shape, frequency, amplitude. This makes it possible to clarify auscultatory data: the sound symptomatology is objective, accurate. It is applied in a complex.
Polycardiography (PCG)
The method of simultaneous simultaneous registration of ECG, FCG and sphygmograms of the carotid artery, the structure of the phase of the heart cycle is estimated. A sphygmogram of the carotid artery helps to accurately calculate the phases of systole of the left ventricle and analyze the diastole.
Variational pulsography (HSV)
It analyzes the distribution of the values of cardio intervals. It shows the predominance of para- or sympathetic regulation of the rhythm.
Impedansography (IG)
Impedance is the total resistance, which consists 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 recording 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 current of high frequency and low power is used. Impedansography makes it possible to study the hemodynamics of any part of the body, as well as determine the stroke volume of blood (UO).
Echocardiography (echocardiography)
Myocardium and blood in the chambers of the heart have different acoustic densities, and a picture of the internal structures of the working heart of a contracting myocardium, valve flaps, etc. is obtained.
Ultrasound of the heart is based on the property of ultrasound to reflect differently from structures with different acoustic densities. Sound goes through a whole chain of transformations - reflection, perception, amplification and conversion into an electrical signal, which is fed to the recorder.
Doppler ultrasound (Doppler ultrasound)
The ultrasound method is focused on the study of blood flow, its temporal and speed indicators. The principle is that the frequency of the ultrasound sent by the sensor changes in direct proportion to the linear velocity of blood flow, and the reflected ultrasound is recorded on the same sensor.
Methods in Dentistry
Functional research methods in dentistry are in demand because they significantly expand the possibilities of diagnosing diseases in almost all of its sections, made it possible to objectively evaluate the results of treatment, and predict the outcome of pathologies.
The movements of the lower jaw, the electrical activity of muscles, the state of blood flow in tissues, etc. are studied. Kinesiography studies the dysfunction of the EMF 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 opportunity 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 (left and right). But the movements of the lower jaw do not occur on their own, they depend on the dentition, occlusion, TMJ (temporomandibular joints), periodontal disease, and also on the strength of the muscles that are attached to it. Therefore, the study of its movements allows us to study each of these components in the norm and in diseases.
Masticiography
The method of masticatiography was developed by I. S. Rubinov back in 1940. Its minus was that it revealed the work of the lower jaw only in a vertical plane (opening and closing the mouth). Today, the methods are more advanced: modern functiographers 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 the periodontal functionality under the influence of external forces. It converts an electrical impulse into a mechanical one. In the study, the tooth is percussed at high speed with a special sensor (every 250 ms) at a level between the cutting edge of the tooth and its equator (the most convex part).
After that, the response is recorded by the microprocessor of the device. It depends on the elasticity and endurance of the dental ligamentous apparatus. With a healthy periodontium, the data is 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 recording their biopotentials. The technique is used to diagnose and assess the functional state of the masticatory muscles in injuries and inflammations, after reconstructive operations in the MFA, TMJ diseases, and orthopedic dentistry.
What is electromyography? An objective method for studying the neuromuscular system by registering the electric potentials of the masticatory muscles, temporal, facial, tongue and bottom of the oral cavity. Examine the state of rest and under load - at maximum stress, chewing, swallowing, speech and pushing the lower jaw forward.
Rheography, or impedanceography, which has already been mentioned, is used in dentistry to assess the functional state of tooth pulp, periodontal tissues, and the oral mucosa with fixed, removable, and arch prosthetics (a type of removable prosthetics).
Radioisotope Diagnostics
It is based on the fact that radioactive isotopes accumulate in affected organs and tissues. They are selectively absorbed by them, using this method it is possible to carry out radio sialography (quantitative description of the salivary glands), radio scanning of the salivary glands and periodontium, radiometry and to determine the nature of the healing of jaw fractures, TLS tumors.
Intravital microscopy, or contact biomicroscopy, is a morphofunctional method for studying the blood supply to periodontal tissues and oral mucosa. To do this, use devices with luminescence to examine the studied tissue in polarized reflected light.
Axiography
The displacement of the axis of the articular head of the lower jaw in the sagittal and vertical planes forms a path characterized by a distance and a trajectory in the form of a curve that forms the angle of the lateral articular path or the Bennett angle with the Frankfurt plane (ophthalmic horizontal). When projecting on a horizontal plane, this is the angle between the front and side movements of the articular head. On average, it is 17 °.
To record and measure the articular path using axio - or condylography. Those. axiography in dentistry - registration of movements of the lower jaw. The trajectory is graphically recorded 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, impose it on another and compare with the norm.
The price of axiography ranges from 2800 to 5300 rubles. Without it today, orthodontic treatment is impossible. It applies:
- with TMJ dysfunctions;
- pain in the jaw during movements;
- crunching or clicking in the jaw during movements;
- selection of bracket system, plates or other orthodontic appliances.
The price of axiography is high. But the importance of research is difficult to overestimate.
Chewing test
Assessment is carried out on 3 indicators. This is the effect, effectiveness and ability to chew.
Functional chewing test technique: the essence of the experiment is explained to the patient. Then pre-prepared portions offer to chew them. A serving is 5 grams of almonds.
Chewing starts and stops after the signal. After 50 seconds, the entire mass is spat out in the basin.
Then they offer to rinse your mouth with boiled water and spit it out in a bowl - 2 times.
The mass is collected, dried and weighed to a hundredth of a gram. Then, according to a special formula, the size of the loss of chewing effectiveness is determined.
To count the chewing movements use the Persin method (Karl Pearson). Its essence is that the movement of the circular muscle of the mouth is studied.
Ultrasound osteometry
The acoustic method is a comparison of the delay time of ultrasonic pulses measured on the same areas of damaged and intact bones. During fractures, sound conduction speed decreases by 200-700 cm / s.
All functional research methods are auxiliary and must be combined with clinical data.