Stangerbad

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Special bathtub for Stangerbad, with the clearly visible metal plates on the inside of the bathtub and the control panel in the foreground

The Stangerbad (also hydroelectric full bath or hydroelectric three-quarter bath ) belongs to the electrotherapies , more precisely to the hydroelectric baths, and is mostly used by medical pool attendants or physiotherapists , less often by doctors. The patient sits in a bathtub filled with water and is flooded with constant direct current ( galvanism ). It is a combination of an electrophysiological application with a thermal stimulus. The Stangerbad is included in the remedies catalog of the statutory health insurance . The term Stangerbad has been protected as a word mark since May 4, 1951 .

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The first mentions of medical experiments with electricity and water come from the middle of the 19th century. Albert Eulenberg brought out the book The hydroelectric baths in 1883 , in which he presented his scientific investigations. The master tanner came during his studies of tannery and Heinrich Stanger (1854 *) Electrical Engineering at the idea that tanning method using electricity to improve. His attempts were successful, after which he set up an electric tannery in Ulm . His father, Johann Stanger, was suffering from gout at the time . My hands and elbows improved as a result of working in the new tanning pits. Heinrich Stanger then started experiments with other gout and rheumatoid patients , which also showed noticeable success. According to his theory, the tannins dissolved in the water were the reason for the relief of the discomfort and the current was the means of transport into the body. Heinrich Stanger named the Bad Stangerbad , which was developed together with the doctor Emil Hartmann (1862-1914), and set up one each in Ulm, where Hartmann founded the "Sanatorium Ulm" in 1899, and one in Nagold . He had the tubs, which must be made of electrically insulating material , made of wood. Other tubs of the time were made of faience (clay). Modern tubs are made of fiberglass-reinforced plastic.

application

In the bathtubs for the Stangerbad, which are usually also equipped with an underwater pressure jet massage , there are metal plates at the foot end and on the sides. Additional metal plates can be attached to the bottom and top of the tub, but for safety reasons these must be provided with perforated plastic covers. These plates serve as an anode (positive pole) and cathode (negative pole) and the selective effect on the body depends on their location. Due to ion migration and the neutralization of the respective ions at the electrodes near the cathode, the current has a different effect than near the anode. With today's tubs, you can freely choose which panels represent which pole. This is necessary because the patient is always in the same position during the treatment, lying on his back with the upper body slightly elevated. If the polarity could not be changed, it would be e.g. B. not possible to change the current direction in a patient. Some versions of the tubs offer the option of connecting a pole to a brush , which can then be directed over the area of ​​the body to be treated.

The water temperature depends entirely on the patient's tolerance and illness. For pain and muscle hypertension , the water temperature will be 34 ° C and above, for muscle hypotonia and paresis below that. The current strength is adapted to the patient's feeling. The current should tingle on the skin, but not cause pain or discomfort. Usually, currents of 200–600 mA are used.

Salt or tannin-containing additives are often added to the water to improve the conductivity of the water, which has led to the assumption that this is the reason for the additives. Gillert and Rulffs , the authors of a textbook, contradict this assumption, since an improvement in conductivity would mean a further reduction in the already low current portion (only about a third) that flows through the body and would therefore rather stand in the way of the therapeutic goal . Rather, they assume that the additives cause skin irritation that reduces skin resistance and thus makes the skin more permeable to electricity.

The power sources for Stangerbaths must be particularly safe. In Germany, the Medical Devices Act (MPG) regulates whether a product can be placed on the market. A CE marking and therefore compliance with the relevant standards, as with other products duty. The operator of the Stangerbad must carry out safety and measurement tests in accordance with the Medical Devices Operator Ordinance.

effect

With the help of thermal conductivity measurements, it was possible to prove that a direct current flow increases the blood flow in the skin by 500% and in deeper muscles by up to 300%. The superficial increase in blood flow is also favored by the warmth of the bathing water. The increased blood flow improves the metabolism of the cells ( trophics ). The calming effect of the anode on the excitability of the nerves leads to a reduction in pain and muscle tone . By increasing the excitability of the nerves, the cathode increases muscle tone and, in relation to the effect of the anode, increases blood flow to the tissue. In summary, it can be said that the Stangerbad has a tonus-regulating, pain-relieving and blood circulation-promoting effect.

indication

Since the tone of the muscles can be changed in both directions with the Stangerbad, the therapy can be used for muscle hypertension or hypotonicity, spasticity and paresis. The increase in blood flow has positive effects on the periphery - arterial circulatory disorders . The treatment for rheumatism , sciatica and ankylosing spondylitis and spondylarthrosis shows further good results . The Stangerbad can also be used for adnexitis (inflammation of the ovaries and fallopian tubes ) as well as for menstrual cramps and a lack of menstruation ( amenorrhea ).

The Stangerbad allows you to perform iontophoresis , a medical procedure in which the body absorbs medicinal substances through the skin . The medicinal product must be available in ionized form and is added to the bath water. The electrical current allows the medicinal substances to penetrate the skin and are absorbed by the body.

Contraindication

The hydrostatic pressure , the warmth of the water and the electrical current are risk factors in patients with acute heart disease, heart failure and pacemakers . Therapy with the Stangerbad is definitely not recommended here. Patients with metal in their bodies (e.g. splinters or after an osteosynthesis ) and skin diseases should also not be treated. Furthermore, fever and a damaged lymphatic system are contraindications for the Stangerbad.

economics

The Stangerbad is a comparatively expensive therapy due to its acquisition and maintenance costs. Therefore, Stangerbad baths are rarely found in small therapy centers or private massage practices. In the large spa centers and university clinics, the cheaper four-cell bath is now preferred to the full bath . The University of Heidelberg had z. B. in 1999 over a total of 3 systems for Stangerbad pools, now only one. For several years now, the University of Vienna Hospital has only been treating in the four-cell bathroom. In the four-cell bath, only the extremities are immersed in a basin each containing one or two electrodes. This enables currents to be generated both through the body and across the extremities.

literature

  • Otto Steueragel: Scripts on Electrotherapy Volume II. Practice in question and answer. Low frequency - medium frequency - interference. Boppard, ISBN 3-9800445-2-1
  • Otto Gillert, Werner Rulffs: Hydrotherapy and Balneotherapy. Theory and practice. Pflaum, Munich 1990, ISBN 3-7905-0586-2
  • Dr. med. Alfred Pfleiderer: The Stangerbad according to its nature, effect and application . Hippokrates-Verlag, Stuttgart 1932
  • Bernard Kolster, Gisela Ebelt-Paprotny: Guide to Physiotherapy. Findings, techniques, treatment, rehabilitation . Urban & Fischer Verlag 1996. ISBN 3-437-45160-X
  • Pschyrembel naturopathy and alternative healing methods . 3. Edition. de Gruyter, Berlin / New York 2006, ISBN 3-11-018524-5
  • W. Bechtoldt: Experiences with the Stangerbad treatment of orthopedic disorders . In: Archives for physical therapy . Volume 17 (1965), pp. 69-73, PMID 5294846

Web links

Individual evidence

  1. ↑ Cure catalog of the statutory health insurances ( Memento of September 28, 2007 in the Internet Archive ) entered into force on April 2, 2005 (PDF; 400 kB) (see under Hydroelectric Pools )
  2. ↑ Extract from the trademark register of the German Patent and Trademark Office
  3. ↑ a b Steueragel: Scripts on Electrotherapy Volume II , see literature, page 22 ff.
  4. ^ Rudolf Köster: Proper names in the German vocabulary: A lexicon. De Gruyter, Berlin 2003, ISBN 978-3-11-017702-2 , p. 168 ( limited preview in the Google book search).
  5. ^ Andreas Mettenleiter : Personal reports, memories, diaries and letters from German-speaking doctors. Supplements and supplements II (A – H). In: Würzburg medical history reports. 21, 2002, pp. 490-518; P. 512 (on Hartmann, Emil )
  6. ↑ a b c d Gillert, Rulffs: Hydrotherapy and Balneotherapy , see literature, page 183 ff.
  7. ↑ Kolster, Ebelt-Paprotny: Guide to Physiotherapy , see literature, page 223
  8. ↑ As of 2006, information from the administration of the respective clinic
This version was added to the list of articles worth reading on January 17, 2007 .