Physical rehabilitation, medical culture and massage. Therapeutic physical culture as a means of medical and physical rehabilitation. Limiting factors that exclude physical activity

Voronyanskaya L.K., Galkin L.G., Evsyutina V.B.
Kharkiv State Academy of Physical Culture
Belgorod State Technological University named after V.G. Shukhova

Annotation: The data on orthopedics as a medical discipline, diseases of the musculoskeletal system and methods of their treatment are presented. The influence of systematic physical activity in early dates in order to eliminate the complications that have arisen: muscle atrophy, contractures, normalize the support function of the limbs and thereby prevent disability. Particular attention is paid to the role and therapeutic effect physical exercise to restore the functional and anatomical and physiological capabilities of the musculoskeletal system and the working capacity of patients.

Keywords:orthopedics, orthopedic diseases of the musculoskeletal system (ODA), physical rehabilitation, remedial physical culture (exercise therapy), physical exercises.

Introduction.

Orthopedics, as a medical discipline, appeared in the middle of the 18th century and was described by French scientists as congenital and acquired deformities of the musculoskeletal system of children and adults. The book, which was published by the French professor Andri, he called "Orthopedics or the art of preventing and correcting deformities of the body in children by means available to fathers and mothers and all those people who have to raise children." The most successful definition of the term "orthopedics" was given by R.R. Harmful: “Orthopedics is that special branch of surgery that deals with the study, prevention and treatment of all kinds of deformities of the limbs and spine, both congenital and acquired, due to various pathological processes and traumatic injuries.

The musculoskeletal system (ODA) is a receptacle for vital organs, protecting them from external influences... The brain is located in the cranial cavity, the spinal cord is located in the spinal canal, the heart and large vessels, lungs, esophagus, etc. are located in the chest cavity, the urogenital organs are located in the pelvic cavity. Bones are involved in mineral metabolism, being a depot of calcium, phosphorus, and other salts. However, after injuries, diseases, and especially after surgical interventions on the tissues of the ODA, functional disorders often develop, sharply limiting the patient's motor capabilities. Based on this, the rehabilitation of orthopedic patients includes a complex of conservative and surgical treatment aimed at restoring the functional capabilities of the musculoskeletal system. Thus, orthopedics includes conservative treatment, reconstructive surgery of the musculoskeletal system of various etiologies, as well as prosthetics. The goal of rehabilitation in this industry is to achieve, within the appropriate time frame, a stable, optimally adequate sanogenetic potential for restoring disturbed human functions, adapting it to the environment and participating in social life with previous or changes due to illness social functions... According to scientific research it is the versatility of rehabilitation that helps prevent disability and restore the functional capabilities of the patient's body and return to work.

The connection of work with the most important scientific programs and practical tasks of modern orthopedics is inextricably linked with ODA traumatology, prosthetics and physical rehabilitation. In addition, orthopedics is closely related to pediatrics (congenital and acquired deformities as a result of diseases in children, such as rickets, poliomyelitis, etc.) with neuropathology (paralytic deformities) and partially with gynecology (pelvic deformities and other deformities arising from birth trauma of the fetus) ...

The problem of congenital malformations is very urgent, since the number of people with congenital pathology is increasing. The first place among developmental defects belongs to ODA anomalies - about 30%, nervous system- 28.1%, cardiovascular - 14.2%.

In connection with a significant increase in disability among orthopedic patients in Ukraine, the Law "On the rehabilitation of disabled people in Ukraine" No. 2961-1U of October 6, 2005 was adopted. This Law defines the basic principles for the creation of legal, socio-economic, organizational conditions for the elimination or compensation of disabilities caused by health disorders with persistent disorders of the body's functions, the functioning of the system to support the functional, mental, social well-being of disabled people, and help them achieve social and material independence.

Purpose, tasks of work, material and methods.

Target of this work is to familiarize with the role of physical therapy (exercise therapy) of patients with various types of orthopedic diseases of the musculoskeletal system, for this we set the following tasks: to study the literature sources of the authors on this problem, as well as many years of experience in medical and research institutions of Ukraine, Russia, Belarus; to show the importance of the scientific and methodological approach in the complex physical rehabilitation of orthopedic and traumatological patients.

Research results.

To determine the role of physical therapy in the rehabilitation of patients with diseases of the musculoskeletal system, we studied the classification of the etiology and clinical and functional characteristics of ODA diseases. Orthopedic diseases include acquired systemic diseases of the musculoskeletal system and congenital deformities of the skeleton, such as: pseudarthrosis, amniotic constrictions, limb defects, chondrodystrophy, arthrogryposis, osteochondropathy and various other pathologies of the spine and joints.

The causes of congenital deformities are exogenous, endogenous, genetic factors.

Exogenous factors of congenital deformities of the musculoskeletal system are the forced position of the fetus, atypical shape of the uterus, induration of the placenta, entanglement with the umbilical cord, etc. A certain role can be played by unsuccessful surgical intervention when mechanical damage or fetal membrane occurs. As well as various physical radioactive chemical infectious factors that adversely affect the development of the fetus.

Endogenous factors affecting the anomaly in the development of the musculoskeletal system of the fetus include: uterine malformations, toxicosis, which can lead to impaired fetal development, especially in the early periods, as well as concomitant cardiovascular, hormonal disorders, the mother's age, especially primiparous. Some abnormalities of ODA can be inherited - genetic factors. A number of congenital disorders are based on a lack of certain enzymes, metabolic changes depend on a hereditary lack of enzyme activity (gene-enzyme), which affects the biochemical reactions of the body.

The modern methods of treatment used in orthopedics are very diverse. These are: operative and conservative, depending on the pathology and the degree of the disease. Treatment of congenital diseases should begin as early as possible - from the 10-12th birthday (after the navel is overgrown). Conservative methods include: massage, exercise therapy, different kinds In physiotherapy, corrective dressings and orthopedic shoes, corsets, orthoses are very widely used. All these methods of conservative treatment are the main methods of physical rehabilitation, since they are aimed at restoring the functional and anatomical and physiological capabilities of the body. With a disease in the human body, various structural and functional disorders occur. Forced prolonged physical inactivity can worsen the course of the disease, cause a number of complications. In this regard, complex treatment should be carried out, as early as possible from the moment the disease is detected, which should include not only medical, surgical methods, but also physical ones at a certain stage. The early application of functional methods of therapeutic physical culture, massage of hydrokinesis therapy, physiotherapy, etc. in the physical rehabilitation of patients with disorders of the musculoskeletal system is sweat-substantiated.

Exercise therapy has a direct therapeutic effect, stimulating defense mechanisms, accelerating and improving the development of compensations, improving metabolism and regenerative processes, restoring impaired functions. The therapeutic effect of physical exercises is manifested in the form of four main mechanisms: a tonic effect, a trophic effect, the formation of compensations, and the normalization of function.

The tonic effect of physical exercises consists in changing the intensity of biological processes in the body under the influence of a dosed load. The tonic effect of physical exercises is due to the fact that the motor zone of the cerebral cortex, sending impulses to the motor apparatus, simultaneously affects the centers of the autonomic nervous system, exciting them. Excitation of the central nervous system, and increased activity of the endocrine glands stimulate autonomic functions, i.e. improve the activity of the cardiovascular, respiratory and other systems, increase metabolism and various protective reactions, including immunobiological.

The alternation of exercises that enhance the processes of excitation in the central nervous system (for large muscle groups, with pronounced muscle effort at a fast pace), with exercises that enhance the processes of inhibition (breathing exercises, exercises in muscle relaxation), contribute to the restoration of normal mobility of nervous processes.

The trophic effect of physical exercises is manifested in the fact that under the influence of muscle activity, both metabolic processes and regeneration processes in the body improve. Exercise helps to shorten the time between so-called clinical and functional recovery. The success of using the trophic action of physical exercises largely depends on the optimality of the physical loads used in this case.

The formation of compensations is achieved by the therapeutic effect of physical exercises. Compensation is a temporary or permanent restoration of impaired (lost) functions. The process of restoring disturbed and lost functions is in the nature of dosed training. The use of physical exercises to compensate for lost functions extends not only to the field of traumatology, surgery, orthopedics, but also to internal diseases, which can lead to a sharp dysfunction of organs and various kinds of decompensation. Exercise increases the function of a tissue or organ and gradually helps to restore the impaired compensation of vital functions of the body.

The use of exercise in medicinal purposes- a means of conscious intervention in the process of normalization of function. The main action of the movement is characterized by a general stimulation of physiological functions. The main action of the movement is characterized by a general stimulation of physiological functions. Movement is the basis of the musculoskeletal system, it has a general tonic effect on the patient's body, contributes to a better manifestation of trophic processes, the restoration of the function of the affected areas of the ODA.

The use of exercise therapy in the rehabilitation process occurs in stages (hospital, convalescent department, sanatorium, clinic, home treatment). For the successful restoration of the motor functions of orthopedic patients, it is necessary to observe gradualism and consistency, as well as a conscious attitude of patients to methods of recovery. It is important to observe the principle of adequacy in the applied physical activity. In the system of comprehensive rehabilitation of physical performance, the following forms of exercise therapy are used in summer, autumn and spring: therapeutic gymnastics, walks (hiking and skiing in winter), jogging, swimming, rowing, ice skating, outdoor and sports games, close tourism. When implementing the rehabilitation process, it is necessary that the above forms of exercise therapy are within the permissible motor activity of orthopedic patients, corresponding to the stage of rehabilitation, and the patient's condition.

Before the appointment of exercise therapy classes, the tasks of the therapeutic use of physical exercises are determined, the means and forms of their solution are selected. In order to do all this correctly, it is necessary to take into account the phase of development of the disease, the reaction of the body to it, the state of all organs and systems of the patient that are not involved in the disease process, his mental response to the disease and other individual characteristics. In all cases, it is important to observe the principles of combining the general and local effects of physical exercises, taking into account that recovery always largely depends on the general condition of the patient's body.

The methodology of exercise therapy is based on general pedagogical principles: the methodologist's explanation of the prospects for accelerating the restoration of impaired functions under the influence of physical exercises increases the patient's interest in exercise therapy. The effectiveness of exercise therapy is always possible only with the patient's active attitude to classes.

conclusions

Studied literary sources on this issue; showed the importance of a differentiated approach in carrying out complex physical rehabilitation of orthopedic and traumatological patients.

Thus, having shown the importance of the scientific and methodological approach in the complex physical rehabilitation of orthopedic and traumatological patients, we conclude that the use of the exercise therapy technique based on general pedagogical principles contributes to the achievement of the most effective result in the restoration of psychological, regenerative processes and functional capabilities of patients with pathology of the musculoskeletal system. locomotor system.

Prospects for further research in this direction of our work consists in the differentiated practical application of modern methods and means of exercise therapy in the complex rehabilitation of patients with diseases of the musculoskeletal system by specialists of medical institutions when prescribing complexes and evaluating their effectiveness. Further educational and methodological work on this issue with the publication of the material is also planned.

Literature

1. Belaya M.A. Physiotherapy and massage: textbook - method. allowance / M.A. Belaya. - M .: Soviet sport, 2001 .-- 272 p.

2. Bolshakov E.M. Experience of organizing rehabilitation treatment in the Minsk region / E.M. Bolshakov. // Rehabilitation of the sick and disabled: abstracts of the reports. - Minsk, 1992 .-- P. 13.

3. Gaiko G.M. Orthopedic and traumatic service station and prospects for development in Ukraine: / G.M. Gaiko. // Book of abstracts of the XIIth study of traumatologists - orthopedists of Ukraine. - Kiev, 1996 .-- S. 1 - 2.

4. The Law of Ukraine "On the Rehabilitation of Invalids in Ukraine". - No. 2961-IV dated 06.10.2005.

5. Kozlova L.V., Kozlov S.A., Semenenko L.A. Fundamentals of rehabilitation: textbook. allowance / L.V. Kozlova, S. A. Kozlov, L. A. Semenenko. - Rostov n / a: Phoenix, 2003 .-- 480 p.

6. Medical physical culture: Handbook / ed. V.A.Epifanova. - M .: Medicine, 2001 .-- 528 p.

7. Milyukova I.V., Evdokimova T.A. Complete encyclopedia remedial gymnastics/ I.V. Milyukova, T.A. Evdokimova // under total. ed. T.A. Evdokimova. - SPb .: Owl. - M .: Eksmo, 2003 .-- 512 p.

8. Murza V.P. Physical rehabilitation: navch. posibnik / V.P. Murza. - K .: Orlan, 2004 .-- 559 p.

9. Nikolaeva L.F. Ways of development of the rehabilitation direction in health care / L.F. Nikolaeva // Vopr. balneologists, physiotherapy and lay down. physical education. - 1989. - No. 1. - S. 1-6.

10.Sergieni E.V. Tasks of the medical and social expertise service for solving the issues of rehabilitation of disabled people / E.V. Sergieni // Current problems of rehabilitation of the innovations: mater. All-Ukrainian Science and Practice Conference. - Vinnytsia: UDNDIRI, 2007 .-- S. 7 - 12.

11. Smirnova L.A., Shumada I.V. Traumatology and Orthopedics: Pract. classes / L.A. Smirnova, I.V. Shumada. - K .: Vishcha school. head publishing house, 1984 .-- 352 p.

12. Trubnikov V. F. Orthopedics and traumatology / V. F. Trubnikov.-M. - M.: Medicine, 1971. - 392 p.

13. Yumashev G.S. Traumatology and orthopedics / G.S. Yumashev. - M.: Medicine, 1977 .-- 503 p.

14. Yunusov FA, Gaiger G., Mikus E. Organization of medical and social rehabilitation abroad / FA. Yunusov, G. Geiger, E. Mikus. - M., 2004.-310 p.

Rehabilitation- a complex multifaceted problem that has various aspects - medical, physical, mental, professional, socio-economic, aimed not only at physical recovery and preservation, but also at the possible complete restoration (preservation) of the personality and social status. In many countries, the training of such specialists, called physical rehabilitation therapists or kinesitherapists, is expanding. One of the most important aspects of training rehabilitologists is physical therapy.

The goal of rehabilitation is achievement full recovery functions impaired due to illness or injury, or, if this is unrealistic, the optimal realization of the physical, mental and social potential of the disabled person, the most adequate integration into society.

The basic principles of medical rehabilitation are most fully described by one of its founders, K. Renker (1980):

q Rehabilitation should be carried out from the very onset of illness or injury to the full return of a person to society (continuity and solidity).

q The problem of rehabilitation should be addressed in a comprehensive manner, taking into account all its aspects (complexity).

q Rehabilitation must be accessible to all who need it (accessibility).

q Rehabilitation must adapt to the ever-changing patterns of illness, and take into account technological progress and changes in social structures (flexibility).

Taking into account the continuity, there are stationary, outpatient, and in some countries (Poland, Russia) - sometimes also the sanatorium stages of medical rehabilitation.

Since one of the leading principles of rehabilitation is the complexity of impacts, only those institutions in which a complex of medical-social and professional-pedagogical activities are carried out can be called rehabilitation. The following aspects of these activities are distinguished:

1. Medical aspect - includes issues of treatment, diagnostic and treatment plan.

2. Physical aspect - covers all issues related to the use of physical factors (physiotherapy, exercise therapy, mechano- and occupational therapy), with an increase in physical performance.

3. Psychological aspect - acceleration of the process of psychological adaptation to the life situation changed as a result of illness, prevention and treatment of developing pathological psychological changes.

4. Professional aspect - for working people - prevention of possible decline or disability; for disabled people, if possible, restoration of working capacity; this includes the issues of determining the ability to work, employment, occupational hygiene, physiology and psychology of work, labor training for retraining.

5. Social aspect - covers the issues of the influence of social factors on the development and course of the disease, social security labor and pension legislation, the relationship between the patient and the family, society and industry.

6. Economic aspect - the study of economic costs and the expected economic effect of various methods of rehabilitation treatment, forms and methods of rehabilitation for planning medical and socio-economic activities.

Physiotherapy is one of the most important and effective methods of medical rehabilitation, which is widely used in diseases of various etiologies with various clinical syndromes. This is determined, on the one hand, by the breadth of the effect of therapeutic physical exercises on various functional systems of the body - cardiovascular, respiratory, musculoskeletal, nervous, endocrine, and, on the other hand, by the training and restorative effect of these exercises in case of deficiency of various body functions.

Self test on the topic: The role and place of physical therapy (exercise therapy) in the system of medical rehabilitation. Exercise therapy for cerebrovascular accidents Completed by the 2nd year student of the medical school AFKB Maria Dmitrieva Koroteeva 2014

The role and place of medical physical culture in the system of medical rehabilitation is of paramount importance. Therapeutic physical culture (exercise therapy) means the use of physical culture means to a sick person with a therapeutic and prophylactic purpose for a faster and more complete restoration of health and working capacity and prevention of the consequences of the pathological process. Therapeutic physical culture is widely used in hospitals, clinics, sanatoriums, schools, boarding schools. Therapeutic physical culture as an integral part of the system of physical education and physical culture is a medical and pedagogical process and solves special problems. It is designed to restore impaired health, eliminate the formed inferiority physical development, moral and volitional qualities of the sick, to promote the restoration of their working capacity, in other words, their comprehensive biological and social rehabilitation.

Therapeutic physical culture is also a therapeutic and restorative process, since it fosters a patient's conscious attitude to the use of physical exercises, instills in him hygienic skills, provides for his participation in the regulation of the motor regime, fosters the correct attitude to hardening by natural factors (sun, air, water).

Based on the data of the physiology of muscular activity and clinical and functional studies, the following basic principles of achieving fitness have been formulated: Systematicity (selection and distribution of exercises, their dosage, sequence), the system of training is dictated by the tasks of training. The regularity of classes involves their rhythmic repetition and, accordingly, the alternation of loads and rest. In medical physical culture (exercise therapy), regularity is usually understood as the regularity of classes. Duration. The effectiveness of physical exercise directly depends on the duration of the exercise. Having started physical exercises under the guidance of specialists in a medical and prophylactic institution, the patient must necessarily continue these exercises on his own at home. With recovery, some therapeutic methods (medication, physiotherapy, balneological) are limited or excluded, and the proportion of physiotherapy exercises (exercise therapy) increases.

A gradual increase in physical activity. In the process of training, the functional capabilities and abilities of the body increase, therefore, physical activity should increase. This is one of the ways of physical improvement of the body. Individualization. It is necessary to take into account the individual, physiological and psychological characteristics of each practitioner, strong and weak sides his body, a type of higher nervous activity(VND), fitness of the patient, features of the underlying disease. Variety of funds. In exercise therapy, they rationally combine complementing each other, gymnastic, sports, playing, applied and other types of exercises, for a versatile effect on the body.

To the main positive sides methods of exercise therapy include: Deep physiology and adequacy Universality, which is understood as a wide range of actions - there is not a single organ that does not respond to movements. A wide range of influence of exercise therapy is provided by the involvement of all levels of the central nervous system, endocrine and humoral factors. Lack of negative side effects(with the correct dosage of physical activity and a rational method of training) Possibility of duration of use, which has no restrictions, moving from therapeutic to preventive and general health-improving Formation of a new dynamic stereotype, reactively eliminating or weakening the pathological stereotype. In a normal stereotype, motor skills predominate, and the general task of exercise therapy lies in its restoration. Transfer of all physiological systems of an aging (and not only) organism to a new, more high level that provides increased vitality and energy storage. An optimal motor regime delays aging.

The therapeutic effect of special physical exercises is expressed in a tonic effect, the formation of compensations, trophic effects and normalization of functions. The basis of the therapeutic effect of physical exercises and other remedies for exercise therapy is considered to be the effect on the nervous system, which thereby regulates the functions of the affected organs and systems, stimulates the mechanisms of recovery and recovery.

Exercise therapy for disorders of cerebral circulation Violation of cerebral circulation, accompanied by cerebral hemorrhage, is called a stroke. Stroke is divided into hemorrhagic and ischemic cerebral infarction. The severity of a stroke depends on the extent of the damage caused by the circulatory disturbance. In severe cases, general symptoms are observed - loss of consciousness, disturbances of cardiac activity, breathing, at the same time there is a violation of motor function. Exercise therapy for hemorrhagic stroke is prescribed with complete stabilization of the patient's condition. If a stroke is combined with hypertension, then all physiotherapy exercises depend on the value of blood pressure. Cerebral circulation disorders occur with atherosclerosis. With bruises and concussion. The main sign of cerebrovascular accident is dizziness, static balance disorder, cardiac arrhythmias, nausea, vomiting. Drug therapy can stop the course of the disease. But she is unable to return the ability to move. Only special gymnastic exercises can help in this. Kinesitherapy is indicated at the heart of early rehabilitation after a dynamic disturbance of a cerebral impairment in order to completely restore motor function. It is especially necessary in the restoration of motor skills. At the onset of the disease, complete flaccid paralysis develops, which after 1-2 weeks is gradually replaced by spastic paralysis and contours begin to form in the flexors of the arm and extensors of the leg. The recovery process begins in a few days and lasts for years. Movement in the leg is restored faster than in the arm.

The early period is 2-5 days. Special breathing exercises are used, passive, semi-passive. The intermediate period is from 5 to 30 days. Treatment by position. Active breathing exercises. Treatment by position. General massage... Physiotherapy. Late period from 1 to 4 months. Special remedial gymnastics is used. Orthostatic gymnastics. General strengthening gymnastics. Special gymnastics. Training in standing and walking. Walking in various forms (walking with gradual acceleration and deceleration). Exercises with objects. The effective period is up to 2 years. Restoration of household and work skills. General strengthening and special gymnastics. Occupational therapy. Exercises are required to be done smoothly, they should not cause acute pain. The exercises should be repeated many times, pauses for breathing, follow the plans and rhythmic breathing. Tasks of exercise therapy. Restore movement functions; to help reduce increased muscle tone and reduce the severity of friendly movements; contribute to overall health and strengthening of the body; improve emotional status. Exercise therapy classes are prescribed from 2-5 days from the onset of the disease after the day from the beginning of the disappearance of the phenomena of a coma.

Literature 1. Epifanov V.A. and other Remedial physical culture. Moscow: 1987. 2. Popov S.N., Damsker I.S. Healing Fitness. M .: Physical culture and sport. 1988.

Introduction 2 Physiotherapy (exercise therapy) 3

Features of physical exercises with students with disabilities 5

Diseases of the cardiovascular system 7

Functional disorders of posture and scoliosis 8

Diseases of the digestive system 9

Kidney disease and urinary tract 10

Diseases of the joints 10

Conclusion 12

List of used literature 13

INTRODUCTION.

Physical activity is one of the important conditions for human life and development. It should be considered as a biological stimulus that stimulates the processes of growth, development and formation of the body.

Physical activity depends on the functionality of the patient, his age, sex and health.

Physical exercise (training) leads to the development of functional adaptation.

Physical activity, taking into account social conditions, ecology and other factors, changes the reactivity, adaptability of the body.

The preventive and therapeutic effect of dosed training is possible if a number of principles are observed: systematicity, regularity, duration, dosing of loads, individualization.

Depending on the state of health, the patient uses "various means of physical culture and sports, and in case of deviations in the state of health, physiotherapy. Exercise therapy in this case is a method of functional therapy.

Physiotherapy (exercise therapy)

A feature of the exercise therapy method is also its natural biological content, since one of the main functions inherent in every living organism is used for therapeutic purposes - the function of movement. The latter is a biological stimulus that stimulates the processes of growth, development and formation of the body. Any complex of physiotherapy exercises involves the patient in active participation in the treatment process - in contrast to other therapeutic methods, when the patient is usually passive and the treatment procedures are performed by medical personnel (for example, a physiotherapist).

Exercise therapy is also a method of functional therapy. Physical exercises, stimulating the functional activity of all major systems of the body, ultimately lead to the development of functional adaptation of the patient. But at the same time, it is necessary to remember about the unity of the functional and morphological and not to limit the therapeutic role of exercise therapy to the framework of functional influences. Exercise therapy should be considered a method of pathogenetic therapy. Physical exercises, influencing the patient's reactivity, change both the general reaction and its local manifestation. The patient's training should be considered as a process of systematic and dosed use of physical exercises for the purpose of general improvement of the body, improvement of the function of one or another organ, disturbed by the painful process, development, formation and consolidation of motor (motor) skills and volitional qualities.

The stimulatory effect of physical exercise on the body is carried out through neurohumoral mechanisms.

When exercising in the tissues, the metabolism is increased.

The majority of patients are characterized by a decrease in vitality. It is inevitable in bed rest due to a decrease in physical activity. At the same time, the flow of proprioceptive stimuli is sharply reduced, which leads to a decrease in the lability of the nervous system at all its levels, the intensity of the course of vegetative processes and muscle tone. With prolonged bed rest, especially in combination with immobilization, the neuro-somatic and autonomic reactions are perverted.

Physical exercises have a tonic effect, stimulating motor-visceral reflexes, they contribute to the acceleration of metabolic processes in tissues, activation of humoral processes. With an appropriate selection of exercises, it is possible to selectively affect the motor-vascular, motor-cardiac, motor-pulmonary, motor-gastrointestinal and other reflexes, which makes it possible to increase mainly the tone of those systems and organs in which it is reduced.

Exercise helps to normalize acid-base balance, vascular tone, homeostasis, metabolism of injured tissues, and sleep. They contribute to the mobilization of the defenses of the patient's body and the separative regeneration of damaged tissues.

The use of physical exercises by patients is the main means of active intervention in the process of forming compensation.

Spontaneous compensation is formed in the form of correcting the respiratory function of the operated patients with the help of breathing exercises, lengthening the expiration, diaphragmatic breathing, etc.

Formation of compensations for disturbed vegetative functions. The use of physical exercises in this case is based on the fact that there is not a single autonomic function that, according to the mechanism of motor-visceral reflexes, would not obey to one degree or another the influence of the musculo-articular apparatus.

Features of physical exercises with students with deviations in health

Students of colleges, universities, universities, depending on physical development, health and functional training, are divided into 3 groups: basic, preparatory and special. Students with deviations in health, as a rule - chronic diseases or injuries of the musculoskeletal system, are engaged in special medical groups.

The recruitment of groups is carried out by a doctor. The main criterion for inclusion in a special medical group is a particular disease, level of physical fitness, foci of chronic infection. Groups are formed according to nosology (morbidity). So, students with diseases of the cardiorespiratory, digestive, endocrine systems make up one group; students with injuries (diseases) of the ODA, the peripheral nervous system - another; having deviations from the side of hearing or vision - the third; having deviations from the central nervous system (neuroses, etc.) - the fourth.

The following tasks are faced by the heads of special medical groups of students: improving the functional state and preventing the progression of the disease; increasing physical and mental performance, adaptation to external factors; relieving fatigue and increasing adaptive capabilities; raising the need for hardening, health-improving physical education.

Medical contraindications to physical activity (physical education) are absolute and relative.

Physical education lessons in special medical groups are conducted for the following diseases: diseases of the circulatory system; joint diseases; respiratory diseases; diseases of the digestive system; kidney and urinary tract diseases; endocrine and metabolic diseases; female diseases; nervous and mental illness; surgical diseases; traumatology and orthopedics; eye diseases and ENT organs; skin diseases.

The rehabilitation system includes physical education lessons, preferably in the fresh air, exercise therapy classes, health path, skiing, cycling, etc. Cyclic sports are preferable, especially for diseases of the heart, lungs, obesity, etc.

When conducting classes with students with changes (diseases) of the musculoskeletal system, preventive measures are important, aimed primarily at giving the student the correct posture and at normalizing the functions of the ODA, preventing contractures. Excessive loads should not be allowed (especially in a standing position, lifting weights, performing exercises on simulators, etc.). Exercises with dumbbells, balls and simulators should be performed only in a spine-friendly mode, lying down and with the inclusion of stretching and relaxation exercises at the end of the session.

An integral part of physical education is medical control, which is carried out in accordance with the "Regulations on medical control over the physical education of the population" (approved by order of the USSR Ministry of Health No. 986 of 1977). First of all, these are the annual in-depth medical examinations (UMO) of students. The medical commission includes doctors of various specialties: therapist, traumatologist-surgeon, ophthalmologist, neuropathologist, gynecologist, otolaryngologist and other specialists. Anthropometric and morphological studies (examinations of all students), fluorography (or radiography of the lungs and heart), electrocardiography (ECG), clinical analysis of blood, urine and testing are carried out. In addition, preventive examinations of students of all courses are carried out annually (quarterly or by semester).

There are many forms of physical culture that are used to normalize the functional state and posture of students, as well as to prevent diseases.

Diseases of the cardiovascular system

For students with diseases of the cardiovascular system, a group method of training is shown, preferably on the street, in a park or in a public garden, that is, physical education in combination with hardening. The lesson is structured so that cyclical movements prevail (various types of walking and running, their combination, skiing, ice skating, breathing exercises). During winter time, you need to make sure that students breathe through their noses. Relaxation exercises are shown. Exercises with breath holding, straining, etc. are excluded.

In the process of classes, it is necessary to control the pulse, breathing, skin color and the general condition of the student. Morning exercises and hardening are very important. In the autumn-spring period - fortification (the intake of vitamins C and E is especially indicated). If possible, it is recommended to conduct UFO.

Functional posture disorders and scoliosis

Functional posture disorders are muscle imbalances. They are associated with functional changes in ODA (weakness of muscles, ligaments, etc.) in case of hypodynamia (limitation of movement), improper working posture, etc. Posture disorders are manifested in a decrease or increase in the physiological curvature of the spinal column.

To prevent defects in posture and its normalization, daily physical education is necessary (UGG, exercises with rubber bands, gymnastic sticks, medicine balls, with dumbbells in a prone position, exercises on simulators with low tensions in a prone, recumbent position, swimming, special exercises at a gymnastic wall and etc.). Excludes exercises with dumbbells in the initial standing position, jumps and jumps with dumbbells. The lesson includes outdoor games (or elements of sports games), breathing and general developmental exercises, walking, walking in a squat, skiing, cycling, etc. Swimming and hydrokinesis therapy should take a large place. With regular exercises (3-5 times a week for 35-45 minutes), it is possible to eliminate functional disorders of posture. Scoliosis is a progressive disease of the spine characterized by its curvature. Spinal deformity leads to numerous disorders of the internal organs. One of the important tasks of physical education is to stop the progression of the disease.

Depending on the degree of scoliosis, one or another set of physical exercises is used: walking, walking in a squat, general developmental and breathing exercises. Exercises with dumbbells, medicine balls are performed in the supine position. Hydrokinesis therapy, swimming (breaststroke method), exercises with a gymnastic stick, stretching exercises, on a gymnastic wall and others successfully train muscles. The lesson also includes exercises for coordination, balance and a number of general developmental exercises for the muscles of the back, abdomen, buttocks, etc. Regular physical education makes it possible to stop the progression of the disease, eliminate muscle asymmetry, etc.

Diseases of the digestive system

The most common are hyperacid gastritis, stomach and duodenal ulcers, cholecystitis and biliary dyskinesia, colitis (more often in women). In addition, gastric emptying is not uncommon. The nature of the influence of training on digestion is different: weak (small, moderate) loads stimulate, strong (intense, long-term) inhibit the function of the gastrointestinal tract (motor, secretory and absorption). In addition, exercise has a positive effect on the regenerative processes in the gastric and duodenal mucosa. At the same time, microcirculation in the tissues of the mucous membrane, in the muscles improves, and the volume of circulating blood (BCC) increases.

The restoration of conditioned reflex activity of the gastrointestinal tract begins an hour after eating and reaches a maximum only 3-3.5 hours after eating. The feeling of satiety is accompanied by a decrease in the excitability of the skeletal muscles. Thus, exercising soon after eating disrupts natural digestive processes. Failure to comply with these rules leads to a deterioration in functional and regenerative processes in the gastrointestinal tract.

Classes are held during the period of remission. The lesson includes walking, running (their combination), breathing and general developmental exercises, outdoor games (or elements of sports games), swimming, cycling, skiing, etc. At first, you should spare the abdominal press, avoid exercising on simulators. It is better to include general developmental exercises in the supine position, sitting, with breathing exercises ("belly breathing").

With increased irritability and sleep disturbance, it is advisable to conduct classes accompanied by music (or color music). At home, after performing the UGG, a shower or rubdown with cool water is shown.

Kidney and urinary tract diseases

The most common diseases are: hydronephrosis, glomerulonephritis, pyelitis, pyelonephritis, kidney stones, cystitis, kidney prolapse, etc.

Physical education is carried out during the period of remission. The lesson includes dosed walking, jogging, outdoor games (or elements of sports games), skiing, general developmental and breathing exercises, exercise on simulators. In the summertime - cycling (in case of urolithiasis - first drink 0.5-1.5 liters of liquid), walking on rough terrain. When the kidneys are lowered, jumps, jumps and similar exercises are excluded, a special complex of general developmental exercises and swimming are performed.

Hypothermia should be avoided (swimming in the pool in the autumn-winter period, taking a cold shower or dousing cold water), which can provoke an exacerbation of disease.

Diseases of the joints

According to the WHO, every fifth inhabitant of the planet has joint dysfunction or complains of pain in them. Of the many joint diseases, the most common are inflammatory diseases (arthritis) and degenerative diseases (arthrosis).

The first group of diseases includes infectious arthritis, rheumatoid arthritis, etc. The second group includes deforming osteoarthritis, periarthritis, etc.

Arthritis is a systemic disease of the connective tissue, manifested mainly by chronic progressive inflammation of the joints, limitation of movement in the joint (joints), muscle atrophy, etc. As the disease progresses, limitation of movement increases, joint pain occurs not only during exercise, but also at rest.

The role of exercise during the period of remission is especially great. Under the influence of physical exercises, the activity of the cardiovascular, respiratory systems, the neuromuscular system is activated, metabolism is normalized, mobility in the joint improves, muscle strength increases, pain disappears.

Active movements should be performed in well-equipped conditions (in a prone position, on all fours, sitting, in the water, hanging, etc.). Exercise should not be painful.

In case of infectious arthritis, the lesson includes walking, cycling, skiing, general developmental and breathing exercises, exercises with shells (balls, sticks, dumbbells, etc.) in a lying and sitting position, outdoor games (or elements of sports games). Jumps, jumps (multijumps), exercises with dumbbells, kettlebells in a standing position, as well as swimming in the autumn-winter period are excluded due to the danger of exacerbation of the disease.

With arthrosis, exercises on simulators, hydrokinesis therapy, swimming are shown. In addition, the lesson includes outdoor games (or elements of sports games), walking, skiing, cycling, rowing, etc.

When conducting self-study, they include UGG, cycling (stationary bike), skiing and hardening procedures.

Conclusion

Physiotherapy exercises (LFK) is a method that uses means of physical culture with a therapeutic and prophylactic purpose for a faster and more complete recovery of health and prevention of complications of the disease. Exercise therapy is usually used in combination with other therapeutic agents against the background of a regulated regimen and in accordance with therapeutic objectives.

At certain stages of the course of treatment, exercise therapy helps to prevent complications caused by prolonged rest; accelerating the elimination of anatomical and functional disorders; preservation, restoration or creation of new conditions for the functional adaptation of the patient's body to physical activity.

The active factor of exercise therapy is physical exercises, that is, movements specially organized (gymnastic, applied sports, playing) and used as a nonspecific stimulus for the treatment and rehabilitation of the patient. Physical exercise helps to restore not only physical, but also mental strength.

BIBLIOGRAPHY:

1. Dubrovsky V.I. and Gotovtsev P.I. "Self-control during physical education", - M .: Physical culture and sport, 1984.

2. Dubrovsky V.I. and Dubrovsky N.M. "A practical guide to massage", - M .: Step, 1993.

17 Literature .... …………………………………………………………………… 19 Introduction (Description Exercise therapy) Therapeutic physical Culture (Exercise therapy) - A set of methods of treatment, prevention and ... difficult cases - a doctor on Exercise therapy... Application curative physical education, increasing the effectiveness of complex therapy ...

Therapeutic physical culture (exercise therapy) - a method of treatment consisting in the application of physical exercises and natural factors of nature to a sick person for therapeutic and prophylactic purposes. This type of treatment is based on motor training.

V Exercise therapy different physical exercises: gymnastic (the most simple and accessible to patients), sports and applied (walking and skiing, terrenkur, swimming, rowing, tourism, etc.) and games (mobile and sports - towns, badminton, volleyball, etc.). Exercise therapy is a method of general, nonspecific active, functional therapy, and each physical exercise- a nonspecific irritant. Salient feature Exercise therapy - dosed physical training of patients. In medical institutions (hospital, clinic, etc.) procedures Exercise therapy carried out by individual and group methods. Indications for Exercise therapy usually coincide with the beginning of the patient's recovery, mainly in chronic diseases. Exercise therapy it is advisable to use for patients who have been on bed for a long time, weakened, with reduced physical tone. Usage Exercise therapy with childhood diseases is justified by the need for movement of the growing body of the child. In the elderly, it supports and develops the function of the main body systems and prevents premature aging. Exercise therapy plays an essential role in the treatment of internal diseases, especially in diseases of the cardiovascular and respiratory systems; it is used in diseases of the nervous system, in injuries and diseases of the musculoskeletal system, as well as in surgery (chest, abdominal, reconstructive, neurosurgery, etc.).

Theoretical foundations based on modern physiological and clinical concepts Exercise therapy , systematized physical exercises and identified methodological provisions for their use. Various private methods are substantiated and applied Exercise therapy for many diseases and injuries.

General basics medical physical culture

Classes Exercise therapy have a therapeutic effect only with the correct, regular, long-term use of physical exercises. For these purposes, a methodology for conducting classes, indications and contraindications for their use, taking into account their effectiveness, and hygienic requirements for places of employment have been developed.

Distinguish between general and specific methods. Exercise therapy ... General methodology Exercise therapy provides for the rules for conducting classes (procedures), the classification of physical exercises, the dosage of physical activity, the scheme for conducting classes in different periods of the course of treatment, the rules for constructing a separate lesson (procedure), forms of application Exercise therapy , schemes of driving modes. Private methods Exercise therapy are intended for a specific nosological form of the disease, trauma and are individualized taking into account the etiology, pathogenesis, clinical characteristics, age, physical fitness of the patient. Special exercises to influence the affected systems, organs must necessarily be combined with fortifying, which provides general and special training.

The main means Exercise therapy are physical exercises and natural factors of nature. Physical exercise many, and they affect the body in different ways.

Physical exercise classification

Exercise in Exercise therapy divided into three groups: gymnastic, applied sports and games.

Gymnastic exercises

Consist of combined movements. With their help, you can influence various systems of the body and individual muscle groups, joints, developing and restoring muscle strength, speed, coordination, etc. exercises are subdivided into general developmental (restorative), special and respiratory (static and dynamic).

General strengthening exercises

It is used to improve and strengthen the body, increase physical performance and psycho-emotional tone, activate blood circulation, respiration. These exercises facilitate the therapeutic effect of special.

Special exercises

Selectively affect the musculoskeletal system. For example, on the spine - with its curvature, on the foot - with flat feet and injury. For a healthy person exercises for the body are fortifying; with osteochondrosis, scoliosis, they are classified as special, since their action is aimed at solving treatment problems - increasing the mobility of the spine, correcting the spine, strengthening the surrounding muscles. Exercises for the legs are fortifying for healthy people, and after surgery on the lower extremities, trauma, paresis, diseases of the joints, the same exercises referred to as special. The same exercises, depending on the method of their application, can solve different problems. For example, extension and flexion in the knee or other joint in some cases is aimed at developing mobility, in others - to strengthen the muscles surrounding the joint ( exercises with burden, resistance), in order to develop musculo-articular feeling (accurate reproduction of movement without visual control). Usually special exercises used in combination with general developmental.

Gymnastic exercises subdivided into groups:

• · On anatomical basis;
• · By the nature of the exercise;
• · By species;
• · On the basis of activity;
• · On the basis of the items and shells used.

By anatomical character highlight the following exercises:

• · For small muscle groups (hands, feet, face);
• For medium muscle groups (neck, forearms, shoulder, lower leg, thigh);
• For large muscle groups (upper and lower limbs, trunk),
• · Combined.

By the nature of the muscle contraction of the exercise subdivided into two groups:

• Dynamic (isotonic);
• · Static (isometric).

Contraction of a muscle, in which it develops tension, but does not change its length, is called isometric (static). For example, when actively lifting the leg up from the initial position lying on the back, the patient performs dynamic work (lifting); when holding the leg raised up for some time, the muscles work in isometric mode (static work). Isometric exercises are effective for injuries during immobilization.

Dynamic exercises are most often used. In this case, periods of contraction alternate with periods of relaxation.

By nature, other groups of exercises are also distinguished. For example, stretching exercises are used for joint stiffness.

By species trait exercises are subdivided into exercises:

• In throwing,
• For coordination,
• For balance,
• In resistance,
• Hangs and stops,
• Climbing,
• Corrective,
• Respiratory,
• Preparatory,
• · Ordinal.

Balance exercises are used to improve coordination of movements, improve posture, and also to restore this function in diseases of the central nervous system and the vestibular apparatus. Corrective exercises are aimed at restoring the correct position of the spine, chest and lower limbs. Coordination exercises restore overall coordination of movements or individual body segments. They are used from different IPs with a different combination of arm and leg movements in different planes. Necessary for diseases and injuries of the central nervous system and after prolonged bed rest.

By sign of activity dynamic exercises are divided into the following:

• Active,
• Passive,
• · For relaxation.

To facilitate the work of the flexor and extensor muscles of the arms and legs, exercises are carried out in the PI, lying on the side opposite to the exercised limb. To facilitate the work of the muscles of the foot, the exercises are carried out in the PI on the side on the side of the limb being exercised. To facilitate the work of the adductor and abductor muscles of the arms and legs, exercises are carried out in the PI on the back, abdomen.

To complicate the work of the flexor and extensor muscles of the arms and legs, exercises are carried out in the PI while lying on the back, abdomen. To complicate the work of the adductor and abductor muscles of the arms and legs, exercises are carried out in the PI, lying on the side opposite to the exercised limb.

To perform the exercises with effort, the resistance provided by the instructor or a healthy limb is used.

Mentally imaginary (phantom), ideomotor exercises or exercises "in sending impulses to contraction" are performed mentally, used for injuries during immobilization, peripheral paralysis, paresis.

Reflex exercises are aimed at the muscles distant from the trainees. For example, exercises that strengthen the muscles of the shoulder girdle are used to strengthen the muscles of the pelvic girdle and hip.

Passive exercises are exercises performed with the help of an instructor, without volitional effort of the patient, in the absence of active muscle contraction. Passive exercises are used when the patient cannot perform active movement, to prevent stiffness in the joints, to recreate the correct motor act (with paresis or paralysis of the limbs).

Relaxation exercises reduce muscle tone and create conditions for relaxation. Patients are taught "volitional" muscle relaxation using swing movements, shaking. Relaxation is alternated with dynamic and statistical exercises.

V depending on the gymnastic apparatus and apparatus used exercises are subdivided into the following:

• · Exercises without objects and shells;
• · Exercises with objects and apparatus (gymnastic sticks, dumbbells, clubs, medicine balls, jump ropes, resistance bands, etc.);
• · Exercises on shells, simulators, mechanical devices.

Breathing exercises

All exercises are associated with breathing. Breathing exercises are divided into the following:

• Dynamic,
• · Static.

Dynamic breathing exercises are combined with movements of the arms, shoulder girdle, trunk; static (conditionally) are carried out with the participation of the diaphragm, intercostal muscles and abdominal muscles and are not combined with the movements of the limbs and trunk.

When using breathing exercises, exhalation should be intensified. With a static full type of breathing, all respiratory muscles (diaphragm, abdominal muscles, intercostal muscles) are involved in the process of inhalation and exhalation. Full breathing is the most physiological; during inhalation, the chest expands in the vertical direction due to the lowering of the diaphragm and in the anteroposterior and lateral directions as a result of the movement of the ribs up, forward and sideways.

Static breathing exercises include:

• Exercises that change the type of breathing:
• o the above-described full type of breathing;
• o chest breathing;
• o diaphragmatic breathing;
• Exercises with dosed resistance:
• o diaphragmatic breathing with resistance - the instructor's hands are located in the region of the costal arch edge (closer to the middle of the chest);
• o diaphragmatic breathing with a bag of sand (from 0.5 to 1 kg) placed on the upper square of the abdomen;
• o upper thoracic bilateral breathing with overcoming resistance, which is carried out by the instructor, pressed with his hands in the subclavian region;
• o lower thoracic breathing with the participation of the diaphragm with resistance from the pressure of the instructor's hands in the area of ​​the lower ribs;
• o upper chest breathing on the right with resistance when pressed by the instructor's hands in the upper part of the chest;
• o use of inflatable toys, balls.

Distinguish between general and special breathing exercises. General breathing exercises improve lung ventilation and strengthen the main breathing muscles. Special breathing exercises are used for lung diseases, paresis and paralysis of the respiratory muscles.

Drainage breathing exercises called exercises that promote the outflow of secretions from the bronchi into the trachea, followed by the production of sputum during coughing.

For a better outflow of discharge from the affected area, static and dynamic breathing exercises are used. Drainage exercises are carried out in the initial positions lying on the stomach, on the back, on the side with the raised foot end of the bed, sitting, standing. The choice of the starting position depends on the location of the lesion.

Sports and applied exercises

Applied sports exercises include walking, running, crawling and climbing, throwing and catching a ball, rowing, skiing, skating, cycling, terrenkur (dosed ascent), hiking. The most widely used is walking - for a wide variety of diseases and almost all types and forms of occupation. The amount of physical activity when walking depends on the length of the path, the size of the steps, the pace of walking, the terrain and complexity. Walking is used before starting classes as a preparatory and organizing exercise. Walking can be complicated - on toes, on heels, walking with a cross, in a half-squat, with high knees. Special walking - on crutches, with a stick, on prostheses. It is used in case of damage to the lower extremities. According to the speed, walking is divided into: slow - 60-80 steps per minute, medium - 80-100 steps per minute, fast - 100-120 steps per minute and very fast - 120-140 steps per minute.

Games are divided into four groups that increase in load:

• · On site;
• · Sedentary;
• · Movable;
• · Sports.

In exercise therapy they use croquet, bowling alley, small towns, relay races, table tennis, badminton, volleyball, tennis and elements of other sports games (basketball, football, handball, water polo). Sports games are widely used in the conditions of sanatorium-resort treatment and are carried out according to general simplified rules with the selection of partners with the same physical fitness.

Gymnastic exercises with specially selected musical accompaniment are advisable to use when conducting group morning and therapeutic exercises. This has a beneficial effect on the state of the nervous, cardiovascular and respiratory systems, on metabolism. Dance elements and dance steps should also be included in the procedures.

Exercise in water and swimming in a pool at a water temperature of 25-27 ° C are effective in treating diseases of the vascular system, respiratory system, metabolism, nervous system, damage to the musculoskeletal system during a period of persistent remission of a chronic disease. Exercises at a water temperature of 34-36 ° C are appropriate for patients with spastic paresis.

In exercise therapy, mechanical devices and simulators of local (local) and general action... To develop joints while limiting movements in them and strengthening weakened muscles in patients with diseases and the consequences of injuries of the musculoskeletal system, exercises are prescribed on local mechanical devices - as an addition to the procedures of therapeutic gymnastics.

Simulators and mechanical devices of general action - bike simulators, rowing machine, treadmill and others - are prescribed for diseases of the cardiovascular, respiratory systems, exogenous constitutional obesity and other diseases in the stage of compensation.

Exercise dosage

The dosage in exercise therapy is the total amount of physical activity that the patient receives during the session).

The load should be optimal and match functionality sick. To dose the load, you should take into account a number of factors that affect the magnitude of the load, increasing or decreasing it:

1. Starting positions lying, sitting - ease the load, while standing - increase.
2. The size and number of muscle groups. The inclusion of small groups (feet, hands) - reduces the load; exercises for large muscles - increase.
3. Amplitude of motion: the more, the greater the load.
4. The number of repetitions of the same exercise: increasing it increases the load.
5. Execution rate: slow, medium, fast.
6. Rhythmic exercise eases the load.
7. The requirement for the accuracy of the exercises: at first it increases the load, later, when developing automatism, it decreases.
8. Exercises difficult for coordination - increase the load, so they are not included in the first days.
9. Positive emotions in the classroom in game form help to carry the load more easily.
10. Various degrees of effort of the patient during exercise: changes the load.
11. The principle of load dissipation with alternation of different muscle groups: allows you to select the optimal load.
12. The use of objects and projectiles affects not only the increase, but also the decrease in the load.

The total physical activity in the class depends on the intensity, duration, density and volume of it. The intensity corresponds to a certain level of its threshold value: from 30-40% at the beginning and 80-90% at the end of treatment. To determine the intensity threshold, the performance of loads on a bicycle ergometer with an increasing power from 50 to 500 kgm / m and more is used up to the tolerance limit. The duration of the load corresponds to the time of the classes. Load density refers to the time spent actually doing the exercise and is expressed as a percentage of the total time spent exercising. The volume of the load is the total work that was done in the lesson. Uniform performance of exercises in a lesson without interruptions is designated as a flow method, the total physical load is determined by the intensity and duration of the lessons. With the interval (split) method with pauses between exercises, the load depends on the density of the sessions.

Movement mode (activity mode) is a system of those physical activities that the patient performs during the day and during the course of treatment.

Strict bed rest are prescribed to seriously ill patients. For the prevention of complications, exercises in static, breathing, passive exercises and light massage are used.

Extended bed rest prescribed in a generally satisfactory condition. Allow transitions to a sitting position in bed from 5 to 40 minutes several times a day. Medical gymnastics is used with a small dosage of physical activity with an acceptable increase in heart rate by 12 beats / min.

Ward mode includes a sitting position up to 50% during the day, moving around the department with a walking pace of 60 steps per minute at a distance of 100-150 m, therapeutic exercises up to 20-25 minutes long, with an increase in heart rate after class by 18-24 beats / min.

On free mode in addition to the ward, they include moving up the stairs from the 1st to the 3rd floor, walking around the territory at a pace of 60-80 steps per minute for a distance of up to 1 km, with rest every 150-200 m. a day in the gym, the duration of the lesson is 25-30 minutes, with an increase in the pulse after it by 30-32 beats / min.

The pulse rate in the classroom should be no more than 108 bpm for adults and 120 bpm for children.

In a sanatorium-resort environment, a gentle, gentle training and training regime is used.

Sparing mode corresponds mainly to a free regime in a hospital, with a resolution of walking up to 3 km with rest every 20-30 minutes, games, bathing (when prepared and tempered).

Gentle trainer the mode allows for medium physical activity: walking up to 4 km in 1 hour is widely used, training, skiing at an air temperature not lower than 10-12 ° C, boating in combination with rowing 20-30 m, sports games with lightweight conditions of their conduct.

Training mode used in cases where there are no pronounced deviations in the functions of various organs and systems. Running, sports games are allowed according to the general rules.

Forms and methods of physiotherapy exercises

The system of certain physical exercises is a form of exercise therapy; these are therapeutic exercises, morning hygienic exercises, independent exercises for patients on the recommendation of a doctor, instructor; dosed walking, health path, physical exercise in water and swimming, skiing, rowing, training on simulators, mechanical devices, games (volleyball, badminton, tennis), small towns. in addition to physical exercises, exercise therapy includes massage, hardening with air and water, occupational therapy, and right therapy (horseback riding).

Hygienic gymnastics intended for the sick and healthy. Carrying out it in the morning after a night's sleep is called morning hygienic gymnastics, it helps to relieve inhibition processes, the appearance of vigor.

Physiotherapy- the most common form of using physical exercises for treatment, rehabilitation. The ability, with the help of a variety of exercises, to purposefully influence the restoration of disturbed organs and systems, determine the role of this form in the exercise therapy system. Classes (procedures) are carried out individually for seriously ill patients, by small-group (3-5 people) and group (8-15 people) methods. The groups unite patients according to nosology, i.e. with the same disease; localization of injury. It is wrong to combine patients with different diseases into one group.

Each lesson is built according to a specific plan and consists of three sections: preparatory (introductory), main and final. The introductory section provides for preparation for performing special exercises, gradually includes it in the load. The duration of the section takes 10-20% of the time of the whole lesson.

In the main section, classes solve the problems of treatment and rehabilitation and use special exercises in alternation with general strengthening exercises. Duration of the section: - 60-80% of the total time of the lesson.

In the final section, the load is gradually reduced.

Exercise is monitored and regulated by observing the body's responses. Pulse control is simple and affordable. The graphic representation of the change in its frequency during exercise is called the physiological load curve. The greatest rise in heart rate and maximum load is usually achieved in the middle of the session - this is a one-peak curve. In a number of diseases, after an increased load, it is necessary to apply a decrease in it, and then increase it again; in these cases, the curve may have several vertices. You should also count your heart rate 3-5 minutes after exercise.

The density of classes is very important, i.e. actual exercise time, expressed as a percentage of the total exercise time. In inpatients, the density gradually increases from 20-25 to 50%. In case of spa treatment on a training mode in groups of general physical training, the density of classes is 80-90%. Individual self-study supplements the instructor-led therapeutic exercises and can only be carried out subsequently independently with a periodic visit to the instructor for instructions.

The gymnastic method, carried out in medical gymnastics, is the most widespread. The play method complements it when working with children.

The sports method is used to a limited extent and mainly in spa practice.

When using exercise therapy, the principles of training should be observed, taking into account the therapeutic and educational objectives of the method.

1. Individualization in the technique and dosage, taking into account the characteristics of the disease and the general condition of the patient.
2. Systematic and consistent use of physical exercises. They start with simple exercises and move on to complex exercises, including 2 simple and 1 difficult new exercise in each lesson.
3. Regularity of exposure.
4. The duration of the sessions ensures the effectiveness of the treatment.
5. The gradual increase in physical activity in the course of treatment to ensure the training impact.
6. Variety and novelty in the selection of exercises are achieved by updating them by 10-15% with a repetition of 85-90% of the previous ones to consolidate the results of treatment.
7. Moderate, prolonged or fractional loads are more appropriate to use than reinforced ones.
8. Compliance with the cyclicity of the alternation of exercises with rest.
9. The principle of comprehensiveness - provides for the impact not only on the affected organ or system, but also on the entire body.
10. The visibility and accessibility of exercises is especially necessary in classes with lesions of the central nervous system, with children, the elderly.
11. Conscious and active participation of the patient is achieved by skillful explanation and selection of exercises.

To carry out exercise therapy, a lesson scheme (procedure) is drawn up, in which sections, the content of the sections, dosage, target setting (tasks of the section) and methodological instructions are indicated. An example scheme in table 1

Table 1. An approximate scheme of the therapeutic gymnastics procedure for I degree circulatory failure

The scheme does not list the exercises, but indicates which of the existing ones in the classification should be used. In accordance with the scheme, a set of exercises is made up - with an indication of the starting positions, a description of the exercise, its dosage (number of repetitions or duration in minutes) and methodological instructions (if necessary for individual exercises).

The course of application of exercise therapy is divided into periods: introductory, main and final (or the beginning, middle and end of the course of treatment). Accordingly, schemes and exercise complexes are made for each period.