Appointment LFK. Abstract: Fundamentals of physiotherapy exercises
The concept of therapeutic physical culture (LFK)
The peculiarity of exercise therapy in comparison with other methods of treatment and rehabilitation is, in fact, that it uses as the main remedy physical exercises. One of characteristic features Exercise therapy is a process of dosed physical exercise training that permeates the entire course of treatment and rehabilitation.
The essence of training is repeated, systematically repeated and gradually increasing physical activity, which causes positive functional in the human body, and sometimes even structural changes. As a result of training, the regulatory mechanisms are normalized, improved, increasing the adaptive capabilities of the patient's body to dynamically changing environmental conditions.
In physical therapy, a distinction is made between general and special dosed training. General training is used to improve, strengthen and general development organism, while general strengthening and general developmental physical exercises are used. Special training is used to develop the functions and restore the organ involved in the pathological process. Here apply special exercises, which directly affect the affected system, diseased organ, traumatic focus.
In the process of therapeutic and rehabilitation training, it is important to observe the following physiologically justified pedagogical principles:
1. Individual approach to the patient. It is necessary to take into account the age, gender and profession of the patient. motor experience, the nature and extent of the pathological process and the functional capabilities of the patient.
2. Consciousness. It should be said that for the most effective application exercise it is essential to be conscious and Active participation the patient himself.
3. The principle of gradualism. A gradual increase is needed physical activity in all its indicators: volume, intensity, number of exercises, the number of repetitions and complexity both within one lesson and from one workout to another.
4. Systematic. In the process of health training, it is extremely important to systematically use a variety of means of exercise therapy and rehabilitation, which is optimal for each patient.
5. Cyclicity. Alternation of work and rest in compliance with optimal interval(rest between two exercises or between two sessions). If the next session falls on the phase of supercompensation, then the effects of the training are summed up, and the functionality increases.
6. Systematic impact. Sequential alternation of starting positions and exercises for different muscle groups.
7. Novelty and variety in the selection and application of physical exercises (10-15% of physical exercises should be updated, and 85-90% are repeated to consolidate progress treatment).
8. Moderate impact. The training load should be adequate to the patient's condition.
The concept of therapeutic physical culture (LFK) - the concept and types. Classification and features of the category "The concept of therapeutic physical culture (LFK)" 2014, 2015.
Therapeutic physical culture is an independent medical discipline that uses the means of physical culture for the prevention of exacerbations and the treatment of many diseases and injuries and rehabilitation. The specificity of therapeutic physical culture in comparison with other methods of treatment lies in the fact that it uses physical exercise as the main therapeutic agent, which is a significant stimulator of the vital functions of the human body.
Therapeutic physical culture should be considered as one of the elements of modern complex treatment. Comprehensive treatment refers to individually selected medical methods and means that provide a change in the reactivity of the organism in positive side, improvement and restoration of the functions of an organ or system affected by the disease. Complex treatment affects not only pathologically altered tissues, organs or organ systems, but also the whole organism as a whole. Specific gravity various elements complex treatment depends on the period and clinical course of the disease. In the process of clinical recovery and the need to restore the ability to work of a person who has undergone a particular disease or injury, an essential role in complex treatment belongs to therapeutic physical culture as a method of functional therapy. Physical exercises, regardless of the place of their application, affect the reactivity of the whole organism and involve the mechanisms involved in the overall reaction. pathological process. In this regard, therapeutic physical culture can be called a method of pathogenetic therapy.
Therapeutic physical culture provides for the conscious and active performance of appropriate physical exercises by patients. In the process of practicing them, the patient acquires the skill in using natural factors of nature for the purpose of hardening, learns to observe the regime of movements, use physical exercises for therapeutic and prophylactic purposes. This allows us to consider the use of physical exercises with therapeutic purpose medical and educational process.
Therapeutic physical culture uses the same means and principles of application as physical education for a healthy person. It is based on the principles of the Soviet system physical education, namely the principles of comprehensive impact, application and health orientation. Thus, in its content, therapeutic physical culture is integral part Soviet system of physical education.
The use of physical exercises for therapeutic purposes has long been known.
In China, written sources testifying to the appearance therapeutic gymnastics and massage, date back to the third millennium BC. The sacred books of the Vedas, which appeared a thousand years later in India, contain detailed description therapeutic effect of breathing exercises, special passive movements, bathing and rubbing the body. AT Ancient Greece therapeutic gymnastics was studied and developed by Hippocrates, which was reflected in his writings. Therapeutic gymnastics, massage and water procedures the ancient Greeks were obligatory and essential elements of treatment. Roman doctors, primarily Galen, using the experience of the Greeks, widely used therapeutic exercises and occupational therapy.
In the Middle Ages, physical exercises for therapeutic purposes were used very limitedly.
AT further development The outstanding Tajik scientist Abu-Ali Ibn-Sina (Avicenna) played an important role in medical physical culture. He theoretically substantiated the use of physical exercises with therapeutic and preventive purpose, the use of solar and air baths and described in detail a number of gymnastic and applied exercises. During the Renaissance, a number of prominent scientists (A. Comenius and I. Mercurialis) in their writings promoted the importance of physical education. In the XVIII century. and especially in the nineteenth century. reappeared work on medicinal value physical exercise. The Swedish system of physical education Ling had a great influence on the development of medical gymnastics in Europe.
22. O basic principles physiotherapy exercises. The principle of individuality.
Physiotherapy - the leading method of medical rehabilitation - rehabilitation treatment and supportive therapy. The correct use of physiotherapy exercises helps to accelerate recovery, restore impaired ability to work and return patients to active work.
Physiotherapy exercises for diseases of the musculoskeletal system are carried out in compliance with the following principles:
individuality in the method and dosage of physical exercises, depending on the characteristics of the disease, age and general condition client,
consistency (selection of a specific set of exercises),
regularity,
moderation (class duration 25-40 minutes),
comprehensive effect of physical exercises on the body.
An integrated approach, in each individual case, begins with a consultation with an exercise therapy doctor, an orthopedic traumatologist, an endocrinologist, a manual therapy doctor, and other specialists, continues with physiotherapy exercises in combination with medical massage, acupuncture and physiotherapy, under the supervision of specialists, which increases efficiency the use of physiotherapy exercises and helps to consolidate the rehabilitation effect.
Physical exercise has a wide variety of effects on the body. As a result of the course application of physiotherapy exercises:
the processes of excitation and inhibition in the central nervous system are balanced,
normalizes psycho-emotional state child,
has a general strengthening effect on the body,
increases immunity,
the respiratory muscles are strengthened (prevention of respiratory diseases),
treatment and prevention of constipation in children,
correction of posture defects is carried out, weak muscles of the back and limbs are strengthened,
flattens out muscle tone back and limbs
the curves of the spine and its mobility are correctly formed,
strength endurance is developed, the muscular corset is strengthened.
Physical therapy helps to strengthen musculoskeletal system, favorably affects the cardiovascular system, respiratory organs, vision, normalizes blood pressure, corrects posture, provides physical preparation for childbirth and postpartum recovery, and helps in the fight against obesity. Thus, exercise therapy has a positive effect on the human body both in the process of treatment and as a preventive measure.
In the process of repeated repetition of physical exercises, existing ones are improved, lost ones are restored and new (for example, compensatory) motor skills and physical qualities are developed, positive changes in the function of organs and systems occur, which together contribute to the restoration of health, fitness, increased physical performance and other changes in the state organism. Physical activity in the process of exercise therapy should be adequate to the functional capabilities of the patient. So, in old age, the period necessary to adapt to a given level of load is lengthened, tolerance to physical activity decreases, and recovery processes slow down.
The use of musical accompaniment during exercise therapy enhances the tonic effect of exercises or has a calming effect on the nervous system, depending on the rhythm of the music.
Dosing of physical activity in various forms of exercise therapy is determined by the nosological form, the severity of the course of the disease, the patient's condition, his age and gender. When prescribing exercise therapy, functional tests with physical activity are carried out. In the process of exercise therapy, the doctor controls the adequacy of physical activity to the patient's condition by his well-being, respiratory rate, heart rate, and blood pressure.
Abstract on the discipline " Physical Culture»
on the topic "Fundamentals of physiotherapy exercises"
General foundations of physiotherapy exercises
Physical therapy exercises provide healing effect only with proper, regular, long-term use of physical exercises. For these purposes, a methodology for conducting classes, indications and contraindications for their use, accounting for effectiveness, hygiene requirements to work places.
There are general and private methods of exercise therapy. The general methodology of 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 course of treatment, rules for constructing a separate lesson (procedure), forms of exercise therapy, schemes of movement modes. Private methods of exercise therapy are designed for a specific nosological form of the disease, injury and are individualized taking into account the etiology, pathogenesis, clinical features, age, physical fitness sick. Special exercises for influencing the affected systems, organs must be combined with general strengthening, which provides general and special training.
Physical exercises are performed after they are explained or shown. In elderly patients, with organic lesions The CNS should combine demonstration and verbal explanation of exercises. During class, there should be calm environment, the patient should not be distracted by extraneous conversations and other irritants.
Physical exercise should not increase pain, since pain reflexively causes vasospasm, stiffness of movements. Exercises, causing pain, should be carried out after preliminary relaxation of the muscles, at the time of exhalation, in optimal starting positions. From the first days of training, the patient should be taught correct breathing and the ability to relax muscles. Relaxation is more easily achieved after an energetic muscle tension. With unilateral lesions of the limbs, relaxation training begins with a healthy limb. Musical accompaniment of classes increases their effectiveness.
The main means of physical therapy are physical exercises and natural factors nature. There are many physical exercises, and they affect the body in different ways.
Classification of physical exercises
Physical exercises in exercise therapy are divided into three groups: gymnastic, sports and applied and games.
Gymnastic exercises
Consists of combined movements. With their help, you can influence various body systems and individual muscle groups, joints, developing and restoring muscle strength, speed, coordination, etc. All exercises are divided into general developmental (general strengthening), 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 make it easier therapeutic effect special.
Special exercises
Selectively act on the musculoskeletal system. For example, on the spine - with its curvature, on the foot - with flat feet and trauma. For a healthy person, exercises for the body are general strengthening; with osteochondrosis, scoliosis, they are classified as special, since their action is aimed at solving the problems of treatment - increasing the mobility of the spine, correcting the spine, strengthening the muscles surrounding it. Leg exercises are general strengthening for healthy people, and after surgery on the lower extremities, trauma, paresis, diseases of the joints, these same exercises are classified 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 weights, resistance), in order to develop muscle-articular feeling (accurate reproduction of movement without visual control) . Usually, special exercises are used in combination with general developmental ones.
Gymnastic exercises are divided into groups:
by anatomical sign;
The nature of the exercise
By type;
On the basis of activity;
On the basis of the objects and shells used.
According to the anatomical feature, they are distinguished 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, torso),
combined.
According to the nature of muscle contraction, exercises are divided into two groups:
dynamic (isotonic);
static (isometric).
Muscle contraction, 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); while holding the leg raised up for some time, the work of the muscles is carried out in isometric mode (static work). Isometric exercises are effective for injuries during the period of immobilization.
The most commonly used dynamic exercises. In this case, periods of contraction alternate with periods of relaxation.
Other groups of exercises are also distinguished by their nature. For example, stretching exercises are used for joint stiffness.
By type, exercises are divided into exercises:
in throwing,
for coordination,
for balance,
in the 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 recovery right position spine, chest and lower extremities. Coordination exercises restore overall coordination of movements or individual segments of the body. They are used from different PIs with a different combination of movements of the arms and legs in different planes. Necessary for diseases and injuries of the central nervous system and after prolonged bed rest.
On the basis 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 IP lying on the side opposite to the limb being exercised. To facilitate the work of the muscles of the foot, exercises are carried out in the PI on the side on the side of the exercised limb. 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 performed in the IP lying on the back, stomach. To complicate the work of the adductor and abductor muscles of the arms and legs, exercises are carried out in the IP lying on the side opposite to the exercised limb.
To perform 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 the period of immobilization, peripheral paralysis, paresis.
Reflex exercises consist in influencing muscles that are distant from the trainees. For example, to strengthen muscles pelvic girdle and hips use exercises that strengthen the muscles of the shoulder girdle.
Passive exercises are called exercises performed with the help of an instructor, without the patient's willpower, in the absence of active muscle contraction. Passive exercises are used when the patient cannot perform an 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, create conditions for relaxation. Patients are taught "volitional" muscle relaxation using swing movements, shaking. Relaxation is alternated with dynamic and static exercises.
Depending on the gymnastic objects and apparatus used, exercises are divided into the following:
exercises without objects and shells;
Exercises with objects and equipment (gymnastic sticks, dumbbells, maces, medicine balls, jump ropes, expanders, etc.);
exercises on shells, simulators, mechanoapparatuses.
Breathing exercises
All exercises are related to breathing. Breathing exercises are divided into the following:
dynamic,
static.
Dynamic breathing exercises are combined with the movements of the arms, shoulder girdle, torso; 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 torso.
When using breathing exercises, exhalation should be activated. With a static full type of breathing, all respiratory muscles participate in the process of inhalation and exhalation (diaphragm, abdominal Press, intercostal muscles). Full breath most physiological; during inhalation, the chest expands into 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 to the sides.
Static breathing exercises include:
breathing exercises:
o above complete type breathing;
o chest type breathing;
o diaphragmatic breathing;
Dosed resistance exercises:
o diaphragmatic breathing with resistance - the instructor's hands are located in the edge of the costal arch (closer to the middle of the chest);
o diaphragmatic breathing with a bag of sand (from 0.5 to 1 kg) placed on the area of 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 region of the lower ribs;
o upper chest breathing on the right with resistance when pressed by the hands of the instructor in the upper part of the chest;
o use inflatable toys, balls.
There are general and special breathing exercises. General breathing exercises improve lung ventilation and strengthen the major respiratory 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 discharge from the bronchi into the trachea, followed by 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 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 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, health path (metered climbing), and hiking. The most widely used is walking - with the most various diseases and almost all kinds and forms of occupations. The amount of physical activity during walking depends on the length of the path, the size of the steps, the pace of walking, the terrain and the complexity. Walking is used before the start of classes as a preparatory and organizing exercise. Walking can be complicated - on toes, on heels, walking in a cross step, in a semi-squat, with high knees. Special walking - on crutches, with a stick, on prostheses. It is used for lesions of the lower extremities. Walking speed 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 of increasing load:
in place;
inactive;
mobile;
sports.
In exercise therapy they use croquet, bowling alley, 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 treatment and are carried out according to general lightweight rules with the selection of partners with the same physical fitness.
Gymnastic exercises with specially selected musical accompaniment appropriate to use when group lessons morning and therapeutic exercises. It favorably affects the state of the nervous, cardiovascular and respiratory systems, on metabolism. Dance elements and dance steps should also be included in the procedures.
Physical exercises in water and swimming in the pool at a water temperature of 25-27 ° C are effective in the treatment of diseases vascular system, respiratory organs, metabolism, nervous system, damage to the musculoskeletal system during the 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 are used. To develop joints with limited movements in them and strengthen weakened muscles in patients with diseases and consequences of injuries of the musculoskeletal system, exercises on local action mechanical devices are prescribed - as an addition to therapeutic exercises.
Simulators and mechanical devices of general action - exercise bikes, a rowing machine, a treadmill and others - are prescribed for diseases of the cardiovascular, respiratory systems, exogenous-constitutional obesity and other diseases in the compensation stage.
Dosage of exercise
Dosage in exercise therapy is the total amount of physical activity that the patient receives during the procedure).
The load must be optimal and correspond to functionality sick. For the dosage of the load, a number of factors should be taken into account that affect the magnitude of the load, increasing or decreasing it:
1. Starting positions lying, sitting - lighten the load, standing - increase.
2. Size and number of muscle groups. The inclusion of small groups (feet, hands) - reduces the load; exercises for large muscles - increase.
3. Range of motion: the larger, the greater the load.
4. The number of repetitions of the same exercise: increasing it increases the load.
5. The pace of execution: slow, medium, fast.
6. Rhythmic execution of exercises facilitates the load.
7. The requirement for accuracy in performing exercises: at first it increases the load, later, when automatism is developed, it decreases.
8. Exercises that are difficult for coordination - increase the load, so they are not included in the first days.
9. Relaxation exercises and static breathing exercises - reduce the load: the more breathing exercises, the less the load. Their ratio to general strengthening and special can be 1:1; 1:2; 1:3; 1:4; 1:5.
10. Positive emotions in class at game form help to carry the load more easily.
11. Different degree of effort of the patient during exercise: changes the load.
12. The principle of load dissipation with the alternation of different muscle groups: allows you to choose the optimal load.
13. The use of items and shells affects not only the increase, but also the decrease in the load.
The total physical load in the lesson 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 increasing power from 50 to 500 kgm/m and more up to the tolerance limit is used. The duration of the load corresponds to the time of classes. The concept of load density refers to the time spent on the actual exercise, and is expressed as a percentage of the total time of the session. Load volume is general work that was done in class. Uniform performance of exercises without interruptions in a lesson is referred to as a streaming method, while the total physical load is determined by the intensity and duration of classes. With the interval (separate) method with pauses between exercises, the load depends on the density of classes.
Mode of movement (activity mode) is a system of those physical activities that the patient performs during the day and throughout the course of treatment.
Strict bed rest administered to seriously ill patients. To prevent complications, exercises in static, breathing, passive exercises and light massage are used.
Extended bed rest is prescribed for general satisfactory condition. Allow transitions to a sitting position in bed from 5 to 40 minutes several times a day. Apply therapeutic exercises with a small dosage of physical activity with an allowable increase in heart rate by 12 beats / min.
The ward mode includes a sitting position up to 50% during the day, movement around the department at a walking pace of 60 steps per minute for a distance of up to 100-150 m, therapeutic exercises for up to 20-25 minutes, with an increase in heart rate after exercise by 18-24 beats ./min.
In 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. Therapeutic exercises are prescribed 1 time per day in the gym, the duration of the lesson is 25-30 minutes, with an increase in heart rate after it by 30-32 bpm.
The pulse rate in the classroom should be no more than 108 beats / min for adults and 120 beats / min for children.
In sanatorium-resort conditions, sparing, sparing-training and training modes are used.
Gentle mode corresponds basically free regime in a hospital, with permission to walk up to 3 km with rest every 20-30 minutes, games, bathing (if prepared and hardened).
The sparing training mode allows for average physical activity: walking up to 4 km in 1 hour, walking, skiing at an air temperature of at least 10-12 ° C, boating in combination with rowing 20-30 m are widely used, sport games with facilitated conditions for their implementation.
The training mode is used in cases where there are no pronounced deviations in the functions various bodies and systems. Running, sports games according to the general rules are allowed.
Forms and methods of physical therapy
The system of certain physical exercises is a form of exercise therapy; This is therapeutic gymnastics, morning hygienic gymnastics, self-study patients on the recommendation of a doctor, instructor; dosed walking, health path, physical exercises in the water and swimming, skiing, rowing, exercises on simulators, mechanical devices, games (volleyball, badminton, tennis), towns. in addition to physical exercises, exercise therapy includes massage, hardening with air and water, occupational therapy, ray therapy (horseback riding).
Hygienic gymnastics is intended for sick and healthy people. Carrying it out in the morning after a night's sleep is called morning hygienic gymnastics, it helps to remove the processes of inhibition, the appearance of cheerfulness.
Therapeutic gymnastics is the most common form of using physical exercises for the purpose of treatment and rehabilitation. The ability to purposefully influence the restoration of damaged organs and systems with the help of various exercises determines 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 on the localization of the 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 the implementation of special exercises, gradually includes in the load. The duration of the section takes 10-20% of the time of the entire lesson.
In the main section of the lesson, they solve the problems of treatment and rehabilitation and use special exercises in alternation with restorative ones. Duration of the section: - 60-80% of the total time of the lesson.
In the final section, the load is gradually reduced.
Physical activity is controlled and regulated by observing the body's responses. Heart rate control is simple and affordable. Graphic image changes 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 the pulse 3-5 minutes after class.
The density of classes is very important, i.e. the time of the actual exercise, expressed as a percentage of the total time of the lesson. In inpatients, the density gradually increases from 20-25 to 50%. At spa treatment in the training mode in groups of general physical training a density of 80-90% is acceptable. Individual self-study supplements the therapeutic exercises conducted by the instructor, and can subsequently be carried out only independently with periodic visits to the instructor for instructions.
The gymnastic method, carried out in therapeutic gymnastics, is most widely used. The game method complements it when working with children.
The sports method is used to a limited extent and mainly in sanatorium practice.
When using exercise therapy, one should follow the principles of training, taking into account the therapeutic and educational objectives of the method.
1. Individualization in the method 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. Start simple and move on to difficult exercises, including 2 simple and 1 difficult new exercises in each lesson.
3. Regularity of exposure.
4. Duration of classes ensures the effectiveness of treatment.
5. The gradual increase in physical activity during treatment to provide a training effect.
6. Variety and novelty in the selection of exercises - are achieved by updating them by 10-15% with the repetition of 85-90% of the previous ones to consolidate the results of treatment.
7. Moderate, continuous or fractional loads - it is more expedient to use than reinforced ones.
8. Compliance with the cyclical alternation of exercises with rest.
9. The principle of comprehensiveness - provides for the impact not only on the affected organ or system, but on the whole organism.
10. Visibility and accessibility of exercises - it is especially necessary in classes with CNS lesions, with children, the elderly.
11. Conscious and active participation of the patient - is achieved by skillful explanation and selection of exercises.
For conducting exercise therapy draw up a lesson plan (procedure), which indicates the sections, the content of the sections, dosage, target setting (section tasks) and guidelines (Table 3).
table 3
| Section and content of the procedure | Dosage, min | Target setting | |
| I | Elementary exercises for limbs in IP sitting | 2 - 5 | Introductory section of the procedure. gradual retraction of cardio-vascular system in an increased load |
| Exercises for the body, combined movements of the arms and legs, arms and body alternately with breathing exercises in the sitting IP | 5 - 6 | Cardiovascular training by targeting the larger muscle groups of the body, combined with proper movement. Contribute to the reduction of congestion in the liver, spleen and large venous vessels abdominal cavity by movement of the body and periodic changes in intra-abdominal pressure, both upward and downward | |
| III | Elementary limb exercises and breathing exercises | 3 | Reducing the overall physiological load. Create conditions for the relative rest of the heart muscle. Strengthen the suction activity of the chest with deep breathing exercises |
| IV | Seated limited resistance exercises or exercises with dumbbells | 3 | Training the heart muscle by applying movements with increasing effort |
| V | Final elementary and breathing exercises | 2 - 3 | Reducing the overall physical load on the body |
| Total: | 15 - 20 | ||
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, they make up a set of exercises - indicating the starting positions, a description of the exercise, its dosage (number of repetitions or duration in minutes) and guidelines (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, for each period, schemes and sets of exercises are made.
An approximate set of physical exercises for circulatory insufficiency of the 1st degree
1. IP - sitting on a chair, hands on hips. calm breathing static character (3-4 times).
2. IP - sitting, hands on knees. Extension of the arms g of the wrist joint (6-8 times).
3. IP. - sitting. Dorsiflexion of the feet in the ankle joint (6-8 times).
4. IP - sitting, hands down. Hands to the sides - inhale, lower - exhale (4-5 times).
5. IP - the same. Throwing straight arms forward, to the sides, lower (5-6 times). .
6. IP - sitting. Alternately lifting the hips. Draw in the stomach while adducting the hips (5-6 times).
7. IP - stsdya. Take your hands to the sides - inhale, lower - exhale (4-5 times).
8. IP - sitting, hands are fixed on the back of the chair. Bending the back without taking your hands off. When bending - inhale, when bending - exhale.
9. IP - sitting, hold on to the seat with your hands, legs extended. Breeding and bringing straight legs with sliding feet on the floor (6-8 times).
10. IP - sitting, hands on the chin. Spread your elbows to the side - inhale, bring your shoulders, squeeze chest and slightly tilt the body - exhale (4-5 times).
11. IP - sitting, hands on hips, legs apart shoulder width apart. Tilts of the body alternately to the right - to the left on the exhale. When straightening - inhale (3-4 times).
12. PI - sitting, arms lowered, raising arms to the sides up - inhale, lowering - exhale (3-4 times).
13. IP - sitting on a chair, hands on hips. Exercise in raising, lowering, retracting back and bringing forward the shoulder girdle (6-8 times).
14. IP - sitting on the edge of a chair, hold on to the seat with your hands. Imitation of the movements of a cyclist with sliding feet on the floor (10-12 times).
15. IP - sitting. Calm breathing of a static character (3-4 times).
16. IP - sitting. Raising the arms to the sides, up - inhale, lower - exhale (3-5 times).
17. IP - sitting. Circular movements in the wrist joints (5-6 times in both directions).
18. IP - sitting. Rolling feet from toes to heel (5-6 times).
Indications, contraindications and risk factors in physiotherapy exercises
Therapeutic exercise is indicated at any age for almost all diseases, injuries and their consequences, She finds wide application:
in the clinic of internal diseases;
in neurology and neurosurgery;
in traumatology and orthopedics;
· after surgical treatment diseases internal organs;
in pediatrics;
in obstetrics and gynecology;
in phthisiology;
in psychiatry;
in ophthalmology - with uncomplicated myopia;
in oncology - in patients without metastases after radical treatment.
The list of contraindications is very small and mainly concerns the initial period of the acute stage of the disease or exacerbation of chronic diseases, the acute period of injury, with indications for surgical intervention, with bleeding.
General contraindications to appointment of exercise therapy:
acute infectious and inflammatory diseases With high temperature body and general intoxication;
· acute period disease and its progressive course;
· malignant neoplasms before their radical treatment, malignant neoplasms with metastases;
Severe oligophrenia (dementia) and mental illness with a sharply impaired intellect;
· Availability foreign body near large vessels and nerve trunks;
· acute disorders coronary and cerebral circulation;
acute thrombosis and embolism;
increase in cardiovascular insufficiency with decompensation of blood circulation and respiration;
· bleeding;
general serious condition sick;
・significantly pronounced pain syndrome;
negative dynamics of the ECG, indicating a deterioration in coronary circulation;
atrioventricular blockade.
Temporary contraindications to the appointment of exercise therapy:
exacerbation chronic diseases;
complication during the course of the disease;
Intercurrent diseases of an infectious or inflammatory nature;
acute injuries;
The appearance of signs indicating the progression of the disease and the deterioration of the patient's condition;
vascular crisis (hypertonic, hypotonic or normal blood pressure);
Heart rhythm disturbance: sinus tachycardia (over 100 beats / min), bradycardia (less than 50 beats / min), an attack of paroxysmal or atrial fibrillation, extrasystoles with a frequency of more than 1:10.
Risk factors that can cause damage to the osteoarticular apparatus include:
severe osteoporosis in the elderly, especially in women;
Significant effort on the part of the patient with fragile callus after fractures of the bones of the extremities, in patients with spastic paralysis with impaired pain sensitivity.
Literature
1. Evseev Yu. Physical culture. Textbook for universities. Phoenix. 2008.
2. Evseev S.P. Adaptive physical culture. Terra-Sport, 2003.
3. Epifanov V.A. Therapeutic physical culture and sports medicine. Infra-M, 2007
4. Suleimanov I.I. Introduction to the subject "Physical culture of pupils and students": textbook. allowance / Suleymanov I.I.; OGIFK. - Omsk, 2003
5. Vasilkov A. Theory and methods of sports. Textbook. Phoenix, 2008.
6. Shchegolev V.A. Physical culture and sport in the upbringing of students: textbook.-method. allowance / Shchegolev V.A.; VLGIFC. - Velikiye Luki, 2005