Medical groups of students for physical education. The list of diseases and pathological conditions that prevent admission to sports
Physical education classes are designed to provide a minimum level motor activity for students with health purpose. In the classes themselves, the intensity of the load can be very, very high. It can only be successfully dealt with healthy student. However, statistics recent years disappointing. The state of health of high school students - future applicants - is steadily deteriorating. And this means that every year the number of students with certain restrictions in relation to physical activity will increase. This is a serious fact that cannot be ignored, especially considering that the teacher is responsible for the life and health of students in physical education classes. One of mandatory conditions admission and physical education at the university is the provision of students medical certificate with the conclusion of a doctor about the state and health group. Such medical examinations are organized by the universities themselves. These activities are not strictly regulated in terms of the number of medical examinations, the contingent subject to its passage, etc. As a result, at present there is no single structure for conducting medical examinations in universities. In some of them, students are examined only in the first year, in some - students of the first and second years, in some - students from the first to the fourth year, etc.
In general, medical admission to physical education classes is a separate and problematic topic at present. The recently introduced innovations regarding the ban on complete exemption from practical training are not entirely clear. On the one hand, of course, it is necessary to involve young people as massively as possible in physical activity. However, there are situations when such activities cannot be recommended under any circumstances. We are talking about such serious diagnoses as heart failure, serious problems with vision, severe forms asthma, etc. After all, almost main goal recreational activities is to strengthen the health of students, but not its deterioration, and even more so not the provocation of attacks of the disease.
Another questionable point is the concealment, at the request of the student, of his diagnosis. Of course, information about human diseases should be strictly confidential and under no circumstances should it be made public. However, the teacher must be aware of the problems of his students, since it is he who is responsible for them in the lesson. In addition, depending on a particular diagnosis, an individual set of exercises can be compiled for a particular student, or a student can be exempted from those tasks that will be contraindicated for him. But such decisions are possible only if the teacher is fully and timely informed about the state of health of his students.
It also seems timely to note the not always high-quality medical examination in universities for admission to physical education classes. Due to the large flow of students, such examinations are often carried out superficially and are based on the information provided by those medical institutions where the student was observed earlier. As a result, there are situations when students with serious diagnoses did not receive a note in the final certificate that they were assigned to a special medical group. And on the contrary, those whose health condition completely allowed them to engage in general group, received the right to relieve the burden, tk. were assigned to a special group. One of the main factors behind this problem is the catastrophic lack of medical staff and extremely low salaries, which does not contribute at all to changing the situation in better side. And the system of high school medical examination itself needs to be improved. Perhaps it would be necessary to create several state medical centers exclusively for students, in which people receiving higher education could apply for any qualified medical assistance, including admission to physical education classes.
It is this problem that caused the need for physical culture practitioners to conduct a special survey with first-year students at the beginning of each school year concerning their state of health. Students are explained for what purposes the teacher collects confidential information of a medical nature, the importance of timely informing about health problems, as well as possible indulgences during practical classes is brought to the attention of students. And if it turns out that the future student has health problems that are not reflected or are insufficiently reflected in the medical report, the teacher is forced to make a decision on the dosage of the load for such a contingent, and in individual cases- and the question of admission to practical training.
Based on the results of a medical examination at the university, each student receives a medical certificate in the form of a certificate indicating health groups, to which it refers, based on the main indicators of the state of health at the time of the commission and on the basis of medical documents indicating the presence of any health problems or their absence.
Traditionally, there are three main health groups: basic, preparatory and special.
The main health group includes students who do not have serious contraindications to classes physical culture. It is assumed that such students can choose any sport for themselves or engage in general physical training groups without any restrictions on the intensity of the load, the complexity of the exercises performed and passing the control test standards for the result.
The preparatory health group includes students with minor deviations in health, which generally do not interfere with regular physical education, but still suggest a number of restrictions, depending on the diagnosis. This can be partial or complete exemption from passing control standards (for asthma, for problems with the heart, joints), exemption from running or jumping exercises during the session (for example, with progressive myopia), etc. IN this case self-control over one's well-being and on the part of the student himself is necessary. It is especially not permissible to perform exercises that are contraindicated for him according to the existing diagnosis.
A special group includes students with significant and very serious health problems. The vast majority of students assigned to this group, with limitations (sometimes very serious), but still can engage in physical education. Of course, they are exempt from passing any standards whatsoever. They are exempted from increased peak load during the lesson itself - this mainly applies to running and jumping series of exercises. However, the decision to limit the load or completely exclude it should be made by the teacher on the basis of the diagnosis in each specific case individually. It is necessary to say a few words about the group of students who under no circumstances can be admitted to practical classes in physical culture. These are students for whom even moderate physical activity can lead to death (for example, heart disease), as well as disabled people, for whom the performance of typical exercise is not possible (for example, with amputation of limbs or with blindness). Of course, for such a contingent of students should be provided individual approach. Tasks should be adequate to the state of health of students. It is allowed to perform theoretical tasks.
Test questions.
1. What are the conditions for admission to practical training in physical culture at the university?
2. What problems do teachers and students face during medical examinations at universities?
3. What health groups can you list?
4. Give a description of each of the health groups.
/Attention! Permission to work in sports section only a doctor can give. Therefore, the list of contraindications is given for informational purposes only./
Developed by the authors (G.A. Makarova, A.B. Krasnov, 2000), on the basis of: a) "Requirements for the health of citizens entering the service in the internal affairs bodies, secondary schools and medical colleges, educational institutions, persons ordinary and commanding staff of internal affairs bodies", b) "List of medical contraindications for admission of applicants to higher and secondary physical education institutions" (Committee on Physical Culture and Sports under the Council of Ministers of the USSR, Department of Research and Educational Institutions, M., 1971) and c) "List of diseases preventing selection for admission to comprehensive schools sports profile, Youth Sports School, centers for training reserves of big sports "(R.E. Motylyanskaya et al., 1988), is presented below.
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DISEASES AND PATHOLOGICAL CONDITIONS HIDDENING ADMISSION TO SPORTS
I. All acute and chronic diseases in the acute stage
II. Features of physical development
1. A pronounced lag in physical development, which prevents the implementation of exercises and standards provided for by the curriculum; a sharp disproportion between the length of the limbs and the body.
2. All kinds of deformations upper limbs, excluding or complicating the possibility of performing various sports exercises.
3. Pronounced deformation chest, complicating the functioning of the organs of the chest cavity.
4. Severe deformity of the pelvis, affecting the statics of the body or violating the biomechanics of walking.
5. Shortening of one lower limb by more than 3 cm, even with a full gait; pronounced curvature of the legs inward (X-shaped curvature) or outward (O-shaped curvature) with a distance between the inner condyles of the femurs or the inner malleoli of the tibia more than 12 cm.
III. Neuropsychiatric diseases.
Injuries of the central and peripheral nervous system
1. Psychotic and non-psychotic mental disorders due to organic damage brain. Endogenous psychoses: schizophrenia and affective psychoses. Symptomatic psychoses and others mental disorders exogenous etiology.
Persons with a mild short-term asthenic condition after an acute illness are allowed to play sports after a complete cure.
2. Reactive psychoses and neurotic disorders.
Persons who had acute reactions to stress, adaptation disorders and slightly pronounced neurotic disorders, characterized mainly by emotional-volitional and vegetative disorders, are allowed to go in for sports after a complete cure.
3.-Mental retardation.
4. Epilepsy.
6. Injuries to the head and spinal cord and their consequences.
7. Vascular diseases brain and spinal cord and their consequences (subarachnoid, intracerebral and other intracranial hemorrhages, cerebral infarction, transient cerebral ischemia, etc.).
Persons with rare syncope are subject to in-depth examination and treatment. The diagnosis of "neurocirculatory dystonia" is established only in cases where a targeted examination did not reveal other diseases accompanied by disorders of the autonomic nervous system. Even in the presence of rare fainting, such persons cannot be admitted to martial arts, complex coordination, traumatic and water sports.
8. Organic diseases of the central nervous system (degenerative, tumors of the brain and spinal cord, congenital anomalies and other neuromuscular diseases).
9. Diseases of the peripheral nervous system (including the availability of objective data without functional impairment).
10. Injuries of peripheral nerves and their consequences (including mild residual effects in the form of mild sensory disturbances or slight weakening of the muscles innervated by the injured nerve).
11. Consequences of fractures of the bones of the skull (vault of the skull, facial bones, including the lower and upper jaw, other bones) without signs of organic damage to the central nervous system, but in the presence of a foreign body in the cranial cavity, as well as a replaced or unreplaced defect of the bones of the cranial vault.
12. Temporary functional disorders after acute diseases and injuries of the central or peripheral nervous system, as well as their surgical treatment.
Persons who have suffered a closed injury of the brain and spinal cord, with an instrumentally confirmed absence of signs of damage to the central nervous system, can be allowed to play sports no earlier than 12 months after complete recovery (traumatic sports).
IV. Diseases internal organs
1. Congenital and acquired heart defects.
2. Rheumatism, rheumatic heart disease (rheumatic pericarditis, myocarditis, rheumatic valvular disease). Non-rheumatic myocarditis, endocarditis. Other heart diseases: cardiomyopathies, organic disorders heart rate and conduction, valve prolapse (II degree and above, I degree - in the presence of regurgitation, myxomatous valve degeneration, cardiac arrhythmias, ECG changes), ventricular preexcitation syndromes, sinus node weakness syndrome.
Rare single resting extrasystoles and sinus arrhythmia of a functional nature are not a contraindication for sports.
Persons who have undergone non-rheumatic myocarditis without an outcome in myocardiosclerosis, in the absence of cardiac arrhythmias and conduction, against the background of high tolerance to physical activity, can be allowed to play sports 12 months after complete recovery.
3. Hypertension, symptomatic hypertension.
4. Ischemic disease hearts.
5. Neurocirculatory dystonia (hypertensive, hypotensive, cardiac or mixed types) are allowed conditionally.
6. Chronic non-specific diseases of the lungs and pleura, disseminated lung diseases of non-tuberculous etiology (including diseases accompanied by even minor respiratory dysfunction).
7. Bronchial asthma.
In the absence of attacks for five years or more, but the persisting altered bronchial reactivity, admission to certain sports is possible (sports aimed at developing endurance, winter sports, as well as sports that take place in halls and are associated with using talc, rosin, etc.).
8. Peptic ulcer of the stomach and duodenum in the acute stage. Peptic ulcer of the stomach and duodenum in remission with digestive disorders and frequent exacerbations in history.
Persons with peptic ulcer stomach or duodenum that have been in remission for 6 years (without digestive dysfunction) can be allowed to play sports (sports aimed at developing endurance are not recommended).
9. Other diseases of the stomach and duodenum, including autoimmune gastritis and special forms of gastritis (granulomatous, eosinophilic, hypertrophic, lymphocytic), diseases of the gallbladder and biliary tract, pancreas, small and large intestines, with significant and moderate dysfunction and frequent exacerbations .
Persons with Helicobacter pylori gastritis can be allowed to play sports after appropriate treatment.
Persons with chronic gastritis and gastroduodenitis with minor dysfunction and rare exacerbations, as well as biliary dyskinesia with rare exacerbations can be allowed to play sports.
10. Chronic liver disease (including benign hyperbilirubinemia), cirrhosis of the liver.
11. Diseases of the esophagus (esophagitis, ulcer - until complete recovery; cardiospasm, stenosis, diverticula - in the presence of significant and moderate dysfunction).
12. Chronic kidney disease ( chronic glomerulonephritis, chronic primary pyelonephritis, nephrosclerosis, nephrotic syndrome, primary wrinkled kidney, renal amyloidosis, chronic interstitial nephritis and other nephropathies).
13. Pyelonephritis (secondary), hydronephrosis, urolithiasis.
Instrumental removal or spontaneous passage of a single stone from urinary tract(pelvis, ureter, bladder) without crushing stones of the urinary system, small (up to 0.5 cm) single calculi of the kidneys and ureters, confirmed only by ultrasound, without pathological changes in the urine, unilateral or bilateral stage I nephroptosis is not a contraindication to sports.
14. Systemic diseases connective tissue.
15. Diseases of the joints - rheumatoid arthritis, arthritis associated with spondylitis, ankylosing spondylitis, osteoarthritis, metabolic arthritis, consequences of infectious arthritis.
Persons who have had a complete reversal of reactive arthritis may be allowed to play sports six months after a complete cure.
16. Systemic vasculitis.
17. Diseases of the blood and blood-forming organs.
Persons with temporary functional disorders after non-systemic blood diseases are allowed to go in for sports after a complete cure.
18. Persistent changes in the composition of peripheral blood (leukocyte count less than 4.0x109/l or more than 9.0x109/l, platelet count less than 180.0x109/l, hemoglobin content less than 120 g/l).
19. Malignant neoplasms of lymphoid, hematopoietic and related tissues: lympho-, myelo-, reticulosarcomas, leukemias, lymphoses, lymphogranulomatosis, paraproteinemic hemoblastoses (including conditions after surgical treatment, radiation and cytostatic therapy).
20. A history of acute radiation sickness of any severity, as well as a radiation dose previously received in an accident or accidental exposure that exceeds the annual maximum allowable dose by five times (in accordance with radiation safety standards - 76/87).
21. Endocrine diseases, nutritional and metabolic disorders (simple goiter, non-toxic nodular goiter, thyrotoxicosis, thyroiditis, hypothyroidism, diabetes, acromegaly, diseases of the parathyroid glands, adrenal glands, gout, obesity II-III degree).
V. Surgical diseases
1. Diseases of the spine and their consequences (spondylosis and related conditions, diseases of the intervertebral discs, other diseases of the spine, severe disorders of the position of the spine in the sagittal plane: rachitic kyphosis, tuberculous kyphosis, Scheuermann-Mau disease, Calve disease; scoliotic disease, severe instability).
Persons with non-fixed curvature of the spine in the frontal plane (scoliotic posture) and initial signs of intervertebral osteochondrosis with an asymptomatic course can be admitted to symmetrical sports.
2. Consequences of fractures of the spine, chest, upper and lower extremities, pelvis, accompanied by dysfunctions.
3. Diseases and consequences of damage to the aorta, main and peripheral arteries and veins, lymphatic vessels: obliterating endarteritis, aneurysms, phlebitis, phlebothrombosis, varicose and post-thrombotic disease, elephantiasis (lymphedema), varicose veins of the spermatic cord (moderate and significant severity); angiotrophoneurosis, hemangiomas.
4. Surgical diseases and lesions of large joints, bones and cartilage, osteopathies and acquired musculoskeletal deformities (intra-articular lesions, osteomyelitis, periostitis, other bone lesions, osteitis deformans and osteopathies, osteochondropathy, persistent contractures of the joints, other diseases and lesions of the joints, bones and cartilage).
With Osgood-Schlaterra disease, the issue of the possibility of admission to sports is decided individually.
5. Chronic or habitual dislocations in large joints that occur with minor physical exertion.
6. Defects or absence of fingers that impair the functions of the hand.
7. Defects or absence of toes that violate the full support ability, making it difficult to walk and wear shoes (ordinary and sports).
For the absence of a toe on the foot, it is considered the absence of it at the level of the metatarsophalangeal joint. Complete reduction or immobility of the finger is considered as its absence.
8. Flat feet and other deformities of the foot with significant and moderate impairment of its functions.
In the presence of flat feet of the II degree on one leg and flat feet of the I degree on the other leg, the conclusion is made on the flat feet of the II degree.
Persons with flat feet of the 1st degree, as well as of the 2nd degree without arthrosis in the talonavicular joints can be allowed to play sports.
9. Hernia (inguinal, femoral, umbilical), other abdominal hernias. Expansion of one or both inguinal rings with clearly felt protrusion of the contents at the time of the annular examination abdominal cavity when straining - until complete recovery.
small umbilical hernia, preperitoneal wen of the white line of the abdomen, as well as the expansion of the inguinal rings without hernial protrusion during physical exertion and straining are not a contraindication to playing sports.
10. Hemorrhoids with frequent exacerbations and secondary anemia, prolapse of stages II-III. Recurrent anal fissures.
Persons who have undergone surgical interventions regarding varicose veins of the lower extremities, veins of the spermatic cord, hemorrhoidal veins, fissures of the anus, they can be allowed to play sports if after 1 year after the operation there are no signs of recurrence of the disease and local circulatory disorders.
11. Protrusion of all layers of the rectal wall when straining.
12. Consequences of skin injuries and subcutaneous tissue accompanied by violations motor functions or making it difficult to wear sportswear, shoes, or equipment.
13. Weak scars after operations and injuries, which, in their localization, make it difficult to perform physical exercises; scars prone to ulceration; scars soldered to the underlying tissues and preventing movements in a particular joint during exercise.
14. Diseases of the mammary glands.
15. Malignant neoplasms of all localizations.
16. Benign neoplasms - until complete recovery.
Persons with temporary functional disorders after surgical treatment of benign neoplasms are allowed to go in for sports after a complete cure.
VI. Injuries and diseases of the ENT organs.
1. Diseases and injuries of the larynx, cervical trachea, accompanied by even minor violations of the respiratory and voice functions.
2. Curvature of the nasal septum with a pronounced violation of nasal breathing (surgery in similar cases carried out at the age of at least 15 years).
3. Diseases of the outer ear - until complete recovery.
4. Diseases of the Eustachian tube - until complete recovery.
5. Purulent unilateral or bilateral epitympanitis or mezatympanitis in all forms and stages.
6. Persistent residual effects of transferred otitis media (persistent cicatricial changes in the tympanic membrane, the presence of perforation of the tympanic membrane).
7. Otosclerosis, labyrinthopathy, cochlear neuritis and other causes of deafness or persistent hearing loss in one or both ears (normally, in both ears, the perception of whispered speech should be at a distance of 6 m, the minimum allowable decrease in this distance is up to 4 m).
8. Violation of the patency of the Eustachian tube and a disorder of the barofunction of the ear.
9. Vestibular-vegetative disorders, even in a moderate degree.
10. Diseases of the paranasal sinuses - until complete recovery.
11. Deformities and chronic changes in the state of the tissues of the nose, oral cavity, pharynx, larynx and trachea, accompanied by impaired respiratory function.
12. Diseases of the upper respiratory tract(nasal cavity polyps, adenoids, decompensated form of chronic tonsillitis) - until complete recovery.
Chronic decompensated tonsillitis is commonly understood as a form of chronic tonsillitis, characterized by frequent exacerbations (2 or more per year), the presence of tonsillogenic intoxication (low-grade fever, fast fatiguability, lethargy, malaise, changes in the internal organs), involvement in inflammatory process peritonsillar tissue, regional lymph nodes (peritonsillar abscess, regional lymphadenitis).
The objective signs of chronic decompensated tonsillitis include: discharge of pus or caseous plugs from lacunae when pressing on the tonsil with a spatula or when probing it, rough scars on the palatine tonsils, hyperemia and swelling of the palatine arches and their fusion with the tonsils, the presence of festering follicles in the subepithelial layer, an increase lymph nodes along the anterior edge of the sternocleidomastoid muscles.
14. Complete absence sense of smell (anosmia).
15. Persons with temporary functional disorders after exacerbation of chronic diseases of the upper respiratory tract, their injuries and surgical treatment are allowed to play sports after a complete cure.
VII. Eye injuries and diseases
1. Lagophthalmos, inversion of the eyelids and growth of eyelashes towards the eyeball (trichiasis), causing constant eye irritation; eversion of the eyelids, disrupting the function of the eye, fusion of the eyelids between themselves or with the eyeball, preventing or restricting eye movement and disrupting the function of vision, at least one eye.
2. Ptosis of the eyelid, which disrupts the function of vision in one or both eyes.
3. Persistent incurable lacrimation due to disease of the lacrimal ducts.
4. Chronic diseases of the conjunctiva, cornea, uveal tract and retina of an inflammatory or degenerative nature with frequent exacerbations.
5. Diseases of the optic nerve.
6. Atrophy of the optic nerve.
7. Severe congenital and acquired (including traumatic) cataract.
8. Turbidity, destruction of the vitreous body.
9. Congenital and acquired defects in the development of the membranes of the eye that impair the function of vision.
10. Afakia.
11. Changes in the fundus.
12. Conditions after a penetrating injury to the eye.
13. foreign body in the eye, not indicated for extraction.
14. Restriction of the field of view of one or both eyes by more than 20 °.
15. Violations locomotive apparatus eye.
16. Severe nystagmus of the eyeball with a significant decrease in visual acuity.
17. Concomitant strabismus more than 20 ° - the issue of admission is decided individually.
18. Violations of color perception - the issue of admission is decided individually, depending on the specifics of the chosen sport.
19. Refractive errors: general variant - visual acuity: a) less than 0.6 in both eyes (without correction); b) not less than 0.6 for the best and 0.3 for the worst eye (without correction); private options - see table. 1-2.
Farsightedness. With this type of refractive error, the issue of physical education and sports is decided depending on visual acuity and the ability to use correction.
Small degrees of farsightedness, as a rule, are characterized by high (without correction) visual acuity: 1.0 or 0.9-0.8. With such visual acuity and farsightedness of small degrees, all sports are possible.
Persons with farsightedness of +4.0 D and above, with a decrease in relative visual acuity, when correction is mandatory, may be allowed to practice only those sports where the use of glasses is permissible. At the same time, the glasses should be light, firmly fixed, have high optical properties, and in the summer have yellow-green filters.
In case of hyperopia of high degrees (above +6.0 D), which usually occurs with microphthalmos with a tendency to detachment, sports are contraindicated.
With far-sighted and myopic astigmatism of weak degrees and relatively high visual acuity, all sports are possible.
VIII. Dental diseases
1. Violations of the development and eruption of teeth: the absence of 10 or more teeth in one jaw or their replacement with a removable prosthesis, the absence of 8 molars in one jaw, the absence of 4 molars in the upper jaw on one side and 4 molars in the lower jaw on the other side or replacement with removable dentures.
2. Maxillofacial anomalies, other diseases of the teeth and their supporting apparatus, diseases of the jaws with significant and moderate disorders of the respiratory, olfactory, chewing, swallowing and speech functions.
3. Diseases of hard teeth, pulp and periapical tissues, gums and periodontium, salivary glands, tongue and oral mucosa, not amenable to treatment.
IX. Skin and venereal diseases
1. Infections and other inflammatory diseases of the skin and subcutaneous tissue, difficult to treat; common forms of chronic eczema, diffuse neurodermatitis with widespread lichenification, pemphigus, dermatitis herpetiformis, widespread psoriasis, widespread abscessing and chronic ulcerative pyoderma, limited and often recurrent forms of eczema, diffuse neurodermatitis with focal lichenification skin, discoid lupus erythematosus, photodermatitis.
2. Other diseases of the skin and subcutaneous tissue: chronic urticaria, recurrent angioedema, limited scleroderma.
3. Disease caused by the human immunodeficiency virus (HIV), including HIV infection.
4. Syphilis and other sexually transmitted diseases: tertiary, congenital syphilis; primary, secondary and latent syphilis with delayed negativity of classical serological reactions.
Individuals with primary, secondary, latent syphilis, gonorrhea and other venereal diseases (chancre, lymphogranuloma, inguinal granuloma, non-gonococcal urethritis) can be allowed to play sports after monitoring the cure and deregistration.
5. Mycoses: actiomycosis, candidiasis of internal organs, coccidoidosis, histoplasmosis, blastomycosis infections, sporotrichosis, chromomycosis, mycetomas.
Persons suffering from dermatophytosis caused by fungi (microsporum, epidermophytosis, trichophyton) can be allowed to play sports after monitoring the cure and deregistration.
X. Diseases of the genital area
1. Diseases of the male genital organs (hyperplasia, inflammatory and other diseases of the prostate gland; dropsy of the testicle, orchitis and epididymitis; hypertrophy foreskin and phimosis; diseases of the penis; dropsy of the testicle or spermatic cord; finding both testicles in the abdominal cavity or inguinal canals; other diseases of the male genital organs) with significant and moderate dysfunction. In the presence of diseases that can be treated conservatively or surgically - until they are completely cured.
2. Inflammatory diseases female genital organs (vulva, vagina, Bartholin glands, ovaries, fallopian tubes, uterus, pelvic tissue, peritoneum) - until complete recovery.
3. Expressed varicose veins veins in the vulva.
4. Kraurosis of the vulva.
5. Genital and extragenital endometriosis.
6. Severe violations of the position of the female genital organs.
7. Sharply expressed or accompanied by a violation of the functions of malformations and underdevelopment of the female genital area (pronounced infantilism of organs), hermaphroditism.
8. Omission or partial prolapse of the female genital organs.
9. Persistent violations of menstrual function.
XI. Infectious diseases
In the presence of positive serological or allergological reactions (Wright, Heddelson, Burne) without clinical manifestations of brucellosis, the issue of admission to sports is decided individually.
The carriage of the surface (Australian) antigen of viral hepatitis B is the basis for a detailed examination in order to exclude latent chronic disease liver.
Persons who have recovered from viral hepatitis, typhoid fever, paratyphoid fever in the absence of liver dysfunction and gastrointestinal tract, may be allowed to go in for sports, but not earlier than 6 months after the end of inpatient treatment (sports aimed at developing endurance are not shown).
2. Tuberculosis of the respiratory organs: lungs, bronchi, intrathoracic lymph nodes, pleura, including inactive with small residual changes after the disease, including spontaneously cured tuberculosis.
The presence of single small petrificates in the lungs or intrathoracic lymph nodes is not a contraindication to sports.
3. Tuberculosis of extrathoracic localization: peripheral and mesenteric lymph nodes, pericardium, peritoneum, intestines, bones and joints, urinary organs, eyes, skin, and other organs.
Persons with inactive tuberculosis of the respiratory organs and extrathoracic localizations, i.e., in the absence of signs of activity after completion of treatment for 5 years, deregistration and the absence of any residual changes, may be allowed to play sports.
Table 1
The possibility of playing sports with refractive errors (R.A. Pinkachenko, 1988)
|
Sports that can be practiced without correction |
Sports for which correction is allowed |
Sports that are incompatible with the application of correction |
Sports in which reduced visual acuity is dangerous, and the use of correction is contraindicated |
| All kinds of wrestling, weightlifting, speed skating. Figure skating, swimming. Rowing, some types of light athletics (walking, throwing, smooth running, cross-country, pole vault) | Sports and rhythmic gymnastics, athletics skiing and skating, figure skating, fencing, rowing, shooting, weightlifting, some sport games(tennis, gorodki, volleyball, basketball), cycling. | All kinds of wrestling, boxing, football, hockey, water polo, motorcycle and equestrian sports, ski jumping and diving, mountain climbing. | Motorcycle and equestrian sports, sailing and water motor sports, alpine skiing, diving, mountaineering. |
table 2
Contraindications to sports for persons suffering from myopia (R.A. Pinkachenko, 1988)
|
Kind of sport |
Contraindications depending on the degree of myopia and the condition of the eyes |
|
| Boxing | Any degree of myopia | |
| Wrestling | Any degree of myopia | |
| Weightlifting | Any degree of myopia | |
| Bicycle racing on the track | contact correction | |
| Bicycle road racing | High myopia, as well as any degree of myopia against the background of changes in the fundus | contact correction |
| Sports gymnastics | All types of myopia, except for stationary myopia of a weak degree. | Without correction |
| Rhythmic gymnastics | Usually without glasses. With a significant decrease in vision, contact correction. | |
| Target shooting, bullet shooting, archery | Complicated myopia | Spectacle or contact correction. |
| Modern pentathlon | See related sports | |
| Horseback Riding | Myopia of a high degree, as well as any degree of myopia against the background of changes in the fundus. | Without correction |
| Fencing | Complicated myopia | |
| Swimming | Complicated myopia | Without correction |
| Water polo | Myopia of a high degree, as well as any degree of myopia against the background of changes in the fundus. | Without correction |
| Diving | All types of myopia, except for stationary mild myopia | Without correction |
| Rowing | Complicated myopia | Spectacle correction |
| Sailing | Complicated myopia | Without correction |
| Ski race | Complicated myopia | Without correction |
| Biathlon | Complicated myopia | Spectacle or contact correction |
| Skiing | All types of myopia, except for stationary mild myopia | Without correction |
| Ski jumping | Any degree of myopia | |
| Nordic combined | Any degree of myopia | |
| Ice-skating race | Myopia of a high degree, as well as any degree of myopia against the background of changes in the fundus. | Without correction |
| Figure skating | Myopia of a high degree, as well as any degree of myopia against the background of changes in the fundus. | Without correction or with contact correction |
| Race walking | Complicated myopia | Without correction |
| Short distance running | All types of myopia, except for stationary mild myopia | Without correction |
| Running for medium and long distances | Complicated myopia | Without correction |
| Throwing | High and complicated myopia | Without correction |
| jumping | Any degree of myopia | |
| Volleyball basketball | Myopia of a high degree, as well as any degree of myopia against the background of changes in the fundus. | Without correction |
| Football, handball | All types of myopia, except for stationary mild myopia | Without correction |
| Hockey | Any degree of myopia | |
| Table tennis, table tennis, badminton. | Myopia of a high degree, as well as any degree of myopia against the background of changes in the fundus. | Without correction |
| luge | All types of myopia, except for stationary mild myopia | Without correction |
| Motorsport | All types of myopia, except for stationary mild myopia | Without correction |
| Townships | Myopia of a high degree, as well as any degree of myopia against the background of changes in the fundus. | Spectacle correction |
For physical education, students are divided into 4 medical groups: basic, preparatory, special "A" (improving) and special "B" (rehabilitation).
The recruitment of medical groups is carried out on the basis of a conclusion on the state of health, an assessment of the functional capabilities of the body (according to the type of reaction of the cardio-respiratory system to dosed physical activity) and the level of physical fitness of the student.
The conclusion on the state of health based on the results of preventive medical examinations is entered in the medical record (form 026 / y-2000) of the child and includes a diagnosis (basic and accompanying illnesses), assessment of physical and neuropsychic development, body resistance, as well as recommendations for physical education.
The functional capabilities of the student's body are determined by the medical worker of the school at the beginning of the academic year based on the results of the test with dosed physical activity. The test is carried out before determining the level of physical fitness (hereinafter referred to as FP) for children of the main medical group(according to the medical report of the previous academic year for children in grades 2-11 and the medical report before entering a school for first graders). At the end of the school year, before the final determination of the level of physical activity, a test with dosed physical activity is carried out for all children who do not have medical contraindications to its implementation. In the event of a child’s illness (injury) that occurred during the school year and is accompanied by significant impairments in his health, in order to decide on the appointment of a medical group, it is necessary to repeat the test with a dosed physical load to assess the functional capabilities of the body before resuming physical education.
The level of PP is determined annually by a physical education teacher at the beginning and at the end of the academic year based on the results of control exercises. Determining the level of AF in children is allowed only with permission from a doctor.
With an adverse reaction of the cardio-respiratory system child's body for dosed physical activity, the determination of the level of FP is prohibited.
The main medical group for physical education includes students without deviations or with minor deviations in the state of health, a favorable type of reaction of the cardio-respiratory system to dosed physical activity and a level of AF corresponding to age and gender.
The preparatory medical group for physical education includes students:
without deviations or with minor deviations in the state of health, a favorable type of cardio-respiratory system for dosed physical activity and a level of AF that does not correspond to age and gender;
with minor deviations in the state of health, a satisfactory or unfavorable type of response of the cardio-respiratory system to dosed physical activity;
frequently ill (3 or more times a year);
convalescents from the main medical group after suffering diseases, injuries and the expiration of the terms of exemption from physical education for a period determined individually by a medical institution.
To the special medical group "A" ( health group) for physical education include students with pronounced deviations in the state of health of functional and organic genesis in the stage of compensation.
The special medical group "B" (rehabilitation group) for physical education includes students with pronounced deviations in the state of health in the stage of subcompensation.
When recruiting medical groups of students for physical education, one should be guided by the list of deviations in the state of health, presented in Appendix No. 1.
The staffing of medical groups of students for physical education is carried out by the pediatrician of the educational institution on the basis of the conclusion of each specialist involved in the conduct of preventive medical examinations, which gives recommendations on physical activity and the medical group for physical education is necessarily indicated. Doctors-specialists take into account not only the nosological form of the disease, but also the stage of the disease, the degree of severity of violations of body functions and the likelihood of complications.
To clarify the diagnosis, the student should be sent for additional medical examination. In difficult cases, when appointing a medical group for physical education, it is necessary to consult specialists from a medical and sports dispensary.
Students who have not passed a medical examination are not allowed to engage in physical education.
The recruitment of medical groups for physical education should be completed by June 1. The lists of students assigned to medical groups are approved by the local act of the educational institution.
In the lists of students of special medical groups, the body systems in which deviations are found should be indicated.
Changes in the state of health (functional disorders, diseases, injuries) and the functional capabilities of the body that have arisen summer period, are taken into account when distributing into medical groups for the current academic year based on the results of the survey in September.
First grade students at the beginning of the school year go to without fail examination to establish the type of reaction of the cardio-respiratory system to dosed physical activity. Based on the results of the survey, the medical group for physical education is specified.
The medical group for physical education of each student is entered in the "Health Sheet" of the class journal. The second copy of the "Health Sheet" must be handed over to the teacher of physical education.
When organizing classes for students of the special medical group "A", their age and nosological forms of the disease should be taken into account. It is recommended to single out the following subgroups: students with diseases of the circulatory, respiratory, nervous and endocrine system; diseases of the digestive system and urinary system; diseases of the musculoskeletal system and organs of vision.
It is advisable to complete medical groups according to classes (I-II, III-IV, V-VIII, IX-XI). At not enough students should combine students of three to four grades (I-IV, V-VIII, IX-XI). The occupancy of the special medical group "A" can be at least 14 to 20 children.
Students of the special medical group (subgroup A and subgroup B) are engaged in physical education separately from the students of the main and preparatory groups according to a special program.
In this regard, in educational institutions appropriate lessons of physical culture for this contingent of schoolchildren are entered into the grid of the educational schedule.
The main form of physical education for SHG students is lessons that are held three times a week for 45 minutes. Attendance by students is required. Lessons must be supplemented by a system of homework, sports events, physical education sessions in the classroom.
However, additionally with lessons in ad hoc groups , students of a special medical group, may attend physical education lessons for students of the main group.
At the same time, the content of educational tasks in these lessons for schoolchildren of a special medical group should be distinctive (individual) and consist mainly of exercises of corrective and breathing exercises, exercises of therapeutic physical culture, as well as exercises and motor actions learned in the lessons in special study groups(for example, repetition and reinforcement exercises).
Schoolchildren classified as SMG for health reasons are exempted from physical exercises according to the program high school, from participation in competitions
Changing the medical group of students for physical education during the academic year.
Changing the medical group for physical education is established by the pediatrician of the school on the proposal of the teacher in physical education based on the characteristics of the dynamics of health indicators, functional capabilities of the body and PT.
With a positive dynamics of indicators, it is possible to transfer from the special medical group "A" to the preparatory one and from the preparatory medical group to the main one.
If the physical load is inadequate for the functional capabilities of the student's body, the student should be transferred from the main to the preparatory, or from the preparatory to the special medical group "A".
The timing of the resumption of physical education after illness.
The timing of the resumption of physical education for students after illnesses is set individually by the attending physician. medical institution.
Admission of students to physical education classes.
Before the start of physical education, the teacher should check the well-being of students.
It is not allowed to allow students to engage in physical culture if:
the presence of complaints of pain of various localization, dizziness, nausea, weakness, palpitations;
acute period of the disease (fever, chills, catarrhal phenomena, etc.);
traumatic damage to organs and tissues of the body ( acute period): bruise, wound, sprain, hematoma, etc.;
bleeding hazards (nosebleed on the day of class, condition after tooth extraction, menstrual period);
severe violation of nasal breathing;
severe tachycardia or bradycardia (taking into account age and gender standards).
The above contraindications apply to students of all medical groups for physical education and are most often temporary.
Contraindications and restrictions to exercise.
When conducting physical education classes, the teacher should contact Special attention and exercise increased caution when using physical exercises that are potentially dangerous and harmful to the health of children (Appendix No. 2).
In the presence of a disease, one should strictly dose physical activity and exclude physical exercises that are contraindicated for their implementation for health reasons (Appendix No. 3).
Comprehensive assessment of the health status of students
Characteristics of health groups according to the state of health of students.
A comprehensive assessment of the state of health consists of assessing the levels and harmony of the physical and neuropsychic development of children and adolescents; the degree of resistance and reactivity of the organism (the degree of resistance of the organism to adverse factors); functional state of the main body systems; the presence or absence of chronic diseases (incl. congenital pathology). On this basis, students with a similar condition can be assigned to health groups:
health group I- healthy children normal development and a normal level of functions, and children with external compensated congenital developmental defects;
health group II- children are healthy, but with risk factors for the occurrence of pathology, functional and some morphological abnormalities, chronic diseases in the stage of stable clinical and laboratory remission for at least 3-5 years, congenital malformations, uncomplicated diseases of the organ of the same name or a violation of its function, as well as with reduced resistance to acute chronic diseases;
health group III– children with chronic diseases and congenital malformations varying degrees activity and compensation, with saved functionality;
health group IV- children with significant deviations in the state of health of a permanent (chronic diseases in the stage of subcompensation) or temporary nature, but without a pronounced impairment of well-being, with reduced functionality;
health group V - children with chronic diseases in a state of decompensation, with significantly reduced functionality.
Based on the results of a medical examination of students, the doctor makes a conclusion about the state of health and the level of physical development of each student, paying attention to the characteristics of the state of the musculoskeletal system and other organs involved in the performance of individual exercises.
Assessment of the level of physical fitness is given on the basis of a sports history, analysis of performance and observations made during the performance of test tasks.
The principle of distribution of students by health groups.
All schoolchildren, on the basis of a medical report, are divided into three groups: basic, preparatory and special.
The main criterion for inclusion in a particular medical group is the level of health and functional state organism. For distribution to a special medical group, it is necessary to establish a diagnosis with the obligatory consideration of the degree of dysfunction of the body.
To the main medical group when doing physical culture, health group I is wholly, and partially - health group II (in cases where the existing disease does not impose significant restrictions on motor mode).
These are students without deviations in the state of health and physical development, having a good functional condition and age-appropriate physical fitness, as well as students with minor (often functional) deviations, but not lagging behind their peers in physical development and physical fitness. For example: moderate overweight body, some functional disorders of organs and systems, dyskinesia of some organs, skin-allergic reactions, flattening of the feet, mild neurocirculatory dystonia, mild asthenic manifestations.
Those who belong to this group are allowed to take full-scale classes according to the curriculum of physical culture, prepare and pass tests of individual physical fitness.
The preparatory medical group includes students of the II health group, having a lag in physical development; insufficient physical fitness; minor deviations in health status. The special goal of physical education of students with insufficient physical and motor development(preparatory group) is to increase their physical fitness to normal level. A weakened state of health can be observed as residual effects after suffering acute diseases, when they pass into the chronic stage, and in chronic diseases in the compensation stage.
Students are engaged in physical exercises according to the general program, but this requires compliance with a number of restrictions and special methodological rules, in particular, they are contraindicated in large volumes of physical activity with high intensity.
To a special medical group
include students whose health condition requires physical exercises according to a separate program that takes into account the characteristics of their health. Students are not exempted from physical education, which is so widely practiced: this category of students needs physical exercises (properly organized!) even more than healthy ones.
Physical education classes for students assigned to a special medical group are mandatory and are included in the structure of the general teaching load of students.
Students classified for health reasons to a special medical group, are characterized by more pronounced deviations in the state of health and are divided into two subgroups: A and B.
In the first subgroup (A) students with reversible health deviations are included:
deviations in the state of health of a permanent or temporary nature (after injuries and previous diseases), requiring limitation of the volume and intensity of physical activity, but allowing the implementation of a specialized curriculum in physical culture in a special content and mode of physical activity.
If the health and physical development of these children improve, they can subsequently be transferred to preparatory group.
Students assigned to subgroup A are engaged in physical education according to a special program in educational institution under the guidance of a teacher (teacher) of physical culture.
Thanks to regular physical exercises in combination with certain therapeutic and preventive procedures, the students of this subgroup retain an objective opportunity to move to the preparatory or main group.
to the second subgroup(B) includes students with significant deviations in health, which are characterized by organic, hardly reversible changes in the state of organs and systems, including serious chronic diseases that require a significant limitation of the volume and intensity of physical activity (depending on the nature and severity of the disease) and performing physical exercises of a therapeutic (exercise) or health-improving nature under the supervision of a qualified teacher and doctor.
As a rule, in the process of regular physical exercises and with appropriate courses of treatment, students of this subgroup have the opportunity to medical indications go to group A.
Students assigned to subgroup B are engaged in physical education in a polyclinic, medical and physical education dispensary or in educational institution under the guidance of a qualified teacher and specially trained medical worker on individual programs.
With a progressive improvement in the state of health, children of subgroup B can be transferred to subgroup A on the recommendation of the attending physician.
Transfer from one medical group to another is made after an additional medical examination and pedagogical testing based on the results of the academic quarter, half year, academic year.
Medical examination (examinations) for admission to physical education and participation in mass sports competitions is carried out in outpatient clinics, departments (offices) of sports medicine of outpatient clinics, medical and physical education dispensaries (centers of physical therapy and sports medicine) by a general practitioner (pediatrist), a doctor for physiotherapy exercises, doctor for sports medicine based on results medical examinations.
Medical examination (examinations) and execution of a medical opinion on admission to sports and participation in sports competitions is carried out in the departments (offices) of sports medicine of outpatient clinics, medical and physical education dispensaries (centers of physical therapy and sports medicine) by a doctor in physical therapy and a sports medicine doctor based on the results of staged (periodic) and in-depth medical examinations carried out as part of the provision of medical care during training events 1 .
SCROLL
^ DISEASES AND PATHOLOGICAL CONDITIONS HIDDENING ADMISSION TO SPORTS 2
I. All acute and chronic diseases in the acute stage
II. Features of physical development
1. A pronounced lag in physical development that prevents the implementation of exercises and standards provided for by the curriculum; a sharp disproportion between the length of the limbs and the trunk.
2. All types of deformities of the upper limbs, which exclude or hinder the possibility of performing various sports exercises.
3. Severe deformity of the chest, impeding the functioning of the organs of the chest cavity.
4. Severe deformity of the pelvis, affecting the statics of the body or violating the biomechanics of walking.
5. Shortening of one lower limb by more than 3 cm, even with a full gait; pronounced curvature of the legs inward (X-shaped curvature) or outward (O-shaped curvature) with a distance between the internal condyles of the femurs or the internal malleoli of the tibia of more than 12 cm.
III. Neuropsychiatric diseases.
Injuries of the central and peripheral nervous system
1. Psychotic and non-psychotic mental disorders due to organic brain damage. Endogenous psychoses: schizophrenia and affective psychoses. Symptomatic psychoses and other mental disorders of exogenous etiology.
Persons with a mild short-term asthenic condition after an acute illness are allowed to go in for sports after a complete cure.
2. Reactive psychoses and neurotic disorders.
Persons who had acute reactions to stress, adaptation disorders and slightly pronounced neurotic disorders, characterized mainly by emotional-volitional and vegetative disorders, are allowed to go in for sports after a complete recovery.
3.-Mental retardation.
4. Epilepsy.
6. Injuries of the brain and spinal cord and their consequences.
7. Vascular diseases of the brain and spinal cord and their consequences (subarachnoid, intracerebral and other intracranial hemorrhages, cerebral infarction, transient cerebral ischemia, etc.).
Persons with rare syncope are subject to in-depth examination and treatment. The diagnosis of "neurocirculatory dystonia" is established only in cases where a targeted examination did not reveal other diseases accompanied by disorders of the autonomic nervous system. Even in the presence of rare syncope, such persons cannot be allowed to engage in martial arts, complex coordination, traumatic and water sports.
8. Organic diseases of the central nervous system (degenerative, tumors of the brain and spinal cord, congenital anomalies and other neuromuscular diseases).
9. Diseases of the peripheral nervous system (including the availability of objective data without functional impairment).
10. Injuries of peripheral nerves and their consequences (including mild residual effects in the form of mild sensory disturbances or slight weakening of the muscles innervated by the injured nerve).
11. Consequences of fractures of the bones of the skull (vault of the skull, facial bones, including the lower and upper jaws, and other bones) without signs of organic damage to the central nervous system, but in the presence of a foreign body in the cranial cavity, as well as a replaced or unreplaced bone defect vault of the skull.
12. Temporary functional disorders after acute diseases and injuries of the central or peripheral nervous system, as well as their surgical treatment.
Persons who have suffered a closed injury of the brain and spinal cord, with an instrumentally confirmed absence of signs of damage to the central nervous system, can be allowed to play sports no earlier than 12 months after complete recovery (traumatic sports are not recommended).
IV. Diseases of the internal organs
1. Congenital and acquired heart defects.
2. Rheumatism, rheumatic heart disease (rheumatic pericarditis, myocarditis, rheumatic valvular disease). Non-rheumatic myocarditis, endocarditis. Other heart diseases: cardiomyopathies, organic heart rhythm and conduction disorders, valve prolapse (II degree and above, I degree - in the presence of regurgitation, myxomatous valve degeneration, cardiac arrhythmias, ECG changes), ventricular preexcitation syndromes, sick sinus syndrome.
Rare single resting extrasystoles and sinus arrhythmia of a functional nature are not a contraindication for sports.
Persons who have undergone non-rheumatic myocarditis without outcome in myocardiosclerosis, in the absence of heart rhythm and conduction disturbances, against the background of high tolerance to physical activity, can be allowed to play sports 12 months after complete recovery.
3. Hypertension, symptomatic hypertension.
4. Ischemic heart disease.
5. Neurocirculatory dystonia (hypertensive, hypotensive, cardiac or mixed types) - conditionally allowed.
6. Chronic nonspecific diseases of the lungs and pleura, disseminated lung diseases of nontuberculous etiology (including diseases accompanied by even minor respiratory dysfunction).
7. Bronchial asthma.
In the absence of attacks for five years or more, but the persisting altered bronchial reactivity, admission to certain sports is possible (sports aimed at developing endurance, winter sports, as well as sports that take place in halls and associated with the use of talc, rosin, etc.).
8. Peptic ulcer of the stomach and duodenum in the acute stage. Peptic ulcer of the stomach and duodenum in remission with digestive disorders and frequent exacerbations in history.
Persons with gastric or duodenal ulcer who have been in remission for 6 years (without digestive dysfunction) may be allowed to play sports (sports aimed at developing endurance are not recommended).
9. Other diseases of the stomach and duodenum, including autoimmune gastritis and special forms of gastritis (granulomatous, eosinophilic, hypertrophic, lymphocytic), diseases of the gallbladder and biliary tract, pancreas, small and large intestines, with significant and moderate dysfunction and frequent exacerbations.
Persons with Helicobacter pylori gastritis can be allowed to play sports after appropriate treatment.
Persons with chronic gastritis and gastroduodenitis with minor dysfunction and rare exacerbations, as well as biliary dyskinesia with rare exacerbations, may be allowed to play sports.
10. Chronic liver disease (including benign hyperbilirubinemia), cirrhosis of the liver.
11. Diseases of the esophagus (esophagitis, ulcer - until complete recovery; cardiospasm, stenosis, diverticula - in the presence of significant and moderate dysfunction).
12. Chronic kidney diseases (chronic glomerulonephritis, chronic primary pyelonephritis, nephrosclerosis, nephrotic syndrome, primary wrinkled kidney, renal amyloidosis, chronic interstitial nephritis and other nephropathies).
13. Pyelonephritis (secondary), hydronephrosis, urolithiasis.
Instrumental removal or independent discharge of a single stone from the urinary tract (pelvis, ureter, bladder) without crushing the stones of the urinary system, small (up to 0.5 cm) single stones of the kidneys and ureters, confirmed only by ultrasound, without pathological changes in the urine , unilateral or bilateral stage I nephroptosis are not a contraindication to sports.
14. Systemic connective tissue diseases.
15. Diseases of the joints - rheumatoid arthritis, arthritis associated with spondylitis, ankylosing spondylitis, osteoarthritis, metabolic arthritis, consequences of infectious arthritis.
Persons who have had a complete reversal of reactive arthritis may be allowed to play sports six months after a complete cure.
16. Systemic vasculitis.
17. Diseases of the blood and blood-forming organs.
Persons with temporary functional disorders after non-systemic blood diseases are allowed to go in for sports after a complete cure.
18. Persistent changes in the composition of peripheral blood (leukocyte count less than 4.0x10 9 /l or more than 9.0x10 9 /l, platelet count less than 180.0x10 9 /l, hemoglobin content less than 120 g/l).
19. Malignant neoplasms of lymphoid, hematopoietic and related tissues: lympho-, myelo-, reticulosarcomas, leukemias, lymphoses, lymphogranulomatosis, paraproteinemic hemoblastoses (including conditions after surgical treatment, radiation and cytostatic therapy).
20. A history of acute radiation sickness of any severity, as well as a radiation dose previously received in an accident or accidental exposure that exceeds the annual maximum allowable dose by five times (in accordance with radiation safety standards - 76/87).
21. Endocrine diseases, nutritional and metabolic disorders (simple goiter, non-toxic nodular goiter, thyrotoxicosis, thyroiditis, hypothyroidism, diabetes mellitus, acromegaly, diseases of the parathyroid glands, adrenal glands, gout, obesity II-III degree).
V. Surgical diseases
1. Diseases of the spine and their consequences (spondylosis and related conditions, diseases of the intervertebral discs, other diseases of the spine, severe disorders of the position of the spine in the sagittal plane: rachitic kyphosis, tuberculous kyphosis, Scheuermann-Mau disease, Calvet disease; scoliotic disease , phenomena of pronounced instability).
Persons with non-fixed curvature of the spine in the frontal plane (scoliotic posture) and initial signs of intervertebral osteochondrosis with an asymptomatic course can be admitted to symmetrical sports.
2. Consequences of fractures of the spine, chest, upper and lower extremities, pelvis, accompanied by dysfunctions.
3. Diseases and consequences of damage to the aorta, main and peripheral arteries and veins, lymphatic vessels: obliterating endarteritis, aneurysms, phlebitis, phlebothrombosis, varicose and post-thrombotic disease, elephantiasis (lymphedema), varicose veins of the spermatic cord (medium and significant degree expressiveness); angiotrophoneurosis, hemangiomas.
4. Surgical diseases and lesions of large joints, bones and cartilage, osteopathies and acquired musculoskeletal deformities (intra-articular lesions, osteomyelitis, periostitis, other bone lesions, osteitis deformans and osteopathies, osteochondropathy, persistent joint contractures, other diseases and joint lesions , bones and cartilage).
With Osgood-Schlaterra disease, the issue of the possibility of admission to sports is decided individually.
5. Chronic or habitual dislocations in large joints that occur with minor physical exertion.
6. Defects or absence of fingers that impair hand function.
7. Defects or absence of toes that violate the full support ability, making it difficult to walk and wear shoes (ordinary and sports).
For the absence of a toe on the foot, it is considered the absence of it at the level of the metatarsophalangeal joint. Complete reduction or immobility of the finger is considered as its absence.
8. Flat feet and other deformities of the foot with significant and moderate impairment of its functions.
In the presence of II degree flat feet on one leg and I degree flat feet on the other leg, the conclusion is made for II degree flat feet.
Persons with flat feet of the 1st degree, as well as of the 2nd degree without arthrosis in the talonavicular joints can be allowed to play sports.
9. Hernia (inguinal, femoral, umbilical), other abdominal hernias. Expansion of one or both inguinal rings with a protrusion of the contents of the abdominal cavity, which is clearly felt at the time of the annular examination, when straining - until complete recovery.
A small umbilical hernia, a preperitoneal wen of the white line of the abdomen, as well as an expansion of the inguinal rings without a hernial protrusion with physical activity and straining are not a contraindication to sports.
10. Hemorrhoids with frequent exacerbations and secondary anemia, prolapse of stages II-III. Recurrent fissures of the anus.
Persons who have undergone surgery for varicose veins of the lower extremities, veins of the spermatic cord, hemorrhoidal veins, anal fissures, can be allowed to play sports if after 1 year after the operation there are no signs of recurrence of the disease and local circulatory disorders.
11. Protrusion of all layers of the wall of the rectum when straining.
12. Consequences of injuries of the skin and subcutaneous tissue, accompanied by impaired motor functions or making it difficult to wear sportswear, shoes or equipment.
13. Weak scars after operations and injuries, which, in their localization, make it difficult to perform physical exercises; scars prone to ulceration; scars soldered to the underlying tissues and preventing movements in one or another joint during exercise.
14. Diseases of the mammary glands.
15. Malignant neoplasms of all localizations.
16. Benign neoplasms - until complete recovery.
Persons with temporary functional disorders after surgical treatment of benign neoplasms are allowed to go in for sports after complete recovery.
VI. Injuries and diseases of the ENT organs.
1. Diseases and injuries of the larynx, cervical trachea, accompanied by even minor disorders of the respiratory and vocal functions.
2. Curvature of the nasal septum with a pronounced violation of nasal breathing (in such cases, the operation is performed at the age of at least 15 years).
3. Diseases of the outer ear - until complete recovery.
4. Diseases of the Eustachian tube - until complete recovery.
5. Purulent unilateral or bilateral epitympanitis or mezatympanitis in all forms and stages.
6. Persistent residual effects of transferred otitis (persistent cicatricial changes in the tympanic membrane, the presence of perforation of the tympanic membrane).
7. Otosclerosis, labyrinthopathy, cochlear neuritis and other causes of deafness or persistent hearing loss in one or both ears (normally, in both ears, the perception of whispered speech should be at a distance of 6 m, the minimum allowable decrease in this distance is up to 4 m).
8. Violation of the patency of the Eustachian tube and a disorder of the barofunction of the ear.
9. Vestibular-vegetative disorders, even in a moderate degree.
10. Diseases of the paranasal sinuses - until complete recovery.
11. Deformities and chronic changes in the state of the tissues of the nose, oral cavity, pharynx, larynx and trachea, accompanied by impaired respiratory function.
12. Diseases of the upper respiratory tract (nasal polyps, adenoids, decompensated form of chronic tonsillitis) - until complete recovery.
Under chronic decompensated tonsillitis it is customary to understand a form of chronic tonsillitis characterized by frequent exacerbations (2 or more per year), the presence of tonsillogenic intoxication (low-grade fever, fatigue, lethargy, malaise, changes in the internal organs), involvement in the inflammatory process of peritonsilic tissue, regional lymph nodes (peritonsillar abscess, regional lymphadenitis).
Objective signs of chronic decompensated tonsillitis include: discharge of pus or caseous plugs from lacunae when pressing with a spatula on the tonsil or when probing it, rough scars on the palatine tonsils, hyperemia and swelling of the palatine arches and their fusion with the tonsils, the presence of festering follicles in the subepithelial layer, an increase in lymph nodes along the anterior edge of the sternocleidomastoid muscles.
13. Ozena.
14. Complete lack of smell (anosmia).
15. Persons with temporary functional disorders after exacerbation of chronic diseases of the upper respiratory tract, their injuries and surgical treatment are allowed to play sports after a complete cure.
VII. Eye injuries and diseases
1. Lagophthalmos, inversion of the eyelids and growth of eyelashes towards the eyeball (trichiasis), causing constant eye irritation; eversion of the eyelids, disrupting the function of the eye, fusion of the eyelids between themselves or with the eyeball, preventing or restricting eye movement and disrupting the function of vision, at least one eye.
2. Ptosis of the eyelid, which disrupts the function of vision in one or both eyes.
3. Persistent incurable lacrimation due to disease of the lacrimal ducts.
4. Chronic diseases of the conjunctiva, cornea, uveal tract and retina of an inflammatory or degenerative nature with frequent exacerbations.
5. Diseases of the optic nerve.
6. Atrophy of the optic nerve.
7. Severe congenital and acquired (including traumatic) cataract.
8. Turbidity, destruction of the vitreous body.
9. Congenital and acquired defects in the development of the membranes of the eye that impair the function of vision.
10. Afakia.
11. Changes in the fundus.
12. Conditions after a penetrating injury to the eye.
13. Foreign body in the eye, not indicated for extraction.
14. Restriction of the field of view of one or both eyes by more than 20 °.
15. Violations of the motor apparatus of the eyes.
16. Severe nystagmus of the eyeball with a significant decrease in visual acuity.
17. Concomitant strabismus more than 20 ° - the issue of admission is decided individually.
18. Violations of color perception - the issue of admission is decided individually, depending on the specifics of the chosen sport.
19. Refractive errors: general variant - visual acuity: a) less than 0.6 in both eyes (without correction); b) not less than 0.6 for the best and 0.3 for worst eye(without correction); private options - see table. 1-2.
Farsightedness. With this type of refractive error, the issue of physical culture and sports is decided depending on visual acuity and the ability to use correction.
Small degrees of farsightedness, as a rule, are characterized by high (without correction) visual acuity: 1.0 or 0.9-0.8. With such visual acuity and farsightedness of small degrees, all sports are possible.
Persons with farsightedness of +4.0 D and above, with a decrease in relative visual acuity, when correction is mandatory, can be allowed to practice only those sports where the use of glasses is permissible. At the same time, glasses should be light, firmly fixed, have high optical properties, and in summer time have yellow-green filters.
In case of hyperopia of high degrees (above +6.0 D), which usually occurs with microphthalmos with a tendency to detachment, sports are contraindicated.
With farsighted and nearsighted astigmatism of weak degrees and relatively high visual acuity, all kinds of sports are possible.
VIII. Dental diseases
1. Violations of the development and eruption of teeth: the absence of 10 or more teeth in one jaw or their replacement with a removable prosthesis, the absence of 8 molars in one jaw, the absence of 4 molars in the upper jaw on one side and 4 molars in the lower jaw with the other side or replacing them with removable dentures.
2. Oral and maxillofacial anomalies, other diseases of the teeth and their supporting apparatus, diseases of the jaws with significant and moderate disorders of the respiratory, olfactory, chewing, swallowing and speech functions.
3. Diseases of hard teeth, pulp and periapical tissues, gums and periodontium, salivary glands, tongue and oral mucosa, not amenable to treatment.
IX. Skin and venereal diseases
1. Infections and other inflammatory diseases of the skin and subcutaneous tissue, difficult to treat; common forms of chronic eczema, diffuse neurodermatitis with widespread lichenification, pemphigus, dermatitis herpetiformis, widespread psoriasis, widespread abscessing and chronic ulcerative pyoderma, limited and often recurrent forms of eczema, diffuse neurodermatitis with focal lichenification of the skin, discoid lupus erythematosus, photodermatitis.
2. Other diseases of the skin and subcutaneous tissue: chronic urticaria, recurrent angioedema, limited scleroderma.
3. Disease caused by the human immunodeficiency virus (HIV), including HIV infection.
4. Syphilis and other venereal diseases: tertiary, congenital syphilis; primary, secondary and latent syphilis with delayed negativity of classical serological reactions.
Persons with primary, secondary, latent syphilis, gonorrhea and other venereal diseases (chancroid, lymphogranuloma, inguinal granuloma, non-gonococcal urethritis) can be admitted to sports after control of cure and removal from the dispensary.
5. Mycoses: actiomycosis, candidiasis of internal organs, coccidoidosis, histoplasmosis, blastomycosis infections, sporotrichosis, chromomycosis, mycetomas.
Persons suffering from dermatophytosis caused by fungi (microsporum, epidermophytosis, trichophyton) can be allowed to go in for sports after monitoring the cure and deregistration.
X. Diseases of the genital area
1. Diseases of the male genital organs (hyperplasia, inflammatory and other diseases of the prostate gland; dropsy of the testicle, orchitis and epididymitis; hypertrophy of the foreskin and phimosis; diseases of the penis; dropsy of the testicle or spermatic cord; finding both testicles in the abdominal cavity or inguinal channels; other diseases of the male genital organs) with significant and moderate dysfunction. In the presence of diseases that can be treated conservatively or surgically - until they are completely cured.
2. Inflammatory diseases of the female genital organs (vulva, vagina, Bartholin glands, ovaries, fallopian tubes, uterus, pelvic tissue, peritoneum) - until complete recovery.
3. Severe varicose veins in the vulva.
4. Kraurosis of the vulva.
5. Genital and extragenital endometriosis.
6. Severe violations of the position of the female genital organs.
7. Sharply expressed or accompanied by a violation of the functions of malformations and underdevelopment of the female genital area (pronounced infantilism of organs), hermaphroditism.
8. Omission or partial prolapse of the female genital organs.
9. Persistent violations of menstrual function.
XI. Infectious diseases
In the presence of positive serological or allergological reactions (Wright, Heddelson, Burne) without clinical manifestations of brucellosis, the issue of admission to sports is decided individually.
Carriage of the surface (Australian) antigen of viral hepatitis B is the basis for a detailed examination in order to exclude latent chronic liver disease.
Persons who have been ill with viral hepatitis, typhoid fever, paratyphoid fever in the absence of liver and gastrointestinal tract dysfunctions may be allowed to go in for sports, but not earlier than 6 months after the end of inpatient treatment (sports aimed at endurance development).
2. Tuberculosis of the respiratory organs: lungs, bronchi, intrathoracic lymph nodes, pleura, including inactive with small residual changes after the disease, including spontaneously cured tuberculosis.
The presence of single small petrifications in the lungs or intrathoracic lymph nodes is not a contraindication to sports.
3. Tuberculosis of extrathoracic localization: peripheral and mesenteric lymph nodes, pericardium, peritoneum, intestines, bones and joints, urinary organs, eyes, skin, and other organs.
Persons with inactive tuberculosis of the respiratory organs and extrathoracic localizations, i.e., in the absence of signs of activity after completion of treatment for 5 years, removal from the dispensary register and the absence of any residual changes, can be allowed to play sports.
Table 1
The possibility of playing sports with refractive errors
(R.A. Pinkachenko, 1988)
| Sports that can be practiced without correction | Sports for which correction is allowed | Sports that are incompatible with the application of correction | Sports in which reduced visual acuity is dangerous, and the use of correction is contraindicated |
| All kinds of wrestling, weightlifting, speed skating. Figure skating, swimming. Rowing, some types of athletics (walking, throwing, smooth running, cross-country, pole vault) | Sports and rhythmic gymnastics, athletics, skiing and speed skating, figure skating, fencing, rowing, shooting, weightlifting, some sports games (tennis, gorodki, volleyball, basketball), cycling. | All kinds of wrestling, boxing, football, hockey, water polo, motorcycle and equestrian sports, ski jumping and diving, mountain climbing. | Motorcycle and equestrian sports, sailing and water motor sports, alpine skiing, diving, mountaineering. |
table 2
Contraindications for sports activities
suffering from myopia
(R.A. Pinkachenko, 1988)
| Kind of sport | Contraindications depending on the degree of myopia and the condition of the eyes | Tips for Using Optical Correction |
| Boxing | Any degree of myopia | |
| Wrestling | Any degree of myopia | |
| Weightlifting | Any degree of myopia | |
| Bicycle racing on the track | | contact correction |
| Bicycle road racing | High myopia, as well as any degree of myopia against the background of changes in the fundus | contact correction |
| Sports gymnastics | . | Without correction |
| Rhythmic gymnastics | | Usually without glasses. With a significant decrease in vision, contact correction. |
| Target shooting, bullet shooting, archery | Complicated myopia | . |
| Modern pentathlon | All types of myopia, except for stationary mild myopia | See related sports |
| Horseback Riding | Myopia of a high degree, as well as any degree of myopia against the background of changes in the fundus. | Without correction |
| Fencing | Complicated myopia | Spectacle or contact correction |
| Swimming | Complicated myopia | Without correction |
| Water polo | Myopia of a high degree, as well as any degree of myopia against the background of changes in the fundus. | Without correction |
| Diving | All types of myopia, except for stationary mild myopia | Without correction |
| Rowing | Complicated myopia | Spectacle correction |
| Sailing | Complicated myopia | Without correction |
| Ski race | Complicated myopia | Without correction |
| Biathlon | Complicated myopia | Spectacle or contact correction |
| Skiing | All types of myopia, except for stationary mild myopia | Without correction |
| Ski jumping | Any degree of myopia | |
| Nordic combined | Any degree of myopia | |
| Ice-skating race | Myopia of a high degree, as well as any degree of myopia against the background of changes in the fundus. | Without correction |
| Figure skating | Myopia of a high degree, as well as any degree of myopia against the background of changes in the fundus. | Without correction or with contact correction |
| Race walking | Complicated myopia | Without correction |
| Short distance running | All types of myopia, except for stationary mild myopia | Without correction |
| Running for medium and long distances | Complicated myopia | Without correction |
| Throwing | High and complicated myopia | Without correction |
| jumping | Any degree of myopia | |
| Volleyball basketball | Myopia of a high degree, as well as any degree of myopia against the background of changes in the fundus. | Without correction |
| Football, handball | All types of myopia, except for stationary mild myopia | Without correction |
| Hockey | Any degree of myopia | |
| Table tennis, table tennis, badminton. | Myopia of a high degree, as well as any degree of myopia against the background of changes in the fundus. | Without correction |
| luge | All types of myopia, except for stationary mild myopia | Without correction |
| Motorsport | All types of myopia, except for stationary mild myopia | Without correction |
| Townships | Myopia of a high degree, as well as any degree of myopia against the background of changes in the fundus. | Spectacle correction |
^
Diseases of an infectious nature that can be transmitted through the water of swimming pools 3
| Diseases | The degree of connection with the water factor |
| 1. Adenovirus pharyngo-conjunctival fever | +++ |
| 2. Epidermophytosis (“swimmer scabies”) | +++ |
| 3. Viral hepatitis A | ++ |
| 4. Coxsackie infection | ++ |
| 5. Dysentery | ++ |
| 6. Otitis, sinusitis, tonsillitis, conjunctivitis | ++ |
| 7. Tuberculosis of the skin | ++ |
| 8. fungal diseases skin | ++ |
| 9. Legionellosis | ++ |
| 10. Enterobiasis | ++ |
| 11. Giardiasis | ++ |
| 12. Cryptosporidiosis | ++ |
| 13. Amoebic meningoencephalitis | + |
| 14. Polio | + |
| 15. Trachoma | + |
| 16. Molluscum Contagiosum | + |
| 17. Gonorrheal vulvovaginitis | + |
| 18. Ascariasis | + |
| 19. Trichuriasis | + |
| 20. Acute salmonella gastroenteritis | + |
| 21. Strongyloidiasis | + |
Connection with the water factor:
high;
essential;
Possible