Physical rehabilitation. Therapeutic physical education and physical therapy - abstract Therapeutic physical education and physical rehabilitation

INTRODUCTION

Therapeutic physical culture is an independent medical discipline that uses the means of physical culture to treat diseases and injuries, prevent their exacerbations and complications, and restore working capacity. The main means (and this distinguishes therapeutic physical culture from other methods of treatment) are physical exercises - a stimulator of the vital functions of the body.

Therapeutic physical culture is one of the most important elements of modern complex treatment, which means an individually selected set of therapeutic methods and means: conservative, surgical, medication, physiotherapy, therapeutic nutrition, etc. Complex treatment affects not only pathologically altered tissues, organs, or systems organs, but also for the entire body as a whole. The proportion of various elements of complex treatment depends on the stage of recovery and the need to restore a person’s ability to work. A significant role in the complex treatment of physical culture as a method of functional therapy.

Physical exercise affects the reactivity of the whole organism and involves the mechanisms that participated in the pathological process in the overall reaction. In this regard, therapeutic physical culture can be called a method of pathogenetic therapy.

Therapeutic physical culture involves conscious and active performance of appropriate physical exercises by patients. In the process of training, the patient acquires skills in using natural factors for the purpose of hardening, physical exercises for therapeutic and preventive purposes. This allows us to consider physical education as a therapeutic and pedagogical process.

Therapeutic physical culture uses the same principles of the use of physical exercises as physical culture for a healthy person, namely: the principles of comprehensive influence, application and health-improving orientation. In its content, therapeutic physical culture is an integral part of the physical education system.

The relevance of my work lies in the fact that at the moment the attention of various specialists is attracted by non-drug treatments - physical exercises, hardening, physiotherapy, massage, reflexology, manual therapy, etc. A new approach to treatment through therapeutic physical exercises is increasingly strengthening its position, since the use of only medications often does not have the necessary positive effect, and often causes side effects (toxic, allergic). The use of exercise therapy leads to an active motor mode and positive emotions, which serves as a source of energy for the body’s self-defense at all levels of its life, both normally and in pathology.

The purpose of the work is to study therapeutic physical culture as a means of medical and physical rehabilitation.

To do this, it is necessary to solve the following problems:

.To study the mechanisms of the therapeutic effect of physical exercise.

Consider the means, forms and methods of exercise therapy.

SECTION 1. Exercise therapy IN THE SYSTEM OF MEDICAL AND PHYSICAL REHABILITATION

1.1General characteristics of the exercise therapy method

Therapeutic physical education (therapeutic physical education) refers to the use of physical education means on a sick person for therapeutic and prophylactic purposes for a faster and more complete restoration of health and ability to work and to prevent the consequences of the pathological process. Exercise therapy studies the changes that occur in the patient’s body under the influence of various physical exercises, which, in turn, makes it possible to create exercise therapy techniques that are justified from a clinical and physiological point of view for various pathological conditions.

Exercise therapy as an integral part of the system of physical education and physical culture is a therapeutic and pedagogical process and solves special problems. It is designed to restore impaired health, eliminate the existing inferiority of physical development, moral and volitional qualities of the sick, to promote the restoration of their ability to work, in other words, their comprehensive biological and social rehabilitation.

Exercise therapy is also a therapeutic and educational process, since it instills in the patient a conscious attitude towards the use of physical exercises and massage, instills in him hygienic skills, provides for his participation in regulating the motor regime, and fosters the correct attitude towards hardening with natural factors.

The main positive aspects of the exercise therapy method include:

deep physiology and adequacy;

universality, which means a wide range of actions - there is not a single organ that does not respond to movements. The wide range of influence of exercise therapy is ensured by the involvement of all levels of the central nervous system, endocrine and humoral factors;

absence of negative side effects (with the correct dosage of physical activity and rational exercise methods);

the possibility of long-term use, which has no restrictions, moving from therapeutic to preventive and general health (I.B. Temkin)

the formation of a new dynamic stereotype that reactively eliminates or weakens the pathological stereotype. In the normal stereotype, motor skills predominate; its restoration is the general task of exercise therapy;

transfer of all physiological systems of an aging (and not only aging) organism to a new, higher level, which ensures increased vitality and accumulation of energy. Optimal motor mode delays aging.

1.2 Clinical and physiological rationale for the therapeutic use of physical exercises

Human motor activity in the form of various forms of muscular activity (labor, physical exercise) plays an important role in his life; it has become a biological need in the process of evolution. Movements stimulate the growth and development of a child; in an adult, they expand the functional capabilities of all body systems, increase its performance, and in old age they maintain body functions at an optimal level and slow down involutive processes. Muscle activity has a positive effect on mental and emotional state. Sports, like work, increases the social significance of the individual.

The patient's body is in unfavorable conditions not only due to pathological changes, but also due to forced hypokinesia. Rest during illness is necessary: ​​it facilitates the functioning of both the affected organ and the entire body, reduces the need for oxygen and nutrients, promotes more economical functioning of internal organs, and restores inhibitory processes in the central nervous system (CNS). But if the restriction of motor activity continues for a long time, then the decrease in the functions of the most important systems becomes persistent, the excitation processes in the central nervous system weaken, the functional state of the cardiovascular and respiratory systems, as well as the trophism of the whole body, worsens, conditions are created for the occurrence of various complications, and recovery is delayed.

Therapeutic exercise improves impaired functions, accelerates regeneration, and reduces the adverse effects of forced hypokinesia. Physical exercises have a varied effect depending on their selection, methods of implementation and physical activity. The effects of exercise can be general and specific. The general effect is manifested in the activation of all functions of the body, which promotes recovery, prevention of complications, improvement of the emotional state, reduction of the adverse effects of forced hypokinesia during illness, and the special effect is in the targeted improvement of the function of a certain organ impaired by the disease or in the development of compensation. The overall effect is non-specific, so different physical exercises for different muscle groups can have the same effect on the body, and the same exercises can be effective for different diseases. Special physical exercises can in some cases have a specific effect on the pathological process.

Depending on the method of conducting classes (primarily on the magnitude and sequence of physical activity), different therapeutic effects of physical exercise are achieved. During the development of the disease, minimal physical activity is used; The special exercises used have a direct therapeutic effect, contribute to the formation of compensation and the prevention of complications. During the recovery period, by gradually increasing the load from session to session, a training effect is achieved, which restores the body's adaptation to physical activity, improves the functions of all body systems, including the function of the diseased organ or system. After achieving the maximum possible therapeutic effect for chronic diseases, after completing rehabilitation treatment for an acute illness or injury, as well as in old age, moderate physical activity is used to maintain the achieved treatment results, toning the body, increasing its adaptive capabilities.

The mechanisms of the therapeutic effect of physical exercises scientifically substantiate the use of therapeutic physical culture. Throughout the history of the use of physical exercises for therapeutic purposes, not only the methodology for their use has been developed, but also the mechanisms of their action have been studied. The discovery of new data on the mechanisms of the therapeutic effect of physical exercise, firstly, deepens our knowledge in this most important issue of the theory of therapeutic physical culture and, secondly, is of great practical importance, as it expands the capabilities of this therapeutic method, improves the training methodology, and improves the results treatment

1.2.1Mechanism of tonic action

At the onset of a disease, especially an acute one, excitatory processes in the central nervous system intensify, protective and pathological reactions appear, body temperature rises, and the activity of many internal organs is activated. During this period, the patient is advised to rest; physical exercises are not used or are used very limitedly.

As acute phenomena subside, as well as in chronic diseases, the level of basic life processes decreases. This is explained by the predominance of inhibition processes in the central nervous system, which is a consequence of the disease itself and a decrease in the patient’s motor activity (reduction in the number of impulses coming from the receptors of the musculoskeletal system). The same reasons lead to a decrease in the activity of the endocrine glands (adrenal glands, thyroid gland, etc.). Physical exercises increase the intensity of vital processes in the body, reduce the adverse effect on the patient of a motor regimen with limited activity.

During physical exercise, the motor zone of the central nervous system is excited, which spreads to its other areas, improving all nervous processes. The activity of the endocrine glands increases. Thus, an increase in the secretion of hormones from the adrenal medulla activates the activity of many internal organs; An increase in the secretion of cortical hormones increases the body's resistance, metabolism, and has an anti-inflammatory effect. At the same time, through motor-visceral reflexes, autonomic functions are stimulated: the activity of the cardiovascular system improves, the blood supply to all organs and tissues increases, the function of external respiration increases, and protective reactions are activated.

The tonic effect of physical exercise is enhanced by the positive emotions that arise during therapeutic physical education classes. The very knowledge that therapeutic physical training can help restore health, that in this method of treatment much depends on one’s own perseverance and activity, increases self-confidence, and distracts from anxious thoughts about the disease. Improved mood, the appearance of vigor and even unconscious pleasure from performing physical exercises, which I. P. Pavlov called muscle joy, activate nervous processes and stimulate the activity of the endocrine glands, which, in turn, improves the processes of regulation of the functions of internal organs.

Any physical exercise has a tonic effect. Its degree depends on the mass of contracting muscles and the intensity of the exercises. Exercises that involve large muscle groups and are performed at a fast pace have a significant impact. The mechanisms of motor-visceral reflexes activate the work of internal organs when working both the muscles of the trunk and the muscles of the legs or arms. Therefore, you can achieve a general tonic effect by performing physical exercises with stress on healthy body segments.

In addition to the general tonic effect, some physical exercises also have a targeted effect, stimulating primarily the functions of certain organs and systems. For example, exercises for the abdominals, diaphragm and hip movements of the legs increase intestinal motility, and certain breathing exercises improve bronchial patency and ventilation.

The tonic effect of physical exercise should be strictly dosed depending on the patient’s condition and the period of the disease. In the acute and subacute periods of the disease, with a severe general condition of the patient, exercises are used that stimulate the activity of only a separate organ or system. For example, movements in small distal joints increase peripheral circulation, but cause only minor changes in the activity of other organs.

In the initial period of recovery, as well as in chronic diseases, to consolidate the results of treatment (maintenance therapy), general tonic effects are indicated. Therefore, physical exercises are used for various muscle groups, the total physical load of which is not too great. It may not exceed the load of previous classes. Such a load should not tire those involved, but evoke a feeling of cheerfulness and joy.

To restore the functions of the entire body during the recovery period, constantly increasing physical activity is used, which gradually enhances the stimulating effect and, through training, improves the body’s adaptation and improves reserves.

Thus, the tonic effect of physical exercise consists in changing (most often intensifying) the intensity of biological processes in the body under the influence of dosed muscle load.

1.2.2Mechanism of trophic action

When the disease occurs, a change in the structure of organs and tissues occurs - from minor, subtle disturbances in the chemical composition of cells to pronounced structural changes and damage, and in some cases even to cell death. These pathological manifestations of the disease are always associated with metabolic disorders. Treatment is aimed at accelerating the regeneration (restoration of structure) of cells, which is achieved by improving and normalizing metabolism. The trophic effect of physical exercise is manifested in the fact that metabolic processes are activated under their influence.

When performing physical exercises, the regulatory systems (nervous and endocrine) stimulate the activity of blood circulation, breathing, and activate metabolic processes. Muscle contractions require adenosine triphosphoric acid (ATP). During rest, resynthesis and ATP synthesis increase, energy reserves increase (super-recovery phase). ATP is a source of not only movement energy, but also plastic processes. Therefore, an increase in ATP ensures the renewal of cells and tissues, their regeneration. During muscle activity, lactic and pyruvic acids enter the blood from the muscles, which are used as energy material by other organs. Physical exercise not only activates metabolism, but also directs trophic processes to regenerate damaged cells.

A striking example of the influence of therapeutic physical education on regenerative processes in the body is the treatment of fractures. The formation of callus with the correct comparison of fragments and immobilization occurs without the use of physical exercises. However, its formation in such cases is slow, and the structure is defective. Such a callus is initially much larger in volume than the bone (periosteal callus), its structure is loose, and the bone elements located in it do not correspond to the intact surrounding areas. Only after the patient begins to perform various industrial and everyday activities, i.e., use functional loads, does the restructuring of the callus occur: excess tissue elements are absorbed, the structure of the bone elements comes into line with the undamaged areas.

If therapeutic physical culture is used from the very first days after injury, bone regeneration is significantly accelerated. Physical exercise, improving blood circulation and metabolism, promotes the resorption of dead elements and stimulates the growth of connective tissue and the formation of blood vessels. Timely use of special physical exercises (exercises with axial load are especially effective) accelerates the processes of formation and restructuring of callus.

Under the influence of muscle activity, the development of muscle atrophy caused by physical inactivity is delayed. And if atrophy has already developed (during immobilization after injuries, damage to peripheral nerves, etc.), restoration of muscle structure and function is possible only by performing physical exercises that activate metabolic processes.

Various physical exercises have a trophic effect, regardless of the location of their influence. The degree to which exercise affects overall metabolism depends on the number of muscles involved in the movement and the intensity of its implementation. Some physical exercises have a targeted trophic effect on certain organs. Thus, movements in the joint improve its trophism and contribute to the restoration of its structure in case of diseases and arthrogenic contractures caused by changes in structure. And exercises for the abdominal muscles improve the trophism of the abdominal organs.

The trophic effect of physical exercise is also manifested in the improvement of oxidative processes in the body, and the strengthening of tissue metabolism stimulates the elimination of pathological processes, for example, the healing of sluggish wounds.

In case of metabolic disorders, the trophic effect of physical exercise contributes to its normalization. And not only due to the activation of metabolism due to increased energy costs, but also due to improved function of regulatory systems. For example, in diabetes mellitus, physical exercise increases tissue metabolism, sugar consumption and its deposition in muscles, and also enhances the effect of insulin, which in some cases makes it possible to reduce its dose. In mild forms of diabetes, physical exercise, improving hormonal regulation, sometimes reduces blood sugar levels to normal values.

2.3Compensation formation mechanism

In diseases, dysfunctions are compensated by adaptation (adaptation) of the damaged organ or other organ systems by optimizing regulatory mechanisms. Thus, compensation is a temporary or permanent replacement of impaired functions. The formation of compensation is a biological property of living organisms. If the functions of a vital organ are impaired, compensatory mechanisms are activated immediately. Physical exercise improves the functions of other organs and systems involved in gas exchange<#"justify">1.2.4Mechanism for normalizing body functions

To restore health and performance after illness or injury, it is necessary to normalize all body functions. Physical exercise activates various functions. Initially, they help restore motor-visceral connections, which, in turn, have a normalizing effect on the regulation of other functions. During the recovery period, large training physical activities become possible, which normalize the activity of regulatory systems.

Physical exercise also helps eliminate movement disorders. For example, long-term immobilization of the lower limb during a fracture develops a new walking skill - with a straight leg, which remains even after the removal of the cast. Walking can be normalized quite quickly with the help of special physical exercises.

Clinical recovery is not always accompanied by restoration of performance. A person who has suffered, say, pneumonia, may have a normal temperature, blood composition, and the structure of the lung tissue restored, but at the first attempt to perform physical work, profuse sweating, shortness of breath, dizziness and weakness will appear. It will take a long time to restore functionality.

Performing correctly selected and precisely dosed physical exercises during the recovery period will contribute to the normalization of the body’s autonomic functions, the restoration of motor qualities reduced during the illness, and the optimal functioning of all body systems during muscle work. For this purpose, for example, special physical exercises are used that improve a certain motor quality (muscle strength, coordination of movements) or organ function (external respiration, intestinal motility, etc.). They are dosed in such a way as to have a tonic effect, that is, the loads in them should gradually but constantly increase. Such training causes the body to adapt to increasing physical activity by improving the functions of the regulatory and autonomic systems and the musculoskeletal system, i.e. it leads to the normalization of all functions of the body as a whole.

Thus, the therapeutic effect of physical exercise is diverse. It manifests itself in a complex manner (for example, in the form of a simultaneous tonic and trophic effect). Depending on the specific case and stage of the disease, you can select such special physical exercises and such a dosage of load that will ensure the predominant action of one mechanism necessary for treatment during a given period of the disease.

physical therapeutic exercise sports

1.3Indications and contraindications

Indications for exercise therapy

Therapeutic exercise is used for almost any ailment and injury and has no age or gender restrictions. The main indications for its use are considered to be the absence, weakening or distortion of a function established as a result of disease, injury, injury or their complications when the condition of positive dynamics in the physical condition and well-being of the patient is met. It is worth emphasizing that the effect of physical therapy increases significantly with its earlier and systematic use in complex comprehensive treatment and rehabilitation.

Contraindications to exercise therapy

Frankly speaking, there are few contraindications for physical therapy, and in most cases they are all temporary, short-lived and relative. General contraindications include:

· lack of contact with the patient due to mental disorders;

· acute infectious and inflammatory diseases;

· intoxication;

· pronounced pain syndrome;

· external or internal bleeding or the threat of its occurrence;

· thrombosis;

· embolism;

· high body temperature;

· arterial hypertension (with indicators above 200/120 mm Hg);

· malignant neoplasms, tumors (in the phase before radical treatment methods);

· metastases;

· irreversible progressive diseases;

· the presence of a foreign body near large vessels or nerve trunks.

When prescribing exercise therapy to patients, it is necessary to take into account limiting, restraining, limiting indicators and risk factors. Their findings make it possible to clarify the methodology and dosage of physical activity during physical therapy exercises. Such limiting factors usually include deviations in physical development and mental state, concomitant diseases and complications that influence the choice of physical exercises for the underlying disease. Risk factors are considered to be conditions in which the patient may receive injury or damage while performing prescribed physical exercises (osteoporosis, fragile callus, cardiac or aortic aneurysm, etc.).

From the above, we can conclude that indications and contraindications for exercise therapy are an important point in choosing a comprehensive treatment strategy for a patient. That is why physical therapy must be prescribed and supervised by a properly qualified specialist in any appropriate medical, sanatorium or rehabilitation institution.

SECTION 2. Exercise therapy. FORMS AND METHODS OF LFK

2.1Physical exercise

Physical exercises used for therapeutic purposes are divided into gymnastic, ideomotor, applied sports, exercises in sending impulses to muscle contraction and games (see diagram at the bottom of the page).

Gymnastic exercises are specially selected combinations of natural movements for humans. By selectively influencing individual muscle groups or joints with the help of gymnastic exercises, you can improve overall coordination of movements, restore and develop strength, speed of movement, agility and flexibility.

Recently, in therapeutic physical culture, to restore the functions of the musculoskeletal system and cardio-respiratory system, rhythmic (dance) movements are used with musical accompaniment, which corresponds to the state of higher nervous activity.

Gymnastic exercises are classified according to several criteria.

Anatomically, exercises for the muscles of the head, neck, torso, girdle of the upper limbs, muscles of the upper and lower limbs, abdominal muscles and pelvic floor.

Based on activity - active (performed by the student himself); passive (performed by a methodologist of therapeutic physical culture with the patient’s volitional effort); active-passive (performed by the student with the help of a physical therapy methodologist).

Based on the use of gymnastic apparatus and apparatus - exercises without apparatus and apparatus; exercises with objects and equipment (with a gymnastic stick, rubber, tennis or volleyball ball, medicine ball, clubs, dumbbells, expander, jump rope, etc.); exercises on apparatus (on a gymnastic wall, an inclined plane, a gymnastic bench, gymnastic rings, mechanotherapeutic equipment, uneven bars, a beam, a crossbar, etc.).

By type and nature of execution - serial and drill, preparatory (introductory), corrective, coordination of movements, breathing, resistance, hanging and resting, hopping and jumping, rhythmoplastic exercises.

Ordinal and drill exercises (formations, turns, walking, etc.) organize and discipline students, developing the necessary motor skills. They are used at the post-hospital stage of rehabilitation, as well as in health groups.

Preparatory (introductory) exercises prepare the body for the upcoming physical activity. Their choice depends on the objectives of the lesson, as well as on the level of physical fitness of the patient.

Corrective exercises prevent and reduce postural defects and correct deformities. They are often combined with passive correction: traction on an inclined plane, wearing an orthopedic corset, special styling using rollers, massage. Corrective exercises have a combined effect on various muscle groups - they simultaneously strengthen some and relax others. For example, with pronounced thoracic kyphosis (stooping), a corrective effect is exerted by gymnastic exercises aimed at strengthening weakened and stretched back muscles and stretching and relaxing the pectoralis major muscles, which are in a state of increased tone; for flat feet - special exercises to strengthen the muscles of the lower leg and foot in combination with exercises to develop correct posture.

Exercises for coordination of movements and balance are used to train the vestibular apparatus in case of hypertension, neurological diseases, and for elderly and older people involved in health groups. They are performed in various starting positions (standing on a narrow support area, on one leg, on toes), with open and closed eyes, with and without objects, on a gymnastic bench, gymnastic balance beam. Movement coordination exercises also include exercises aimed at developing everyday skills lost as a result of a particular disease (fastening buttons, lacing shoes, lighting matches, opening a lock with a key, etc.). Modeling, assembling children's pyramids, mosaics, etc. are widely used.

2 Sports and applied exercises

Among the applied sports exercises in therapeutic physical culture, the most commonly used are walking, running, jumping, throwing, climbing, balance exercises, lifting and carrying weights, dosed rowing, skiing, skating, therapeutic swimming, and cycling. Applied sports exercises contribute to the final restoration of the damaged organ and the entire body as a whole, and instill in patients perseverance and self-confidence.

In therapeutic and health-improving physical culture, applied sports exercises are used to prevent diseases and develop physical qualities.

Along with the listed exercises, games are used in therapeutic physical culture. All types of games (games in place, sedentary, active, sports) help improve the functioning of all organs and systems of the body. They are carried out during the recovery period under medical and pedagogical supervision in the final part of the therapeutic gymnastics class.

2.3 Games in exercise therapy

As a means of therapeutic physical culture, games are aimed at improving motor skills and qualities in changing conditions, at improving the functions of a number of analyzers; they have a tonic effect on the patient’s body; Due to their general influence, they also acquire training significance, increasing the functionality of the main organs and systems.

Depending on the special tasks that are solved in classes, the content of the games includes a variety of motor skills - walking, running, throwing, balance, etc. The games develop such qualities as dexterity, mobility, speed of reaction, attention. It is very important to switch the patient’s psyche to the game process: this distracts him from thinking about the disease.

Sedentary, active and sports games are used for therapeutic purposes.

Sedentary games have a slight effect on the cardiovascular and respiratory systems and improve the overall tone of patients. These games can be used in wards with bed rest patients, in the introductory part of group classes (to organize the group, to increase interest) and in the final part (to reduce physical activity). The content of such games includes exercises for attention, coordination of movements, and basic gymnastic exercises.

Outdoor games are, as a rule, part of a group therapeutic exercise class, which is carried out in a clinic, dispensary, or sanatorium. Characteristic of outdoor games is the desire of those participating in the game for individual or team superiority. These games place significant demands on the nervous, cardiovascular, and respiratory systems. When conducting outdoor games, the load is regulated by the inclusion of breaks, the selection of teams (the same in age and physical fitness), the change of the “driver,” and the duration of the game.

Sports games (volleyball, badminton, tennis, gorodki) are used in sanatorium-resort treatment. The physiological impact of the load of sports games, other things being equal, depends on the technical preparedness of patients (the level of previous training and knowledge of technical techniques of the game). When conducting sports games, it is often necessary to reduce physical activity, which is achieved:

· facilitating gaming rights;

· increasing the number of players in the team;

· selection of partners of equal strength;

· reducing the duration of games;

· replacing players during the game, etc.

2.4 Forms and methods of exercise therapy

Forms of exercise therapy

· Morning hygienic exercises;

· Therapeutic gymnastics classes;

· Independent exercise;

· Walking, walking;

· Mass forms of health-improving physical culture;

· Dosed ascents;

· Dosed swimming, rowing, skiing;

· Elements of sports games;

· Close-range tourism;

· Elements of sports;

· Excursions;

· Physical education mass performances, holidays.

Morning hygienic exercises

Hygienic gymnastics at home is carried out in the morning; this is a good means of transition from sleep to wakefulness, to the active work of the body. The physical exercises used in hygienic gymnastics should be easy. Static exercises that cause strong tension and holding your breath are unacceptable. Exercises that affect various muscle groups and internal organs are selected, taking into account the patient’s state of health, physical development and degree of workload. The duration of gymnastic exercises should be no more than 10-30 minutes. The complex includes 9-16 exercises: general development exercises for individual muscle groups, breathing exercises, exercises for the torso, relaxation exercises, and for the abdominal muscles. All gymnastic exercises should be performed freely, at a calm pace, with gradually increasing amplitude, involving first small muscles and then larger muscle groups.

Physiotherapy

The procedure (lesson) of physical therapy is the main form of exercise therapy. Each procedure consists of three sections: introductory, main and final.

The introductory section of the lesson gradually prepares the patient’s body for increasing physical activity. Use breathing exercises and exercises for small and medium muscle groups and joints. During the main section, a training (general and special) effect on the patient’s body occurs. In the final period, breathing exercises and movements are carried out, covering small and medium muscle groups and joints - this reduces overall physical stress.

The correct use of physical exercises involves the distribution of physical activity taking into account its optimal physiological curve, i.e. dynamics of the body's reactions to physical exercise throughout the entire procedure. The distribution of physical activity in LG procedures is carried out according to the principle of a multi-vertex curve.

Initial provisions. In PH there are three main positions: lying (on your back, on your stomach, on your side), sitting (in bed, on a chair, on a couch, etc.) and standing (on all fours, supported by crutches, parallel bars, the back of a chair, etc. .).

LG tasks. The therapeutic task can be defined as the goal of restorative measures at a given stage of development of the pathological condition. The objectives of treatment (including exercise therapy) are determined by ideas about the etiology and pathogenesis of a disease or injury.

In some cases, treatment objectives are determined not by pathological changes inherent in the main process, but by the individual picture of the disease and measurements of other organs and systems (for example, the prevention of musculoskeletal deformities in diseases of the spine). Complex therapy may include the tasks of normalizing autonomic disorders, restoring lost or impaired motor skills or the normal structure of movement after injury (reconstructive operations), etc. Selection of exercise therapy tools in accordance with treatment objectives. Special objectives are characteristic only for a certain form of pathology and a combination of morphofunctional changes. General tasks are associated with changes in the body’s defenses, reactivity, growth and development of the patient, emotional sphere, etc., which are typically characteristic of many diseases.

To solve general therapeutic problems, the stimulating and normalizing effect of exercise therapy is a priority, while the therapeutic effect extends to the body as a whole. They use general developmental physical exercises, general massage, outdoor games that are adequate to the therapeutic and protective regime, and hardening agents.

The dosage of physical activity in LH classes is of great importance, since it largely determines the therapeutic effect of physical exercise and massage. An overdose can worsen the condition, and an insufficient dosage does not give the desired effect. Only compliance with physical activity to the patient’s condition and his capabilities can optimally improve the functions of various body systems and have a therapeutic effect.

Physical activity is dosed depending on the objectives of a specific treatment period, manifestations of the disease, functionality, age of the patient, and his tolerance to physical activity. You can change physical activity using various methodological techniques.

Depending on the tasks faced during different periods of treatment, the dosage of loads can be therapeutic, tonic (supporting) and training.

Particular systematization of physical exercises is the basis for constructing differentiated exercise therapy techniques. The correct choice of physical exercises to a certain extent determines their effectiveness. Particular systematization of physical exercises, taking into account their targeted effect on the affected system or organ, depending on the etiology, is a necessary element of the well-founded construction of any differentiated and effective technique.

The influence of physical exercise on various physiological mechanisms involved in the regulation of circulatory function, as well as on smoothing the clinical manifestations of the disease, should be considered. Basically, when systematizing and choosing physical exercises, it is necessary to take into account their effect on the redistribution of blood, both during the transition from relative rest to physical activity, and when using different starting positions. It is necessary to distribute physical activity among different muscle groups (small, medium, large); take into account the strength of muscle tension, as well as the simplicity and dynamism of physical exercises. In general, they provide for the activation of energy processes (total load), the diverse effects of physical exercise on heart function, as well as the mobilization of extracardiac factors in order to improve circulation and prevent congestion.

Methods for performing the LH procedure. The LH procedure can be carried out individually and in groups.

· The individual method is used in patients with limited physical activity due to a serious condition. A variant of the individual method is independent; it is prescribed to patients who find it difficult to regularly visit a medical facility, or those discharged for follow-up treatment in an outpatient or home setting.

· The group method is most common in medical institutions (clinic, hospital, sanatorium-resort treatment). Groups are formed with a focus on the underlying disease and functional state of patients.

1.stage-by-stage control - before the start of treatment and before discharge; it includes an in-depth examination of the patient and the use of functional diagnostic methods that characterize the state of the cardiovascular system, respiratory, nervous systems and musculoskeletal system. The choice of examination methods is determined by the nature of the pathology. Working with pulmonary patients, along with assessing the functional state of the cardiovascular system, requires the inclusion of special methods for studying the respiratory system: spirography, pneumotachometry, oxygemography, reflecting the state of external respiration, oxygen consumption and use. When working with cardiac patients, ECG, FCG, and other methods are used. Examination of patients with surgical and traumatic pathologies, in addition to the methods already mentioned, includes myotonometry, myoelectrography;

2.current monitoring is carried out throughout the patient’s treatment at least once every 7-10 days using the simplest methods of clinical and functional examination and functional tests, anthropometry, pulse monitoring, blood pressure, ECG, etc.;

.express control to determine the patient’s response to a certain physical activity. The scope of research is determined in each case by the real possibilities and objectives of the survey. It can be carried out according to an expanded or limited program. In both cases, indicators such as the patient’s well-being, external signs of fatigue, pulse reaction and blood pressure are assessed. The expanded program includes a functional examination.

CONCLUSIONS

Therapeutic physical culture is used in complex treatment for various diseases and injuries of the body and has no age restrictions; it is primarily a therapy of regulatory mechanisms, using adequate biological arcs for mobilizing the adaptive, protective and compensatory properties of the body to eliminate the pathological process. Together with the motor dominant, health is restored and maintained.

.During the work, the mechanisms of the therapeutic effect of physical exercise were studied: physical exercise has a tonic (stimulating), trophic, compensatory and normalizing effect on the body.

The tonic effect of physical exercise is the most universal. For all diseases, at a certain stage, they are used to stimulate excitation processes in the central nervous system, improve the activity of the cardiovascular, respiratory and other systems, increase metabolism and various protective reactions, including immunobiological ones. The tonic effect is expressed in the restoration of impaired motor-visceral reflexes, which is achieved by choosing physical exercises that purposefully increase the tone of those organs where it is more reduced.

The trophic effect of physical exercise is expressed in the acceleration of regeneration processes. In cases where true organ regeneration does not occur, physical exercise helps accelerate the formation of scar tissue and compensatory organ hypertrophy. Under the influence of physical exercise, the resorption of dead elements is accelerated by improving local blood circulation. The effect of physical exercise is also manifested in improving oxidative processes in the body. In diseases, these processes often worsen. Muscular activity, enhancing all types of metabolism, also activates oxidative processes.

The formation of compensation occurs when any function of the body is disrupted. In these cases, specially selected physical exercises help to use unaffected systems. Physical exercise accelerates the development of compensations and makes them more perfect.

Physical exercises ensure normalization of functions by helping to inhibit pathological conditioned reflex connections and restore normal regulation of the activity of the whole organism. Physical exercise helps eliminate movement disorders.

.The main means of exercise therapy are physical exercises, which are divided into the following: gymnastic, general developmental and respiratory, active and passive, without apparatus and on apparatus; applied sports: walking, running, throwing balls (inflatable, basketball, volleyball, etc.), jumping, swimming, rowing, skiing, skating, etc.; games: sedentary, active and sports.

The main forms of exercise therapy: morning hygienic gymnastics (UGG), LH procedure (lesson), dosed ascents (terrenkur), walks, excursions, short-range tourism.

Methods (techniques) of exercise therapy, in essence, are the tasks of exercise therapy. The name of the exercise therapy technique indicates the disease or pathological condition for which this method is used.

List of sources used

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Physical rehabilitation includes the appointment of various means of physical rehabilitation (physical therapy, various types of massage, preformed and natural factors). It is carried out by doctors of physiotherapy, exercise therapy and massage, as well as nursing staff (physiologists, massage therapists, exercise therapy instructors).

Physiotherapy(exercise therapy) is one of the most important and effective methods of physical rehabilitation, which is widely used in diseases of the nervous system of various etiologies with a variety of clinical syndromes, both neurological and neurosurgical. This is determined, on the one hand, by the breadth of the impact of therapeutic physical exercises on various functional systems of the body - cardiovascular, respiratory, musculoskeletal, nervous, endocrine, and on the other hand, by the training and restorative effect of these exercises in cases of deficiency or insufficiency of various body functions.

Modern theoretical and practical aspects of physical therapy allow us to formulate the most general principles for the use of this method of medical rehabilitation.

1. The purposefulness of exercise therapy techniques, predetermined by a specific functional deficit in the motor, sensory, vegetative-trophic sphere, in cardiovascular, respiratory activity.

2. Differentiation of exercise therapy techniques depending on the typology of functional deficit, as well as the degree of its severity.

3. The adequacy of the physical therapy load to the individual dynamic capabilities of the patient, assessed by the general condition, the state of the cardiovascular and respiratory systems and the reserve capabilities of the deficient functional system at a given specific stage of the disease (for a given exercise therapy session), in order to achieve a training effect at the optimum loads.

4. Timely application of exercise therapy techniques in the early stages of the disease in order to maximize the possible use of preserved functions to restore impaired ones, as well as the most effective and rapid development of adaptation if it is impossible to completely restore the functional deficit.

5. Consistent activation of physical therapy interventions by expanding the methodological arsenal and volume of exercise therapy, increasing training loads and training effects on certain functions and on the entire patient’s body.

6. Functionally justified combination of the use of various means of exercise therapy - therapeutic exercises, massage, postural exercises - depending on the period of the disease of the nervous system, functional deficiency, the degree of its severity, the prognosis of restoration of functions and the addition of complications, as well as the stage of rehabilitation of the patient.

7. The complexity of the use of exercise therapy techniques in medical rehabilitation with other methods - drug therapy, physiobalneotherapy, acupuncture, hyperbaric oxygenation, hardware treatment, orthopedic measures, etc.

The use of the listed principles of using exercise therapy is mandatory both when constructing a treatment complex for a specific session and course, and when developing a rehabilitation program for a given patient or a group of similar patients.

There are many methods and types of physical activity that take place in rehabilitation activities.

Massage is one of the oldest methods of physical influence on the body of a sick person. Many manuals and monographs are dedicated to him, which describe the techniques, tactics and features of various types of massage.

Massage is a set of techniques of mechanical influence in the form of friction, pressure, vibration, carried out directly on the surface of the human body, both with hands and with special devices, through air, water or other media. Massage can be general and local. Depending on the tasks, the following types of massage are distinguished: hygienic, therapeutic, sports, self-massage.

Important tasks that are solved with the help of massage are:

1. General tonic effect - by enhancing blood and lymph circulation, as well as nonspecific stimulation of exteroceptive and proprioceptive sensitivity (classical, segmental, acupressure);

2. Regional-tonic effect on flaccid muscles - is achieved by using various methods of classical massage in a large volume, with sufficient force, as well as special massage, thanks to longitudinal rubbing and kneading of the muscle belly in its various states (relaxation or varying degrees of tension) and subsequent shaking , fine-point vibration and short-term painful pressure on the muscle;

3. A relaxing effect on rigid, spastic and locally spasmodic muscles, carried out using general relaxing techniques of classical massage (stroking, shaking, fine vibration), performed at a slow pace with mandatory pauses between techniques, as well as using acupressure and segmental massage of certain points and zones;

4. The anti-pain effect is achieved by the reflex effect of acupressure, segmental, oriental and classical (in a relaxing version) massage.

All massage techniques must be combined with various methods of therapeutic exercises. Only in special cases, when the general condition of the patient does not allow for therapeutic exercises, does massage become an independent, strategically important method.

Physiotherapy. In the complex rehabilitation of patients, various types of physiotherapeutic procedures are used. All of them solve practically the same problems: reducing the activity of the inflammatory process, activating reparative processes, reducing pain, improving blood and lymph circulation, as well as tissue trophism, preventing and eliminating contractures, restoring the body’s most important immune-adaptive systems.

The principles of physiotherapy are the timely use of physical factors, their correct combination, continuity in treatment. There are several groups of artificially obtained and natural healing physical factors.

Mechanotherapy is a system of functional treatment using various devices and equipment, used in combination with other means and methods of modern medical rehabilitation of patients.

Based on their effectiveness, mechanotherapy devices can be divided into the following groups:

1. “Diagnostic” devices that help to take into account and accurately evaluate the effect of motor recovery;

2. Supporting, fixing devices - helping to highlight individual phases of voluntary movements;

3. Training devices that help dose the mechanical load during movements;

4. Combined devices from the first three groups.

Currently, the following groups of mechanotherapy devices are widely used in the practice of rehabilitation treatment based on the principle of their effect on the human body:

1. Devices based on the block principle (functional mechanotherapeutic table, stationary block unit, portable block unit), designed for dosed strengthening of various muscle groups of the upper and lower extremities;

2. Devices based on the pendulum principle to restore mobility and increase range of motion in various joints of the upper and lower extremities and devices to improve overall performance (simulators). Pendulum devices are reliable in operation. The stands allow for changing the height of the device mounting. On a stand consisting of a base rigidly connected by four guide columns to the top cover, two mechanotherapy devices can be simultaneously supported. There are two plates on the columns on which the devices are installed. The presence of a counterweight allows the device to be easily secured using a locking device at the desired height.

Healing Fitness- a scientific-practical, medical-pedagogical discipline that studies the theoretical foundations and methods of using physical education for the treatment and rehabilitation of sick and disabled people, as well as for the prevention of various diseases. A distinctive feature of exercise therapy compared to other methods of treatment and rehabilitation is that it uses physical exercise as the main therapeutic agent - a powerful stimulator of the vital functions of the body.

Exercise therapy is not only therapeutic and prophylactic, but also therapeutic and educational a means that instills in the patient a conscious attitude towards the use of physical exercises, as well as active participation in the treatment and rehabilitation processes, which is based on training in physical exercises. In this regard, physical therapy is not only a therapeutic process, but also a pedagogical process. The object of the influence of exercise therapy is a patient with all the characteristics of the reactivity and functional state of the body. This determines the individual characteristics of the means and methods of exercise therapy used, as well as the dosage of physical activity in the practice of exercise therapy.

Exercise therapy - natural biological content method, since it is based on the use of the biological function of the body - movement, which is the main stimulator of the process of growth, development and formation of the body. Movements, stimulating the activity of all systems, help improve the overall performance of the body.

Exercise therapy - nonspecific therapy method, and the physical exercises used in it are nonspecific stimuli that involve all parts of the nervous system in the response. Physical exercises can selectively influence various functions of the body, which is very important for pathological manifestations in individual systems and organs.

Exercise therapy - pathogenetic therapy method. The systematic use of physical exercise can influence the reactivity of the patient’s body and the pathogenesis of the disease, changing both the general reaction of the body and its local manifestation.

Exercise therapy - method of active functional therapy. Regular and dosed physical training stimulates the functional activity of all major systems of the body, promoting the patient’s functional adaptation to increasing physical activity.

When using exercise therapy, the patient's direct connection with natural and social factors expands, which contributes to his adaptation to the external environment.

Exercise therapy - method of primary and secondary prevention. Its preventive value is determined by the health-improving effect on the patient’s body.

Exercise therapy - rehabilitation therapy method, therefore it is widely used in the process of rehabilitation - in particular physical.

Rehabilitation- a method of restoring health, functional state and ability to work, impaired by diseases, injuries or physical, chemical and social factors.

The goal of rehabilitation is the effective and early return of sick and disabled people to everyday and work processes and to society; restoration of a person’s personal properties.

Rehabilitation should be considered as a complex socio-medical process. It can be divided into several types: medical, physical, psychological, professional (labor) and socio-economic.

Medical rehabilitation. Includes medicinal, surgical, physiotherapeutic and other treatment methods, which, along with the treatment of the disease, help restore those body functions that are necessary for a person to return to normal functioning.

Labor (vocational) rehabilitation. Aimed at restoring working capacity and returning a person to a familiar work and social environment. If necessary, provides the opportunity to change profession.

Psychological rehabilitation. It is aimed at correcting the patient’s mental state, as well as at forming his conscious attitude towards treatment, medical recommendations, and the implementation of rehabilitation measures. It is also necessary to create conditions for the patient’s psychological adaptation to the life situation that has changed as a result of the disease.

Socio-economic rehabilitation. Aimed at restoring economic independence and social usefulness to the affected person.

Physical rehabilitation. An integral part of medical, socio-economic and professional rehabilitation. A system of measures aimed at restoring or compensating a person’s physical capabilities and intellectual abilities, improving the functional state of the body, developing the necessary physical qualities, psycho-emotional stability, increasing the adaptive capabilities of the human body using means and methods of physical culture, exercise therapy, elements of sports and sports training, massage , physiotherapy and natural factors.

The main means of physical rehabilitation are physical exercises, and in particular exercise therapy.

No other means or methods of rehabilitation can replace physical exercise.

Successful rehabilitation requires: an early start of restorative (rehabilitation) measures (RM), their phased successive and continuous use during the period of illness, the complex nature of RM, individualization of effects by means of exercise therapy, taking into account the personal characteristics of the patient and the course of his disease.

The most common three-stage rehabilitation system is: Stage 1 - inpatient, or hospital leave; Stage 2 - sanatorium (or in an inpatient rehabilitation center); Stage 3 - outpatient.

Therapeutic physical culture is widely used at all stages of rehabilitation.

At the hospital stage, exercise therapy prevents the development of possible complications, increases the overall tone of the body, activates its defenses, and stimulates recovery processes. During classes, the patient learns the correct position in bed, active and passive movements; adapts to expanding range of motion in a sitting position and then standing; learning to walk.

At the sanatorium stage (or in an inpatient rehabilitation center), exercise therapy promotes further activation of the patient and his more complete functional recovery; preparing him for everyday activities, restoring self-care skills, training in walking and other applied activities; preparation for work.

At the outpatient stage, exercise therapy is aimed at further and final restoration of impaired functions, and, if necessary, at improving compensation and preparing the patient for socially useful work.

Occupational diseases include diseases caused by exposure to unfavorable factors in the work environment. Occupational pathology is closely related to other clinical disciplines, as well as occupational health.

Some types of work, under certain conditions, can cause occupational diseases, which is usually facilitated by insufficient technical equipment of production and non-compliance with sanitary and hygienic standards.

Occupational factors that have an adverse effect on people's health are varied. It should be noted that when exposed to them, not only occupational diseases, but also industrial injuries can occur. The latter include acute diseases that arise as a result of mechanical, thermal, chemical or electrical damage to a tissue or organ directly in the workplace or on the territory of an enterprise. Currently, there is a generally accepted division of occupational diseases both on the etiological principle and on the system-organ basis.

According to the etiological principle, the following groups of occupational diseases are distinguished:

1) caused by exposure to industrial dust (pneumoconiosis, dust bronchitis, etc.);

2) caused by the influence of physical factors of the working environment (vibration disease, injuries caused by exposure to intense noise, various types of radiation, high and low temperatures, etc.);

3) caused by exposure to chemical factors in the working environment (acute and chronic intoxication);

5) occupational diseases from overstrain of individual organs and systems (diseases of the musculoskeletal system, peripheral nerves and muscles, etc.).

Exposure to chemical compounds on the body causes acute, subacute and chronic intoxication. The most common intoxications are compounds of lead, mercury, benzene and its homologues, amino and nitro derivatives, pesticides, etc. Physical factors are the cause of vibration disease, cochlear neuritis, radiation pathology, decompression (caisson) sickness. When the body is exposed to industrial dust, pneumoconiosis (silicosis, metalloconiosis, etc.), dust bronchitis, chronic nasopharyngolaryngitis, as well as some allergic diseases and neoplasms often develop. Diseases caused by physical overload and overstrain of individual organs and systems include such common lesions of the musculoskeletal system as glenohumeral periarthritis, epicondylitis of the shoulder, deforming osteoarthritis, bursitis, etc. This group also includes mono- and polyneuropathies, including compression and autonomic-sensory neuropathies, cervical and lumbosacral radiculitis, etc.

Brucellosis, tuberculosis, infectious hepatitis, some forms of dermatomycosis, etc., arising from contact during work are recognized as occupational.

Of great importance in improving working conditions is the creation in our country of a special service at the State Center for Sanitary and Epidemiological Surveillance (SCSES) for preventive and routine sanitary supervision at industrial enterprises, transport and agricultural facilities in Russia. An important role in preventing the development of occupational diseases belongs to a rational regime of work and rest, as well as medical and sanitary care for workers and medical examination.

The dispensary method provides, in particular, for professional selection through preliminary medical examinations of people entering work in hazardous working conditions. Thanks to this, the possibility of occurrence of occupational diseases and, to a certain extent, the appearance of their severe forms is reduced. Periodic examinations of workers make it possible to identify occupational diseases already in the initial stages and timely carry out health-improving measures both in relation to working conditions and in relation to the diseases themselves (treatment, rational employment, etc.).

Occupational morbidity is greatly influenced by work experience in production with negative factors. For example, after 10-15 years of such work, diseases were registered in 70-80% of patients with chronic intoxication, pneumoconiosis, in 55-65% - with hand diseases from functional overexertion, in the overwhelming majority (almost 90%) of patients with neuritis of the auditory nerves. The majority (65%) of occupational dermatoses developed during the first three years of work, and vibration disease (approximately 40% of cases) developed after 6-10 years of work.

The age of patients at the time of detection of the disease ranged from 30-39 years to 50 years. Disability due to occupational diseases is more than 80% under the age of 45.

Examinations and clinical examinations of workers are carried out by occupational pathologists. Those who are suspected of having an occupational disease or poisoning are referred for consultation to a specialized institution. Registration of an occupational disease is carried out by the city sanitary and epidemiological station or the institute clinic.

The specificity of occupational diseases is that their cause is in working conditions. Therefore, in the treatment of this group of patients, changing working conditions comes first.

Patients with occupational diseases are more often transferred to disability than patients with somatic diseases. Disability is given to them primarily for preventive purposes, in order to help the patient acquire another specialty, to support him financially while mastering a new profession. It is necessary to transfer to disability as early as possible, as soon as the disease is diagnosed.

Based on their ability to reverse development, occupational diseases can be divided into three groups:

diseases that go away even without any treatment, only with changes in working conditions. These are allergic diseases, dermatitis (dermatoses), rhinopathies;

diseases capable of reversal, subject to more or less long periods of active treatment (with a mandatory change in working conditions, of course). This group includes the vast majority of occupational diseases: chronic intoxication, vibration disease, hand diseases from functional overexertion, dust bronchitis, etc.;

diseases that are not capable (or very little capable) of reverse development. This group includes all pneumoconiosis, severe forms of chronic intoxication (toxic encephalopathy, pneumosclerosis, etc.), occupational hearing loss and some diseases of the musculoskeletal system (aseptic necrosis, coxarthrosis, osteochondrosis, arthrosis of the joints, etc.).

Medical rehabilitation requires many years of treatment for the second and third groups and is impossible in advanced cases (in the third group).

In the complex treatment of occupational diseases, exercise therapy, massage, oxygen therapy, general ultraviolet irradiation (UVR), physiotherapy, hydrotherapy, sauna, diet therapy, etc. are used.

The systematic use of physical culture and exercise therapy helps to increase the body's functional capabilities for physical activity. Under the influence of physical exercise and massage, the function of the cardiorespiratory system, tissue metabolism, etc. improves.

The method of exercise therapy is determined by the nosological form of the occupational disease, the stage and severity of its course, the general condition of the patient, his age, and gender. Physical activity is increased gradually, along with changing the starting positions, selecting general developmental and breathing exercises. Exercises are performed at a slow and medium pace, breathing exercises are performed with an emphasis on exhalation. Exercises for pronouncing sibilant vowels are shown. To activate breathing, massage the chest and respiratory muscles. Classes are conducted in a group method, accompanied by music, for 15-35 minutes. The complex of recreational activities includes dosed walking in the fresh air (in the forest, park, pine grove, etc.), skiing, rowing, etc., and a bathhouse (sauna).

During sanatorium-resort treatment in the Crimea, the North Caucasus and in areas with a mountainous climate, dosed walking and running, games, swimming, diet therapy, taking an oxygen cocktail, vitamin supplementation, etc. are used.

Professional dyskinesias

(coordinating neuroses)

Coordinator neuroses (occupational dyskinesia, writer's cramp, writer's cramp) are one of the rare but unique occupational diseases. It is based on the neurosis of the higher coordinating centers of the central nervous system. The main thing is the overstrain of muscle groups involved in performing a certain work: writing, playing musical instruments (violinists, pianists, cellists, etc.), typing, etc.

It is believed that the disease more often occurs in individuals with instability of the central nervous system, weak links in the musculoskeletal system, etc.

The disease develops gradually. One of the early clinical signs is a feeling of awkwardness, heaviness in the hand when performing precise movements, increased fatigue, inaccuracy of finger movements, etc.

There are 4 clinical forms: convulsive, paretic, trembling and neural.

Occupational dyskinesias differ in the duration of their clinical course and tend to progress.

Rehabilitation should be comprehensive and include: wet wraps of the whole body, pine baths, galvanic collar according to A. Shcherbak, warm chamomile baths (1-2 times a day, 15-20 minutes, course of 8-10 procedures), two-chamber hydrogalvanic baths for upper extremities (36°C, 15-20 minutes daily, course 10-15 procedures).

Applications of ozokerite (paraffin) 20-30 min. A course of 15-20 procedures.

Ep UHF in an oligothermic dosage, daily or every other day, 5-8 minutes, course of 10-15 procedures.

Ultrasound (phonophoresis) - paravertebral, dose 0.2-0.4 W/cm2, 5-8 min. Course of 8-10 procedures.

Hydrokinesitherapy (swimming, special exercises in water for the upper and lower extremities). Course 15-20 days, 15-35 minutes daily.

General bromine electrophoresis according to Vermeule or collar according to Shcherbak.

Electrosleep (frequency 10-12 Hz, pulse duration 0.2 m/s), daily or every other day for 30-40 minutes. Course of 8-10 procedures.

Local darsonvalization for 5 minutes daily. Course of 8-10 procedures.

Massage of the head, collar area, parvertebral areas (to the lower corners of the shoulder blades) and arms (from the proximal parts), 10-15 min. A course of 15-20 procedures. 2-3 courses per year.

Oxygen cocktails, or after a massage - oxygen inhalation (5-8 min).

Exercise therapy (include exercises for stretching connective tissue formations for the upper extremities, breathing exercises and relaxation exercises), walking, cycling, rowing, skiing, as well as visiting a sauna (bath) 2 times a week, followed by segmental - reflex massage.

Pneumoconiosis

Pneumoconiosis is a chronic, slowly progressive fibrosis of the lungs. Some of its types are named according to the dust that caused them: silicosis - from silicon dioxide (quartz) dust, asbestosis - from asbestos dust, anthracosis - from coal dust, etc.

The treatment is complex. First of all, isolate a person from exposure to dust. The vast majority of patients are diagnosed with occupational disability. Often, in addition to silicosis, these patients also have vibration disease.

The effectiveness of rehabilitation depends on when it started, when contact with harmfulness was eliminated, at what stage the disease is, etc. It is also important how rationally the patient is employed.

Rehabilitation should be comprehensive and include restoration of impaired functions, as well as stopping the progression of the disease. Particular attention is paid to physical education (skiing, rowing, swimming, running combined with walking, etc.), exercise therapy, chest massage, as well as diet, vitaminization (vitamins C, P, PP, etc.), physiotherapy and sanatorium -resort treatment.

Comprehensive treatment includes the following:

Inhalations of enzymes (hyaluronidase, trypsin, chymotrypsin, etc.) or alkaline and salt-alkaline inhalations daily or every other day, course of 15-20 procedures. After inhalation - LH (breathing, coughing and general developmental exercises) in various starting positions, games, walking.

Electrophoresis of adrenaline on the area of ​​the cervical sympathetic nodes. A course of 10-15 procedures every other day.

Electrophoresis with novocaine and calcium on the chest. A course of 15-20 procedures every other day.

Ultrasound on the chest. A course of 15-20 procedures every other day.

Nasal electrophoresis of diphenhydramine. A course of 10-15 procedures every other day.

UV irradiation of the chest or general ultraviolet irradiation using an accelerated method (November-December, January-February) or quartz treatment of the feet (5-20 biodoses, No. 3-5) with taking ascorbic acid every other day or daily. A course of 15-20 procedures.

Oxygen therapy (inhalation of moistened oxygen or taking an oxygen cocktail) after a general massage and vibration massage of the chest No. 15.

Spa treatment is indicated: sun-air baths, sea bathing, games and running along the seashore, rowing, exercise therapy, diet, physiotherapy and oxygen cocktails, vibration chest massage.

Description of the presentation by individual slides:

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Topic: “The role and place of exercise therapy in the system of medical rehabilitation” Malysheva Elena Viktorovna

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Therapeutic physical education (physical therapy) is a method that uses physical education means for therapeutic and prophylactic purposes for faster and more complete restoration of health and prevention of complications of the disease. Exercise therapy involves patients consciously and actively performing appropriate physical exercises. In the process of training, the patient acquires skills in using natural factors for the purpose of hardening, physical exercises for therapeutic and preventive purposes. This allows us to consider therapeutic physical education classes as a therapeutic and pedagogical process.

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The active factor in exercise therapy is physical exercise. These are specially organized (gymnastic, applied sports, game) movements that are used as a nonspecific stimulus for the purpose of treatment and rehabilitation. Physical exercises have a varied effect depending on their selection, method of execution and physical activity, and contribute to the restoration of not only physical, but also mental strength. V.K. Dobrovolsky identified four main mechanisms of the therapeutic effect of physical exercise: tonic effect, trophic effect, formation of compensation, normalization of functions.

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Rehabilitation is a complex of medical, legal, socio-economic, pedagogical measures aimed at restoring or compensating for impaired body functions (physical or mental health) and the ability to work of sick and disabled people, as well as restoring broken social ties.

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Medical rehabilitation - combines therapeutic measures aimed at restoring human health - impaired or lost body functions that led to disability. T.O.medical rehabilitation includes measures to prevent disability during the period of illness and help the individual achieve the maximum physical, mental, social, professional and economic usefulness of which he will be capable within the framework of the existing disease.

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Successful rehabilitation requires: an early start of rehabilitation measures, staged successive treatment from the onset of the disease to its outcome, a comprehensive nature of treatment, including all types of rehabilitation treatment and labor rehabilitation, individualization of measures taking into account the personal characteristics of the patient.

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In Russia, the rehabilitation system for sick and disabled people includes medical and rehabilitation institutions (medical and sanatorium-resort), rehabilitation centers, public organizations of persons with disabilities, etc.

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The patient's body is in unfavorable conditions not only due to pathological changes, but also due to forced hypokinesia. Rest during illness is necessary: ​​it facilitates the functioning of both the affected organ and the entire body, reduces the need for oxygen and nutrients, promotes more economical functioning of internal organs, and restores inhibitory processes in the central nervous system (CNS). But if the restriction of motor activity continues for a long time, then the decrease in the functions of the most important systems becomes persistent, the excitation processes in the central nervous system weaken, the functional state of the cardiovascular and respiratory systems, as well as the trophism of the whole body, worsens, conditions are created for the occurrence of various complications, and recovery is delayed.

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It has been proven that information about muscle work through nerve and humoral channels enters the central nervous system and the center of the endocrine system (hypothalamus), is integrated there, and then these systems regulate the functions of internal organs and their trophism

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The use of physical education and massage for medicinal purposes has a long history. Chinese doctors used rubbing and stretching of joints for many diseases. It is believed that prophylactic (preventative) medicine originated in Ancient China. The Chinese paid a lot of attention to disease prevention. The aphorism “A real doctor is not the one who treats the sick, but the one who prevents the disease” belongs to the Chinese. In ancient India, yogis had more than 800 different breathing exercises, especially many for holding the breath, used for preventive purposes and for the treatment of many diseases. In Ancient Rome, therapeutic gymnastics reached a high level of development: bodily exercises, massage and hydrotherapy in thermal baths (baths) were especially widely used. Oribaz's collection, written in 360 AD, collected all the materials of that time, with an entire book devoted to therapeutic gymnastics. The Egyptians treated rheumatic diseases with gymnastic exercises, massage, diet, and water treatments.

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In Russia, physical exercises for therapeutic purposes began to be used already in the 18th century. Thus, in the works of outstanding Russian physicians N.I. Pirogova, S.P. Botkina, P.F. Lesgaft and many others contain statements about the importance and use of physical exercises and hardening for the treatment of diseases. In 1870, the first doctoral dissertation on physical therapy was defended at the Medical-Surgical Academy of St. Petersburg (G.G. Benese. Rational gymnastics as a means of maintaining health and healing some chronic ailments).

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In Russia, after the First World War, rehabilitation of the wounded and disabled began to develop widely. Dispensaries are organized for war invalids, as well as special schools for disabled children. In a number of hospitals and infirmaries, methods of functional treatment of fractures were used. The creation of a physical therapy department in such large research institutions as the State Institute of Physiotherapy and Orthopedics, the Institute of Emergency Medicine. N.V. Sklifosovsky

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The most common is a 3-stage rehabilitation system: hospital - inpatient rehabilitation center or sanatorium - clinic (sanatorium). Therapeutic physical culture is widely used at all stages of rehabilitation. At the hospital stage, therapeutic physical culture (if used early) prevents the development of complications leading to decreased ability to work. During the training, the patient learns the correct position in bed, passive movements, adapts to expanding the range of movements in a sitting position, then standing, and learns to walk. During long-term rehabilitation, therapeutic physical culture is aimed at eliminating impaired functions, developing compensation, and general strengthening of the body.

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In an inpatient rehabilitation center, therapeutic physical culture pursues the goal of further activating the patient, preparing him for everyday activities, restoring self-care skills, training in walking, and creating the basis for the use of occupational therapy. In the clinic, therapeutic physical culture is aimed at further restoration of functions, and, if necessary, at improving compensation and preparing the patient for socially useful work. Motor qualities are improved through training. Along with gymnastic exercises, applied sports exercises and games are widely used.