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Breathing exercises are divided into static and dynamic.
Static exercises include exercises that are not combined with movements of the limbs and torso, namely exercises:
a) in even rhythmic breathing, in slowing down breathing;
b) in changing the type (mechanism) of breathing (thoracic, diaphragmatic, full and their various combinations);
c) in changing the phases of the respiratory cycle (various changes in the ratios of the time of inhalation and exhalation, the inclusion of short pauses and breath holdings due to "blowing" and other methods, the combination of breathing with the pronunciation of sounds, etc.).
Static breathing exercises also include exercises with metered resistance:
a) diaphragmatic breathing with overcoming the resistance of the hands of the methodologist in the region of the edge of the costal arch closer to the middle of the chest (Fig. 5.2):
b) diaphragmatic breathing with a bag of sand (0.5-1 kg) placed on the upper quadrant of the abdomen;
c) upper thoracic bilateral breathing with overcoming resistance with the pressure of the hands of the methodologist in the subclavian region (Fig. 5.3);
d) lower thoracic breathing with the participation of the diaphragm with resistance under the pressure of the hands of the methodologist in the region of the lower ribs (Fig. 5.4);
d) upper- and mid-thoracic breathing with overcoming resistance when the methodologist presses with his hands in the upper part of the chest (Fig. 5.5);
e) the use of inflatable toys, balls, various devices.
Rice. 5.2. Diaphragmatic breathing with overcoming the resistance of the hands of the methodologist
Rice. 5.3. Upper chest breathing with overcoming the resistance of the hands of the methodologist
Rice. 5.4. Lower chest breathing with overcoming the resistance of the hands of the methodologist
Rice. 5.5. Upper and mid-thoracic breathing with overcoming the resistance of the hands
Dynamic exercises are called exercises in which breathing is combined with various movements:
a) exercises in which movements facilitate the implementation of individual phases or the entire respiratory cycle;
b) exercises that provide a selective increase in mobility and ventilation separate parts or in general one or both lungs;
c) exercises that help restore or increase the mobility of the ribs and diaphragm;
d) exercises that help stretch adhesions in the pleural cavity;
e) exercises that form the skills of a rational combination of breathing and movements.
Drainage breathing exercises are called exercises that promote the outflow of discharge from the bronchi into the trachea, from where sputum is evacuated during coughing. When performing special physical exercises, the affected area should be located above the bifurcation of the trachea, which creates optimal conditions for the outflow of discharge from the affected bronchi and cavities.
For a better outflow of discharge from the affected area, static and dynamic drainage exercises are used (Fig. 5.6).
Rice. 5.6. Drainage breathing exercises: A - static breathing exercises: scheme of drainage positions for all segments of the lung (I-IX; Arabic numerals indicate the bronchi, for which the best drainage conditions are created in the indicated position); B - dynamic breathing exercises: torso tilt to the left with a raised hand contributes to the drainage of the bronchi of the upper lobe of the right lung (I); tilting the body forward helps to remove sputum; the methodologist presses on the chest synchronously with the cough push (II); pulling the leg up chest helps to increase the mobility of the diaphragm, the removal of sputum from the lower lobe of the right lung (III); the inclination of the torso to the foot of the left leg contributes to the drainage of the bronchi of the right lower lobe (IV); imitation of crawling under the barrier stimulates the drainage of the bronchi of the lower lobes of both lungs (V)
Ideomotor exercises consist in the active sending of impulses to contraction individual groups muscles without changing the position of limb segments. Such exercises, causing muscle contractions, affect their strengthening and increase efficiency. Exercises are recommended for patients on bed rest, with immobilization, paralysis and paresis.
Rhythmoplastic exercises are more often used after the patient is discharged from the hospital at the stage of rehabilitation treatment (polyclinic - sanatorium aftercare) in order to completely correct the functions of the musculoskeletal system (for example, in diseases of the joints, after injuries or surgical interventions), as well as in neurological practice (with neurosis) . Exercises are performed with musical accompaniment in a given rhythm and tonality, depending on functional state patient, type of higher nervous activity, age and exercise tolerance.
Exercises with the use of gymnastic objects and equipment. Depending on the specific conditions, the exercises are performed: without objects; with items and projectiles ( gymnastic sticks, balls, dumbbells, clubs, etc.); on shells (mechanotherapeutic shells can also be included here).
In accordance with the general kinematic characteristics, exercises are divided into cyclic and acyclic (Scheme 5.4).
Scheme 5.4. Kinematic characteristics of exercises
Cyclic movements are characterized by a regular successive alternation and interconnectedness of the individual phases of the integral movement (cycle) and the cycles themselves. The interconnection of each cycle with the previous and subsequent is an essential feature of the exercises of this class.
The physiological basis of cyclic movements is the rhythmic motor reflex. The choice of the optimal tempo when learning clichical movements accelerates the process of assimilation of the rhythm of stimuli, as well as the establishment of the optimal rhythm of all physiological functions. It helps to increase the lability and resistance of the nerve centers to rhythmic stimuli, and accelerates workability.
Locomotive (displacement) cyclic exercises include running and walking, skating and skiing, swimming, cycling, etc. These exercises include repeated repetition of stereotypical cycles of movements.
Acyclic movements are complete, complete motor acts, not interconnected, having independent significance. Acyclic movements are characterized by a relatively short duration of execution and an extraordinary variety of forms. By the nature of the work, these are mainly exercises that maximally mobilize the strength and speed of muscle contraction. Acyclic movements, like cyclic ones, are characterized by rhythm, i.e. a regular sequence of individual phases, different in duration and effort, with an emphasis on the main parts of the movement.
Acyclic movements are divided into: a) single motor acts and their combinations; b) actually power; V) speed strength exercises. They make up the main arsenal of sports disciplines (for example, sport games, gymnastics, etc.).
All cyclic exercises can be divided into anaerobic and aerobic, with the predominance of the anaerobic or aerobic component of energy production, respectively. When performing anaerobic exercises, the leading quality is power, while performing aerobic exercises - endurance.
Physical exercises used to treat various diseases can be low, moderate, high, and (rarely) maximum intensity.
With low-intensity exercises in the form of, for example, slow rhythmic movements of the feet or squeezing and unclenching the fingers of the hand, as well as isometric tensions of small muscle groups (for example, the flexor muscles of the forearm during plaster immobilization), the overall physiological changes are insignificant. Changes in activity of cardio-vascular system are favorable and consist of a combination of a slight increase in the stroke volume of the heart and general blood flow velocity, a slight increase in systolic and a decrease in diastolic and venous pressure. There is a slight decrease and deepening of breathing.
Exercises of moderate intensity are accompanied by muscular tensions of medium strength with average speed contraction, stretching, isometric tension and relaxation of a relatively large number of muscle groups or muscles. Examples can be movements performed at a slow and medium pace with the limbs and torso, movements similar to those used in self-service, walking at a slow and medium pace, etc. The activation of cortical processes in them is moderate. Pulse and systolic blood pressure in most cases slightly increase, diastolic - decreases. Respiratory movements moderately become more frequent and deep, pulmonary ventilation increases. The recovery period is short.
High-intensity exercises involve large muscle groups with moderate or high strength and sometimes with a significant speed of their contractions, pronounced static tensions of synergistic muscles, intense changes in vegetative-trophic processes under the influence of postural-tonic reactions (for example, fast "streaming" of balls, fast walk, exercises on gymnastic apparatus, accompanied by the transfer of body weight to the upper limbs, skiing, etc.). These exercises significantly increase the excitability and mobility of cortical processes. The pulse rate increases markedly, systolic blood pressure increases and diastolic blood pressure decreases. Unsharply quickens and deepens breathing; pulmonary ventilation often ensures the delivery of more oxygen than is absorbed by the body. The recovery period is quite long.
Exercises of submaximal and maximum intensity include the movement of a large number of muscles with maximum intensity and high speed their contractions, pronounced postural-tonic reactions (for example, speed running). Patients can maintain a high power of work performed for no more than 10-12 seconds, so the activity of the vegetative organs and metabolism do not have time to increase to the maximum limits. Oxygen debt is growing rapidly. The activity of the cardiovascular and respiratory systems is maximally enhanced at the end of classes; a large heart rate is combined with a slightly changing stroke volume of the heart and a marginal increase in respiratory function.
Epifanov V.A.
To change the type of breathing
1. Diaphragmatic breathing.
I. p .: lying on your back, legs bent at the knees. The right hand is bent at the elbow, lies with the palm on the stomach, the left - on the chest. Inhale: the abdominal wall is extended, the right arm is raised, the left is motionless. Exhale: the stomach is drawn in, while the right hand slightly squeezes the abdominal wall, the left hand is motionless. Inhale - through the nose, exhale - through the mouth, at first the exhalation is calm, and as this type of breathing is mastered, the exhalation intensifies and ends with the maximum tension of the muscles of the anterior abdominal wall.
2. Thoracic breathing.
I. p .: the same. Inhale: the right hand is motionless, the left one rises up by raising the chest. Exhale: the right hand is motionless, the left goes down. Inhale through the nose, exhale through the mouth.
3. Full breath.
I. p .: the same. Inhale: simultaneously raise the right and left arms. Exhale: simultaneously lower the right and left arms. Inhale through the nose, exhale through the mouth. I. p. then change: first sitting, comfortably leaning back in a chair, and then standing; mainly focus on the diaphragmatic type of breathing.
Appendix 3
Special dynamic
Breathing exercises
1. I. p .: standing, feet shoulder-width apart, arms to the sides at shoulder level, maximally laid back, palms turned forward, fingers wide apart. On account 1 - instantly cross your arms in front of your chest, elbows under your chin so that your hands hit your shoulder blades (at the same time a loud powerful exhalation is made). At the expense of 2 - smoothly accept and. n. (calm breath).
2.
I. p .: standing, feet shoulder-width apart, bending on toes, arms up, to the sides. On account 1 - sinking onto the foot, lean forward, bending over, cross the arms across the sides in front of the chest, whip the brushes on the shoulder blades (powerful, loud exhalation of the maximum possible depth). At the expense of 2-3 - in an inclination, the arms are smoothly spread apart and crossed in front of the chest, whipping the brushes on the shoulder blades 2-3 times (with the maximum tension of the muscles of the anterior
abdominal wall to complete the exhalation). At the expense of 4 - and. n. (calm
breath).
3.
I. p .: standing, feet shoulder-width apart, on toes, bending over, hands
up back, brushes in the "lock". At the expense of 1 - falling on the foot,
deep bend forward pike, whip forward down backward like
cutting with an ax (loud, powerful exhalation). On account 2 - smoothly
accept and. n. (calm breath).
4.
I. p .: standing, feet at the width of the "ski", a slight tilt forward and
squat, right hand forward, hand “squeezes the ski pole”,
the left one is far behind, the hand is open, "a ski pole on a strap."
On account 1 - smoothly, moderately squatting, right hand down back to
thigh, left forward down to the thigh (powerful exhalation, completed
at the moment of bringing the arm to the hips); straightening up left hand forward,
“the hand squeezes the ski pole”, the right hand is far back, the hand opens (calm breath). On account 2 - and. P.
5.
I. p .: standing, feet on the width of the foot, on toes, slight inclination
forward, hand in front shoulder-width apart, brushes compress "ski
sticks." On account 2 - sinking onto the foot, half-squat, tilt
forward until the abdominal wall touches the thighs, arms down back, hands
open (powerful loud exhalation). On the count 2-3 - stay
in an inclination, active completion of exhalation by muscle contraction before
her abdominal wall. At the expense of 3-4 - and. n. (calm breath).
6.
I. p .: standing, feet shoulder-width apart, slight forward bend, right hand
forward up, squeeze the brush for a “stroke”, left symmetrically behind,
the wrist is relaxed. At the expense of 1-2 - four quick circles with hands,
as when swimming crawl on the chest (powerful exhalation with a contraction
muscles of the anterior abdominal wall). At the expense of 3-4 - two slow
circle (calm breath).
7.
I. p .: standing, feet shoulder-width apart, right arm up, hand turned
to the right and compressed for the "stroke", the left is below, relaxed and turned
back. At the expense of 1-3 - three circles with your hands, as when swimming crawl on your back, light turns of the body following the "rowing" hand (powerful, loud exhalation with contraction of the muscles of the anterior abdominal wall). At the expense of 4 - one circle with your hands (calm breath).
8.
I. p .: standing, feet shoulder-width apart, high on toes, slight inclination
forward, arms forward up, hands clenched for a “stroke”. For each
account - "stroke" (i. p. - hands down back, to the hips, falling on
foot, slight bending of the legs in the joints and an increase in inclination -
powerful exhalation; hands through the sides up forward, the hands are relaxed
Lena) as when swimming butterfly (inhale).
9.
I. p .: standing, feet shoulder-width apart, on toes, arms up, hands
turned forward and compressed for a "stroke". Down on the foot, hands
to the sides down to the hips (powerful loud exhalation), rising
on toes, arms forward up, hands relaxed, and. n. (powerful
breath).
10. I. p .: emphasis lying. At the expense of 1 - emphasis crouching (powerful exhalation). On account 2 - and. n. (calm breath). Tempo: both movements in 1-2 seconds.
11.
I. p .: left leg in a semi-squat, toe to the left, right forward, on
heel, toe to the right, head raised, arms bent at the elbows, hands
on the belt. On account 1 - jump up and squat, heels together,
socks apart (powerful exhalation). At the expense of 2 - a jump, changing the position of the legs, and. n. (calm breath).
Tempo: both movements in 1-2 seconds.
12.
I. p .: standing with the right side at the support, the right leg is laid back,
bent at the knee, foot in the air, right hand holding on to the support
at shoulder height.
For each account - an extremely high swing of the right
leg forward up until the thigh touches the chest and shoulder (powerful
exhalation) and the maximum swing back (calm breath). Tempo: one
count per second. The same with the left foot.
13.
I. p .: standing, lunge with the right foot, left straight behind, with the toe outside, on the inner arch, the right arm is bent at the elbow under the straight
angle, at the level of the hypochondrium, tightly pressed to the body, the left hand
hands on the elbow of the right hand. At the expense of 1 - a sharp tilt forward,
pressing the left forearm to the upper third of the right thigh (at the same time - a powerful exhalation). At the expense of 2-7 pressure from top to bottom
continuation of exhalation by contraction of the muscles of the abdominal wall. To account
8 - and. n. (inhale with relaxation of the muscles of the anterior abdominal wall
and their sipping), in this position it is good to cough.
When doing breathing exercises, the mouth is wide open, children are usually told: "Show me how you bite an apple." Exhalation - loud, sharp, clearly audible.
All breathing exercises end with a contraction of the muscles of the anterior abdominal wall, while the children are explained: “Make sure that the stomach grows to the back”, especially in those exercises where the exhalation is longer (2, 5, 7, 13).
Inhalation is done through the nose or mouth, depending on the pace of the exercises performed, while the anterior abdominal wall protrudes (“Inflate the watermelon”).
Exhalation should be carried out without a deep breath, since a preliminary deep breath can cause reflex irritation of the receptors of the mucous membrane of the trachea and bronchi and after exhalation, a strong cough.
14. The skill of a full elongated exhalation. Walking at an average pace. Inhale and exhale only through the nose. The pace is average. Exhale - three steps - inhale; four steps - exhale. After 3-4 days, increase the duration of the exhalation by one count (5, 6, etc.), so that after 4-6 weeks the exhalation takes 9-12 steps.
LAB #13
Emphysema
This is a chronic disease, which leads to chronic obstructive bronchitis. The elastic connective tissue of the lungs is replaced by fibrous tissue, pneumosclerosis develops, the lungs expand, the residual volume of the lungs increases, shallow breathing, rigidity and inactivity of the chest develop.
Tasks of exercise therapy and massage
Strengthen local ventilation of the lungs, reduce hypoxemia and shortness of breath, increase metabolism in all tissues, especially in the heart muscle and nervous system, improve the function of the respiratory muscles.
Peculiarities exercise therapy techniques
They use expiratory gymnastics, that is, exercises that promote full exhalation, strengthen the muscles of the trunk and abdominals, which are involved in breathing and maintain the mobility of the chest and spine - static and dynamic breathing exercises in combination with restorative ones.
IP in bed and semi-bed rest - lying and sitting with support on the back of a chair, and in general mode - standing, so as not to impede the function of the diaphragm. Exhale through
Continue
Exercise therapy for respiratory diseases
In recent years, there has been a steady increase in the number of patients with respiratory diseases due to the development of industry and urbanization.
With various diseases of the respiratory apparatus, its function is impaired, as a result of which respiratory failure of varying degrees develops:
1st degree hidden, manifested by shortness of breath with a small physical activity, which is not called in a healthy person.
In 2nd degree it comes with little pressure.
3 degree characterized by dyspnoea at rest.
Function change external respiration may occur due to: restriction of mobility of the chest and lungs; reduction of the respiratory surface of the lungs; airway obstruction; deterioration in the elasticity of the lung tissue; decreased diffusion capacity of the lungs; violations of the regulation of respiration and blood circulation in the lungs.
Respiratory diseases can be divided into two groups:
1st group- inflammation - acute and chronic bronchitis, pneumonia, pleurisy.
2nd group– inflammation + allergy – bronchial asthma.
These diseases result in:
Violation of the regulation of breathing from the nervous system;
Violation of the ratio of inhalation - exhalation;
Inflammation (of the bronchi, lungs, pleura) with impaired blood supply;
Spasm of the smooth muscles of the bronchi;
Reduction of the respiratory surface of the bronchus;
Violation of the drainage function of the bronchi;
Restricted chest movement.
Clinical manifestations or symptoms depend on the form of the disease, but there are common signs:
- shortness of breath (there are three types: inspiratory - when inhalation is difficult, expiratory - exhalation is difficult, and mixed).
- Cough (in some cases, it serves as a protective mechanism - for example, if it is necessary to “push out” a foreign body or excess bronchial secretion from the respiratory tract - sputum, in others it only aggravates bronchospasm - for example, with bronchial asthma).
- Department of sputum.
- Breathlessness (bronchospasm).
- Pain in the chest area.
Mechanisms of therapeutic action of physical exercises.
Physical exercises, stimulating the respiratory center in a reflex and humoral way, help to improve ventilation and gas exchange in the lungs, eliminating or reducing respiratory failure.
Under the influence of exercise therapy, the general tone of the body, its resistance to adverse environmental factors increase, and the neuropsychic state of the patient improves.
Physical exercises, strengthening the respiratory muscles, increase the mobility of the chest and diaphragm.
Systematic and targeted exercises, increasing blood and lymph circulation in the lungs and chest, contribute to faster resorption of the inflammatory infiltrate and exudate.
Fundamentals of exercise therapy for respiratory diseases.
A feature of the exercise therapy technique for respiratory diseases is the widespread use of special breathing exercises.
First of all, patients learn to voluntarily change the frequency of the depth and type of breathing (thoracic - upper thoracic and lower thoracic breathing, diaphragmatic or abdominal and mixed), elongated exhalation, which can further increase due to the pronunciation of sounds and their combinations.
It is very important to choose the correct initial position of the patient during dynamic and static breathing exercises, which allows you to increase ventilation in the left or right lung, lower, middle or upper parts of it.
Drainage starting positions should be used to help remove sputum and pus from the bronchi.
For example, if the focus of inflammation is in the anterior segment upper lobe of the right lung, the patient sitting should deviate back, when draining the posterior segment - forward, when draining the apical segment - to the left.
In the exhalation phase, the instructor puts pressure on upper part chest on the right. Vibration massage or light effleurage during exhalation helps to expel sputum.
When draining middle lobe of the right lung the patient should lie on his back, pulling his legs to his chest and throwing his head back, or on his stomach and healthy side.
Drainage lower lobe of the right lung carried out in the position of the patient lying on the left side, with the left hand pressed to the chest.
In this case, the foot end of the bed should be raised by 40 cm. In order to avoid leakage of the discharge into a healthy lung, it is recommended to complete this procedure by draining a healthy lung.
When performing dynamic drainage exercises, the choice of starting positions plays a certain role.
So, for example, when a purulent process is localized in the upper lobe of the lung, the most complete emptying of the cavity will be achieved when performing exercises in the initial positions of sitting and standing. The starting position on a healthy side, lying on your back, is recommended when the process is localized in the middle lobe of the right lung. When the purulent process is located in the lower lobe of the lung, the most effective drainage of the cavity is carried out in the initial position of the patient lying on his stomach and healthy side.
Frequent change of starting positions, active movements associated with body rotations are favorable factors that improve the emptying of purulent meanness.
In complexes therapeutic gymnastics and in self-study exercises to strengthen the respiratory muscles should be provided.
Contraindications to the appointment of exercise therapy:
1. severe condition with an acute illness;
2. high temperature;
3. severe respiratory (3rd degree) and heart failure;
4. pronounced exacerbation of a chronic disease;
5. frequent attacks of suffocation.
Acute and chronic pneumonia.
Pneumonia(pneumonia) is a serious infectious disease caused by microbes, viruses and their combinations.
The disease can be acute and chronic.
Acute pneumonia is focal and croupous.
Symptoms:
Heat;
Pain in side when breathing;
Cough (dry, then wet);
Intoxication;
Violation of the activity of the cardiovascular and other body systems.
Focal pneumonia - This is an inflammation of small areas of lung tissue with involvement in the process of the alveoli and bronchi.
Croupous pneumonia - an acute infectious disease in which the inflammatory process captures an entire lobe of the lung.
The course of croupous pneumonia, compared with focal pneumonia, is more severe, since the whole lobe or the entire lung is involved in the process.
Treatment complex: medication (antibacterial, antipyretic, anti-inflammatory and expectorant drugs), exercise therapy and massage.
Exercise therapy is prescribed after a decrease in temperature and improvement general condition.
Tasks of exercise therapy:
1. Increasing the general tone of the patient's body;
2. Strengthening blood and lymph circulation in the lungs in order to accelerate the resorption of exudate and prevent complications;
3. Activation of tissue metabolism in order to improve trophic processes in tissues;
4. Increased pulmonary ventilation, normalization of the depth of breathing, increased diaphragm mobility, sputum removal.
5. Prevention of the formation of adhesions in the pleural cavity.
6. Adaptation of the respiratory apparatus to physical activity.
The method of exercise therapy depends on the motor mode on which the patient is located.
Bed rest.(3-5 days)
Exercises are performed in the starting positions lying on your back and sore side.
Simple gymnastic exercises low intensity and breathing exercises.
Begin the lesson by doing simple exercises for small and medium muscle groups of the upper and lower extremities; exercises for the muscles of the body are performed with a small amplitude.
Static and dynamic breathing exercises are used.
At first, deep breathing is not allowed, as it can cause pain in the chest. To normalize the rapid breathing that occurs in a patient with pneumonia, exercises are used to slow down breathing.
The exhalation should be long, which helps to improve ventilation of the lungs.
The duration of the lesson is 10-15 minutes; the number of repetitions of each exercise is 4-6 times. The pace of execution is slow. The ratio of gymnastic and breathing exercises is 1:1 or 1:2.
Half bed or ward regime.(5 - 7-9 days).
Starting positions are any depending on the patient's condition - lying on his back, on his side, sitting on a chair and standing.
Physical exercises are performed with a large amplitude.
The load is increased by increasing the number of general strengthening exercises, the participation of larger muscle groups, the use of various objects in the classroom, as well as the use of dosed walking.
Special exercises are breathing exercises of a static and dynamic nature, turns and tilts of the body in combination with breathing exercises (to prevent the formation of adhesions).
The duration of the lesson increases to 20-25 minutes, the number of repetitions of each exercise is 6-8 times, the pace is average.
Free or shared mode.
(10-12 day stay in the hospital).
The tasks of exercise therapy are reduced to the elimination of residual inflammation in the lungs, the complete restoration of respiratory function and its adaptation to various loads.
Assign gymnastic exercises for all muscle groups, use shells and objects, increase the distance and walking time.
The duration of classes increases to 25-30 minutes.
chronic pneumonia- the result of incomplete cure of acute pneumonia.
The disease is characterized by the growth of connective tissue (pneumosclerosis), the formation of adhesions, a decrease in lung elasticity, leading to impaired ventilation and pulmonary insufficiency.
Distinguish: period of exacerbation
remission period.
The period of exacerbation proceeds as acute pneumonia.
IN remission period there is chronic intoxication, respiratory failure, pneumosclerosis, or bronchiectasis (bronchial deformation) may develop.
Exercise therapy is prescribed during the subsidence of inflammation and improvement of the general condition of the patient.
The exercise therapy technique is not much different from the technique for acute pneumonia.
Particular attention should be paid to special breathing exercises that contribute to the development of full breathing.
In the remission stage, in addition to LH and UGG, games, swimming, rowing, cycling, skiing, walking, excursions, tourism, tempering procedures are used.
Pleurisy.
Pleurisy is an inflammation of the pleura that covers the lungs, the inside of the chest, and the diaphragm.
Pleurisy is always secondary, i.e.
manifests itself as a complication of pneumonia, tuberculosis and other diseases.
Pleurisy happens dry And exudative.
Dry pleurisy - This is an inflammation of the pleura with the formation of a minimum amount of fluid on it. A plaque of fibrin protein forms on the surface of the pleura.
The surface of the pleura becomes rough; as a result, with respiratory movements, breathing is difficult, there are pains in the side, which increase with deepening of breathing and coughing.
Exudative pleurisy- this is inflammation of the pleura with sweating into the pleural cavity of liquid exudate, which displaces and compresses the lung.
Therapeutic exercise in diseases of the respiratory system. Special exercises
Thus, limiting its respiratory surface and making it difficult to breathe. After resorption of the effusion, adhesions may form, limiting chest excursion and pulmonary ventilation.
Tasks of exercise therapy:
1. general strengthening effect on the patient's body;
2. stimulation of blood and lymph circulation in order to reduce inflammation in the pleural cavity;
3. prevention of the development of adhesions;
4. restoration of the correct breathing mechanism and normal lung mobility;
5. increasing tolerance to physical activity.
Bed rest.
Exercises are performed lying on your back or on a sore side.
Apply simple exercises for small and medium muscle groups, performed at a slow pace. In this mode, breathing does not deepen and special breathing exercises are not used. The duration of the lessons is 8-10 minutes. After 2-5 days, the patient is transferred to
Chamber mode. Initial positions are used lying on a healthy side (static control is performed), sitting and standing.
To prevent the formation of adhesions, tilts and turns of the torso are used in combination with breathing exercises. The duration of the lessons is 20-25 minutes.
On free mode special exercises are used to increase the mobility of the chest.
Depending on where the adhesions were formed, the specificity of ex.
In the lateral sections - tilts and turns of the body in combination with an accentuated exhalation. In the lower parts of the chest - tilts and turns of the torso are already combined with a deep breath. In the upper parts - it is necessary to fix the pelvis and lower limbs, which is achieved in the i.p. sitting on a chair. Weights are used to increase the effect.
The duration of the lesson is 30-40 minutes.
Bronchial asthma
Bronchial asthma - This is an infectious-allergic disease characterized by attacks of expiratory dyspnea (suffocation) resulting from spasm of small and medium bronchi. The mechanism of breathing is sharply disturbed, especially exhalation.
Factors contributing to the development of bronchial asthma.
1st group external factors:
1. various allergies - non-infectious allergens (pollen, dust, industrial, food, medicinal, tobacco smoke);
2. infectious factor (viruses, bacteria, fungi);
3. mechanical and chemical irritants (pairs of acids, alkalis, etc.)
4. physical and meteorological factors (changes in air temperature and humidity, fluctuations in atmospheric pressure);
5. stressful and neuropsychic effects.
2nd group - internal factors:
1. biological defects of the immune, endocrine and autonomic nervous system;
2. defects in the sensitivity and reactivity of the bronchi;
3. metabolic defects and rapid response systems.
clinical picture.
During the course of the disease, a period of exacerbation and an interictal period are distinguished.
During an attack, the patient has loud breathing, accompanied by whistling and wheezing.
The patient cannot exhale air. He rests his hands on the table to fix the belt of the upper limbs, due to which the auxiliary respiratory muscles take part in breathing.
In the interictal period, in the absence of complications of bronchial asthma, there are no symptoms, but complications appear over time: pulmonary- emphysema, respiratory failure, pneumosclerosis; extrapulmonary - heart failure, damage to the heart muscle.
Tasks of exercise therapy:
1. balancing the processes of inhibition and excitation in the central nervous system.
2. reduction of spasm of bronchi and bronchioles;
3. increase in the strength of the respiratory muscles and mobility of the chest;
4. prevent the development of emphysema;
5. activation of trophic processes in tissues;
6. mastering the skill of controlling the phases of breathing during an attack in order to alleviate it;
7. learning to exhale.
The course of exercise therapy in stationary conditions includes 2 periods: preparatory and training.
Preparation period usually short (2 - 3 days) and serves to familiarize with the patient's condition, aimed at teaching the method of breathing control.
Training period lasts 2 - 3 weeks.
Classes are held in the initial positions sitting, standing with support on a chair, standing.
The forms of classes are as follows: LH, UGG, dosed walks.
Special exercises are used in LH classes:
1. breathing exercises with an extended exhalation;
2. breathing exercises with the pronunciation of vowels and consonants, contributing to a reflex decrease in spasm of the bronchi and bronchioles;
3. exercises to relax the muscles of the belt of the upper limbs;
4. diaphragmatic breathing.
Sound gymnastics are special exercises in pronouncing sounds.
The greatest force of the air jet develops with sounds p, t, k, f, medium - with sounds b, d, e, c, h; the smallest - with sounds - m, k, l, r.
At the sanatorium or polyclinic stages with rare attacks, dosed walking and sports games are used.
Bronchitis.
Bronchitis - is an inflammation of the lining of the bronchi.
There are acute and chronic bronchitis.
At acute bronchitis acute inflammation of the tracheobronchial tree occurs.
Causes: infections (bacteria, viruses), exposure to mechanical and chemical factors.
Factors contributing to the development of the disease are cooling, smoking, alcohol consumption, chronic focal infection in the upper respiratory tract, etc.
Acute bronchitis is manifested by coughing, as well as a feeling of constriction behind the sternum; temperature is low. Subsequently, the cough intensifies, sputum appears; sometimes shortness of breath is noted, chest pains occur, the voice becomes hoarse.
Chronical bronchitis - This is a chronic inflammation of the bronchi, which is mainly a consequence of acute bronchitis and is characterized by a long course.
With bronchitis, there is hyperemia and swelling of the bronchial mucosa, often with the accumulation of sputum in them, which makes breathing difficult and intensifies coughing.
The use of exercise therapy is most effective in the initial stage of bronchitis, when it is not complicated by other diseases.
Tasks of exercise therapy:
strengthening and hardening of the patient's body, as well as the prevention of possible complications;
2. improvement of lung ventilation;
3. strengthening the respiratory muscles;
4. Facilitate expectoration and sputum discharge.
With chronic bronchitis exercise therapy used in the form of LG. Exercises for the upper limbs, shoulder girdle and torso are widely used, alternating with DU (with an emphasis on exhalation), as well as corrective exercises (for right position chest) and elements of self-massage of the chest.
If it is difficult to remove sputum, elements of drainage gymnastics are used. In order to enhance ventilation of the lungs and improve air permeability through the bronchial tree, "sound gymnastics" is used.
In acute bronchitis, the exercise therapy technique is similar to that for pneumonia during periods of ward and free regimens.
I.p. - lying on the back - the volume of the chest corresponds to the inspiratory phase, the diaphragm is raised, the function abdominal muscles limited, breathing difficult.
I.p. - lying on the stomach - the movements of the ribs of the lower half of the chest predominate.
I.p. - lying on the side - chest movements on the supporting side are blocked, the opposite side moves freely.
- standing - an advantageous position for breathing exercises, because. chest and spine can move freely in all directions. In this position, VC reaches its highest values.
- sitting (free position, the spine forms an arc), lower-lateral and lower-back breathing prevails, abdominal breathing is difficult.
I.p. - sitting with a bent back, upper chest breathing prevails, abdominal breathing is somewhat facilitated.
To enhance upper chest breathing in any sp.
put your hands on your waist.
To increase the mobility of the lower chest aperture - raise your hands on your head or above head level.
There are drainage positions of the body and drainage exercises.
drainage positions of the body - postural drainage. The location of the affected area of the lungs above the bifurcation of the trachea is provided. As a result, favorable conditions are created for the outflow of sputum from the cavities and affected bronchi. Reaching the bifurcation of the trachea, where the sensitivity of the cough reflex is most pronounced, sputum causes a reflex involuntary cough, accompanied by its separation.
A necessary condition for sputum separation is an elongated forced exhalation.
drainage exercises - exercises that improve the outflow of sputum.
Contraindications to the appointment of drainage positions and exercises: pulmonary bleeding (but not hemoptysis), severe cardiopulmonary insufficiency, acute myocardial or pulmonary infarction.
As you know, the right lung has three lobes: upper, middle, lower.
The left lung has two lobes: upper and lower.
Upper lobes
Drainage positions:
Lying on a sore side with a raised head end of the bed by 30-40 cm;
Lying on your back with the foot end of the bed raised.
Drainage exercises:
Lying on a healthy side, while the head end of the bed is lowered by 25-30 cm. The arm on the side of the lesion is raised up - inhale. As you exhale, slowly turn onto your stomach to prevent sputum from flowing into a healthy lung.
Sitting on a chair - inhale, tilt the torso to the healthy side while simultaneously turning it 45 ° forward, while the arm on the side of the lesion is raised up - exhale.
Average share
Drainage positions:
Lying on your back with your legs pulled up to your chest and your head thrown back;
Lying on the left side with the head and arm lowered down.
Drainage exercises:
Sitting on the couch (the leg end is raised by 20-30 cm), it is necessary to slowly straighten the torso back at a slow pace.
At the same time, the instructor easily presses on the anterior surface of the chest, contributing to the promotion of sputum. On exhalation, coughing, the patient makes torso turns to the left and forward, trying to touch the feet. During the tilt, the patient secretes sputum. Together with coughing shocks, the instructor presses on the area of the middle lobe (anterolateral surface of the chest). The rest phase is from 30 seconds to 1 minute, the exercise is repeated 3-4 times;
Lying on your back with the head end of the bed lowered by 40 cm.
after spreading the arms to the sides, the patient takes a breath and, on exhalation, pulls up to the right half of the chest right leg bent at the knee joint.
lower lobes
Drainage positions:
Sputum is secreted under the condition of deep diaphragmatic breathing in I.P. lying on the back (stomach) on an inclined plane (at an angle of 30-40 °) upside down.
Drainage exercises:
Lying on your back.
Spread your arms to the sides - inhale, while exhaling, coughing, pull one leg to your chest;
Sitting on a chair - slowly tilt the torso forward.
On exhalation, the patient, coughing, takes out his toe with his hands;
Standing, feet shoulder width apart. Tilt forward, touch the toe - exhale.
With bilateral damage, I.P. are used. standing on all fours. As you exhale, bending your arms, lower your upper body to the couch; raise the pelvis as high as possible.
Chapter 4 Therapeutic exercise in diseases of the respiratory system
At the end of the exhalation, coughing, return to I.P. - breath.
From the main position on exhalation, alternately raise the right arm to the side and up while lowering the healthy side of the body. On exhalation, tilt the upper chest as low as possible, raise the pelvis as high as possible.
At the end of the exhalation - coughing.
I.p. - sitting on the couch or lying on the couch: spread your arms to the sides - inhale, as you exhale, alternately pull the legs bent at the knee joints to the chest.
Exercise therapy is contraindicated in the late periods of bronchiectasis, when pulmonary bleeding, the spread of pus and the deterioration of the patient's condition are possible.
Publication date: 2014-11-03; Read: 5946 | Page copyright infringement
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Federal Agency for Education
Ministry of Education and Science of the Russian Federation
State educational institution of higher
professional education
Bryansk State University. Academician I.G. Petrovsky"
ABSTRACT
Therapeutic physical culture in diseases of the respiratory system
Completed: student of physics and mathematics
faculty, 1st year, 1st group Kutsebo A.S.
Checked by: Sulimova A.V.
Bryansk 2010
Introduction
Man is a social being, representing the highest stage of development of living organisms on Earth, possessing a complexly organized brain, consciousness and articulate speech.
The essence of a person cannot be reduced to the features of his anatomical structure, for example, the vertical position of the body, the specific structure of the limbs and the complex organization of the brain.
Man, with all his specific features, is a product of social historical development. At the same time, it has not only its own social history, but also its natural prehistory. The evolution of the anatomical and physiological structure of animals gradually prepared the possibility of a transition to the anatomical and physiological structure of man. And the emergence of consciousness was prepared by the entire previous course of the natural history of the mental development of animals.
The beginning of the manufacture of artificial tools marked the beginning of the emergence of man. And as a result of steadily developing labor activity, man not only modified nature, but also modified himself. Until, finally, over hundreds of years, it reached the modern type of structure and turned into a new biological species called Homo Sapiens (reasonable man).
The human body, like all animals, has a cellular structure.
The cells that form it have a different structure according to the functions they perform and form different tissues (muscular, nervous, bone, internal environment, and others). Organs and organ systems are made up of tissues.
The connection of all organs and tissues with each other and the connection of the whole organism with the external environment is carried out by the nervous system.
The highest anatomical and functional development of the brain and its cortex distinguishes man from all animals. An expression of the special development of nervous (intellectual) activity in a person is the presence, in addition to the first signal system, of conditionally reflex connections formed under the direct influence of stimuli emanating from the external and internal environment - another signal system, which consists in the perception of speech, signals that replace the direct perception of the stimulus.
The second signaling system underlies the process of thinking, which is peculiar only to man.
And like all living things, the human body is subject to destruction, both from external environmental factors and as a result of an unreasonable attitude towards one's health.
Therapeutic exercise for diseases of the respiratory system
On this moment a very topical topic is therapeutic physical culture (exercise therapy) - as a method of treatment, consisting in the application of physical exercises and natural factors of nature to a sick person for therapeutic and prophylactic purposes. This method is based on the use of the main biological function of the body - movement. In my abstract, I would like to dwell in more detail on the use of exercise therapy for respiratory diseases.
1. Medical history physical education(LFK)
The history of physical therapy is the history of the use of physical movements and natural factors for the treatment and prevention of diseases - this is the history of civilization, the history of medicine and health care, the history of physical culture and sports.
Even a superficial look at history allows us to conclude that there is a significant difference in the motor activity of various peoples in various historical periods of time.
It is one thing for a Chinese Buddhist monk who did not have to work, another for a Russian peasant who earns his daily bread by hard physical labor in cold climatic conditions. In the first case, the lack of movement was replenished by gymnastics, which the Chinese brought to perfection, and in the other - muscle fatigue eliminated by the Russian bath. AND Chinese gymnastics, and the Russian bath, in modern terms, were means of physical therapy. In case of injury or illness, a person instinctively restricts certain movements and motor activity generally.
The primary task of the most ancient healers was to determine which movements are currently harmful for the patient, and which, on the contrary, are useful.
That is, the motor mode is necessary at this stage of treatment. Other important task medicine to determine the natural factors that are useful for the patient.
These issues were dealt with by the most accessible and closest medicine to the common man - ethnoscience. The issues of rehabilitation and physiotherapy exercises were for a long time in the hands of traditional medicine.
1.1 exercise therapy in Ancient Greece and in ancient Rome
Ancient Greek philosopher Plato (circa 428-347 BC)
BC e.) called the movement "the healing part of medicine", and the writer and historian Plutarch (127 g) - "the pantry of life." In ancient Greece, the first information about medical gymnastics dates back to the 5th century BC and is associated with a doctor named Herodicus. We can learn about this wonderful doctor from the historical and philosophical treatises of Plato.
He writes “Herodicus was a gymnastics teacher: when he fell ill, he used gymnastic techniques for treatment; in the beginning, he mainly tormented himself, and then later on the rest of humanity.
Herodice is considered the founder of therapeutic gymnastics, for the first time patients began to seek help not in churches, but in gymnasiums - in institutions where gymnastics was taught.
Herodic himself, according to Plato, suffered from some incurable disease (probably tuberculosis), however, while doing gymnastics, he lived to almost a hundred years, teaching his patients therapeutic exercises. Later, Hippocrates, a student of Herodicus, who is rightly called the father of medicine.
(460-377 BC) introduced certain hygienic knowledge and understanding of the “therapeutic dose” of physical exercises for a sick person into Greek gymnastics. Hippocrates considered exercise one of the most important means of medicine. And caring about the preservation of people's health, he recommended doing what is today called physical education - "Gymnastics, physical exercises, walking should firmly enter the daily life of everyone who wants to maintain working capacity, health, a full and joyful life" - he said.
Claudius Galen (129-201 AD) - a follower and admirer of Hippocrates, an anatomist, physiologist and philosopher, the first sports doctor known to us, who at the beginning of his medical career treated gladiators in ancient rome. He created the foundations of medical gymnastics - gymnastics for the restoration of health and the harmonious development of a person.
For example, he promoted recreational gymnastics, condemning the thoughtless passion for sports.
At the same time, he expressed himself sharply and figuratively. Galen wrote, condemning the ancient Roman athletes: “Neglecting the ancient rule of health, which prescribes moderation in everything, they spend their lives in excessive training, eating a lot and sleeping a lot, like pigs. They have neither health nor beauty. Even those of them who are naturally well-built will eventually gain weight and swell. They can fell and hurt, but they can't fight." In his writings, Galen summarized the unique experience of treating combat injuries, as well as the experience of subsequent peaceful medical practice.
He wrote: "Thousands and thousands of times I restored the health of my patients through exercise."
1.2 Exercise therapy in Europe
In the Middle Ages in Europe, physical exercises were practically not used, although in the Renaissance (in the XIV-XV centuries) with the advent of works on anatomy, physiology and medicine, interest in physical movements for the treatment of diseases naturally rose.
The Italian physician and scientist Mercurialis, based on an analysis of the available literature of that time, wrote the famous essay “The Art of Gymnastics”, in which he described the massage, bath and bodily exercises of the ancient Greeks and Romans.
If not for this work, then perhaps in those years Europe would not have awakened interest in the therapeutic gymnastics of ancient healers.
Physiotherapy exercises and breathing exercises for various lung diseases are aimed at restoring bronchial conduction, improving the discharge of thick sputum. Exercise contributes to a better blood supply to the lungs and other organs, and has a general strengthening effect on the body as a whole.
Physiotherapy
Any physical activity, no matter how gentle they are, cannot be performed with severe respiratory failure, intoxication, hemoptysis, fever, purulent processes in the lungs and bronchi.
Physical education in diseases of the lungs and bronchi should begin with the simplest and easiest exercises to perform. This is especially important when
Gradually under medical supervision physiotherapy exercises move on to more difficult exercises.
The main thing in physical therapy is the regularity of the events. The body must gradually get used to normal work, rebuild after the disease to a new level. Everything should be as comfortable as possible for the present condition of the patient.
A set of exercises
The complex begins with exercises in the prone and sitting position. At the same time, various types of breathing are trained - upper diaphragmatic and lower. The patient, lying or sitting, raises his arms up and down, swings his arms, rotates shoulder girdle. During charging, you should carefully monitor your breathing. It should be as deep and effective as possible. If during the exercise the patient suffocates, coughs, the amount of exercise should be reduced to an acceptable level or stopped altogether for a while.
For more effective workouts additional tools are involved in the exercises. It can be a regular stick, light dumbbells, an elastic band, a rubber ball.
One of the exercises aimed at the rapid discharge of sputum is to place the hands with a stick or tape behind the back. Then tilts forward and backward, from side to side. This exercise the first stage of recovery can be carried out in bed, sitting or lying down. Gradually, all physical activities are performed in a standing position.
The duration of training, their intensity depend on the patient's condition. It is necessary to take into account the level blood pressure, pulse, body temperature, age of the patient, his fitness.
Breathing exercises
Various breathing exercises are practiced to help restore health in case of pulmonary pathologies.
The Buteyko method of volitional elimination of deep breathing (VLHD) helps with bronchopulmonary diseases, pneumonia, bronchial asthma, COPD, allergies, angina pectoris and other heart diseases, migraine, gastrointestinal colic, hypertension.
Buteyko method. Video
The paradoxical breathing exercises of A.N. Strelnikova are known far beyond the borders of our country. Her results are truly amazing. With the help of a few simple dynamic breathing exercises, some of which are performed while compressing the chest while inhaling, it turned out to be possible to stop an asthma attack in bronchial asthma, get rid of chronic bronchitis and sinusitis, overcome stuttering, and restore the lost voice.
Breathing exercises Strelnikova. Video
Let us dwell in more detail on the centuries-old respiratory gymnastics according to the yoga system.
Breathing technique in yoga
After removal of pulmonary edema and during the recovery period for other pulmonary pathologies, gymnastics is shown according to the yoga system.
Yoga breath control techniques known as "pranayama" means "prolonging the life force". They guide the practitioner to the right way help you breathe in and out correctly. They can improve lung capacity, help reduce stress and improve your mind, and help you develop breathing control techniques on your own.
For some people it is quite difficult to practice yoga in terms of fulfilling the tasks in this practice, while for others, the knowledge of all the "basics" of yoga and meditation is easy. Initially, a person doing yoga breathing exercises may feel uneven in this process, but over time and with acquired skills, yogic breathing become smooth and light.
Technique for beginners
It is designed to help practitioners learn to be aware and in control of their breathing, relax during abdominal breathing, relieve stress, and breathe fully. This technique is also referred to as diaphragmatic breathing, as a method that allows you to move from small chest breathing to deep breathing with a full chest. To be able to practice this method, you must:
- Sit on the floor with your legs crossed and place your palms on your stomach
- Keeping your back straight, slowly inhale through your nose and use your diaphragm while pushing your arm forward, filling your lungs deeply with air.
- After exhaling air through the nose, contract the abdominal muscles to push the air out of the lungs.
- Intermediate stage of breathing technique
The three phases of breathing, slightly more complex than simple abdominal breathing, stimulate the person to breathe in a full manner to fill the lungs with air from the bottom up. While breathing through the nose is one continuous breath, the lungs will fill in three stages:
During the first phase (similar to abdominal breathing), the person inhales and fills the lower part of the lungs using the diaphragm.
He continues to inhale air in the second phase to expand and open his chest.
In the third stage, air enters the upper chest and lower throat.
It is necessary to place the hands on the stomach, and then on the ribs, and finally on the upper chest when doing the three-stage breathing, to make sure that the technique is performed correctly.
progressive technology
Today, training is also available in what is known as "fire breathing," a technique that can strengthen the diaphragm, expand lung capacity, and help clear the respiratory system. To practice this technique, sometimes referred to as "bellows breathing" or "cleansing breathing", it is recommended to be on a high floor with your legs crossed and your palms resting on your knees. After that, you need to quickly breathe through your nose, this process will resemble a snort. When performing this technique, the emphasis should be placed on both inhalation and exhalation. As the number of breaths increases, a steady pace and rhythm must be developed. At correct execution, the stomach will pulsate in the same rhythm with breathing.
Breath of Ujjayi
Ujjayi is a set of breathing exercises that translates as "victorious", it calms the mind, raises body temperature and promotes mental clarity. This complex can help develop concentration and allows you to control your breathing as you move from one yoga posture to the next.
Breath of Ujjayi. Video
To practice ujjayi breathing, you need to start from a comfortable position on the floor or a sturdy chair. Inhalation through the nose must be done by slightly squeezing the back of the throat and directing the air along its back wall. Exhalation through the mouth should be done with the sound signal "ha" and repeat it several times.
Today, most people believe that yoga is the experience of pure ecstasy through the union of mind, soul and body. But many yoga practitioners and teachers will agree that in addition to providing relaxation and peace, yoga practice develops the limitless abilities of a person to help him control his mind and be in harmony with his inner being.
In lung diseases, there is a violation of the functions of external respiration due to a deterioration in the elasticity of lung tissues, a violation of normal gas exchange between blood and alveolar air, and a decrease in bronchial conduction. This latter is due to spasm of the bronchi, thickening of their walls, mechanical blockage with increased sputum production.
? Violations of the function of external respiration in these diseases are due to three main reasons:
Respiratory diseases are characterized symptoms:
Sputum production
Hemoptysis
Chest pain
1. Violation of the mechanics of breathing associated with a deterioration in the elasticity of the lung tissue, a change in the rhythm of the phases of respiration, a deterioration in the mobility of the chest, a decrease in the tone and extensibility of one's own and auxiliary respiratory muscles.
2. A decrease in the diffuse capacity of the lungs, which disrupts the normal gas exchange between blood and alveolar air as a result of morphological changes.
3. Decrease in bronchial patency as a result of bronchospasm, thickening of the walls of the bronchi, increased secretion, mechanical blockage of the bronchi during in large numbers sputum
& Repeat!!!
Shortness of breath (dyspnea) - violation of the frequency, rhythm and depth of breathing or increased work of the respiratory muscles, manifested by subjective sensations of lack of air or difficulty breathing.
Types of shortness of breath:
1. Tachypnea - rapid shallow breathing (over 20 per minute).
2. Bradypnea - pathological decrease in breathing (less than 16 per minute).
Types of breathlessness:
1. Inspiratory dyspnea - inhalation is difficult.
2.Expiratory shortness of breath - exhalation is difficult.
3. Mixed shortness of breath - both phases of breathing are difficult.
Forms of shortness of breath (violation of the rhythm of breathing):
1. Cheyne-Stokes breathing - breathing, in which, after a respiratory pause, first shallow rare breathing appears, which gradually increases in depth and frequency, becomes very noisy, then gradually decreases and ends with a pause (it can last from several to 30 s).
2. Biot's breathing - rhythmic periods of deep respiratory movements alternate at approximately equal intervals with long respiratory pauses (it can last from several to 30 seconds).
3. Kussmaul breathing - deep rare breathing with a deep noisy inhalation and increased exhalation; it is observed in deep coma.
Respiratory failure- a state of the body in which the normal gas composition of the blood is not maintained or is maintained due to the increased work of the external respiration apparatus, which reduces the functionality of the body.
There are three degrees of respiratory failure:
degree - shortness of breath that occurs during physical exertion that has not previously caused it - latent respiratory failure. At rest, the indicators of external respiration correspond to official values.
degree - shortness of breath that occurs due to slight physical exertion, but there may not be a lack of oxygen due to complexatory excessive ventilation.
degree - shortness of breath that occurs at rest, lung volumes differ from the proper. There is excessive ventilation of the lungs, lack of oxygen in the body
? Mechanisms of action of physical exercises in the pathology of the respiratory system:
1. Stimulate the function of external respiration, are conditioned reflex stimuli respiratory system and proprioceptive regulators of the respiratory reflex.
2. Increase the mobility of the chest, stimulate the excursion of the diaphragm, strengthen the respiratory muscles, improve the mechanism of breathing, coordination of breathing and movements.
3. They increase the productivity of cough, stimulating the receptor apparatus and the cough center, and contribute to the excretion of sputum.
4. Improve blood and lymph circulation in the lungs and pleura, thereby contributing to faster resorption of exudate.
5. Contribute to the prevention of complications that can develop in the lungs with many diseases (adhesions, abscesses, emphysema, pneumosclerosis), and secondary deformities of the chest.
6. As a result of the trophic action, it is possible to improve the elasticity of the lung tissue and the mobility of the lung.
7. Mobilize auxiliary mechanisms of blood circulation, improve blood oxygenation, increase oxygen consumption by tissues, which affects the fight against hypoxia.
8. Normalize gas exchange by influencing external and tissue respiration, improve redox processes.
9. Stimulate metabolic processes.
10. Increase physical performance, have a general strengthening and tonic effect.
? Tasks of exercise therapy in pathology of the respiratory system.
1. Achievement of regression of reversible and stabilization of irreversible changes in the lungs, formation of compensation and normalization of function.
2. General toning effect:
Stimulation of metabolic processes;
Increased neuropsychic tone;
Restoration and increase of tolerance to physical activity;
Stimulation of immune processes.
3. Preventive effect:
Improving the function of external respiration;
Mastering the breath control technique;
Increasing the protective function of the respiratory tract;
Reducing intoxication.
4. Pathogenetic (therapeutic) effect:
Correction of the "mechanics" of breathing;
Acceleration of resorption in inflammatory processes;
Improvement of bronchial patency;
Removal or reduction of bronchospasm;
Regulation of the function of external respiration and an increase in its reserves.
? The main methods of exercise therapy for pathology of the respiratory system:
1. General toning exercises:
Improve the function of all organs and systems, activate breathing;
To stimulate the function of external respiration, exercises of moderate and high intensity are used;
2. Special exercises (breathing) exercises:
Strengthen the respiratory muscles, increase the mobility of the chest and diaphragm;
Contribute to the stretching of pleural adhesions;
Reduce congestion in the respiratory system;
Facilitate the excretion of sputum;
Improve the mechanism of breathing, coordination of breathing and movement.
3. Physical exercises are selected in accordance with the pathogenesis, clinical picture, the prevalence of certain symptoms and syndromes of the disease, the severity of the patient's condition. A prerequisite is to take into account the effectiveness of a single procedure of therapeutic exercises and the entire course of exercise therapy
Contraindications to the appointment of exercise therapy for lung diseases:
1. Lack of contact with the patient due to his serious condition or mental disorder;
2. Sinus tachycardia (heart rate over 100 beats / min);
3. Sinus bradycardia (heart rate less than 50 beats / min);
4. Respiratory failure of the 3rd degree;
5. Lung abscess to a breakthrough in the bronchus or encystation;
6. Hemoptysis, the threat of bleeding and thromboembolism;
7.Asthmatic status;
8. A large amount of exudate in the pleural cavity;
9. Pronounced inflammatory process.
Attention! The presence of "rusty" sputum is not a contraindication for the appointment of exercise therapy, because. this is a sign of a violation of the permeability of the vascular wall.
? Massage for respiratory diseases
Tasks: reflex trophic effect on the lungs, strengthening the respiratory muscles, improving blood and lymph circulation, increasing the mobility of the ribs.
Indications: outside the period of exacerbation in chronic pneumonia, pneumosclerosis, chronic bronchitis, emphysema, bronchial asthma.
Contraindications: acute febrile conditions, acute exudative pleurisy, bronchiectasis in the stage of tissue decay, cardiopulmonary failure of the 3rd degree.
Similar information.
To special exercise used in diseases of the respiratory system include: static breathing exercises, including consciously controlled localized breathing, and dynamic, draining, stretching pleural adhesions, with the pronunciation of sounds. When performing any of these exercises, it is possible to lengthen and deepen inhalation or exhalation, holding the breath after inhalation or exhalation.
Static breathing exercises
When performing them, the main attention is paid to the work of certain groups of respiratory mice, the act of breathing itself (the ratio of respiratory phases) and the ventilation of certain sections of the lungs in static position torso and limbs. Breathing is usually performed through the nose, but in obstructive disorders, exhalation can also be performed through the mouth with or without resistance, as well as with the pronunciation of sounds.■ Mixed (full) breathing, carried out in the initial position (ip) standing, sitting without support on the back of a chair or sitting astride a chair, arms along the body, is carried out with the participation of all the main and auxiliary respiratory muscles.
■ Chest breathing is performed with the participation of the muscles of the chest in the I.P. standing, sitting, arms along the body, on the belt. This type of breathing allows you to increase ventilation in the upper and middle sections of the lungs.
■ Abdominal breathing is carried out in ip. lying on your back with legs bent at the knee and hip joints (emphasis on the feet), sitting with support on the back of a chair, standing, hands behind the head. With this breathing, ventilation in the lower and middle sections of the lungs increases. It is possible to increase ventilation in the upper sections of the lungs with calm or deep breathing in a sitting position with arms resting in front of you on the back of a chair, hands on your belt, on your hips, or standing with your hands on your belt. Ventilation in the lower parts of the lungs increases if the arms are raised above the horizontal level. In the supine position with legs bent at the knee and hip joints, ventilation of the lower lung increases, since the lower dome of the diaphragm moves in this position with maximum amplitude.
■ Consciously controlled localized breathing increases ventilation in one lung or part of it. When performing these exercises, during exhalation, the patient’s chest is slightly compressed in the area where ventilation should be increased, and during inspiration, the pressure on the chest is gradually reduced. The patient is forced, overcoming resistance, to strain the muscles more precisely where the pressure is exerted. As a result, the movement of the ribs increases in this area and the ventilation increases. There are two- and one-sided; right and left lower and upper chest; two- and right-sided mid-thoracic; back breathing.
When performing lower thoracic breathing, the massage therapist's hands are placed on the lower lateral parts of the chest in the I.P. patient sitting, standing. Pressure is exerted on both sides (bilateral) or on one side (unilateral). Unilateral lower thoracic breathing can be performed while sitting, standing or lying on a roller on the opposite side. Pressure is exerted on the lower lateral surface of the chest in the frontal plane on one side.
Mid-thoracic breathing is performed in I.P. standing, sitting, lying on the left side. With unilateral breathing, the instructor's hands are placed on the middle sections of the right half of the difficult cage in front and behind. With bilateral breathing, one hand is located on the sternum, the other - behind in the middle of the chest. The chest is compressed in the sagittal direction.
Upper chest breathing is performed in I.P. standing, sitting, lying on the back. The instructor's hands are placed in the subclavian regions and apply dorsal pressure on both or one side.
Retrothoracic breathing is performed in I.P. sitting with the most kyphotic back ("coachman's position") or lying on the back. The instructor's hands will be placed on the lower-mid chest and apply pressure ventrally.
Dynamic breathing exercises are performed with the movement of the torso and limbs. At the same time, abduction and extension of the limbs, as well as extension of the body, is usually accompanied by inhalation, flexion and adduction - by exhalation. To enhance ventilation in the posterior segments of the lungs, inhalation is performed while bending thoracic spine, and exhale - when it is unbent.
Static and dynamic breathing exercises can be performed with deepening and slowing down of the phases of breathing, depending on the characteristics of the impairment of respiratory function. Thus, with restrictive changes, exercises with a deepening of inhalation are recommended, and with obstructive ones, the exhalation is lengthened, and the inhalation does not deepen and can even be specially reduced. This minimizes stress skeletal muscle so as not to cause a reflex tension of the smooth muscles of the bronchi.
It is known that in the absence of obstacles, the flow of gas through the respiratory tubes is calm, laminar, and only in the places where the bronchi divide do turbulences appear and the flow becomes turbulent. With laminar gas flow, the resistance increases inversely with the 4th power of the radius. Therefore, changing the radius even by a small amount entails a significant increase in resistance. For example, in bronchial asthma (BA), it can increase by 20 times. This is facilitated by the appearance of turbulent air movement in the bronchi, filled with even a small amount of sputum. It has been established that the sum of linear and transverse pressure (on the bronchus wall) of the air flow is a constant value.
The increase in linear pressure seen in narrowed airways reduces the pressure on the walls, causing them to constrict even more during rapid exhalation (1, 6).
Breathing with a slow extended expiration increases the pressure on the walls of the bronchi and reduces the linear pressure and, therefore, prevents the narrowing of the runway.
Drainage exercises are a combination of voluntary dynamic breathing with a certain body position. At the same time, the topographic anatomy of the bronchi, lobes and segments is fundamental.
The main purpose of the exercises is to facilitate coughing up the contents of the runway, bronchiectasis and other cavities that communicate with the bronchi. A feature of the performance of drainage exercises is to give such a position to the body when the drained area is above the bronchus, located vertically. In this postural position, the patient should gradually deepen his breathing, wait for the cough to appear, and then, coughing, change the position of the body to the opposite. These movements are repeated many times. Before performing drainage exercises, it is advisable to take a medicine that kindles phlegm.
Exercises for draining an entire lobe of the lung or its segments
Drainage of the upper lobe of the right lung is carried out in I.P. sitting, leaning back, the left forearm is on the right thigh, the right hand is raised up. Then the patient, coughing, must perform several inclinations down and to the left, touching right hand gender. The movement is repeated 6-12 times. Drainage of the left upper lobe is carried out with the left hand raised.Drainage of the middle lobe is performed lying on an inclined plane (the leg horse is raised by 10-15 cm) on the left side, deviating backwards so that the forearm of the right hand lies behind the couch. When coughing, turn on the stomach. (Segments 4-5 of the left lobe are also drained, but in the supine position on the right side).
Drainage of the lower lobes occurs with the maximum tilt of the body forward and staying in this position until a cough appears, and then returning to a vertical position. For drainage of one lower lobe, I.P. is used. lying on the opposite side with a raised foot end by 30-40 cm and then, when a cough appears, turn to the side of the same name.
A significant role in the violation of the draining function of the bronchi is played by changes in the bronchial mucosa with a violation of the ciliated epithelium and early expiratory closure of the airways (ECDA). In healthy lungs, ECDP occurs at the end of maximal exhalation at the level of residual lung volume (RLV). Early EPDP occurs when the lumen is partially narrowed by sputum, due to inflammation of the mucous membrane or bronchospasm: in the area of narrowing, the flow accelerates and the radial pressure decreases, which prevents the collapse of the bronchi. The same happens with the loss of elasticity of the bronchioles and alveoli, the acceleration of breathing. With early ECDP, hypoxemia develops.
Under the influence of physical exercises, sputum is excreted due to the movement of sputum due to gravity during the patient's stay in a postural position, the movement of sputum at the time of exhalation due to the kinetic energy of the air stream, a local increase in intra-alveolar and intra-bronchial pressure when compressing the chest with the hands during exhalation, separation viscous sputum from the bronchial mucosa with local vibration of the chest.
The use of a functional corner table, the LH technique on which provides for a combination of draining exercises with massage, contributes to obtaining the maximum draining effect.
Exercises for stretching adhesions create conditions under which, due to the elastic properties of the chest and lung tissue, the pleura sheets are separated, which contributes to the stretching of adhesions. Exercises are effective only during the formation of adhesions.
Stages of formation of pleural adhesions
There are three stages in the formation of pleural adhesions.In the first (early) stage, which lasts 15 days, the adhesion is a loose connective tissue infiltrated with fibroblasts. Newly formed blood vessels consist of a single layer of endothelium. During this period, when performing special exercises rupture of adhesions is possible.
Second stage(duration from 15 days to 2 months) - fibrillaogenesis stage: fibroblasts turn into mature fibrocytes that produce collagen; vessels form an elastic frame, but have a convoluted structure. In parallel, in the adhesion itself, the formation of elastic fibers from reticular cells takes place. At this stage, when using special exercises, it is possible to stretch the adhesions.
In the third stage(over 2 months) complete fibrosis sets in: continuous development of collagen fibers, the tissue becomes coarse-fibred and practically inextensible (“hard fixative”). Such adhesions, limiting the mobility of the lungs, adversely affect the respiratory function, and it is no longer possible to stretch them with the help of physical exercises.
■ To stretch the adhesions of the diaphragmatic pleural cavity, deep diaphragmatic breathing is used with a pause after inhalation in the supine position or lying on the side, similar to the diseased lung, with legs bent at the knee and hip joints.
■ For stretching adhesions in the costal pleura, IP is used. lying on its side, the healthy lung of the same name, standing, sitting. During exhalation and its delay, the hand is raised up on the side of the pleural lesion. At the same time, the torso can be tilted to the healthy side with localization of adhesions in the lateral region, extension of the body - with adhesions in the anterior region and flexion of the body - in the posterior region.
■ With the localization of adhesions in the sinuses in the IP. sitting or standing, with hands behind the head, take a sharp deep breath and hold the breath for 3-5 s.
Exercises with the pronunciation of sounds (sound gymnastics)
The goal of sound gymnastics is to normalize the duration and ratio of inhalation and exhalation (1:1.5; 1:1.75), increase or decrease the resistance to the air stream on exhalation, and facilitate sputum secretion. In diseases of the bronchopulmonary system, exercises are used with the pronunciation of consonants and vowels. Consonants create vibration vocal cords, which is transmitted to the trachea, bronchi and bronchioles.According to the strength of the air stream, consonants aim at three troupes: the smallest force develops at sounds m-m-m, rr; the jet has an average intensity with sounds b, g, e, c, h; the greatest intensity - with the sounds p, f. Vowel sounds allow you to lengthen the exhalation and equalize the resistance in the runway. They are pronounced in a certain sequence: a, o, and, boo, bot, bak, beh, bih. Vibrating sounds zh-zh-zh-zh, rrrr increase the efficiency of draining exercises.
Only trained muscles are able to provide full breathing and normal gas exchange, therefore, in the treatment of respiratory organs, physical exercises have a special place.
They are aimed primarily at training those muscles that are involved in the process of breathing: the diaphragm, external and internal intercostal muscles, the square muscle of the lower back, the rectus and transverse abdominal muscles, the external and internal oblique abdominal muscles, etc.
In addition, breathing exercises contribute to the creation of a branched circulatory system in the tissues of the bronchi, lungs and entire chest, which significantly improves the blood supply to these organs.
Exercise 1
Starting position - standing, feet shoulder width apart. Extend your arms to the sides (Fig. 49) and inhale deeply. During a forced exhalation, make springy movements with your hands back and slightly forward, inhale - hands down. Repeat 5-7 times.
Exercise 2
Starting position - standing, feet shoulder width apart.
Take a deep breath; as you exhale, perform springy movements with your hands: one - up and back, the other - down and back. Then switch hands. Repeat at an average pace 4-6 times. Breathing is even.
Exercise 3
Starting position - standing, feet shoulder-width apart, feet parallel, shoulders deployed, torso straightened, arms at the waist.
Inhale and do a half squat. Return to initial position- exhale. Repeat 6-8 times.
Exercise 4
Inhale, then, exhaling slowly, tilt your torso forward (Fig. 50), swinging your arms freely. Repeat 4-5 times. 
Exercise 5
Lean your right hand on the back of a chair, put your left hand on your belt. Take a deep breath; Exhaling, swing your right leg back and forth. Do the same by swinging with the other leg. Repeat with each leg 4-5 times.
Exercise 6
Starting position - standing, feet shoulder-width apart, arms lowered.
Spread your arms to the sides - inhale; slowly lean forward, trying to reach the floor with your fingers - exhale.
(If dizziness occurs, you should immediately sit on a chair.)
Exercise 7
Starting position - standing, legs slightly apart, hands on hips.
Take a deep breath; exhaling, tilt the body to the right, helping with the raised left hand. Do the same on the other side. Repeat 4-5 times on each side.
Exercise 8
Starting position - standing sideways to a chair.
Rest your left hand on the back of a chair. Take a deep breath, bend your right leg at the knee and exhale circular motions V hip joint now to one side, then to the other. The same with the other leg. Repeat 4 times with each leg.
Exercise 9
Starting position - standing, hands on the back of the chair. Take a deep breath, sit down - exhale, return to the starting position - inhale. Repeat 6 times.
Exercise 10
Starting position - standing, feet shoulder-width apart, hands on the belt.
Take a deep breath and as you exhale, perform circular movements with your torso: forward, side, back. Repeat 3-4 times on both sides.
Exercise 11
Starting position - standing, legs slightly apart. Grasp the back of a chair with your hands. Exhale and do a squat, if it is difficult - a half squat. Repeat 8-10 times.
Exercise 12
Walk at an average pace for 3-5 minutes: inhale for 3-4 steps, exhale for 5-7 steps.
As a warm-up, you can use breathing exercises that are performed while standing at a fairly fast pace.
cleansing breath
Stand with your feet shoulder-width apart, lean forward slightly, and place your hands on your hips. Inhale deeply through the nose and exhale the air through the mouth with force, but not quickly, gradually. Fold your lips into a tube. Repeat several times. Long exhalation strengthens the diaphragm.
Ankle relaxation
Stand up straight, arms along the body. Inhaling deeply, rise on your toes and extend your arms forward. Keep your balance. While exhaling, stand on your feet, lower your arms.
Relaxation of the knee joints
Stand up straight, arms along the body. Take a deep breath. Exhaling, squat. Do not spread your knees, keep your torso straight. As you inhale, rise up.
Padasansalana
Stand straight, arms along the body, do not strain. While inhaling, lift your right leg up without bending your knee. Hold the pose for a few seconds. Exhaling, return the leg to its original position. While inhaling, lift your right leg without bending your knee. As you exhale, lower your leg. As you inhale, lift your right leg to the side. Hold the pose for a few seconds, being careful not to bend your leg. Lower your leg as you exhale. As you inhale, lift your leg to the left, keep it straight. After a few seconds, as you exhale, lower your leg. Repeat the same movements with your left leg.
Relaxation of the hip joints
Stand up straight, take a deep breath. Exhaling, sit on your heels with your knees apart. Shift your body weight from your toes to your heels. Try to spread your knees with your hands. As you exhale, rise up.
Bending the body forward and backward
While inhaling, raise your arms up and bend back. Exhaling, return to an upright position and lean forward. Touch your palms to the floor, if possible. While inhaling, straighten your torso again and bend back. Repeat 4 or 5 times.
Pulling hands back
Stand up straight. Raise your arms forward at shoulder level, palms together. As you inhale, move your arms back as far as you can. Expand your chest. As you exhale, move your hands forward. Repeat 10 cycles.
Lock
Put your fingers in the castle, stretch your arms forward with your palms inward. Slowly inhaling the air, stretch your arms forward, turning the lock outward. Exhale. Place your palms on your chest and relax. Repeat the exercise by raising your arms at a 45-degree angle and then vertically.
Pulling up
Stand up straight, arms along the body. Taking a deep breath, raise your arms and reach up, rising on your toes. Fold your fingers into the lock, then turn your palms outward. Exhaling, lower your arms and stand on a full foot. Repeat 5 times.
The following practices are combinations of asanas and pranayamas and are very helpful in treating asthma.
Breathing for asthma
Inhale-exhale
Stand straight, feet together, arms along the body. Take a deep breath, during which raise your hands forward to shoulder level and slowly spread apart, slightly shifting your shoulder blades. As you exhale, lower your arms along your torso. Perform 5 times.
Hasta Uthanasana
Stand up as in the previous exercise. Cross your arms in front of you. On a deep breath, slowly raise your arms above your head while maintaining a crossed position. At the same time, tilt your head slightly and look at your hands. As you exhale, extend your arms to the sides at shoulder level. On a slow, deep breath, raise your arms above your head again, crossing them. As you exhale, lower your arms down in front of you to the starting position.
Repeat 5 to 10 times.
Utthita lolosana
Stand up straight, feet 1 meter apart. Raise your arms above your head, do not bend your elbows. Bend your wrists palms forward so that your arms hang gently.
Then bend your torso, stretch your arms forward parallel to the floor and “drop” your torso down, allowing your arms and head to swing between your hips. In this position, be completely relaxed, like a rag doll. In the upper position, when swinging, pull the torso parallel to the floor; when lowering the body, pull the arms back, as far as possible from the legs. After five full swings, return to the position with your arms raised, then lower them along the torso.
This exercise should be done in sync with the breath. Inhale deeply as you raise your torso and extend your arms forward; exhale forcefully with each downward swing of the torso to expel all the air from the bottom of the lungs. To enhance the effect, say the sound “ha” with each exhalation; this sound should come from the abdomen.
Contraindications. Asana is not practiced in case of high blood pressure, problems with the spine and the presence of vertigo (dizziness).
Awakening of the alveoli
Performed in the morning after sleep. Stand straight, feet together, arms along the body. Take a deep breath, hold your breath. Gently, but sharply enough, tap the chest and sides of the body with the pads of your fingers while holding your breath. Exhale. Repeat the exercise 5 times.
Exhale in portions
The starting position is the same as in the previous exercise. Inhale deeply through your nose and then exhale through your mouth in small portions with a "ha-ha-ha" sound. Do the exercise 5 times.
Hiss
Stand up straight, inhale deeply, then exhale through your mouth with closed teeth, making a hissing sound. Do the exercise 5 times.
After the dynamic breathing exercises, do the full yogi breathing while lying down in Savasana.
Perform full breaths during relaxation in any position where there is a possibility of conscious breathing. It should be smooth and harmonious. After exhaling, hold your breath for a few seconds. Begin with full breathing 5 to 10 times every day, then practice it for 10 minutes daily.
Breath top lungs
Lie down in Savasana, place your hands behind your head on the floor. Legs can be bent, feet placed next to the buttocks. Grab your left elbow with your right hand and your right elbow with your left hand. Practice full yogi breathing. This posture promotes deep full breathing, especially in the area of the collarbones at the top of the lungs.
