Physical therapy how to do them. Therapeutic exercise (physical therapy)

• Individual approach to the patient in accordance with his motor capabilities and condition.
• Consciousness – meaningful attitude of the patient to the proposed physical exercises, direct active participation of the patient himself in the process of implementation physical exercise and monitoring the correctness of their implementation, which is achieved by the skillful explanation of the methodologist.
• Visibility – demonstration of physical exercises combined with explanation.
• Systematicity – regularity of classes with a gradual and consistent increase in load: from simple exercises to more complex ones, from the known to the unknown (at each lesson, include one complex new exercise or 2 simple ones).
• The principle of consolidation of skills – engage in physical exercise constantly so as not to lose the results achieved.
• Cyclicality alternating exercise with rest.

Forms of therapeutic physical culture

• Hygienic (morning) gymnastics prepares the body for daytime activity after sleep, which reduces the activity of nervous processes and muscle tension. During sleep, pulse and breathing become slower, the activity of nervous processes decreases, intestinal motility slows down, digestion processes slow down, and metabolism decreases. Hygienic gymnastics is designed to activate all these processes. Classes are held before breakfast, in the absence of contraindications (as determined by the doctor), in a ventilated room in light clothing that does not restrict movement, for 15-20 minutes, preferably to the accompaniment of music.
  The gymnastics complex consists of 10-15 exercises from various starting positions for all muscle groups, including exercises for coordination, flexibility, relaxation, correcting posture, and self-massage. The load must correspond to the state of health, age, gender, and physical development. For men, it is recommended to include strength exercises: with dumbbells, expanders, with moderate static tension; for women – exercises to develop flexibility, strengthen muscles abdominals, pelvic floor; elderly should be avoided strength exercises, widely used breathing exercises and for muscle relaxation, self-massage of the head and neck to improve blood supply to the blood vessels of the brain, children need to include exercises to correct posture, develop flexibility, coordination of movements and balance.
• Therapeutic gymnastics – the main form, which also includes independent exercises by patients (fractional load), in which mainly gymnastic exercises are used for therapeutic and prophylactic purposes.
• Walks(walking, skiing, cycling, boating).
• Close-range tourism– hiking for 1-3 days reduces stress nervous system, improve vegetative functions.
• Healthy running (jogging), during which all skeletal muscles are involved and the nervous system experiences significant tension.

Class organization methods

• Individual (with seriously ill patients).
• Group (based on the principle of the uniform nature of the disease or injury and the level functional state organism).
• Independent.

Each lesson includes three sections: introductory, main and final. Introductory section(warm-up) consists of several general developmental exercises, sequentially covering all muscles, takes 10-20% of the total time. Main section takes 60-80% of the total time, consists of special exercises in relation to this disease, which must be alternated with general developmental exercises. Final section takes 10-20% of the total time. The load is gradually reduced in order to normalize the increased activity of the cardiovascular and respiratory systems (slow walking combined with deep breathing).

Movement Modes is determined by the attending physician strictly individually.

For hospitals

Mode I

• Strict bed rest prescribed for seriously ill patients - light massage, passive exercises for the limbs with partial and full range of motion 2-3 times a day for 5-10 minutes and deep static breathing every hour.
• Extended bed rest prescribed when the patient’s general condition is satisfactory. Active eating and active toileting, independent turns on one side, transition to a sitting position in bed 2-6 times a day for 5-40 minutes, basic exercises for the limbs with breathing exercises are allowed.

Mode II

• Semi-bed (ward)– staying in the ward out of bed sitting 50% of the time, moving around the floor, walking slowly (at a speed of 60 steps per minute) at a distance of 100-150 m. Therapeutic exercises are performed according to individual indications: in the initial position lying, sitting, standing, or with objects weighing up to 0.5 kg. Gradually include exercises for the trunk muscles. Duration of classes is 20-25 minutes.

Mode III

• Free– walks within the hospital, for a distance of up to 1 km at a speed with rest every 200 m at a speed of 60-80 steps per minute. Classes are held in the exercise therapy room for 25-30 minutes. Use objects weighing up to 1 kg, games.

The pulse rate in adults should not exceed 108 in adults and 120 beats per minute in children.

For clinics, sanatoriums and resorts

• Gentle (for exhausted, overworked and convalescing) – similar to free mode. Dosed walking on level ground for a distance of 1.5-3 km at a slow to medium pace is also allowed, resting every 10-20 minutes, swimming with the use of support devices for 10-20 minutes.
• Gentle-training– physical activity is made more difficult, exercises are performed for 30-45 minutes, with objects (weighing up to 3 kg), on apparatus. Prescribed dosed walking on level ground at an average and fast pace for an hour for a distance of up to 4 km, a health path with an elevation of 5-10 degrees for a distance of 2-3 km for 1 hour with rest every 10-15 minutes, swimming for 10 -30 minutes. They use rowing boats, volleyball, badminton, and tennis.
• Coaching The regimen is prescribed to persons without significant deviations in health and physical development, that is, practically healthy people. The physical activity is great; dosed walking and running are prescribed. Sports games carried out according to general rules. An increase in heart rate up to 120-150 beats per minute (in the elderly up to 120-130 beats per minute), an increase in systolic blood pressure up to 150 mm Hg. Art., reducing the minimum to 55 mm Hg. Art.

Therapeutic exercise indicated for almost all diseases.

General contraindications to the use of physical therapy are:

• general serious condition of the patient;
• risk of bleeding;
• unbearable pain when performing physical exercises;
• febrile and acute inflammatory diseases;
• malignant tumors.

Exercise therapy is prescribed by the attending physician; a physician-specialist in exercise therapy selects the methodology, determines the nature of the classes, dosage and controls the performance of physical exercises. The procedures are carried out by exercise therapy instructors, guided by the doctor’s recommendations regarding the nature of the disease.

Magnitude physical activity must correspond to the patient’s condition and physical capabilities. Overall intensity physical training depends on the patient’s individual tolerance to physical activity.

In the selection and application of general strengthening and special targeted exercises, take into account clinical manifestations illness or injury and methodological principle– from a healthy organ to a diseased one. The optimal combination of general and specific (local) is used in exercise therapy for any pathology, but it is especially important to take this into account in orthopedics, traumatology and neurology. The total load should be distributed evenly and consistently across all muscles to prevent fatigue and improve blood circulation. The load is adjusted based on the physiological curve - the pulse rate during the session, which is recorded graphically. Dosage depends on the number and location of the muscles involved in the exercises, the form of movement, amplitude, strength, rhythm, tempo of movements, duration of exercise and complexity of the exercises. For each patient determine:

• density of classes(the time of actual exercise, expressed as a percentage of the total time of exercise) for inpatients should not be higher than 50% (in the first days of classes it is 20-25%), in other cases, density up to 80-90% is acceptable;
• (ANDP) starting positions (lying, sitting, standing). IP lying on the back, on the stomach, on the side provides stable balance, maximum relaxation of skeletal muscles, facilitates the performance of exercises, is prescribed to patients on bed rest, for diseases of the spine. Seated IP eliminates significant static muscle tension lower limbs, creates freedom of movement of the limbs, neck and torso, is prescribed to weak patients and for diseases of the lower extremities. Standing IP is characterized by a high center of gravity and a small support area. Balance is maintained with the direct participation of different parts of the nervous system due to the contraction of many muscles of the body. The most stable position is a standing position with legs wide apart;
• number of muscle groups participating in the exercise, selection of exercises for them, the ratio of breathing exercises to general strengthening and special ones aimed at restoring impaired functions (1:1, 1:2, 1:3, 1:4, 1:5). You should start with exercises for small muscle groups. When performing complex exercises, the load increases. The more breathing exercises, the less the load. To develop muscle strength (paresis and malnutrition) it is used isometric exercises with great tension and dynamic exercises which are carried out slowly, but with great resistance;
• number of repetitions of each exercise, pace (slow, medium, fast) and range of motion in the joints;
• duration of the lesson. Total duration individual lessons– 5-20 minutes, group – 15-40 minutes;
• independent studies– performing special exercises throughout the day;
• usage game exercises, music– to create positive emotions, objects and equipment in order to change the load. So, exercises with gymnastic stick reduce tension in the muscles of the sore arm and increase the load on the muscles of the healthy arm.

Normally, during exercise, the possibility of increasing the intensity of the load is felt, no discomfort or chest pain, increased normal breathing rate, lack of coordination, pallor, heart rhythm disturbances. Immediately after exercise, you feel “muscular joy”; you should feel good. The time for recovery of heart rate and blood pressure to initial values ​​in healthy people should not exceed 3 minutes. During the break between exercises there may be slight fatigue, but no more than 2 hours, no sleep or appetite disturbances, local fatigue persists for no more than 12 hours.

(exercise therapy) is a therapeutic method, the main means of which are physical exercises used for therapeutic and therapeutic purposes for injuries and various diseases. Exercise therapy, along with the main task (restoration of impaired functions), develops reaction speed, strength, endurance, dexterity, coordination and helps to quickly return to social and work activities after illness. Exercise therapy is used in combination with a properly organized regimen in clinical, outpatient, sanatorium and resort practice and at home.

Physical exercise changes: primarily affects the central nervous system, causing a change in the mobility of nervous processes in the cerebral cortex; correct the functions of the main body systems (breathing, etc.), metabolic processes; contribute to their compensation; influence the emotional state of the patient, distract from thoughts about the disease, and cause a feeling of cheerfulness and confidence.

Rice. 1. Various types exercises:
1 - passive;
2 - active with projectiles;
3 - active on the gymnastic wall.

Rice. 2. Basic exercises to strengthen muscles abdominal wall in a standing position.

Exercise therapy is indicated for open and closed fractures, soft tissue injuries for faster healing, callus formation, contractures of various origins, polyarthritis, . Widely used during operations on the abdominal, thoracic cavities, etc. (pre- and postoperative gymnastics) as a means of preventing various postoperative complications (intestinal atony, restriction of movement in the joints, etc.) and combating them. Physical exercise improves the nutrition of the heart muscle and enhances its contractile function. Exercise therapy is used in the initial stages of circulatory failure, myocarditis in the subacute and chronic periods, myocardial infarction, hypotensive conditions; for vascular diseases of the extremities: obliterating lesions of the arteries, chronic and varicose veins veins Therapeutic exercise is indicated for lung diseases (pneumonia, pleurisy, bronchial asthma, etc.); stomach and intestines (colitis, enterocolitis), with prolapse of the stomach and others internal organs, constipation, liver and biliary tract diseases; for metabolic and endocrine diseases (obesity, ); diseases of the female genital area (chronic inflammatory processes, prolapse of the walls, incorrect positions uterus, menstrual disorders). Exercise therapy is used in the postpartum and periods. Physical exercises are widely used for diseases and injuries of the central and peripheral nervous system. Exercise therapy is indicated as a method of restorative therapy for paralysis and paresis caused by cerebral circulatory disorders, with the consequences of diseases of the nervous system (meningitis, vestibular function disorders and neuroses). Exercise therapy is widely used in the complex treatment of various pathologies in children (diseases of the cardiovascular and respiratory systems, etc.). Exercise therapy is especially indicated as a therapeutic and prophylactic agent for defects and diseases of the musculoskeletal system in children (postural disorders, etc.).

The main means of therapeutic physical education - sets of physical exercises - are divided into gymnastic, sports-applied (, etc.), mobile, etc. They are used in combination with natural factors (air, water, sun), which are most fully used in spa treatment. Of the complex of remedies, gymnastic exercises in the form of therapeutic exercises are most often prescribed. When prescribed to a patient independent studies At home, special recommendations for self-control are given. Gymnastic exercises classified: a) according to anatomical principle - for small muscle groups (hands, feet, face), medium (muscles of the neck, arms, legs, muscles), large (muscles of the thigh, abdomen, back); b) by activity (Fig. 1) - passive and active; the latter can be free, lightweight (in water, on sliding surface etc.), with effort, for relaxation, etc.; c) according to the specific principle - respiratory, preparatory, corrective, in throwing, balance, resistance, with apparatus, crawling, climbing, jumping, jumping, hanging and resting, etc.

Therapeutic gymnastics for children - see Gymnastics, for young children.

Rice. 3. Basic exercises to strengthen the abdominal muscles in a sitting position.

Rice. 4. Basic exercises to strengthen the muscles of the abdominal wall in a lying position.

Rice. 5. Therapeutic exercises for gynecological diseases in the prone position.

Physical exercises are used in the form of general and special training. Objectives of general training: strengthening the body, improving the functions of basic systems. Special training is aimed at restoring impaired functions. To carry out the tasks of special training, certain groups of exercises are selected. For example, to strengthen the abdominal muscles, exercises are used in standing, sitting and lying positions (Fig. 2-4); to improve blood circulation in the pelvic area - while lying on your stomach (Fig. 5).

The condition for the effectiveness of exercise therapy is long-term, systematic, regular exercise with a gradual increase in load both in each procedure and throughout the entire course of treatment; taking into account the individual characteristics of the patient: age, profession, motor activity, features of the course of the disease. Exercise therapy is used in the form of a therapeutic gymnastics procedure - individually or in groups (in a ward, a therapeutic gymnastics room or in an open area), pre- and postoperative gymnastics; self-study of patients performing tasks; morning hygienic exercises (see). An additional form of influence is (see). In addition, near (see), dosed ascents (see), skiing, skating, rowing, swimming, games are used.

Methodological principles of classes: the load is dosed according to the physical capabilities of the patient, general strengthening exercises should alternate with breathing and special ones. The amount of load in the exercises depends on the starting position, duration of the procedure, number of repetitions of the exercises, tempo, range of movements, their complexity, degree of effort in the exercise, use of equipment, and combination with breathing exercises.

The methodological guidance of exercise therapy is carried out by medical and physical education clinics, which include exercise therapy rooms with a staff of specialist doctors and exercise therapy instructors.

Exercise therapy classes in the conditions of a paramedic-midwife station are conducted only by an instructor (methodologist) of physical therapy or a paramedic with special training. Therapeutic gymnastics rooms must have gymnastic bench, wall, horizontal ladder, sticks, clubs, dumbbells, balls, etc.

When choosing a complex of physical therapy for the spine, pay attention to two factors.

1. General level physical training body. There are three main levels: people who are actively involved in sports; people who only do exercises and people who lead a passive lifestyle with sedentary work. Separate complexes must be used for each group therapeutic exercises for the spine.

2. Various stages of the condition of the spine after an exacerbation of pain. Experts distinguish three main stages of spinal restoration: the period immediately following an exacerbation (2 – 4 days), the period of spinal restoration (2 – 4 weeks after an exacerbation), the period of spinal healing and prevention (from 4 weeks and throughout life). For each stage of spinal restoration, you need to choose a separate exercise therapy complex.

This material describes a complex of therapeutic exercises for the spine, designed for people with different physical fitness. Simple exercises are immediately described, and then more complex ones that increase the load on the spine.

The proposed physical therapy exercises should be started as soon as the acute pain in the spine goes away.

With the help of physical therapy exercises, you can solve several problems:

1. Reduce pain by eliminating compression of the intervertebral discs.

2. Strengthen the muscles and ligaments that support the spine.

3. Accelerate the growth of healthy tissue (bone and cartilage).

4. Thanks to increased blood flow, tissues are cleansed of waste and toxins.

Exercise therapy for the spine - necessary theoretical information

The exercises are intended for prevention and recovery, and not for a one-time, quick treatment of the spine. Problems arise over years and cannot be solved within a few days.

Exercises are best done several times a day, at least in the morning and evening, some can be done at work - don’t be lazy.

When doing the exercises, take your time, avoid sudden, fast movements.

Gradually increase the load - number of repetitions and amplitude.

When performing exercises, try to feel the spine and back muscles, do not do exercise therapy simply mechanically.

The main task when performing physical therapy is to increase blood flow in the spine.

Therapeutic gymnastics for the lumbar spine - technique

In the image: gently arch your back up, and then bend down - without jerking, gradually increasing the amplitude

1. Contraction of the abdominal muscles, without moving the body, until slight fatigue appears in them.

2. Starting position: standing on all fours, resting on your knees and palms; raise your head and gently bend your back down, lower your head and arch your back up. Perform from 3 to 10 times.

3. Starting position: lying on your back, arms along your body, legs half-bent at the knees resting on the entire surface of the foot: place both legs to the right of the body, trying to reach your knees to the floor (perform the movement without jerking, do not straighten your legs), the shoulder blades do not come off surfaces. Then repeat the movement in the other direction. Perform up to 10 times in each direction.

In the image: smoothly lift the pelvis up (no need to bend) and lower it down

4. Starting position: lying on your back; pull your toes towards you at the same time, feel the tension in your back, hold the tension for 3 - 5 seconds, relax. Perform 3 – 5 times.

5. Starting position: lying on your back, legs bent at the knees and resting on the entire surface of the feet, arms along the body; leaning on your shoulder blades and feet, raise your pelvis and lower it. Perform 3 – 10 times.

In the image: Raise the leg to the body and gently press it to the stomach.

6. Starting position: lying on your back, arms along the body; bending your leg at the knee and hip joint, helping yourself with your hands to press your thigh to your stomach; hold your leg down for a few seconds. Perform 3 – 5 times with each leg.

7. Starting position: standing on all fours, leaning on your palms and knees; raise slightly bent leg back; repeat with the other leg. Perform 5 – 10 times with each leg.

8. Starting position: sitting on your knees bent (buttocks resting on your heels), arms freely lowered; Take a kneeling position, sit on the floor to the left of your feet, and then to the right. Perform 10 – 12 times.

9. Starting position: lying on your back, arms along your body; clasp your legs with your hands and press them to your chest, roll on your back from your buttocks to your head; come back to starting position. Perform 5 – 7 times.

Exercise therapy for the thoracic spine - technique

1. Starting position: lying on your back, knees bent, legs as relaxed as possible; pull your knee towards you, trying to reach your nose with it, while simultaneously tilting your head and lifting top part torso towards the knee; The exercise will be more effective if you support the bent leg with your hands under the knee. Perform 4 – 6 times with each leg.

2. Starting position: sitting on a chair, hands on your knees; bending down, reach the toe of the opposite leg with one hand, straighten up and repeat with the other hand. Perform bends on each leg 4 – 6 times.

3. Starting position: standing holding the back of a chair; squats with a straight back up to 20 times, without lifting your heels from the floor.

Therapeutic gymnastics for the cervical spine - technique

Exercises for the upper spine must be performed especially carefully, since it is very mobile and excessive zeal can only cause harm.

1. Starting position lying on your back; gently press the back of your head into the pillow and hold the tension for 3 – 5 seconds then relax; then lightly pressing your palm on your temple, straining your neck muscles, hold your head in its original position; perform in both directions for 3 – 5 seconds; During breaks, completely relax the muscles of your neck and head. Perform 2 – 3 times.

2. Starting position: sitting on a chair, arms freely lowered along the body; gently move your head back while pressing your chin to your chest. Perform 3 – 5 times.

Additional articles with useful information

Therapeutic exercise for joints

In addition to the spine, our body also has a huge number of joints. Our mood and performance depend on their correct functioning. The method of treatment and restoration of joints should be determined by the doctor in each individual case individually, but we must remember that if therapeutic exercises are not prohibited, then they must be done.

Back massage for spinal health

It is difficult to find a person who has never had back pain in his life. Perhaps only preschool children can boast of this. At school, due to sitting at a desk for a long time, children first develop back problems. These are harbingers of future serious illnesses.

Exercises in physical therapy

The main means of exercise therapy are physical exercises - muscle movements, a powerful biological stimulator of human vital functions. Exercise therapy uses the entire arsenal of means accumulated by physical education.

For therapeutic purposes, specially selected and methodically developed physical exercises are used. When prescribing them, the doctor takes into account the characteristics of the disease, the nature and degree of changes in systems and organs, the stage of the disease process, information about parallel treatment, etc.

The therapeutic effect of physical exercise is based on strictly dosed training, which in relation to sick and weakened people should be understood as a targeted process of restoration and improvement of impaired functions of the whole organism and its individual systems and organs.

A distinction is made between general training, which aims to improve the overall health and strengthening of the body, and special training, aimed at eliminating impaired functions in certain systems and organs.

Gymnastic exercises are classified: a) according to anatomical principles - for certain muscle groups (hands, feet, etc.); b) by activity - passive and active.

Passive exercises are exercises with impaired motor function, performed by the patient either independently, with the help of a healthy limb, or with the help of a methodologist or exercise therapy instructor.

Active exercises are exercises performed entirely by the patient himself. To carry out the tasks of special training, certain groups of exercises are selected. For example, to strengthen the abdominal muscles, exercises are most often used in a lying position on the back and stomach and on special gymnastic benches with foot rests.

As a result of the systematic use of physical exercises, functional adaptation of the body to gradually increasing loads and correction (leveling) of disorders that have arisen in the process of disease occur. The basis for the therapeutic effect of physical exercise and other exercise therapy is considered to be the effect on the nervous system, the function of which is impaired during the disease process. Important mechanisms of action of physical exercises are also their general tonic effect on the patient.

Physical exercises help normalize distorted or restore lost functions and affect the trophic function of the nervous system. The use of physical exercise increases the effect of other therapeutic agents (medicines, physiotherapeutic, balneological, etc.). However, during the recovery process there are usually other healing methods are gradually limited or excluded, and the place of exercise therapy methods, on the contrary, is increasing and expanding. Exercise therapy differs from all other treatment methods in that during the use of physical exercises the patient himself actively participates in the treatment and recovery process. And it is this fact that enhances the effect of physical exercise.

Exercise therapy classes have great educational value: the patient gets used to systematically doing physical exercises, this becomes his daily habit. Thus, exercise therapy classes turn into general physical education classes, becoming a household necessity, a way of life for the patient even when he has already recovered and returned to work.

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Therapeutic exercise (physical therapy) is a set of methods of treatment, prevention and medical rehabilitation, which are based on the use of methodically developed and specially selected physical exercises. When prescribing them, doctors take into account the nature of the disease, its characteristics, stage and degree of the pathological process in organs and systems.

Physiotherapy exercises at the Yusupov Hospital are prescribed by the attending physician, and the method of exercise is determined by a specialist in exercise therapy. Therapeutic exercise is used in various forms: therapeutic and hygienic gymnastics, walking, sports entertainment, outdoor games. At the Yusupov Hospital, rehabilitation specialists individually create a complex of exercise therapy for each patient. Classes are conducted individually and innovative physical therapy techniques are used.

What is exercise therapy in medicine?

The history of exercise therapy begins in ancient China, where therapeutic gymnastics techniques with a main emphasis on breathing exercises were successfully used to heal patients. The use of physical exercises for healing purposes in Russia began in the 16th and 17th centuries, often in combination with physiotherapeutic procedures, hardening and hydrotherapy. At the moment, exercise therapy is successfully combined with drug treatment, surgical interventions, physiotherapy methods, and massage. Physiotherapy and sports medicine are inextricably linked, as athletes need to quickly and effectively recover from injuries.

The therapeutic effect of physical exercise is based on loads that are strictly defined for each patient. There is general training for healing and strengthening the body and special training, which is aimed at eliminating impaired functions in certain organs and systems.

Sets of physical therapy exercises help increase joint mobility and reduce the effects of muscle strain. They allow you to improve metabolic processes in pathologically altered tissues. WITH with the help of physical therapy(photo is available on the Internet) the patient can improve health, lose weight, and restore impaired functions. The use of physical therapy prevents further progression of the disease, accelerates recovery time and increases the effectiveness of complex therapy.

Physical therapy is an independent scientific discipline. IN medicine exercise therapy is a method of treatment that uses means physical culture for prevention, treatment, restoration of impaired functions and maintenance therapy. In the process of repeated physical exercises, existing motor skills are improved, lost ones are restored and new ones are developed. physical qualities, occur positive changes functions of organs and systems. This together contributes to the restoration of health, fitness, increased physical performance and other positive changes in the state of the human body.

Physical activity in progress exercise therapy classes, which are carried out by specialists from the Yusupov Hospital, corresponds to the functional capabilities of the patient. When performing physical exercises, the functional activity of internal organs increases. This is due to the activation of neurohumoral mechanisms, the inclusion of additional metabolic regulators, the action of hormones of the endocrine glands, tissue hormones, and other biologically active substances. Under the influence of exercise therapy, the mobility and balance of the processes of excitation and inhibition increases, the activity of the visual, motor, auditory, vestibular and tactile analyzers improves.

Forms, methods, tasks and means of exercise therapy

The main forms of exercise therapy include:

• morning hygiene exercises;
• therapeutic exercises;
• dosed ascents (terrenkur);
• excursions;
• walks;
• short-range tourism.

Therapeutic exercise at home (hygienic gymnastics) is carried out in the morning. She is good remedy transition from sleep to wakefulness, to the active work of the body. Physical exercises that are used in hygienic gymnastics, should be easy. Rehabilitologists of Yusupov gymnastics do not include gymnastics complex static exercises, causing severe tension and holding your breath. Select exercises that affect various groups muscles and internal organs.

When developing a set of exercises, rehabilitation specialists take into account the previous illness, health status, physical development and the patient's workload. The duration of gymnastic exercises is no more than 10-30 minutes. The complex consists of general developmental exercises for individual muscle groups, breathing exercises, exercises for the torso, abdominal muscles, and relaxation. Patients should perform all gymnastic exercises freely, at a calm pace, with gradually increasing amplitude, first involving small muscles, and then larger muscle groups.

The main form of exercise therapy is therapeutic exercises. Each procedure consists of three sections:

• introductory;
• main;
• final.

In exercise therapy they use both general strengthening and special exercises. When drawing up a lesson plan, rehabilitation therapists follow the principle of gradual and consistent increase and decrease of physical activity, and maintain the optimal physiological load curve. When selecting and conducting exercises, alternate muscle groups who are involved in physical activity.

Exercise therapy performs several tasks. The therapeutic task is defined as the goal of restorative measures at this stage of development of the pathological condition. The objectives of treatment using physical therapy methods are determined by ideas about the cause and mechanism of development of an injury or disease. Thus, when respiratory failure develops in a patient with pneumonia in the acute period, the leading therapeutic task is to compensate for respiratory failure. Changes in bronchial asthma external respiration dictate the need to improve bronchial patency, relieve spasm and evacuate pathological contents of the bronchi.

Complex therapy may include the following tasks:

• normalization of autonomic disorders;
• restoration of impaired or lost motor skills;
• restoration of normal movement patterns after injury or reconstructive surgery.

The selection of exercise therapy tools is carried out in accordance with the treatment objectives. Special tasks are characteristic only for a certain form of pathology and a combination of morphofunctional changes. General tasks are associated with changes in reactivity, the body’s defenses, the patient’s growth and development, and the emotional sphere. They are characteristic of many diseases.

To solve special problems, rehabilitation specialists at the Yusupov Hospital select exercise therapy products taking into account the mechanisms of trophic and compensatory action. Selective massage has a selective effect on the tissue of the massaged area of ​​the body and the corresponding internal organ associated with the irritated zone of segmental innervation, and specially selected breathing exercises have a specific effect on respiratory system. The effectiveness of exercise therapy depends not only on the dosage of physical activity, but also on correct selection a variety of means, a sequence of physical exercises during a single session and during the course of treatment.

The basic rules of exercise therapy are as follows:

• repetition, regularity and duration of exposure, which are necessary to strengthen motor skills;
• gradual increase in physical activity, helping to avoid physical overstrain;
• comprehensive impact through exercises for different groups muscles;
• availability of the exercise in accordance with the individual characteristics of the patient.

To enhance the training effect of exercises in the rehabilitation clinic of the Yusupov Hospital, exercise therapy specialists use computerized and mechanical simulators from the world's leading manufacturers. To create conditions that reduce the load, Exart devices, verticalizers, suspension systems to reduce the load on the musculoskeletal system, acting similarly to a swimming pool.

Exercise therapy for the spine

The most common spinal curvatures are:

• scoliosis (to the side);
• kyphosis (backward);
• lordosis (anterior).

The most acceptable forms of exercise therapy for spinal curvature are therapeutic exercises and exercises in water. Gymnastic exercises are used in the initial position “lying”, “standing on all fours”. Train your back muscles gluteal region, belly. To correct the defect, special corrective exercises of two types are used - symmetrical and asymmetrical. To increase the mobility of the spine, exercises on all fours, mixed hangs, and exercises on an inclined plane are used.

Exercise therapy complex for protrusion lumbar region spine includes the following exercises:

• walking on all fours;
• “boat” (lying on your stomach, you need to stretch your arms and legs straight up, stay in a tense state for 1 minute and return to the starting position);
• “lazy” press – lying on your back with straight legs, tense your abs as much as possible for a few seconds and then relax.

Therapeutic exercise for the lumbar spine is performed daily, with increasing loads. The method of exercise therapy for spinal injuries is divided into four stages. During the first ten days after injury, exercise therapy helps to raise general tone, improve the functioning of the digestive and circulatory system, body endurance. At the second stage of treatment, the following tasks are solved:

• normalization of the functioning of internal organs;
• stimulation of regeneration processes;
• muscle strengthening;
• improved blood flow.

The main tasks solved at the third stage of treatment are strengthening and developing the muscles of the pelvic floor, trunk and limbs, improving spinal mobility and coordination of movements. The fourth stage is aimed at increasing the mobility of the spinal column, further developing and strengthening muscles, restoring correct walking skills and healthy posture.

Exercise therapy in traumatology

Rehabilitators choose exercise therapy techniques for injuries depending on the period of the disease. The objectives of the first period, corresponding to acute injury, are to normalize the patient’s psycho-emotional state, improve metabolism, respiratory and cardiovascular systems, excretory organs. In the second period, the following forms of exercise therapy are used: morning exercises, walking, dosed running and walking, swimming. The third period takes place in a rehabilitation center or sanatorium. The objectives of exercise therapy during this period are:

• final restoration of functions;
• adaptation of the body to everyday and industrial stress;
• formation of compensations, new motor skills.

At the Yusupov Hospital, rehabilitation specialists take an individual approach to the choice of means and exercise therapy techniques for spinal injury, after surgery knee joint, for hypertension, after a stroke and other diseases. In order to undergo a rehabilitation course using the latest techniques call the Yusupov Hospital.

References

• ICD-10 (International Classification of Diseases)
• Yusupov Hospital
• Badalyan L. O. Neuropathology. - M.: Education, 1982. - P.307-308.
• Bogolyubov, Medical rehabilitation (manual, in 3 volumes). // Moscow - Perm. - 1998.
• Popov S. N. Physical rehabilitation. 2005. - P.608.

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