Exercising in the rehabilitation system during hypodynamia

Physical inactivity (hypokinesia) - long-term limitation of motor activity, especially with no load on the lower extremities (walking, running, etc.) occurs in patients who are long on bed rest for a long time do not train athletes (due to illness, injury), the astronauts during the flight, persons with disabilities (amputation of the lower limbs, cerebral palsy, paralysis, the blind, etc.).

Under the influence of inactivity in the body undergoes substantial changes in the central nervous system, blood and lymph circulation, muscular system, metabolic processes, etc. All this leads to detrenirovannosti and changes in functional systems, homeostasis.

Stiffness (restricted movement) results in a decrease in the flow of proprioceptive influences on the autonomic functions of many organs and systems. Decreased venous pressure, tone and strength of muscles, the metabolism, which significantly modifies the course of reparative processes. Violated the basic parameters of muscle activity: contractility, the ability to maintain long-term activity, limited range of motion in joints, etc. Physical inactivity slows down the process of reparative tissue regeneration, leads to a decrease in tissue oxygen saturation, venous pressure, changes in heart muscle (according to ECG) and muscle atrophy lower limbs in the postoperative period and at a number of other diseases in patients who are hospitalized. Studies have shown that virtually no such organ or system, whose functions would not change under hypodynamic conditions.

In the maintenance of homeostasis and functional state of the important role played by the muscular system. Skeletal muscles does not only locomotor (musculoskeletal) function, but has a significant impact on the muscular blood flow, metabolic processes in tissues. Muscular system, directly or indirectly affects the blood and lymph circulation, metabolism, respiration, endocrine balance, immunity, etc. Therefore, the restriction or no movement can cause disturbances of the physiological effects of the organism with the environment and lead to a temporary functional disturbance or deep pathological changes.

In athletes who are hospitalized after surgery on tissue Oda, also there is a change from the cardiovascular, respiratory and muscular systems, change of biochemical parameters, decreased venous pressure, disturbed microcirculation, etc.

  Task of rehabilitation: the normalization of functional status, metabolism, tissue and recovery, restoration to adapt to domestic and industrial conditions.

We can distinguish two periods: the early period of rehabilitation and reintegration of the late period.

In patients who are hospitalized, even at the tenth and especially on the fifteenth day showed a significant reduction in strength and muscle tone of the lower extremities, venous pressure, respiratory muscles, lowering blood pressure, arterial oxygen saturation, and immunity (VI Dubrovsky, 1971 , 1973, 1992).

Effect of physical exercise and workout is great, if training is conducted in the initial standing position (involved the support function of the lower limbs), that is, when connected musculoskeletal system with the loads on the reflex zones of the foot (running on a rubber track with various irregularities, the effect on foot vibratodami needle, the use of needle applicators - walking on them, the use of acupuncture to stop ABC).

The basic principle of rehabilitation in the first period is the gradual application of load (at first sit up in bed, then sitting on a chair near the bed and doing the exercises), and then walking on the ward, then exit to the street with a gradual increase in load in walking.  MH at this stage consists of a General developing exercises, isometric exercises in the lower limb muscles and the training of their support function. For example, standing and holding on to a chair, walking on the spot to perform squats and other exercises combined with breathing exercises with small loads (to monitor heart rate). Once the patient begins to walk, all exercises should only be performed while sitting (the first 3-5 days) and standing. In an integrated system of rehabilitation of the first period include gymnastics, segmental massage, a common vibrating massage, vacuum massage, exercises with rubber shock absorbers (Figure 160), followed by stretching of connective tissue formations, exercises in the isometric dosage walking, climbing stairs for 3-5 floor, running water, training on simulators, a treadmill (walking and running), bicycle, play, occupational therapy, oxygen cocktails, fortification (especially vitamins C and B group). Approximate range of LH is shown in Fig. 161.

Loads must comply with functional status, sex and age of the patient. Control is carried out by Pulse, testing, and biochemical parameters, ECG, myography, etc.

Fig. 160. Approximate complex K with a rubber shock absorber

Not conducted MH in the water as it does training effect and to a greater degree of muscle relaxation occurs, and also because it weakened the patient's body susceptible to colds. For the same reason - asthenia patients - should not be given medical baths, especially hyperthermia with various additives, as they lead to a sharp drop in blood pressure. At lowering blood pressure is not shown, and a sauna (bath).

In the second period of rehabilitation includes exercises with weights, jogging, swimming, biking, skiing, training on simulators, douches, sauna (bath), diet therapy, herbal medicine, fortification, occupational therapy. Approximate range of dumbbell exercises shown in Fig. 162.

Rice, 161. Approximate complex LH in the first period of readjustment

The second stage connects gidrokinezoterapiyu (water temperature 28-30 ° C) with walking on the ground, running with special cuffs on ankles and inflatable vests, but not touching the bottom of the legs (this is particularly important after surgeries on tissues ODA), games, swimming with spatulas on hand and with the circles on the legs (for resistance), exercise with special weights.

Duration of sessions 10-35 mins 2-3 times a day.

Approximate a set of exercises:

1. In conclusion, made 2-3 breathing exercises.

2. Diving board on his feet, inflatable ring (for resistance load).

3. Swimming with a spatula on the ankles, inflatable balloons.

4. Free-swimming 3-5 minutes.

5. Running on the spot in fins for 1-2 minutes. Then - breathing exercises.

6. Walking, jogging in place and along a side, not touching the bottom of your feet. Several series, whose number increases every 3 days.

7. IP - Lying on his back, flippers on their feet. Holding on to the side of the pool, bend and straighten your knees and joints tazobdrennyh.

Fig. 162.  An example set of exercises with dumbbells during the second period of readjustment

8. IP - The same. Movement of legs style "breaststroke".

9. IP - The same. Flexion and extension of his feet, trying to toes (flippers), touch side of the pool.

10. IP - Standing water at shoulder level, at the hands of a spatula. Imitation Boxing (shadow boxing). Then run 2.3 breathing exercises.

11. IP - Standing in water up to their shoulders, arms in hand. Perform movements legs (walking on the spot with high knee lift), your hands, "press" on the water and quickly make direct hand in the water. Then - the free-swimming and breathing exercises.

12. IP - Standing (no feet touching the bottom of the pool), hand in hand. Brisk walking on the ground, his hands "rely" on the water. Then - the free float.

The third period (spa treatment) includes sun and air baths, outdoor games and in the sea, swimming, jogging, walking, combined with running cross country, fortification, diet, oxygen cocktail, vibrating massage, sauna (bath), morning hygienic gymnastics on the beach (river or in the park, the park) and then taking a contrast shower.