Healing Fitness. Therapeutic exercise as a method of treatment The mechanism of action of exercise therapy

The therapeutic effect of exercise therapy is based on the process of dosed training. Training consolidates and improves conditioned reflex and unconditioned reflex connections, i.e. enhances regulatory and coordinating influence CNS on the functions of various organs and systems of the body. High plasticity of the central nervous system allows, as a result of systematic training through physical exercise, to develop a new dynamic stereotype, which determines the accuracy and coordination of responses of the main body systems, as well as their significant economy.

The essence of the influence of physical exercise on the functions of internal organs should be considered in the light of the theory of motor-visceral reflexes.

▲ The main mechanisms of the influence of physical exercise on the visceral sphere (including the cardiovascular system):

The stimulating effect of physical exercise, consisting of a training and a trophic effect, is carried out by the reflex mechanism as the main one. The functions of internal organs are influenced by three groups of receptors - exteroceptors, proprioceptors and interoceptors; any of them causes a vegetative response.

The leading system during physical exercise is proprioception, which causes a variety of conditioned and unconditioned visceral changes. These motor-visceral reflexes are carried out by all levels of the central nervous system. The neuroregulatory apparatus (vegetative centers), which determines the normalization of the activity of internal organs, is under the dominant influence of the motor analyzer (kinesthesia). A normal dynamic motor-visceral stereotype is characterized by dominant motor skills, which can be restored by systematic and regular physical therapy exercises, on exercise machines, walking, running, swimming, etc.

Impact of funds Exercise therapy on hemodynamics is characterized by the activation of all main and auxiliary hemodynamic factors (cardiac, extracardiac vascular origin, tissue metabolism, etc.). The process of dosed training, leading to increased adaptation and functional capacity of the cardiovascular system, and consequently to improved circulatory function, is ensured by the development of temporary connections between the cortex and internal organs, the cortex and the muscular system, the creation of a single integral functioning system, characterized by a higher level of performance [Moshkov V.N., 1982].

When assessing the therapeutic effect of exercise therapy, their ability to normalize the disturbed inhibitory-excitatory relationship of cortical processes and restore their dynamic balance should be taken into account. Skeletal muscles, being a powerful regulator of autonomic functions, actively influence hemodynamics.

The locomotor dominant selectively acts on internal organs, stimulating the functions of some and inhibiting the functions of others. In this regard, exercise therapy agents, depending on the pathological background, can act not only in different quantitative terms, but also in diametrically opposite directions. For example, an increase in blood pressure during exercise

physical exercises is the integral result of three main mechanisms: the physical exercises themselves (motility), the increase in muscle tone during them, and a shift in the lability of the central nervous system (diagram 5.1).

It can be concluded that a functional relationship between skeletal muscle and blood pressure exists, but it is a much more complex interaction than previously thought (mechanical theory of “muscle

pump").

Physical exercises act selectively on vascular tone. This selectivity of the influence of muscle activity is the result of changes in the lability of nerve centers under the systematic action of proprioception. In a state of detraining and in pathology, regulation is carried out according to the mechanism of the cardiovascular motor system, which leads to a violation of the harmony between hemodynamics and muscle tension. Systematic training rebuilds the pathological dynamic stereotype, and all activity of the circulatory system comes under the dominant influence of the motor analyzer. Regulation begins to be carried out in the direction of motor skills -> cardiovascular system. The dominant of the motor analyzer is inherent

healthy body. Proprioceptive impulses arising during physical exercise break the vicious circle, stimulate nervous trophism and restore the normal relationship between the locomotor system and the cardiovascular system.

The significant importance of physical exercise training methods in establishing a certain level of blood pressure can be confirmed by the experience of carrying out exercise therapy. According to the generally accepted method of PH for hypertension [Moshkov V.N., 1977], low-intensity exercises are used, the summation of the effect of which is manifested in a clear depressor effect (decrease in blood pressure at rest). The PH technique for primary arterial hypotension [Temkin I.B., 1977], on the contrary, involves the use of physical exercises of significant power and intensity, including speed-strength loads. As a result of their systematic and regular use, a significant increase (normalization) of blood pressure at rest is recorded. Therefore, it is natural to use specially selected and dosed physical exercises as a healing and training, preventive and therapeutic agent (reflex therapy). Systematic training with physical exercises leads to an increase in the functional state of the cardiovascular system in a healthy person and normalizes various deviations in the functions of the circulatory system in pathology and detraining.

The influence of exercise therapy on the cardiovascular system is expressed in the training of basic and auxiliary hemodynamic factors. In this case, one should take into account the increase in the contractile function of the myocardium, which occurs as a result of increased nutrition of the heart muscles during a number of physical exercises, activation of blood flow in them, the introduction of additional capillaries of the heart muscle, etc. All this leads to an increase in redox processes in the myocardium, resulting which is an increase in its propulsive function. In other words, exercise therapy activates the main factor of hemodynamics - cardiac. Strengthening the contractility of the myocardium during physical exercise is facilitated by a more complete diastolic phase, due to an increase in the mass of circulating blood during physical activity (LH procedure) due to blood that was at rest in a deposited state. Normalization of central regulation of vascular tone during exercise, massage and

other procedures lead to activation of the second hemodynamic factor - extracardiac.

When training with physical exercises, the processes of tissue metabolism are rationalized, redox processes in the muscles are activated, their predominance over the breakdown processes is noted, potential substances are more economically spent and, thus, their accumulation in the tissues. All this leads to economization of the work of the heart and the entire cardiovascular system, since the demands of the periphery to the central circulatory apparatus are reduced (V.N. Moshkov).

A significant activation of venous circulation is facilitated by a group of auxiliary extracardiac hemodynamic factors that are activated during physical activity - respiratory movements of the chest and diaphragm, changes in intra-abdominal pressure, rhythmic contractions and relaxations of skeletal muscles, etc. All this allows us to consider exercise therapy as a powerful and effective factor in the activation of hemodynamics , strengthening the adaptation of the cardiovascular system to increasing physical activity and increasing its functional ability.

One should also take into account the significant positive impact of exercise therapy on the emotional sphere of the patient and their ability to increase psychological tone. Due to the fact that with diseases of the cardiovascular system, patients experience disturbances in the psycho-emotional sphere, this circumstance becomes important. Exercise therapy means help remove a kind of psychological brake, do not allow the patient to “go into illness,” and develop confidence in his abilities and a positive outcome of the disease (I.B. Temkin).

5.1.2. Means and forms of therapeutic physical cultureFacilities Exercise therapy

Physical exercise determine the formation, strengthening and strengthening of nerve connections between CNS and afferent systems of the locomotor apparatus and internal organs.

One of the tasks of pulmonary hypertension in diseases of the circulatory system is the development in patients of correct full breathing, as well as the ability to combine muscle activity in different motor modes with breathing. Breathing disorders and inability to regulate them are typical for patients with

pathology of the circulatory system and are, apparently, signs of decreased function of the cardiovascular system and general incoordination of movements. Therefore, teaching patients how to breathe correctly, developing in them vital and important everyday skills and qualities (coordination of movements, voluntary relaxation of skeletal muscles, muscle strength, endurance to static force, posture, normalization of the dynamic stereotype, etc.) are included in the tasks of exercise therapy as a method of neuromotor re-education of the patient.

The main part of PH exercises for diseases of internal organs is exercises isotonic in nature(for classification see Chapter 2). Exercises in isometric mode are included in strictly dosed doses, and their nature and volume are different for various diseases of the circulatory system. Features of muscle activity in the isometric mode make it possible to systematize physical exercises according to three main criteria: a) anatomical, which takes into account not only the localization of muscle groups involved in performing static tension, but also the mass of muscle tissue; b) the intensity of the developed static force; c) the duration of the developed static voltage (Table 5.1). In practical work, it is necessary to constantly take into account all these signs of exercises, since they are closely related to each other (I.B. Temkin).

In the effect of exercises in the isometric mode on the central nervous system, in particular on interaceptive processes and relationships, it is first of all necessary to note their distinct stimulating effect, followed by shifts in the opposite direction in the recovery period. In some diseases of the circulatory system (for example, with primary arterial hypotension), exercises in the isometric mode create protective arousal, thus providing a directed pathogenetic effect. The change from excitation to inhibition in the aftereffect period of exercises in isometric mode, as well as the strengthening of inhibitory processes as a result of breathing exercises and exercises in voluntary muscle relaxation, which are combined with static efforts, provides a pathogenetic effect in certain diseases of the circulatory system (for example, hypertension). Exercises in the isometric mode provide broad intersystem regulatory influences and, above all, reflex interaction between the locomotor and visceral systems (M.R. Mogendovich).

Table 5.1 Application of exercises in the isometric mode of exercise therapy for diseases of the circulatory system (taking into account various signs of systematization) [Temkin I.B., 1977]

* Subliminal and ultimate.

For diseases of the circulatory system breathing exercises used: a) as special, helping to normalize blood circulation; b) as a means to reduce the amount of general and special load in the PH procedure; c) to teach patients proper rational breathing and the ability to voluntarily regulate breathing during physical activity.

The dominance of the motor analyzer, caused by physical exercise, normalizes the state of the respiratory system. Under the influence of proprioceptive impulses, the functional lability of the respiratory center changes: excessively high - decreases, and pathologically low - increases. It is also important that the activation of proprioceptive afferentation provides another important link in improving the body - increasing the coordination of the functions of two interconnected systems - blood circulation and respiration. Motor dominance not only normalizes and increases the functional ability of each individual system, but also integrally determines the correlation of their activities at a higher level.

Exercisesin any relaxation skeletal muscles are used for circulatory diseases: a) as special ones that help optimize the function of the circulatory apparatus; b) as a means of expanding the range of motor skills, abilities and qualities of the patient; c) as a means to

corresponding to a decrease in the level of general and special load and the LG procedure. A distinctive physiological feature of these exercises is a distinct inhibitory effect on the central nervous system. The work of the human motor apparatus is entirely subordinate to the central nervous system: excitation of motor centers causes muscle contraction and tonic tension, and inhibition causes muscle relaxation. In this case, the completeness of muscle relaxation is directly proportional to the depth and degree of the developed inhibitory process (M.R. Mogendovich, V.N. Moshkov).

An important condition for optimizing the functions of the body and increasing its performance is the rational alternation of muscle tension and relaxation. At the same time, volitional relaxation, as well as active muscle tension during isometric efforts, should be considered as a kind of training of the entire locomotor apparatus. The impact of the mechanism of motor-visceral reflexes naturally affects various autonomic functions, primarily breathing and blood circulation.

Physical exercises in an aquatic environment. A characteristic feature of this type of influence is the influence on the body of a complex of factors: a) the exercises themselves; b) water temperature; c) hydrostatic water pressure; d) resistance to movement, etc. In assessing the mechanism of the effect of exercise in an aquatic environment on the cardiovascular system, one should take into account not only the motor-visceral regulatory pathway, but also the additional effect of skin receptors.

Thus, when practicing LH in water, proprioceptive afferentation changes as a result of the exercises themselves (isotonic in nature), and also through the chain reflex mechanism, it becomes involved in the regulation of the circulatory organs.

Sports and applied exercises.A very important form of muscle activity in diseases of the circulatory system- natural locomotion of a cyclic nature.

Natural cyclic locomotion (walking and running) has long been used as a means of prevention and treatment. By placing less demands on the cardiovascular system, they serve as a means of expanding the motor mode of patients. Movement on descents significantly expands the arsenal of methodological techniques for dosing the load when practicing natural cyclic locomotion.

Natural locomotion of a cyclic nature is a component of three forms of exercise therapy - morning hygienic gymnastics, exercise therapy and play sessions, and in exercise therapy walking and running

can serve not only as general developmental exercises, but also as special exercises.

Rational combination of breathing and movement- a prerequisite for physical exercise and a guarantee of obtaining favorable results from its use. In this case, the intensity of cyclic work is important. In some diseases of the circulatory system, a sharp decrease in the functional state of the cardiovascular system, walking training should be preceded by preparing patients with specially selected gymnastic exercises.

A separate form of exercise therapy consists of health paths, dosed walking and short-range walking, in which walking is the main means.

Games. From a physiological point of view, games are complex forms of acyclic muscle activity, which significantly complicates the dosage of general and special load. However, this deficiency is very well compensated by the high emotionality of the games. The positive emotions that arise during the game serve to remove a kind of “psychogenic brake” that has developed as a result of illness and hypokinesia. A positive emotional background during the game contributes to the manifestation of the true functional capabilities of the cardiovascular system, which, as a rule, are much higher than what both the doctor and the patient think. Gaming activity allows you to turn on and use the fairly large reserve capabilities of the cardiovascular system of patients, which is difficult with other forms of muscle activity (as a result of fear). This shows a very important positive quality of gaming loads.

In modern exercise therapy, games are used as an auxiliary form and are one of the components of the active motor regimen of patients.

Forms Exercise therapy

All main forms are used for diseases of the cardiovascular system. Exercise therapy(see chapter 2); Special exercises are widely used in voluntary relaxation of skeletal muscles (autogenic training), massage - therapeutic, segmental reflex, acupressure.

Each of the forms Exercise therapy has its own characteristics, depending on the nature of the physical exercises that comprise it, and accordingly, it is important to varying degrees for different

diseases of the circulatory system. Naturally, the tasks facing different forms of exercise therapy are different. Basic form Exercise therapy- therapeutic exercises, which, together with other types of physical activity, constitute the patient’s regimen (inpatient, outpatient, sanatorium-resort). The combination of several forms of exercise therapy in the motor mode is very important, primarily to ensure versatility of the impact.

Physical exercises have a tonic (stimulating), trophic, compensatory and normalizing effect on the body.

Tonic (stimulating) effect of exercise

During the disease, the body is in particularly unfavorable conditions, both due to dysfunction caused by the pathological process, and due to forced hypokinesia, which worsens the patient’s condition and contributes to the progression of the disease. The tonic effect of physical exercise is expressed primarily in the stimulation of motor-visceral reflexes. Strengthening the afferent impulse of proprioceptors stimulates cellular metabolism in the neurons of the central link of the motor analyzer, as a result, the trophic influence of the central nervous system on skeletal muscles and internal organs is enhanced, i.e. for the whole body.

The advantages of physical exercises: their physiology and adequacy, versatility (wide spectrum of action), absence of negative side effects (with the correct dosage of exercise and rational training methods), the possibility of long-term use (almost without restrictions) with a transition from therapeutic to preventive and general health benefits.

Trophic effect of exercise

One of the mechanisms of physiological regulation of tissue metabolism is trophic reflexes. The trophic function is performed by various parts of the central nervous system, including the cerebral cortex and the hypothalamus. The implementation of any type of nervous activity - from a simple reflex act to complex forms of behavior - is associated with a change in the level of metabolic processes, especially if the musculoskeletal system acts as an executive effector mechanism. The information emanating from its proprioceptors has a high level of trophic influence on all organs, including cells of the nervous system.

The trophic influence of physical exercise in the phase of formation of a regenerate that replaces a defect is well known. It is based on the activation of plastic processes with increased protein delivery, which provides compensation for energy expenditure on muscle work. The therapeutic use of physical exercise not only stimulates trophic processes, but also, directing them along a functional channel, contributes to the formation of the most complete structure of the regenerate.

The trophic effect of physical exercise can manifest itself in the form of regenerative, or compensatory, hypertrophy. Regenerative hypertrophy occurs in the form of a more intense physiological reaction of tissue elements. For example, active muscle loads in patients with traumatic injuries of the lower extremities lead to increased neurotrophic effects on a certain group of muscles, activation of the RNA-protein system, increased protein synthesis and decreased breakdown (especially myofibrillar proteins), increased power of enzymatic systems of anaerobic and especially aerobic synthesis of macroergs due to increased utilization of lipids and carbohydrates. An increase in functional load (along the axis of the tubular bone) enhances the hydrodynamic effect of elastic bone deformations on microcirculation and tissue trophism and leads to the predominance of bone formation processes over resorption processes.

In case of diseases and damage to the central and peripheral nervous system, muscle dysfunction (paresis, paralysis) can cause the development of stiffness in the joints and contractures. With a long absence of active movements in the joints, secondary changes develop in them, which in turn reduce the range of movements. In the process of performing special physical exercises, blood and lymph circulation in the periarticular tissues improves, mobility increases, which in turn leads to a more complete functional restoration of the entire limb. Using viscero-visceral and motor-visceral relationships in this way, it is possible to select physical exercises taking into account the localization of their trophic action, in a specific area or organ.

Formation of compensation

Compensation is a temporary or permanent replacement of impaired functions. Compensatory processes go through two stages: immediate and long-term compensation. So, for example, with a traumatic injury to the right hand, the patient immediately begins to act in various everyday situations with his left hand - this is an urgent compensation, it is necessary in extreme situations, but is obviously inferior. Subsequently, as a result of physical training and the formation of a system of new structurally fixed connections in the brain, skills are developed that provide long-term compensation - relatively free performance of everyday manipulations with the left hand, which are usually performed with the right.

As a result of studying compensatory processes in violation of motor functions and functions of internal organs, P. K. Anokhin formulated several general principles characterizing the process of formation of functional systems that compensate for the defect. These principles can be applied to compensatory processes when various organs are damaged. For example, damage to the lower limb causes problems with balance and walking. This entails a change in signaling from vestibular apparatus receptors, muscle proprioceptors, skin receptors of the limbs and torso, as well as visual receptors (the principle of defect signaling). As a result of the processing of this information in the central nervous system, the function of certain motor centers and muscle groups changes in such a way as to restore balance to one degree or another and maintain the ability to move, albeit in an altered form. As the degree of damage increases, signaling of a defect may increase, then new areas of the central nervous system and their corresponding muscle groups are involved in compensatory processes (the principle of progressive mobilization of spare compensatory mechanisms). Subsequently, as the damage itself is effectively compensated or eliminated, the composition of the afferent impulse flow entering the higher parts of the nervous system changes. Accordingly, certain departments of the functional system that were previously involved in compensatory activity are switched off, or new components are switched on (the principle of reverse afferentation of the stages of restoration of impaired functions). The preservation of a fairly stable anatomical defect after regular physical exercise will make itself felt by a certain combination of afferentations entering the higher parts of the nervous system, which on this basis will ensure the formation of stable compensation of temporary connections and optimal compensation, i.e. minimal lameness for a given injury (principle of authorized afferentation).

Long-term training of compensatory mechanisms (walking on crutches, with a cane, independently) can provide sufficient compensation for impaired or lost functions, however, at a certain stage, further improvement of complex reflex mechanisms no longer leads to a significant change, i.e. stabilization of compensation occurs (the principle of relative stability of compensatory devices). During this period, a dynamically stable equilibrium is established in the patient’s body with a certain structural and functional defect in the external environment.

The role of the cerebral cortex in compensatory processes when the underlying parts of the nervous system are damaged is that the cortical parts of the analyzers are sensitive to any change in the relationship of the body with the environment. This explains the crucial role of the cortex in compensating for movement disorders after injuries and reconstructive operations. For example, after an operation to split the forearm (creation of the Krukenberg hand), there are only anatomical prerequisites for compensating for the missing hand. In order for the newly formed branches of the hand to more or less take on the function of the missing hand, profound changes in the functions of the shoulder and forearm are necessary, associated with the restructuring of the corresponding nerve centers. Without training based on a verbal explanation of the training of certain muscle groups, showing the pattern of the movement itself and consolidating it during the training process, such a restructuring is impossible even for several years. To develop compensation in this case, active activity of cortical mechanisms, in particular the mechanisms of the second signaling system, and physical training of certain muscle groups of the shoulder and forearm are necessary.

Therapeutic effects of exercise explained by the important social and biological role of movements in human life.

F. Engels proved that the main factor that created man was labor. Without muscular work, a person can neither cognize nature nor influence it. Muscle movements are necessary for normal human functioning.

During illness, various structural and functional disorders occur in the body. At the same time, protective processes are enhanced, compensations develop, and metabolism changes. For many diseases, treatment requires a sharp restriction of physical activity. But forced long-term physical inactivity can worsen the course of the disease and cause a number of complications. Healing Fitness, on the one hand, has a direct therapeutic effect (stimulating protective mechanisms, accelerating and improving the development of compensation, improving metabolism and regenerative processes, restoring impaired functions), on the other hand, it reduces the adverse consequences of reduced motor activity.

The therapeutic effect of physical exercise is manifested in complex mental, physiological and biochemical processes, which occur in the body during exercise Exercise therapy. Therefore, the modern understanding of the mechanisms of the therapeutic effect of physical exercise is based on achievements in these sciences.

Physiological processes are especially well studied. This is a great merit of the domestic physiological school of I. M. Sechenov, I. P. Pavlov, N. E. Vvedensky. Works of Soviet scientists Yu. I. Danko, V. K. Dobrovolsky, S. M. Ivanov, A. A. Leporsky, M. R. Mogendovich, V. N. Moshkov, I. M. Sarkizov-Serazini, I. B Temkina et al. made a huge contribution to the clinical and physiological substantiation of the therapeutic effect of physical exercise.

The human body must constantly adapt to changing conditions of the internal and external environment. This adaptation is achieved by changing the functions of cells of various organs and systems interconnected with each other. Processes occurring in any organ or system cause changes in the activity of other organs or systems. The connection of all functions and processes is carried out by regulatory systems: nervous and humoral.

Nervous regulation The body's activities are carried out through reflexes. The influences of the external world are perceived by exteroreceptors (visual, auditory, tactile, gustatory, etc.), the resulting excitations in the form of impulses reach the cerebral hemispheres and are perceived in the form of various sensations. The central nervous system, in turn, forms a response.

Muscle movements are carried out under the influence of impulses arriving to the muscles from the central nervous system. At the same time, any muscle contraction leads to the appearance of a stream of impulses coming from the muscles to the nerve centers, which bring information about the intensity of the contractile process. Thus, there is close interaction between regulators and regulated processes.

The same reflex interaction exists between the internal organs and the central nervous system. Impulses from the receptors of internal organs (interoreceptors) also enter the nerve centers, signaling the intensity of the functions and condition of the organ. The nerve centers that regulate the work of this organ, in turn, send strengthening or weakening impulses to it, changing its activity. In this way, self-regulation of internal organs and metabolism is carried out (without the participation of our consciousness). But in addition to the self-regulation of individual organs and systems, there is a more complex intersystem regulation of physiological functions. For example, there is a close connection between muscle activity and the functions of all organs and systems. This relationship is explained theory of motor-visceral reflexes, developed by M. R. Mogendovich (1947). Proprioceptive impulses from the receptors of muscles, ligaments, tendons enter the central nervous system (cerebral cortex, subcortical centers, reticular formation of the brain stem) and, through reflexes through the centers of the autonomic nervous system, regulate the activity of internal organs and metabolism. Under conditions of normal functioning of the body, proprioception prevails over other types of afferent stimuli, significantly influencing other physiological processes.

Closely related to the nervous one is another regulatory mechanism - humoral. It lies in the fact that chemical compounds formed in the body (hormones, metabolites), as well as ions of hydrogen, potassium, calcium, etc., enter the blood and spread throughout the body, changing the functions of organs and systems. These chemicals also affect chemoreceptors and nerve cells, changing their condition. On the other hand, the formation of hormones is to a certain extent subject to the influence of the nervous system. Thus, both regulatory mechanisms are interconnected and complement each other.

In motor-visceral reflexes, the nervous mechanism is also closely intertwined with the humoral one. When performing muscular work, hormones (adrenaline, etc.) are released into the blood, which have a stimulating effect on the work of the heart, and the metabolites formed in the muscles dilate the arterioles that supply blood to these muscles. Chemically active substances also affect the nervous system (Fig. 3).

Rice. 3. Scheme of motor-visceral reflexes.

In diseases, reflex regulation is disrupted. Pathological dominants and pathological reflexes arise that distort normal processes in the body, and compensatory changes in the regulation and functioning of a number of organs and systems are also formed.

In the light of the presented data on the physiological mechanisms of regulation of functions in the body, it becomes clear therapeutic effect of exercise. The modern idea of ​​it was developed by prof. V.K. Dobrovolsky (1947, 1952). It manifests itself in the form of four main mechanisms: tonic effect, trophic effect, formation of compensation and normalization of functions.

Mechanisms of the tonic effect of physical exercise

The tonic effect of physical exercise is to change the intensity of biological processes in the body (general tone) under the influence of dosed muscle load. In diseases, the general tone changes. At the beginning, an increase in excitatory processes in the central nervous system is often observed, protective reactions are activated and pathological reactions appear, body temperature rises, and the activity of many internal organs intensifies.

Mechanisms of trophic action of physical exercises

The trophic effect of physical exercise is manifested in the fact that, under the influence of muscle activity, metabolic processes and regeneration processes in the body improve. In diseases, metabolism and the normal structure of tissues and organs are disrupted. Treatment is aimed at restoring damaged structures by improving and normalizing metabolism. Physical exercise is a powerful stimulator of metabolism.

Mechanisms for forming compensation

The therapeutic effect of physical exercise is manifested in the formation of compensations. Compensation is a temporary or permanent replacement of impaired functions. In diseases, dysfunctions are compensated by changing or enhancing the function of the damaged organ or other organ systems, replacing or leveling the impaired function. The formation of compensation is a biological pattern. If the function of a vital organ is impaired, compensatory mechanisms are activated immediately.

Function normalization mechanisms

Normalization of functions consists in restoring the functions of both an individual damaged organ and the entire organism under the influence of physical exercise. For a complete recovery, it is not enough to restore the structure of the damaged organ; it is also necessary to normalize its functions and, first of all, restore the correct regulation of all processes in the body.

Indications and contraindications for the use of therapeutic physical culture

Healing Fitness gives a positive effect and is indicated, in fact, for all diseases: internal, nervous and surgical diseases, injuries, etc. Therapeutic physical culture is used at certain stages of the disease.

Physical exercise is most often contraindicated only temporarily. Cannot be used Exercise therapy in cases where it is undesirable to activate physiological processes in the body, in the acute period of the disease, in general severe condition, high temperature, severe pain, danger of massive bleeding, as well as in the conservative treatment of malignant tumors.

It should be noted that as treatment methods improve contraindications The use of therapeutic physical culture is being narrowed down; it is beginning to be used even in intensive care units, in cases of extremely serious condition of patients.

Therapeutic exercise (physical therapy) is a therapeutic and preventive method that helps the body recover and prevent the development of many diseases. Exercise therapy is used in conjunction with other therapy methods to obtain the maximum possible positive results.

All physical activity is selected individually depending on the disease and general condition of the patient. It allows you to restore not only the functionality of organs and systems, but also your mental and emotional state.

Movement is life. Movement is a biological stimulant and stimulus that promotes growth, development and recovery. The exercise therapy complex involves the patient’s active actions during therapy, unlike other methods.

Physical exercise affects reactivity to various factors, changing the general and local reaction. Studies have shown that hypokinesia (lack of physical activity) reduces the body's resistance and is a risk factor for the development of many diseases. Therefore, forced hypokinesia, which develops due to a pathological condition, creates unfavorable conditions for the patient.

Of course, rest during illness is necessary, but if it is prolonged, then the decline in all body functions becomes persistent, which aggravates the general condition, slows down the healing process and contributes to the development of complications. Therefore, physical therapy exercises are vital.

Effect of exercise therapy

Physical therapy exercise therapy:

If you carefully choose the type of exercise, you can cause a localized effect that changes the condition only where it is really needed.

Mechanisms of therapeutic action

Physical exercise has a multifaceted effect on our body:

Contraindications

Treatment with physical exercises has a number of contraindications, like other methods of therapy:

• severe general condition;
• intense pain;
• risk of bleeding;
• heat;
• a sharp increase in pressure;
• tumors, etc.

If it is possible to prescribe physical therapy classes at an early stage, then maximum results can be achieved.

Before using physical therapy, it is important to correctly diagnose the disease. You can read about the symptoms and treatment of spinal cord diseases. All about the manifestations of spinal hernia -.

Exercise therapy products

Exercise therapy is a set of physical exercises.
Classification of physical activity:

• ideomotor;
• gymnastics

Ideomotor exercises are a type of activity that is performed mentally. They are indicated for paresis and paralysis.

Gymnastics develop strength, endurance, balance, restore coordination, mobility in joints, etc.

Types of gymnastic exercises:

• static and dynamic;
• active and passive;
• stretching and relaxation;
• for arms and legs, neck, back, abs, etc.;
• By nature they distinguish between respiratory, preparatory, corrective, balance, etc.

Static exercises are aimed at tensing muscles and involve holding dumbbells motionless, holding your weight on machines, on the floor, etc. They develop strength, endurance, strengthen muscles and prevent the development of muscle tissue atrophy.

Stretching exercises relieve fatigue due to muscle strain and increased tone. Relaxation exercises also work.

Passive exercises are exercises that are performed by an instructor without the patient experiencing muscle tension. These classes are indicated for paresis and paralysis. They are aimed at restoring motor activity and are combined with ideomotor exercises.

Breathing exercises have a beneficial effect on all tissues, organs and systems, normalize the breathing process, help strengthen the respiratory muscles, and prevent the development of congestion.

Corrective exercises affect the spine. Their job is to correct your posture.

Swimming, walking, running, skiing, skating or cycling, sports games, etc. - all these are types and methods of exercise therapy.

Self-study is the most common form, in which a set of exercises is taught to you by an instructor or physical therapy doctor. They must be performed regularly every day at the same time up to 3 times a day.

Therapeutic walking involves a dosed load on the bronchopulmonary, cardiovascular and musculoskeletal systems. The speed of movement, distance, duration of the procedure and the number of stops are regulated.

A health path is a type of therapeutic walking that involves climbing into a mountainous area. The load depends on the terrain, the type of climb, its duration and the duration of the route.

Sports games are group exercises, which are always carried out under the supervision of a coach or instructor, and are widespread in rehabilitation centers.

Morning hygienic gymnastics is a set of exercises in the morning aimed at strengthening the heart, blood vessels and respiratory system, normalizing metabolism and toning the body. The duration of the lesson is no more than 20 minutes.

Therapeutic gymnastics is a set of exercises that have a general strengthening effect on the body. They must solve specific problems in accordance with the severity of the disease. The duration of classes varies from 10 minutes to 45.

Methods of therapeutic exercises:

• individual sessions. They are indicated for patients in the postoperative period with limited motor activity;
• group. The group consists of patients with identical disease;
• consultative and independent. Performing special exercises that you are taught at home.

All classes are divided into specific parts:

• introductory In essence, this is a warm-up that prepares your muscles, organs and systems for further exercise. It also tones your body;
• main This is the main stage of the lesson, occupying 80% of the total time. It is aimed at restoring lost functions, improving general condition and forming compensatory reactions;
• final. An important period that allows you to quickly recover from stress and relax.

Therapeutic exercise is used for therapeutic and prophylactic purposes for faster and more complete restoration of health, ability to work and prevention of complications of the disease.

Therapeutic physical culture is usually used in combination with other means of treatment in accordance with the objectives of rehabilitation therapy.

The treatment method of exercise therapy (therapeutic physical culture) is based on the use of the biological function of a living organism - the function of movement, which for humans has not only biological, but also social significance.

Physical culture occupies an important place not only in medicine (in particular, for diseases of the nervous system), but also in the everyday life of modern people, since it increases physical activity (intensifies body functions) of people living in civilization, counteracts hypokinesia and has an effect on the body has a therapeutic, restorative and preventive effect.

In therapeutic physical culture, the main factor is not movement in general, but physical exercise as an organized form of movement (gymnastics, applied sports, games, labor). They are considered as nonspecific irritants used for therapeutic and restorative purposes. Movement will only fulfill its therapeutic and preventive role when it is used in an organized form (physical exercise), in accordance with medical indications and the objectives of rehabilitation therapy, is applied according to a reasonable method, and is dosed taking into account the state of people’s health, the characteristics of damage to the nervous system and disorder its functions.

The use of predominantly active physical exercise distinguishes therapeutic physical culture from other treatment methods. Thus, consciously performing physical exercises involves patients in active participation in the treatment process. The unity of mental and somatic functions is a characteristic feature of this method.

Therapeutic physical culture or Exercise therapy as a treatment method, pursues not only medicinal purposes, it develops reaction speed, coordination, agility, strength, endurance, etc. In this regard, it is considered not only a therapeutic, but also a therapeutic and educational process.

Recognizing the important role of rest in the treatment of patients with diseases and injuries of the nervous system, it should be noted that rest and movement are not opposed to each other within the framework of therapeutic physical culture. Rest (strict bed rest) and movement (physical exercise, work) in the regimen and treatment of patients never exclude, but always complement each other.

Exercise therapy treatment method(therapeutic physical culture) is biologically suitable for a person, mobilizes his activity, and physical exercises have a wide range of effects. This explains the success of using the method for various diseases and injuries and, in particular, for diseases and injuries of the nervous system.

Therapeutic physical culture is a method of general nonspecific therapy, and physical exercise serves as a nonspecific stimulus. Neurohumoral regulation of functions always determines the general reaction of the body during physical exercise, in connection with which therapeutic physical culture should be considered a method of general active therapy. In addition to its health-improving and general strengthening effects, physical exercise can have a special (correct) effect on various functions of the nervous system that are impaired by disease or injury. Also, physical therapy - functional therapy. Physical exercises, stimulating the functions of all major systems of the body, lead to functional adaptation of the patient. It is necessary to remember the unity of the functional and morphological and not to limit the therapeutic role of therapeutic physical culture to the framework of functional influences.

In therapeutic physical culture or exercise therapy, the principle of dosed physical exercise training is used as a method of treatment. Systematic and dosed training is considered as a means of general improvement of the body, improving the functions of organs impaired by the disease process, developing and consolidating motor skills and volitional qualities. From a general biological point of view, fitness is an important factor in functional fitness, in which systematic muscular activity plays a very important role.

Dosed training with physical exercises adapts the body to increasing activity and improves the restoration of trophic processes, affected movement functions and other disorders, ultimately leading to functional adaptation of a person.

Special training is designed to develop functions impaired due to illness or injury. For diseases of the nervous system, physical exercises are used that are directly aimed at restoring movement.

Dosed physical training brings the most complete success if the following general principles are observed:

1. systematic impact of physical exercises with a specific selection of exercises and the sequence of their application (choice of starting positions, alternation and type of exercises, methods of their application, dosage, etc.);
2. regularity of exposure (from one to several times a day), especially in case of injuries and diseases with impaired movement function;
3. duration of the treatment course of physical exercises; for most patients with diseases of the nervous system, this means regular exercises throughout their lives;
4. increasing the dosage of physical exercise, both during a separate procedure and a course of treatment; gradual increase in physical activity;
5. individualization of physical exercises depending on the characteristics of the disease, age, gender and condition of the patient.

Prices for exercise therapy for teenagers and adults are presented in the “Prices” section.