The technique of using physiotherapy exercises for various deviations. Healing Fitness

Plan:

Definition of medical physical culture. Basic concepts.

Indications and contraindications for physical therapy.

Methods and means of therapeutic physical culture.

Goals and objectives of therapeutic physical culture in case of various deviations in the state of health of students.

Orientation and basic principles of physical education of students with various deviations in the state of health.

Literature.

Definition of medical physical culture. Basic concepts

Therapeutic Physical Culture(LFK) - academic discipline studying the theoretical foundations and methods of using physical culture for the treatment and prevention of various diseases. Exercise therapy is an integral part of the physical education of students with poor health. Therefore, it is not only a therapeutic, but also a pedagogical process.

Therapeutic action exercise manifests itself in the form of four main mechanisms:

tonic effect;

trophic action;

formation of compensations;

function normalization.

In physical therapy, there are: general and special training.

Goal of the general training: improvement, strengthening of the body by means of general strengthening and developing physical exercises.

The purpose of the special training: compensation for impaired functions due to illness or injury.

Indications and contraindications for exercise therapy

exercise therapy shown for all diseases: internal, nervous and surgical diseases, injuries, etc., is used at certain stages of various diseases.

Absolute contraindications to the appointment of exercise therapy

acute infectious and inflammatory diseases with high body temperature and general intoxication;

acute period of the disease and its progressive course;

malignant neoplasms before their radical treatment, malignant neoplasms with metastases;

severe oligophrenia (dementia) and mental illness with a sharply impaired intellect;

Availability foreign body near large vessels and nerve trunks;

acute disorders of the coronary and cerebral circulation;

acute thrombosis and embolism;

increase in cardiovascular insufficiency with decompensation of blood circulation and respiration;

bleeding;

the general serious condition of the patient;

significant pain syndrome;

negative dynamics of the ECG, indicating a deterioration in coronary circulation;

atrioventricular block.

Temporary contraindications for exercise therapy

exacerbation of chronic diseases;

complication during the course of the disease;

concomitant diseases of an infectious or inflammatory nature;

acute injuries;

the appearance of signs indicating the progression of the disease and the deterioration of the patient's condition;

vascular crisis (hypertonic, hypotonic or normal blood pressure);

violation of the rhythm of heart contractions: sinus tachycardia (over 100 beats / min), bradycardia (less than 50 beats / min), an attack of paroxysmal or atrial fibrillation, extrasystoles with a frequency of more than 1:10.

Introduction

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

Physiotherapy- this is one of essential elements modern complex treatment, which is understood as an individually selected complex of therapeutic methods and means: conservative, surgical, medical, physiotherapeutic, nutritional therapy, etc. Complex treatment affects not only pathologically altered tissues, organs or organ systems, but also the entire body as a whole . The proportion of various elements of complex treatment depends on the stage of recovery and the need to restore the person's ability to work. A significant role in complex treatment belongs to therapeutic physical culture as a method of functional therapy.

Physical exercises affect the reactivity of the whole organism and involve the mechanisms that participated in the pathological process in the overall reaction. In this regard, physical therapy can be called a method of pathogenetic therapy.

Exercise therapy provides for the conscious and active performance by patients of appropriate physical exercises. In the process of training, the patient acquires skills in using natural factors of nature for the purpose of hardening, physical exercises - for therapeutic and prophylactic purposes. This allows us to consider classes in therapeutic physical culture as a therapeutic and pedagogical process.

Exercise therapy uses the same principles for the use of physical exercises as physical culture for healthy person, namely: the principles of comprehensive impact, application and health orientation. According to its content, therapeutic physical culture is an integral part of the Soviet system of physical education.

Means of therapeutic physical culture

In therapeutic physical culture, the following main means are used for the prevention and treatment of diseases and injuries: physical exercises (gymnastic, sports-applied, ideomotor, that is, performed mentally, exercises in sending impulses to muscle contraction, etc.), natural factors of nature ( sun, air, water), therapeutic massage, motor mode. In addition, additional means are used: occupational therapy and mechanotherapy (see diagram).

Occupational therapy refers to the restoration of impaired functions with the help of selectively selected labor processes. Mechanotherapy is the restoration of lost functions with the help of special devices. It is mainly used to prevent contractures (stiffness in the joints). In sports practice, after damage to the musculoskeletal system, training devices can be used to increase the range of motion in the joints (according to a sparing method).

Therapeutic massage (classical, acupressure, segmental-reflex) is used for the purpose of both treatment and prevention of diseases (for example, hygienic massage performed in the morning hygienic gymnastics complex).

Means of therapeutic physical culture used in sports practice, as well as for the prevention of diseases, are referred to as means of therapeutic physical culture.

Classification and characteristics of physical exercises

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

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

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

Gymnastic exercises are classified according to several criteria.

According to the anatomical feature - exercises for the muscles of the head, neck, torso, belt of the upper extremities, muscles of the upper and lower extremities, abdominal muscles and pelvic floor.

On the basis of activity - active (performed by the student himself); passive (performed by a methodologist of medical physical culture with a strong-willed effort of the patient); active-passive (performed by the practitioner with the help of an exercise therapy methodologist).

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

According to the species characteristic and the nature of the performance - ordinal and drill, preparatory (introductory), corrective, for coordination of movements, breathing, in resistance, hangs and stops, jumps and jumps, rhythmoplastic exercises.

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

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

Corrective exercises prevent and reduce postural defects, correct deformities. They are often combined with passive correction: traction on an inclined plane, wearing an orthopedic corset, special styling using rollers, and massage. Corrective exercises have a combined effect on various muscle groups - at the same time they strengthen some and relax others. For example, with severe thoracic kyphosis (stoop), gymnastic exercises aimed at strengthening weakened and stretched back muscles and stretching and relaxing the large muscles have a corrective effect. pectoral muscles in a state of increased tone; with flat feet - special exercises to strengthen the muscles of the lower leg and foot, combined with exercises to form the correct posture.

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

Breathing exercises (static, dynamic, drainage) are leading in any form of therapeutic physical culture. They have a beneficial effect on the functions of the cardiovascular and respiratory systems, stimulate metabolism, and the activity of the digestive system. Their calming effect is used in violation of the nervous regulation of various functions of the body, for faster recovery from fatigue, etc. Static breathing exercises are performed in various initial positions at rest, i.e. without movements of the legs, arms, torso, dynamic - in combined with movements of the limbs, torso. Drainage exercises include breathing exercises specifically aimed at the outflow of exudate from the pleural cavity and the removal of sputum (with exudative pleurisy, bronchiectasis, chronic bronchitis and other respiratory diseases).

There are abdominal (diaphragmatic), chest and mixed breathing. Getting Started breathing exercises, you need to teach the patient to breathe correctly through the nose - deeply, rhythmically, evenly. Given that correct breathing the rhythm of respiratory movements (inhalation-exhalation) is developed, their frequency decreases, exhalation lengthens and intensifies.

Hangs, stops, jumps, jumps as a kind of gymnastic exercises are included in the method of therapeutic physical culture during the recovery period. They are performed with a strict dosage according to indications under the supervision of a specialist in therapeutic physical culture.

Rhythmoplastic exercises are used at the post-hospital stage of rehabilitation for the final restoration of the functions of the musculoskeletal system (for diseases of the joints, after injuries), as well as in neurological practice (for neuroses, overwork). Such exercises are performed with musical accompaniment with a given rhythm and tonality, depending on the functional state of the patient, the type of higher nervous activity.

In therapeutic physical culture, in addition to gymnastic exercises, ideomotor exercises are widely used (especially at the hospital stage of rehabilitation). Performed mentally, they not only cause weak muscle contraction, but also improve their functional state, which leads the body to a state of functional readiness. These exercises are used for paralysis and paresis, with prolonged immobilization of the limbs or trunk, that is, when the patient cannot actively perform the exercises. In sports practice, ideomotor exercises are used during the period of temporary non-attendance of training due to illness in order to maintain sports form and the level of technical skill. physical culture treatment exercise

Exercises in sending impulses consist in the fact that the patient is offered to relax or contract the muscles of the immobilized joint while mentally imagining the movement being made. These exercises are used for different types immobilization of limbs to prevent atrophy of muscle groups, improve blood circulation and metabolism in them (for example, when applying a plaster cast on the thigh and knee-joint the patient actively contracts the quadriceps muscle of the thigh, straining the patella under the cast).

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

In medical and health-improving physical culture, sports and applied exercises are used to prevent diseases, educate physical qualities, preparation for labor and defense of the Motherland.

Walking strengthens the muscles not only of the lower extremities, but of the whole body due to the rhythmic alternation of muscle tension and relaxation, which improves blood and lymph circulation, respiration, metabolism and has a general strengthening effect.

Dosed running evenly develops the muscles of the whole body, trains the cardiovascular and respiratory systems, increases metabolism, forms deep and rhythmic breathing. In therapeutic physical culture, running is prescribed to trained patients with an individual dosage under careful medical and pedagogical control. Running is not only a means of health-improving physical culture, but also a means of maintenance and preventive therapy.

Jumping refers to short-term intense exercises used during the recovery period with an individual dosage (with mandatory control of heart rate). Throwing exercises help restore coordination of movements, improve mobility in the joints, increase the strength of the muscles of the limbs and torso, the speed of the motor reaction. Classes use stuffed balls, discs, a spear, balls with a loop, grenades. Climbing the gymnastic wall and the rope helps to increase mobility in the joints, develop the strength of the muscles of the trunk and limbs, and coordinate movements. Climbing is of great practical importance in everyday life, military affairs.

Exercises in balance are used for lesions of the vestibular apparatus, for hypertension, after amputation of the lower extremities, for posture disorders, scoliosis and flat feet.

Exercises in lifting and carrying weights require strict medical and pedagogical control. They are used in health-improving physical culture for training during the period of final restoration of functions. These exercises are contraindicated in violation of posture, scoliosis, flat feet, diseases of the spine, stomach, joints, hypertension, etc.

Dosed rowing is used to develop rhythmic movements that promote deep breathing, development and strengthening of the muscles of the upper limbs, torso and increase the mobility of the spine. An increase in intra-abdominal pressure during rowing has a positive effect on the digestion process and tissue metabolism. Rowing in conditions of clean, fresh, ionized air saturated with water vapor (preferably sea air) has a healing effect on the entire body. Dosed rowing is prescribed for diseases of the joints, cardiovascular and respiratory systems and is carried out with certain short pauses for rest under medical and pedagogical supervision.

Dosed skiing strengthens all muscle groups, increases metabolism, improves the functioning of the cardiovascular and respiratory systems, trains the vestibular apparatus, improves mood, and contributes to the normalization of the condition. nervous system have a tempering effect.

Skating improves metabolism, the activity of the cardiovascular, respiratory and nervous systems, the function of the vestibular apparatus, and develops coordination of movements. It is prescribed during the recovery period and for the prevention of diseases under medical and pedagogical supervision to well-trained people who can skate.

Dosed therapeutic swimming increases heat transfer, improves metabolism, activates the function of the digestive and respiratory organs, strengthens the muscles of the whole body, the nervous system, and has a hardening effect. It is used for diseases of the spine to relax muscles and release it from axial load, for postural disorders, diseases respiratory system, as well as to relieve fatigue in the mode of the working week or sports training.

Cycling is used for general health purposes, as well as to strengthen muscles and increase mobility in the joints of the lower extremities. For the same purpose, exercises on a bicycle ergometer are used for injuries of the musculoskeletal system, paresis of the lower extremities, metabolic disorders and for training. of cardio-vascular system.

Along with the listed exercises, games are used in therapeutic physical culture. All types of games (games on the spot, sedentary, mobile, sports) contribute to the improvement of the work of all organs and systems of the body. They are carried out during the recovery period with medical and pedagogical supervision in the final part of therapeutic exercises.

Methodology therapeutic use physical exercise. Dosage

Before the appointment of therapeutic physical culture, the tasks of using physical exercises are determined, means and forms are selected to solve these problems. To do all this correctly, it is necessary to take into account the phase of the development of the disease, the reaction of the body to it, the state of all organs and systems not involved in the disease process, the patient's mental reaction to the disease and his other individual characteristics.

In all cases, it is important to observe the principle of combining the general and local effects of physical exercises, remembering that recovery largely depends on the general condition of the patient's body.

Each physical exercise used in therapeutic physical culture has a restorative, supportive or prophylactic effect on the patient. Therefore, when prescribing therapeutic physical culture, it is necessary to determine (in addition to medical indications) the direction of its use: in order to restore impaired functions, maintain them and health in general, or to prevent diseases, their complications and other deviations in health.

Based general provisions therapeutic physical culture, various private methods are built, reflecting the originality of the pathophysiological and clinical manifestations of the disease in an individual patient or a group of patients, compiled according to a nosological sign. The main principles of the application of therapeutic physical culture are the integrity of the body (the unity of mental and physical), the unity of the environment and the body (social and biological), the unity of form and function, general and local, treatment and prevention (V. N. Moshkov, 1984).

The methodology of therapeutic physical culture should be based on general pedagogical (didactic) principles. Its effectiveness is possible only with the active attitude of the patient to classes. The methodologist's explanation of the prospect of accelerating the recovery of impaired functions under the influence of physical exercises increases the patient's interest in them.

The principle of visualization in teaching movements is carried out not only through visual sensations, but also with the help of other senses. Demonstration of physical exercises confirms the explanation and helps the practitioner to perform them correctly.

The principle of accessibility depends on the assessment by a doctor or methodologist of the clinical manifestation of the disease and the level of physical fitness of the patient.

The healing effect of therapeutic physical culture is the result of the implementation of the principle of systematic training, built taking into account the gradualness and sequence of exercises. Classes begin with simple and easy exercises known to the patient. As its functionality grows, more complex exercises are assigned (with strict consideration of the body's reaction). Classes are held daily, sometimes several times a day, at a certain dosage, in combination with the prescribed daily routine.

The principle of an individual approach involves taking into account gender, age, fitness level, the general condition of the patient, the course of the underlying and concomitant diseases.

Along with didactic principles great importance has an optimal dosage of means of therapeutic physical culture - the establishment of a total dose (value) of physical activity when using both one exercise and any complex (morning exercises, therapeutic exercises, a walk, etc.) (V. N. Moshkov).

Physical activity should be adequate to the functional capabilities of the patient. An excessively small or large load will not have a sufficient therapeutic effect. The load is dosed by the choice of initial positions, the selection of exercises, the number of general developmental and breathing exercises, their duration, the number of repetitions of each exercise, the pace, the amplitude of movements, the degree of force tension, the complexity of movements, their rhythm, the emotionality of classes, their density.

In therapeutic physical culture, the choice of starting positions depends on the motor regimen prescribed by the doctor. There are three main starting positions: lying (on your back, on your stomach, on your side), sitting (in bed, on a chair, on a carpet with straight legs, sitting in bed or on a chair with your legs down), standing (on all fours - knee- carpal, on half-fours - knee-elbow, standing without support, relying on crutches, sticks, walkers, bars, crossbar, gymnastic wall, back of a chair, etc.). For example, in diseases of the cardiovascular and respiratory systems, you can perform exercises in the prone position, reclining with your head held high, sitting, standing; with diseases of the digestive system - sitting, lying on your back, standing; with injuries of the spine - lying on the back and on the stomach, standing on all fours, reclining, standing.

The selection of physical exercises and the determination of their duration is carried out taking into account the principle of gradualness (from easy to difficult, from simple to complex), as well as the characteristics of the patient's personality and the course of the disease.

The duration of physical exercises is determined by the actual time spent by the patient on their implementation. It depends on the complexity of the exercises, the number of exercises in the complex, the individual reaction of the patient's body to the load.

The number of repetitions of each exercise depends on the characteristics of the course of the disease, the number, nature and type of exercises included in this complex, the duration of their implementation. The number of repetitions of exercises for small muscle groups may be greater than for large ones.

The pace of movement may vary. Distinguish between slow, medium and fast pace. In a hospital, exercises are usually performed at a slow and medium pace, at the outpatient and sanatorium stages of rehabilitation - at a slow, medium and fast pace.

Reducing or increasing the amplitude (range) of movements also allows you to adjust the physical load.

The degree of force tension during the performance of movements depends on volitional tension, the use of weights, resistance, or a combination of them. Weighting can be carried out by the weight of one's own body, the weight of objects, the weight or resistance of a partner.

The degree of complexity of movements also affects the magnitude of the load. It is necessary to complicate the exercises gradually, as they master them, and also as the functional capabilities of the body grow.

The rhythm of movements, or the system of their alternation, has a great influence on performance. Properly selected rhythm of movements delays the onset of fatigue. The rhythm of movements helps to reduce the load on the nervous system due to the development of automatism.

The number of general developmental and breathing exercises in a lesson depends on the period and nature of the disease. As the recovery progresses, the proportion of these exercises decreases due to the introduction of special exercises. In some cases, for example, with diseases of the respiratory system, digestion or in the postoperative period, these exercises are special.

The use of the emotional factor consists in creating positive emotions in the patient during physical exercises. This increases the therapeutic effect of classes and delays the onset of fatigue.

Of great importance for dosing physical activity is the density of the lesson. It is determined by the ratio of the duration of the actual exercise to the duration of the entire lesson. In therapeutic physical culture, the load density reaches 25-30%. Basically, it depends on the duration of the breaks between individual exercises. In therapeutic and health-improving physical culture, the density of the load increases significantly.

Dosage load in physical therapy classes has a very importance, since the therapeutic effect of physical exercises largely depends on it. An overdose can cause a deterioration in the condition, and an insufficient load does not give the desired effect. Only in accordance with the patient's condition and his capabilities, physical activity can optimally change the functions of various body systems and have a therapeutic effect.

Physical activity is dosed depending on the tasks of this period of treatment, manifestations of the disease, functionality and age of the patient. It is far from always necessary to strive for great physical exertion. Health-improving and therapeutic effect in many diseases is achieved by special physical exercises with moderate physical activity. For example, improvement in peripheral circulation can be obtained by using exercises for small muscle groups and breathing exercises, which are classified as low-intensity exercises.

You can change the physical load in various methodological techniques, since it depends on many factors. The main of them is the volume of muscle groups involved in the movement, the number and nature of physical exercises: pace, amplitude of movement, degree of muscle tension.

You can increase or decrease physical activity by increasing or decreasing the number of repetitions of each exercise and changing the nature of their implementation.

Specially selected starting positions allow you to regulate the impact of physical exercises. Some of them in themselves cause physiological changes, as they require muscular efforts of a static nature. For example, in the sitting position, the heart rate increases by 5-8%, and in the standing position - by 10-20% compared to the prone position.

The alternation of muscle loads, when exercises for one muscle group are replaced by exercises for another group, and exercises with a large muscle load alternate with exercises that require little muscle effort, or with breathing exercises and relaxation exercises, prevents premature fatigue and provides an opportunity for a long time, without long rest breaks to do physical exercise.

Physical activity is also regulated by the degree of complexity of the exercises. Exercises that are difficult to coordinate can cause tension in muscles not involved in movement, thereby increasing the load.

The intensity of physical exercises can be small, moderate, large and maximum (V. K. Dobrovolsky). Low-intensity exercises include exercises involving the movement of small and medium muscle groups, performed at a slow and medium pace, static breathing exercises and muscle relaxation exercises. Starting positions should not cause large static stresses and make it difficult to perform exercises. Physiological changes during the performance of these exercises are insignificant: a slight change in heart rate, a moderate increase in the maximum and a decrease in the minimum blood pressure, slowing down and deepening of breathing.

Exercises of moderate intensity involve the movement of medium (at a medium and fast pace) and large (at a slow and medium pace) muscle groups. Dynamic breathing exercises, exercises with objects and small weights, walking at a slow and medium pace, sedentary games are used. When performing these exercises, the heart rate increases slightly, the maximum arterial and pulse pressure moderately increases, and pulmonary ventilation increases. The duration of the recovery period is several minutes.

Exercises of high intensity are characterized by the simultaneous inclusion of a large number of muscle groups in the work, the performance of movements at an average and fast pace. These include exercises on gymnastic equipment, with weights, brisk walking, running, jumping, moving and sport games, skiing, etc. All of them place significant demands on the nervous, cardiovascular and respiratory systems: they cause an increase in heart rate, an increase in maximum arterial and pulse pressure, and an increase in metabolism. The duration of the recovery period is over 10 minutes.

Exercises of maximum intensity are rarely used in therapeutic physical culture. Such exercises with maximum load include, for example, speed running. When they are performed, oxygen debt arises, so the activity of the cardiovascular and respiratory systems is significantly enhanced.

It is necessary to dose general and local physical exercise. The total load consists of the body's energy costs for the performance of muscle work in all physical exercises. The correspondence of its capabilities to the patient can be judged by outward signs fatigue and reactions of the cardiovascular and respiratory systems - the dynamics of heart rate and respiration. Local physical activity has mainly local effects. An example of such a load is exercises to restore the movement of paralyzed muscles.

Passive movements and exercises performed with help have little overall effect, so they must be dosed by the degree of local influence. In some cases, local loads, for example, exercises to strengthen the muscles of the body with compression fractures, are dosed both according to the general and local effects (according to heart rate and the degree of muscle fatigue) on the patient's body. For more accurate assessment the subjective sensations of the patient are taken into account as well as the general and local load.

Depending on the tasks in different periods of treatment, there are three main options (both general and local) for the dosage of loads: therapeutic, tonic (supportive), and training.

Therapeutic dosage is used in cases where it is necessary, first of all, to have a therapeutic effect on the affected system or organ, form compensation, and prevent complications. At the same time, the total physical load in classes is usually small and increases slightly from lesson to lesson. When the condition worsens, it decreases. Local physical activity consists of special exercises and may be small (for example, in the initial period of treatment of patients bronchial asthma or with neuritis of the facial nerve) or moderate (for example, in the treatment of fractures during the period of immobilization). Signs of general fatigue may not be observed, although fatigue of individual muscle groups is often noted. Physiological changes in the cardiovascular and respiratory systems are not very pronounced.

A tonic (maintenance) dosage is used in a satisfactory condition of the patient with prolonged immobilization, chronic diseases with an undulating course, after the end of rehabilitation treatment with the maximum possible therapeutic effect. General and local physical activity depends on the functionality of the organism as a whole, a separate affected organ or system. They should stimulate the functions of the main systems, i.e., have a tonic effect and support results achieved treatment. Physical exercise of moderate or high intensity is used. A characteristic feature of this variant of the dosage of loads is that they do not increase during the course of therapeutic physical culture. The lesson should not tire the patient, but cause a feeling of cheerfulness, a surge of strength, and an improvement in mood.

The training dosage is used during the recovery period and during the period of rehabilitation treatment, when it is necessary to normalize all the functions of the patient's body, increase his performance or achieve a high degree of compensation. Physical loads during the performance of both general developmental and special exercises are increased from lesson to lesson due to various methodological techniques and are dosed in such a way as to cause fatigue. Physiological changes in the activity of the main systems, as a rule, are significant, but depend on the disease and the patient's condition. A training effect in certain periods of the disease can also be exerted by exercises of moderate intensity with a gradually increasing dosage. To determine the amount of physical activity that has a training effect, various tests are carried out. So, in diseases of the cardiovascular system, the maximum allowable physical activity is determined using a tolerance test; the value of the axial load in diaphyseal fractures - using the pressure of the injured immobilized leg on the scales until the onset of pain (80% of the obtained value - the optimal load); training effect to increase muscle strength has a load of 50% of the maximum.

Forms of therapeutic physical culture

There are many forms of therapeutic physical culture: morning hygienic gymnastics, therapeutic exercises, independent physical exercises, therapeutic dosed walking, dosed ascents (health path), mass forms of recreational physical culture, dosed swimming, rowing, etc. (see diagram).

Morning hygienic gymnastics is the performance of a specially selected set of physical exercises that promotes the transition of the body from a state of inhibition (sleep) to an active daily regimen. At the post-hospital stage of rehabilitation, morning hygienic exercises can be performed outdoors, combining it with a short walk.

Remedial gymnastics is the main form of therapeutic physical culture aimed at restoring the function of the affected organ and the whole organism as a whole. The lesson consists of three parts: introductory, main and final. In the first, elementary gymnastic and breathing exercises are given, preparing the patient for increasing physical activity. In the second, special and general developmental exercises are used that have a positive effect on the affected organ and the entire body of the patient. The third includes elementary gymnastic and breathing exercises to relax muscle groups, which reduce the overall physical load and contribute to the restoration of physiological parameters.

Independent classes in therapeutic exercises are carried out by patients who know how to perform physical exercises correctly and are conscious of the quality of their performance. A set of exercises for them is made up by specialists in therapeutic physical culture, taking into account the individual characteristics of each patient. Self-study, which are carried out with a preventive purpose, are built on the basis of the recommendations of the specialists themselves, as well as recommendations received with the help of funds mass media(TV and radio programs, special literature, etc.).

Therapeutic dosed walking is carried out to normalize gait after injuries and diseases of the nervous system, musculoskeletal system, metabolism, to train the cardiovascular and respiratory systems, as well as to adapt the body to stress. Therapeutic walking is dosed by the speed of movement, the length of the distance, the length of the step, the terrain, the quality of the soil. Such walking is an independent form of therapeutic physical culture, in contrast to walking as a sports-applied exercise used in therapeutic exercises as a means of therapeutic physical culture.

Dosed ascent (terrenkur) - treatment by dosed walking with a gradual ascent and descent on special routes. This form of training is used for diseases of the cardiovascular, respiratory systems, metabolic disorders, traumatic lesions of the musculoskeletal system and the nervous system. Depending on the steepness of the ascent, the health path routes are divided into groups with an ascent angle of 4-10°, 11-15°, 16-20°. The most famous health path routes are in Kislovodsk, Essentuki, Sochi, Gurzuf, Yalta.

Dosed swimming, rowing, skiing, skating, etc. can be not only means of therapeutic physical culture (as a kind of sports and applied exercises), but also an independent form. They are designed for further training of the functions of the affected organs and the whole organism as a whole, increasing the efficiency of convalescents, and preventing diseases. This form of training is applied individually - taking into account indications, contraindications and appropriate dosages. Recently, it has been widely used in the rehabilitation of athletes, young and middle-aged people.

The mass forms of recreational physical culture include elements of sports games, close tourism, elements of sports, mass physical culture performances, and holidays. These forms are selected and dosed individually. They are used during the period of final recovery in order to train all organs and systems. Mass forms of therapeutic physical culture can also be used for preventive purposes, especially in health groups, resorts and sanatoriums.

Conclusion

Health is not only the absence of diseases, but also a certain level of physical fitness, preparedness, functional state of the body, which is the physiological basis of physical and mental well-being. Physical activity is one of the indispensable conditions of life, which has not only biological, but also social significance. It is considered as a natural biological need of a living organism at all stages of ontogenesis and regulated in accordance with the functional capabilities of the individual is the most important principle. healthy lifestyle human life.

Thus, even short review The possibilities of physiotherapy exercises allow us to draw conclusions about the great importance that it has in human life:

doing physical exercises, a person himself actively participates in the treatment and recovery process, which has a beneficial effect on his psycho-emotional sphere;

acting on the nervous system, the functions of damaged organs are regulated;

as a result of the systematic use of physical exercises, the body adapts better to gradually increasing loads;

the most important mechanism of exercise therapy is also its general tonic effect on a person;

physiotherapy exercises also have an educational value: a person gets used to systematically perform physical exercises, this becomes his daily habit, contributes to a healthy lifestyle.

List of used literature

1. V.A. Epifanov "Therapeutic physical culture". - Moscow, 1987. - 528 p.

Vardimiadi N.D., Mashkova L.G., "Therapeutic exercise and diet therapy for obesity." - K .: Health, 1998. - 43 p.

Vasilyeva Z.L., Lyubinskaya S.M. "Reserves of health". - L.: Medicine, 1980. - 319 p.

Demin D.F. "Medical control during physical training." - St. Petersburg: 1999.

Dubrovsky V.I. "Therapeutic physical culture: a textbook for university students." M.: VLADOS, 1998-608s.

Epifanov V. A. Therapeutic physical culture and sports medicine. Textbook M. Medicine 1999, 304 p.

Popov S. N., Ivanova N. L. "On the 75th anniversary of the DEPARTMENT OF THERAPEUTIC PHYSICAL CULTURE, MASSAGE AND REHABILITATION RGUPC / Physical Education in Prevention, Treatment and Rehabilitation" No. 3, 2003.

Preobrazhensky V. “How to survive in a tent, kiosk, bank. Gymnastics hidden from prying eyes” //FiS. - 1997.

Tolkachev B.S. "Physical culture against illness".-M .: Fizkult. I sport, 1980. - 104 p.

Encyclopedia of health. / Ed. V. I. Belova. - M.: 1993.

Tutoring

Need help learning a topic?

Our experts will advise or provide tutoring services on topics of interest to you.
Submit an application indicating the topic right now to find out about the possibility of obtaining a consultation.

41921 0

The main means of exercise therapy (Scheme 5.2) are physical exercises used for therapeutic purposes, as well as natural factors of nature, additional ones are mechanotherapy (training on simulators, block installations), massage and occupational therapy (ergotherapy). The means of exercise therapy also include massage and motor mode of the patient undergoing treatment with rehabilitation therapy.

Scheme 5.2. Means of exercise therapy

Physical exercise

Physical exercises used in exercise therapy are divided into gymnastic, sports-applied and games (diagram 5.3).

Scheme 5.3. Classification of physical exercises

Gymnastic exercises used for therapeutic purposes in medical institutions affect not only various systems of the body as a whole, but also individual muscle groups, joints, spine, allowing you to restore and develop some motor qualities - strength, speed, coordination, endurance, etc. In this regard, exercises are divided into general developmental (generalizing, general strengthening) and special:
- general developmental exercises aimed at improving and strengthening the whole body;
- the task of special exercises is a selective effect on one or another part (segment, region) of the musculoskeletal system, for example, on the foot - with flat feet, on the spine - with its deformation, on one or another joint - with restriction of movements.

The classification of physical exercises is based on several features:
is an anatomical sign. There are exercises for small (hand, foot, face), medium (neck, forearm, lower leg, thigh), large (limbs, torso) muscle groups;
- the nature of muscle contraction. Physical exercises are divided into dynamic (isotonic) and static (isometric).

Dynamic exercises - exercises in which the muscle works in isotonic mode; in this case, periods of contraction alternate with periods of relaxation, i.e. the joints of the limbs and torso are set in motion. Muscle tension during isotonic exercises can be dosed by using a lever, changing the speed of movement of a moved body segment and using additional weights, resistances, gymnastic equipment, etc. An example of a dynamic exercise can be flexion and extension of the arm in the elbow joint, abduction of the arm in the shoulder joint, tilt of the torso forward, and side, etc.

The contraction of a muscle, in which it develops tension, but does not change its length, is called isometric.

This is a static form of reduction. For example, if a patient from the starting position lying on his back lifts his straight leg up and holds it for some time, then he performs first dynamic work (lifting), and then static work, when the hip flexor muscles produce isometric tension. Muscle tension under a plaster cast in traumatic injuries of the limbs is widely used to prevent muscle hypotension.

The degree of activity. Physical exercises can be active and passive, depending on the task, the patient's condition, the nature of the disease or injury, and also to create a strictly adequate load.

Active exercises can be performed in light conditions, i.e. with the elimination of friction force, gravity, reactive muscle forces (for example, flexion at the elbow joint with support on the horizontal plane of the table or abduction of the lower limb, sliding the foot along the plane of the couch / bed, etc.). To facilitate the execution of movements, special sliding planes (horizontal and inclined), roller carts, as well as various suspensions that eliminate the friction force at the moment of active movement are proposed. To impede muscle contraction, you can use movements with a shock absorber or resistance provided by a methodologist. Resistance can be created at different stages of the movement - at the beginning, middle and end.

Passive-active exercises are those in which the patient helps the methodologist to make passive movements, and active-passive exercises are those in which the methodologist resists the movement actively performed by the patient. Exercises in passive movements are used in the form of moving individual segments of the body. They can be performed by an exercise therapy methodologist or the patient himself (with the help of healthy limbs or under the influence of gravity), passive movements are used to stimulate the restoration of movements and prevent contractures and stiffness in the joints (with paresis and paralysis, in the post-immobilization period, etc.).

Exercises using reflex movements are used when the patient cannot voluntarily contract certain muscles. With paralysis and paresis of central origin, as well as in children of the first year of life, both physiological and pathological reflexes can be used.

Stretching exercises are used in the form of various movements that cause a slight excess of their inherent passive mobility in the joints. The therapeutic effect of these exercises is used for contractures and joint mobility, deterioration of the elastic properties of the tissues of the musculoskeletal system and skin, an excessive increase in muscle tone (spastic paresis and paralysis), to restore mobility lost during diseases, etc.

Attention! When stretching hypotrophic, degenerative and denervated muscles, their overstretching easily occurs with subsequent deterioration in function (in particular, a decrease in strength) and a slowdown in the normalization of activity.

Exercises in active relaxation of various muscle groups can be applied to individual segments of the body (hand, foot), limbs as a whole, limbs and torso at the same time. They contribute to the normalization of increased tone in various manifestations of pathology (pain contractures, spastic paresis, etc.) and improve overall coordination of movements.

Corrective (corrective) exercises are called physical exercises in which the movements of the limbs and trunk or individual segments of the body are aimed at correcting various deformities (neck, chest, spine, feet, etc.). In these exercises, the most important are the starting position, which determines their strictly localized impact, the optimal combination of force tension and stretching, the formation, in all possible cases, of a slight hypercorrection of the vicious position.

Coordination exercises are widely used for violations of coordination movements as the main manifestation of CNS disease. (spastic paresis, hyperkinesis, ataxia, etc.).

Balance exercises are characterized by:
a) movements of the vestibular apparatus in different planes during movements of the head and torso;
b) changes in the area of ​​support (for example, the transition from the main stance to the stance on one leg) at the time of the exercise;
c) by moving the height of the common center of gravity in relation to the support (for example, when moving from the initial sitting position to standing on toes with arms raised).

Exercises in balance activate not only vestibular, but also tonic and statokinetic reflexes.

In terms of the overall effect of exercises in balance, they are similar in intensity to exercises with dosed power stress.

Respiratory exercises include exercises in which the components of the respiratory act are regulated arbitrarily (by verbal instructions or by command). The use of breathing exercises for therapeutic purposes can provide:
a) normalization and improvement of the breathing mechanism and mutual coordination of breathing and movements;
b) strengthening the respiratory muscles (main and auxiliary);
c) improving the mobility of the chest and diaphragm; prevention and correction of chest deformities;
d) stretching of the moorings and adhesions in the pleural cavity;
e) prevention and elimination of congestion in the lungs; removal of sputum.

Respiratory exercises also have an inhibitory, less often an activating effect on cortical processes, promote blood circulation, and reduce increased (after other physical exercises) vegetative functions.

6935 0

Aerobic programs significantly affect the cardiovascular system, and therefore health. As a result of busy aerobics, there are positive changes in the state of health.

K. Cooper developed a system of points for comparing the energy "cost", for example, walking, running and other types of aerobic physical activity, based on the mathematical relationship between oxygen consumption during various types loads of a given intensity and duration. For example, he calculated that running a mile (land mile = 1609.34 m) for 8 minutes requires an oxygen consumption equivalent to 5 points on the proposed scale.
The program of improving exercises consists of the main 4 stages.

The first stage - before starting classes, it is necessary to undergo a medical examination in order to determine a rational motor regimen that is adequate to the age-related anatomical, physiological and clinical characteristics of this contingent.

The second stage - the doctor recommends those involved to determine their optimal pulse. It is advisable to learn to count the pulse on the wrist or in the region of the heart, and not on the carotid artery (on the neck), since too much pressure on the neck can reduce the pulse by 3-4 beats per minute. To determine the optimal heart rate, it is necessary to subtract half the age from 205 (for women - 220 minus age). For example, at 50 years old, the maximum calculated heart rate for men will be: 205 - 25 = 180, for women: 220 - 50 = 170. The optimal heart rate is 80% of these numbers (for example, from 180 is 144 per minute). If you manage to keep the pulse at this level for at least 20 minutes 4 times a week, this means a good aerobic effect. The same effect can be achieved if you maintain a pulse of 130 per minute for 30 minutes or 150 for 10 minutes 4 times a week (Table 4.6).

Table 4.6. Permissible maximum heart rate depending on age and degree of preparedness (according to K. Cooper)

The third stage is the choice of the most suitable type of aerobic exercise. Among the main types of physical exercises with optimal health potential, 5 are distinguished (in descending order of importance).

Ski trips. The physiological load on the body during skiing significantly depends on the degree of skill in the technique and the speed of skiing. Rhythmic sliding, terrain and climatic conditions enable a large number of muscle groups - all this gives a "significant aerobic effect.

Swimming, which involves all the major muscles in the work, improves the functioning of the respiratory system and the cardiovascular system.

Running is used for the purpose of a more intense impact on the functions of blood circulation and respiration, on metabolism and to increase overall endurance.

Cycling - speeds less than 15 km / h have a very low aerobic "cost", speeds of 30 km / h are already competitive. The average optimal speed that provides a good training effect is about 25 km/h.

Walking should be an essential part of every activity. It should also be used in independent daily activities with moderate physical activity. The disadvantage of walking is that it takes 3 times longer to get the same aerobic effect as running.

In addition to these basic types of aerobic exercises, there are many others that are used to achieve the desired health effect (for example, roller skating, rhythmic gymnastics, etc.).

The fourth stage is the construction of classes according to the aerobics program. When doing aerobic exercises, there are 3 main phases: warm-up, aerobic phase, recovery period.

When doing aerobic exercise, you can use a points system: a man should score 35 points per week, a woman - at least 27. Trying to divide 30 points into 2 workouts per week can be more dangerous than helpful. Strenuous physical training is absolutely contraindicated for people over 40 years old if it is carried out only once a week. Exercising 3 times a week, you can ensure the growth of aerobic capacity, and with 4 sessions a day, the state of health improves significantly. The number of points earned per week shows the level of physical fitness. Tables 4.7 and 4.8 present sample programs walking and running for persons 50 years and older.

Table 4.7. Walking program (50 years and older; according to K. Cooper)

Table 4.8. Running program (50-59 years; according to K. Cooper)

The recovery period takes at least 5 minutes; during this time, you should continue to move, but at a fairly low pace in order to gradually reduce the heart rate.

When conducting medical and pedagogical observations or self-control in the process of running, it is recommended to use a test with a 12-minute running load (according to K. Cooper). Oxygen consumption is determined by the distance traveled and estimated physical fitness(Table 4.9).

Table 4.9. 12-minute walk and run test (according to K. Cooper)

It is very important to combine the principles of general health-improving and therapeutic effects of physical exercises.

In diseases of the nervous system, manifested against the background of its age-related changes, the main task of training should be to restore the disturbed cortical neurodynamics, in particular, the activation of inhibitory reactions. For this purpose, tasks for attention, asymmetric exercises, exercises in balance, relaxation (general and local), outdoor games and elements of sports games (with appropriate dosage) are widely used.

Deviations in the activity of the cardiovascular system in middle-aged and elderly people are often combined with stage 1 or II hypertension, cardiosclerosis, and atherosclerosis. The choice of physical exercises and the method of their implementation in these cases should be aimed primarily at improving peripheral blood circulation, mobilizing auxiliary blood circulation factors. All exercises of an isotonic nature (for example, exercises in balance, with a change in the position of the head and torso) should be performed at a slow or medium pace, in a standing and sitting initial position.

Age-related changes in the function of the respiratory system are most often combined with pulmonary emphysema and chronic pneumonia. Age-related restructuring of the bronchi and lungs, accompanied by impaired function of external respiration, exacerbates diseases of the respiratory system. Attention should be paid to the adaptation of the respiratory organs to muscle load, widely using such exercises of a cyclic nature, in which the phases of inhalation and exhalation are most clearly consistent with the rhythm of the breath itself. It is necessary to activate the exhalation, diaphragmatic breathing. It is recommended to widely use in the motor mode walking, walking.

Involutive changes occurring in the body are often combined with pathological disorders of fat metabolism. In such cases, it is necessary to combine systematic physical activity with diet therapy. The motor mode should be saturated with a wide variety of means of physical culture (swimming, physical exercises of an aerobic nature, outdoor and sports games, massage, etc.).

Among the most frequently combined involutive and pathological conditions include changes to the ODA. With changes in the spine (for example, osteochondrosis, spondyloarthrosis) that exceed age, special exercises are widely used to help strengthen muscular system, increased mobility, correction of posture defects. With various changes in the joints of the limbs, special attention is paid to exercises that improve mobility in them and strengthen the muscles that provide movement and stability. In difficult cases (gluteal mobility associated, for example, with arthrosis of the III degree), the necessary compensations are formed.

The recommended forms and means of physical culture (physical exercises, active motor mode, hardening of the body, etc.) are true allies of health. These funds will help maintain health, restore and strengthen it, prolong life, make it full. However The best way to maintain health is to prevent, to prevent the development of diseases. That is why prevention is so important.

Therapeutic exercise (LFK)

Physiotherapy exercises (LFK) include methods of treatment, prevention and medical rehabilitation based on the use of therapeutic exercises, consisting of specially selected and methodically developed physical exercises. When prescribing a course of physiotherapy exercises, the doctor takes into account the characteristics of the disease, the nature, degree and stage painful process occurring in systems and organs human body. The health-improving effect of therapeutic gymnastics is based on physical activity, strictly dosed in relation to patients with poor health.

Types of physiotherapy exercises (LFK)

There are two types of physiotherapy exercises: general training and special training. General training in exercise therapy is aimed at strengthening and improving the body as a whole; and special training during the course of physiotherapy exercises are prescribed by a doctor to eliminate violations in the functioning of certain organs or systems in the body. Exercises included in exercise therapy gymnastics differ in anatomical principle and degree of activity. According to the anatomical principle, the exercises of therapeutic gymnastics are divided into physical education for the muscles of the arms, legs, respiratory organs, etc. - that is, we are talking about gymnastics for specific muscle groups. According to the degree of activity, physiotherapy exercises are divided into active (exercises performed completely by the patient himself) and passive (exercises performed by a patient with impaired motor functions of the body with the help of a healthy limb, or with the help of a methodologist).

To achieve results in physiotherapy exercises, certain exercises are used to restore the functions of one or another part of the body (for example, to strengthen the abdominal muscles, physiotherapy includes a set of physical exercises in a standing, sitting and lying position). As a result of taking a course of exercise therapy, the body adapts to gradually increasing loads and corrects the disorders caused by the disease. The attending physician prescribes a course of therapeutic exercises, and a specialist in physiotherapy exercises (exercise therapy) determines the methods of training. The procedures are carried out by an instructor, in especially difficult cases - by a physiotherapist. The use of therapeutic exercises, increasing the effectiveness of complex therapy of patients, accelerates the recovery time and prevents further progression of the disease. You should not start exercise therapy classes on your own, as this can lead to a deterioration in the condition, the method of therapeutic exercises prescribed by the doctor must be strictly observed.

Physical basis of exercise therapy

Physiological basis of health training:

The system of physical exercises aimed at increasing the functional state to the required level (100% DMPK and above) is called health-improving or physical training (conditional training abroad). The primary goal of health training is to increase the level physical condition to safe values ​​that guarantee stable health. The most important goal of training for middle-aged and elderly people is the prevention of cardiovascular diseases, which are the main cause of disability and mortality in modern society. In addition, it is necessary to take into account age-related physiological changes in the body in the process of evolution. All this determines the specifics of health-improving physical culture and requires an appropriate selection of training loads, methods and means of training.

In health-improving training (as well as in sports), the following main components of the load are distinguished, which determine its effectiveness: type of load, load value, duration (volume) and intensity, frequency of classes (number of times a week), duration of rest intervals between classes.

Load type

The nature of the impact of physical training on the body depends, first of all, on the type of exercise, the structure of the motor act. In health training, there are three main types of exercises with different selective focus:

• Type 1 - aerobic cyclic exercises that contribute to the development of general endurance;
• Type 2 - cyclic exercises of mixed aerobic-anaerobic orientation, developing general and special (speed) endurance; training gymnastics medical
• Type 3 - acyclic exercises that increase strength endurance. However, only exercises aimed at developing aerobic capacity and general endurance have a health-improving and preventive effect on atherosclerosis and cardiovascular diseases. In this regard, the basis of any wellness program for middle-aged and elderly people should be cyclic exercises of an aerobic orientation.

Research by B.A. Pirogova (1985) showed that the decisive factor determining the physical performance of middle-aged people is precisely the general endurance, which is estimated by the value of the IPC.

In middle and old age, against the background of an increase in the volume of exercises for the development of general endurance and flexibility, the need for speed-strength loads decreases (with the complete exclusion of speed exercises). In addition, in people over 40 years of age, the reduction of CHD risk factors (normalization of cholesterol metabolism, blood pressure and body weight), which is possible only when performing aerobic endurance exercises. Thus, the main type of load used in recreational physical culture is aerobic cyclic exercises. The most accessible and effective of them is health jogging. In this regard, the physiological foundations of training will be considered using the example of health-improving running. In the case of using other cyclic exercises, the same principles of dosage of the training load remain. According to the degree of impact on the body in health-improving physical culture (as well as in sports), threshold, optimal, peak loads, as well as overload are distinguished. However, these concepts regarding physical culture have a slightly different physiological meaning.

Threshold load is a load that exceeds the level of habitual physical activity, the minimum value of the training load that gives the necessary healing effect: compensation for missing energy costs, increasing the body's functional capabilities and reducing risk factors. From the point of view of compensating for the missing energy costs, the threshold is such a duration of load, such a volume of running that correspond to an energy consumption of at least 2000 kcal per week. Such energy consumption is ensured when running for about 3 hours (3 times a week for 1 hour), or 30 km of running at an average speed of 10 km / h, since running in aerobic mode consumes approximately 1 kcal / kg per 1 km of track ( 0.98 in women and 1.08 kcal/kg in men). An increase in functionality is observed in novice runners with a weekly volume of slow running equal to 15 km. American and Japanese scientists have observed an increase in BMD by 14% after completing a 12-week training program, which consisted of 5-kilometer runs 3 times a week (K. Cooper, 1970). French scientists in the forced training of animals in a thread bath (3 times a week for 30 minutes) after 10 weeks found a significant increase in the density of the myocardial capillary bed and coronary blood flow. Loads twice as small in volume (15 min each) did not cause such changes in the myocardium.

A decrease in the main risk factors is also observed with a running volume of at least 15 km per week. So, when performing a standard training program (running 3 times a week for 30 minutes), there was a clear decrease in blood pressure to normal values. Normalization of lipid metabolism in all indicators (cholesterol, LIV, HDL) is observed with loads over 2 hours per week. The combination of such training with a balanced diet allows you to successfully deal with overweight. Thus, the minimum load for beginners, necessary for the prevention of cardiovascular diseases and health promotion, should be considered 15 km of running per week, or 3 sessions of 30 minutes each.

The optimal load is a load of such volume and intensity that gives the maximum healing effect for a given individual. The zone of optimal loads is limited from below by the level of threshold loads, and from above - by maximum loads. Based on long-term observations, the author found that the optimal load for trained runners is 40-6O min 3-4 times a week (on average 30-40km per week). A further increase in the number of kilometers run is not advisable, since it not only does not contribute to an additional increase in the functional capabilities of the body (MNS), but also creates a risk of injury to the musculoskeletal system, disruption of the cardiovascular system (in proportion to the increase in training loads). So, Cooper (1986), based on data from the Dallas Aerobics Center, notes an increase in injuries to the musculoskeletal system when running more than 40 km per week. There was an improvement mental state and mood, as well as a decrease in emotional tension in women with a weekly running volume of up to 40 km. A further increase in training loads was accompanied by a deterioration in mental state. With an increase in the volume of running loads in young women up to 50–60 km per week, in some cases, menstrual irregularities were noted (as a result of a significant decrease in the fat component), which can cause sexual dysfunction. Some authors call the running "barrier" 90 km per week, the excess of which can lead to a kind of "running addiction" as a result of excessive hormonal stimulation (the release of endorphins into the blood). It is also impossible not to take into account the negative impact of large training loads on immunity, discovered by many scientists (Gorshkov, M.Ya. Levin, 1984, etc.).

In this regard, everything that goes beyond the optimal training loads is not necessary from a health point of view. Optimal loads provide an increase in aerobic capacity, overall endurance and performance, i.e., the level of physical condition and health. Maximum length the training distance in health-improving running should not exceed 20 km, since from that moment on, as a result of the depletion of muscle glycogen, fats are actively included in the energy supply, which requires additional oxygen consumption and leads to the accumulation of toxic products in the blood. Running 30-40 km requires an increase in special marathon endurance associated with the use of free fatty acids (FFA), and not carbohydrates. The task of recreational physical education is to improve health through the development of general (rather than special) endurance and performance.

Marathon running problems.

Overcoming the marathon distance is an example of overload, which can lead to a long-term decrease in performance and depletion of the body's reserve capabilities. In this regard, marathon training cannot be recommended for health-improving physical education (especially since it does not lead to an increase in the “amount” of health) and cannot be considered as the logical conclusion of a health-improving run and the highest level of health. Moreover, according to some authors, excessive training loads not only do not prevent the development of age-related sclerotic changes, but also contribute to their rapid progression (A.G. Dembo, 1980, etc.). In this regard, it is advisable to at least briefly dwell on the physiological characteristics of marathon running. IN last years marathon distance is becoming more and more popular, despite the difficulties associated with overcoming it and extreme effects on the body. Ultra-long distance running is inherent in the aerobic nature of energy supply, however, the ratio of the use of carbohydrates and fats for oxidation is different depending on the length of the distance, which is associated with muscle glycogen stores. In the muscles of the lower extremities, high-class athletes contain 2% glycogen, while recreational joggers have only 1.46%. The reserves of muscle glycogen do not exceed 300-400 g, which corresponds to 1200-1600 kcal (4.1 kcal is released during the oxidation of carbohydrates). If we take into account that during aerobic running 1 kcal / kg is consumed per 1 km of the path, then for an athlete weighing 60 kg this amount of energy would be enough for 20-25 km. Thus, when running for a distance of up to 20 km, muscle glycogen stores fully ensure muscle activity, and there are no problems in replenishing energy resources, and carbohydrates account for about 80% of total energy consumption, and only 20% for fats. When running for 30 km or more, glycogen reserves are clearly not enough, and the contribution of fats to energy supply (due to FFA oxidation) increases to 50% or more. Toxic metabolic products accumulate in the blood, poisoning the body. With a running time of 4 hours or more, these processes reach a maximum and the concentration of urea in the blood (an indicator of the intensity of protein metabolism) reaches critical values ​​(Yummol/l). Nutrition at a distance does not solve the problem of lack of carbohydrates, since during the run the processes of absorption from the stomach are disturbed.

Additional difficulties also arise due to fluid loss with sweat - up to 5-6 liters, and on average - 3-4% of body weight. Marathon is especially dangerous high temperature air, which causes a sharp increase in body temperature. Evaporation from the body surface of 1 ml of sweat leads to the release of 0.5 kcal of heat. The loss of 3 liters of sweat (the average loss during a marathon race) provides a heat loss of about 1500 kcal. Thus, during the Boston Marathon, runners aged 40-50 experienced an increase in body temperature (according to telemetric registration) up to 39-41 degrees (Magov, 1977). In this regard, the danger of heat stroke increased, especially with insufficient preparedness; even cases of death from heat stroke during a marathon have been described.

Preparation for a marathon, which requires a significant increase in training loads, can also have a negative effect on the body. American authors Brown and Graham (1989) note that in order to successfully overcome a marathon, it is necessary to run at least 12 km daily or 80–100 km per week for the last 12 weeks before the start, which is much more than the running optimum (no longer a recreational, but a professional training). ). In people over 40, such a load often leads to overstrain of the myocardium, motor apparatus or central nervous system. Those who are sufficiently prepared and at all costs decided to subject themselves to this difficult test, need to go through a cycle of special marathon training. Its meaning is to painlessly and as early as possible "teach" the body to use fats (FFA) for energy supply, thus preserving glycogen stores in the liver and muscles and preventing a sharp decrease in blood glucose (hypoglycemia) and the level of performance. To do this, it is necessary to gradually increase the distance of Sunday running up to 30-38 km, while not changing the volume of loads on the remaining days. This will avoid an excessive increase in the total volume of running and overstrain of the musculoskeletal system.