Therapeutic Exercises
Therapeutic exercises (TE) – independent medical discipline ,which
is used the means of physical culture with curative , prophylactic and
sanitary purposes .
The main tasks of TE are :
1. To save and support the sick organism in the best functional
condition .
2. To prevent the complications, which can cause disease and that may
be in the results of forced rest .
3. To stimulate the potential protective forces of an organism in fight
against diseases .
4.To join Залучити sick man to active participation in the process of
recovering .
5. To accelerate removing of local anatomic and functional signs of
disease .
6. To restore in short period the functional full value of man .
7. To bring up positive attitude patients to the hardening of own
organism by ordinary natural factors .
TE is different in comparison of other
methods of treatment
• Generally accessible and free of page;
• Natural – in its base are physical
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exercises;
Rise reactivity of an organism;
Have potential action according to
medicines;
Haven’t any allergic reactions;
Haven’t traumatic influence;
Have universal influence (generally
strengthen and selective );
It’s easy in dosage and studying of
the loading reaction;
give possibility during long term or
constantly use it for treatment and
prophylactic of recurrences;
Have little number of
contraindications, but when they take
place ‘they are contemporary;
Contraindications to TE
Constant:
hard non-reversed progressive general organic diseases( when activation as
general as local physiological processes is not permissible ), where the main
task of treatment is the facilitation of patient suffers , when the hope on
the health is absent (malignant tumors , blood and mental diseases ,
cardiac and respiratory insufficiency progressing).
Temporary:
- acute period of disease ;
- severe condition of patient ;
- acute inflammatory process , with high body’s temperature, increasing of
ERS, leucocytes (TE may be used at sub febrile temperature; in such cases
ERS must show the tendency to normal figures );
- acute period of non inflammatory diseases and processes (hypertonic
crises , insult );
- progressing of disease (depends of the dynamic);
- painful syndrome( not depends of pain locus;
- bleeding or its menace , hemoptysis ;
- presents of foreign bodies near main line vessels and nervous trunks .
Means of the TE
• The means of TE are :
- physical exercises ;
- modes of moving activity
;
- initial poses ;
- factors of hardening ;
- massage and methods of
self-massage .
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Physical exercises- – specially organized
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movements for reaching of curative and
sanitary effect . They are :
Gymnastic;
Sports-applied;
Gamesі;
Working.
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Gimnestic exercises influence on the
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different system of an organism and on the
separate muscles groups , bring up such
elements of moving as amplitude , force ,
speed . They are divided by anatomical
signs for muscles:
Mimic;
Neck;
Upper extremities;
Upper extremities and shoulders;
Back;
Abdomen press;
Pelvis;
Lower extremities .
According to loading :
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With out loading : for action on the separate parts
of body , joints , muscles ; for training of nervous ,
cardio-vascular , respiratory systems , for increasing
of metabolism , mobility of back bone , acceleration
of regeneration;
With loading : for intensification of the exercises
action on an organism and for the increasing of the
emotional tone of classes . They are divided on :
а)exercises with apparatus (gymnastic sticks , dumbbells , espanders , maces );
b) exercises on gymnastic apparatuses and special
devices (exercises on the gimnastic wall , bench ,
mechanical-therapeutic apparatuses);
contraction :
According to character of muscles
Dynamic(isotonic): there is changing of muscles
contraction and relaxation, together with moving in
joints;
Static(isometric): muscles tension is with out
moving in joints . Such exercises are conducted
when the extremities are immobilised. At isometric
exercises rest of hurted bones don’t ifringement ,
but support the tone of nervous and muscles
systems of extremity, provide the normal blood
circulation in muscles and periosteum.
Simples;
Complex.
According to complexity:
For activity:
active: are executed by patients with the help of will effort. They may be
conducted in more easy conditions . For this are used special sliding planes,
decreasing the friction force in the moment of active moving, or create the
dosage resistance in the moment of conducting of active moving; this
resistance may be on the start,middle or end of moving. Active exercises
imfluence on the nervous system, increasing general patient’s activity ; patient
have real possibility to control of his senses at moving ; take place the
dislocation of tendons, and that prevent the adhesion formation ; active
moving stimulate capillaries and general muscles and tissues blood
circulation.
passive: are executed with out will effort of patient with the instructor’s help
; in this case there is no active muscles contraction . Such exercises are
appointed when the patient can’t do this exercises independently. Passive
movements improve blood-and lymph circulation , stimulate active movements
formation thank reflex influence, support elastic state of the ligaments and
tendons , prevent limits of joint’s mobility .
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Ideomotor exercises – impulse sending for
muscles contraction . At the restoration of
movements the usual stereotype of the
exciting and inhibition of the CNS saves in
thoughts . It support the functional mobility of
extremity.
an organism :
For the influence on
- generally strengthen: directed on the sanitary
and strengthen of the whole organism .
special: act separately on this or other part of
locomotorium .
of exercises:
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According to character
on stretching;
on balance;
corrective;
on coordination;
on relaxation;
reflex;
respiratory , they are divided on:
а) dynamic (connect with the movements of
hands , shoulders , whole body;
b) static – are conducted only with the help
of the diaphragm and inter costal muscles ;
c) special – are used for prophylactic and
struggle with lungs complications.
Sports – applied exerciseswalking :
-walking (usual , complicated , dosage )
- running ;
- climbing and crawlingrowing ;
- rowing;
- swimming;
- cycling ;
- ski .
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on the place;
not mobile;
mobile;
sporting .
Games:
In the In TE are used : table tennis, badminton, skittlealley,gorodkirel, relay races.
Working therapy
This is the method of active restoration of the functions and
capacity for work , which were disordered in the process of disease,
with the help of work.
WT is appointed at diseases of locomotorium, nervous and mental
disorders. Such kinds of work are used: joinery, potter’s, manufacturing
of flowers, plaiting of baskets, work in garden, kitchen-garden.
Thanks to WT restore and improve muscles force, joint mobility ,
blood circulation and trophicity processes of organism, attention is
developed , hope on recovery is appeared.
Divide 5 working modes ( Tretjakov S., 1981.):
0 – mode of temporary non attendance of working therapy
department;
1 – rest mode : patient go in for working therapy in ward;
2 – pupil mode: patient learn recommending kind of work;
3 – mode of the short working day: according to medical indications
working day is shorter on one hour or there are additional brakes in
work ;
4 – mode of full working day with limitation of the kind of work;
5 – mod of full working day.
Навантаження адекватне, якщо:
а) у пацієнта відсутні скарги, немає різко виражених ознак
втоми;
б) на піку навантаження пульс збільшується:
при ліжковому режимі на 8 уд. за 1 хв
при палатному – на 16 уд. за 1 хв
при вільному – на 24 уд. за 1 хв
при тренуючому – за формулою 180 – вік пацієнта.
в) підвищення систолічного АТ на 40 мм. рт. ст., підвищення
або зниження діастолічного АТ на 10 мм. рт. ст.; пульсовий тиск
повинен збільшитись;
г) почащення дихання на 6-8 дихальних рухів;
д) дихання і тиск повинні змінюватись синхронно з пульсом;
ж) всі показники відновлюються за 3-5 хв.
Loading is adequate, if :
а) there is no complaints and expressed signs of tiredness
б) on the pick of loading pulse is increased:
- at bed mode - on 8 b. per 1 min.
- at ward mode – on 16 b. per 1 min.
- at free mode – on 24 b. Perb1 min.
- at training mode – for the formula 180 – patient’s
age .
в) rising of the systolic AP on the 40 mm Hg. , rising or
decreasing diastolic AP
on the 10 mm Hg. ; pulsing
pressure has increase ;
г) accelerating of breathing on the 6-8 respiratory
movements;
д) breathing and with pressure must change
synchronic to pulse;
ж) all indexes are restoring for 3-5 min.
TE
TE forms
Accessible
Action
selectivity
FORMS
Easy dosage
Positive
emotions
Natural
character
According to
health state
According
to
equipmen
t
MHG
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CG
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Individual
tasks
for
independent
lessons . .
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Going
foot
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Terrain cure
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Playing
class
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Elements of
sports
exercises
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Running
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MODES OF MOVING ACTIVITY
Mode
Initial
pose
Exerci
ses
numb
er
N-ber
of
repetiti
ons
Tempo
Amplitu
de
Muscles’ Pulse
groups
Slow
Limited
Mall
Middle
Bed
Laying
8
4-6
Half bed
Sitting
16
6
Middle
Middle
Free
standing
24
8
Middle
and fast
Full
All
Training
Standing
>24
8
Fast
Full
All
+8
+16
+24
180age
Influence of massage on the mechanic –and proprioreceptors .
Mechanical action
Mechanic receptors (receivers of force ,
speed , acceleration )
Proprioreceptors (muscles spindles ,
Joint’s receptors)
Lemnisc- and spine and
Cutaneo-visceral reflexis(change of internal organs
Thalamic ways
Activity)
)
Segmental
reflexis
Specific and non specific thalamic nucleus ,
internal geniculate body, brain trunk’s
nucleus , hypothalamus .
Somatic and sense cortex of the cerebral
Hemispheres
Generalized answer on action
Mechanic action (massage)
Formation of BAS
Acetylcholine
Amino acids
Polypeptides
Irritation of hit receptors
Thalamus,
hypothalamus
Histamine
Irritation of
chemo receptors
Speed of the first
Blood adrenaline conimpulse transference
centration
increasing
increasing
Cardio-vascular an respiratory systems
activity changing
Stimulation of
muscles
action
Adaptive forces of
an organism
mobilization
Somatic and sensor
Cortex’ zone
Capillaries
expansion
Increasing
of the capillaries walls
penetration
Increasing of the lymph
formation ,
stimulation of tissues
metabolism
Humoral massage influence .
THANK YOU FOR ATTANTION!