• Physiotherapy

    The total duration of a single procedure of therapeutic gymnastics depends on many of the above points and ranges from 10-15 minutes for seriously ill patients( period of bed rest after acute illnesses, exacerbations of

    or complications of chronic diseases) to 45-60 minutes in sessions with neurological patients with paralyzesor other disorders, with trauma at a young age, obesity without pronounced changes in the cardiovascular system.

    The room, where physical therapy classes are held, should be well ventilated, but it is necessary to exclude the possibility of unfavorable effects on the patient drafts. Before classes in the room should be wet cleaning, wipe the dust. Before performing exercises in bed, the patient's bed needs to be moved away from the wall or from furniture to create full-fledged conditions for the implementation of any complexes of physiotherapy exercises and to ensure the prevention of injuries to the patient. Walking patients are better performing physical exercises on the carpet, previously carefully cleaned. Before the gymnastic complex, which requires a lying position of the patient, a clean sheet or a specially designed thin flannel blanket should be placed on the carpet. Furniture around the carpet - the places of the patient's physical training - should be moved to a safe distance in order to avoid bruises and other injuries. Persons caring for patients during the whole period of physical therapy should be beside the patient, protect him from possible falls, monitor his state of health, follow all the instructions of the doctor and instructor, stop the session in time when the patient's state of health worsens.

    Independent( or with the help of carers) physical exercises in the home provide multiple( 3-5 or more times a day) repetition of patients with a set of special exercises procedure of medical gymnastics, previously mastered under the guidance of an instructor. To achieve a therapeutic effect, multiple occupational exercises are required, the frequency of which is determined by the specialists of therapeutic physical training. Each procedure of medical gymnastics is built according to a certain plan, which includes three sections: introductory, main and final.

    In the first, introductory section, preparations are made for an increased level of exercise, the necessary tuning of the body's functional systems, which ensures the best action of the remedies of physical therapy. Include physical exercises that promote a rapid, but gradual transition from the level of reduced physiological activity to the level of the necessary intensity of physical activity, determined by medical problems. The introductory part of the procedure, with the correct method of its conduct, accelerates the process of adaptation to the loads, establishes the best relationship between the nervous system of the patient, his motor apparatus and the multifarious processes that provide movement( blood circulation, metabolism, lymphatic system, etc.).The introductory section for beginners up to 20% of the total duration of the procedure of therapeutic gymnastics, and later reduced to 10-15 %. The introductory section uses simple exercises for small and medium muscle groups in combination with respiratory exercises.

    In the main section the leading therapeutic tasks are solved, consisting in the impact on both affected organs and systems, and on the whole organism of the patient. For their implementation include both special and general developmental exercise in optimal baseline positions and in an optimal combination with respiratory exercises. Throughout the entire

    of the main section, the level of intensity of physical activity( and, correspondingly, the intensity of the work of the physiological systems of the body) should be maintained, which provides the most rapid solution of medical problems. The instructor in exercise therapy assesses the tolerance of patients to physical exertion and educates those caring for the patient. The duration of the main section is 60-75% of the total duration of the procedure.

    In the final section, the physical load gradually decreases to a level corresponding to the motor regimen on which the patient is. Exercises should correspond to the acceleration of recovery processes. In addition, the final section uses exercises that fix the healing effect achieved earlier, that is, elementary exercises are performed in alternation with respiratory exercises to reduce physical activity and calm the function of the cardiopulmonary system. The duration of the section is 10-20 % of the total duration of the procedure.

    In the procedures of curative gymnastics the amount of physical exercise is determined by the correct use of a variety of methodical techniques. The most important of them are the following.

    1) Graduality and consistency in increasing and decreasing physical activity: as a rule, at the beginning and at the end, lighter exercises are prescribed, and in the middle - more complex exercises.

    2) The obligation to alternate the muscle groups included in the exercise, and "dissipate" the burden on the entire body of the patient. Compliance with this principle requires the alternation of exercises for the hands, legs, body and eliminates the use of several consecutive exercises for one musculoskeletal link.

    3) The inclusion of respiratory exercises for improving respiratory function, circulation, and for pausing and reducing the load. The most appropriate ratios of respiratory exercises with others are the ratio 1: 3,1: 4, and for heavier patients 1: 2 or even 1: 1( especially with severe circulatory disorders).Depending on the condition of the patient, his mood, the dynamics of the course of the disease, as well as a number of other conditions, the individualization of therapeutic physical education in the course of classes should be conducted using other methodical methods: selecting the starting positions( standing, sitting, lying), the number of repetitions of each exercise, the rateand the amplitude of movements, their simplicity and complexity, the degree of effort in performing exercises, etc. Those caring for sick persons should, with the help of a physician or a physical training instructor, master the aboveetodicheskie techniques of therapeutic exercises to use them when working with patients to learn methods of control over the patient's condition during the study and evaluation of the effectiveness of this important component of therapy.