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Therapeutic physical culture (physical therapy)

Therapeutic physical culture (physical therapy) is a method of using means of physical culture for therapeutic and prophylactic purposes for more rapid and complete restoration of health and prevention of complications of the disease. Physical therapy usually used in combination with other therapeutic drugs on the background of the regulated mode and in compliance with therapeutic objectives.

During the various stages of treatment exercise therapy helps to prevent complications caused by long-term peace; to accelerate the elimination of anatomic and functional abnormalities; the preservation, restoration or creation of new conditions for functional adaptation of the patient's body to physical stress.

Factor of the physical therapy physical exercises are, that is movement, especially organized (gymnastic, sports-applied, games) and used as a nonspecific irritant for the treatment and rehabilitation of the patient. Physical exercises help to restore not only physical, but also mental strength.

Feature of the method of physical therapy is its natural-biological content, as used for medical purposes one of the main functions, inherent in every living organism, is a function of the movement. The latter is a biological irritant, stimulating the processes of growth, development and regulation of the body. Any complex physical therapy involves the patient in active participation in the treatment process in contrast to other healing methods when a patient is usually passive and therapeutic procedures are performed by medical staff (e.g. physiotherapist).

Physical therapy is also a method of functional therapy. Physical exercise, stimulating the functional activity of all major systems of the body eventually lead to the development of functional adaptation of a patient. But at the same time it is necessary to remember the functional and morphological unity and not to limit the therapeutic role of physical therapy within the functional effects. Physical therapy should be regarded as a method of pathogenetic therapy. Physical exercise, affecting the reactivity of the patient, change as the overall reaction, and its local manifestation. Training the patient should be seen as a process of systematic and dosed application of physical exercises for healing the body, improve the function of one or other body, violated painful process, development, education and retention of a motor (motor) skills and qualities (see table).

The participation of the oxidation processes at rest and during exercise
(in cm³ of oxygen per hour at Warcrofmu)

Note: the Expansionary effects on the body exercise is through darogu - moral mechanisms. When performing physical exercises in the tissues increases the metabolism.

For most patients is characterized by reduced vitality. It is inevitable in the conditions of bed rest due to the reduction of motor activity. This drastically reduces the flow proprioceptive stimuli, which leads to lower lability of the nervous system at all levels, the intensity of vegetative processes flow and muscle tone. With prolonged bedrest, especially in combination with immobilization, there is a perversion of the neuro-vegetative and somatic reactions.

Disease (trauma) and physical inactivity lead to significant changes of homeostasis, muscle atrophy, functional impairment of the endocrine and cardiorespiratory systems, etc. Therefore, the use of exercise for the prevention and treatment of diseases is pathogenetically grounded:

• Therapeutic action of physical therapy
• Non-specific (pathogenetic) effect. Stimulation of the motor-visceral reflexes, etc.
• Activation of physiological functions (proprioreceptive afferentation, humoral processes, etc.)
• Adaptive (compensatory) effect on functional systems (tissues, organs, etc.)
• Stimulation of morpho-functional disorders (reparative regeneration, etc.)

• Results (efficacy) influence of physical exercises on a sick man
• Normalization of emotional state, acid-base balance, metabolism, etc.
• Functional adaptability (adapt) to the social and employment skills
• Prevention of complications of the disease and the occurrence of disability
• Development, education and consolidation of motor skills. Increased resistance to environmental factors

Physical exercises are toning, stimulating motor-visceral reflexes, they contribute to the acceleration of processes of tissue metabolism, activation of humoral processes. With a suitable choice of exercises can selectively affect motor-vessel, motor-cardiac, motor and pulmonary, motor, gastrointestinal, and other reflexes, which improves mainly the tone of those systems and organs, which he reduced.

Physical exercises help to normalize the acid-base balance, vascular tone, homeostasis, metabolism of injured tissues, as well as sleep. They contribute to the mobilization of protective forces of an organism of the patient and reparative regeneration of damaged tissues.

The use of exercise in patients - the main means of active intervention in the process of formation of compensations.

Spontaneous compensation is in the form of correction of respiratory function of patients operated with the help of breathing exercises, lengthening the exhalation, diaphragmatic breathing, etc.

Consciously form of compensation, for example, when immobilizing the left arm the formation of household skills for the right hand; walking on crutches in fractures of the lower extremity (limbs); to walk on the prosthesis in amputations of lower limbs.

Compensation is required when various kinds of reconstructive surgery, creating the replacement of lost motor function. For example, the mastery of full-fledged movements of the hand and fingers after surgery and transplant of muscle, or amputation followed by prosthesis borucki.

The formation of the compensation of disturbed autonomic functions. The use of exercise in this case is based on the fact that there is no vegetative functions, by which the mechanism of the motor-visceral reflexes would escape to some extent influenced by muscular-articular apparatus.

Specially selected physical exercises consistently to provide the necessary compensation reaction of the internal organs; activates afferent signaling from the internal organs, consciously involved in compensation, combined with afferentation coming from participating in the movement of muscles; provide the desired combination of motor and autonomic components of motion and their conditioned reflex consolidation. These mechanisms are most easily used in diseases of the lung, because respiratory function may be deliberately adjusted during the execution exercises. In diseases of one lung (or after surgery) can, for example, to generate a compensatory gain of function of the other, healthy lung due to the delayed and in-depth active exhalation.

In cardiovascular diseases the formation of the compensation is not easy to achieve. However, if the patient with circulatory failure will be to perform careful (slow) movement of the lower limbs in combination with deep breathing, it is possible to form some compensation for the blood supply to the tissues and organs. Hypotension appropriate selection of exercises contributes to persistent compensatory increase in vascular tone.

In diseases of the gastro-intestinal tract, kidneys and metabolism it is difficult to form the compensation. But using special physical exercises can be activated, for example, insufficient or excessive braking of a motor or secretory function of the gastrointestinal tract in order to compensate for disruptions. This compensation may become effective in respect of changes in secretory and motor function due to food intake (diet), mineral water (depending on acidity), pharmaceutical substances, etc.

The use of exercise for therapeutic purposes is a means of conscious and effective intervention in the process of normalization functions. For example, in patients with diseases of cardiovascular system perform special exercises causes the flow of impulses from the blood vessels, heart muscle, lungs and other organs, and thereby a normalization of blood pressure, blood flow rate, venous pressure, improves blood flow to the muscles, etc.

Paresis of the intestine in the postoperative period, the use of breathing exercises and exercises for the muscles of the stomach normalizes the lability of the peripheral nervous link, peristalsis is restored.

Special breathing exercises can by the mechanism of the motor-pulmonary reflexes to activate the drainage function of the bronchi and to ensure the strengthening of the sputum.

Using with the medical purpose of physical exercises is shown at relevant stages of disease development, in various surgical procedures, the clinic of nervous diseases, gynecological, urological and other diseases. Contraindications are extremely limited, they are often temporary.

Contraindications physical therapy

Description of physical exercises

Means of physical therapy

Gymnastics in water ( hydrocolonotherapy )

Forms of application of medical physical culture

Therapeutic exercise for injuries and diseases

An approximate complex of therapeutic exercises for amputation

V.I. Dubrovsky,
Academician of the Russian Academy of Natural Sciences,
IANPO and the New York Academy of Sciences,
Doctor of Medical Sciences, Professor,
A.V. Dubrovskaya, pediatrician

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