Exercise therapy for functional diseases of the nervous system. Exercise therapy for diseases of the nervous system

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Neuroses- these are functional diseases nervous system, developing under the influence of prolonged overstrain of the nervous system, chronic intoxication, severe trauma, long-term illness, constant consumption of alcohol, smoking, etc. The predisposition to this disease and the characteristics of the nervous system are also of a certain importance. The main forms of neuroses: neurasthenia, psychasthenia and hysteria.

Neurasthenia- this, according to I.P. Pavlov’s definition, is a weakening of the processes of internal inhibition, which is manifested by a combination of symptoms of increased excitability and exhaustion of the nervous system. Neurasthenia is characterized by rapid fatigue, irritability, excitability, poor sleep, decreased memory and attention, headaches, dizziness, disturbances in the functioning of the cardiovascular system, and frequent mood swings for no apparent reason.

Psychasthenia occurs predominantly in people of the thinking type (according to I.P. Pavlov) and is characterized by the development of processes of stagnant excitation (foci of pathological stagnation, the so-called sore points). A person is overcome by painful thoughts, all sorts of fears (whether he locked the apartment, turned off the gas, anticipation of trouble, fear of the dark, etc.). With psychasthenia, frequent nervousness, depression, inactivity, autonomic disorders, excessive rationality, tearfulness, etc.

Hysteria- a form of functional disorder of the nervous system, accompanied by a disorder of mental mechanisms and, as a consequence, a disruption of the normal relationship between the first and second signaling systems with a predominance of the first. Hysteria is characterized by increased emotional excitability, mannerisms, fits of convulsive crying, convulsive seizures, desire to attract attention, speech and gait disorders, hysterical “paralysis.”

Treatment of neuroses is complex: creation of favorable conditions, medicinal physiotherapy and psychotherapy, physical therapy.

Physiotherapy especially indicated for neuroses, as it increases strength nervous processes, promotes their alignment, coordinates the functions of the cortex and subcortex, the first and second signaling systems.
Exercises are chosen depending on the form of neurosis.
With neurasthenia, for example, physical therapy is aimed at increasing the tone of the central nervous system, normalizing autonomic functions and involving the patient in a conscious fight against his illness.
The objectives of physical therapy for psychasthenia are: to increase emotional tone and excite automatic and emotional reactions; in case of hysteria - enhance inhibition processes in the cortex cerebral hemispheres.
With all forms of neuroses, it is important to distract yourself from difficult thoughts, develop persistence, activity, and evoke positive emotions in yourself.
Due to the increased sensitivity and emotionality of a person in a state of neurosis, at the beginning of classes one should not focus on mistakes and shortcomings in performing the exercises.
In the first period of classes, it is advisable to conduct them individually. Use simple general developmental exercises for large muscle groups that do not require intense attention; perform them at a slow and medium pace. In the future, exercises with more complex coordination of movements can be included in classes. Classes should be quite emotional. For patients with neurasthenia and hysteria, the exercises need to be explained more; for patients with psychasthenia, they need to be shown.
When treating hysterical “paralysis,” distracting tasks are used (for example, they are asked to change the starting position). So, with “paralysis” of the hand, exercises with one or several balls are used. If the “paralyzed” arm is involuntarily involved in work, it is imperative to draw the patient’s attention to this.
As you master exercises with simple coordination, classes include exercises to maintain balance (on a bench, balance beam), as well as climbing, on a gymnastic wall, various jumps, and swimming. Walking, walking, and fishing also help relieve stress on the nervous system, relieve irritation, and strengthen the cardiovascular and respiratory systems.
The duration of classes in the first period is initially 10-15 minutes, and as adaptation progresses - 35-45 minutes. If the load is tolerated well, then in the second period, exercises are introduced into the classes that develop attention, precision of movements, coordination, dexterity, and speed of reaction. To train the vestibular apparatus, perform exercises with eyes closed, circular movements of the head, bending of the body, exercises with sudden changes in movements while walking and running. Outdoor games, walking, skiing, cycling, volleyball, and tennis are widely used.

Neurasthenia

For neurasthenia, therapeutic exercises “train” the process of active inhibition, restore and streamline the excitatory process. Physical therapy classes, in addition to the mandatory morning exercises, should be carried out in the morning for 15-20 minutes. Starting position - sitting. In the first week of classes, general developmental exercises are performed 4-6 times in a row, and breathing exercises - 3 times. As you master the exercises, the number of repetitions increases to 10 times, and the duration of classes increases to 30-40 minutes.
During exercise, you may experience painful sensations(palpitations, dizziness, shortness of breath) - this must be taken into account and the load adjusted so as not to get tired. To do this, you need to stop exercising and rest a little. Exercises should be varied - then they will not get boring and you will not lose interest in physical education.
It is better to conduct classes with music. We recommend soothing melodies of moderate and slow tempo, combining major and minor sounds. Such music can also be used as a healing factor.

Psychasthenia

Psychasthenia is characterized by anxious suspiciousness, inactivity, and concentration on one’s personality and experiences. Therapeutic exercise helps to lift the patient out of a depressed moral and mental state, distract him from painful thoughts, and facilitate communication with people.
Emotional, fast paced exercises are recommended. The music accompanying the classes should be cheerful, its tempo should be moderate, moving to fast. It is necessary to widely use games, relay races, elements of competitions, and dances.
In the future, to overcome feelings of inferiority, low self-esteem, and shyness, it is recommended to include in classes exercises for overcoming obstacles, maintaining balance, and strength exercises.
Patients with psychasthenia are characterized by non-plastic motor skills, clumsiness of movements, and clumsiness. They usually do not know how to dance, so they avoid and do not like dancing. At obsessive states Appropriate psychotherapeutic preparation is of great importance. It is important to understand that exercise will help overcome feelings of unreasonable fear.
To increase emotional tone, exercises are used in pairs, overcoming resistance, and games; to suppress feelings of indecision and self-doubt - exercises on apparatus, to maintain balance, jumping.
To excite automatic reactions and raise emotional tone, you need to speed up the pace of movements: from 60 movements per minute (this is a slow pace characteristic of psychasthenics) to 120, then from 70 to 130 and subsequently from 80 to 140. The final part of the classes includes exercises that contributing to a slight decrease in emotional tone. After doing therapeutic exercises, you should be in a good mood.

An approximate set of exercises for psychasthenia

Before class, you need to count your pulse.
1. Walking in a circle alternately in one direction and the other, with acceleration - 1-2 minutes.
2. Walking in a circle on toes, alternately in one direction and the other, with acceleration - 1 minute.
3. Starting position - standing, arms along the body. Relax all muscles.
4. Starting position - the same. Alternately raise your arms up (starting with the right), accelerating your movements - from 60 to 120 times per 1 minute.
5. Starting position - feet shoulder-width apart, hands clasped in a “lock”. On the count of 1-2, raise your arms above your head - inhale; on a count of 3-4, lower through the sides - exhale. Repeat 3-4 times.
6. Starting position - arms extended in front of the chest. Squeeze and unclench your fingers with acceleration - from 60 to 120 times per 1 minute. Perform for 20-30 s
7. Starting position - feet shoulder-width apart, hands clasped in a “lock”. On the count of 1, raise your arms above your head - inhale; on the count of 2, sharply lower down between your legs, exhaling loudly. Repeat 3-4 times.
8. Starting position - legs together, hands on the belt. On the count of 1-2, sit down - exhale; on the count of 3-4 stand up - inhale. Repeat 2-3 times.
9. Starting position - standing on your toes. On the count of 1, lower yourself onto your heels - exhale; on the count of 2, rise on your toes - inhale. Repeat 5-6 times.
10. Exercises in pairs to overcome resistance:
a) starting position - standing facing each other, holding hands, bent at the elbows. Alternately, each person resists with one hand and straightens the other. Repeat 3-4 times;
b) starting position - standing facing each other, holding hands. Resting your knees against each other, squat down (arms straight), then return to the starting position. Repeat 3-4 times;
c) the starting position is the same. Raise your hands up - inhale, lower - exhale. Repeat 3-4 times;
d) and, p. - the same. Place your right foot on the heel, then on the toe and make three foot taps (dance tempo), then separate your arms and clap your palms 3 times. Same with the left foot. Repeat 3-4 times with each leg.
11. Starting position - standing facing the wall 3 m from it, holding a ball in your hands. Throw the ball with both hands so that it hits the wall and catch it. Repeat 5-6 times.
12. Starting position - standing in front of the ball. Jump over the ball and turn around. Repeat 3 times in each direction.
13. Exercises on apparatus:
a) walk along a bench (log, board), maintaining balance. Repeat 2-3 times;
b) jumping from a gymnastic bench. Repeat 2-3 times;
c) starting position - standing at the gymnastic wall, holding the ends of the bar with your hands extended forward at shoulder level. Bend your elbows, press your chest against the gymnastics wall, then return to the starting position. Repeat 3-4 times.
14. Starting position - standing, arms along the body. On the count of 1 - 2, rise on your toes - inhale; on the count of 3-4, return to the starting position - exhale. Repeat 3-4 times.
15. Starting position is the same. Alternately relax the muscles of the arms, torso, and legs.
After class, count your pulse again.

Hysteria

Hysteria, as already mentioned, is characterized by increased irritability, emotional instability, frequent and rapid mood swings, tearfulness and loudness.
Physical therapy for hysteria helps get rid of emotional instability and “explosions” of irritability, increases activity, enhances conscious-volitional activity, and creates a stable, calm mood.
Classes should include exercises for attention, precision of execution, coordination and balance (on different areas of support), dance steps to pleasant melodic music, then move on to smooth dancing (waltz, slow foxtrot). The pace is slow. It is necessary to calmly but accurately perform all movements.
The first classes begin with the accelerated pace characteristic of this group of patients - 140 movements per 1 minute and reduce it to 80, subsequently - from 130 movements to 70, then from 120 to 60.
The so-called differentiated inhibition is developed with the help of simultaneously performed but different movements for the left and right hand, left and right leg. They also include strength exercises on apparatus at a slow pace with load on large muscle groups.

Restoration of impaired functions of the brain and spinal cord The method of physical exercise is a therapeutic and educational process that involves the conscious and (as far as possible) active participation of the patient. Physical exercises combined with psychotherapeutic influences are aimed primarily at increasing overall vitality, which creates favorable preconditions for restoration and compensation of lost functions. Under the influence of systematic training, the function of peripheral receptors and nerve pathways improves. Afferent impulses influence the nature and direction of flows nervous excitement, arising in the brain, which stimulate the development of impaired motor functions.

Thus, both passive and active movements contribute to the restoration of all parts reflex arc and conditioned reflex connections.

In the complex treatment of patients after injuries and diseases of the central nervous system in a hospital setting, mainly therapeutic exercises and therapeutic walking are used. In sanatorium-resort conditions, in addition, simple sports exercises and elements of games are used.

IN specialized literature there are comprehensive classifications and systematizations of all therapeutic exercises And optimal timing their application, which is the basis of the healing process (M.M. Krugly, 1957; V.N. Moshkov, 1959, 1972; V.L. Naidin, 1972; etc.).

Tasks Exercise therapy for diseases of the central nervous system and injuries are:

• activation of vital functions of the body (respiratory, cardiovascular, etc.);
• prevention of the development of motor and other complications (contractures, stiffness in joints, bedsores, congestive pneumonia, etc.);
• restoration of lost functions, creation of temporary or permanent compensation;
• restoration of walking skills, grasping objects, etc.;
• raising the general tone of the body and improving the mental state of the patient.

The effectiveness of targeted treatment physical culture is largely determined by the clarity of the tasks set at each stage of the recovery period.

When treating the consequences of focal brain lesions, the following are used: positional treatment, therapeutic exercises, massage. These funds are necessary both for true restoration of functions and for compensation of movement disorders.

Treatment by position is carried out as follows. The arm, bent at the elbow joint, is moved away from the body to an angle of 90°, turning the shoulder outward and the forearm with the palm up ( rice. 75), the fingers are straightened and held with a sand roller, which is placed on the palm, placing the thumb in abduction and opposition to the rest. In this position, place the hand on a special plane or chair, standing nearby with a bed. Sometimes special tires are used for this purpose. When treating contractures of the lower extremities, a long bag of sand is placed on the outside of the sore leg or the leg is placed in a special anti-rotation splint to limit external rotation of the hip; a small cushion is placed under the knee to prevent hyperextension of the knee joint; for the entire foot, including the toes, create a support and place it, slightly pronating, at an angle of 90° to the shin.

Rice. 75. Treatment by positioning the affected arm.

At spastic paralysis Treatment with position lasts 15-45 minutes. At flaccid paralysis and paresis, a positioning treatment session to avoid increasing muscle tension can be quite long - up to 3-4 hours. In these cases, he provides for an average physiological position of the limbs so that weakened muscles do not experience excessive stretching and joints are not subject to deformation. It is advisable to conduct several positional treatment sessions during the day, alternating them with therapeutic exercises, massage and physiotherapeutic procedures.

To avoid unpleasant consequences treatment by position, the tonic state of muscle groups and mobility in the joints should be determined after removal of the fixation. It is not recommended to allow an increase in spasticity or muscle rigidity compared to the original, as well as hypostatic edema, complaints of pain and numbness, and the appearance of stiffness. Such symptoms indicate excessive stretching, improper fixation, or an overdose over time. All of the above-mentioned positional treatment methods are local in nature and pursue special goals.

Therapeutic exercise for diseases of the central nervous system.

Neuroses is a disease of the nervous system that develops with prolonged exposure to mental or other unfavorable factors, external or internal environment, leading to deviations from the norm in the function of higher nervous activity in humans. Neuroses can develop secondary due to past diseases and injuries. The following main forms of neuroses are distinguished: neurasthenia, psychasthenia, hysteria.
Neurasthenia is the most common disease that occurs as a result of excessive tension in the nervous system in strength or duration, which exceeds the limits of endurance. of a given organism. At its core, neurasthenia has “a weakening of the processes of internal inhibition and is clinically manifested by a combination of symptoms of increased excitability and exhaustion” (I. P. Pavlov).
Patients with neurasthenia complain of fatigue when performing any work, poor sleep, decreased memory, attention, headaches, dizziness, frequent shifts moods for no particular reason. They are not restrained in their behavior. In athletes, neurasthenia can develop after prolonged physical and mental stress, due to overexertion, especially in sports that require attention and visual strain (ice hockey, motor racing, etc.). In most cases, not all symptoms of the disease appear, but certain manifestations predominate. Treatment of patients with neurasthenia should be comprehensive. After identifying the causes of the disease, physical therapy is prescribed, aimed at increasing the tone of the central nervous system, normalizing autonomic functions and involving the patient in conscious and active participation in the fight against his illness. Physical therapy is also prescribed for the treatment of scoliosis in children. Back exercises for scoliosis help compensate for curvature and develop muscles in the right direction.

Psychasthenia occurs mainly in people with working conditions and is characterized by the presence of stagnant processes (foci of pathological stagnation, the so-called “sore points”). With psychasthenia, inactivity, frequent nervous states, depression, persistent red dermographism, increased excitability of vasomotors, increased sweating, and tearfulness are observed; patients overcome difficult thoughts and fears. An important therapeutic factor is to distract the patient from difficult thoughts, increase self-confidence, develop perseverance, and activity. That's why the main objective physical therapy - increasing emotional tone and disrupting automatic and emotional reactions. It is recommended to include exercises with faster tempo, overcoming obstacles, balance, throwing, and game exercises in therapeutic fitness classes.
Hysteria is one of the forms of pathology of higher nervous activity, which is accompanied by a deficiency of higher mental mechanisms and, as a consequence, a disruption of the normal relationship between the first and second signaling systems with a predominance of the first. The symptoms of the disease are quite diverse: increased emotional excitability, attacks of convulsive crying, the desire to attract attention, affective outbursts, convulsive seizures, gait disorder to paresis and paralysis, speech disorders, etc. The causes of hysteria can be adverse emotional experiences, mental trauma .
Complex treatment of patients with hysteria, which includes physical therapy, should be structured in such a way that it helps to enhance the processes of inhibition in the cerebral cortex. Strict regulation of the regime is useful, especially the alternation of sleep and wakefulness and passive rest in the air. Exercises in the form of games, walks, close hiking, skiing, and swimming are recommended.

In the treatment of patients with neuroses and physical therapy viewed as natural biological method with physiologically based use of physical exercises and natural factors of nature. It directly affects the main pathophysiological manifestations of neuroses - it helps to align the dynamics of the main nervous processes, coordinate the functions of the cortex and subcortex, the first and second signaling systems, etc.
The methodology of physical therapy is differentiated depending on the pathophysiological disorders in higher nervous activity (neurasthenia, hysteria, psychasthenia), clinical manifestation the disease, its main symptoms, emotional tone, age, functional capabilities of the patient.
IN inpatient conditions patients are most often on bed rest. In the first half of the course of treatment (first period), simple exercises that do not require intense attention are prescribed. In the future, exercises with more complex coordination of movements can be gradually introduced into the procedures. The first days of procedures help determine the patient’s reaction to the proposed load and correctly form groups. It is necessary to pay serious attention to the emotional side of classes. The commands must be calm and the explanation must be clear. The load must match functional status patient (according to the physiological curve of the procedure). After classes, he should feel cheerful and slightly tired. The heart rate and breathing should return to the original resting data 5-10 minutes after the end of the procedure. In classes for neurasthenics with weakened inhibition processes and a predominance of excitation processes, in addition to hygienic gymnastics, various exercises should be introduced that help balance the emotional tone of patients, elements sports games according to simplified rules (volleyball, table tennis, small towns). For symptoms such as feelings of uncertainty, fear, lack of coordination of movements, it is recommended to use exercises to help overcome these feelings: balance exercises (on a bench, balance beam), climbing a gymnastic wall, jumping over a pit, diving, swimming with a gradual increase distances, etc. Walking, close tourism, fishing, hunting have a positive effect on the restructuring of the neuropsychic sphere, help relieve the nervous system from the usual type of professional activity, affect the cardiovascular and respiratory systems, increase the body’s adaptability to various physical activities.
Patients with psychasthenia should first be recommended the simplest exercises (for arms, legs, torso) from easier starting positions (sitting, lying down). They should be made more difficult gradually by introducing exercises with gymnastic sticks, skiing, swimming, etc. During the exercises, it is necessary to divert the patient’s attention from obsessive thoughts and interest him in exciting game exercises.
During the procedures, it is necessary to include rest breaks and alternate general strengthening exercises with breathing exercises. For general toning purposes, you can include corrective exercises with dosed tension and exercises in pairs. Exercises to develop the function of the vestibular apparatus are also recommended. The duration of the lesson is initially 10-15 minutes; as patients adapt to the load, its time gradually increases to 35-45 minutes.
Patients with psychasthenia need to regularly, strictly individually, harden the body: rubbing, short showers with gradually decreasing temperatures (from +35 to +24 ° C), bathing with the obligatory subsequent rubbing of the body until the skin turns red (vascular gymnastics).
Classes are conducted individually and in small groups. It is recommended to select a group so that it includes several people who have well mastered the nature of the exercises. This is important because most patients with psychasthenia have poor coordination of movements.
If the patient does not tolerate the load of the first period well, then in the second period special exercises are introduced into the classes to help improve attention, speed and accuracy of movements, coordination, develop dexterity, and speed of reaction. To train the vestibular system, it is advisable to use exercises with closed eyes, circular movements of the head, tilts of the body in different directions, exercises with sudden changes in movements on command while running, walking, etc. If the load is transferred well, jumping, skipping, and exercises with a skipping rope are added , outdoor and sports games.
Good treatment results are achieved in sanatorium conditions, where patients spend a lot of time on fresh air and can, in terms of indicators, combine climatotherapy with various types of physiotherapy: balneotherapy, etc... Physical exercise stimulates in patients various physiological mechanisms, the interaction of which is disrupted due to the disease, helps balance
internal environment of the body with external environment which promotes health.
During classes, you should constantly draw the patient’s attention to the slightest improvement. motor activity, instill the idea that regular and persistent performance of tasks improves his general state and leads to restoration of impaired functions. The methodologist should carefully study the patient’s character, observe his reaction to the load, and his attitude towards physical activity. This helps to individualize classes and, as a rule, is the key to a positive therapeutic effect.
The fulfillment of the listed tasks becomes possible only with the comprehensive implementation of all therapeutic and rehabilitation measures, of which therapeutic fitness, positional treatment and massage play a particularly important role.
Patients with various types of neuroses are recommended to continue exercising at home in the form of morning hygienic exercises (the complex is compiled by a doctor, taking into account the characteristics of the patient’s impaired functions), attend health groups, play volleyball, walk more, ride a bicycle, etc.
See article -

Physical strength exercises increase the functional restructuring of all key elements nervous system, providing a stimulating effect on both efferent and afferent systems. The basic basis of the mechanism of action of strength physical exercises is the process of exercise, therefore the dynamic restructuring of the nervous system also affects cerebral cortex cells, and peripheral nerve fibers. When performing physical exercises, all kinds of reflex connections increase (cortico-muscular, cortico-visceral, as well as muscle-cortical), which contributes to a more coordinated and harmonious functioning of the main functional systems body.

Actively involving the patient in the process of conscious and clearly dosed exercise is a powerful stimulator of the formation of subordination influences. The plasticity of the central nervous system allows systematic complexes of physical therapy exercises develop a dynamic stereotype that determines accuracy, coordination and impressive economization of reactions.

Exercise therapy for diseases of the nervous system has a normalizing effect on imbalances in inhibition and excitation. Important role neurohumoral regulation during strength exercises is carried out by the autonomic nervous system, which innervates the tissue of muscle fibers, regulates the metabolic process in them, and adapts it to functional activity. The function of the cardiovascular system, respiratory and other body systems is also stimulated, which improves the nutrition of working muscles, eliminates congestion, and accelerates the resorption of foci of inflammation. Positive emotions when performing physical exercises develop in the patient against the background of unconditional and conditional connections. They help mobilize various physiological mechanisms and distract the patient from painful experiences.

Stroke.

In the rehabilitation of patients who have suffered a stroke, there are 3 stages: early (3 months), late (up to 1 year) and the stage of compensation of residual disorders motor function. Therapeutic exercise for strokes is aimed at reducing pathological tone, reducing the degree of paresis (increasing muscle strength), eliminating synkinesis, recreating and developing the most important motor skills. Therapeutic exercises and massage are prescribed when the patient’s condition has stabilized (no increase in symptoms of cardiac and respiratory disorders). Treatment by positioning begins from the first day of illness, passively turning the patient every 1.5-2 hours during the day and 2.5-3 hours at night from the healthy side to the back and to the affected side. When placing the patient in a horizontal position (lying down), you should ensure that the hand of the affected arm is always in the mid-physiological phase, and that the leg does not rest against anything. The upper limb is abducted by 90", extended in all joints and rotated outwards. When the tone of the carpal flexor muscles increases, a splint must be applied to the hand with extended and spread fingers. Pressure applied to the surface of the hand and sole leads to an increase in muscle tone and the formation of vicious attitudes. A little is allowed. elevated position of the patient (no more than 30°) headboard (with mild and moderate severity ischemic stroke) for 15-30 minutes 3 times a day already on the 1st day of the disease.

It is necessary to try to activate the patient as early as possible - transfer him to a sitting position. The patient can be seated on a bed with his legs down on the 3-5th day from the start of treatment. Transfer to a sitting position is done passively, the patient is provided with sufficient support. The duration of sitting is from 15 minutes to 30-60 minutes or more with good tolerance. The question of the period of expansion of the motor regime during hemorrhagic stroke is decided individually.

Motor rehabilitation for strokes includes a number of successive stages. Preference is given to functional exercises.

• Restoration of some components of the motor act - methods of active muscle relaxation, training in dosed and differentiated tension of muscle groups, differentiation of the amplitude of movements, training in minimal and isolated muscle tension, training and mastering the optimal speed of movements, increasing muscle strength.
• Increasing proprioception - overcoming dosed resistance to the movement being performed, using reflex mechanisms of movement (reflex exercises).
• Restoring simple friendly movements - training various options interarticular interaction with visual and kinematic control.
• Revival of motor skills - restoration of individual links of a motor act (skill), learning transitions (connections) from one motor element to another, revival of a motor act as a whole, automation of a restored motor act.

Restoration of impaired motor functions during central paresis happens in a certain sequence: first, reflex movements and muscle tone are restored, and then friendly and voluntary movements appear, which are restored from the proximal to the distal (from the center to the periphery); restoration of motor function of the flexors is ahead of the restoration of movements in the extensors; arm movements appear later than legs; specialized hand movements (fine motor skills) are especially slowly restored. In the process of practicing physical therapy with the patient, the skills of motor activity in a lying position (raising the head, pelvis and body, movements in the limbs, turns) and independent transition to a sitting position are gradually practiced. While maintaining static and dynamic balance (equilibrium) while sitting, the patient learns to move to a standing position (on average on the 7th day for uncomplicated ischemic stroke). Learning to walk independently requires the patient to be able to stand up and sit down independently, maintain a standing posture, transfer body weight and place the supporting leg correctly. Training begins with assisted walking, but long-term use aids when walking, it inhibits defensive reactions and develops in the patient a fear of falling. Gait training includes training in direction of movement (forward, backward, sideways, etc.), step length, rhythm and speed of walking, and walking on stairs. Active and passive movements should not cause increased muscle tone or pain.

LH classes with stroke patients are carried out individually due to the significant variability of motor and sensory disorders. The duration of the LH procedure is 20-25 minutes with bed rest and 30-40 minutes with free rest. The complex of exercise therapy for strokes must include, in addition to special exercises, breathing exercises(static and dynamic), general strengthening exercises, exercises with objects, training on simulators, sedentary and active games. As a rule, an additional small-group or group lesson lasting 15-20 minutes is conducted.

The achieved functionality must be applied in self-service activities. Manipulations with household items, clothing, eating skills, personal hygiene, management skills are trained. household, behavior in the city. To develop skills daily activities Separate additional training should also be carried out with an occupational therapist lasting 30-40 minutes.

The choice of exercises and planning of individual complexes depend on the severity and degree of movement disorders, the presence accompanying symptoms(spasticity, synkinesis, aphasia) and diseases, the patient’s behavior, his general development and exercise tolerance.

The massage is carried out in a differentiated manner: on muscles whose tone is increased, only gentle methods of stroking and rubbing are used, and on stretched (weakened) muscles all massage techniques are allowed. The duration of the massage is 20-25 minutes, 30-40 sessions per course, with breaks between courses of 2 weeks.

Contraindications for activating patients are signs of cerebral edema, depression of consciousness; The rate of increase in exercise intensity may be limited in patients with cardiopulmonary problems (failure) and atrial fibrillation.

Spinal cord injuries and diseases.

The main task of exercise therapy for spinal cord lesions is to normalize the patient’s motor activity or develop adaptive capabilities. The complex of therapeutic measures includes exercises that stimulate voluntary movements, exercises aimed at strengthening the muscle corset, weakening increased tone muscles, training in independent movement and self-care skills. In case of injuries and diseases of the spinal cord, the nature of motor disorders depends on the location of the lesion. Spastic paresis and paralysis are accompanied by increased muscle tone and hyperreflexia. Flaccid paresis and paralysis are characterized by hypotonia and muscle atrophy, hypo- or areflexia. In this regard, when various forms movement disorders, sets of physical exercises vary significantly. The main task of LH in case of flaccid paralysis is to strengthen muscles, and in case of spastic paralysis, it is to develop skills to control them.

Exercise therapy classes begin 2-3 days after admission to the hospital; before that, only positional treatment is carried out. The starting position of the patient is lying on his back. LG Provo

do 2-3 times a day from 6-8 minutes to 15-20 minutes. Shapes and exercise therapy products are selected taking into account motor modes and depending on the objectives of treatment, both strengthening and special techniques LG.

• Developing voluntary movements in segments, increasing muscle strength - active movements for the affected limbs with relief (on suspensions, in a horizontal plane, in water, after resistance of antagonists), exercises with overcoming resistance, isometric exercises with low exposure, reflex exercises using natural synkinesis , special LH techniques (method of proprioceptive facilitation, method of neuromotor retraining, etc.). If it is impossible to make active movements, use ideomotor exercises and isometric exercises for healthy limbs.
• Prevention and treatment of muscle atrophy, contractures, deformities - training in active muscle relaxation techniques, passive movements in joints involving paretic muscles, anti-conjugate and ideomotor training, correction of the position of paretic limbs, orthopedic prevention.
• Recreation and compensation of coordination of movements - complex vestibular gymnastics, a series of exercises for precision and accuracy of movements, training and teaching fine differentiation and dosage of efforts, speed and amplitude of movements, exercises for maintaining balance in a variety of starting positions, a combination of isolated movements in several joints.
• Restoration and compensation of movement skills - development of support ability of the lower extremities, special exercises to strengthen the ligamentous-muscular apparatus of the feet, restoration of the spring function of the feet; exercises that restore the direction of movements in space; gradual restoration of gait kinematics, dynamic coordination gymnastics; exercises in a variety of starting positions (lying, kneeling, on all fours, standing), learning to walk independently with and without support.
• Improving respiratory and cardiovascular activity - static breathing training with dosed resistance, dynamic breathing exercises, passive exercises for the limbs, rotations and rotations of the torso (passively and actively), exercises aimed at intact muscle groups.
• Developing self-care skills - restoring the skills of personal hygiene, nutrition, dressing, moving and housekeeping, handwriting and typing, classes in ego therapy rooms, training behavior skills in the city.
• Labor skills training - classes in occupational therapy rooms and workshops.
• All listed exercise therapy methods are closely interrelated and are used in different combinations depending on the patient’s individual treatment plan.

In case of spastic paralysis, movements that bring the attachment points of spastic muscles closer together or are associated with forceful tension, as well as massage techniques that increase muscle tone, are contraindicated. In case of flaccid paralysis, you should not use exercises associated with stretching the paretic muscles.

Lesions of the peripheral nervous system.

The objectives of exercise therapy in cases of damage to the peripheral nervous system are considered to be: improvement of blood circulation and trophic processes in the affected limb, strengthening of paretic muscle groups and ligamentous apparatus, prevention of the development of contractures and stiffness of joints, promotion of regeneration of the damaged nerve, development and improvement of replacement movements and coordination of movements, general strengthening effect on the patient's body.

The method of applying exercise therapy is determined by the volume movement disorders(paresis, paralysis), their localization, degree and stage of the disease. They use positioning treatment, massage, LH. Treatment by position is indicated to prevent overstretching of already weakened muscles with the help of splints, stacking, and corrective positions, with the exception of the time of gymnastics. LH uses active movements in the joints of a healthy limb, passive and ideomotor movements of the affected limb (for paralysis), friendly active exercises, active exercises for weakened muscles. Muscle training is carried out in facilitated conditions of their functioning (support on a smooth surface, use of blocks, straps), as well as in warm water. During classes, it is necessary to monitor the occurrence of voluntary movements, selecting optimal starting positions, and try to maintain the development of active movements. If muscle function is satisfactory, active exercises with additional load (resistance to movement, weighting of the limb) are used, aimed at restoring muscle strength, exercises with gymnastic apparatus and equipment, applied sports exercises, and mechanotherapy. LH is carried out for 10-20 minutes with fractional loads throughout the day due to the rapid depletion of the damaged neuromuscular system. Prevention and treatment of contractures includes performing physical exercises that help increase the volume of motor activity in the joints and balance the tone of the flexor and extensor muscles.

According to experts, movement is life. And when various diseases correct physical exercise can become a real panacea for the patient - they can speed up recovery, prevent relapses, improve overall physical state. So for diseases of the nervous system, gymnastics is the most important part complex treatment. And all patients with such problems, without exception, are advised to systematically perform a set of individually selected exercises. The topic of our conversation today on this page www.site will be exercise therapy for diseases of the central nervous system and peripheral.

Exercise therapy for diseases of the nervous system

Therapeutic exercise for diseases of the central nervous system helps to activate vital important functions body: respiratory, cardiovascular, etc. Gymnastics effectively prevents the occurrence of motor and other complications, including contractures, stiffness in the joints, bedsores, congestive pneumonia, etc.

Exercises, when performed systematically, help restore lost functions or create temporary or permanent compensation. Physical therapy also helps restore walking and grasping skills. Gymnastics also perfectly improves the overall tone of the body and optimizes mental condition sick.

Exercise therapy for diseases of the peripheral nervous system

Gymnastics for such diseases is aimed at optimizing blood circulation processes, as well as trophism in the affected area; it helps prevent adhesions and scar changes, eliminate or reduce vegetative-vascular and trophic disorders (promoting nerve regeneration).

Exercises for diseases of the peripheral nervous system help strengthen paretic muscles and ligaments, and weaken muscle dystonia. This effect can prevent or eliminate muscle contractures, as well as stiffness in the joints.

Therapeutic exercise also helps to improve substitution movements and coordinate them with each other. Such activities cope with limited mobility spinal column and with its curvature.

Exercises for diseases of the peripheral nervous system have a pronounced general health-improving, as well as general strengthening effect on the patient, contributing to the overall restoration of performance.

Features of exercise therapy for diseases of the nervous system

Indicated for patients with diseases of the nervous system early start Exercise therapy. At the same time, physical activity must be relevant: it is selected according to individually, should gradually increase and become more complex.

Even a slight complication of the exercises already at the psychological level makes the previous versions of the exercises easier. However, overload for patients with diseases of the central nervous system and peripheral nervous system is strictly contraindicated; in this case, their symptoms may worsen. movement disorders. To speed up progress, it is extremely important to finish classes on those exercises that patients do best. This ensures the most positive psychological preparation patient for the next session.

Simple exercises must be alternated with complex ones: to ensure complete training of higher nervous activity. In this case, the motor mode should be steadily expanded: from lying in bed, to sitting in bed, and then standing.

Doctors strongly recommend the use of all means, as well as physical therapy methods. Patients are shown to have therapeutic exercises, positional treatment, massages. Extension therapy is also an excellent effect - mechanical straightening or stretching along the longitudinal axis of certain parts of the body that are characterized by a violation of the correct anatomical location.

However, the classic and most popular method of physical therapy for diseases of the nervous system is different exercises.

What exercises are used for diseases of the nervous system?

Patients are advised to perform isometric exercises designed to improve muscle strength. Doctors also recommend exercises that alternate tension and relaxation of muscle groups. You should also perform exercises with acceleration and deceleration, various exercises for deceleration and balance.

Alternative medicine specialists also advise paying attention to ideomotor activities, during which mental impulses are sent.

Some examples of exercise therapy for diseases of the nervous system

Quite often, patients with focal brain lesions are treated with positioning. In this case, the affected limbs (usually the arm) are fixed in a stationary position using various devices (a roller with sand, etc.). The duration of positioning treatment can vary from a quarter of an hour to four hours, depending on the type of disease and the patient’s condition.

For diseases of the peripheral nervous system, the patient is advised to perform exercises aimed at optimal contraction of paretic muscles, as well as stretching their antagonists. Particular attention is paid to the development of the necessary motor skills: walking and running, the ability to write, hold and throw small objects.

Therapeutic exercise promotes speedy recovery patients with diseases of the nervous system, both peripheral and central.

Ekaterina, www.site

P.S. The text uses some forms characteristic of oral speech.