Creating a comfortable environment for people with musculoskeletal disorders. Topic18. Creating a comfortable environment for people with musculoskeletal disorders Psychological characteristics of a person with a musculoskeletal disorder

Functions and structural features of the human musculoskeletal system. Diseases and disorders of the musculoskeletal system

Ability to walk - one of the main skills that develops in the first year of a person’s life. People don't even think about what it is miracle- make a step. It’s just that many people think that this action is very simple and unsophisticated. By the way, before we take a step, it never occurs to us question: “At what angle should I step now?” At the moment, hundreds of thousands of books have been written about how musculoskeletal system person. For decades, scientists have been studying the structure of our system of balance and movement. And all research leads to the same result. Ability to walk is a unique mechanism planned to the smallest detail in the human body.

Perfect movement mechanism

A healthy child is born along with all the vital systems that will provide him with everything he needs for life and healthy growth. Moreover, all the systems in his body are already so complex that structure Science cannot yet explain many of them. One of these systems is musculoskeletal system. You don’t even notice, but in order to take one step, many come into action. systems: brain, skeleton, spine, joints, muscles, bones. From the first day you were born, every second, without your participation, a colossal mechanism works inside you.

Bones and skeleton

Skeleton , which is basis our body consists of 206 strong bone structures. Thanks to 206 Bones connected in a clear sequence allow us to move with ease. The structure of the bones is amazing in its perfection. Skeleton And bones, in essence, fulfill functions carrying the body and protecting its internal organs. Therefore bones were created specially durable in order to accurately perform several critical tasks. For example, the femur is so strong that in an upright position it can withstand up to 1 tons.

The bones are approximately 20 % of the human body, that is 16 carries approximately kilograms of bones 80 kilograms of a person. For example, during each step the load on this bone is three times the weight of a person. When a pole vaulter lands after a jump, the load on the femur is 1400 kilograms for every centimeter of bone. But, despite this incredible load and pressure on the bone, the athlete easily gets up after a jump and walks as if nothing had happened. But what makes our bones so strong?

Bones stronger than steel

Internal bone structure is a marvel of engineering, and amazes with its lightness and incredible strength. It turns out that many engineering structures architects learned from the structure of human bones. Architectural structures built on the principle of human bone tissue are extremely strong, durable and much cheaper to construct. We all know that steel It is considered the most durable and reliable material, because steel is strong on the one hand, and flexible on the other. It turns out that our bones many times stronger than steel and 10 times more elastic, and besides, easier than steel. Human skeleton made of bones 3 times lighter than the same skeleton made of steel. After all, if bones had only one of these properties, for example, strength, but at the same time they would be heavier than they are now, then the skeleton would be so heavy that it would be difficult for a person to make any movement. And he wouldn’t be able to walk at all, because it would be impossible to carry such a heavy body. Each step would take a lot of strength and energy. Bones They would begin to break more often and a crunch would be heard with every step, and when jumping they would crack altogether. Or vice versa, if the bones were light, but not durable. Then our body would not be so strong and flexible. We would turn into flabby mass of bones. But none of this happens, because our bones strong and light in the most ideal quantities.

Bones , depending on what part of the body they are located, they have different features. All bones are flexible and strong. But the degree of these two properties varies depending on where the bone is located. For example, the chest has a special flexibility. After all, protecting vital organs (heart and lungs), it expands when you inhale and contracts when you exhale, making its contribution to. The flexibility of bones can change at certain periods of life. For example, the pelvic bones in women soften and move apart from each other towards the end pregnancy. This is extremely important because it prevents the baby's head from being subjected to mechanical trauma and compression during birth, which could lead to the death of the baby. The bones of the skull, on the contrary, are more durable and much less flexible. After all, they protect within themselves the most important command center of the body -. Thanks to properties of bones we can easily and freely make all kinds of movements, without experiencing any pain or heaviness.

Bones that repair themselves

Bones by degree rigidity can be compared to stones. But still, bones sometimes break down. Amazing properties appear here too. In addition to flexibility, lightness and strength, bones are also endowed with the ability self-healing. When a bone is broken, you just need to fix it in the desired position, the bones will do the rest themselves. The strength and elasticity of bones prevents them from breaking even with strong impacts. But if the bone breaks, then after a fairly short time it grows together and becomes as good as new, as if there was no fracture.

Human Skeletal Control Center: Spine

Spine - this is the basis of our skeleton. The entire weight of the upper body falls on the spine. The spine consists of 33 round vertebrae strung on top of each other. With every movement everything 33 the vertebrae come into action. Occurs between the vertebrae friction. But what is surprising is how this system 33 The vertebrae are protected from friction and the heaviness of body weight pressure. It turns out that in spine a special protection system has been created. Between the 33 vertebrae there are special cartilage discs. These disks work on the principle shock absorbers in car wheels that absorb loads. The shape of the discs is optimal for uniform load distribution. Bends WITH-shaped shapes evenly take on all the weight falling on the vertebrae. Every time we take a step, our body generates a reverse impact force from the surface on which we stand. Thanks to the curves WITH-shaped disks, this force does not cause harm our spine.

Amazing joint lubrication system

Any of our actions is carried out easily and painlessly thanks to joints. Duty joints- maintain the most favorable distance between the bones so that the bones do not touch when moving and there is no friction between them. This is the only way we can move painlessly without experiencing discomfort in our knees, elbows or hands. If there were no buffer zones between the bones in the form joints, then people would begin to move like robots, i.e. short sharp movements. The rubbing surfaces of the joints are covered with a thin cartilage tissue with many small holes. Beneath this layer is slippery joint fluid. As soon as the bone presses on some part of the joint, slippery tissue is squeezed out of the hole in the cartilage. liquid. And like oil in the parts of a machine lubricates the surface joint so that the bone slides easily over it without causing pain to the person.

Legs - support for the body and bones

While walking, they bear the main load legs. The legs have a unique structure that facilitates their mechanical functions. Curved shape feet, it turns out, has a support function, helping to withstand the load of body weight. This is why people with developed flat feet experience heaviness and pain when walking. When walking, the foot steps first with the heel, and then smoothly falls on the toes. At this time, the toes (especially the big toes) have a serious task. We walk and stand on our feet all day. But, despite this, none of the many soft tissues, nerves and thin vessels that are abundantly located on the soles of the feet are squeezed. Because feet have a special layer, which, like a pillow, dampens the negative effects of body weight, evenly distributing pressure across the foot.

Strong union of muscles and bones

In order to walk and perform movements, a person does not need only a skeleton and bones. It is also necessary to have a system muscles, therefore, all the bones that make up the human skeleton are connected by muscles. Shrinking muscles They tighten the bones and thereby provide movement. Any of our movements is possible only thanks to close cooperation muscles and bones. Two completely different systems in structure (muscular and inert) exist in perfect harmony.

Poor balance in the body and coordination of movements

A prerequisite for any movement (arms, legs) is movement coordination And equilibrium. No matter how perfect the connection between muscles and bones may be, without a balance system we would still not be able to stand on two legs. Thanks to balance a person can walk even on a very thin rope. Balance system controls our body every second and regulates our movement with the highest precision. An important element of balance is located in. This center of balance in the ear is called labyrinth. The area responsible for maintaining balance is a piece of tissue the size of a pea, resembling in structure snail. It consists of three small semicircular bones. Inside the semicircular bones there is a special liquid - endolymph. And the inner surface of the bones is covered with hair cells. The slightest movement of our body leads liquid(endolymph inside the cochlea) into movement, and fluid vibration causes hair vibration. Hair cells work like switch. By bending in one direction, the hairs turn the button on, and by bending in the opposite direction, they turn it off.

The constant wave-like movement of the hairs causes a chain of chemical reactions and the appearance electrical impulses in nerve endings. These electrical impulses are transmitted via nerve endings to cerebellum, located at the back of the brain. Cerebellum every second analyzes signals coming from the inner ear. But to ensure balance, he needs other information. For example, in order for us to stand upright, cerebellum collects and analyzes information from billions in a split second receptors in the muscles of the legs, feet, back, chest and neck. It calculates body position relatively the force of gravity. In a split second, it sends commands to the muscles about what movements and in which direction they should make. Today, leading engineers are working on creating robots, which could replicate a person’s gait. The largest companies invest millions of dollars in these projects. But not even the most technologically advanced robot can replicate perfection human gait.

Diseases and

All diseases And musculoskeletal disorders can be divided into several groups. First- are independent, and second- these are secondary ones that appear as a result of any complications occurring in the body. For example, to independent diseases and disorders musculoskeletal system include arthritis and arthrosis. Below I will list the most common diseases and disorders of the musculoskeletal system with a brief description, ranging from the most common and less significant to those dangerous to human life.

List of diseases and disorders of the musculoskeletal system:

Poor posture

Many people suffer from this disorder. This happens when spine Unsteadily deviates forward or behind, as well as in the lateral direction. There are several classifications postural disorders: sluggish posture, upright posture (flat back), kyphotic posture (round back), lordotic posture, rounded back, slouched posture (slouching), asymmetrical (scoliotic) posture and scoliosis.

Flat feet

It occurs when deformation feet, which is accompanied by flattening of its arches. Several types are classified flat feet: transverse, longitudinal and mixed. There are many reasons for flat feet, for example, excess weight, foot injury, rickets suffered in childhood, etc. There is congenital flatfoot, but in most cases it is acquired during life due to a number of reasons. If you don't fix it musculoskeletal disorders, then this can subsequently lead to serious problems.

Radiculitis

Sciatica occurs when the nerve roots of the spinal cord become inflamed. Several types are classified radiculitis: cervicothoracic and lumbosacral. There are many reasons for the occurrence of radiculitis, for example, prolonged hypothermia, excessive weight, acquired or congenital changes in the spinal column, etc. With radiculitis, a person experiences prolonged or sharp pain, numbness in the legs and arms, poor sensitivity, etc.

Osteochondrosis

Osteochondrosis occurs with complex dystrophic disorders in articular cartilage. This disease can develop in any joint, but most often it occurs in intervertebral discs spine. Several types are classified osteochondrosis: lumbar, thoracic and cervical. There are many reasons for the occurrence of osteochondrosis, for example, excess weight, lack of nutrients in the diet, back injuries, sedentary lifestyle, excessive weights and physical activity, stress, etc. With osteochondrosis, a person experiences constant aching pain in the back, and sometimes numbness and aching in the limbs. If left untreated, limb atrophy may occur.

Arthritis

Arthritis is an inflammatory diseasesjoints. Several forms are classified arthritis: primary form (rheumatoid arthritis, osteoarthritis, septic arthritis, juvenile idiopathic arthritis, gout, pseudogout, Still's disease, spondylitis) and arthritis that manifests itself against the background of other diseases (purpura, reactive arthritis, psoriatic arthritis, hepatitis, etc.) . With arthritis, a person experiences various pain, which depend on the type of arthritis, as well as sometimes redness of the skin, changes in the shape of the joint and limitation in its mobility.

Arthrosis

It is a disease that occurs during degeneration, i.e. disintegration joint tissue, as a result, the cartilage tissue of the articular surfaces is affected. Several types are classified arthrosis: primary and secondary. Primary- this is when the cause of arthrosis has not been established, but secondary- this is when there is a clear cause of the disease. For example, the causes of arthrosis include: trauma, inflammation and joint dysplasia, endocrine diseases, metabolic disorders, etc. With arthrosis, a person experiences severe pain in the joint during any movement. If this disease is not treated, the joint may completely collapse, as a result of which it will have to be replaced with an artificial one on the operating table.

Myositis
Spondylolisthesis
Ankylosing spondylitis
Myalgia
Pinched nerve
Sciatica
Spondylosis
Gout
Intervertebral disc protrusion
Intervertebral hernia
And etc.

Summary

The human body is equipped with perfect skeleton And skeletal system. Thanks to our musculoskeletal system we can easily walk, run, make any movement. Our body and organism work for us 24 hours a day throughout our lives. The deeper we study the structure of our body, the more clearly we realize how perfect and fragile it is.However, it is very important to ensure that your musculoskeletal system, as well as the correct lifestyle to avoid various diseases And violations musculoskeletal system, which can ultimately lead to very sad consequences.

Rehabilitation of people with disabilities is not only a pressing problem for society, but also a priority direction of state social policy. Of great importance is the creation of the necessary conditions, thanks to which the fullest development of abilities and maximum integration of disabled people into society is possible. An accessible environment is the physical environment, transport, information and communication facilities, equipped to take into account the needs arising from disability, and allowing such people to lead an independent lifestyle.

Living rooms for people with disabilities in general residential buildings can be designed for one (single) and two (an elderly couple, single-parent families - a mother with a disabled child, a family member with an infirm disabled person) people and must have an area of at least 9 and 12, respectively m 2 (12 and 16 m2 when a disabled person moving in a wheelchair, or a frail person moving within the room or apartment, is accommodated in such a room).

The width of a living room for disabled people must be at least 3.0 m (for the infirm - 3.3 m; for those using a wheelchair - 3.6 m). The depth of the living room should be no more than twice its width. If there is a summer room in front of the room with a width of 1.5 m or more, the depth of the room should be no more than 4.5 m.\

For disabled people who use a wheelchair, the sleeping space becomes multifunctional, since along with living space this room can also have work functions. The convenience of a bedroom for a disabled person is largely determined by the placement of beds, to which wheelchair access must be provided. There should be a place near the bed to store the wheelchair at night. The minimum width of the wheelchair maneuvering area in the sleeping area should be at least 1.3 m, while the layout of the sleeping area as a whole should ensure its circular turn with a diameter of 1.5-1.6 m.

To transfer from a wheelchair to a bed, it is necessary to provide transition devices (ceiling rings, rotating rods, rope walkways, loop holders, etc.) with fastening in the ceiling and wall structures.

In some cases, it may be necessary to provide double-sided bed access or exclusively left- or right-sided access, which should be taken into account when designing. In double sleeping quarters, the beds, as a rule, should be located separately. Among other amenities, this arrangement ensures rational use of room space.

The bedroom should, as a rule, have a direct (or through its own hall) entrance to the sanitary unit. Bedside equipment should include a table (bedside table) for installing a telephone, local lighting, storing and displaying small items, medicines, alarm devices, etc. at night.

Living rooms (for married couples, single-parent families with disabled people, etc.) should be equipped with individual closets for linen, clothes, shoes and other personal belongings. Individual closets for outerwear for disabled people should be provided in the front apartments; Such cabinets should be either built-in or suspended in order to ensure close access to wheelchairs.

Residential premises for people with disabilities and other groups of people with disabilities should not be located adjacent to premises with high noise levels.

The area of rooms (Figure 5.2) in buildings of recreational institutions and hotels of category two stars and below should be increased by no less than 20% or MGN should be accommodated in rooms of increased area (of a higher category or occupied according to a different formula).

Common rooms (living rooms), individual living rooms, living rooms of suites and other residential units must provide the possibility of wheelchair access to the resting place, to most elements of furniture (in particular to cabinets, sideboards, tables, etc.) , to places where household appliances are installed; Of particular importance is the possibility of access to the window and the presence of a viewing platform for communication between a disabled person and the external environment.

Furniture and equipment installed in living rooms must allow them to be used without assistance. The filling of furniture in rooms used by people with disabilities and other categories of people with disabilities should not exceed 40% of the floor area. Furniture in rooms used by a disabled person in a wheelchair should be arranged in such a way that there is free space in the center of the room, allowing the chair to be rotated 360°. The minimum width of passages and passages in living rooms and kitchens must be at least 0.9 m. It is recommended to round the corners of furniture and other piece equipment in order to prevent injuries. It is advisable to use a weighted structure for the main furniture or secure it in order to make it difficult to move it when run over by a wheelchair.

AUXILIARY PREMISES

In the front, hallways, halls of apartments, residential units, rooms intended for the accommodation of disabled people using wheelchairs, complete freedom of movement and turning of the wheelchair by 360° must be ensured (the area not occupied by furniture and equipment - 1 .6 ´ 1.6 m), and the availability of other necessary premises is ensured.

The width of the front must be at least 1.8 m; internal corridors - 1.15 m; door leaves - 0.9 m (clean opening - at least 0.85 m). There should be space in the front for storing an outdoor wheelchair. At the entrance to the apartment and at the doors to all its premises, an area for stopping a wheelchair should be provided. The width of the internal corridors should ensure movement and, if necessary, turning of the wheelchair by 90 and 180°.

In apartments intended for the accommodation of various categories of disabled people, it is recommended to provide an increased number of storage rooms (Figure 5.4), built-in closets, and other storage facilities for typhoid equipment, voluminous literature, crutches and other devices and materials.

It is recommended that an apartment designed for the needs of disabled people include space for household work and self-employment. The width of such a room must be at least 2.5 m; area - 8 m2. In the absence of the specified premises, a workplace (with an approximate closet 0.45-0.6 m deep) can be provided within the kitchen or common room, and a pantry for storing materials and products (at least 4 m2) - both in the apartment and outside outside of it. An additional workplace can be organized near the glazed part of the summer room.

Kitchens, the equipment of which is adapted to the needs of the disabled or elderly, should, as a rule, provide them with the ability to independently manage the household, which, in addition to comfort, increases the level of rehabilitation. Kitchen layout solutions should allow most manipulations to be carried out from one stop of a wheelchair. At the same time, the area for the wheelchair must provide the possibility of its circular turn. The range of equipment installation heights should be within 0.4-1.4 m.

The kitchen area for apartments housing elderly couples and small families with disabled people must be at least 9 m2 or, if there is a disabled person using a wheelchair, as well as for complex or large families and family orphanages, 12 m2. It is possible to reduce the area of the working kitchen below the given values if there is an approximate dining area in the dining room or living room. For one-room apartments with a living room area of at least 16 m2, it is allowed to install a kitchen niche (with natural light according to SNiP 23-05) with an area of 4.5-5.5 m2 with a front of equipment with a total length of at least 2.4 m. The kitchen must have width not less than: in a one-room apartment - 2.2 m; in others - 2.8 m.

It is recommended to arrange the kitchen equipment in an L-shape or U-shape (Figure 5.6) in order to ensure the possibility of central maneuver of the wheelchair. The equipment should include a stove and a refrigerator, in which the height of the bottom shelf from the floor should be 0.6 m. The working surface of the kitchen equipment should be located at a height of 0.82 m from the floor level, while free space should be left below (0.7 m) for easy wheelchair access. The installation height of kitchen equipment should not exceed 1.6 m for access from the wheelchair level; the bottom of the equipment should not be located less than 0.3 m from the floor level.

It is recommended to use kitchen equipment with the possibility of individual height adjustment, while it is advisable to install all working surfaces of the main equipment fixed at one level - from 0.78 to 0.91 m (depending on the individual characteristics of the persons being served). It is recommended to arrange niches (steps, footrests) at the bottom of the equipment for fixed foot support at a height of 0.2-0.24 m from the floor level.

SANITARY FACILITIES

Differences in the ability to use sanitary facilities make it possible to distinguish the following groups of disabled people: a) those requiring assistance both in moving and in undressing and in the hygienic cycle; b) requiring some assistance in the hygiene cycle; c) practically no need for outside help; d) people using crutches, canes, i.e. whose movement is difficult. Group “a” requires assistance from residents or staff, a lift, and a transfer area; group “b” - additional area is required for independent maneuver in a wheelchair, a transfer area, handrails and bars; approximately the same is required for disabled people of group “B”, but in a smaller area. Those walking on crutches or with the help of a cane require support elements (handrails, bars), and the area of the sanitary unit should be slightly larger than the usual standards (within 20%).

Sanitary facilities for disabled people can be designed combined or separate. For disabled people with lesions of the musculoskeletal system, as a rule, combined sanitary facilities are used, equipped with a toilet, washbasin and bath or shower. Sitz baths or polybaths with a seat, baths with opening side doors, etc. are recommended. It may be recommended to use a variant arrangement of sanitary equipment that takes into account individual requests, as well as the ability to adjust the height of the installed equipment. It can be considered rational to install the equipment in a united front along one of the walls, which facilitates the maneuver of a wheelchair. It is advisable to ensure the reach of the washbasin from both the wheelchair and the toilet. The shower should be used while sitting on a special bench. In order to reduce the number of movements, it is possible to use toilets combined with a bidet.

Depending on the set of sanitary equipment, the dimensions of sanitary facilities for disabled people in a wheelchair are: 2.1 ´ 1.9 m (toilet and washbasin, both devices on the same wall) or 1.9 ´ 1.8 m (washbasin on the side ); indoor shower with drain - 1.7 ´ 1.5 m; combined bathroom with shower without tray, washbasin and toilet - 2.4 ´ 2.2 m.

The doors of sanitary facilities should, as a rule, open outward (when opening doors inward, the sanitary unit must have increased dimensions). It is recommended to equip the doors of sanitary units with locks that allow opening both from the outside and from the inside.

In sanitary facilities, wheelchair rotation must be ensured by 360° (Ø 1.5-1.6 m); When a wheelchair approaches the toilet, an area must be reserved for turning the chair 90°. For ease of use by disabled people using wheelchairs, toilet seats should be located at the height of the wheelchair seat (0.5 m). To raise the toilet seat from the nominal height (0.45 m), additional pads or seats should be used. It is advisable to install the washbasin (or washstand) at a height of 0.85 m, which allows direct access for a wheelchair.

In areas free from equipment, wall handrails should be provided at a height of 0.9 m with a diameter of 50 mm (the same in the front apartments, rooms and other residential cells). Bars, handrails, hanging elements of additional equipment of sanitary facilities must have reinforced fastenings designed for a dynamic load of at least 120 kgf. The diameter of the support rods is 25-32 mm. The level of the bottom of the bath should, as a rule, be at the floor level; It is allowed to provide a step up to 0.15 m high near the bathroom. In a bathroom for disabled people using wheelchairs, an additional seat should be provided for transferring from a wheelchair to a seat in the bathroom. The floor of sanitary facilities should not be slippery.

Washbasin sinks should be of the console type. Faucets in bathrooms and kitchens should be equipped with elbow-type openers and equipped with thermostats that limit the temperature of the incoming water to 50 °C.

Additional equipment of sanitary facilities for various categories of disabled people includes, as a rule, handrails (wall or floor installation and fixation), ceiling guides or an interwall rod for hanging a lift, ring, trapezoid, etc. The installation height of the equipment must be adjusted individually. The fastening of instruments and equipment must be strong.

SUMMER ROOMS

Summer premises (terraces, verandas, loggias, balconies) must be a mandatory part of apartments and residential units for the permanent residence of disabled people.

The minimum width of summer premises for the use of a wheelchair must be at least 1.4 m, however, it is recommended that in summer premises it be possible to turn the wheelchair around. Terraces, verandas, balconies and loggias must have windproof (possibly transformable) screen walls and sun protection. In summer rooms it is advisable to provide the possibility of drying clothes. The bottom of the glazing (and the top of the blind fencing of external walls and summer premises) in apartments for disabled people in wheelchairs should be at a height (not higher) of 0.6-0.7 m. The total height of the fencing, taking into account the lathed part, should not be less than 1.2 m. The height of the thresholds should not exceed 0.025 m. If necessary, to level the floor levels of the main and summer rooms, it is recommended to install raised floors that allow precipitation to pass to the level of the main floor of the summer room. The area of summer premises is recommended to be no less than: for one-room apartments - 3 m2; for two-room apartments - 6 m2; for three to five-room apartments - two loggias (or balconies) of 6 m2 each. For apartments located on the ground floor, it is advisable to provide terraces with access to the apartment area; the latter is recommended to be hidden from prying eyes with decorative screen walls or shrub plantings. In the summer rooms of the first floors it is possible to install hatches in the underground (basements) for storing vegetables.

Control questions: 1. What area of the premises is provided for one or two disabled people? 2. What should be the minimum width of the room? 3. What are the requirements for a disabled person’s bedroom? 4. What are the requirements for the hallway? 5. What are the requirements for the kitchen? 6. What are the requirements for a bathroom? 7. What are the requirements for a summer room?

The main cause of musculoskeletal disease is lack of physical activity - physical inactivity. It arises “in connection with the active replacement of manual labor with mechanized labor, the development of household appliances, vehicles, etc. It has an adverse effect on the condition of all organs and systems of the body, contributes to the appearance of excess body weight, the development of obesity, atherosclerosis, hypertension, coronary heart disease "

“In older people, under the influence of natural age-related changes in the nervous structures and musculoskeletal system, the volume and speed of movements decrease, the coordination of complex and subtle movements is impaired, muscle tone is weakened, and some stiffness occurs. All this usually manifests itself earlier and in a more pronounced form in those who lead a sedentary lifestyle.”

The lack of motor activity of the muscles surrounding the bones leads to metabolic disorders in bone tissue and loss of their strength, hence poor posture, narrow shoulders, sunken chest and other things, which adversely affect the health of internal organs.

The lack of sufficient motor activity during the day leads to loosening of the articular cartilage and changes in the surfaces of the articulating bones, to the appearance of pain, and conditions are created for the formation of inflammatory processes in them.

There are different causes of musculoskeletal diseases.

Congenital deformities

Congenital deformities are based on defects in the development of the embryonic nucleus at a certain stage of embryogenesis, diseases or injuries suffered in utero, narrowness of the uterine cavity, lack of amniotic fluid, etc. For example, congenital dislocation of the hip, congenital clubfoot, congenital torticollis, other neck deformities, other congenital malformations lower limb and developmental defects of the upper limb, and others.

Bone tumors

Among different localizations of neoplasms, bone tumors account for 11.4%. They can be primary and secondary. Primary bone tumors consist of bone and cartilaginous structures that are at different stages of differentiation; they arise from tissues involved in bone formation (periosteum, endosteal elements, etc.), and from tissues not directly related to osteogenesis (hematopoietic elements of the red bone marrow , its vessels, reticular and mesenchymal formations, etc.). Secondary tumors grow into bone tissue from surrounding tissues (malignant synovioma) or develop into bone from a metastatic focus (bone metastases from cancer of the prostate, breast and thyroid glands, bronchi, internal organs, hypernephroma, etc.). Metastases usually affect several skeletal bones and occur as an osteolytic form with significant bone destruction or as an osteoplastic form with a predominance of bone formation processes. Diseases such as chondroblastoma, chondroma, osteochondroma, osteogenic sarcoma, osteosarcoma, joint sarcoma and others.

Diseases bordering on bone tumors

There is a group of skeletal diseases that manifest themselves in the form of tumors of similar formations. These include a group of genotinic chondrodysplasias (chondromatosis of bones, multiple exostoses, etc.), as well as osteopathies of uncertain nature, fibrous dysplasia with a dangerous tendency to malignancy, etc.

Aseptic necrosis, or osteochondropathy

Aseptic necrosis was first described in 1909-1910. In the literature, this disease is also found under the name children's de; forming osteochondritis of the hip joint, epiphysionecrosis, infantile coxalgia.

Boys aged 4-12 years are most often affected. The disease can be unilateral or bilateral and occurs as a result of vascular disorders in the subchondral spongy substance of the femoral head due to repeated microtraumas. M.I. Sitenko (1935) considered the cause of the disease to be a disruption of the ossification process of the epiphysis of the femoral head. Often the disease appears after closed reduction of a congenital hip dislocation. There is probably a hereditary predisposition to the disease.

Infectious (chronic) polyarthritis and arthritis

Arthritis of various etiologies is only a local manifestation of a general disease. Arthritis and polyarthritis are classified according to etiological (infectious arthritis with a known pathogen) and pathogenetic principles and according to the generality of the tissue reaction (allergic arthritis, collagenosis, etc.). It is customary to distinguish between infectious arthritis with an unknown pathogen (rheumatic), infectious nonspecific (rheumatoid) and infectious arthritis of a certain etiology (brucellosis, gonorrheal, septic, etc.). The course of arthritis can be acute, but in the vast majority of cases the disease is subacute or chronic. Infectious polyarthritis and arthritis are the most common chronic joint diseases. They can be nonspecific and specific.

Inflammatory bone diseases and their consequences

Inflammatory bone diseases include osteomyelitis, a number of typically occurring forms of primary chronic osteomyelitis (tumor-like osteomyelitis, sclerosing osteomyelitis, post-typhoid osteomyelitis, etc.), as well as Bgodie abscess.

Osteomyelitis is a purulent inflammation of the bone marrow and all bone elements, caused by the introduction of infection into the bone by blood flow from some source (hematogenous osteomyelitis) or resulting from an open injury (traumatic, or wound, osteomyelitis). Osteomyelitis can be nonspecific and specific (tuberculous, syphilitic, etc.). In clinical practice, nonspecific osteomyelitis is more common, resulting from the hematogenous spread of infection, the transition of the inflammatory process to the bone from other tissues and organs (felon, etc.), as well as exogenous infection in open fractures. One type of exogenous osteomyelitis is gunshot osteomyelitis, which occurs with gunshot injuries to the musculoskeletal system. According to the course, acute and chronic osteomyelitis are distinguished. The latter may be primarily chronic and develop from acute.

Send your good work in the knowledge base is simple. Use the form below

Students, graduate students, young scientists who use the knowledge base in their studies and work will be very grateful to you.

Posted on http://www.allbest.ru/

Introduction

In recent decades, there has been a trend towards deterioration in people's health throughout the world. There is an increase in morbidity for all major groups of diseases, an increase in mortality, a decrease in birth rates, and life expectancy. It is impossible to stop this process by relying only on medicine, since in most cases doctors deal with people who are already sick. In order not to get sick, a person needs to learn to stay healthy. Achieving a high level of all types of health (mental, physical and others) is much easier if it is established in childhood.

In recent years, there has been enormous interest in the problem of individual human health, which is confirmed by a large number of studies by leading scientists in Russia and the world (I.A. Arshavsky, N.G. Veselov, M.Ya. Vilensky, N.P. Dubinin, etc.) . The health of our children is of particular concern, since the health of the nation and the progressive dynamics of the entire society are connected with the health of the new man of the 21st century and the future of Russia. The health of a growing person is not only a social problem, but also a moral one. The child himself must be able to not only be healthy, but also raise healthy children in the future.

Exercise helps improve health. Skeletal muscles are the main apparatus with the help of which physical exercises are performed. Well-developed muscles are a reliable support for the skeleton. For example, with pathological curvatures of the spine, deformations of the chest (and the reason for this is weakness of the muscles of the back and shoulder girdle), the work of the lungs and heart becomes difficult, blood supply to the brain worsens, etc. Trained back muscles strengthen the spinal table, relieve it, taking part of the load on themselves, prevent the “fallout” of intervertebral discs and slipping of the vertebrae.

Physical exercises to improve health are aimed at developing correct posture and arch of the foot, strengthening skeletal muscles, and improving the functioning of various organs and systems. Physical exercise has a comprehensive effect on the body. Thus, under the influence of physical exercise, significant changes occur in the muscles. If muscles are doomed to long-term rest, they begin to weaken, become flabby, and decrease in volume. Systematic physical exercise helps strengthen them. In this case, muscle growth occurs not due to an increase in their length, but due to the thickening of muscle fibers. The strength of muscles depends not only on their volume, but also on the strength of nerve impulses entering the muscles from the central nervous system. In a trained person who is constantly engaged in physical exercise, these impulses cause the muscles to contract with greater force than in an untrained person.

1. Musculoskeletal system and its diseases

1.1 Definition of the musculoskeletal system

The musculoskeletal system consists of skeletal bones with joints, ligaments and muscles with tendons, which, along with movements, provide the supporting function of the body. Bones and joints participate in movement passively, subject to the action of muscles, but play a leading role in the implementation of the support function. The specific shape and structure of the bones gives them greater strength, the reserve of which for compression, tension, and flexion significantly exceeds the loads possible during the daily work of the musculoskeletal system.

For example, the human tibia, when compressed, can withstand a load of more than a ton, and its tensile strength is almost as good as cast iron. The ligaments and cartilage of the joints also have a large margin of strength. Skeletal muscles carry out both static activity, fixing the body in a certain position, and dynamic activity, ensuring the movement of the body in space and its individual parts relative to each other. Both types of muscle activity closely interact, complementing each other: static activity provides a natural background for dynamic activity.

As a rule, the position of the joint is changed with the help of several muscles of multidirectional, including opposite, action. Complex joint movements are performed by coordinated, simultaneous or sequential contraction of non-directional muscles. Coherence (coordination) is especially necessary to perform motor acts that involve many joints (for example, skiing, swimming).

Skeletal muscles are not only an executive motor apparatus, but also a kind of sensory organ. In muscle fiber and tendons there are special nerve endings - receptors that send impulses to cells at various levels of the central nervous system. As a result, a closed cycle is created: impulses from various formations of the central nervous system, traveling along the motor nerves, cause muscle contraction, and impulses sent by muscle receptors inform the central nervous system about each element of the system. The cyclic system of connections ensures precision of movements and their coordination. Although the movement of skeletal muscles is controlled by various sections of the central nervous system, the leading role in ensuring interaction and setting the goal of a motor reaction belongs to the cerebral cortex. In the cortex of the greater hemispheres, the motor and sensory zones of the representations form a single system, with each muscle group corresponding to a certain section of these zones. This relationship allows you to perform movements, attributing them to environmental factors acting on the body. Schematically, the control of voluntary movements can be represented as follows.

The tasks and purpose of a motor action are formed by thinking, which determines the direction of a person’s attention and efforts. Thinking and emotions accumulate and direct these efforts. The mechanisms of higher nervous activity form the interaction of psychophysiological mechanisms of movement control at various levels.

Based on the interaction of the musculoskeletal system, the development and correction of motor activity is ensured. Analyzers play a major role in the implementation of motor reactions. The motor analyzer ensures the dynamics and interrelation of muscle contractions and participates in the spatial and temporal organization of the motor act.

The balance analyzer, or vestibular analyzer, interacts with the motor analyzer when the body position in space changes. Vision and hearing, actively perceiving information from the environment, participate in spatial orientation and correction of motor reactions.

1.2 Causes of musculoskeletal diseases

There are different causes of musculoskeletal diseases.

Congenital deformities

Bone tumors

Diseases bordering on bone tumors

Aseptic necrosis, or osteochondropathy

Infectious (chronic) polyarthritis and arthritis

Inflammatory bone diseases and their consequences

2. Physical exercises for musculoskeletal disorders

2.1 Forms of combating diseases of the musculoskeletal system

Physical exercise and sports increase the strength of bone tissue, promote stronger attachment of muscle tendons to bones, strengthen the spine and eliminate unwanted curvatures in it, promote expansion of the chest and the development of good posture.

The main function of joints is to carry out movement. At the same time, they act as dampers, a kind of brakes that dampen the inertia of movement and allow an instant stop after rapid movement. With systematic exercise and sports, joints develop, the elasticity of their ligaments and muscle tendons increases, and flexibility increases.

When working, muscles develop a certain force that can be measured. Strength depends on the number of muscle fibers and their cross-section, as well as on the elasticity and initial length of the individual muscle. Systematic physical training increases muscle strength precisely by increasing the number and thickening of muscle fibers and by increasing their elasticity.

It is estimated that all human muscles contain about 300 million muscle fibers. Many skeletal muscles have a force greater than their body weight. If the activity of the fibers of all muscles is directed in one direction, then with simultaneous contraction they could develop a force of 25,000 kg m.

The main physical form of combating diseases of the musculoskeletal system is physical therapy. It is used in the form of therapeutic exercises, walking, health paths, games, and strictly dosed sports exercises. Therapeutic gymnastics is the main form of exercise therapy. Therapeutic gymnastics exercises are divided into 2 groups: for musculoskeletal and respiratory.

The former, in turn, are divided according to the localization of the effect, or anatomical principle, for small, medium and large muscle groups; according to the degree of activity of the patient - passive and active. Passive exercises are exercises for the affected limb, performed by the patient with the help of a healthy limb or with the assistance of a physical therapy instructor; active - exercises performed entirely by the patient himself.

Based on all of the above, we can conclude that in case of diseases of the musculoskeletal system, the main emphasis should be on: exercises aimed at strengthening bone, muscle tissue, and joints.

The method of treating diseases of the musculoskeletal system necessarily includes physical therapy.

Classes are conducted by the best rehabilitation specialists. The effectiveness of each individual lesson and training set will ensure lasting results.

Kenesitherapy for scoliosis, kyphosis, flat feet, osteochondrosis, osteoporosis.

Joint exercises for arthritis, arthrosis and injuries.

“Relaxation” gymnastics for radiculitis, osteochondrosis, acute pain in the spine and joints.

Adaptive physical culture to improve metabolism and adaptation to physical activity.

Corrective, detorsion gymnastics for the formation of a corrective muscle corset and normalization of muscle tone.

There are two types of physical therapy: general training and special training. General training in exercise therapy is aimed at strengthening and healing the body as a whole; and special training during a course of physical therapy is prescribed by a doctor to eliminate disturbances in the functioning of certain organs or systems in the body.

To achieve results in physical therapy, certain exercises are used aimed at restoring the functions of one or another part of the body (for example, to strengthen the abdominal muscles, therapeutic exercises include a set of physical exercises in standing, sitting and lying down). As a result of completing a course of exercise therapy, the body adapts to gradually increasing loads and corrects disorders caused by the disease.

The attending physician prescribes a course of therapeutic exercises, and a physical therapy specialist (physical therapy) determines the training methodology. The procedures are carried out by an instructor, or in particularly difficult cases by a physical therapy doctor. The use of therapeutic exercises, increasing the effectiveness of complex therapy for patients, accelerates 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 worsening of the condition; the method of doing therapeutic exercises prescribed by your doctor must be strictly followed.

2.2 General exercises for joint mobility

To increase joint mobility, you can use the following exercises:

Starting position - arms forward, palms down. Movement of the hands up, down, in, out.

Starting position - arms forward, palms inward. Movement of the hands up, down, in, out, at the wrist joint.

Starting position - arms forward. Circular movements in the wrist joints, elbow and shoulder joints.

Starting position - hands on the belt. Turns the body left and right with different positions of the arms (to the sides, up).

Starting position - hands behind your head. Circular movements of the body.

Starting position - hands to shoulders. Circular movements of the pelvis to the left and right.

Starting position - half squat, hands on knees. Abduction of legs to the left and right. Circular movements in the knee joints to the left and right.

Starting position - main stance. Tilt left, right.

Starting position - arms up to the sides. Bend forward until your hands touch the floor.

Starting position - lying on your back, arms up. Bend forward, hands to toes.

Exercises for the muscles of the arms and shoulder girdle are performed from a wide variety of starting positions (standing, crouching, lying, hanging, kneeling, etc.). Movements to the sides, up, back and forth are carried out both with straight arms and bent at the elbow joints. Exercises for the arms and shoulder girdle can be widely used in combination with exercises for other muscle groups (legs and torso, etc.).

Exercises for the neck muscles are mainly tilting the head forward, backward, to the sides, turning the head and rotational movements.

Exercises for the leg muscles should be selected taking into account all muscle groups that perform flexion and extension of the legs at the hip, knee and ankle joints, as well as abduction and adduction by the hips. These are various movements with straight and bent legs, lunges forward, to the sides, back, raising on toes, squats on two and one legs with and without support from the arms, jumping in place, moving forward, etc.

Exercises for the trunk muscles help develop mobility in the spine. It's basically tilting and turning in different directions.

They are performed from the starting position standing, sitting, lying on the stomach and back, kneeling, etc. After exercises aimed at developing a particular muscle group, a relaxation exercise should follow, normalizing muscle tone. These are raising the arms and freely, relaxed lowering them, wide, sweeping movements of the body without tension, bending forward with lowered arms, relaxing the muscles in a sitting position, lying down, shaking the arms, legs and some others.

Exercises for training posture. As a rule, with age, as a result of weakening of the muscles of the legs and torso, incorrect or forced positioning of individual parts of the body at work or at home, posture worsens.

Constant use of specially selected exercises will help maintain correct and beautiful posture for many years.

2.3 Modes of motor activity of patients with postural disorders and scoliosis

Physical rehabilitation of scoliotic patients is carried out in conjunction with medical, psychological and social rehabilitation and includes: a rational daily routine and physical activity, a properly balanced diet, as well as other methods of conservative therapy.

The daily regimen of patients with scoliosis consists of therapeutic measures in accordance with the medical requirements of educational activities, sleep, wakefulness, eating and entertainment. Children sleep on an orthopedic bed or on a bed with a wooden or metal shield. During daytime rest, educational activities and medical procedures, the child should lie primarily on his back or stomach on a low pillow. The entire complex of rehabilitation measures is carried out according to three modes of physical activity. The gentle regimen (RD1) is prescribed for progressive scoliosis of degrees I - II, uncompensated scoliosis, scoliosis of IV degree, conditions after surgical interventions, as well as for a short period of time for all patients during the acclimatization period. Rehabilitation measures for patients with RDI include wearing a functional Colt. For the convenience of daytime and night sleep in a corset, a plaster crib or half-bed is made taking into account the corset. The corset is removed during treatment procedures. The gentle-training regimen (RDII) is prescribed to patients with non-progressive, compensated degrees II-III scoliosis. This mode eliminates stress on the spine associated with prolonged sitting, running, jumping, and physical work. As a rule, there is no need to wear a corset in children with ADII. The training mode (RDIII) is used for children with grade I non-progressive scoliosis. Their complex of rehabilitation measures includes dosed exercise, elements of sports games, short-range tourism, etc.

Rational nutrition of patients is based on compliance with the physiological ratios of basic substances - proteins, fats, carbohydrates (1: 1: 4) with an increased content of mineral salts and vitamins in food. A sufficient content of complete proteins and carbohydrates in food is necessary to ensure plastic and energy processes in the body. Mineral salts (calcium salts, phosphorus salts, etc.) should be included in the diet through food projects.

2.4 Exercise therapy in complex rehabilitation of patients with postural disorders and scoliosis

The leading role in the rehabilitation of patients with postural disorders and scoliosis belongs to exercise therapy. The clinical and physiological rationale for the use of exercise therapy in the complex rehabilitation of patients with scoliosis is the connection between the conditions for the formation and development of the spinal ligamentous apparatus with the functional state of the muscular system. Exercise therapy promotes the formation of a rational muscle corset that holds the spinal column in the position of maximum correction. In case of incomplete correction, exercise therapy provides stabilization of the spine and prevents the progression of the disease. General developmental, breathing and special exercises are used.

Special exercises are aimed at correcting pathological deformation of the spine - corrective exercises. They can be symmetrical, asymmetrical, or detorsional. Uneven muscle training when performing symmetrical exercises helps to strengthen weakened muscles on the convex side of the curvature and reduce muscle contractures on the concave side of the curvature, which directly leads to the normalization of traction of the spinal column.

2.4.1 Exercise therapy to strengthen the muscle corset

When choosing exercises to strengthen the muscle corset, it is necessary to take into account the initial state of the muscles, individual characteristics of posture, as well as the degree of postural impairment. “Pumping up” already strong and especially overstressed muscle groups is not only pointless, but also harmful. Depending on the nature of postural disorders, special attention should be paid to training weakened muscles.

Examples of exercises for the muscles of the back, upper back and shoulder girdle. It is necessary to strengthen these muscles with increased thoracic kyphosis and pterygoid scapulae.

1. Place your hands on your waist, raise your head and shoulders, and squeeze your shoulder blades together. Do not hold your breath, do not raise your stomach (do not lift your lower ribs off the floor). Maintain this position until the muscles become slightly tired.

2. Perform the same exercise, but place your hands at the back of your head and pull your shoulders back.

3. Perform the same exercise, keeping your hands in the “wings” position.

4. Raise your head and shoulders, spread your arms to the sides, clench and unclench your hands.

5. Raise your head and shoulders, slowly move your arms up, to the sides and towards your shoulders (imitate the movements of breaststroke swimming).

It is especially necessary to strengthen the lower back muscles with reduced lumbar lordosis.

Starting position: lying on your stomach.

1. Alternately pull back (lift off the floor) and lower straight legs to the floor. The pace is slow, do not lift your pelvis off the floor.

2. Take the straight leg back (make sure that the pelvis remains motionless), hold in this position for 35 counts. Repeat for the other leg.

3. Take one leg back, then the other, slowly lower both legs.

Examples of abdominal exercises.

The strength of the muscles of the anterior abdominal wall must be increased with increased lumbar lordosis and protruding abdomen.

If your abdominal muscles are very weak, it is dangerous to start training with conventional exercises involving lifting your legs and torso from a position lying on your back. A sharp increase in intra-abdominal pressure can lead to divergence of the rectus abdominis muscles and a hernia. For the most untrained, it is better to start strengthening the abdominal press with easier exercises.

Starting position: lying on your back, lower back pressed to the floor.

1. Tilt your head forward, raise your shoulders from the floor, stretch your hands to your toes (exhale). Return to the starting position (inhale).

2. Bend one leg, stretch it forward (towards the ceiling), bend it, place the foot on the floor (exhale, straighten the leg (inhale). Repeat for the other leg.

3. Bend both legs, straighten them forward, bend them, lower your feet to the floor (exhale), straighten your legs (inhale).

Examples of exercises for the lateral muscles of the trunk.

These muscles are especially important for maintaining symmetrical body position in the frontal plane. In case of postural disorders in the sagittal plane, the muscles of the right and left sides of the body are trained with the same intensity. The same load for both sides is also used for moderate asymmetry of the torso, including mild scoliosis and in the initial period of training for any stage of scoliosis. If muscle asymmetry is weak, then symmetrical training (the same number of repetitions of the exercise for each side) evens out muscle strength. Weak muscles on the convex side experience greater tension and are “pulled up” to stronger muscles on the concave side, which do not receive the same training effect.

In case of severe postural disorders in the frontal plane, it may be necessary to strengthen the muscles on the convex side of the curvature and relax on the concave side, but such asymmetrical training can only be carried out after consulting an orthopedist and a specialist in physical therapy.

Starting position: lying on your side.

1. Raise and lower the straightened “upper” leg.

2. Raise the “upper” leg, attach the “lower” leg to it, and slowly lower both legs.

3. Raise both legs, hold them for 35 counts, and slowly lower them.

4. Starting position: lying on the floor on the couch, the torso is suspended, the “lower” arm rests on the floor, the feet are fixed under the support or are held by a partner. Place your hands on your belt, hold your torso suspended for 35 counts, and return to the starting position.

This exercise is also used as a functional test for the lateral muscles of the body.

Examples of exercises for the muscles of the back of the thighs.

With an increased pelvic tilt angle and increased lumbar lordosis, it is necessary first of all to strengthen the muscles of the back of the thighs and abdominals. The hamstrings are involved in lower back exercises, and the exercises here involve the lower back muscles.

The lower back muscles with increased lumbar lordosis usually need to be relaxed and stretched. After performing exercises in which the lower back muscles involuntarily tense, you should do several deep bends forward or lie on your stomach on a support, relaxing the muscles.

1. Starting position: resting on your knees and palms with straightened arms (standing on all fours). Straighten one leg parallel to the floor and stretch it back and slightly up (towards the ceiling). Keep the pelvis motionless.

2. Perform the same exercise while simultaneously bending your elbows.

These exercises can be performed with weights (for example, a cuff with sand) or with the help of a partner who provides resistance to the movement of the leg back, holding it.

3. Starting position: lying on your stomach on a gymnastic bench, one leg pressed against it, the other hanging down with a weight on the ankle joint. Raise your straight leg with the load and lower it. Instead of a load, a partner can provide resistance to the movement of the leg.

4. Starting position: hanging on the gymnastic wall facing it. Pull your straight leg back, hold for 35 counts, lower. Repeat for the other leg. Keep the pelvis pressed against the wall.

5. Take both legs back at the same time, hold for 35 counts, and lower. The pelvis is pressed against the wall.

Examples of exercises for the muscles of the anterior thighs.

Just as in the previous group of exercises, here we must remember that by strengthening weakened muscles, we are forced to load those that need relaxation and stretching more than training.

With a reduced pelvic tilt angle and smoothed lumbar lordosis, one should strive to strengthen the muscles of the back and front of the thighs. Exercises for the anterior thigh muscles are performed with the participation of the abdominal muscles, and their tension smoothes out lumbar lordosis.

After performing such exercises with reduced lumbar lordosis, it is necessary to relax the abdominal muscles and stretch them, for example, lie on your back with a high cushion under your lower back.

Starting position: lying on your back.

1. Alternately raise and lower straight legs.

2. Raise and lower both legs at the same time.

Starting position: hanging on the horizontal bar or on the gymnastic wall with your back to it:

3. Alternately raise and lower your legs to the horizontal without bending them at the knees.

4. Raise your right leg, attach your left leg to it, lower your right leg, then your left leg.

5. “Angle”: simultaneously raise both legs to an angle of 90°.

As you train, the load on the muscles increases. To do this, you can keep your legs raised longer and perform exercises with a load on the ankle joints or with the help of a partner who resists lifting your legs.

The next two exercises allow you to avoid tension in the abdominal muscles, but for the first you need not only a gymnastic wall or a crossbar attached to the wall, but also an assistant, and for the second, good coordination of movements and the ability to control muscle tension and relaxation.

6. Starting position: standing at arm's length from the gymnastic wall, facing it. Grasp the bar at chest level with your hands and squat down until your hips are horizontal. The partner, standing behind, presses his hands on the child’s thighs at the hip joints. Overcoming resistance, slowly straighten your legs.

7. The same exercise can be performed without a gymnastic apparatus and without a partner. Sit down (hips horizontally), rest your hands on your thighs at the hip joints, relax your abdominal muscles. Slowly straighten your legs, overcoming the weight of your torso.

2.4.2 Corrective exercises

Corrective exercises are special exercises that are aimed at correcting pathological deformation of the spine. They can be symmetrical, asymmetrical, or detorsional.

Symmetrical exercises are based on the principle of minimal biomechanical impact of special exercises on the curvature of the spine. These exercises do not require taking into account the complex biomechanical conditions of the deformed musculoskeletal system, which minimizes the risk of their erroneous use. Symmetrical exercises have a different effect on symmetrically located muscles of the trunk, which, as a result of spinal deformation, are in a physiologically unbalanced state.

The advantage of symmetrical exercises is, firstly, that they are easier to select and perform correctly, and, secondly, that they involve the body’s internal reserves in the process of compensating for violations.

When performing such exercises, it is necessary to maintain the middle position of the spine. This in itself is not an easy task for a child with a postural defect in the frontal plane, since the muscles of the right and left sides of the body with such disorders are developed unequally and exercises that are symmetrical in the nature of their execution are asymmetrical in terms of muscle work. To keep the back straight, weakened muscles on the convex side of the curvature are forced to overcome the resistance of stronger muscles on the concave side. With asymmetrical posture, any symmetrical exercises to strengthen and stretch the muscles of the back and abdominals are corrective if, when performing them, you are especially careful to ensure that the spine is exactly in the midline. During such training, muscle tone is gradually leveled out: the muscles on the convex side become stronger and more resilient, and the overstrained muscles on the concave side are slightly stretched.

Examples of symmetrical corrective exercises.

Starting position: lying on your stomach.

The hands are placed one on top of the other under the chin. Take the correct body position (spinous processes in a straight line, arms and legs are located symmetrically relative to the spine). At the same time, raise your arms, chest and head without lifting your legs, pelvis and stomach from the floor. Hold this pose for 37 counts, maintaining the correct body position. Breathing is free.

Perform the same exercise while simultaneously raising your legs straight.

Starting position: lying on your back, arms extended along the body.

1. Take the correct body position, check it by raising your head and shoulders. Place your hands on your belt, slowly sit down, maintaining correct posture, return to IP (exhale). Relax your muscles (inhale), check your body position.

2. “Bicycle”: circular movements with legs.

3. Raise your straight legs at an angle of 3045°, spread them apart, connect, lower (exhale), relax the muscles (inhale).

Asymmetrical exercises are also based on the principle of spinal correction, but are distinguished by an optimal effect on its curvature, moderate stretching of muscles and ligaments on the concave arc of curvature and differentiated strengthening of weakened muscles on the convex side.

Asymmetrical corrective exercises are used to reduce scoliotic curvature. They are selected individually and affect the pathological deformation locally. Asymmetrical exercises train weakened and stretched muscles. For example, from a starting position standing, arms along the body, feet shoulder-width apart, perform the following exercise:

a) on the side of thoracic scoliosis, the forearm drops, the shoulder rotates outward, and the scapula is brought to the midline. At the moment of adduction of the scapula, the rib protrusion is corrected;

b) on the opposite side of the thoracic scoliosis, the forearm is raised, and the shoulder rotates forward and inward, while the scapula is pulled outward. This movement involves the forearm, shoulder and shoulder blade. Torso rotation is not allowed. When performing this asymmetrical exercise, the upper portion of the trapezius muscle is stretched and the scapular muscles on the side of scoliosis are strengthened; strengthening the upper trapezius muscle and stretching the scapular muscles on the opposite side. Exercises help to equalize muscle tone, the position of the forearms, and reduce the asymmetry of the position of the shoulder blades. It should be remembered that incorrect use of asymmetrical exercises can provoke further progression of scoliosis.

2.4.3 Detorsion exercises

Detorsion exercises perform the following tasks: rotation of the vertebrae in the direction opposite to torsion; correction of scoliosis by leveling the pelvis; stretching contracted and strengthening stretched muscles in the lumbar and thoracic spine. For example, on the side of the lumbar concavity - moving the leg back in the opposite direction; on the side of thoracic scoliosis - abduction of the arm with a slight rotation of the body in the upper part forward and inward. When the leg is abducted, the pelvis is moderately abducted in the same direction. The exercise promotes detorsion in the lumbar and thoracic spine.

Correction of vertebral torsion is carried out as follows. In case of right-sided thoracic scoliosis, in conditions of fixation of the lumbar spine and pelvis, exercises are performed with rotation of the shoulder girdle and right arm from right to left, since the torsion of the vertebrae is in the direction from left to right. Detorsion exercises for the lumbar spine are carried out by rotating the lower back, pelvis and legs from left to right while fixing the thoracic spine.

As an example, we give exercises used for S-shaped scoliosis (right-sided thoracic, left-sided lumbar). To correct the deformity, asymmetrical exercises are used: raising the left arm of the left leg, tilting to the left to correct the lumbar curvature, while the left arm is raised up and turned, and the head is pressed with the palm of the right hand on the costal hump, the head and shoulders are tilted to the right. Correction of lumbar curvature is also carried out with a fixed thoracic spine by tilting the pelvis and legs to the left.

In order to correct the thoracic curvature, the torso is tilted to the right, using an asymmetrical position of the arms. Correction of torsion deformity of the lumbar spine is carried out in a supine position while fixing the head, arms and chest by bending and throwing the left leg over the right. To correct torsion deformation of the thoracic spine when fixing the legs, pelvis, and lumbar spine, the torso, shoulders, arms, and head are rotated from right to left. Simultaneous correction of both torsion curvatures is possible. To do this, the child, from a position lying on his left side with his arm outstretched and his left leg bent at the hip and knee joints, turns his right shoulder and chest forward, and turns his right leg and pelvis back with his straightened leg. In addition, in the initial standing position, the left leg is fixed in front of the right, the left arm is raised up, the right arm is placed on the chest, while the arm and shoulder girdle are rotated to the left, and the pelvis to the right.

For the thoracolumbar type of scoliosis with the apex of the curvature at the level of the XI-XII thoracic vertebrae, it is advisable to train the iliopsoas muscle on the concave side of the spine according to I. I. Kon. In the starting position, lying on your back, the thigh and lower leg are bent at an angle of 90°. A cuff connected through a block to a weight is placed on the thighs. Exercises are carried out by bending the hip to an acute angle. The amount of load applied to the thigh cuff is 3-5 kg, the number of exercises is 15-20. After 3 months the number of exercises is doubled, after 6 months - tripled. Isometric training of the iliopsoas muscle is carried out from the same starting position by holding a load of 8-15 kg for 10 s. Over 3 months of treatment, the load retention time is gradually increased to 30 s, over 6 months - to 1 min. This treatment method helps to reduce the tilt of the lumbar spine on the side of the iliopsoas muscle training.

2.5 Unloading the spine

Unloading the spine in the treatment of scoliosis is a necessary condition for a special and local effect on it. The unloading position not only allows you to more effectively influence the area of bone deformation, but also improves blood and lymph circulation in the surrounding muscles and ligaments.

As the child grows, the curvature of the spine may increase due to overload of the growth cartilages. Therefore, unloading the spine involves reducing pressure on the intervertebral cartilage on the concave side of the curvature, creating uniform pressure on the end plates of the vertebrae. To unload the spine and correct its deformation during oral and written schoolwork, children take a lying position, sleep in plaster beds, and wear functional corrective corsets.

Spinal unloading is achieved by keeping patients in a lying position for most of the day. During school hours and homework, children lie on medical couches. They do written lessons while lying on their stomachs, with their elbows lightly resting on the couch. During school hours, a wedge-shaped pillow made of thick plywood and covered with foam rubber and leatherette is placed under the child’s chest. The stand corresponds to the following dimensions: its height is equal to the length of the child’s shoulder, its length is the distance from the chin to the XII rib plus 2 cm, its width is the distance between the shoulder joints. During oral lessons, children can be in a supine position, with a support placed under their head and upper back.

Unloading the spine can also be achieved by relaxing and stretching the muscles that are actively involved in maintaining correct posture.

Teaching a child to relax is often the most difficult task in a physical therapy course. Relaxing is especially difficult for an untrained person. This task requires some experience in handling your muscles, the ability to control the degree of their tension. It is important not only to learn how to relax muscles at rest, but also to be able to relax those muscles that are not involved in movement - both during exercise and in everyday life. Relaxation relieves muscle tension and speeds up recovery after training. It is especially important to learn to relax postural muscles with increased tone - this is a necessary condition for the formation of correct posture.

When relaxed, the tone of not only the skeletal muscles decreases, but also the smooth muscles of the internal organs in the corresponding areas. Relaxation exercises are an excellent way to train inhibitory reactions for excitable children. Constant stress causes muscle tension throughout the body, and relaxing the face and hands relieves mental stress and makes it easier to relax larger muscles.

To check whether the child has relaxed the muscles, you can press on them and feel the decrease in muscle tone (as the muscles relax, they become softer).

Muscle tone can also be checked using passive movements - take the child’s limb and move it. Relaxed limbs do not resist or assist passive movements; If you lift a relaxed arm or leg and suddenly release it, it does not stay in the air, but falls limply. Until the relaxation skill is developed, it is necessary to constantly check whether the child performed the exercise correctly and whether his muscles are completely relaxed.

It is necessary to relax the muscles not only after the load, but also before it. This applies to each lesson and to the training course as a whole.

To facilitate relaxation, training begins in a comfortable starting position, preferably lying on your back. The feeling of muscle relaxation can be evoked in a child in contrast to the feeling of tension: “Tighten your arm... now relax.”

Relaxation is facilitated by additional techniques such as shaking, rocking, and swinging limbs.

Muscle elasticity is closely related to the flexibility of the spine. If the mobility of the spine in the corresponding section is normal or slightly above normal, there is no need to further stretch the muscles.

Simultaneously with stretching, it is necessary to strengthen the antagonist muscles, the tension of which ensures the execution of movements during stretching exercises.

Conclusion

Physical exercise is necessary at any age. From adolescence to old age, a person is able to perform exercises that strengthen his body and have a wide variety of effects on all his systems. They give rise to a feeling of vivacity and special joy, familiar to everyone who systematically engages in any kind of sport.

Human health will primarily depend on lifestyle, which is largely personalized and determined by historical and national traditions (mentality) and personal inclinations (image).

Poor posture is a major disorder of the musculoskeletal system. Poor posture is a sign that your child is not healthy. Scoliosis is not just a violation of a child’s posture due to curvature of the spine. It is not for nothing that doctors practicing the methods of Far Eastern medicine call the spine the “tree of life”, and traditional medicine has come to the conclusion that the spine is connected to vital internal organs and disruption of its functioning leads to damage to the kidneys, liver, heart, etc. Therefore We can rightfully say: if your child has been diagnosed with scoliosis, this is very serious. And if you want your child to grow up healthy and not lose the ability to enjoy life since childhood, he needs to be treated. Not limited to visits to doctors, it is necessary to make changes in his lifestyle, but in no case should you self-medicate or seek help from specialists whose qualifications cause you distrust.

For thousands of years, humanity has been searching for the wonderful elixir of life, sending fairy-tale heroes on long journeys to distant lands. But he turned out to be much closer - this is physical culture, which gives people health, joy, a feeling of fullness of life. A modern specialist must be a seasoned, physically fit person. It is difficult to build yourself and your health according to a strict schedule. But if this succeeds, then everything else succeeds.

In conclusion, the following conclusions can be drawn:

1) a course of physical rehabilitation for patients with scoliosis helps strengthen the back muscles, lateral muscles of the torso and especially the abdomen;

2) during physical exercise, muscle tone is normalized;

Based on our own research results and analysis of literary sources, we can say that physical rehabilitation increases the functional reserves and defenses of the body. Adequately selected means and methods of physical rehabilitation improve the trophism of organs and tissues and lead to a more rapid restoration of impaired functions.

The musculoskeletal system consists of skeletal bones with joints, ligaments and muscles with tendons, which, along with movements, provide the supporting function of the body. Physical exercise and sports increase the strength of bone tissue, promote stronger attachment of muscle tendons to bones, strengthen the spine and eliminate unwanted curvatures in it, promote expansion of the chest and the development of good posture.

Physical education exercises have a preventive, corrective and tonic effect.

The complexity of defining and combining specific physical exercises and the sequence of their implementation in classes make it necessary to take into account the complex nature of the impact of exercises on students.

Life is motion.

Bibliography

physical education spine disease posture scoliosis

1. Abramov M.S. Physical Culture. M.: INFRAM, 2003.

2. Vainer E. N., Rastvortseva I. A. Valeological education as an integral part of the domestic system of health formation // Valeology. 2004. N 2. P. 5859

3. Dubrovsky V.I. Sports medicine: Textbook. for students higher textbook establishments. - 2nd ed., add. - M.: Humanite. ed. VLADOS center, 2002. - 512 pp.: ill.

4. Home medical encyclopedia. Editor-in-Chief Pokrovsky V.I., Moscow: “Medicine”, 1993

5. Kaptelin I.O., Lebedeva I.P. Therapeutic exercise in the system of medical rehabilitation. -- M., 1995.

6. Milyukova I.V., Evdokimova T.A. Physiotherapy. The newest reference book / Under the general editorship. prof. T.A. Evdokimova. - St. Petersburg: Owl; M.: Publishing House Eksmo, 2003. - 862 p.

7. Oreshkin Yu. A. To health through physical education. M.: Logos, 2002. 287 p.

8. Pravosudov V.P. Instructor's manual for physical therapy. -- M., 1980.

9. Pasynkov E.I. Physiotherapy. - M.: Medicine, 1980.

10. The spine is the key to health / P.S. Bragg, S.P. Maheshwarananda, R. Nordemar and others - St. Petersburg: Diamant LLC, 2001. - 512 p.

11. Potapchuk A. A., Didur M. D. Posture and physical development of children. St. Petersburg: Rech, 2001.

12. Guide to physical therapy and physical prevention of childhood diseases / Ed. A. N. Obrosov and T. V. Karachevtseva. - M.: Medicine, 1978. - 392 p.

13. Runova M. Preservation and strengthening of child health // Preschool education. 1999. No. 6.

14. Physical education. Textbook. Editors Golovin V. A., Maslyakova V. A., Korobkova A. V. et al., Moscow: “Higher School”, 1983.

15. Physical culture / Ed. T.Yu. Zhiglova. M.: Sport, 2001. P. 198.

16. Physical culture and valeology. Misharov A.Z., Kamaletdinov V.G., Kharitonov V.I., Kubitsky S.I.. Chelyabinsk: DCNTI, 1999. - 325 p.

17. Physical rehabilitation: Textbook for academies and institutes of physical culture / Under the general editorship. prof. S.N. Popova. - Rostov n / D: publishing house "Phoenix", 1999. - 608 p.

18. Kharitonov. An effective method of motor training. Omsk: OGPI, 1999. - 213. p.

Posted on Allbest.ru

Send your good work in the knowledge base is simple. Use the form below

Similar documents