From Big Medical Encyclopedia

PHYSIOTHERAPY EXERCISES (LFK) as a method of treatment

PHYSIOTHERAPY EXERCISES (LFK) as a method of treatment — use of a complex of means of physical culture with the preventive, medical and rehabilitation purposes. LFK widely would apply in system of complex treatment in, policlinics, sanatoria. LFK should be considered as very effective additional to lay down. an action to the main methods — surgical, medicamentous, etc., it is one of methods medical rehabilitations (see).

In addition to lay down. - professional, tasks, LFK pursues also the educational aims. Regular use of LFK in-tse, policlinic, house conditions develops at the patient a conscientious attitude to use physical. exercises, imparts a gigabyte. skills, correct relation to a hardening of an organism.

The main means of LFK — physical. exercises — are known long ago to applied medicine. So, in Ancient Chinese medicine in the 3rd millennium the medical gymnastics was described and applied BC, in a cut the main attention was paid to breathing exercises. In Ancient Greece Hippocrates considered exercises means of stimulation fiziol, processes, pointing to their recreational and recovery value. K. Galen recommended gymnastics and occupations certain types of work at obesity, the general weakness, disturbances of movements in joints, etc.

to Ibn-Xing in « Canon of medical science » (see) emphasized importance of occupations physical. exercises for preservation of health. In Merkuriali's treatise (G. Mercuriali, 1569) «Art of gymnastics» summed up works of antique and medieval authors in the area to lay down. gymnastics. In 1780 Mr. of J. Tissot in the book «Medical and Surgical Gymnastics», attaching huge significance physical. to exercises, put forward situation that «the movement can often replace different drugs, but any medicine will not replace the movement». In the second half of 19 century the system of mechanotherapy — the lokalistichesky direction, on Krom physical began to develop. exercises were applied only to the struck musculoskeletal link or body without need of the general training of other muscular groups. G. Zander, H. Krukenberg, Caro, Stepanov's works were of great importance for development of mechanotherapy. Over time mechanotherapy lost the universal character and took the appropriate place in system of recovery treatment. A great influence on development of the doctrine about use physical. exercises for treatment the Swedish system of Ling rendered (R. N. of Ling); it was also characterized by lokalistichesky tendencies. Exercises were aimed at the development of movements in separate muscular groups and joints. The attention was not paid to use of natural movements, development of the movement skills having applied value (in particular, outdoor games with their emotional coloring, etc. did not enter this system). Noncritically apprehended Swedish system extended in a number of the countries.

At the end of 19 — the beginning of 20 century various methods of so-called medical gymnastics were developed. So, in 1881 Mr. Ertel (M. of J. Oertel) the method of terrainkur, in 1884 Mr. P. Schott — gymnastics for patients with heart diseases, in 1910 L. Singer, Gofbauer (M. of S. Hofbauer), etc. — gymnastics offered at bronchial asthma, emphysema, an idiopathic hypertensia.

In Russia distribution of medical gymnastics (the term «physiotherapy exercises» arose only after Great October socialist revolution) was promoted by the ideas about physical. education, preventive and to lay down. use physical. exercises, to-rye M. Ya. Mudroye, S. P. Botkin, G. A. Zakharyin, A. A. Ostroumov, P. F developed. Lesgaft and his follower V. V. Gorinevskny. Grants on medical gymnastics and massage were created by I. N. Pirussky, E. N. Zalesova, V. F. Diakovsky, M. K. Barsov, K. G. Solovyov, etc.

In development and consolidation of the LFK method in the USSR it is possible to allocate four main stages. The first stage (1923 — 1930) — distribution and implementation of LFK to system a dignity. - hens. treatments. The second ethane (1931 — 1941) — implementation of LFK in the general system to lay down. - the prof. of institutions (policlinics, hospitals, etc.) using the differentiated techniques at various diseases. The third stage (1941 — 1945) is significant wide use of LFK in the period of the Great Patriotic War in hospitals. The fourth stage which began since 1945 is characterized by further broad implementation of LFK in system to lay down. - professional, institutions.

Features of the LFK method

Characteristic feature of the LFK method — its physiology and naturalness for an organism. Efficiency of its use is also explained by it at various diseases and injuries. Important feature of the LFK method — active participation of the most sick in medical and recovery process therefore the doctor at purpose of LFK should define accurately degree it physical. activities (at all other methods of therapy of the patient is in rather passive state). In LFK the main is widely used biol, function of an organism — the movement, however not the movement in general, and physical. exercise as organized form of motion. In the organization of treatment of patients rest and the movement are not opposed, and supplement each other.

LFK — a method of the general, nonspecific therapy, and everyone physical. exercise — a nonspecific irritant. Along with all-recreational and fortifying impact on the patient physical. exercises can exert preferential impact on defined funkts, the systems and bodies involved in patol, process and by that on the course of a disease. Proceeding from it, LFK is also method of pathogenetic therapy. Besides, LFK — a method funkts, therapies, since physical. exercises stimulate and develop function of all main bodies and systems.

Characteristic feature of the LFK method — a training of patients by means of physical. exercises, edge it is subdivided into the general and special. The general training is applied for the purpose of improvement, strengthening of an organism in general and development of adaptation to increasing physical. to loadings, special — for the purpose of recovery, normalization and development of functions of the bodies or systems broken owing to a disease or an injury. At implementation of a special training certain physical are selected. the exercises exerting the direct normalizing and recovery impact on function of the struck body or system. At various diseases appoint the special, directed exercises. The general and special training is carried out by certain rules. Depending on character, a stage of development and weight of a course of a disease a technique and a dosage physical. exercises shall have individual character. In selection and use physical. exercises are obligatory system (the necessary sequence for various musculoskeletal links), a regularity (daily) and duration (months, years), gradualness of increase physical. loads of an organism of the patient both throughout the procedure, and during a course of treatment. The training of patients only then is effective when physical. loading increases gradually, exercises become complicated, the number of their repetitions increases and initial positions vary. It promotes adaptation of an organism to increasing physical. to loadings.

Influence of physical exercises on an organism

Fig. 1. Electroencephalograms at an idiopathic hypertensia (against the background of complex therapy): 1 — before carrying out a course of remedial gymnastics alpha activity is almost not expressed; diffusion change of bioelectric activity of bark of big hemispheres (D — right, S — left) a brain with dominance of the bystry potentials which are a sign of disturbance of mobility of nervous processes; 2 — after carrying out a course of remedial gymnastics; emergence of a well-marked synchronous alpha rhythm testimonial of normalization of bioelectric activity of bark; a voltage — 50 mV.
Fig. 2. Record of biopotentials of a tibial nerve at a polyneuritis (against the background of complex therapy): above — to a course of remedial gymnastics; below — after a course of remedial gymnastics (the increase of amplitude of biopotentials testimonial of improvement of function of the neuromuscular device); a voltage — 10 Hz.

Appointment to sick LFK increases confidence it in a favorable outcome of a disease, distracts from «leaving in a disease», promotes elimination of alarm and improves a psychological state. Physical. exercises promote emergence at sick positive emotions. The patient carries out physical. exercises iod constant control of consciousness (corrective function of a cerebral cortex) that stimulates and increases the general operability of an organism. Even visualization about the movement changes biopotentials of muscles, speeds up pulse, breath and raises the ABP. Medical and recovery action physical. exercises it is based on their ability to stimulate fiziol. processes. They actively influence the course of trophic processes, promoting improvement of function not only neuromuscular system, but also internals. It is known that for a normal fiziol, activity of c. the N of page is necessary inflow of afferent impulses, deficit to-rykh at decrease physical. activities — hypokinesias (see) brings to patol, to changes in an organism and deterioration in a course of a disease. Under the influence of systematic occupations of LFK reorganization of bodies and fabrics, stimulation of both efferent, and afferent systems accelerates funkts, that facilitates carrying out nervous impulses and promotes compensation of the broken functions, formation of the new, dynamic stereotype which is characterized by more high level of operability of an organism. Physical. exercises influence processes of excitement in a cerebral cortex, raising and leveling mobility of nervous processes (fig. 1), train interaction and regulatory functions of various systems and by that stimulate mechanisms of recovery and recovery. Thus, physical. exercises exert beneficial effect on all organism in general and on the struck systems and bodies in particular. From positions of the exercise H. E. Vvedensky about a parabiosis physical. exercise should be considered as the factor which is characterized by the anti-parabiotic influence increasing mobility fiziol, processes and promoting improvement of function of the neuromuscular device (fig. 2).

Fig. 3. Kimogramma of muscle work of the left shin at the patient with the residual phenomena after a fracture of bones of the left shin: above — prior to a procedure of remedial gymnastics: below — after the procedure of remedial gymnastics (increase in amplitude of biopotentials and operating time of muscles demonstrates recovery of their function)

Influence physical. exercises on internals and systems it is caused by strengthening of neurohumoral bonds between the functioning muscular system, bark of big cerebral hemispheres, a subcortex and internals. The regulation of functions of internals which is carried out by c. the N of page, occurs in close interrelation with afferent systems, in particular kinaesthetic, cover a role at physical. exercises increases. During the performance physical. exercises motor and visceral regulation of vegetative functions is followed by their reflex reorganization for ensuring the increased activity of skeletal muscles. The reticular formation takes active part in this process, in addition to bark. Recovery of functions of internals and systems is carried out on the mechanism of motor and visceral reflexes. During the performance physical. exercises join neurogenic factors humoral and hormonal that forms the uniform neurohumoral mechanism of regulation of functions of an organism. So, products of muscle performance (a histamine, acetylcholine) are biogenic stimulators of activity of bodies and systems and consequently, and all organism. Under the influence of muscle performance allocation of corticosteroids increases that promotes adaptation of an organism to increasing physical. to loading. Physical. exercises result in dominance of cholinergic influences that is also one of mechanisms of adaptation of internals to increase physical. loadings. Long exercise of a musculoskeletal system leads to a partial or complete recovery of its function (fig. 3).

Means and the LFK forms

the Main means of LFK — physical. exercises, to-rye are divided on gymnastic, sports and applied (walking, run, swimming, rowing, circulation on skis and so forth), mobile and sports (see. Games, in physical culture and sport ). In LFK exercises of labor character are also used (see. Labour therapy ). Use during the carrying out physical. exercises of natural factors of the nature — the sun, air, waters — are raised by their efficiency and promotes a hardening. Forms of use of LFK — to lay down. gymnastics, morning gigabyte. gymnastics with inclusion of the LFK elements, the dosed walking or walks, terrainkur, occupations sports exercises in strictly dosage form (swimming, rowing, circulation on skis, etc.), games. In each of the LFK forms the principle stated above — a combination of the general and special training is observed.

Remedial gymnastics — LFK main form. Use of gymnastic exercises in LFK has a number of advantages: a possibility of division of exercises into elements and their gradual summing, selective impact on various groups of muscles, musculoskeletal links and systems of an organism, convenience in dosing physical. loadings, and also use physical. exercises in various conditions (in the enclosed space, in the open air).

Fig. 4. Diagrammatic representation of exercises of remedial gymnastics: 1 — 2 — passive, carried out by means of the methodologist; 3 — 5 — active, with shells; 6 — 8 — active exercises on wall (Swedish) bars.

Exercises to lay down. gymnastics divide into two groups: for a musculoskeletal system and for respiratory system. The first, in turn, are subdivided into subgroups on the following signs: on localization of influence or the anatomic principle (for small, average and large muscular groups), on a degree of activity of the patient — passive and active. The exercises for the affected extremity which are carried out by the patient or independently by means of a healthy extremity, or by means of the methodologist or LFK instructor, active — the exercises which are carried out by the patient are called passive. Include in passive exercises and massage (see). Active exercises can be facilitated (by means of various devices — straps, special little tables, etc.)> free and with effort — static (isometric) and dynamic. Exercises to lay down. gymnastics it is possible to carry out as with use of gymnastic apparatus and objects, and without them (fig. 4). The exercises which are carried out on special devices including and pendular character, with so-called burdening, are called mechanotherapy (see). Exercises with shells, objects and devices use for the purpose of creation of a support, strengthening or easing physical. loadings, simplification of performance of exercises, and also for the purpose of a variety of occupations. In to lay down. to gymnastics distinguish also preparatory (or introduction), serial (or disciplining), corrective exercises (see. Gymnastics corrective ), exercises in sending of impulses. Special position is held by the exercises imagined — ideomotor (see. Ideomotor act ).

The breathing exercises applied in to lay down. to gymnastics for the purpose of improvement of function of external respiration, are divided into two look: static, carried out without the movement of hands and muscles of a shoulder girdle, and dynamic when phases of breath are combined with the movement of hands, a shoulder girdle and the case. During the performance of exercises of dynamic character auxiliary respiratory muscles participate in the act of breath, except the main respiratory muscles (a diaphragm, outside and internal intercostal muscles) (the broadest muscles of a back, upper back gear muscles, big and small chest, etc.). Thanks to it breath becomes fuller and deep and the bigger amount of oxygen gets into lungs with inhaled air. Breathing exercises of dynamic character interfere also with emergence of developments of stagnation in a liver, improve activity went. - kish. path, respiratory system. As well as static, they are widely used at various diseases and after intensive exercises for the purpose of decrease physical. loads of an organism. Breathing exercises in to lay down. to gymnastics apply not separately, and in combination with other gymnastic exercises. Besides, there are physical. the exercises which are carried out in combination with phases of breath. Exercises concern to them, in to-rykh muscles of a prelum abdominale, the lower extremities and the case participate (e.g., inclinations of the case forward, pressing of the legs bent in knees to a stomach are carried out on an exhalation).

Fig. 5. The diagrammatic representation of exercises of remedial gymnastics in water (bathtub).

A specific place in LFK is held by physical. exercises in water (a bathtub, the pool or an open reservoir) — a so-called kinezogidroterapiya. Performance of exercises in water (fig. 5) is facilitated by mechanical and thermal influence of an aqueous medium owing to what many movements, implementation to-rykh is complicated in a bed, on a couch, in the LFK hall, in water are carried out without essential efforts or is free due to simplification of weight of an extremity and reduction of pains or the spastic phenomena in muscles. At vertical position of a body in water training in walking is facilitated, stability in standing and walking increases. Physical. exercises in water can be applied as at full immersion in it of a body, and at partial (a brush, a forearm, feet, etc.)*. Physical. exercises in morning a gigabyte. to gymnastics (see. Charging ) for LFK carry special to lay down. character. Use fortifying and breathing exercises according to a condition of patients, their physical more often. readiness.

The dosed walks, walking in the fresh air exert especially beneficial effect on the psychological sphere of the patient. They will be out on the flat area, since a route from 1000 to 3000 m long with moderate physical., loading.

For terrainkur (see) specially mark a route with ascension at an angle from 3 to 15 — 20 °. Degree physical. loads of an organism and energy expenditure at terrainkur are defined by the size of an angle of lead, a distance of a route, rate of walking, quantity of stops for rest.

Sports exercises (skiing, swimming, rowing, etc.), apply near tourism in LFK in strictly dosage form. So, e.g., to lay down. the rowing passes in quiet speed (20 — 22 grebk in 1 min.), duration of occupations — 15 — 30 min. Near tourism is carried out under observation of the instructor of LFK; length of a route is from 8 to 20 km, duration of transitions is no more than 4 hours with frequent halts for rest, rise pe more than on height of 400 m etc.

Mobile and sports use as one of the LFK forms preferential in sanatoria.

Technique and dosage of all physical. exercises in LFK is defined nozol, the form of a disease, a stage and weight of its current, the general condition of the patient, age previous physical. fitness. Physical. load of an organism increases gradually, with inclusion of different muscular groups. Each exercise is carried out with a certain number of repetitions, rhythmically, at the set speed, with gradual increase in amplitude of the movement in joints. Technique of use physical. exercises provides in LFK: the choice of initial positions (lying, sitting, standing), optimum for treatment of this stage of a disease; selection of exercises for various muscular groups of hands, legs, the case, observance of accuracy of their performance and the correct combination to breathing exercises; as a rule, one breathing exercise is alternated to three-four exercises for a musculoskeletal system. Consider also density physical. loadings and emotional background of training (procedures).

Fig. 6. The physiological curves constructed according to change of pulse during the occupations by remedial gymnastics: 1 — the first half of a medical course (the cardiovascular system of the patient is not adapted to an exercise stress); 2 — the second half of a medical course (the cardiovascular system of the patient is adapted to an exercise stress). Occupation is divided into three periods: I \introduction (25% of all time of occupation in the first half of a medical course and 15% in the second half), II — the main (50% and 70%)", III — final (25% and 15%) (on abscissa axis). In the first half of a medical course the exercise stress is insignificant, the main period of occupation is reduced and pulse of the patient at the end of occupation is returned to initial size (the dotted line showed standard deviations of pulse). In the second half of a course the exercise stress is raised, the main period of occupation is extended, and pulse of the patient at the end of occupation slightly becomes frequent (the dotted line showed its possible return to initial size or some delay).

Classes of LFK are given individually or by a group method, the group method is most widespread. Patients are selected in groups for classes in uniformity of a disease, level funkts, conditions of an organism, to age and degree of fitness to physical. to loadings. Both individual, and group classes are given taking into account a so-called fiziol, a curve (frequency rate of increase and decrease physical. loads of an organism throughout occupation, according to a respiration rate, pulse, the ABP level that is registered graphically; fig. 6). The usual duration of individual occupation is 5 — 20 min., group — 15 — 40 min. In addition to the procedure to lay down. gymnastics the patient often appoint independent occupations — performance of special exercises (the principle of fractional loadings).

At various diseases and injuries of LFK it is useful to combine with fizio-and a balneoterapiya, and also klimatoterapevtichesky procedures. For the patient the movement, heliation, an air-cure, thalassotherapy are a uniform therapeutic complex, at Krom the factors making it supplement each other and strengthen their action. According to indications of LFK combine with medicamentous therapy.

The attending physician, and the choice of a technique, definition of a dosage, character of occupations and control of execution physical appoints LFK. exercises the specialist doctor on LFK carries out. Procedures are carried out by instructors of LFK in chambers of medical institutions, offices and the LFK halls of policlinics, a wedge, in-t, sanatoria or in the open air. Offices and the LFK halls are equipped with necessary gymnastic stock and the equipment according to the approved standards.

Techniques of LFK at individual diseases — see articles on individual diseases.


LFK should be applied when it is necessary to raise a tone of an organism of the patient, to stimulate fiziol, processes, to promote recovery of function of the struck body or system, to counteract developments of stagnation, to prevent progressing of a disease and possible complications, certainly, in the absence of contraindications. Terms for purpose of LFK, as a rule, match the beginning of recovery of the patient, they are strictly individual and are defined by the attending physician.

At cardiovascular diseases of LFK it is shown both at the compensated condition of blood circulation, and at its insufficiency to I and II stages. LFK value in complex treatment of coronary heart disease is especially big (out of an attack of stenocardia, in various terms after a myocardial infarction); techniques of LFK depend on weight of a current and are directed to stimulation of recovery (morfofunktsionalny) processes in a myocardium, noncardiac factors of blood circulation, a training of a cardiac muscle, the prevention of negative influence of long rest on an organism of the patient, his mentality. LFK is shown at dystrophy of a myocardium, subacute and hron, myocarditis. Considering that physical. exercises strengthen corticovisceral bonds and reduce displays of vegetative dysfunction, LFK is shown in all stages of a course of a hypertension taking into account features a wedge, manifestations, at arterial hypotension, etc. The expressed beneficial effect physical. exercises, in particular respiratory, on function of external respiration defines wide indications of LFK at a pulmonary tuberculosis, nonspecific diseases of a respiratory organs: acute and hron, pneumonia, bronchitis, bronchoectatic disease, pneumosclerosis, silicosis, emphysema of lungs and bronchial asthma. Use of LFK is shown out of the period of an aggravation at a peptic ulcer of a stomach and duodenum, cholelithiasis and cholecystitis, and also at diseases of a stomach with disturbance of its motive and secretory function. The stimulating influence physical. exercises on processes of a metabolism allows to apply widely LFK at obesity, gout, a diabetes mellitus. LFK is shown at effects of hemorrhages, thromboses and embolisms of brain vessels, in the recovery period after injuries of a head and spinal cord and peripheral nerves, paresis, paralyzes, contractures, and also at a lack of coordination of movements and vestibular function. LFK is widely applied in complex recovery treatment of poliomyelitis, diencephalic disturbances, various forms of neurosis, hysteria, a psychasthenia, neurasthenia. In obstetrics physical. exercises apply in all stages of pregnancy and in a puerperal period, in gynecology — at an underdevelopment of a uterus, its wrong situation and omission, subacute and hron, inflammatory processes of a uterus and its appendages, and also at frustration of a menstrual cycle. Occupations of LFK in a climacteric are of great importance. LFK is appointed at the opened and closed fractures of bones of hands, legs (for the purpose of stimulation of formation of a bone callosity and recovery of movements). At injuries of a backbone at various levels, and also its deformations (at scoliosis and considerably the expressed kyphosis and a lordosis) LFK use for recovery of function of the movement, strengthening of «a muscular corset» of a backbone, correction of a backbone, correction of a bearing and prevention of complications; at restriction of movements in joints, contractures, a hypotrophy of muscles at polyarthritis, an ankylosing spondylarthritis (Bekhterev's disease), the deforming spondylosis and osteochondrosis of various departments of a backbone. The surgical clinic of LFK applies in the postoperative period for the purpose of stimulation of reparative processes and the prevention of complications after appendectomies, herniotomies, resections of a stomach, a gall bladder, etc. Especially the particularly important of LFK becomes after operative measures on bodies of a chest cavity for the purpose of recovery of function of breath, after reconstructive heart operations and vessels.


Cardiovascular insufficiency of the III Art., heavy disturbances of a rhythm and conductivity of heart, the malignant course of a hypertension, an aneurysm of heart, tromboembolic episodes at cardiovascular diseases, acute feverish and inflammatory diseases, bent to bleedings, malignant new growths and other diseases and states, at to-rykh the active motive mode it is contraindicated.

The physiotherapy exercises at children

Use of LFK at children's age have the features connected as with anatomo-fiziol, an originality of a children's organism, and with specifics of a course of diseases at children's age. The big need inherent to children for the movements makes important biol, to the devil of the growing organism, being an indispensable condition for normal formation and development of an organism of the child. At children at any it is long the current disease the symptoms characteristic of the disease, but also a deviation in growth and development, funkts, disturbances because of restriction of a physical activity develop not only patol. Therefore one of the main tasks of LFK in pediatrics — the prevention of lag of the child in development by completion of deficit of movements and use of specially picked up exercises for directly medical, corrective influences at certain diseases.

LFK — a continuous component of the regime of children in to lay down. - professional, establishment, the important pedagogical factor promoting the organization of children's collective, respect for discipline, increase in an emotional tone, the prevention of negative psychoemotional reactions.

Fig. 7. Group occupations remedial gymnastics in an office of physiotherapy exercises of policlinic.

The same LFK forms, as at adults, but differ in wide use of games and imitating movements. The LFK elements widely apply during the training on physical. to education with children of early age, at special groups of comprehensive schools, policlinics (fig. 7), in summer camps.

Characteristic features of a technique of LFK at children the combination of means of so-called all-recreational influence with is special, training taking into account age data of development of mentality and motility, compliance of LFK of exercises which are picked up by the instructor to lay down. to tasks at adequate the general physical. to loading. Occupations shall attract interest of children and be carried out on a positive emotional background. A number of authors developed various techniques of LFK for children of certain age groups at these or those diseases.

Fig. 8. The girl who is carrying out exercise of corrective gymnastics in front of the mirror.

Technique LFK shall correspond age fiziol, to characteristics. Reflex physical exercises are shown to children of early age, to-rykh the training of certain muscular groups at the help of instinctive motive reflexes is the cornerstone (Babinsky, etc.). After disappearance of a hyper tone of flexion muscles (about 1,5 — 2 months of life) passive exercises join. In process of increase in autokinesias special attention is paid to formation of active movement skills (see. Gymnastics for children of early and preschool age ). The combined use of all types of the exercises and massage which are carried out in optimum initial positions provides correct physical. development and correction of the arising disturbances of a bearing (fig. 8).

Indications. LFK is shown at the majority of diseases of children's age as one of effective remedies all-stimulating and pathogenetic therapy.

LFK widely use in complex therapy of diseases of early children's age (rickets, a hypotrophy, etc.) for ensuring improvement and normalization of the broken exchange processes, the prevention of deformation of a musculoskeletal system, lag in psychomotor development, etc. So, in initial stages of rickets widely use methods of massage, passive and nek-ry active gymnastic exercises, it is preferential in initial positions lying. At reconvalescence gradually more places allocate for active exercises for development of the movement skills which are available for the child and the prevention of complications.

At rheumatism of LFK apply step by step, since the period of a high bed rest. Widely use exercises for small joints and muscular groups, respiratory and fortifying, strictly dosed depending on a condition of the patient. Physical. exercises apply for strengthening of a cardiac muscle, improvement of the general and endocardiac hemodynamics, the prevention of complications from joints, a nervous system and for the general strengthening of an organism of the child. With expansion of the mode during the occupations of LFK increase also physical. loading for gradual adaptation of cardiovascular system to the increasing physical activity of the child.

Fig. 9. The children who are carrying out breathing exercises at bronchial asthma (inflation of rubber toys).

LFK apply in complex therapy of bronchial asthma (fig. 9). For recovery of the broken mechanisms of nervous control and improvement of functions of external respiration apply special breathing exercises («sound gymnastics») with accruing all-physical. training adequate fiziol, to age opportunities of an organism. At acute and hron, pneumonia of LFK uses for recovery of the broken function of external respiration, for fight against a hypoxia and an anoxemia, commissural process, for a rassasyvaniye patol, elements, the prevention of an atelectasis and emphysema. At these diseases apply static and dynamic breathing exercises, exercises of the all-developing character with use of fortifying, imitating and game exercises more often.

Contraindications are, as a rule, limited to serious condition of the sick child, high temperature, toxicosis, new growths. In each separate case the question of indications and contraindications for purpose of LFK is solved only by the attending physician.

Techniques of LFK at various diseases at children — see articles on individual diseases, e.g. Children's paralyzes , Dystrophy , Osteomyelitis , Poliomyelitis , Scoliosis etc.

See also Physical culture .


PHYSIOTHERAPY EXERCISES (LFK) as discipline — the section of clinical medicine studying action of physical exercises and other means of physical culture (the motive mode, massage, labor therapy) and developing methods of their use in the treatment-and-prophylactic and rehabilitation purposes.

The term «physiotherapy exercises» was approved by the Plenum of Council of physical culture Narkomzdrava the USSR in 1929. This term replaced the old concepts «kinesitherapy», «motor-therapy», «medical gymnastics», etc., as a rule, considering use physical. exercises from tightly local, mechanistic positions.

Specialists of LFK together with the corresponding specialists develop the general theoretical bases of use physical. exercises with to lay down. - professional, the purposes, in system of medical rehabilitation, study the mechanism of their therapeutic action at various patol, states, develop indications and contraindications, the differentiated techniques of use of cure of LFK for various diseases — internal diseases, surgical, neurologic, children's diseases, etc. (see. Physiotherapy exercises as method), combinations of a technique to other types of treatment (physiotherapeutic, balneal, etc.).

LFK is closely connected about a wedge, disciplines, and also theoretical disciplines (anatomy, physiology, biochemistry, hygiene, pedagogics, etc.), necessary for justification of the differentiated use of means of LFK depending on features of diseases, a condition of patients, age, sex, a profession, etc. One of the LFK directions is use of its cure for diseases at children's age.

LFK is integrally connected with physical culture (see. Physical culture ), it borrows it a rich arsenal of forms and means for use in to lay down. - professional, the purposes.

A great influence as disciplines rendered on formation of LFK works of outstanding domestic scientists of I. M. Sechenov, I. P. Pavlov, H. E. Vvedensky, M. Ya. Mudrov, G. A. Zakharyin, S. P. Botkin, P.F. Lesgaft, etc.

LFK as scientific, a wedge, discipline was created after Great October socialist revolution. The big role in its formation and development was played by the first people's commissar of health care and the chairman of the Supreme council of physical culture at VTsIK N. A. Semashko. The significant contribution to development of discipline was made by V. V. Gorinevsky, V. V. Gorinevskaya, V. K. Dobrovolsky, B. A. Ivanovsky, I. M. Sarkizov-Serazini, etc.

In 1928 in Central in-those physical cultures the country's first LFK department was organized, to-ruyu I. M. Sarkizov-Serazini, in 1931 — LFK department in TsIU of doctors headed, the cut managed B. A. Ivanovsky.

In the 30th 20 century of LFK are won by the increasing recognition; stages of formation of LFK — cm. Physiotherapy exercises as method. At a wedge, research in-ta departments and offices of a lech.fizkultura are created. LFK joins in curricula of medical higher education institutions. In 1944 the first textbook on LFK for medical students V. V. Gorinevskaya and E. F. Dreving, in 1950 — V. N. Moshkov's monograph «The general fundamentals of medical physical culture» where theoretical bases of LFK were systematized, in 1959 — the textbook on LFK and medical control of S. M. Ivanov is published. In 1957. M3 of the USSR are approved training programs on LFK for all f-tov medical in-comrade of LFK is taught on the 6th course of medical in-t in the course of passing by students of a subinternship in a complex about a wedge, disciplines. In a number of medical in-t training of specialists doctors on LFK and sports medicine through a wedge, an internship and a postgraduate study is made. Training of the instructors on LFK who are directly giving the classes appointed by the doctor is carried out in in-ta of physical culture and medical and sports clinics (see. Clinic medical and sports ).

During the Great Patriotic War the methods developed by LFK widely and with great success were used for recovery of health of wounded and patients. In post-war time of department and offices of LFK would will be organized in all large and policlinics for adults and children. In 1950 the Provision on medical and sports clinics is approved, in structure to-rykh departments of LFK are provided; clinics are the organizational and methodical centers for LFK for all to lay down. - professional, institutions.

In 1966 there was a resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About measures for further development of physical culture and sport», LFK which played an important role in expansion of use. In this resolution M3 USSR it is offered to expand use of physical culture in to lay down. - professional, work of medical institutions to increase network of offices of LFK at policlinics, to increase training of students of medical higher education institutions and doctors concerning use of means of physical culture in to lay down. - professional, the purposes.

Research in the field of LFK is concentrated by hl. obr. in industry a wedge, research in-ta, at departments of medical and sports in-t and in large medical and sports clinics. In 1970 in Kiev the first in a health system Research was open for in-t of medical problems of physical culture of M3 of USSR. In in-those big department of LFK functions; to specialized council in-that the right of protection and reception the edging is granted. theses. In Central research in-those balneology and physical therapy of M3 of the USSR since 1973 the department of LFK and medical control is organized. The academic council of it in-that is specialized council for reception and protection the edging. and dokt, theses on discipline «Physiotherapy exercises and sports medicine».

LFK is considered as one of the leading components in system of medical rehabilitation of patients of a different profile. At the USSR Academy of Medical Sciences as a part of Scientific council on physical culture and sport the All-Union problem commission on LFK in system of medical rehabilitation functions, plans edges and coordinates all research in the country in the field of LFK. Plays a large role in distribution of scientific achievements on LFK All-Union scientific and medical about-in on medical control and LFK, organized in 1968, a cut combines not only specialists doctors on LFK, but also instructors of LFK. The all-Union congress about-va took place in 1975 in Kiev. About-va on medical control and LFK are organized by Nauchnomeditsinskiye in all federal republics and many large cities. The «Balneology, Physical Therapy and Physiotherapy Exercises» magazine where scientific works in the field of LFK are published is issued.

In the socialist countries (NRB, VNR, GDR, ChSSR) in-you sports medicine, developing also questions of use of physical culture and sport as remedy and prevention are available.

Bibliography: Wine-makers D. A. Private techniques of medical physical culture, L., 1970; Gubert K. D. and Ryss M. G. Gimnastika and massage at early age, M., 1972; Danko Yu. I. Sketches of physiology of physical exercises, M., 1974, bibliogr.; Ivanov S. M. Physiotherapy exercises at bronchial asthma at children, M., 1965, bibliogr.; it, Physiotherapy exercises at chronic pneumonia at children, M., 1968, bibliogr.; about N e, Medical control and physiotherapy exercises, M., 1970; To aptelina.f. Recovery treatment (physiotherapy exercises, massage and work therapy) at injuries and deformations of a musculoskeletal system, M., 1969; Leporsky A. A. Physiotherapy exercises at diseases of a metabolism and diseases of joints, M., 1960, bibliogr.; Medical physical culture, under the editorship of V. E. Vasilyeva, M., 1970; Medical physical culture, under the editorship of S. N. Popov, M., 1978; Medical physical culture, under the editorship of. And. M. Sarki-zova-Serazini, M., 1960; Medical physical culture at diseases at children's age, under the editorship of S. M. Ivanov, M., 1975, bibliogr.; Mogendovich M. R. and T e of m to and I. B N. Physiological fundamentals of medical physical culture, Izhevsk, 1975, bibliogr.; Moshkov V. N. General fundamentals of physiotherapy exercises, M., 1963, bibliogr.; it, Medical physical culture in resorts and in sanatoria, M., 1968, bibliogr.; about N e, Medical physical culture in clinic of nervous diseases, M., 1972, bibliogr.; it, Medical physical culture in clinic of internal diseases, M., 1977, bibliogr.; Postnikovav.M. The general technique of use of physical exercises in physiotherapy exercises, M., 1967, bibliogr.; Sarkizov-Serazi-n and I. M. Rol and value of the Russian science in development of physiotherapy exercises, in book: Sketches on stories physical. cultures, under the editorship of N. I. Toropov, century 4, page 20, M. — L., 1949; Sokolov A. And. and Zausayev V. I. Use of medical physical culture in maxillofacial surgery, M., 1970, bibliogr.; Stolyarova A. G. and Tkachyov G. R. Rehabilitation of patients with postinsultny motive frustration, M., 1978; Fonarev M. I. Medical physical culture at diseases of children of early age, L., 1973, bibliogr.; Khrushchev S. V. Physiotherapy exercises at rheumatism at children, M., 1966, bibliogr.; Kraus H. R an a b W. Hypokinetic disease, diseases produced by lack of exercise, Springfield, 1961.

V. N. Moshkov; S. M. Ivanov (ped.).