Therapeutic exercise for stomach ulcers

4. Physiotherapy for stomach ulcers

Impulses from receptors internal organs enter the central nervous system, signaling the intensity of functioning and condition of organs. When the disease occurs, reflex regulation is disrupted, pathological dominants and vicious (pathological) reflexes arise, distorting the course of normal processes in the human body. The disease suppresses and disorganizes motor activity- an indispensable condition for the normal formation and functioning of any living organism. Gishberg L.S. Clinical indications for the use of physical therapy for diseases of internal organs. SMOLGIZ, 1948 Therefore, physical therapy is very important element treatment of ulcerative processes. ulcerative symptom gastrointestinal tract physical

It is already known that performing dosed physical exercises, accompanied by positive changes in the functional state of the centers of the subcutaneous region and an increase in the level of basic life processes, causes positive emotions (the so-called psychogenic and conditioned reflex influence). This is especially applicable when peptic ulcer, when the neuropsychic state of patients leaves much to be desired (normalization of the symptoms of dystonia expressed in patients from the nervous system). It should be noted the effect of physical activity on nervous regulation digestive apparatus.

With regular exercise, as in the process of physical training, energy reserves gradually increase, the formation of buffer compounds increases, and the body is enriched with enzyme compounds, vitamins, potassium and calcium ions. This leads to activation of redox processes and increased stability acid-base balance, which in turn has a beneficial effect on scarring ulcerative defect(impact on the trophic and regenerative potency of gastrointestinal tissues).

The effect of physical exercise is determined by its intensity and time of use. Mild to moderate muscle tension stimulates basic functions gastrointestinal tract, when as intense, they depress.

Favorable influence of exercise therapy on blood circulation and breathing, which also expands the functional capabilities of the body and increases its reactivity. Depending on the clinical direction of the disease and functionality the patient is applied various shapes and funds.

Contraindications to classes include:

Fresh ulcer in the acute period.

Ulcer complicated by bleeding.

Preperforative state.

An ulcer complicated by stenosis in the stage of decompensation.

The main objectives of exercise therapy are:

Regulation of excitation and inhibition processes in the central nervous system;

Normalization of the patient’s neuropsychological tone;

Improving respiratory function, blood circulation and digestion, redox processes;

Opposition various complications accompanying peptic ulcer ( adhesions, congestion, etc.);

Normalization muscle tone(which is a powerful regulator of internal organs), increasing muscle strength, proprioceptive sensitivity;

Development of the necessary motor qualities, skills and abilities (breathing, muscle relaxation, elements autogenic training, coordination of movements, etc.).

Arthritis – inflammatory diseases of the joints

Physical therapy for arthritis is an obligatory component of complex treatment, but is contraindicated in the acute period. IN subacute period they use active, mainly lightweight...

Children's cerebral paralysis: concept, etiology, symptoms

There is an opinion that it is possible to engage in therapeutic exercises and physical therapy with a child only from the age of three. However, this statement is wrong...

Diagnosis and treatment of scoliosis

A course of physical therapy for patients with scoliosis of I and II degrees. The goal of the course is to maximize the patient’s mobility, purposefully strengthen the muscular corset, develop balancing reflexes...

Healing Fitness

The term “physical therapy” primarily refers to the branch of medicine that studies the treatment and prevention of diseases using physical education methods (usually in combination with physiotherapeutic procedures and massage). On the other side...

Therapeutic physical training for pyelonephritis

Therapeutic exercise is a set of methods of treatment, prevention and medical rehabilitation, which are based on the use of physical exercises, methodically developed and specially selected...

Therapeutic exercise in gynecology

For chronic inflammatory processes Physical therapy and massage are indicated. Exercise therapy is used to eliminate adhesions, inflammation, general strengthening body, restoration of working capacity...

Therapeutic exercise after pregnancy. Recovery after childbirth

The birth of a child brings a lot of joy and happiness into the home. But also hassle. New concerns arise that require a lot of time and effort. And now the young mother begins to quickly get tired, tired...

Therapeutic exercise for vegetative-vascular dystonia

Dosed use of physical exercises balances the processes of excitation and inhibition in the central nervous system, increases its regulatory role in coordinating activities the most important organs and systems involved in the pathological process...

Exercise therapy for flat feet

A flat foot can be congenital, or it can develop during a person’s life. With flat feet it is disturbed normal function both the foot itself and the entire musculoskeletal system...

Intervertebral hernia

Physical therapy is an independent scientific discipline. In medicine, this is a method of treatment that uses drugs physical culture for prevention, treatment, rehabilitation and maintenance therapy...

Methods of rehabilitation of patients with gastric ulcer

Physical therapy (physical therapy) for peptic ulcers helps regulate the processes of excitation and inhibition in the cerebral cortex, improves digestion, blood circulation, breathing, redox processes...

Features of application physical rehabilitation children, sick rheumatoid arthritis on stationary stage treatment

Physical therapy in the acute phase with significant activity of the process is carried out individually. The classes include simple to perform active exercises for the muscles of the trunk and affected limb segments from the starting positions...

Scheuermann-Mau osteochondropathy

Conservative treatment must be comprehensive. The presence of a corrective corset does not eliminate the need to use such traditional methods treatment like manual therapy, exercise therapy (physical therapy)...

Rehabilitation after myocardial infarction

The basis for starting classes with strict bed rest is the disappearance of the main symptoms acute period- cessation of pain, elimination of complications (collapse, pulmonary edema, severe heart rhythm disturbances)...

Role non-drug methods treatment bronchial asthma

Self-massage and physical therapy improve blood and lymph circulation, pulmonary ventilation, bronchial patency, and increase mobility chest, tone the respiratory muscles, facilitate the discharge of sputum...

For patients with peptic ulcers, exercise therapy is used during periods of calm or during mild exacerbations.
Contraindications to the use of exercise therapy include a fresh ulcer in the acute period, bleeding, a penetrating ulcer, acute perivisceritis, or a sharp narrowing of the pylorus.
Objectives of exercise therapy:
- Normalization of the activity of the central nervous system and restoration of impaired cortico-visceral connections;
- Improving blood circulation, redox processes, reducing and eliminating local inflammatory phenomena;
- Stimulation of trophic and reparative processes in the stomach and duodenum;
- Elimination of dysfunctions of the digestive system, which occurs with peptic ulcer disease;
- Improving the psycho-emotional state of the patient.
It should be remembered that the patient’s complaints are not always
correspond anatomical changes gastric mucosa and duodenum and progression of the ulcer can occur with complete subjective well-being. In this regard, the absence or presence of pain, as well as their intensity, do not make it possible to judge the depth, size of the ulcer, the tendency to increase penetration into adjacent organs, and the healing process. In uncomplicated peptic ulcer pain is the only clinical manifestation, which, however, cannot be a measure of the anatomical state of the ulcer and the subsidence of pain, which often occurs after a short stay of the patient in the hospital, is not a criterion for reducing the ulcerative process. Such originality clinical course peptic ulcer of the stomach and duodenum makes it difficult to use exercise therapy. Therefore, when treating patients with peptic ulcers, it is necessary to spare the abdominal area and very carefully, gradually include exercises for the abdominal muscles in physical therapy classes. However, the patient’s motor mode should be gradually activated due to the increasing total load when performing most exercises, including diaphragmatic breathing and for the abdominal muscles.
The method of exercise therapy depends on the form of the disease (exacerbation, onset of remission, remission). In the acute period of the disease, if there is pain, strict bed rest is prescribed. The patient avoids movements even in bed, sparing the abdominal area, his breathing is predominantly chest. During the period of pronounced pain syndrome Exercise therapy is contraindicated.
IN complex treatment For patients with peptic ulcers, exercise therapy is included when the symptoms of exacerbation begin to subside, 2-5 days after the cessation of acute pain.
Extended bed rest uses easy to perform, simple gymnastic exercises for small and medium muscle groups with a small number of repetitions in a lying and sitting position. Movements in large joints should first be performed with a shortened lever and a small amplitude in lightweight starting positions. Shown are static breathing exercises, enhancing inhibition processes in the cerebral cortex. Performed in the initial position lying on the back with relaxation of all muscle groups, these exercises can induce a drowsy state in the patient, help reduce pain, eliminate dyspeptic disorders, and normalize sleep. Exercises for the abdominal muscles and any exercises that lead to increased intra-abdominal pressure. However, already in the first lessons it is necessary to teach the patient abdominal breathing with a small amplitude of oscillations abdominal wall.
For improvement general condition the patient and in the case of signs of attenuation of the exacerbation (significant subsidence of pain, disappearance or significant decrease in the rigidity of the abdominal wall), the motor mode is activated, the total load is increased, and a ward mode is prescribed. All exercises are performed with gradually increasing efforts for all muscle groups (except for the abdominal muscles), with incomplete amplitude, at a slow and medium pace. Starting positions - lying, sitting, kneeling. Exercises for the core that cause tension in the muscles of the anterior abdominal wall should be used with great caution: short-term slight and incomplete turns of the torso, lifting the pelvis in a supine position with bent legs, lifting the chest with support on the elbows, and some others are allowed. Gradually (under strict control) diaphragmatic breathing deepens. The patient is taught volitional control breathing movements, aimed at increasing the duration of the respiratory phases and the intervals between them, contribute to the activation of redox processes and increase the tone of the whole organism. In case of slow gastric evacuation function, the procedure therapeutic exercises it is necessary to include exercises lying on the right side, and with moderate exercise - on the left side.
Full extensions, sharp turns and bends of the body to the sides, raising and abducting straight legs, which lead to an increase in intra-abdominal pressure, are excluded. During this period, patients are recommended massage, sedentary games, walking at a slow pace. The motor density of the therapeutic gymnastics procedure is average, the duration of the lesson is up to 15 minutes.
When pain and other signs of exacerbation disappear, a free motor regimen is prescribed. General developmental exercises are more varied, and the number of repetitions increases. Exercises for all muscle groups (sparing the abdominal area, except sudden movements) with increasing effort are performed from different starting positions. Classes include exercises with light weights (up to 1-1.5 kg), more complex coordination exercises (a combination of movements of the arms and legs, arms and body), measured walking, exercises in throwing and catching balls, and outdoor games. Prescribe more exercises for the abdominal muscles, combined with breathing and relaxation exercises. Diaphragmatic breathing is periodically carried out at maximum depth. Load intensity is average. The duration of the therapeutic gymnastics procedure is 20-25 minutes. To avoid exacerbation, physical activity is increased carefully, taking into account the patient’s reaction to the preliminary procedures of therapeutic exercises. The appearance of pain in the abdominal area requires reducing the load. Important role exercises of an applied nature are played, they are included in the daily routine. Such exercises make it possible to increase the emotional level of patients and restore adaptation to physical activity.
In sanatoriums and resorts, where patients with peptic ulcer disease are treated during remission, the volume and intensity of exercise therapy increases. The duration of the therapeutic gymnastics procedure is adjusted to 25-30 minutes. Classes include exercises for all muscle groups and joints, exercises with dosed loads for the abdominal muscles (controlled by the patient’s subjective reaction), outdoor games and elements of some sports games. The appearance of pain in the abdominal area requires a ban on games. Sudden movements of the body are unacceptable. Walking, swimming, cycling, skiing, and health paths should be widely used. The route should exclude ascents and descents with a steepness of more than 15-20 °.
An approximate complex of therapeutic exercises for peptic ulcer disease (ward mode) Preparatory part
1 . I. p. - lying on your back, exercises in complete relaxation of the muscles (face, arms, shoulder girdle, legs, abdominals).
2. I. p. - lying on your back, left hand on the chest, the right one on the stomach. Breathing exercises: inhale in slow, intermittent portions of air for 4 seconds, protruding the abdominal wall forward and contracting the diaphragm, then move the chest to the upper inhalation position, contracting the abdominal wall and relaxing the diaphragm, then exhale in small portions through the nose, lasting 6 seconds ; repeat 5-6 times, after performing the exercises - voluntary breathing.
3. I. p. - the same thing, rhythmic breathing (2-3 pulse beats - inhale, 3-4 - exhale), repeat 2-3 times.
4 . I. p. - lying on your back. Flexion, extension, supination of the foot, flexion and extension of the toes; 3-4 times, average pace, arbitrary breathing.
5 . I. p. - the same. Exercises for the fingers of the hand (the little finger corresponds to the meridian small intestine): touch your little finger one by one in front of your chest and stretch them in opposite directions; self-massage of the little finger of the right and left hand.
6. I. p. - lying on your back, hands below in the “lock”. Raise your arms up, stretch - inhale, return to i. n. - exhale; 2-3 times, slow pace.
7. I. p. - the same. Raise your arms up through your sides, inhale through your nose for 4 s, then slowly lower your arms - exhale for 6 s; 2-3 times, slow pace.
8 . I. p. - lying on your back, arms along the body, take your right (left) leg to the side - inhale, return to i. n. - exhale; 2-3 times with each leg, average pace.
9 . I. p. - lying on your back, relax for 30-40 s.
Main part
10 . I. p. - sitting on a chair, with your back resting on the back of the chair, hands: left - on your chest, right - on your stomach. Diaphragmatic breathing: inhale for 4 seconds, pause for 8 seconds, exhale for 6 seconds; 2-3 times, after each exercise - freely inhale and exhale 1-3 times.
eleven . I. p. - sitting on a chair, feet shoulder-width apart. Raise your arms up - inhale, bend towards your left leg - exhale; the same thing to the other leg; 2-3 times to each leg, the pace is slow.
12 . I. p. - sitting on a chair, resting your back against the back of the chair Hands across the sides (pulling your shoulders back) forward - inhale, bringing your palms together, pressing your fingers together, hold your breath for 8 seconds, lower your arms, relax - active exhalation ; 2-3 times, after each exercise - inhale and exhale freely.
13 . I. p. - sitting on the edge of a chair, hands resting behind. Raise your right (left) leg up, bend, straighten and lower; 4-5 times with each leg, breathing randomly.
14 . I. p. - the same thing, hands on the belt. Turn the body to the right (left), reaching the back of the chair with your elbow; 2-3 times in each direction, average pace, random breathing.
15 . I. p. - the same thing, hands down. Tilt to the left, left hand down, right hand in armpit; the same thing - in the other direction, 3-4 times, average tempo, arbitrary breathing.
16 . I. p. - standing behind the chair, resting his hands on the back. Alternate swinging movements of the legs to the sides and crosswise; 3-6 times, fast pace, emphasis on relaxation.
17. I. p. - standing, left hand on chest, right hand on stomach. Diaphragmatic breathing: inhale - 4 s, hold on exhalation - 8 s and exhale - 6 s; 2-3 times, after each exercise, inhale and exhale freely 1-3 times.
18 . I. p. - standing, leaning against the back of the chair. Head back, legs together, press firmly with your hands on the back of the chair, straining the muscles of the legs and body for 8 s, relax, lowering your arms down, 2 - 3 times, voluntary breathing.
19 . I. p. - standing, bend your arms in front of your chest, legs - shoulder-width apart. Move your elbows to the sides with jerks, then straight arms to the sides with your palms up; 2-3 times, breathing is arbitrary.
20 . I. p. - standing, walking: 4 steps - inhale, 8 steps hold your breath, 6 steps - exhale, pause on exhalation - 2-3 steps; 2-3 times, slow pace.
Final part
21. I. p. - sitting, hands to shoulders. Turnover in shoulder joints forward and backward; 3-4 times in each direction, average pace, random breathing.
22. I. p. - the same. Squeeze and unclench your fingers while raising and lowering your feet; 6-8 times, average pace.
23. I. p. - the same. Bring your hands to your shoulders, raise your arms up, lower your hands to your shoulders, lower your arms and relax; 2-3 times, average pace, arbitrary breathing.
24. I. p. - the same thing, hands on the hips. Return the hands with your palms up - inhale, palms down, relax - exhale, 4 times, the pace is slow.
25. I. p. - the same thing, close your eyes. Relax the muscles of the whole body, duration 30-40 s, voluntary breathing.
An approximate complex of therapeutic exercises for peptic ulcer disease (remission period) Preparatory part
1 . I. p. - standing, combined walking (on toes, on heels, cross-step, etc.). With movements for the upper and lower limbs(jerks with bent arms at the elbows to the sides, rotations in the shoulder joints, rotations of the fists, squeezing and spreading fingers, etc.) alternate with breathing exercises; walking with acceleration (90-100 steps/min), slow walking 4 steps - inhale, 6 steps - exhale, duration 2-3 minutes.
2. I. p. - the same, feet shoulder-width apart. Raising your arms up through your sides - inhale for 4 seconds until you connect your arms above your head; rise on your toes, pause while inhaling for 8 seconds, then exhale sharply, lowering your arms; 2-3 times, while holding your breath while inhaling, tense your torso muscles isometrically.
3. I. p. - the same. Raise your left hand to the side, right up, turn your torso to the left - inhale, return to i. n. - exhale; 3-4 times, average pace.
4 . I. p. - the same thing, legs together, hands palms down. Raise it in one fell swoop right leg, taking out left hand, lower your leg; 5-6 times with each leg, fast pace.
5 . I. p. - the same thing, hands down. Raise your hands up left leg on the toe - inhale, return to i. n. - exhale; 3-4 times with each leg, slow pace.
Main part
6. I. p. - kneeling. Raise your arms up - inhale, sit on your heels - exhale; 3-4 times, average pace.
7. I. p. - the same. Raise your arms up - inhale, sit to the right on the floor - exhale; also - to the left; 2-3 times in each direction, the pace is slow.
8 . I. p. - standing on four limbs. With your right knee, reach (without leaving the floor) your left hand, return to i. P.; 3-4 times with each leg, average pace, random breathing.
9 . I. p. - the same, brushes inward. Inhale - bend over, touching your chest to the floor, exhale; 3-4 times, average pace.
10 . I. p. - the same, hands forward. Take a deep breath for 6 seconds, stretch back, sit on your heels without lifting your hands from the floor - exhale slowly for 8 seconds; 2-3 times.
eleven . I. p. - lying on his stomach, head resting on his hands. Raise your right (left) leg up, return to i. P.; 2-3 times with each leg, average pace, random breathing.
12 . I. p. - the same. With your right knee, turning it to the side, get your right elbow, return to i. P.; 2-3 times with each leg, average pace, random breathing.
13 . I. p. - lying on the left (right) side. Take your leg back - inhale, sticking your abdominal wall forward, bend your leg in knee joint, press it to your stomach - exhale; 2-3 times, slow pace.
14 . I. p. - lying on your back, left hand on your chest, right hand on your stomach, feet facing you. Special diaphragmatic breathing: inhale for 6 s, pause on exhalation - 12 s, exhale - 6 s 2 times, after performing them - voluntary breathing.
15 . I. p. - lying on your back, arms along the body. Deep breath- hold your breath for 12 s, while jerking your right (left) knee to your stomach - exhale; 2-3 times, after each exercise performed, inhale and exhale freely 1-2 times.
16 . I. p. - lying on your back, hands behind your head. Flexion and extension of the legs at the hip, knee, ankle joints alternately - imitation of cycling, duration 40-50 s, average pace, voluntary breathing.
17. I. p. - the same thing, arms along the body. Raise your arms up - inhale, relax your elbows down - exhale, relax, rest 30-40 s, 2-3 times, slow pace.
18 . I. p. - sitting, hands resting behind, move your right (left) leg to the side and return to i. P.; 4-5 times with each leg, average pace, random breathing.
19 . I. p. - the same. Raise your legs up, spread your legs apart and cross (“scissors”) for 20-30 s, the pace is fast, breathing is arbitrary.
20 . I. p. - the same thing, legs apart. Raise your hands up - inhale, relax them to the left on the floor - exhale; the same way - in the other direction; 2-3 times in each direction, the pace is slow.
21. I. p. - standing on your knees, hands behind your back (one over the shoulder, the second under the shoulder blade). Take a deep breath for 6 seconds, bend forward - exhale for 8 seconds; 2-3 times, slow pace.
Final part
22. I. p. - standing, hands down. Walking is normal, with arm movements up - inhale, lower your arms down with muscle relaxation - exhale; 1-2 minutes, slow pace.
23. I. p. - the same. When walking, swing your arms with relaxation; 30-40 s, slow pace, random breathing.
24. I. p. - the same. Alternating shin swinging with muscle relaxation, 1 minute, slow pace, voluntary breathing.
25. I. p. - sitting, complete relaxation, counting heart rate and breathing.

The disease is promoted by disturbances in diet, abuse of smoking and alcoholic beverages, overwork of the nervous system, and negative emotions. Physiotherapy exercises are prescribed when acute phenomena subside - the disappearance or significant reduction of pain in the epigastric region, normalization of ESR and leukocytosis, negative analysis feces on occult blood. This condition of the patient usually occurs 5-7 days after hospitalization. Therapeutic gymnastics classes are initially carried out in relation to the extended bed rest 2-3 times a day (1-2 times on your own) for 10-12 minutes, at a slow pace, rhythmically. Class density is 45-50%. During the first lessons, it is necessary to teach the patient abdominal breathing with a small amplitude of vibrations of the anterior abdominal wall. These exercises, by causing slight changes in intra-abdominal pressure, help improve blood circulation and gently massage the organs. abdominal cavity, reduction of spastic phenomena and normalization of peristalsis. As the general improvement progresses, approximately 2 weeks after admission to the hospital, the patient is assigned to a ward regime. In accordance with this, physical therapy exercises are expanded and complicated, with the obligatory condition of sparing the epigastric area. Therapeutic gymnastics classes are carried out in the IP lying, sitting and standing for 15-20 minutes. Class density is 50-60%. Abdominal breathing gradually deepens. Dosed walking is prescribed for a distance of up to 1 km per day.

After persistent disappearance of pain and other signs of exacerbation of the disease, patients are transferred to a free regimen and prepared for discharge for outpatient observation and treatment. In free mode, during therapeutic exercises, you can use exercises with dumbbells weighing 1-2 kg, with medicine balls of the same weight, all exercises are performed with a full range of motion, exercises on a gymnastic wall and bench are also used. Abdominal breathing is performed without restrictions, but slowly. Exercises with sudden and rapid movements that increase fluctuations in intra-abdominal pressure are contraindicated. The duration of therapeutic exercises is 20-25 minutes, density 50-60%. Slow walking is prescribed (80 steps per minute) for a distance of up to 2-3 km, walking up the stairs up to the 4th-5th floors. The use of segmental reflex massage is useful. In case of stable remission, it is allowed to engage in any applied types of physical exercise of moderate intensity or sports games lasting no more than 30-40 minutes. In the daily regimen of such patients, morning exercises and walks are mandatory components.

An approximate complex of therapeutic exercises for a patient with a stomach ulcer aged 40 years who is on extended bed rest

1. IP - lying on your back, hands on your stomach. Raise your hands up and behind your head - inhale. Return to IP - exhale. The exercise is performed slowly and rhythmically. Repeat 4-6 times.

2. IP - the same. Abdominal breathing. As you exhale, pull your stomach in slightly, and as you inhale, relax your abdominal muscles. Repeat 2-3 times.

3. IP - lying on your back. Hands along the body. Simultaneous flexion and extension of the feet and hands into a fist. Slowly, rhythmically. Do not hold your breathing voluntarily. Repeat 8-10 times.

4. IP - the same. Slow alternate bending of the legs without lifting the feet from the bed. When bending, exhale, when extending, inhale. Repeat 5-6 times.

5. IP - the same. Slowly spread your arms to the sides - inhale. Return to IP - exhale. Repeat 4-6 times.

6. IP - the same. Turns on the right side and left. Place your left foot towards your buttock; Slowly pushing off the bed with your left foot, turn onto your right side. Return to IP. Breathing is arbitrary, do not hold. Also turn on your left side. Repeat 2-3 times.

7. IP - the same. Slowly bend your legs and place your feet towards your buttocks, leaning on your elbows and feet, raise your pelvis, return to IP. Breathing is arbitrary, do not hold. Repeat 3-4 times.

8. IP - the same. Relax all muscles, close your eyes. Rest 1 min.

9. IP - the same. Simultaneous flexion and extension of the arms elbow joints and hands into fists with slight tension. Slow and rhythmic. Breathing is arbitrary, do not hold. Repeat 6-8 times.

10. IP - the same. Slowly use your hands to sit down and slowly make a circular movement with your head clockwise and counterclockwise. Breathing is arbitrary, do not hold. Repeat 4-5 times in each direction.

11. IP - sitting on the bed, legs down, hands on the belt. Turn your torso to the right, arms to the sides - exhale, return to IP - inhale. Same in left side. Repeat 3-4 times.

12. IP - lying on your back, hands on your stomach. Abdominal breathing. When inhaling, slightly retract the muscles of the anterior abdominal wall, and when exhaling, relax them. Repeat 3-4 times.

Peptic ulcer – chronic illness with a cyclical, recurrent course, prone to progression and the development of complications, which does not have a clearly defined etiology, unlike secondary ulcers. There are two main clinical forms: gastric ulcer and duodenal ulcer.

Exercise therapy, when applied to patients suffering from peptic ulcer disease, solves the following problems:

1. Influence the regulation of excitation and inhibition processes in the cerebral cortex; to improve and level out related disorders. Improve the coordinated functioning of the circulatory, respiratory and digestive systems.

2. By properly organizing the regimen of movements, physical exercises and passive rest, influence the regulation of the patient’s neuropsychic state.

3. Improve redox processes in all organs, promote the normal course of processes in the body.

4. Improve digestion, blood circulation, breathing, thereby counteracting dysfunction of the digestive system that occurs with peptic ulcer disease (constipation, loss of appetite, congestion, etc.).

The principle of individualization when applying physical therapy for this disease is mandatory.

The use of exercise therapy in the treatment of gastric and duodenal ulcers increases the effectiveness complex therapy patients, accelerates recovery time and prevents further progression of this disease. It is important to keep in mind that in many patients, an ulcer in the active phase may be asymptomatic, which leads to an underestimation of the frequency of gastric and duodenal ulcers and its relapses. Since in many patients the process is asymptomatic, the absence of characteristic pain does not exclude an ulcer as the cause gastrointestinal bleeding, signs of gastric outlet obstruction or sudden complication of an ulcer. LH in an aquatic environment is carried out in pools with fresh or mineral water. The exercises are performed isp. lying down with floatation devices or against a handrail, sitting on a hanging chair, standing and in motion. Lesson duration is from 20 to 40 minutes. Water temperature 24-26 °C. There are 12-15 procedures per course of treatment. Classes are conducted individually or in a small group.

health path on fresh air trains and strengthens the body, normalizes the psycho-emotional sphere. This natural physical exercise is walking. Dose physical activity you can change the distance, the angle of elevation (route number), the pace of walking (covering a given distance in a certain period of time), the number of rest stops and their duration, using breathing exercises during walking and rest, prescribing 1-2 or 3 walks a day, alternating training days with rest days

Sports games, with physiological point vision, represent complex forms of acyclic muscle activity, which significantly complicates their dosage. This deficiency is compensated by their high emotionality. Play activity allows you to turn on and use large reserve capabilities of the cardiovascular system.

LH is used after the acute period of the disease. Exercises should be performed with caution if they increase pain. Complaints often do not reflect the objective condition and the ulcer can progress with subjective well-being (disappearance of pain, etc.). In this regard, when treating patients, one should spare the abdominal area and very carefully, gradually increase the load on the abdominal muscles. You can gradually expand the patient's motor mode by increasing the total load when performing most exercises, including diaphragmatic breathing exercises and exercises for the abdominal muscles.

LH classes are first carried out in relation to bed rest. In the first lessons, it is necessary to teach the patient abdominal breathing with a small amplitude of vibrations of the abdominal wall. These exercises, causing minor changes in intra-abdominal pressure, help improve blood circulation and gentle massage of the abdominal organs, reduce spastic phenomena and normalize peristalsis. Movements in large joints of the limbs are performed first with a shortened lever and a small amplitude. You can use exercises in static tension of the waist muscles upper limbs, abdominals and lower extremities. It is necessary to turn over in bed and move to a sitting position calmly, without significant stress. Duration of LG classes is 8-12 minutes.

With a noticeable subsidence of pain and other exacerbation phenomena, the disappearance or reduction of rigidity of the abdominal wall, a decrease in pain and an improvement in general condition, a ward regime is prescribed (approximately 2 weeks after admission to the hospital). Exercises from I.p. lying, sitting, standing, kneeling position, perform with gradually increasing effort for all muscle groups (except for the abdominal muscles), with incomplete amplitude, at a slow and medium pace. Short-term moderate tension of the abdominal muscles while lying on your back is allowed. Diaphragmatic breathing gradually deepens. Duration of LH classes is 15-18 minutes.

After the disappearance of pain and other signs of exacerbation, in the absence of complaints and general satisfactory condition, a free regimen is prescribed. In LH classes, exercises are used for all muscle groups (sparing the abdominal area and excluding sudden movements) with increasing effort from various starting positions. Include exercises with dumbbells (0.5-2 kg), medicine balls (up to 2 kg), exercises on a gymnastic wall and bench. Diaphragmatic breathing is carried out with maximum depth. Walking is up to 2-3 km per day, walking up stairs - up to 4-6 floors, outdoor walks are desirable. The duration of the LG session is 20-25 minutes.

In the conditions of sanatoriums and resorts, where patients in remission are treated, the volume and intensity of PH exercises increase: general strengthening, breathing exercises, exercises for coordination of movements are widely used, outdoor and some sports games (badminton, table tennis), and relay races are allowed. A health path, walking, and in winter skiing should be recommended (the route should exclude ascents and descents with a steepness exceeding 15-20°; an alternating walking style is indicated). In the LH procedure, strength, speed-strength exercises, static efforts and tensions, jumps and leaps, and performing exercises at a fast pace are excluded. Morning hygienic exercises pursue goals general development and strengthening health, increasing efficiency, and helps hardening, promotes a more complete transition from an inhibited state to an alert state, eliminates stagnation in various departments. Morning hygienic exercises use a small (8-10) number of exercises covering the main muscle groups; physical exercise should be simple.

In diseases of the digestive organs, the effectiveness of LH largely depends on the choice of starting positions that allow differentiated regulation of intra-abdominal pressure.

The most commonly used i.p. lying with legs bent (on the left or right side, on the back); standing, kneeling, on all fours, standing and sitting. I.p. lying down is recommended during the period of exacerbation and immediately after an exacerbation of the disease as the most gentle, promoting the least functional changes, providing best conditions to perform breathing exercises (lying on your back with bent legs), voluntary muscle relaxation. These starting positions are convenient for performing exercises for the abdominal muscles and pelvic floor.

I.p. kneeling (on all fours) are used if necessary to limit the impact on the abdominal muscles, cause mechanical movement of the stomach and intestinal loops; i.p. standing and sitting are used for the greatest impact on the digestive organs.

The main objectives of exercise therapy are:

Regulation of processes of excitation and inhibition in the central nervous system;

Normalization of the patient’s neuropsychological tone;

Improving respiratory function, blood circulation and digestion, redox processes;

Counteraction to various complications accompanying peptic ulcer (adhesions, congestion, etc.);

Promotion functional state musculoskeletal apparatus;

Normalization of muscle tone (which is a powerful regulator of internal organs), increased muscle strength, proprioceptive sensitivity;

Development of the necessary motor qualities, skills and abilities (breathing, muscle relaxation, elements of autogenic training, coordination of movements, etc.).

Therapeutic gymnastics used after the acute period of the disease. Exercises should be performed carefully if they increase pain. Complaints often do not reflect the objective condition and the ulcer can progress with subjective well-being (disappearance of pain, etc.). In this regard, when treating patients, you should spare the abdominal area and very carefully, gradually increase the load on the abdominal muscles. You can gradually expand the patient's motor mode by increasing the total load when performing most exercises, including diaphragmatic breathing exercises and exercises for the abdominal muscles.

Therapeutic gymnastics classes are first carried out in relation to bed rest. In the first lessons, it is necessary to teach the patient abdominal breathing with a small amplitude of vibrations of the abdominal wall. These exercises, causing minor changes in intra-abdominal pressure, help improve blood circulation and gentle massage of the abdominal organs, reduce spastic phenomena and normalize peristalsis. Movements in large joints of the limbs are performed first with a shortened lever and a small amplitude. You can use exercises in static tension of the muscles of the upper limbs, abdominals and lower limbs. It is necessary to turn over in bed and move to a sitting position calmly, without significant stress.

The duration of therapeutic exercises is 8-12 minutes.

If pain and other exacerbation phenomena noticeably subside, abdominal wall rigidity disappears or decreases, pain decreases and general condition improves, a ward regimen is prescribed (about 2 weeks after admission to the hospital). Exercises from the starting position lying, sitting, standing, standing on the knees are performed with gradually increasing effort for all muscle groups (except for the abdominal muscles), with incomplete amplitude, at a slow and medium pace. Short-term moderate tension of the abdominal muscles while lying on your back is allowed. Diaphragmatic breathing gradually deepens.

The duration of therapeutic exercises is 15-18 minutes.

After the disappearance of pain and other signs of exacerbation, in the absence of complaints and general satisfactory condition, a free regimen is prescribed. In therapeutic exercises, exercises are used for all muscle groups (sparing the abdominal area and excluding sudden movements) with increasing effort from various starting positions. Include exercises with dumbbells (0.5-2 kg), medicine balls (up to 2 kg), exercises on a gymnastic wall and bench. Diaphragmatic breathing is carried out with maximum depth. Walking is up to 2-3 km per day, walking up stairs - up to 4-6 floors, outdoor walks are desirable. The duration of the therapeutic gymnastics session is 20-25 minutes.

In the conditions of sanatoriums and resorts, where patients undergo treatment during remission, the volume and intensity of therapeutic exercises increases: general strengthening, breathing exercises, exercises for coordination of movements are widely used, outdoor and some sports games (badminton, tabletop) are allowed. tennis), relay races. A health path, walking, and in winter skiing should be recommended (the route should exclude ascents and descents with a steepness exceeding 15-20°; an alternating walking style is indicated) - Strength, speed-strength exercises, static exercises are excluded in the therapeutic gymnastics procedure effort and tension, jumping and skipping, performing exercises at a fast pace.

Therapeutic gymnastics procedure for patients with duodenal ulcer in remission

No. p/ P		Dosage, min	Section objectives, procedures
	Walking is simple and complicated, rhythmic, at a calm pace		Gradual involvement in the load, development of coordination
	Exercises for arms and legs in combination with torso movements, breathing exercises in a sitting position		Periodic increase in intra-abdominal pressure, increased blood circulation in the abdominal cavity
	Standing exercises in throwing and catching a ball, throwing a medicine ball (up to 2 kg), relay races, alternating with breathing exercises		General physiological load, creation positive emotions, development of full breathing function
	Exercises on a gymnastic wall such as mixed hangs		General tonic effect on the central nervous system, development of static-dynamic stability
	Basic lying exercises for the limbs combined with deep breathing		Reducing stress, developing full breathing

Massage. Impact on the reflexogenic zones of the back, chest and cervical sympathetic nodes, massage of the stomach area.

The patient's position is sitting and lying.

Massage is contraindicated in acute stage diseases of internal organs, with diseases of the digestive organs with a tendency to bleeding, with tuberculosis lesions, with neoplasms of the abdominal organs, with acute and subacute inflammatory processes of the female genital organs, during pregnancy.