Physiotherapy for obese children. Special physiotherapeutic methods for treating obesity

Yulia K, 32 years ago, I went to the clinic of propaedeutics of children's ailments due to scars on the supra-vagina, severe headaches, and the displacement of the arterial pressure to 160/100 mm. rt. Art., disruption of the menstrual cycle, tightness and pain in the cervical spine.
With objective padding, the height was 166 cm, the weight was 115 kg. Excess body weight (60%) - obesity stage III, BMI = 41.8 kg/m 2 BID - 108 cm, PRO - 118 cm. The subcutaneous fatty cellulose is highly concentrated, distributed mainly in the stomach (abdominal type of obesity). The skin of the skin of the primary color, hair, on the skin of the chest, shoulders, abdomen, striatal syndrome.
Laboratory tests and biochemical blood tests revealed: cholesterol – 6.9 mmol/l, β-lipoproteins – 4.5 mmol/l, triglycerides – 2.0 mmol/l. This indicates an increase in the level of cholesterol.

Clinical diagnosis - Hypothalamic obesity stage III, which progresses over time.
Composed - Metabolic syndrome.
Satellite - osteochondrosis of the cervical region of the ridge
Likuvanna carried out - training at school for vaginal control (4 lessons), hypocaloric diet (1200 kcal), exercise therapy, treatment of arterial hypertension.
One-hour transcranial magnetotherapy – 3 sessions per day with the duration of the procedure from 5 to 15 days (with the growth of tension with the skin-based procedure).
Then transcranial magnetic therapy was continued, followed by transcranial electrical stimulation - 10 sessions for a total of 15 sessions. The device "AMO-ATOS-E" was vikorized.
In parallel with the transcranial infusion techniques, electrical stimulation was carried out on the area of ​​the anterior cerebral wall and behind the help of an additional “Myokhvilya” apparatus.
The duration of the first 3 procedures is 10-15 minutes as a result of mild stimulation (mode). There will be 7 procedures with a total of 15-20 sessions in the severe stimulation mode (mode - ). Ushogo 10 sessions.
With repeated treatment 1 month after completion of the treatment course, a clear positive trend was established. It is recommended to repeat the course of physiotherapy after 3 months. With repeated quilting for 6 months, the positive effect was maintained.

Dynamics of clinical and metabolic indicators of Yulia K, 32 years old

To treat the accompanying pathology - osteochondrosis of the cervical lobe of the ridge, the same "AMO-ATOS-E" device was used with a small prismatic vibrating magnetic field to run.
The patient developed paravertebrally in the cervical region, and the disease was resolved while lying on his stomach. Magnetic field mode – variable (), modulation frequency 1-10 Hz with gradual increases from session to session, exposure hour 15 minutes, number of sessions per course – 10.

After the first 5 sessions, the patient felt better and felt bored. After completing the course, the symptoms of chronic osteochondrosis were relieved.

Physiotherapy can have a strong impact on the body. The treatment with natural factors is not limited to the climate and natural mineral waters.

People have learned to put themselves at the service of the manifestations of nature that you don’t care about, don’t care about, and don’t care about. Using additional special equipment, we can produce various exchanges for cleaning – magnetic, light, ultrasonic, electrical energy, water and other physical factors. Various methods of physical therapy allow you to expand the body’s ability to breathe. They rarely stagnate as a single method of disinfection, but those combined with other methods give good results. What does this branch of practical medicine tell us about treating obesity?

Water will come to help

Basic physical method- water bath. Water flows onto a person as a result of a combination of three factors - temperature, mechanical and chemical (the way mineral water is cured). The mechanical factor is understandable: the Charcot shower is popular with many people with a supernatural vagus, and everyone knows how strongly the stream of water flows into the fatty deposits under the skin. But here we need to talk not only about mechanical action - with such a massage, blood circulation in the deep balls of the skin, including in the subcutaneous adipose tissue, increases heat generation in it, and therefore, the loss of energy increases . There is a flow of reflex surges, as a result of which the functioning of the nervous system is normalized, and this, in turn, affects the endocrine organs, equal to cholesterol and many other metabolic processes in the body.

Contraindicated before hydrotherapy There is increased body temperature, malignant new growths, pustular and fungal infections of the skin.

Let’s return to the shower bath, and now let’s talk about other methods of water bathing. The first option is balneotherapy, or therapy followed by baths. There are a lot of them, but not all are effective for treating obesity. How can I speed up?

Carbon dioxide baths.

These are special baths, the water in which is enriched with carbon dioxide bubbles. In this situation, the temperature difference between warm water (36-37 ° C) and carbon dioxide (12-13 ° C) is applied to the skin: the effect of a kind of massage with bulbs is caused. In addition, carbon dioxide penetrates through the skin and, being absorbed into the blood, causes dilation of blood vessels, which destroys the heart tissue. This should be done until the arterial pressure normalizes.

As the baths run, the breath becomes thicker, the metabolism of speech changes, and the skin becomes brighter. The balance between the sympathetic and parasympathetic parts of the autonomic nervous system is regulated. A course of 12-15 baths promotes a “reboot” metabolism, which helps to maintain a healthy diet aimed at combating excess fat. The number of procedures gradually increases (from 7 weeks to 12-15). Conduct sessions either every other day, or two days after sleep, with a break on the third.

Carbon dioxide baths can be dry, without adding water. In this case, the person is in a special room or bath, the top of which is covered with sponge so that the gas does not penetrate. The head, of course, loses the ringing, and it is impossible to breathe the fragments in the wind with such a high concentration of carbon dioxide. Due to the tightness of the water, these baths are safer for people who suffer from serious illnesses of the heart. Dry carbon dioxide baths reduce blood flow in the muscles, brain, blood vessels of the heart, and cause a strong influx into the autonomic nervous system. And what a velvety skin after them! The increase in blood flow and gas exchange in all organs and systems significantly accelerates the exchange of blood, which reduces the decrease in blood volume.

Contraindications for carbon dioxide baths Serve a severe case of hypertensive illness (in such cases, physiotherapy is not indicated), as well as severe angina pectoris and disturbance of heart rhythm.

In this case, the effect of water is observed, which enters the body through the skin and legs. Effective reflex flow on the central nervous system, drinking water normalizes its activity, and it, in turn, regulates the work of the cardiovascular, respiratory and herbal systems. When the blood vessels dilate, the pulse improves, arterial pressure decreases, and the heart becomes red. It is important for us that drinking water will enhance the extraction of fats from lipid depots and stimulate their elimination from the body.

Baths are taken a day, the duration of one procedure is 12-15 minutes. Course – 10-14 procedures.

Indications for hot water bathsє obesity of the 1st-3rd stage, especially in those associated with disorders of the musculoskeletal system, chronic inflammation of the female body, ailments of the skin and many other conditions. Baths are contraindicated for all baths.

Radon baths (alphatherapy).

Radon has a wide range of effects on the body: enhances the breakdown of fat, stimulates the immune system, improves the vitality of the heart muscle, normalizes laryngeal blood (which prevents the development of blood clots and improves blood flow to organs). The infusion of radon on the peripheral nerves weakens, and sometimes relieves, the pain characteristic of neuropathy, which can be observed in treated patients who suffer from diabetes, complex polyneuropathy Yu.

Infusing radon into the liver and exchanging sechoic acid relieves gout, normalizing the immune system reduces the severity of arthritis. This method is widely recommended for the treatment of ill health in the female state sphere. As a result of such a complex influx on the body, patients’ sense of self significantly improves, the intensity of metabolic processes increases, and body weight decreases. The course of treatment consists of 12-15 baths, each containing 10-15 quilins.

Contraindications for radon baths with a decrease in the number of leukocytes (white blood cells) and after a painful experience in the mind of advanced radioactive vibration.

Iodine and bromine, penetrating into the blood through the skin, immediately flow into metabolic processes in the body, regulating fat metabolism. At the same time, galvanization of the nervous system is carried out, blood flow in the throat is normalized, the activity of the supraneural glands and pituitary gland is promoted, and this has a direct effect on the endocrine system. All this increases resistance to stress and normalizes the body’s constant reactions. As a result of these effects, itching of the skin and inflammation of the organs of the physical sphere in both women and men change.

The course of treatment is 15-20 baths, the length of the procedure is 10-15 minutes.

Contraindications for iodine-bromine baths with increased thyroid function, low arterial pressure, gout, severe heart disease.

Turpentine oil stimulates aerobic and suppresses the anaerobic metabolism of speech, normalizes the tone of the sympathetic nervous system, stimulates the metabolism of speech, improves blood flow and the work of supraneural glands. Adding turpentine baths to the treatment complex changes body weight by 30-40% more effectively than without them.

The course consists of 15-16 procedures of 10 skin lesions.

Contrast baths are a very effective way to combat sores: one such procedure results in a decrease in body weight by 200-400 g. After an hour of bathing, at different temperatures, the sores are relaxed and moved I don't care about my tone. This significantly increases the loss of energy, the heart, and the nervous system. To carry out the procedure, use two baths - one with hot water (38-41 °C), the other with cold water (18-23 °C). In young patients, the difference in temperature can be 20 °C, in summer patients the difference may be less – up to 13-15 °C. It is necessary to take three separate skin baths (reserve some hot water). The duration of the course is 12-20 procedures, which are completed every other day.

Contraindications for contrast baths for obesity of the 4th stage or more, for chronically inflamed appendages in women, severe illness of the musculoskeletal system. And of course, there are two bathrooms - like for all other baths.

Another type of hydrotherapy is hydrotherapy – showering. This soul is based on mechanical stimulation of skin receptors and massages of the skin at different depths. The most intense pressure is Charcot's douche (strumenovy douche). The underwater shower-massage is less intense, the circular shower, the dry shower, the half-massage are less intense, and in the remaining place there is a shower. The temperature and severity of the procedure are selected based on the task being performed. A thrilling hot and cold shower promotes the exchange of speech, while a warm shower promotes calmness. A short shower tones the muscles and the cardiovascular system, and then loses its vitality. After a cold and cold shower, it is imperative to rub yourself with a terry towel - this is beneficial for the cardiovascular system and immediately stops colds. The use of hydrotherapy for treatment of obesity allows you to increase your weight loss by another 3-4 kg.

Instead of using warm water and mechanical massage, a much greater effect can be achieved than with the original classic massage. Water relaxes the muscles of the body, which allows the hot jet to wash the tissues more deeply, resulting in more intense blood flow. When the patient endures a deep massage, it is less painful, less painful, relaxation under the infusion of warm water, the muscles are less injured. Sessions should be held a day in advance. Usyogo’s course requires 10-20 procedures of 15-45 skin lesions.

Since specialized physiotherapeutic centers have no capacity, the “water tank” can be controlled at home. Why are such procedures used, such as dousing and wiping? The douche begins with water, the temperature of which drops to 33-34 °C, gradually decreasing during the hour of the skin procedure by 1-2 °C and reaching 20 °C. Rob every other day. The dousing itself should be carried out in such a way that the water flows less evenly along the front and back surfaces of the body. Do not douse the head - rub the head with water on the level of the shoulders. One dousing requires 2-3 glasses of water.

The rubbish is rubbed as it is poured over so that it needs to be rubbed. For this purpose, apply a towel or a towel, soaked in water, and gradually reduce the temperature from 32 to 20 °C or lower. After wiping, you should douse yourself with water, the temperature of which will be 1-2 °C lower than the temperature below during wiping. The procedure lasts 2-3 weeks and works better every day, lasting 1-1.5 months.

A bath by the sea or a pool with sea water gives a miraculous effect.

Swimming in a swimming pool with fresh water has a pleasant effect on the body, but the blood flow does not decrease. Sea water allows you not only to improve the cardiovascular and respiratory systems, but also to stabilize the vagina, and with the right courses, it can be changed. Swimming in the sea is better than France, at a surface temperature of no less than 20 ° C, a water temperature of no lower than 18 ° C and a wind speed of no more than 15 m per second. They start with 5-7 hvilins, with a skin procedure, increasing the water level and bringing it up to 20-25 hvilins. If people cannot swim, they can do exercises. Yaku yourself? Look at section 8. Golovne - steadily energetically collapse near the water. Are you tired? The session must be completed and preferably on the birch.

When you drive, you need to wipe yourself off with a towel. Dry a little in the sun (so that the freshness is preserved), and then rest in the shade. It is recommended to carry out such a bath twice a day. A break for one day is possible, but no more.

Patients often ask, “Can I go to the spa or sauna?” It is possible, of course, that there are no important cardiac complications. For those that have lost fatty tissue, you won’t be able to get insurance, otherwise you might end up succumbing to your homeland. Moreover, a sauna is more effective; at low humidity and high temperature, people sweat more easily and consume more liquid, but at low temperature and high humidity, which is typical for Russian lazna. During one session of “sweating” in the sauna you can drink 400-1000 ml of liquid. With Russian lazna you won’t lose more than 500 ml in one hour.

It is necessary to remember that both the sauna and the spa give proper attention to the heart of the judge, because it is still not easy for him to drown in them.

A good therapeutic effect can be achieved even with the use of other methods of physiotherapy. Pelotherapy and mud baths are widely available.

The medicinal brood gives a complex infusion to the body due to its chemical composition and mechanical powers. It is rich in macro- and microelements, vitamins, hormone-like substances, and biological stimulants. Under the action of the healing brood, the secret exchange of speech improves, the suppression process accelerates, immunity improves, the exchange of speech in the skin and the ligamentous apparatus of the corners increases, which is beneficial for appears on the current page. Mineral salts and organic compounds, which are present in dirt, normalize the microflora of the skin, have an anti-sore and detoxifying effect.

To strengthen your brood You can use electrical and ultrasonic methods of bathing (in which, before speaking, the drainage of the pond itself is changed). Widely used mud masks, which are applied on the beaches of the Dead Sea to the entire body, give only a cosmetic effect, and even a dubious one, since the temperature of the wash and the hour of the procedures are not visible, and the methods of their implementation are not adjusted. Now and then, careful manipulations are carried out on the basis of applying mud applications to the body parts; with obesity against the background of impaired function of the supraneural glands - only in the commercial zone. At the hour of the first procedures, the brood is heated to 38 ° C, the temperature is 10-15 minutes. The temperature of the brood was gradually increased to 40-42 ° C, and the hour was increased to 20 minutes. The course consists of 10-12 procedures. When preserving the function of the supra-neck openings, in addition to the commercial zone, cover another area across it. All other rules for carrying out the procedure are forfeited by those themselves. It is possible to carry out endonasal (through the nose) mud electrophoresis, which helps to normalize the work of the centers of appetite and satiety, and eliminate sleep disorders.

Sand baths are also good at a seaside resort. Take in the other half of the day, when the sand warms up. In addition, sleep activity begins to decline until 4-5 years of age - this is the optimal time for the procedure.

During the hour of the sand bath, the patient lies so that his head is in the shade. The body is covered with a thick ball of heated clean sand, just so that the chest is free. At first, people feel the heat from the baked sand, then it changes to a feeling of cold. When it is warm enough to turn around again, the time has come to finish the procedure. The average won takes 15-30 hvilins - the average person takes an hour.

In case of cervical diabetes, such procedures are not indicated: it is impossible to ensure the sterility of the sand, and debris on the skin after a bath can lead to a serious problem for many months.

Physical methods of bathing include climatotherapy, which is simpler than it seems - bathing in the minds of one or another specific climate (Girsky, sea, forest), and at no cost to overseas resorts and hot countries. Moreover, climatotherapy should begin after 3-5 days of acclimatization, and we, as a rule, spend 1-2 days at sea. While we were acclimating, the time had come to pack the bags again.

If we talk about this kind of treatment, it’s actually the greatest in local sanatoriums. Remember, there is no need to call for a new climate, and all the days of short leave will be a permanent peace. Tim, for those who have no time to spare, trips to mountain and seaside resorts will inevitably bring a lot of pain. There is no need to force the process. And there is no need to suffer from evil sun either. After a period of lubricating on the sun lounger, you can drink a set of 10-20 kilograms: this will be the place of the hypothalamus, worn out by the sun.

Let's not forget about massage in this classic version. The effect of this massage consists of a complex of mechanical, reflexive and biochemical infusions. A professional massage can make a person relax, relax, or, perhaps, get inspired. When this occurs, the vitality of the surface tissues improves, and as a result of the reflex influx, changes occur in the functioning of the internal organs. Massage increases blood circulation, increasing the fluidity of metabolic processes - much the same as during intense physical activity. It is necessary to entrust the massage to a qualified specialist - a physician; most people, as a rule, suffer from concomitant illnesses, so they require special techniques and gentle techniques, for which the individual characteristics of the patient are insured. ienta.

It is best to practice massage in the first half of the day after a light drink. The intensity and severity of the procedures will gradually increase depending on the tolerance level of each person. A ceremonial massage that bathes the whole body should not be performed more than twice a day. If you feel overwhelmed, you will immediately stop, and after normalization, you will begin to resume. To take a full course of massage, you won’t have to go far: there are plenty of people in any region who are good at using this method.

This is a different type of this technique- cupping massage, this is the name of local vacuum therapy. When the fire is poured into the middle of the jar, a negative pressure is created, which is also a necessary liquid infusion: the blood flow will increase at the skin near the jar area, and at the deepest balls. As a result, red blood cells move from the blood to the skin, which stimulates the digestion of tissues in this area, improves local and inflammatory immunity, has an anti-inflammatory effect, and reduces sensitivity to pain. Increasing the blood flow in the muscle will lead to an accelerated metabolism of fats. By moving the jar over the body, you cover the necessary surface, which allows you not only to fight cellulite, but also to shape your figure.

Absolutely accessible wealth and such a physiotherapeutic method as electrotherapy. Its use in case of obesity is not only for strengthening the action of licentious dirt.

The electric strum of a different type, passing through the tissues of the body, itself gives a vasodilating effect, reduces the conduction of impulses along the nerve fiber and muscles, improves the tissue structure, the metabolic processes occurring in them, including the destruction of the brain.

When treating obesity, electrosleep is indicated, endonasal electrophoresis with vitamin B6 and lithium, electrophoresis with bromine, magnesium, calcium in the commercial zone, galvanic electrophoresis according to Shcherbak, alternating low magnetic field frequency The skin method has its own peculiarities. Based on their consideration, the physiotherapist will select an individual electrotherapy program for the patient.

A type of physiotherapeutic treatment is reflexology. The authors of this technique were ancient Chinese doctors. This is a whole philosophy that brings out the understanding of the inner essence of our body, and the place of humans in nature - the Cosmos. At the Gathering, secrets were always carefully guarded, so, perhaps, the Chinese laid out all their wisdom in such a way that they would be understood without initiation. Let’s talk about those on which the infusion of reflexotherapy on sick processes in the body is based – on the right is undying. It is impossible to explain the essence only to direct irritation of the nerve endings, transmission of the signal along the conductor nerve fiber and the reaction of the target organ, although this, incredibly, may be the case.

The treatment should be carried out by inserting the heads into active points, which can be followed by acupressure massage and other types of infusion on such points. There is no independent significance of reflexology in the treatment of obesity, but the additional benefit is good, since the processes of galvanization and awakening in the nervous system, normalizing appetite, mood and living spirit are equally important. and zagalom, especially when combined with psychotherapeutic methods.

There are plenty of holcoreflexotherapy rooms - every great doctor has his own specialty in this profile. As a rule, these are neurologists who are well aware of the subtle interactions between the parts of the nervous system and their anatomical development. However, you can also see a “reflexotherapist” who does not have any medical illumination - such fakers can be found in beauty salons, trying to get clients any way they can. So, first of all, we began to talk about the healing process, which is what the “doctor” did and became called a reflexologist. As a matter of fact, the time and money will be well spent: the knowledge of modern methods of treating obesity, the evidence of ancient doctors and your commitment to the achieved goal will immediately give good result. Just bring the respect to your heads: the stench is overwhelmingly lingering in the wake of individual cleaning. You can ask and buy a hair kit and come to the procedure with it.

Obesity treatment methods

Organizing proper food and increasing energy consumption are the main nutritional steps that are supplemented by natural and preformed physical factors. They help the sick person to tolerate diet better, correct unnecessary metabolic disorders that arise from this, promote non-specific resistance in the body, give preventive and curative measures to avoid getting sick, I usually associated with obesity and weight loss. Zrestoy, this means a greater decrease in body weight.

Indications for the development of natural and preformed physical factors are primarily for obesity; in patients who suffer from the symptomatic form of obesity, the effectiveness of physiotherapy is lower. In case of evidence of concomitant obesity in the cardiovascular system, vascular system, peripheral nervous system, organs, treatment and treatment of their tissues should be carried out using appropriate medicinal methods.

In the treatment of obesity, there are more advanced hydrotherapy procedures, in the mechanisms of which the temperature factor plays an important role. Cold, stimulating heat production in the body, increases energy consumption; It has a guaranteed effect that promotes nonspecific immunity. However, in rich patients, cold activates appetite - an important pathogenetic factor in obese patients. Thermal procedures, as well as intense energy exchange, do not have any side effects, but result in an increase in sweating, and therefore the loss of electrolytes, microelements and vitamins, which between them stagnation, especially in cardiac-vascular pathology.

To reduce body weight, use low-tech methods of external water rejuvenation.

Finnish lazna (sauna): temperature 90-100 ° With one procedure, 2-3 visits for 5-10 minutes, treatment for 15-20 minutes. Ensures the greatest reduction in body weight.

Steam lazne: the temperature in the steam room is 50-70 "C, the humidity in the air is 30-40%. It is not necessary to overexceed 10 minutes in it; it is more important for patients with obesity, who want a less significant change in body mass.

Under the infusion of intense thermal hydroprocedures, the basal metabolic rate increases by up to 30% over the next 5-6 years. At the same time, in a number of joint failures due to significant dehydration, an unpleasant influx on the functional state of the patient’s cardiovascular system can be avoided. Hot dry-air and steam procedures are recommended for patients with obesity stage I-II, young age, without damage to the side of the cardiovascular system, obligatory under full medical supervision, no more than 1-2 times per week, up to 10 -15 procedures for the treatment course. Treatments that are carried out with a rehabilitation method must be controlled in such a way that it is possible to evacuate the patient and provide emergency medical assistance.

For obese patients, it is also recommended to use contrast baths with a difference in water temperature of up to 15-20 °C to ensure the patient’s health and life. During one procedure, carry out 3-4 transitions. The procedure begins by soaking the patient in hot water for 2-3 minutes, then cold water for 1 minute. In addition to decreased body weight, contrast baths improve the indicators of lipid metabolism and the function of the cardiovascular system. Baths are prescribed every other day, the course of bathing is 10-15 procedures.

In case of obesity, hydrotherapy is widely used. The combination of thermal and mechanical stimulation during water procedures provides a varied infusion for the sick and obese (toning, warming, which improves the function of blood circulation, speech exchange), harmonizes the daily life Zhenyu Masi Tila. Most often there is a slaughter of the soul: underwater shower-massage, Charcot, Scottish, vyalovy, circular.

Thermal bath mud, as a rule, stagnates during treatment of concomitant obesity, illness of the musculoskeletal system, organs, peripheral nervous system, including them with hydrotherapeutic procedures and mineral baths.

Natural factors include stagnation of aerotherapy in the form of wind baths and heliotherapy, especially in marine climates.

In a comprehensive body weight loss program, preformed physical factors are introduced - as a rule, to treat various related illnesses using conventional methods. However, certain methods of hardware physiotherapy will ensure the perfection of specific tasks during the treatment of obesity. For example, inhalation of an ultrasonic aerosol of anorexigenic drugs (fepranon formulations) can reduce their side effects on the functional state of the nervous and cardiovascular systems. In cases of hyperintensity and hunger, intranasal electrophoresis with 1% diphenhydramine may be used.

The use of such techniques as electrosleep and central electroanalgesia, which moves the threshold of sensitivity to emotional stress, allows one to relieve feelings of hunger, astheno-neurotic disorders that accompany vascular disorders of the brain, changes and vegetative lability, optimize mood.

For local electrical stimulation of fat depots, the stagnation of the SMT therapy procedure is effective. Two pads with an area of ​​300 cm 2 are spread on the projection of the straight abdominal muscles of the left and right sides of the navel (1st field), then, following the transverse method, on the right and left sides (2nd and 3rd fields). Assign the second row of robots, the mode is changeable, the intensity of the flow and pauses is 2-3 seconds, the modulation depth is 100%, the frequency is 30 Hz. The force of the stream will increase to a pronounced but painless vibration or light flesh will soon be felt. Exposure – 10 minutes on the skin area, daily. Course – 15-20 procedures.

Obese patients are characterized by weakness of the muscles, which ensures the stabilization of the spine, especially the abdominal muscles. The strength of these muscles decreases significantly if the patient undergoes harsh diets, especially fasting, to reduce their symptoms. To improve the “meat corset”, perform symmetrical electrical stimulation of the muscles of the back and the anterior cervical wall. Use any equipment that will provide an electrical stimulation mode (Amplipulse, Stimulus, diadynamic devices, etc.).

Thyroid hormones play the most important role in energy exchange in the human body, which is the basis for the development of the DMV therapy technique. By moving the projection zone of the thyroid gland, they stimulate its functional activity. Along with higher treatment factors, reflexotherapy methods for obesity are actively used - classical corporal and auricular acupuncture, electro-laser acupuncture, micro-aglotherapy, both in general and in other countries. The most commonly chosen auricular points are: 87, 84, 83, 55, 45, 28, 22, 18, 17, as well as corporate points on the E, RP, VB, TR and J meridians - they regulate hunger and metabolic processes in the body.

3.1. Physical rehabilitation for obesity

Obesity- a group of illnesses and pathological conditions that are characterized by excessive deposits of fat in the adipose tissue and other tissues and organs, characterized by metabolic disorders, and are accompanied by changes in functional I will become different organs and systems. According to WHO data, 25-30% of adults and 12-20% of children suffer from obesity. Obesity ailments occur heavily in the structure of underlying illness and disability.

Classification and stage of different types of obesity. Nina is the broadest classification according to D.Ya. Shurigin, that the polyetiological nature of obesity is responsible:

1) forms of primary obesity: a) nutritional-constitutional; b) neuroendocrine: hypothalamic-pituitary; adipose-genital dystrophy (in children and children).

2) forms of secondary (symptomatic) obesity: cerebral, endocrine.

Depending on the nature of the transition, obesity is divided into progressively, completely progressively, steadily and regressively. There are also 4 stages of obesity: Stage I - excess weight up to 29%, Stage II - 30-49%, Stage III - 50-100%, Stage IV - above 100% body weight.

Etiology and pathogenesis. Numerical etiological officials can be divided into exogenous(overexertion, decreased oral activity) and endogenous(Genetic, organic disorders of the central nervous system, hypothalamic-pituitary region). It has now been established that the regulation of the storage and mobilization of fat in fat depots is influenced by a complex neurohumoral (hormonal) mechanism, which is responsible for the cerebral cortex, the subcutaneous structures, and the sympathetic and parasympathetic nerves. ovi systems and organs of internal secretion. Fat metabolism may be affected by stress factors (mental trauma) and central nervous system intoxication.

The regulation of food activity is carried out by the food center located in the hypothalamus. Inflammatory and traumatic lesions of the hypothalamus lead to an increase in restlessness in the grub center, an increase in appetite and the development of obesity. In the pathogenesis of obesity, the pituitary gland also plays a role. Speaking about the development of obesity, one cannot underestimate the importance of hormonal factors, since the process of mobilization of stored fat is closely related to the functional activity of most of the endocrine glands ii. Reduced liver activity naturally leads to a decrease in energy expenditure and fats that have not been oxidized are mostly deposited in fat depots, which leads to excess.

Obesity and serious illnesses, which require special treatment, can also affect all important organs and systems, being a risk factor for the development of cardiovascular illnesses (ICS, atherosclerosis, hypertensive disease a), for example, heart failure. In addition, there is a basic difference between the stage of obesity and the severity of mental insufficiency; A high position of the diaphragm, especially in obese people, changes its excursion and accelerates the development of inflammatory processes (bronchitis, pneumonia, rhinitis, tracheitis) in the bronchovascular system. Diseases of the intestinal tract are revealed (chronic cholecystitis, gum disease, chronic colitis). The liver in such patients is usually enlarged due to fatty infiltration and stagnation. Due to obesity, static pressure on the musculoskeletal system (lower joints, spine) increases, arthrosis of the knee and knee joints, flat feet, herniation of the intervertebral disc (osteochondrosis) arise. Diabetes develops, menstrual irregularities, amenorrhea, infertility, and gout occur. Obesity may be the basis of functional disorders of the nervous system (weakened memory, confusion, headache, drowsiness during the day and sleeplessness at night). Possible culprits of a depressive state: greed on a bad sense of self, lethargy in the mood, bloatiness, drowsiness, shortness of breath, pain in the heart, swelling, etc.

When treating and rehabilitating patients with obesity, a set of methods is used, the most important of which are physical management and diet, directing them to complete the next task:

Improvement and normalization of the metabolism of speech products, juice, fat metabolism;

Replacement of excess body mass;

Updated adaptation of the body to physical requirements;

Normalization of the functions of the cardiovascular, respiratory, herbal and other systems of the body that suffer from obesity;

Improvement and normalization of the patient's rocine sphere;

Enhancement of non-specific support.

An important place in treatment and rehabilitation for obesity is rational eating with the reduction of fats and carbohydrates. The content of fat in the diet should be reduced to 0.7-0.8 g/kg, with the culprit being vegetable fats (1.3-1.4 g/kg), and the content of carbohydrates should be sharply adjusted to 2.5-2.7 g/kg (additional norm 5.2-5.6 g/kg), including sugar, bread, confectionery products, sweet drinks, etc. The amount of protein in hedgehogs is lost to normal - 1.3-1.4 g / kg, or a little more, which precedes the loss of tissue protein, promotes energy expenditure for the preparation of absorbed proteins, creating a similar situation i. When eating food, you also need to add:

1. Reduce the amount of liquid up to 1-1.2 liters, which will enhance the breakdown of fat as a source of internal water.

2. Reduce the amount of kitchen salt to 5-8 g per serving. I like to cook without salt, adding salted products every hour.

3. Inclusion of alcoholic drinks, which weakens self-control over energy consumption.

4. Appetite-boosting ingredients: spices, meat broths and sauces.

5. A regimen of 5-6 meals a day (fractional meals) with additions to the diet between the main meals of vegetables and fruits.

6. Drinking food products (prunes, dried apricots, beet) to promote normal bowel movement, with this method garnishing self-massage of the abdomen, and the formation of crustaceans.

The key to successful bathing, and therefore the improvement of obese patients, is the correct mode of oral activity. The method of exercise therapy is a pathogenic and therefore important and unknown element of complex rehabilitation of patients with obesity. When choosing physical properties, the indicated liquidity and intensity of their vikonanny trace is preserved, so that they have the right to vitality (trivals of mortal importance) to absorb a large amount of carbohydrates, yield at the depot of neutral fats, their splitting and reconversion! Exercise therapy is used in all available forms, selecting them can match the different and individual characteristics of patients, ensuring an increase in energy expenditure. It is entirely necessary to increase the physical intensity of moderate intensity, which increases the consumption of carbohydrates and activates the energy supply for the breakdown of fats.

Physical exercise is carried out in the context of macrocycles, which are divided into two periods: initial, preparatory, and main. U incoming (preparatory) During the period of main task - to overcome the reduced adaptation to physical achievement, to renew in accordance with the current standards of leadership skills and physical efficiency/to achieve the goal actively and systematically engage in physical activity culture. To this end, the following forms of exercise therapy are used: recreational gymnastics (from the training of great muscle groups), dosed walking with exercisers, self-massage. Main period Purposes for the decision to decide the task of celebration and renewal. Cream LH, UGG sick recommend dosed walking and jogging, walks, sports games, active exercises. Further physical rights are directly directed to those in order to maintain the achieved results of rehabilitation; There is running, paddling, swimming, cycling, skiing - walking on licks. One of the important factors of prevention is the treatment of obesity and proper diet: so that fats release the energy stored in them, which is responsible for oxidation.

Busy with the mayor of Boti Trivalimi (45-60 XV і more), the rudges vicent to the great amplituda, the great m'yazovi sediment is healed into the robot, vicoristovy, circles of ruds at the Great Sigloba, accurately for a tokelub (overwhelming, turning, wrapping objects. It is a great duty to take cyclical rights in the occupations of people from above-worldly importance

walking and running In this case it is necessary to resort to the following:

1) walking and jogging can be recommended for patients with stage III obesity, but it is recommended to exercise rowing and exercise bikes, swimming Anna;

2) permission to take up, especially running, an active doctor with a satisfactory functional status, in the process of taking the necessary systematic medical and pedagogical control.

Walking allowed: very high - from 60 to 70 krok/khv (from 2 to 3 km/year) for obese ІІІ stage; full - from 70 to 90 krokiv/khv (from 2 to 3 km/year) for obese ІІІ stage; middle" - from 90 to 120 krok/khv (from 4 to 5.6 km/year) with obesity stage II-I; swedish - from 120 to 140 krok/khv (from 5.6 to 6.4 km/year) in case of obesity І-І stage, even a short one - more than 140 steps/hv, and for those with good physical training - inhale, for 3-4-5 steps - visible) The first advanced training in walking is necessary short-hour repairs 2-3 minutes for Vikonannya dykhalnyh rights.

The run of the “puffer”, the run of dosages. The running activity will be like this: before the run, warm up (10-12 minutes), then run with a “pump” for 5-6 minutes plus walking (2-3 minutes); then make repairs (2-3 times) - and so 2-3 times throughout the lesson. Step by step, the intensity of the run increases, and the discomfort changes to 1-2 minutes, the number of series increases to 5-6, and the pause between them increases. After 2-3 runs (or more), you need to move on to the final run at a moderate intensity up to 20-30 runs at 1-2 intervals.

Zrazkov’s scheme to occupy the FR is advancing:

Patients with obesity, stage III, and those with a satisfied cardiovascular system, do PH 3 times a day, once each with dosed walking and sports games.

Obesity diseases, stage 1-1, due to concomitant illnesses, and also due to a happy state of the cardiovascular system: 2 times a day - LH, 2 times - dosed walking (DH), once dosed running (DB) and sports games (S I) .

Obesity illnesses stage II-I without concomitant illnesses: 2 times - LH, 1 time - DH, 2 times - DB, 1 time - CI.

Swimming, like paddling, also has a positive effect on obesity, since participation in these sports leads to significant energy expenditure. Paddling and swimming activities can be organized at the sanatorium and clinic stages. Every now and then you need to use rowing machines. Swimming activity consists of 3 parts: entrance (10-15 minutes) - activity in the hall (“dry” swimming); main (30-35 minutes) - swimming of moderate intensity in a different way with pauses in the beginning and slow right (5-7 minutes) and final (5-7 minutes) - right the white side to improve the function of blood circulation gu i dikhannya.

Exercising on the gym. In complex obesity treatment, training on exercise machines plays an important role. In this case, it is necessary to work out what systematic physical exercises are necessary, to perform exercises on simulators (with skin drawings, 3-5 minutes of work and additional work) with a stretch of 60-90 minutes to take, comfortably flow into the clinical indicators and find It is more effective to contribute to lipid metabolism. In this case, the heart rate under pressure should not exceed 65-75% of the maximum individual heart rate.

In the process of becoming obligatory there is a system for monitoring health and self-control. With this method, heart rate and blood pressure are measured, self-reported indicators are assessed and functional tests are carried out (Martine's test, velo-ergometric test, Stange's, Genchi's, etc.) tests.

In endocrine and cerebral forms, obesity is less intense, triviality is 20-30 minutes, vicoristy to the right for the middle muscle groups and dichotomy to the right (diaphragmatic diaphragm). The right to vitriol is prescribed later and to drink with caution, but force is not recommended. Massage, water procedures, and other physical procedures are offered as indicated.

For obese indications, self-massage is most effective in areas with the highest accumulation of adipose tissue (self-massage and massage of the abdomen, ulcers, buttocks, etc.). Apply self-massage in the following sequence: stroking, kneading, shaking, rubbing, rubbing, percussive techniques. The massage will end with stroking

Enter

Zagalny characteristics of robots

1.1 Characteristics of obesity

1.1.1 Etiology and pathogenesis

1.1.4 Clinical picture

1.3.2 Massage

1.4 Diet therapy

1.5 Psychotherapy

2.1 Investigation methods

2.1.4 Methods of mathematical statistics

2.2 Organization of investigation

Visnovok

Perelik umovnykh poznachen

AT syst. - systolic arterial pressure

AT diast. - diastolic arterial pressure

DR - Rukhova rehabilitation

Vital capacity - vital capacity of life

BMI – Quetelet body mass index

I. p. - closed position

CG – control group

LG – recreational gymnastics

EG – experimental group

Enter

Beginning in the other half of the 20th century, in the economically developed countries of the world, a completely new problem has arisen - the rapid growth of diseases causing excess food. Hippocrates said that it is extremely common for people to live shorter lives, and that women must continue to be barren. According to foreign data, if people were not ill with obesity, then the average severity of life in the world would have increased due to certain fates.

The number of people in the world who suffer from obesity has increased. Data from the latest research carried out by the Organization of Economic Development and Development in 30 countries of the world indicate that in rich countries the problem of obesity in the nation is becoming even more serious And it will require an incredible vindictiveness. According to the World Health Organization (WHO), nearly 60% of high-risk people survive to 60 years, only 30% survive to 70 years, and only 10% can survive another 10 years. WHO is already treating obesity as an epidemic that is rapidly spreading throughout the world. Over the past 20 years, in most countries of the European Union, the number of people suffering from unemployment has increased by 50%.

There is an increase in obesity in athletes after systematic specific training. Obesity has an unpleasant effect on the body, leading to a decrease in productivity, a shortened life and a period of active creative activity.

Advancement, care and rehabilitation of patients with obesity are important tasks of health protection, the real goal of prevention is to reduce illness and prevent cardiovascular diseases.

Obese patients spend more days on the medicine sheet, may suffer more complications after anesthesia and surgical procedures, and die more often in car accidents and catastrophes. It has been established that if humanity were able to overcome the problem of obesity, then the average level of poverty in life would increase by 4 years.

Between the ages of 50 and 59, body weight exceeded the norm by 15-24%, and mortality was 17% higher than the average. If the overweight of the body was 24-34%, then the mortality rate increased by 41%. Death from cardiovascular disease in obesity is 2 times more common, and from stroke is 3 times more common, less in people with normal body function. In case of obesity, diabetes increases 3-4 times more often.

There is no doubt about the fact that the cultural and technical revolution, which is accompanied by mechanization and automation of manufacturing processes, significantly brings about a wider range of problems. The improvement of oversupply habits, the steady increase in the number of professions associated with hypokinesia, cannot but be seen as factors that lead to an energy imbalance and contribute to obesity.

The relevance of the problem of obesity is also due to the fact that the number of individuals who suffer from overweight is progressively increasing. The increase is 10% of the total cost per 10 days. It is hoped that if this trend continues, then by the middle of the new century the entire population of economically developing countries will suffer from obesity.

physical rehabilitation for an obese woman

Zagalny characteristics of robots

Meta: normalization of body weight, improvement of the cardiorespiratory system and psychoemotional state of women with exogenous obesity І-ІІ stage of the program started at the "School of Obese Patients" ".

Zavdannya:

1.Based on the analysis of scientific and methodological literature, effective methods of physical rehabilitation for obese women can be identified.

2.To develop and theoretically organize the initial program at the “School of Obese Patients”, it is based on the combined theoretical and practical activities and independent activities.

.Show the effectiveness of the divided educational programs in the form of "Schools for Obese Patients."

Object of investigation: rehabilitation process of obese women.

Subject of investigation: physical and psychoemotional state of obese women

Provisions to be taken into account: a comprehensive program of physical rehabilitation for obese women.

Structure and outline of the thesis:The thesis contains the following sections: introduction, background characteristics of the work, chapter 1 “Current stage of rehabilitation of obese patients”, chapter 2 “Methods and organization of investigation”, chapter 3 “Results of investigation and their discussion”, vysnovok, list of wikilists, addendums.

My diploma work is written on 58 sides of the original text. The diploma work has 42 literary items.

Chapter 1. Current state of rehabilitation of obese patients

1.1 Characteristics of obesity

1.1.1 Etiology and pathogenesis

The term “obesity” refers to a body in which the excess body weight is 10% and more than the physical norm exceeds the physiological norm less than 10%, which is considered overweight. Yakshcho masa tila.

Obesity -a group of illnesses and pathological conditions that are characterized by excessive fat deposits in the subcutaneous adipose tissue and other tissues and organs, characterized by metabolic disorders, and are accompanied by changes in functional I will become different organs and systems. The most commonly used diagnostic criterion is obesity and excess body mass compared to the norm established statistically. However, it should be noted that the magnitude of what largely determines the severity of illness is not so much the body fluid itself, but rather the excess fat mass. This excess can really become a problem in those who are sick, as the age, growth, and age of the disease loom.

Numerous etiological factors can be divided into exogenous (over-transmission, decreased oral activity) and endogenous (genetic, organic effects of the central nervous system (CNS), hypothalamic-pituitary region i). It has now been established that the regulation of the storage and mobilization of fat in fat depots is influenced by a complex neurohumoral (hormonal) mechanism, which is responsible for the cerebral cortex, the subcutaneous structures, and the sympathetic and parasympathetic nerves. ovi systems and organs of internal secretion. Fat metabolism may be affected by stress factors (mental trauma) and central nervous system intoxication.

The regulation of food activity is carried out by the food center located in the hypothalamus. Inflammatory and traumatic lesions of the hypothalamus lead to an increase in restlessness in the grub center, an increase in appetite and the development of obesity. In the pathogenesis of obesity, the pituitary gland also plays a role. Speaking about the development of obesity, one cannot underestimate the importance of hormonal factors, since the process of mobilization of stored fat is closely related to the functional activity of most of the endocrine glands ii. Obesity develops in case of severe diseases of the pituitary gland, thyroid gland, supernasal gland and ostricular apparatus of the subglottic gland (cybral diabetes), which take an active part in the regulation of lipid metabolism c. Decreased thyroid function and thyroid problems lead to obesity. Increasing the activity of the islet apparatus of the subglottic gland leads to increased synthesis of sugar into glycogen, its transition into fat and the mobilization of the remaining from the depot. Cortisone, which is a measles hormone, also promotes fat deposition. Damage to any part of this complex regulation leads to disruption of fat metabolism and the development of these and other forms of obesity.

It can be taken into account that the presence of slumping weakness before the development of the condition transmits the existence of factors that provoke culprit illness. Such factors may include overeating, low physical activity, damage to the central nervous system, etc. Reduced liver activity naturally leads to a decrease in energy expenditure and fats that have not been oxidized are mostly deposited in fat depots, which leads to excess.

Fats that enter the body through the skin, reduce the immediate contribution from the creation of triacylglyceride reserves in adipose tissue. This is due to the fact that the warehouse of unsaturated fatty acids in fat depots gradually fills up in rice, similar to the warehouse of unsaturated fatty acids in exogenous fats. The main cause of lipogenesis in obesity is carbohydrates. Glucose, which is found in the blood (as a result of absorption from the intestines) in the bones, which exceeds the consumption of the liver or facilitates the process of deposition of glycogen, is then converted into fatty acids for the synthesis of fatty acids. The most important place for the creation of endogenous, most importantly saturated fatty acids is the liver cells. Excess glucose and triacylglycerides that come from the liver are stored in the fatty cells, where the synthesis of additional fatty acids occurs. Esterification of fatty acids that penetrate the fatty tissue of the adipose tissue, as well as fatty acids that are synthesized in the adipose tissue itself, stored in the digestion of glucose, which must enter the acceptor - α- glycerophosphate. In adipose cells, dangerously, the transformation of glucose into α- Glycerophosphate is consumed due to the suppression of its oxidation by mitochondrial dehydrogenase. As a result, a portion of glucose moves in, which is converted to glycerol, and the esterification of fatty acids begins to take precedence over the release of volatile fatty acids from cells.

In people who suffer from obesity, there is a significant shift in the amount of insulin in the circulating blood, as well as an over-reaction to the flow of glucose into the intestinal tract. The addition of excess food to hyperinsulinism not only reduces the storage of glucose in adipose cells, but also induces the synthesis of a number of enzymes (the enzyme that breaks down citrate, acetyl-CoA - carboxylase and fatty acid synthetase) in the liver and adipose tissue, which leads to stimulation. In addition, increased concentration of insulin inhibits hormone-sensitive lipase, which causes further imbalance in fat storage.

Nutritional-constitutional obesity develops as a result of excess food and poor lifestyle. When more energetic speech reaches the body, less of it is consumed. The result of increased fat storage is not only the overeating or the high amount of fat in the diet, but also the excessive absorption of carbohydrates. Rarely, irregularly, it is important to eat food in the evening before eating. And at the hour of bedtime, apparently, the energy expenditure is small, so the excess life-long words that came with it are deposited in the visible fat in the adipose tissue. Thus, the development of the nutritional-constitutional form of obesity is closely related to the activity of the body and the amount of energy that comes from the skin.

1.1.2 Anatomical characteristics of adipose tissue

Adipose tissue has trophic, storage, form-building and thermoregulatory functions. Adipose tissue is divided into two types: white, composed of single-cell adipocytes, and brown, composed of rich-celled adipocytes. Groups of fatty cells are united into cups, reinforced by one partition of fluffy fibrous unformed tissue, in which the vessels and nerves pass. In its chergu, the skin adipocyte is surrounded by a network of collagen and reticular fibers, in the loops of which numerous blood capillaries pass and lie in the tissue (including the tissue) cells. A large number of adipocytes are genetically determined and are also deposited due to the rational entry of living cells into the body during the prenatal period and early childhood. .

In humans, white adipose tissue prevails, part of which drains organs that preserve their position in the human body (necks, lymph nodes, apples, etc.), filling the spaces of organs that are not yet functioning (breast on the phallus), replaces the vernal cystic cerebrum in the epiphyses long pipe parts. kistok. With loss of adipose tissue, which determines its intended function, changes little. Most of the adipose tissue is reserve (pillar base, omentum, breeches, colonic fat pads, subserosal base). The amount of brown adipose tissue in humans is small (it is the main thing in a newborn baby). Borax adipose tissue is spread in the neck, in the inguinal pit, in the subclavian artery, under the skin of the back and the lateral surfaces of the torso, at the mediastinal and breeches. Similar to white, brown adipose tissue is also formed in the form of patches created by rich adipocytes. Blood vessels, lymphatic vessels and sympathetic nerve fibers pass at the interlobular septa, blood capillaries give rise to richly striated adipocytes, among which they are constricted and single. Brown color of formation of blood-bearing capillaries, high number of mitochondria and lysosum in rich adipocytes. The main function of brown adipose tissue is heat production. Borax adipose tissue raises the body temperature of animals during hibernation and the temperature of newborn children .

Fat tissue performs three important functions:

synthesis of triglycerides from serum lipids and glucose;

saving them in fat depots;

release of free fatty acids (lipolysis).

Fat cells in dangerous people are significantly different from normal fat cells. It’s not just their volume that’s increased, but their size, and the smell of over-replenished lipids. Moreover, these abnormal cells metabilize glucose less efficiently than normal fat cells. In case of obesity, beware of hypertrophy and hyperplasia of fat cells.

Fat storage has the following functions:

) insulate deeply embroidered fabrics from the supernatural influx of cold and heat;

) protect the hands, tissues and internal organs from injuries and impacts;

) “smooth out the sharp edges” of the skeleton, giving the body shape that gentle roundness that seems aesthetic and attractive .

1.1.3 Classification of obesity, advanced level of obesity

Nina is the broadest classification according to D.Ya. Shurigin, that the polyetiological nature of obesity is responsible:

1.forms of primary obesity:

a) nutritional-constitutional;

b) neuroendocrine: hypothalamic-pituitary; adipose-genital dystrophy (in children and children)

2.forms of secondary obesity:

a) cerebral

b) endocrine

c) diencephalic

In case of cerebral obesity, one should be wary of the rough (organic) expression of the parts of the brain, which are responsible for the regulation of fat metabolism. In this case, signs of illness progress. Diencephalic obesity occurs as a result of deterioration of the perineal cord and is accompanied by signs of impaired function. Endocrine obesity results from impaired activity of these and other endocrine glands. And here obesity comes second, but in the first place other, more important signs of illness appear.

Depending on the nature of the transition, obesity is divided into:

ü progressively

ü completely progressing

ü stand

ü regressive

You can also see 4 stages of obesity:

1st stage – shifting of the weight by 10-29%

step - 30-49%

step - 50-100%

foot – more than 100% body mass

The World Health Organization has adopted this classification, shown in Table 1.1.

Table 1.1 - Classification of overweight and obesity by body mass index (WHO, 1998):

Types of body weight IMTR risks of associated illnesses Body weight deficiency less than 18.5 and risks of other illnesses normal body weight 39.9 High obesity 3rd stage 40.0 very high

Table 1.2 - Classification of excess body weight and obesity instead of body fat:

1.1.4 Clinical picture

Increased fat storage negatively affects the function of the cardiovascular system and leads to myocardial dystrophy, damage to the blood vessels of the cerebrospinal fluid and lower ends, promotes the development of atherosclerosis and increased blood pressure. When the blood circulation in patients is impaired, the fatty buttocks are blamed, stagnation in the peripheral vessels is avoided, which results in confusion and drowsiness. Due to coronary sclerosis, patients develop angina pectoris. Obese patients are 2-3 times more likely to suffer from myocardial infarction than people with normal speech metabolism.

Already in the early stages, a tightness appears after slight physical stimulation as a result of changes in the laxity of the diaphragm and the expansion of the chest. Prescribed changes lead to a decrease in vital capacity, decreased ventilation of the lungs and pathology of gas exchange with the development of hypoxemia. During this period, patients present with drowsiness, periodically superficial dizziness, cyanosis, hypertrophy of the right scutum and a progressive development of insufficiency of blood flow. Impaired pulmonary ventilation due to a decrease in nonspecific resistance is often accompanied by the development of inflammatory processes that have been ongoing in the bronchovascular system (bronchitis, pulmonary emphysema, pneumonia, tuberculosis).

Diseases of the intestinal tract are revealed (chronic cholecystitis, gum disease, chronic colitis). Intestinal motility is impaired, which is a result of a poor lifestyle, weakness of the gastrointestinal tract, and excess fat deposits in the area of ​​the abdomen and omentum. Clinically, these disorders are manifested by atonic constipation, hyperintensity of gas, diffuse pain in the abdomen. The liver in such patients is enlarged as a result of fatty infiltration and stagnation, resulting in the accumulation of fat at the hilum, liver capsule, interstitial spaces, the hepatocyte itself, and the reticulum cells. of the liver system and a progressive decrease in its glycogen content. These changes manifest themselves as a slight severity in the right hypochondrium, decreased glucose tolerance, sensitivity to ketones, and increased levels of cholesterol.

For those who are dangerous, they are characterized by a decrease in the instability of nervous processes with great importance of galmic reactions. Possible culprits of a depressive state: greed on a bad sense of self, lethargy in the mood, bloatiness, drowsiness, shortness of breath, pain in the heart, swelling, etc.

Obesity also affects the musculoskeletal system. The fatty deposits at the greater omentum contain an increase in the transverse lordo behind,This is the legacy of compensatory thoracic kyphosis. With increased pain, pressure on the knee joints increases, resulting in the development of arthrosis of the knee and knee joints, flat feet, and herniation of the intervertebral disc (osteochondrosis). Diabetes develops, menstrual irregularities, amenorrhea, infertility, and gout occur. In a number of episodes, disruption of water-salt metabolism is manifested by pastiness and swelling.

The current prevalence of aphid obesity is often accompanied by pathology. The frequency of toxicosis is increasing; the fruits are expected to be great, but with signs of prematurity; Eclampsia often develops; Beware of prematurity and post-term pregnancy. The postnatal period is characterized by the presence of sufficient lactation.

In patients with obesity, heat regulation is also impaired. The supply of heat to dangerous people goes to the forefront of sweating, which can reach up to 2-3 liters per dose. Smooth people are unable to withstand heat and are more susceptible to heat stroke. The body's resistance to infection in obese patients is reduced. There is also a decrease in physical activity and productivity.

1.1.5 Growth of normal body weight

Your body is one of the indicators of the physical development of a person. It depends on age, morphological and physiological influences on the body (genetic factors), on the social status of a person (way of living) and allows one to judge the state of health. They indicate body mass on medical teresas while standing. Bazhano, this procedure was carried out in the same minds .

For mature people, use an objective method to determine the Quetelet body mass index (BMI). Yogo formula is simple:

BMI = weight (kg) / height ² (m ² )

Since men’s BMI is more than 27.2-27.8, and women’s BMI is 26.9-27.3, this means that body fat exceeds the norm.

The main idea is that a BMI in the range of 18.5-24.9 indicates normal body weight. A BMI of 25.0-28.4 indicates the presence of excess body weight (loss). The simplest and most accessible method for determining the ideal body weight for individuals whose height is between 155-170 centimeters can be the Broca's indicator:

Masa = height (cm) - 100

A simple and straightforward method for assessing body tissue using T. Brughi’s method. For an increase of 165 centimeters, you need to select 100 centimeters; for an increase of 165-175, you need to select 105 centimeters; for an increase of 175, you need to select 110 centimeters. It is important that T. Brughi's indices are much more accurate.

Academician Amosov N.M. It matters that it would be ideal for a person to preserve the very same treasure that she had for 20 years.

Normal body weight, as indicated by the Breitman index, is equal to height in centimeters, multiplied by 0.7, minus 50.

In addition to growth indicators, the method of emphasizing the skin folds and applying Korovin can be used. This method is used to measure the thickness of the skin fold in the epidermal region (normally 1.5-2 cm). Increased thickness of folds up to 3 cm indicates excess body weight.

For the development of body weight standards, it is quickly illustrated by tables compiled by A.A. Pokrovsky (table 1.3), M.M. Egorovim and L.M. Levitsky (table 1.4).

Height, narrow chest Normal chest Wide chest MenWomenMenWomenMenWomen152.5-47.8-54.0-59.0155.049.349.256.055.565 ,064.06 3,1160,053,552,160,058,566,064,8162,555,353,861,760,168,066,3165,057,155,363,561,869,566,66 9,0170,060,557,867,864,073,870, 0172,563,359,069,765,276,871 ,2175,065,360,371,766,577,872,5177,567,361,573,867,779,873,7180,088 570.9-77.2-83.6-185,072.8-79.2-85.2-

Note: in women over 30, an increase in weight is allowed, equal to the table in men by 2.5 - 6 kg, in women - by 2.5 - 5 kg.

Table 1.4 - Maximum normal body weight in different age groups with normosthenic status, kg

Growth, cmVic, rocks 20-2930-3940-4950-5960-69 Man-chiniWomenMan-chiniWoman-chiniMan-chiniWoman-chiniMan-chiniWoman-chiniMan-chiniWomen148 50,56,56,253,952,215051,348,956,753,958,156,558,055,757,354,815253,151,058,755,061,559,561,157,660, 35556 63,860,261,959, 015658,555,864,461,567,366,065,862,463,760,915861,258,167,365,870,467,968,264,567,062,416062,929 86 8,264,616264,661,671,070,874,472,272,768,769,166,516467,363,673,971,877,274,075,672,072,272,77 6,573.874,371,516870,868,576 ,275,879,678,277,974,876,073,317072,769,277,777,081,079,879,676,877,27 881,781,177,778,376,317477,574,380,879,984,483,782,5 79,479,378,017680,876,883,382,486,084,684,18 3,988,086,186,582,482,880 , 918085,180,988,087,789,088,187,584,184,481,618287,283,390,689,491,489,389,586,585,482,918489,98 488,085,318693,189,295, 091,096,692,992,889,689,087,818895,891,897,094,498,095,095,091,591,588,91 99,495,694,892,9

Note: for individuals with an asthenic constitution, add 3-5% of the mass indicated in the table; for those with hypersthenic constitution, add 1-2%.

1.1.6 Types of energy exchange

Those that the pathogenesis of obesity may be related to impaired energy expenditure, as the hypothesis seems logical. And it’s not a coincidence that the process of wasting energy in dangerously ill people was constantly happening.

A large number of studies have shown that the amount of energy lost in patients with obesity is no less, but, on the contrary, it is greater in people with normal weight. There are three main types of balance in energy metabolism, similar to up to three types of human constitution.

1.2 Treatment and prevention of obesity

As if treatment for obesity was a simple matter, since it would not require a special attitude and stress on the patient, and with the doctor’s control and steady correction, perhaps there would be no problem, and our patients, under Trying to lose weight with such a natural craving, I would have long ago gotten rid of the greed. vagi.

Uninvited for the great Kilkiy of the prosperous and such RIZNIKH is the way of the permissor Vagi, єdin, and the ethno to give to the zmoshenny of Masi Gir - the eenergic defіcite, Tobto transphygege Vitrati of the overwords. In this situation, fat, as a form of stored energy, begins to be used up to cover the deficit that has created.

The simplest, most sensible, and most likely way of creating an energy deficiency that occurs is a hypocaloric diet. Other proven methods of treating obesity include physical stimulation, the use of tonic drugs and drugs that reduce appetite, psychotherapy, reflexology, etc., without special fixation in early childhood. effective only in a small number of drops (less than 10-20%) and may lead to small, unstable and it is important to control your expenses (less than 5-6% of output).

All of the above methods can either complement dietotherapy, or enhance its effect, or improve the tolerance of treatment. Please note that with reduced body fat there is an improvement in the control of such serious illnesses as arterial hypertension, blood diabetes, atherosclerosis and coronary heart disease, and obesity treatment, Undoubtedly, it can be seen as an effective method of curing these illnesses. And as a result of obesity, due to its daily manifestations, and the reason for them getting sick, then such treatment can again be called etiotropic.

The main way to combat obesity is the diet of the sick person, a comprehensive treatment that combines diet therapy with physical exercise.

Systematically engaging in physical exercises in conjunction with dietary meals is completely followed by periodic treatment of the sick at a sanatorium and at a resort. Treatment of patients who suffer from obesity can be carried out both in nursing homes and in modern sanatoriums and resorts, where medical treatment and physical rehabilitation are carried out, not contraindications for illness oh for the accompanying illnesses. The closest resorts are Sestroretsk, Lipetsk, Darasun, Kislovodsk, Esentuki, Pyatigorsk and in.

For the normal functioning of the body, it is important not only the balance between the energy that it absorbs from the skin, the energy that it expends, but also the balance between proteins, fats, content of carbohydrates, vitamins and minerals depends on the status, age, nature of work activity .

The main role in the prevention and treatment of obesity is played by rhinitis activity. Kozhen is responsible for choosing a pleasant type of physical rights. Physical activity is highly individual. Too great aspirations are cheap, and insufficient ones are worthless. Therefore, it is necessary to take care of your life, health, and physical fitness.

You cannot transfer it every time. It’s hard for someone to get up from the table hungry. A slight feeling of hunger after a quick meal is replaced by a feeling of satisfaction while saving fruitfulness. When there is a feeling of stress, productivity decreases, the need to lie down, lie down, fall asleep arises, which, naturally, leads to irritability. It has been established that the above-world growth of hedgehogs is due to insufficient rotary activity and the appearance of a persistent imbalance between the inflow and outflow of energy.

1.3 Physical rehabilitation for obesity

1.3.1 Engine rehabilitation

In obese patients, physical exercises are important, of an aerobic nature, and trivals hour after hour. Introduce wound hygienic gymnastics, physical exercises, exercise exercises, health path, dosed walking, special physical exercises Vswimming pools, swimming inin closed waters, running, tourism, paddling, biking, licking, horse riding, wheeling and sports games.

Rankova hygienic gymnastics

Hygienic gymnastics should be done from different positions, but it is important to stand. The available physical rights are being explored in order to process the entire meat system with complete care, the physical rights and the right to relaxation. We recommend gymnastic rights for endings, tulub, on apparatus, turns, nakhili tulub, right, which will crush the muscles of the abdominal press. When vikonnі has the right to follow the dikhannya, it may be free, without shutting down.

After getting ready to take the necessary water procedures: wiping off or showering, then rubbing the body with a terry towel until the skin is blackened.

Likuvalna gymnastics

When treating and rehabilitating patients with obesity, a complex of methods is used, the most important among them being physical and diet.

Shown:exogenous constitutional obesity stage I, II, III, IV, neuroendocrine form of obesity with diencephalic or liquor-hypertensive syndrome.

Contraindications:hypertensive and diencephalic crises, acute concomitant illnesses.

Physical exercises are carried out in the context of macrocycles, which are divided into two periods: introductory, or preparatory, and main. External physical stimulation may be submaximal and individualized according to the functional capabilities of the patient’s body. For greater effectiveness, perform various forms of physical exercises throughout the day. The duration of the skin procedure of facial gymnastics ranges from 5 to 45-60 minutes. When you are victorious, you have the right to use gymnastics objects and equipment - medicine balls (1-4 kg), dumbbells (1-3 kg), expanders, etc. The range of projectiles gradually increases. It is recommended to repeat the course 4-5 times for the first time, and then gradually increase the repetition up to 20 times.

Rukhs are formed with great amplitude, large meat groups are received into the work, swings are twisted, round rocs at great angles, right for tulub (nahili, turns, wrapping), right with objects. The rhythmic shortening of large groups of muscles causes increased energy expenditure and depletion of acid, stimulating the functioning of the ear, cardiovascular systems, and tissue metabolism. Even brown ones are also right on shells and special devices. The importance of hearing rehabilitation is due to the fact that physical people have the right to increase energy expenditure, stimulate metabolic processes, normalize the activity of the cardiovascular and respiratory systems, promote feel the vitality and emotional tone of the sick, the fruitfulness and support of the body. Of particular importance in the process is the practice of breathing. Dihalants have the right to increase the presence of acidity in the body, which is necessary for strengthening oxidative processes and active combustion of fatty acids in tissues. All physical rights are guilty of physical rights. The release of meat tissue from fat promotes its short life. The gradual change in fat deposits in the lower abdomen increases the looseness of the diaphragm - a strong post-abdominal factor in blood flow. All this eliminates the development of stagnant symptoms in organs and tissues.

It’s important to the role of the right to the right, the serpent of the m'yazi of the coherent presu, the yaki is not the same to exaggerate the organic thoroughbred in the normal fiziological position, the red to the peristalsis of the intestines, and the transmission spores.

In addition, it promotes the inflammatory tone of the central nervous system and normalizes the functional ligaments between the cerebral cortex that are damaged during illness. With the help of internal organs, it normalizes metabolic processes in the body.

Dosing run, run with "fuck"

Running is an effective way to train the heart and the entire body. When running, the robot produces a large number of skeletal muscles and this stimulates the functions of organs, which significantly promotes energy metabolism. Running exercise will be like this: before running, warm up (10-15 exercises), then dosage 5-6 exercises plus walking (2-3 exercises); then make repairs (2-3 hours) - and so 2-3 times throughout the activity. Step by step, the intensity of the run increases, and the discomfort changes to 1-2 minutes, the number of series increases to 5 - 6, and the pause between them increases. After 2-3 intense (or more) workouts, move on to a more intense run of moderate intensity up to 20-30 runs at 1-2 intervals.

Walking allowed

Natural and feasible walking is beneficial to all vital functions of the body. During an hour of walking, your heart becomes warmer, your breathing slows down, and your legs become more ventilated. Within an hour of walking, more than 50% of all body muscles are used. Depending on the pace and type of walking, energy expenditure increases 3-10 times.

Walking is happening: it’s quite comfortable - it’s 60 before 70 croq/xv (type 2 to 3 km/year) for obesity, stage III; povilna - view 70 up to 90 crops/xw (type 2 up to 3 km/year) for obesity, stage III; middle - from 90 to 120 kroki/xv (from 4 to 5 .6 km/year) for obesity ІІ-І stage; shvidka - from 120 to 140 krokiv/khv (from 5,6 up to 6.4 km/year) for obesity ІІ-І stage; even more than a Swede – over 140 kroki/khv. It’s best for people with good physical fitness.

Swimming and swimming

Swimming can cause a variety of effects on the body. Swimming is a combination of physical preparation and conditioning, which is of great practical importance. It develops vitality, promotes the vital functions of the body, as research has shown, the loss of energy when depriving the body of water on water exceeds the exchange of calm by 2-3 times or more. During swimming, energy loss increases. Its size depends on the speed of swimming, distance, water temperature and other factors.

Vaslubath calms the nervous system, has a calming effect on the body, trains the cardiovascular system, the respiratory apparatus. Vaughn emphasizes the pulp of the upper and lower ends, tuluba. Vesluvannya is emotional, easy to dose.

Swimming, like paddling, also has a positive effect on obesity, since participation in these sports leads to significant energy expenditure. Paddling and swimming activities can be organized at the sanatorium and clinic stages. Every now and then you need to use rowing machines. Swimming activity consists of 3 parts: entrance (10 - 15 months) - activity in the hall ("dry" swimming); main (30 - 35 minutes) - swimming of moderate intensity in different ways with pauses for restoring and breathing right (5 - 7 times) and concluding (5-7 times) - right the white side to renew the functions of blood circulation and breathing.

Sports and recreational games

Sports (football, hockey, basketball, volleyball, tennis, etc.) and competitive games should be one of the first places. Under the hour, there is no continuity of force: periods of high voltage alternate with pauses until the end. The games take place with great emotional excitement, strongly influencing the central nervous system, promoting the functional capabilities of the most important internal organs. The stench conveys the development of such qualities as fluidity of reaction, vibrancy, strength, resiliency, coordination of the spirit, etc. If the games are played in the open air outside of different minds, then the smell will give another effect that grows. During the course of the game, depending on the pace, the balance of forces between the teams, the emotional state, and the expenditure of mass, the mass fluctuates from several hundred grams to 2-3 kg.

If you are obese, play with an inflatable ball (beating, catching, throwing), as well as relay races (on the spot, with passing objects and running). For sports games, it is important to maintain health and fitness levels that are recommended: tennis, badminton, volleyball, etc.

Exercising on the gym

Contraindicated before taking onsimulators: obesity, whatever its etiology, stage IV; concomitant illness, which is accompanied by insufficiency of blood flow of the 2nd and 3rd stages; hypertensive and diencephalic crises, exacerbation of calculous cholecystitis, AT elevation above 200/120 mmrt. Art., increase the pulse to 60 per hour.

In complex obesity treatment, training on exercise machines plays an important role.The best results for low body weight in patients with exogenous-constitutional obesity of the 1st stage can be achieved using exercise machines (an exercise bike, a rowing cycle ergometer, a treadmill). We are suffering from stage II obesity, with functional changes in the cardiovascular system or signs of myocardial dystrophy, with concomitant hypertensive disease not higher than stage IA or arterial hyper Tensions, having previously engaged in physical culture or sports, you can use exercise equipment for up to 40 hours per hour, it is recommended that causes an increase in heart rate by 75% based on the output heart rate (at rest). In this case, follow the 5-line sequence of steps with 3-line pauses for completion. Trival of employment – ​​30-90 min. Course – 18-20 procedures.

We are suffering from exogenous-constitutional obesity stage III with concomitant illnesses (hypertensive disease stage IIA in the remission phase, lack of blood flow is not higher than stage I), we are not physically prepared, in Use exercise machines for up to 60 years, we recommend physical exercise, which causes an increase in heart rate by 50% of the output heart rate (quiet). In this case, perform 3-line movements with 5-line pauses for completion. Trival of employment 20-60 years. Course – 18-20 procedures.

Exercise on exercise machines is completely combined with physical exercises, special physical exercises in the swimming pool for abdominal muscles and other forms of auditory rehabilitation.

In this case, it is necessary to work out what systematic physical exercises should be done, which is necessary to perform on exercise machines (with skin drawings 3 - 5 minutes, work and repair) with a stretch of 60-90 minutes, comfortably flow onto the clinical indicators and find It is more effective to contribute to lipid metabolism.

In the process of becoming obligatory there is a system for monitoring health and self-control. With this method, heart rate and blood pressure are measured, self-reported indicators are assessed and functional tests are carried out (Martine's test, velo-ergometric test, Stange's, Genchi's, etc.) tests.

1.3.2 Massage

Massage actively affects the metabolism of wastes: it increases the removal from the body of mineral salts and nitrogenous wastes, under-oxidized metabolic products, and enhances the removal of acidity and other metabolites from tissues.

Massage expands the functioning capillaries, opens the reserve capillaries, which is why it creates more generous blood flow not only to the area being massaged, but also to the area associated with it reflexively. As a result, gas exchange between blood and tissue increases. With the infusion of massage, the elasticity of meat fibers improves, their rapid function increases, and meat atrophy increases. Massage also provides a significant boost to the oxide-based processes in meats, increasing the flow of sourness, the asimilation function of the tissue of meat tissue, and improves the efficiency of meats.

Massage should be carried out after taking a bath or steam bath with a sweetheart. Self-massage (while standing) near the water gives a good result, as well as 20-25 minutes with the help of a “Tonus”, “Sport”, etc. automassager.

Methodical insertions:

1. The best time to carry out a facial massage for obese people, especially for patients with impaired leg-heart activity, and in the evening - for those who have liver disease or gastrointestinal tract.

Treat the clinic against illnesses such as abdominal weakness, constipation, as well as the patient’s age. Do not confuse the connection with these actions (for example, drums).

The intensity and severity of the procedures gradually increase as the patient’s reaction improves.

If you become depressed, you feel that weakness and other unpleasant symptoms appear, change the massage by dosing or immediately remove it.

After the skin procedure, give patients 15-20 minutes of rest, especially for people with diseases of the cardiovascular system.

As permitted by the doctor, massage is widely used in the lazna with a steam room.

Self-massage is recommended, which consumes more energy. Self-massage is most effective in areas with the greatest accumulation of adipose tissue (self-massage or massage of the abdomen, ulcers, buttocks, etc.). Apply self-massage in the following sequence: stroking, kneading, shaking, rubbing, rubbing, percussive techniques. The massage will end with stroking.

1.3.3 Physiotherapy treatment

Shrouded

When wrapping a naked patient, lay him with his back on a couch, covered with a cloth rug and a heavy linen blanket, soaked in water at a temperature of 25 - 30 ° C and well squeezed. Then they sunbathe in the vlog. Cover the sick person with blankets, cover the front of the neck with a dry towel, and apply a cold compress to the forehead. After the procedure, carefully wipe the patient and let him lie down, cover him with a dry cloth and carpet. The duration of the procedure for impaired speech metabolism is 50-60 minutes or more. Treatment course - 15-20 procedures.

Souls

And water bathing procedures, in which jets of water of varying shapes, temperatures and pressure are poured onto a person’s body.

Charcot's shower (strumovy) is a high-visco shower. During the hour of the procedure, patients should stand at a distance of 3.5-4 meters from the shower. Direct a stream of water through the legs, back, front and side surfaces of the body from the bottom to the top with a flaccid, then compact stream. To obtain the desired effect, manipulations in this order should be carried out several times. Finish the procedure with a dry jet of optimal temperature. The impact of the jet on the head, spine, heart area, mammary glands, and organs is unique. The water temperature at the beginning of the course is 32-35 ° C, at the end - 20-15 ° C; pressure from 150-200 kPa to 250-300 kPa. The duration of the procedure is 1-2 to 3-5 sessions. Treatment course – 15-20 procedures. Charcot's shower is used to improve muscle tone and change the volume of fatty tissue.

Underwater shower-massage is a special type of hydrotherapy procedures, when a sick body is placed in a bathtub, massaged with a stream of water, which is applied under a pressure. Massage with a water jet revitalizes the reddish skin, brightens the blood, lymphatic circulation, and stimulates the exchange of fluids in the tissues.

Contrast baths

The use of contrast baths in the treatment of obesity patients is based on the phenomenon of nonspecific adaptation of various systems of the body (sympathetic-adrenal, thermoregulation, peripheral blood circulation) to a series of subtypes that have reduced absorption body mass for the activation of lipolysis processes, enhancement of neuroendocrine regulation. improvement of the psycho-emotional state of patients. During the procedure, patients are alternately treated in a pool with hot water (40°C), then in a pool with cold water (20°C), for a total of 3 sessions; The active hand dryer mode in the cold bath will stop. The severity of exposure to hot and cold water becomes 3 to 1, 2 to 2, 1 to 3. After the procedure, carefully rub the body with a dry towel. A course of 10-12 baths today. After completing the procedure, the patient is recommended to complete 30 treatments.

Underwater intestinal rinsing

This should be carried out using an additional APKP-type apparatus in a bathtub with a capacity of 400-600 liters or in a special swimming pool, which may be located adjacent to a shower unit and toilet. Water with added medications, chamomile tea, kitchen salt, English salt, Carlsbad salt and other substances in quantities prescribed by the doctor, should be administered to the intestines in portions of 0.5 to 1.5 liters. Water temperature - 38-39 ° C, duration of the procedure - 30-40 minutes. During this hour, pass up to 8-10 liters of water through the colon to the cob and up to 12-15 liters - until the end. Consider carrying out at least 6-10 procedures, 1-2 per week. Intestinal lavage should be done as soon as possible, or not earlier than 3-5 years after eating. After the procedure, you should take a shower and lie down on the couch with a warm stove on your stomach.

Laznya has long been popularized as an excellent way to preserve health. It has a beneficial effect on the central nervous system, nerve-muscle apparatus, blood circulation, skin and other organs. During the influx of the lake, microcirculation increases (the number of functional capillaries increases), venous stasis decreases, the process of tissue regeneration decreases, skin temperature increases, and the temperature decreases. There is a tone of the muscles, the pain changes.

Lasna actively contributes to gas exchange, mineral and protein metabolism, which is mostly seen in the body of fat and lactic acid. All this positively indicates the functions of the internal organs of the prosecutor’s office and the vitality of the body. Then the breakdown products are eliminated from the body. There is a mobilization of the chemically dependent mechanisms of the body.

Magnetotherapy

Ultrasound therapy

Ultrasound therapy is considered to be a factor in the local swelling of adipose tissue. The local blood flow is thickened, lymphatic circulation is increased, which promotes increased tissue oxygenation and metabolism. An ultrasonic frequency of 880 kHz, intensity 1.0-1.2 W/cm, is applied to the area of ​​the anterior abdominal surface or the anterior wall of the abdomen. ² in a stationary regime using a labile technique. Pour onto the skin or the side, 15 quilins for the first and 8 quilins per skin side for the other. The procedure is carried out every 10-12 days per course.

1.4 Diet therapy

The method of medicinal food is the mobilization of fats from fat depots, reducing the restlessness of the food center (appetite) and galvanizing the synthesis of fats in the body from easily digestible carbohydrates.

Treating obesity and subsequently preserving normal body weight is not an episode, but a healthy approach that can be carried out throughout the rest of your life. The sick person himself is responsible for taking an active part in preserving and improving his health. From the regular grub regime to the new one, it is necessary to move step by step, due to the changing nature of grub, grub, and not the immediate exchange of fresh products. The amount of food consumed and its calorie content should be changed in such a way that the sick do not feel as if they are hungry, so that the treatment does not cause severe weakness or nervous irritation.

An important place in treatment and rehabilitation for obesity is rational eating with the reduction of fats and carbohydrates. The content of fat in the diet should be reduced to 0.7-0.8 g/kg, with the culprit being vegetable fats (1.3-1.4 g/kg), and the content of carbohydrates should be sharply adjusted to 2.5-2.7 g/kg (additional norm 5.2-5.6 g/kg), including sugar, bread, confectionery products, and licorice drinks. The amount of protein in a hedgehog increases, which precedes the loss of tissue protein, promotes energy expenditure with the help of digestion of proteins, creating a sense of stress.

ü Eat less fatty skin;

ü wash yourself with malts (chocolate, zucchini, confectionery sparrows, licorice drinks), separate the saplings (one or two licorices per day);

ü Eat more low-calorie bulk and high-fiber products (green vegetables, fruits), bread and coarse pomelo;

ü pour meat, poultry, fish into the song;

ü cut out boroshny herbs, including bread and bakery sprouts, speed up the harvest of potatoes;

ü Combine with sodium salts, salts of any kind: kitchen salt, cured meats, canned veal and pork, sausages, shreds, bacon, cowbass, cheese, canned soups and vegetables, sauces. Boiler should take up to 5-8 g per day, with the main ingredient being vicoristics for salting for an hour;

Limit intake of fresh water to 1-1.2 liters per day, which will enhance the breakdown of fat as “internal” water;

exclude foods from your diet that will stimulate your appetite;

turn off alcoholic drinks, which increase appetite and energy levels;

It turns off rare and obvious meals, especially the main ones taken in the evening, so always do not overeat before going to bed;

avoids periods of intermittent eating with uncontrolled consumption of large quantities of hedgehogs, rich in fats and carbohydrates;

Don’t immediately try to “finish it.” It is necessary to leave the table because there is seemingly insufficient food;

Sit quietly, relaxed, in a calm, welcoming environment. Carefully chew the skin and spend at least 20 quilins on the skin. Remember that this very hour is needed in order for us to understand the situation. The more excited you are to accept hedgehogs, the less likely you are to transfer;

Periodically (1-2 times per week) wash out the chewing days.

Outside fasting has no advantages over a reduction subcalorie diet. It is contraindicated for children and people who suffer from diabetes, liver disease, diabetes, heart disease and chronic respiratory failure.

1.5 Psychotherapy

Apparently, until recent discoveries about the etiology and pathogenesis of obesity, psychotherapy, of course, is not a valid method of treatment for this disease, but with the help of psychotherapeutic methods of treatment, the patient may develop new This is a stereotype of food and a new stereotype of a way of living, which is constructively posed to one’s problems, The value of reducing body weight was strengthened, which, undoubtedly, helped to strengthen and consolidate the effect of elation.

The patient must be reconciled so that everything will be fine, that all the difficulties that will arise during the course of treatment can be improved, and that, in the end, treatment for a new prize will be good. I am in good health. And besides, to the extent that the doctor can control the thoughts and feelings of his patient, that is where the effect of treatment lies.

Most often, doctors call rational psychotherapy as behavior therapy. The patient is taught how to safely get married to her, begin to stream her own food like her, and then smear it evenly, as necessary, so as not to stroke it. Using such methods can consolidate the results of withdrawal, increase the rate of remission and reduce the number of relapses of obesity. In some treatment centers, with individual work (doctor – patient), the method of treatment team is practiced, in which patients are aware of the most difficulties that arise during pre-term diet and regimen. physical importance, to know how to get out of these and other living situations that overcome the depression Masi tila. .

1.6 Surgical methods of debridement

Surgical methods of debridement are used in cases of obesity when other methods of debridement have proven unsuccessful. There are a number of options for surgical treatment: removal of the greater omentum, resection or temporary removal of part of the small intestine, molding of the small scutum, scutum bypass, and others. As a rule, these methods give a cosmetic effect and a great reduction in appearance. In addition, the method of aspiration of subcutaneous adipose cells, which is called liposuction, will eventually become stagnant.

Liposuction is a method of removing subcutaneous fat deposits from one or another part of the body by enhancing the contours of the figure. Fat is removed through small slits. Discover different methods of liposuction. Their choice is to store a lot of fat, which makes it easier to remove. Liposuction is easy to tolerate and provides an excellent cosmetic effect. However, in order to save a lot of money in life, the sick people gradually turn around until the weekend.

Thus, the analysis is scientifically -Methodical literature on the researched problem has shown that today there are a large number of different methods and methods for treating obesity. Most dieters rely on a comprehensive, hypocaloric diet and optimal physical exercise. However, the main problem is that physical symptoms can be eliminated - the stench is to blame for being systematic and persistent over a period of time. This leaves us today with a little-studied problem that we have devoted our further investigation to.

Chapter 2. Methods and organization of research

2.1 Investigation methods

To improve the results of the robotic task, the following tracking methods were used:

analysis of scientific and methodological literature;

pedagogical experiment;

questionnaire;

medical and biological methods;

methods of mathematical statistics

2.1.1 Analysis of scientific and methodological literature

The work of domestic and foreign authors was used. Abstracts of dissertations, scientific and methodological handbooks, methodological recommendations, scientific statistics were reviewed, which made it possible to highlight the relevance of the research, to identify the obvious results of the research, and therefore to Therefore, develop a comprehensive program of physical rehabilitation for patients with obesity.

2.1.2 Pedagogical experiment

An experiment is a method of investigation through which the minds systematically control a situation in which hypotheses about the causal connections of phenomena are examined, tested, and tested.

p align="justify"> Pedagogical experiment is an investigation in the process of which we ourselves discover the phenomena that are important for us and create the minds necessary and sufficient for the manifestation and understanding of their connection between battle and the surroundings of people's lives.

During the research process, a pedagogical experiment was carried out on natural minds to determine the effectiveness of a separate method of physical rehabilitation.

Two groups were formed: experimental and control. The control group studied the conventional method, the experimental group studied a specially developed physical rehabilitation program.

2.1.3 Medical, biological and psychological research methods

During the course of the work, the following tests were used:

1.Vibration of body mass

2.Vimiryuvannya growth

.Variation of body volumes

.Vimiryuvannya AT

.Vimir vital capacity

.Anxiety assessment

.Assessing motivation before getting tired

Vibration of body mass

The amount of body mass occurs on medical devices (important or electrical). The important work must be carried out in our own minds, in our very souls, in our hearts, after the emptying of our stomach and intestines, without wearing clothes. Body weight is measured in kilograms (grams).

Vimiryuvannya growth

Height is measured by height, in centimeters. The follower stands on a platform of height with his back to the counter on the scale and stands at three points: heels, seats, interscapular space. Vymiryuvanny growth in the position of sedentary height, which has a folding bench, fixed on the riser 40 centimeters under the support. To ensure that the stitches are aligned with the crease and interscapular space, the stitches are horizontal to the underside.

Variation of body volumes

The variation of the obligations is based on the additional calibrated centimeter line in centimeters.

The waist circumference varies 3-4 centimeters above the ridges of the club's tassels and 1 centimeter above the navel, in a standing position. Under the hour of death, the quilting is not guilty of pulling in and living. .

The value of the pulse and the heart rate will change soon

The pulse is monitored in the promenal, scronal, carotid, stegnoid, and popliteal arteries, and in the arteries of the top of the foot. The most manual way is to measure the pulse on the promenian artery. To do this, you need to place the other, third, fourth fingers under the promenal artery, at the base of the outer third of the wrist on the side of the thumb. The heart rate quickly improves for 30-60 seconds.

Before the start of physical exercise, the pulse rate of the body increases, it is enough to hold it for 10 - 15 seconds. Then the value is removed and transferred from the structure of the hvilina, then. multiply by 6 (if the pulse rate was maintained for 10 seconds) or 4 (if the pulse rate was maintained for 15 seconds). The normal pulse rate is 60 - 80 beats per hour.

Taylor Anxiety Scale

Purposes for reducing the level of anxiety. This test is self-administered, which consists of 50 points, depending on the date of confirmation “so” or “no”. The assessment of the results of the investigation from the hospital is carried out by checking the number of types of evidence from the patient to indicate concern. Skin conforms “so” to viscosity 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 230, 31, 32, 33, 34, 35, 36 , 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50 and answer “ni” to the word 1, 2, 3, 4, 5, 6, 7, 8 9, 10, 11, 12, 13 are scored 1 point. Then the sumptuous ball is celebrated.

The total score, which amounts to 40 – 50 points, is seen as indicating a very high level of anxiety; 20-40 points to indicate a high level of anxiety; 15-25 points – about medium (with a tendency to high) rhubarb; 5-15 points - about average (with a tendency to low) level of anxiety and 0 - 5 points - about low level of anxiety. (Addendum 3)

Incubator "Renewal of locus of control"

It is developed as a tool for indirect assessment of the patient’s level of motivation for renewal. The test is based on the patient’s thoughts about his power role in the clothes. The patient, having read the explanation, is obliged to determine the step according to the skin from the submissions to the hospitalist. Power supply types 1 - 5 are assessed based on the following rank: “entirely good” - 4 points, “good” - 3 points, “don’t know” - 2 points, “not good” - 1 point, “absolutely not good” - 0 points; Power supply types 6 - 9 are assessed in mirror order ("entirely passable" - 0 points, "passable" - 1 point, "don't know" - 2 points, "not passable" - 3 points, "absolutely not passable" - 4 bali). The total score can be varied from 0 to 36. The higher the score indicates the highest level of motivation to achieve an increase in physical health. (Addendum 2)

To determine the effectiveness of the developed rehabilitation program, the following was determined:

Arithmetic mean:

where n is the number of sub-last ones.

Mean quadratic variation:

de s – mean quadratic variation;

Maximum table values;

Minimum table values;

k – coefficient.

The standard calculation of the arithmetic mean is:

de S – standard calculation of the arithmetic mean;

s – mean quadratic variation;

n – number of sub-last ones.

Student's coefficient:

de t – Student’s coefficient; - The arithmetic mean before the experiment; - arithmetic mean after the experiment; S1 – standard calculation of the arithmetic mean before the experiment; S2 – standard calculation of the arithmetic mean after the experiment.

2.2 Organization of investigation

At the first stage (2005 – 2008), the analysis of scientific and methodological literature was completed, the rehabilitation program was developed, and methods for monitoring the effectiveness of the rehabilitation program were developed. At another stage (2009), a pedagogical experiment was carried out on the basis of physical education -health complex on the basis of the VAT "Slonimsky Meat Processing Plant" (lipen - breast 2009).

At the third stage (now -February 2010) statistical processing and analysis of the collected data and registration of the results of the work were carried out.

The investigator suffered the fate of 20 people. By means of random sampling, two groups were formed: 10 individuals formed a control group and 10 individuals formed an experimental group. All tested - women aged 22 to 34 years.

Patients from the CG were engaged in a program of a group of advanced physical training ("Health" group), with an important emphasis on figure correction and normalization of body weight.

EG patients took up the initial program we developed at the “School for Obese Patients”. The organized activities were held three times a day, spanning two months, in 2009. Then the patients learned the necessary knowledge and worked independently until the end.

Repeated testing was carried out in both groups in infants in 2009.

Chapter 3. Results of investigation and discussion

3.1 Development of a comprehensive physical rehabilitation program

At all stages of the rehabilitation program, attention is transferred to the individual patient, combining biological and psychosocial forms of healing.

For this ordering it is necessary to incorporate the entire complex of changes: morphological, psychological. When developing a rehabilitation program for obese patients, it is necessary to take an individual approach to the patient by setting realistic goals and targets. Also take care of the health and physical preparation of the patient and the presence of concomitant illnesses.

Physical benefits include a decrease in adipose tissue mass, a decrease in visceral fat, an increase in body weight, a decrease in insulin resistance, a normalization of indicators of carbohydrate and lipid metabolism, and a reduction in physical activity. I will become physically and psycho-emotionally ill.

Basic physical instructions for obesity Stage 1:

-activate oxide-hydrogen processes

-promote the adaptive capacity of the body

increase energy consumption

Massage and physiotherapeutic methods not only relieve low body weight, but also reduce metabolic processes, have a beneficial effect on the cardiovascular and central nervous systems, improve tissue trophism, change congestive to tone the muscles, improve the psycho-emotional state.

An important element of a comprehensive physical rehabilitation program for patients at the obesity stage is diet therapy. The basis of a healthy diet should be a balanced, natural, low-calorie diet. It is recommended to gradually change the nature of food, food preparations, and not to immediately reduce the consumption of fresh products.

At the present time, it has been recognized in light medical practice that one of the progressive approaches to solving the problems associated with the treatment of various illnesses is the organization of a system for the treatment of patients, which can be carried out as in the state. ions, and in outpatient minds. The remaining cost to the medical mortgage is cheaper and allows you to create a flexible work schedule for the care of the sick.

Participation in the educational program forms the correct identification of illness, risk factors, guilt and the mind of a progressive transition, which allows the sick person to more clearly understand the complex of recommendations over the course of three hours, forms an active life the position of the patients themselves in the further healing process.

Carrying out the activities of the sports and health center, conversations with physical rehabilitation instructors showed that today the initial programs for the sick and obese are in use every day.

Based on the above, we have developed a program at the “School of Obese Patients”, covered for 25 hours under the supervision of an instructor-methodologist with physical rehabilitation - two months, three times per day yen. In this case, one activity per day is theoretical and two are practical. In addition to these organizations, patients do regular walking, self-massage and exercise.

It is more theoretically possible to carry out training in the form of education, or in the form of methodical training.

Practical employment - employment with recreational gymnastics.

The basis of physical gymnastics is the right for large muscle groups, which is completed at a slow and medium pace with a large number of repetitions with oblique inclusions of a large number of respiratory movements with an emphasis on diaphragmatic breathing.

Physical gymnastics classes are divided into two periods: introductory and preparatory periods, and the main one.

During the introductory period the following concerns prevail:

improve reduced adaptation to physical fitness

-update in accordance with the age-old standards of manual skills and physical performance

achieve your daily routine actively and systematically engage in physical education

-promote non-specific support.

Schedule of the main period:

reduction and normalization of the metabolism of speech, stomach, fat metabolism;

-changes in excess body mass;

-adaptation of the body to growing physical demands;

normalization of the functions of the cardiovascular, circulatory, herbal and other systems of the body that suffer from obesity;

improvement and normalization of the patient's rocine sphere.

The visual complex of rights of representation in tables 3.1 and 3.2

In addition, it is difficult for patients to deal with the obligatory procedure on their own. measured walking.Walking is recommended to be carried out during the day, if daily exercises include physical exercises. It is recommended to go to France or in the evening to the park and the fringe areas. The intensity is dosed individually and increases by 300-400 meters every day. The skin walk should begin and end at a calm pace.

In case of obesity І - ІІ stage the average walking pace stagnates - from 90 to 120 steps per minute (from 4 to 5 .6 km/year); Swedish - type 120 to 140 krokiv/khv (type 5,6 up to 6.4 km/year); very fast – over 140 kroki/khv. It’s best for people with good physical fitness. I especially respect the track of the blow to dikhannya: the chase of the track is deep and rhythmic, you see butibreathless ( 2-3-4 kroku - inhale, na 3-4-5 krokiv – vidikh). The first heavy training in walking requires a short-term recovery 2-3 xv for Vikonannya dikhalnyh rights.

Table 3.1 - Complex of rights for patients at obesity stage 1

Incoming part (10 hvilin) 1. Walkingespecially on scrapers with high quilt rises in a squat position 2. Bigextreme from overlapping of the head with high stitch lifts crosswise with the right side 3. Right while walking1-2 - hands up, inhale 3-4 - hands down, inhale 4. I.P. -keep your feet straight, hands on your waist1-turn the toulub to the right 2-i.p. 3-turn the toecap to the left 4-ip. 5. I.P. - stand with your legs cut 1-2 - alternately with your hands, left forward 3-4 - the same, but right forward 6. I.P. then1 - bend forward, bending, hands on the waist - hands to the sides - hands uphill - i.p. 1 xv 2 xv 4 times 8-10 times 10 times 6-8 times Change heart rate Hands uphill Hands on the waist Walking pace is increased Dihanna more than Ruhu Vikonuvati with a great amplitude Divat forward Main part (30 hvilin)7. I.P. -o.s. Open your arms, inhale, bend your knees, press your hands to your stomach, see. 8. I.P. -keep your legs straight, hands on your waist 1 -bend your left hand, bend it to the right, put your left hand up 2 -ip. 3-4 in the other bek 9. I.p. -o.s. 1 - swing right and grab the back of the foot 2-3 - trim 4 - i.p. 5-8-f, with other legs 10. I.P. - lying on your back, arms in a rounded position 1-2 - straight arms straight out and no way down - inhale 3-4 - i.p., see 11. I.P. thenPochergova zginannya and rosginannya nig at the knee and kulshov suglobakh (bicycle) 12. I.p. - lying on your back, legs bent at the knees and hip angles 1 - bend, lifting the pelvis above the surface 2-3 - trim 4 - i.p. 13. I.P. - lying on your back1 - grouped 2-7 - rolls in grouped 8 - i.p. 14. Stand on the shoulder blades 15. I.P. - lying on your backAlternately lifting straight legs uphill (vertical scissors) 16. I.P. - lying on your back, arms in front of the chest 1-2-raise your arms up-inhale 3-4-ip. -vidih 17. I.P. then1 - sit down, arms to the sides 2-3 - trim 4 - i.p. 18. I.P. - lying on your back, hands behind your head 1 - bend your legs 2 - straighten 3-4 - lower completely into position. 19. I.P. -lying on your back1-right leg up, sticking out from the left side 2-i.p. The 3rd left leg is up, the supports are sticking on the right side of the 4th leg. 20. I.P. thenDeep diaphragmatic dihannia 21. I.P. - emphasis while standing on knees1-right leg back, left arm uphill 2-ip. 3-4 with different legs and arms 22. I.P. then1-2 -spread your legs, stretch back 3-4 -ip. 23. I.P. - supine support1 - with the toe turned to the right, right hand in the back - inhale 2 - ch, see 3-4 in the other side 24. I.P. -lying on your stomach, hands in a tulub1 - pressing the palms onto the base, bend 2-3 - trim 4 - i.p. 25. I.P. lying on your stomach, arms up1 - bend 2-3 - trim 4 - i.p. 26. I.P. -Emphasize sitting behind, legs apart -inhale1 - lean forward, touch your feet with your hands - see 2 - i.p. 4 times 10 times 6-8 times 4 times 30 sec 8-10 times 6-8 times 4 times 8-10 times 10 times 6 times 8 times 6- 8 times 4 times Decrease heart rate Increased tempo Step by step with the skin foot Amplitude is maximum, do not strain the breath Do not lean forward, keep your back straight Inhale through the nose, see through the mouth Amplitude is even, breath is more Bend over more Pidboridd I’m pressed up to my chest Legs are straight The pace is fast, my legs are high do not lift Inhale through the nose, see through the mouth Legs higher, back straight Legs do not raise high Tempo average Right hand on the chest, left hand on the stomach Stretch as far forward as possible, stretching the back Tempo is high Move around the turn Legs on the surface not in Stretch your hands and feet lift your body Vimir Heart rate Breath calmly, rhythmically Concluding part (5 movements) 27. Calm walking 28. I.P. - squat on the right, left sideways on the toe, hands on the waist1-2 - transfer the body weight into a squat on the left 3-4 - with a curled arm i.p. 29. Hand and foot strumming 30. Long walking1-2 times 6 times 10 times 1 time Breathing is relaxed The pace of the exercise is relaxed, the back is straight Adjustment of heart rate Relax the endings as much as possible

Table 3.2 - Complex of rights for patients with obesity 1st stage (with stuffed ball)

Parts of employment Preparation part (10 hvilins)1. Walking calmly at an accelerated and increased pace 2. I.P. -keep your feet straight, hands on your waist 1-turn the top to the right 2nd p. 3-4-f, in the other side 3. I.P. - then 1-nahil tuluba to the right 2-ip. 3-nahil tuluba left 4-ip. 4. I.P. - then 1-push forward 2-push back 3-squat, arms to the sides 4-i.p. 5. I.P. - o.s., hands in front of the chests 1-2 - jerks with the hands in front of the chests 3-4 - jerks with straight arms back 6. I.P. - stand with legs straight, hands on waist 1-2 - squat, hands forward 3-4 - i.p. 7. I.P. - stand with your legs straight, arms forward - at the side 1-max right to left hand 2-ip. 3 swings of the left to the right hand 4 reps 1-2 xv 6-8 times 6-8 times 8 times 10 times 10 times 8-10 times Change heart rate Turn out with progressive increases in amplitude Heal lower When on frail legs in knees don’t bend your hands, don’t lower your arms, move sharply, straighten your back, the pace is easy, don’t lower your arms, push your feet, don’t push your arms, don’t stretch yourself. Main part (30 - 45 exercises)8. I.P. -o.s., ball below 1st ball on the chest 2nd ball forward 3rd ball on the chest 4-i.p. 9. I.P. -keep your feet straight, ball below 1st ball uphill, look at the ball 2nd ball behind your head 3rd ball uphill 4-i.p. 10. I.P. -keep your legs straight, the ball in front of your chest 1 -push forward, touching the ball -visible 2-ip. -inhale 11. I.P. - o.s., ball below 1-3 - full squat, ball forward 4 - i.p. 5 - squat, ball forward 6-8 - stand up completely, v.p. 12. I.P. - High-legged stance, ball at the bottom. Rotate the toe with the hands at the side, lift the ball to shoulder height. 13. I.P. - o.s., ball in front of the chest, 1st ball uphill, rise onto the scrapers - inhale 2nd p. -vidikh 14. I.P. - o.s., ball at the bottom Kick from one side to the other with one-hour throwing (kick) of the ball slightly uphill 15. I.P. - o.s., the ball is on the bent right hand, the left is pointed at the side 1-2 - squat slightly, throw the ball uphill above your head 3-4 - throw the ball with both hands 5-8 - the same with the other hand 16. I.p. - lying on your back, ball between your feet, arms up 1-2 - siv, arms forward - visible 3-4 - ch. - breath 17. I.P. - lying on your back, the ball on the backs 1-4 - right-handed with the ball 5-8 - the same left-handed 18. I.p. - lying on your back, ball between your feet, arms in front of your body 1-2 - bend your legs forward 3-4 - v.p. 19. I.P. - emphasis while standing on your knees, hands on the ball 1 - stretching out at the top, ball uphill 2-3 - trim 4 - v.p. 20. I.P. - supine support, legs on the balls Bent and spread arms in supine support 21. I.P. -sid, arms to the sides 1-2 - sid at the group, see 3-4 - ch. , breath 22. I.P. - emphasis sitting behind, ball between feet 1 - bend legs 2 - v.p. 23. I.P. -sid, ball on stitches 1 - ball forward 2-3 - two springs on the back, ball 4 - ch. 24. I.P. - emphasis sitting behind, ball between feet 1 - side 2 - v.p. 3 - sitting side by side, arms to the sides 4 - v.p. 5 - sіd kut 6-7 - trim 8 - v.p. 25. I.P. - lying on your stomach, ball uphill 1-2 - bend over, ball uphill 3-4 - ch. 5 - bend 6-7 - trim 8 - v.p. 26. I.P. -Sit, arms to the sides, ball on the back, close to the body 1-2 - lie on the ball, bend, arms to the sides - inhale 3-4 - ch, see 27. I.P. - stand on the knees, ball to the back 1 - with a turn of the toe box to the right in an arc forward, the ball back to the stitch 2 - with a gate handle in p.p. 3-4 - the same, in the other side 28. I.P. - lying on your back, ball to the beast 1-2 - raising your legs, swinging the ball under the stitches 3-4 - with a roller handle i.p. 29. I.P. - wide stance of the legs, the ball is high 1-3 - three springy knees to the left 4 - v.p. 5-8 - the same, to the right 30. I.P. - o.s., ball below 1 - deep drop to the right, ball uphill 2 - pull back 3 - straighten 4 - right side i.p. 5-8 - the same ones with the other legs 31. I.P. then 1 - ball forward and with a right swing push the toe of the ball 2 - v.p. 3-4 - the same ones with the other legs 32. I.P. - o.s., the ball is squeezed between the legs of the Stribki with the ball 33. I.P. - o.s., hands in front of the chests 1-2 - turn the toulub into a side with one-hour separation of the arms - inhale 3-4 - ch, see 5-8 - the same, in the other side 10 times 10-12 times 4 times 8-10 times 8 times 6 times 6 times 10-12 times 8-10 times 10-16 times 4 times 10-12 times 8-10 times 8 times 8-10 times 4 times 8-10 times 8 times 8-10 once 6-8 times 6-8 times 8-10 times 3 times Change heart rate Breathe evenly, don’t lower your arms Average tempo Increased tempo Back straight, move forward Legs slightly bend and uncurl when turning Increased tempo Catching) m'ya cha two hands M'ball throw up 0.5 -1 meter in height Do not lift the ball under the support Shoulder blades under the support, press the heels to the support, arms straight Do not push the pelvis under the support Medium tempo, equal pace straight bast, body parts, brush under the shoulder Inhale through the nose, see through the mouth Bend and unbend your legs, do not touch the balls with the balls of your legs, touch your chest with your straight legs, straighten your legs, straighten your back, straighten your legs, keep your legs in line with the pillows, stay calm, Kolina with me don't destroy it, don't turn to Peremakh with straight legs Nakhili konovuvati yakomoga lower behind the standing leg straight Swing with a straight leg, the ball at shoulder height Tempo is flexible, do not overextend breathing Vimir HRConcluding part (5 khvilin)34. Walking at a comfortable pace with “pants” with arms and legs 35. I.P. -keep your legs straight 1-2 - spread your arms to the sides - inhale 3-4 - clasp your chest with your hands, bending your head and body forward - see 36. I.p. - same 1 - raise your right arm up 2 - raise your left arm up 3-4 - relax your arms and lower down 37. Calm walking 2 x 4 times 6 times 1 x Breathe calm Increased pace Increased pace Change heart rate

After physical stimulation, the patients died self-massage.

Massage for obesity is not indicated, and does not lead to a decrease in body weight. Self-massage is recommended, which consumes more energy. The whole body and any part can be massaged with your hands, a special device, or with water.

Self-massage, as well as massage, is contraindicated for elevated body temperature, fever, scalp and fungal illnesses. In some cases, massage cannot be performed because the skin is congested.

Self-massage, similar to massage, extends from the periphery to the center and directly to the adjacent lymphatic nodes. The stench grows in the elbows, knees, groin depressions and groin. The area of ​​lymph nodes cannot be massaged.

Before massage, it is necessary to adopt a position that will achieve maximum relaxation of the muscles in this area.

Massage the foot with sitting, squeezing hands and energetically stroking it several times from the tips of the fingers to the top of the head. Then directly rub your toes, the top of the foot, the sole and the sole of the foot. Rub in a colodic manner, using the fingers of both hands at the same time. Rub the sole with your fist.

The massage will end with gentle stroking of the feet. Then the finger is gently bent, straightened and drawn out.

Homilka can also be massaged while sitting, with your knee bent. With one hand, cover the front surface, with the other hand, the back surface, and at the same time stroke the entire head from the bottom up to the knee joint.

The knee area is massaged while seated, with bulging knees. Smooth the surface of the plot, and then rub it with a circular brush. Do not massage the subcollar fossa.

Massage the stegna with a slightly curved nose, stroke the outer surface of the kidney, and then the inner surface of the knee joint uphill, not reaching the groin area. Rub the stitches with circular brushes, more vigorously on the outer surface. Stitch and knead the quilt. For this purpose, with one or the other hand, they bury it in the folds and squeeze it.

Finish the massage by stroking the area from bottom to top, avoiding the groin area. Massaging the legs if the veins are enlarged is not recommended.

The area of ​​the buttocks is massaged while standing, placing the forehead on the toe and relaxing the right leg and the buttock. With your right hand, stroke and knead the right side, then massage the left side.

Massage the transverse area while standing, slightly leaning back, stroking and rubbing both hands at the same time. The massage arms are circular, cross-sectional and later.

Massage the hand of one hand with your fingers and that of the other. Smooth along the back and then the back surface from the tips of your fingers to the forearm. Stroking gives way to rubbing. Rub the palm of your hand with the “pad” of your thumb, smear the skin of your finger, the back side of the hand, and the wrist area. Finish the massage by stroking your hands, as if you were pulling tight gloves.

Massage the forearm by slightly bending the arm at the elbow and turning the shoulder down, and then up.

All arms fall late, columnarly from the metacarpal joint straight to the elbow.

Smooth the elbow and rub it with a bent hand with columbine hands.

Massage the shoulder with your hand down. Smooth the outer surface of the shoulder and rub it from the bottom up to the elbow, squeezing the elbow joint. When smoothed and rubbed, the inner surface of the shoulder does not reach the groin recess.

Massage the breasts while sitting. The hand on the masked half of the body is lowered. Using the fingers of the other hand, stroke half of the chest between the intercostal spaces from front to back. You should also pay attention to the other half. It is not possible to massage the chest cavity.

Lives can be massaged even more intensely or two years after life. It is best to massage while lying on your back with your knees bent. For this, the cervical wall will begin to relax. Stroking the spine, describing a row of kіl right-handed to the left straight ahead of the year's arrow. The strength of the vice, the spatula is insignificant, gradually increase, especially among those who are dangerous. Stroking is followed by kneading. Vibrate the smaller arms around the lower part of the abdomen, right-handed. Centimeter by centimeter, extend your fingers to the ribs, then across the stomach and further down.

Finish kneading the mixture in the lower abdomen. After kneading, apply circular strokes again. You can stroke it with two hands from the sides to the navel, as if it were lifting it.

Abdominal massage must be completed with active gymnastic exercises, which will enhance the abdominal pressure. During menstruation, when the ruminant fur is pregnant or ill, it is not possible to massage it.

LazneApply 1-2 times per week. The next step should be 3-4 years after the hedgehog, otherwise it won’t be any worse. The purpose of the bath procedure for obesity is to remove water from the body through the skin and dry passages, to strengthen metabolic processes and “burning” of fat deposits. When going out for a swim, it is necessary to adhere to the following rules: keep your mouth open for sweating; adhere to the principles of gradualism and gradualism.

Before you go to take a steam bath, you need to take a shower with warm water. It is not recommended to brush your face and wet your head before the steam room. Having entered the steam room, you first need to warm up: sit, or if possible, lie down so that your head and legs are on the same level or so that your legs are taller. After warming up for 5-10 minutes, quickly rise to your feet. After 10-20 minutes, take a broom (preferably two) and go to the steam room for another 5-10 minutes. You can steam with any kind of broom (birch, oak, with dormant, yalivtsyu). Vibrate the back, legs, breasts, belly, arms. It is necessary to gently roll the body with the broom. Often in lazna, vikoryst mixtures of herbs (shawl, eucalyptus, plantain, mother-y-machukha, motherwort) are used for aroma. Before you go out with your boyfriend, you can’t get in touch with your sweetheart, you can’t wet your head. Steam after sitting, or rather lying down. Invite your partner to take two brooms and work the brooms lightly from the front to the feet and back, then lightly tap, rub, splash with the broom, after which the brooms simply flutter over the body, wave and gently place across the back and press firmly (press with two hands) And they repeat this several times. Rubbing with a broom begins from the buttocks to the cervical spine and back, then rubs the legs from the heel tendon to the buttock fold, then scrubs the feet. Finish steaming with tanning ironing (light touching) with a broom all over your body.

Self-massage is carried out after the first visit to the steam room. The massage lasts for more than 10-15 minutes. Stroking, shaking and gently kneading.

Lazne (sauna) should take no more than 2 years (2-4 visits to the steam room, skin treatment for no more than 10 minutes after showering, swimming in the pool and aftercare). Guys can have a little more than 30 - 35 minutes. After the lazna, garnish with hot tea, birch sap, as well as crane and lingonberry.

3.2 Testing the effectiveness of a comprehensive rehabilitation program for obesity

The expanded program of the “School for Obese Patients” was developed over the course of two months. At the beginning of the pedagogical experiment, anthropometric indicators were assessed - height, body weight, waist circumference.

Doctors who are obese and sick, in which the cardiorespiratory system suffers, have experienced arterial pressure and vital capacity of the leg. Also, the investigators assessed the level of anxiety (for Taylor) and motivation to anxiety. The results from the beginning of the pedagogical experiment are presented in tables 3.3 – 3.6.

Table 3.3 - Anthropometric displays in the EG and CG for the beginning of a pedagogical experiment

No. p/pKG EGmas body IMT waist circumference body mass IMT waist circumference 1. 7325.56885724.67692. 6727.89806527.41773. 10235.291087027.34764. 6926.29756024.65745. 6626.78758530.85936. 8127.06817628.61877. 6527.41738632.77968. 8431.621018832.72959. 5724.03747526.577910. 6930.67788628.4189 X±SX73.3±4.2528.26±1.1183.3±4.0474.8±3.8328.4±0.9883.52±3.22

From the data presented in Table 3.3, it is clear that both in the CG and in the EG, the women who took part in the experiment had above-average body weight. In KG, the body mass index after Kettle at the beginning of the pedagogical experiment became 28.26±1.11 kg/m 2, EG - 28.4±0.98 kg/m 2. If the BMI is greater than 26.9, this indicates the presence of the beginning stage of obesity.

Table 3.4 - Indicators of the cardiorespiratory system in the EG and CG at the beginning of the pedagogical experiment

No. p/pKG EGAD s_stad diastGELAD s_stad diastZHEL1. 15010022001459027002. 1559525001409530003. 1409028001208031004. 1459527001308522005. 150100160105 10021007. 1409027001601 0025008. 1509523001559518009. 1501002600150100220010. 130802100140952300 X±SX146.5±2.6194.5±2.142340±128.81143.0±3.9494.0±2.332380±146.4

Table 3.4 shows that the majority of patients in both groups are wary of arterial pressure movements - both systolic and diastolic. This confirms the literature data that excessive fat storage is negatively associated with cardiac function -The vascular system, first of all, reacts to the development of arterial hypertension.

Obese patients in the early stages develop a tightness after minor physical exertion due to changes in diaphragm laxity. The intended changes lead to a decrease in vital capacity, a decrease in ventilation and the development of hypoxemia.

In patients who take part from the investigator. indicators of vital capacity in the middle are at the borders of the norm. This indicator also increases the level of fitness of the body. Therefore, we have used this indicator to evaluate the effectiveness of the approaches that are being carried out.

Table 3.5 - Indicators of psychoemotional state and level of motivation in the EG and CG for the beginning of the pedagogical experiment

No. p/pКГЭГAnxietyMotivationAnxietyMotivation1. 351143122. 351143103. 41935124. 421140125. 381137106. 41104387. 421240108. 451137129. 411241111114 X±SX39.5±1.1810.9±0.2939.9±0.9410.8±0.44

In the CG, at the beginning of the pedagogical experiment, 4 out of 10 patients had a high level of anxiety, and 6 had an even high level of anxiety. In EG, 2 patients had a high level of anxiety, and 8 patients had a very high level of anxiety. For the test “Renewal of locus of control”, the average score for the group in the CG was 10.9±0.29 points, in the EG - 10.8±0.44 points. The maximum score for this test is 36 points; however, in both groups the results are below average. Then we compared the indicators of the EG and CG and assessed the reliability of the data (Table 3.6).

Table 3.6 - Additional indicators for research in the EG and CG

Indicators of CG (X±Sx) EG (X±Sx) Reliability of values ​​(at t Critias = 2,1) Body weight, kg73.3±4.2574.8±3.83t obs. = 0.26 p>0.05 BMI, kg/m 228.26±1.1128.4±0.98t obs. = 0.1 p>0.05 Waist circumference, cm83.3±4.0483.52±3.22t obs. = 0.04 p>0.05 AT syst. 146.5±2.61143.0±3.94t obs. = 0.74 p>0.05 AT diast. 94.5±2.1494.0±2.33t obs. = 0.16 p>0.05 VC, ml2340±128.812380±146.4t obs. = 0.21 p>0.05 Anxiety, score 39.5±1.1839.9±0.94t obs. = 0.27 p>0.05 Motivation, score 10.9±0.2910.8±0.44t obs. = 0.19 p>0.05

From Table 3.4 it is clear that at the beginning of the pedagogical experiment, for all the follow-up indicators of reliable performance, no differences were found, which makes it possible to carry them out further.

After carrying out the rehabilitation visits, we carried out repeated testing of these same indicators (Tables 3.7 – 3.10). In both groups, practically all indicators that are monitored show positive dynamics of results (Figure 3.1).

Table 3.7 - Anthropometric indicators in the EG and CG as a practical example of a pedagogical experiment

No. p/pKG EGmas body IMT waist circumference body mass IMT waist circumference 1. 7124.86875021.64602. 6627.47805221.93683. 10034.601075621.88664. 6725.53765221.37665. 6526.37746824.68856. 7926.40806223.33787. 6426.99727127.05868. 8230.861007327.14869. 5623.61735820.557010. 6830.22776922.7980 X±SX71.8±4.1327.69±1.1082.6±3.9861.1±2.8923.2±0.7874.5±3.21

From the data shown in Table 3.7, it is clear that the body mass index of the CG has dropped, but the result of the group average exceeds the norm. EG’s indicators have significantly improved and are in line with the norm.

Table 3.8 - Indicators of the cardiorespiratory system in the EG and CG as a result of the pedagogical experiment

No. p/pKG EGAD s_stad diastGELAD s_stad diastZHEL1. 15010023001308031502. 15510026001208034503. 1409029001108035004. 1409027501208027005. 1501006102 9025007. 140802700130902 9008. 1508522001408022009. 150100260012580260010. 140802100125852700 X±SX147.0±2.1192.5±2.862380±128.67124.5±2.6683.5±1.582800±149.3

Table 3.8 shows that most patients in CG are wary of arterial pressure movements - both systolic and diastolic. In the EG, the result significantly improved and in most patients the pressure returned to normal.

The increase in both anthropometric indicators and the development of the cardiorespiratory system could not but affect the psychoemotional state (Table 3.9).

Table 3.9 - Indicators of psychoemotional state and level of motivation in the EG and CG as a result of the pedagogical experiment

No. p/pКГЭГAnxietyMotivationAnxietyMotivation1. 301530302. 271225323. 351018314. 351128305. 261517326. 351820257. 381825308. 451117329. 40131851 X±SX34.6±1.9313.5±0.9622.3±1.6230.1±0.73

In the CG, as a result of the pedagogical experiment, 2 out of 10 patients have a very high level of anxiety, and 8 have a high level of anxiety. In EG, 2 patients had a high level of anxiety, and 8 patients had a medium level of anxiety. For the test “Renewal of locus of control” in the CG the average score for the group was 13.5±0.96 points, in the EG – 30.1±0.73 Bali. The maximum score for this test is 36 points, so in the CG the result is below average, and in the EG it is above average.

Table 3.10 - Follow-up indicators at the end of follow-up in the EG and CG

Indicators CG (X±Sx) EG (X±Sx) Reliability of values ​​(at t Critias = 2,1) Body weight, kg71.8±4.1361.1±2.89t obs. = 2.12 RUR<0,05BMI, kg/m 227.69±1.1023.2±0.78t obs. = 3.31 RUR<0,05Waist circumference, cm82.6±3.9874.5±3.21t obs. = 1.58 p>0.05 AT syst. 147.0±2.11124.5±2.66t obs. = 6.63 RUR<0,05AT diast. 92.5±2.8683.5±1.58t obs. = 2.75 RUR<0,05Vital capacity, ml2380±128.812800±149.30t obs. = 2.13 RUR<0,05Anxiety, score 34.6±1.9322.3±1.62t obs. = RUR 4.88<0,05Motivation, score 13.5±0.9630.1±0.73t obs. = RUR 13.79<0,05

From the data presented in Table 3.10, it is clear that, as a pedagogical experiment, the results in the EG reliably exceed the results in the CG for all indicators except waist loss, but the results are unreliable.

Figure 3.1 - Increase in indicators during the process of pedagogical experiment in the CG and EG

Assessing the dynamics of the results during the pedagogical experiment, it can be said that EG showed an increase in all the following indicators - such as increased body mass and cardiorespiratory fitness ї system and psycho-emotional state. In the CG, changes in both body weight and signs of arterial pressure have practically changed. The increase in symptoms was particularly pronounced, which characterizes the patient’s level of motivation to get dressed. This is exactly what we need to do in advance of the initial program of the “School for the Obese Patient”.

Thus, as a result of the analysis of the conducted pedagogical experiment, it was obvious that the superiority of the initial programs we had developed in the view of the “School for Obese Patients” was obvious in terms of body weight indicators, the development of the cardiorespiratory system, and changes in three the importance of significantly increasing motivation to get excited. You can learn about the most effective way to combat obesity from the patient’s needs, the necessary knowledge, as well as comprehensive treatment, which includes nutritional therapy and optimal physical exercise. no vantagement.

Visnovok

The results of the investigation allow us to draw the following conclusions:

.Based on the analysis of scientific and methodological literature, it was revealed that the most effective methods of physical rehabilitation are those that are used in a comprehensive program for the treatment of obesity and physical exercises , massage, physiotherapy, dietotherapy, swimming, dosed walking, running, climbing, exercise on exercise equipment, sports and sports .

2.The initial program has been expanded in the form of a “School for Obese Patients” to include theoretical and practical lessons under the supervision of an instructor-methodologist with physical rehabilitation, independent exercise in dosed walking , self-massage and relaxation.

.The results of the experimental research confirmed the advantages of the developed program. The level of activity in the indicators of body weight, BMI, arterial pressure, vital capacity, anxiety and motivation is reliable at p≤0.05. On this basis, you can develop a concept that has a divided program in the form of “Schools for the Obese Patient” that is effective for the treatment of stage 1-2 obesity and overweight body weight.

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