Features the use of physical rehabilitation in obstetrics and gynecology.
 Features of Physical Education babies. Physical rehabilitation of sick children early age.

Therapeutic exercises are widely used in obstetrics and gynecology. Its use during pregnancy and early postnatal period, the treatment of gynecological diseases.
Tasks physical therapy:
1) impact on central nervous mechanisms rehulyatsiy: balancing the processes of excitation and inhibition, which may be disrupted under certain physiological conditions, in chronic diseases of genital organs;
2) the formation of correct posture, strengthen the abdominal muscles, perineum, increasing mobile hip joints, Uropygial-zduhlynnoho connection that is important for the benefit of a nice flow delivery and postnatal period;
3) the elimination of stagnant phenomena in the veins of the lower limbs and pelvis: because of the special exercise improves local blood and lymph, promoting resorption of infiltrates, the Union, residual effects of inflammatory processes;
4) correction of defects of the provisions of the uterus (retroverziy, retrofleksiy).
Matching tools, forms and methods of physical therapy, women need to take into account the peculiarities of the body:
- More labile as compared with men nervous system;
- Oxidation processes in women weaker than men;
- More-developed adipose tissue (28% of the total mass of men 18%);
- Vital lung capacity in women is 70% male;
- Lower in comparison with men, the number of red blood cells;
- Lower impact ob'm heart, so adaptation to physical exertion is longer;
- Body of women relatively long;
- Muscles are weaker and thinner (32% of the total mass of men - 40%).
Therefore, women frequently observed defects potsavy and curvature of the spine. Weak abdominal muscles cause frequent enteroptoziv and constipation.
In a physical therapy you need to:
1) load was less than in men, increased pressure should take place gradually;
2) clearly adhere to the principle of "scattering" load;
3) to give preference to dynamic exercise with large amplitudes, not static;
4) must include exercises for back muscles, abdominal and pelvic floor.
Impressions to the appointment of physical therapy:
- Chronic inflammatory diseases of internal genital organs;
- Weak abdominal press;
- Muscle weakness and the liaison office of the uterus and pelvic base;
- Functional enuresis;
- Incorrect position and displacement of the uterus;
- Flaws and shortcomings of the uterus and ovaries;
- Hypoplasia of the sexual sphere;
- Infantilism.
Contraindications to physical therapy appointments during pregnancy.
Acute infectious diseases; long subfebrylna temperature is unclear etiology; purulent processes in all organs and tissues, epilepsy, active phase of rheumatism and acute and progressive chronic cardiovascular insufficiency, destructive forms of tuberculosis, blood diseases; pronounced ptosis the internal organs of the presence of pain at physical efforts; shvatkopodibni abdominal pain, acute appendicitis, acute and subacute thrombophlebitis, aneurysm of the abdominal aorta, severe toxicity of pregnancy, ectopic pregnancy, bleeding from the genitals of different origin, strongly expressed bahatovoddya; used dead birth with negative rezusfaktorom my mother.
In the obstetric and gynecologic practice using active exercises for the muscles typhoid press, pelvic floor, back and lower extremities.

Exercises for muscles of typhoid newspapers carry the original position lying on your back, side, on your stomach, standing, sitting. Perform trunk motions in different directions, the movements of the feet in the hip joint. Along with exercises that strengthen abdominal press, perform exercises on abdominal muscle relaxation from the initial position lying on your back with legs bent, lying on the side of the bent leg, knee-kytychne, knee-elbow position.
To strengthen the pelvic muscles of the bottom of the initial position lying on your back, abdomen,knee-kytychne, knee, elbow perform exercises with active pelvic diaphragm muscle contraction and movements of the hip joint performed straight and curved legs.


The development of fruit growing need oxygen, proteins, fats, carbohydrates, vitamins and minerals. These substances give the body a mother. In the mother's blood enter the fetus exchange end products that are derived excretory organs of women. Thus, the body of a pregnant woman performs additional work that requires effort and rebuilding major systems and organs.
Growing demand for cardiovascular pregnant as a result of the growth of vascular networks of the uterus, increasing the blood supply, the emergence of a new range of placental blood flow.
During pregnancy increases the activity of pulmonary system by increasing the body needs oxygen. Increasing bronchial patency, breathing becomes more frequent and deeper, increasing gas exchange.
Pregnancy increases the load on the muscles of the abdominal wall, spine, feet, long muscles.
During pregnancy there are changes in tone of the autonomic nervous system (at the beginning of pregnancy is increasing tone pneumogastric): change of taste, nausea, increased allocation slyuny affected by vertigo.
Exercise good nice affect on the body, expand its physiological reserves, improve the activities of all organs and systems - neyrodinamiki, breathing, blood circulation, which in turn improves blood supply to the fetus.
Consolidation muscle typhoid press and the ability to relax the stomach muscles will allow effective use of force reduction during the expulsion of the fetus.
To prevent breaks crotch to strengthen the muscles of pelvic floor, increase their flexibility. Trained muscles perineum is preventive factor omission pelvic bottom in puerperium and complications arising from a weak pelvic diaphragm (functional incontinence, etc.).
Systematic training exercises increase diuresis in pregnant women. Exercises for muscles of typhoid press and perineum vnutricherevnyy pressure change that contributes to better perystaltytsi intestine. This is to prevent constipation and Aton.
All pregnant for exercise routine into three periods: period I - up to 16 weeks, II - 17-32 week, the third - from 33 weeks to delivery.
And the period.
Characterized by a complex restructuring of the body of a pregnant, a violation of the autonomic nervous system, pregnancy, strengthening exchange and increased demand for oxygen.
Objectives:
1) develop skills in correct breathing, focusing on diaphragmatic;

2) teach an arbitrary tension and relaxation of muscles;
3) to ensure optimal conditions for the development of the fetus and its relationship with the parent body;
4) start a gradual adaptation of the cardiovascular system of the mother to physical activity.
By combining physical therapy exercises for use of distal and proximal divisions of the hands and feet,

static and dynamic breathing exercises, relaxation exercises, training for typhoid and thoracic breathing, abdominal wall muscles and the perineum. Includes exercises with a sharp increase vnutricherevnoho pressure.
Duration 15-20 min sessions.
II period.
Placenta begins to function. Growing relationship with the parent body of the fetus. Increased minute volume of blood increases heart rate. From 25-26 weeks to decrease in lung vital capacity, limited movements of the diaphragm. Due to changes in the center of gravity of the long back muscles standing experience significant static tension.

Objectives:
1) to ensure good blood circulation and oxygenation of the fetus;
2) strengthen the abdominal press, increase flexibility pelvic base;
3) promote the preservation and development of flexibility and plasticity of the spine and pelvic joints;
4) increase the adaptation of the cardiovascular system to physical exertion.
Using general health, breathing and exercises for back muscles, pelvic diaphragm, abdominal wall, flexibility exercises for the spine, hip joint motion.

From 26 to 32 weeks (the peak of hard work the cardiovascular system) it is advisable to reduce the physical burden by reducing the number of repetitions of exercises and the introduction of static breathing exercises and relaxation of muscles.

Keep in mind that the original position, lying on his back during this period may be progressive hypotension syndrome due to compression of the lower uterus enlarged hollow vein and nerve spletin. Consequently, the reduced inflow of venous blood to the right heart, decreases systolic and minute blood volume with subsequent fall in blood pressure. Changing the starting position for lying on the side or head end raised couches 450 removes this condition.

Duration 25-30 min sessions.

The third period.

Continuing growth and development of the fetus. Strained abdomen, abdominal wall is stretched. Spleen and liver pressed to the diaphragm, the last possible rises up, which limits its excursion. This complicates the work of respiratory and cardiovascular system. Physical activity is restricted pregnant.
With 36 weeks overall women slightly better. Getting the bottom of the uterus, facilitated the activities of respiratory and cardiovascular system.

Objectives:
1) stimulation of respiration, circulation, of the intestine;
2) struggle with stagnant phenomena in the vessels of the pelvis and lower extremities;
3) increase the elasticity of pelvic muscles of the base;
4) increase in motion Uropygial-zduhlynnoho connection, hip joints and spine;

5) Evidence to the automatism of exercise while maintaining rytmichnoh deep breath.
You must complete the training psychoemotional pregnant to birth.
In the last 3-4 weeks did not perform exercises for the muscles to typhoid press from the original prone position.
Physical load decrease due to breathing exercises, rest breaks, writing exercises for muscle relaxation. More exercises are appointed in muscles of legs.

 Exercises should not be raising vnutricherevnoho pressure. Includes exercises in the deep rhythmic breathing, with an emphasis on the chest type. In the last 2 weeks before childbirth advisable to enter into those complex exercises that child will do in the first stage of labor.

Duration: 20-25 min.

Exercise during childbirth.
Pain during contractions cause muscle tension, breath holding, which complicates the peripheral circulation, reduces arterial blood oxygen saturation. It neblahopryyemno affects the fetus, reduced muscle tone, there is a physical weakness, the weakness of patrimonial activity. Exercise during childbirth used to stimulate the activity of patrimonial, preventing early wear and tear women. Optimal functioning of the central nervous system and peripheral bleeding and external respiration is a means of preventing asphyxia.
Contraindications: severe form of toxicosis of pregnant women, serious disease that accompany pregnancy, the risk of bleeding, premature flaking placenta, malposition, premature departure of the next productive waters, AT 140/90 mm Hg and above.
Pre-gymnastics began at the beginning of patrimonial activity while revealing the cervix to 1-2 cm

Physical rehabilitation childbirth.
Postpartum period begins after the expulsion of faeces and lasts 6-8 weeks. On the first day after birth comes back the development of organs and systems changes that occurred during pregnancy and childbirth.
Gymnastics appointed on day 2 after birth.
Exercise increase peripheral circulation and respiratory metabolism, accelerate involution descent system, improve metabolism, increase appetite, sleep childbirth.

Static and dynamic breathing exercises to restore full respiratory skills involving the diaphragm and abdominal wall, which reduces stasis in the abdominal cavity, accelerates venous circulation. Exercises for muscles of typhoid and press the bottom to restore pelvic muscles and stretch the fascia. This speeds up the restoration of normal normal topographic position of the abdomen and pelvis. Exercise blahopryyemno affect the activity of intestine, bladder. Due to the reduction of muscle reflex apparatus breasts when performing exercise in breastfeeding mothers will increase.

Contraindications:
1) high body temperature;
2) weakness due to difficult births and a large loss of blood;
3) eclampsia in generations;
4) breaks crotch IIIst.
Seams to crotch is not against returning to the appointment exercise, but within 5 days do not include exercises with the breeding feet.

Therapeutic exercise in operating rodorozrishenni (abdominal hysterotomy).
Surgical intervention is changing coordinated activity of important physiological systems. Painful stimuli cause reflex functional changes: reducing diaphragmatic breath, flatulence, atony of the bladder, possible thrombosis and embolism.
As a result, operating wounds breathing becomes shallow, reduced vital lung capacity. Attenuation of lung function is reduced prysmoktuyuchoyi of the thorax, thus decreasing the speed of blood flow in the lower extremities, pelvic vessels, the abdominal cavity. Reducing muscle tone typhoid press. Stagnation of peripheral venous blood and shallow breathing violate vnutritkanynnyy exchange that neblahopryyemno affect the processes of operating power wounds, the general condition of women.
When performing therapeutic gymnastics increases peripheral circulation, increased gas exchange. Due to these factors poperedzhuyetsya development of postoperative complications (hypostatic pneumonia, phlebitis, thrombus embolism) operating wound heal faster.
Medical gymnastics designate 2 hours after the operation.
Use:
A) static breath - with a gradual deepening of expiration, with pokashlyuvannyam at the end of expiration;
B) in localized breathing exercises: verhnohrudne - hand practitioner resists breathing movements, pressing on the breast or subclavian areas; nyzhnohrudne nasal - hands grip the sides of the chest at the level III-IV edges; zadnohrudne - hand turn supplied under the back right and left and Press the cauda chest in the middle or bottom, diaphragmatic breathing - hand practitioner presses edge on the edge of the arc closer to the middle and partly on the epigastric area.
B) zahalnoukriplyuyuchi exercises: flexion and extension of fingers, the radiation-zap'yastnyh, elbow joints, rotation inward and outward legs, bending and extension in Tibio-stopnyh, knee joints.
Breathing Exercises performed 2-4 times, 4-6 times zahalnoukriplyuyuchi. On the 2 nd day after the operation performed dynamic breathing exercises, exercises for the pelvic muscles of the abdominal wall and bottom of the initial position lying on his back and side.
A 3-4 day loading increase by the number of exercise repetitions and increase the amplitude of movements. From the 5 th day of exercises performed on the original sitting position, the 6-th - standing.
Therapeutic exercise in chronic inflammation diseases of the digestive system.
 In inflammatory diseases of the digestive system reacts to the entire body of women: raised glands function, metabolism, activity of internal organs.
A close anatomical location, only blood and lymph, inervatsiyu with internal genital inflammation often takes the bladder, rectum, pelvic tissue. Pain causes a woman to lead sedentary lifestyles. The result is a weak abdominal press that promotes anatomical strong person, infringement of blood circulation, stagnant phenomena in the pelvic organs and abdominal cavity.
In the combined treatment of such patients using the therapy.
Contraindications to exercise purpose:
- Bleeding and risk;
- Osumkovani purulent processes to vskryttya purulent foci;
- Aggravation of the inflammatory process, accompanied by fever, ESR.
Tasks LFK:
1) the overall strengthening of the body;
2) withstand hypodynamia;
3) elimination of the inflammatory process.
Methods of medical gymnastics developed by V. Mount Neva, SA Yachu new, LN Startsev (1974).
In order to enhance peripheral circulation include exercises for the distal sections of hands and feet. It promotes neuro-mental tone, improves functional status of the body.
To improve the tone of typhoid press exercises using direct and skew the abdominal muscles: the body tilts, the original seating position without laying hands, moves his feet from the source pronation on the side, on the back.
To instantly eliminate inflammation appoint exercises to speed bleeding in the pelvic region. This would reduce the stagnant phenomena in the organs of the pelvis, so soon will resorption of fluid and towing products of disintegration of fire ignition is pryvintyvnoyu extent of the Union. Appointed to exercise:
A) the flexibility of the spine: flexion, bending, turning, body momentum, which carried a maximum amplitude of the different source terms (standing, standing, kneeling, sitting, lying on his back and abdomen);

B) muscles involved in movements of hip joints: the original position lying on his back - pull down, cultivation and construction of bent leg, lift legs straight, circular movements of legs, imitation cycling, with starting position sitting on the floor - Summary Foot and breeding resistance, Nahal body, allocation and matching feet, rotational movements of feet.

Greatly improves the circulation in small tazi walking: from the lifting of socks, high knee lift, with alternate crossing, with the next attack, in napivprysyadi, full sit down.

Duration of training medical gymnastics in subacute period of 14-20 min between you zdorovlennya - 32-45 min.

For the typical healthy child physical activity from the first years of life.

A child learns movements world and ourselves in it, improving the musculoskeletal system, mental development, regulates metabolic processes. Physical activity is one of the necessary conditions for life.
In children, especially young children, using massage and gymnastics.
Physiological action movements are determined by the basic principles of gymnastics.
1. Gymnastics should be conducted on an empty stomach heart, immediately after the night's sleep.
2. It must be conducted outdoors or in well ventilated areas.
3. Gymnastics should give the child pleasure, unacceptable deal with a child who cries:
a) exercises should be available to answer the age and functional abilities of the child;
b) the method should encourage children to exercise.

4. In gymnastics, unlike other types of physical activity a child, all motions must be accurately and correctly: in breast age - adult movements, the elder - special equipment - gymnastics poles, hoops, etc..
5. In the first half to stimulate the activity of the child used birth - unconditional reflexes, mainly skin, and then - vestibular as leading by these analyzers operate with birth and unconditional reflexes in this period most vividly manifested in connection with the insufficient development of the cortex brain and its lack of braking effect. IM Syechenov wrote that in the first half of life there is no movement, which could not be cause reflex.
In the second half of life, with the development of cerebral cortex, the activity of the child depends on her desire, and "all acts of random movement caused by the activities of brain and by their nature conditional reflex" (Pavlov).
Thus, active exercises in this period stimulated not only sensitive - unconditioned stimulus, and a number of conventional signals:
- Pediatric (toy, ring movement educator or parent, etc.);
- Motor (potyahuvannya hands, foot, etc.);
- Hearing - word, language instruction (sit, Arise, and take the ring, toy, set on the stomach, etc.)
The reaction of the child in response to such conventional signals occur faster if stimulus is complex, ie, the higher the number of analyzers to operate at the same time (visual, motor, auditory).
It must be remembered that the word in half 2 is the weakest component of the complex stimuli and the child may not respond to it, due to the fact that the conditional relationship between the name and most of the action is still very weak. So in this age of word should be supported by visual, and very strong motor signal.
Contraindications to the use of gymnastics at an early age:
1. All acute diseases accompanied by fever.
2. Severe forms hipotrofiyi (atrophy).
3. Purulent and other acute inflammatory lesions of the skin, subcutaneous tissue, lymph nodes, muscles, bones (eczema, lymphadenitis, abscess, osteomyelitis).
4. disease, accompanied lomkistyu and bone pain, with rickets between rozharu and acute hiperstenziyi the course of events.
5. Arthritis.
6. In congenital heart vadah proceeding with cyanosis and pronounced disturbances compensation.
7. Various forms hemohrafichnoho diathesis, especially in haemophilia.
8. Acute nephritis.
9. At large navel eye, hip, and femoral kalytkovyh kylah the risk of incarceration.
Time course and their repeatability.
Exercising with children and babies are held daily.
Time of lessons will be selected no faster than 40 minutes. after meals.
Duration - 5-8 min.
Basic conditions that cause the selection and appointment of physical culture activities.
The first half of life.
The first three months of life: a response predominantly by neuro-muscular apparatus is cutting hypertension flexor hands and feet, which arise on the background and gradually growing equilibration muscles antagonists. This requires the following:
- Frequent communication and gentle conversation with the adult child, which stimulates the complex recovery, coupled with the development of eccentric rozhynalnyh movements of hands and feet, as opposed to concentric prevalent in this age;
- Daily warm baths to promote muscle relaxation;
- Pohladzhuyuchyy light massage that promotes relaxation of muscles;
- Stimulation of active movements of the Child related to the work of extensor, which is used for congenital reflexes:
-food (sosannya, swallowing, slyunovydilennya);
-protective-defensive (turn or lift your head on the provisions of the abdomen in children first weeks of life);
reflex position (posture) and placing parts of the body (in the first six months of life in a horizontal position "on weight" naturally rejects the child's head in a corrective way;
skin-reflexes (each reflex "phenomenon lasagna" is stored to the 2.5 - 3 months., spinal reflex, which is kept for life). These reflexes are irritant to skin touch, and the reaction seen in the reduction of the corresponding muscles: the "phenomenon lasagna - extensor legs, in the spinal reflex - extensor of the spine.
In the first months of life should be used in the exercises only reflexes are associated with the extension to prevent amplification flexor.
With respect to passive movements of the arms and legs, the first three months of life are not desirable, because of physiological hipertonusom limb muscles.
After three months of life, new physiological conditions for other gymnastic exercises. Based on progress so far fully counterbalance flexor and extensor, you can gradually introduce passive exercises for the hands, starting with the simplest.
With three months before the child starts trying to change the position (from the back of abdomen), which should be supported. Example: in order to start the second half to strengthen the muscles of shoulder girdle and back, to have the 4-month and often longer vykladuvaty baby on your stomach and stimulate elements lasagna. By the way, crawling is essential, thus reinforced the whole musculature, to which the child will resist to the seat, standing, walking. It is important to remember that muscles and bones ukriplyuyutsya exercises. Upright mobility provided cervical spine and lumbar lordosis. In the thoracic (chest kyphosis) in the upright position was moving and in position "navkarachky" backbone "lordozuyetsya, his mobility is restored.
It is important that the child is only 7 months to sit, and went up to a year, but more importantly, how to sit, and how to go for the wrong seat deforms the chest and wrong obezzarazhuye walking legs.
Thus, studies with children of the first half of life has several features:
1. An important place is the massage, covering the whole body.
2. In active movements are used mainly reflexes: protective, skin, vestibular.
3. passive exercises for the limbs are introduced after the disappearance hipertonusu-flexor muscles: first hand, then foot.
Exercises.
The first set from 1.5 to 3 months:
1. Massage hands - prohladzhuvannya.
2. Foot Massage - prohladzhuvannya.

3. Teaching on the stomach - an exercise reflex.
4. Back Massage - prohladzhuvannya.

5. Crawling - exercise reflex.
6. Belly Massage - prohladzhuvannya.
7. Foot massage - rubbing.
8. Exercises for feet - (flexion and extension reflex).

9. Extension of the spine on the right and left side - an exercise reflex.

The second complex - 3 to 4 months.
1. Massage hands - prohladzhuvannya.
2. Crossing hands on chest - passive exercise.
3. Foot Massage - prohladzhuvannya, rubbing, kneading.

4. Turn to the back of the right abdomen - an active-passive exercise.
5. Back Massage - prohladzhuvannya, rubbing, kneading.
6. Regulations "plovtsya - exercise reflex.

7. Belly Massage - prohladzhuvannya, rubbing.
8. Foot massage - rubbing, pat.
9. Exercises for feet (reflex).
10. Flexion and extension of hands "box" - a passive exercise.
11. Vibromasazh chest.
12. Turn on your stomach with the back left - right, passive-active.

The third set - 4 to 6 months.

1. Crossing hands on chest - passively.
2. Massage feet.
3. Sliding Steps - imitation cycling movements - passive exercise.
4. Turn to the back of the right abdomen.
5. Back Massage - prohladzhuvannya, rubbing, kneading, pat.
6. "Parinnya" on the stomach - an exercise reflex.

7. Massage abdomen.
8. Lifting the head: the body with the support of hands assigned to the parties - the active exercise.

9. Massage feet.
10. Exercises for the foot.
11. "Boxing".
12. Flexion and extension legs alternately and simultaneously - a passive exercise.
13. "Parinnya" on the back - exercise reflex.
14. Vibrating massage the chest.
15. Turn to the back of the left abdomen.