Respiratory gymnastics for pulmonary emphysema. Video instruction with exercises for treatment

Emphysema of the lungs is most often a consequence of chronic obstructive bronchitis. Pulmonary connective tissue ceases to be elastic, it is replaced by fibrous. As the lungs lose the ability to effectively contract, they increase in size, and pneumosclerosis develops. Symptoms - shallow breathing, rigidity (hardness, inelasticity), lack of mobility chest when breathing. Performing special breathing exercises enhances local ventilation of the lungs, reduces shortness of breath, and develops respiratory muscles.

Features of the disease

Emphysema of the lungs is acute (occurs with acute attacks asthma and due to the removal of one lung) and chronic diffuse (occurs more often, arises as a result of diseases - bronchitis, asthma, pneumosclerosis). There is a spasm, swelling of the mucous membrane, which leads to the accumulation of phlegm in the bronchi and they lose their patency. Further, the disease is accompanied by inflammatory process, which leads to dystrophy of the walls of the bronchi and bronchioles, the lungs lose their tone, cease to completely contract.

Shortness of breath occurs, and often without physical exertion, the inhalation becomes longer. The patient coughs like bronchitis, but with a little viscous mucus. The person takes on a peculiar appearance - the chest is in the form of a barrel, little moves when breathing, cyanosis of the skin is observed. They treat emphysema symptomatically, drugs are basically the same as for bronchitis and bronchopneumonia, but breathing exercises also help.

Features of classes and regime

Respiratory gymnastics is expiratory - exercises are performed that lead to the occurrence of a full inhalation, strengthen the trunk and abdominal muscles involved in breathing, and resume the mobility of the chest.

Gymnastics can be done, even if bed or half-bed rest is assigned, in such cases, you can lie or sit on a chair, leaning against the back. But, if strength allows, it is better to stand, this way the diaphragm functions better.

With emphysema, inhale slowly, through pursed lips, exhale through the nose, so breathing deepens and the diaphragm works better. A quick inhalation is not allowed so that the alveoli do not stretch too much. Each exercise should be performed three times, and should be practiced three times a day. You need to breathe fresh air, so ventilate the room.

It is also useful to walk, swim, be sure to have healthy eating, you should abandon bad habitsespecially from smoking. With emphysema, you may need to change the climate to Crimean, Kislovodsk, but not in the hot season.

Exercises

The task of breathing exercises is to teach the patient to breathe correctly, that is, to use slow, deep and rhythmic breathing. Compensation for the impaired activity of the respiratory apparatus is provided by an arbitrary component of respiration regulation (change in frequency, depth of respiration, structure of the respiratory cycle).

Breathing exercises are used in patients with emphysema and pneumosclerosis to develop full breathing, in which during inhalation the chest expands in all three directions with simultaneous contraction of the diaphragm, and when exhaling, it collapses, accompanied by relaxation of the diaphragm.

results remedial gymnastics with pulmonary heart disease

At the end of the course of treatment with the use of therapeutic exercises, there is usually a decrease in the MOU in patients in whom it exceeded the proper values \u200b\u200bbefore treatment; a decrease in the number of breaths and a deepening of breathing; the maximum ventilation of the lungs increases, the ventilation reserve and the average air flow rate during forced breathing increase. Control over the effect on the patient's body complex treatment using remedial gymnastics can be used to study the function external respiration and oxyhemographic observations before and after dosed exercise.

Walking stairs for pulmonary heart disease

Ascent and descent one step can be used as a dosed load. This view work is habitual for a person, easily dosed, makes rather high demands on the subject (moving his own body weight and maintaining a posture); in addition, at this load, the training effect in repeated studies, as well as the statistical component, is the least pronounced. The amount of physical activity should be dosed in accordance with the patient's functional capabilities. Patients with latent and overt respiratory insufficiency can be assigned 20 ascents within 2 minutes, for patients with pulmonary heart failure, the load is limited to 10-15 ascents.

As a second functional test you can use the test with breath-holding on expiration, proposed by Genchi in 1925. This test, to a certain extent, characterizes the state of the cardiovascular and respiratory systems, the higher parts of the central, peripheral nervous system and reflects the adaptive capacity of a person to conditions of hypoxemia and hypercapnia.

Under resting conditions, the respiratory pause time depends on the oxygen supply in the body. The less this reserve, the faster hypoxemia develops. The test should be regarded as positive with an increase in the time of holding the breath on the submaximal expiration at the end of the course of treatment by 5-7 seconds or more.

Respiratory gymnastics is a set of exercises aimed at training the respiratory muscles. It includes both exclusively breathing techniques and exercises that strengthen the muscles of the abdomen, back, intercostal and other muscles involved in breathing. Exercise improves muscle coordination, increases a person's control over their breathing, and promotes better health.

In contact with

Classmates

Why do you need gymnastics for pulmonary emphysema?

Gymnastics with emphysema is aimed at alleviating the patient's condition by compensating for the reduced functionality of the lungs with rhythmic muscle contractions.

Depending on the stage of emphysema, the lung tissue changes its structure. Lung cells combine to form cavities. These cavities occupy the useful volume of the lung, while the level of gas exchange in them is low. As a result, a person develops shortness of breath, over time he begins to experience respiratory failure.

A distinctive feature is the presence of residual air during exhalation. Residual air itself is a factor that significantly impairs gas exchange.

Respiratory gymnastics is designed to compensate for the imbalances that arise, to teach a person to breathe correctly in conditions of reduced lung functionality.

The goals of breathing exercises:

• Training in concentrated inhalation and exhalation;
• long expiration training;
• development of compensation mechanisms that increase gas exchange in the lungs;
• development of compensating diaphragmatic breathing;
• strengthening the muscles involved in breathing;
• teaching the skill of breathing control during household physical efforts;
• improvement of the patient's psycho-emotional state.

The principles of remedial gymnastics

When doing breathing exercises, adhere to the following rules:

1. Exercises are done for 15 minutes 4 times a day - more often, but not less often.
2. As you exercise, focus on the rhythm of your breathing.
3. Equalize the duration of inhalation and exhalation by lengthening the latter.
4. It is forbidden to strain.
5. You can't hold your breath.
6. Try to keep to a medium pace, take your time.
7. Gymnastics includes static and dynamic exercises.
8. You need to start gymnastics with static exercises.
9. Alternate between static and dynamic exercises.

Respiratory gymnastics should alternate with restorative exercises and rest pauses.

A set of exercises

Static exercises:

1. Pronunciation of consonants on exhalation (2-3 min.).

Performed while sitting. Exhalation is automatically lengthened, the chest vibrates, stimulating coughing and sputum removal. Through this exercise, patients learn to control the duration of inhalation and exhalation.

1. Breathing with deep exhalation (6 repetitions).

Performed while sitting. Exhale as deeply as possible into the count, trying to count to more... It is allowed to help yourself with your hands, pressing on the chest during exhalation (or do the exercise with an assistant).

1. Pronunciation of vowel sounds on exhalation (2-3 min.).

Performed while standing. Sounds are pronounced loudly. Try to lengthen the expiratory phase.

1. Diaphragmatic breathing (6 repetitions).

At the expense of 1-2-3, a deep breath is taken with the “stomach”: the diaphragm bends down - the stomach protrudes. At the expense of 4-5-6, an exhalation is made: the diaphragm goes up, the stomach is drawn in.

Dynamic exercises (each - 6 repetitions):

1. Leaning forward from a prone position.

The upper body rises and leans forward (exhale). At the moment of tilting, the arms are brought back.

1. Pressing the legs to the chest.

Starting position - lying on your back. While inhaling, raise your arms and stretch them up (perpendicular to the body) as much as possible, the chest is expanded, the abdomen protrudes. As you exhale, lower your arms, pull your legs to the body, knees to your chest, grab your legs with your hands. Repeat.

1. Turns while sitting on a chair.

Spread your knees to the sides. Raise your arms to chest level, open your elbows, and your hands under the chin. On inhalation, turn to the left. On exhalation, they return to their original position. Further on inhalation - turn to the right. Exhale - starting position.

1. Stretching while standing.

Raise your hands up and stretch strongly, trying to bring your hands back a little. Look at outstretched arms. At the moment of stretching, an inhalation is made. On exhalation: the arms drop, one of the legs bends at the knee, is grasped with both hands and rises as high as possible to the chest.

1. Walking (2-3 min.)

It is important to monitor the depth of breathing and rhythm. The exhalation should be 2 times larger steps than the inhalation. In the future, with good control over breathing, the exercise can be supplemented by raising (inhaling) and lowering (exhaling) the arms.

One of the options for walking, if your physical condition allows, is to climb stairs. On inhalation, 2 steps are overcome, on exhalation - 4.

Respiratory gymnastics with emphysema Strelnikova

Recall that the lungs with emphysema require controlled active prolonged exhalation. Thus, Strelnikova's technique for emphysema is not effective.

The technique developed by A.N. Strelnikova was created by her for the treatment of asthmatics. Its high clinical efficacy has been confirmed in complex treatment

Respiratory gymnastics is a set of exercises aimed at training the respiratory muscles. It includes both exclusively breathing techniques and exercises that strengthen the muscles of the abdomen, back, intercostal and other muscles involved in breathing. Exercise improves muscle coordination, increases a person's control over their breathing, and promotes better health.

In contact with

Classmates

Why do you need gymnastics for pulmonary emphysema?

Gymnastics with emphysema is aimed at alleviating the patient's condition by compensating for the reduced functionality of the lungs with rhythmic muscle contractions.

Depending on the stage of emphysema, the lung tissue changes its structure. Lung cells combine to form cavities. These cavities occupy the useful volume of the lung, while the level of gas exchange in them is low. As a result, a person develops shortness of breath, over time he begins to experience respiratory failure.

A distinctive feature is the presence of residual air during exhalation. Residual air itself is a factor that significantly impairs gas exchange.

Respiratory gymnastics is designed to compensate for the imbalances that arise, to teach a person to breathe correctly in conditions of reduced lung functionality.

The goals of breathing exercises:

• Training in concentrated inhalation and exhalation;
• long expiration training;
• development of compensation mechanisms that increase gas exchange in the lungs;
• development of compensating diaphragmatic breathing;
• strengthening the muscles involved in breathing;
• teaching the skill of breathing control during household physical efforts;
• improvement of the patient's psycho-emotional state.

The principles of remedial gymnastics

When doing breathing exercises, adhere to the following rules:

1. Exercises are done for 15 minutes 4 times a day - more often, but not less often.
2. As you exercise, focus on the rhythm of your breathing.
3. Equalize the duration of inhalation and exhalation by lengthening the latter.
4. It is forbidden to strain.
5. You can't hold your breath.
6. Try to keep to a medium pace, take your time.
7. Gymnastics includes static and dynamic exercises.
8. You need to start gymnastics with static exercises.
9. Alternate between static and dynamic exercises.

Respiratory gymnastics should alternate with restorative exercises and rest pauses.

A set of exercises

Static exercises:

1. Pronunciation of consonants on exhalation (2-3 min.).

Performed while sitting. Exhalation is automatically lengthened, the chest vibrates, stimulating coughing and sputum removal. Through this exercise, patients learn to control the duration of inhalation and exhalation.

1. Breathing with deep exhalation (6 repetitions).

Performed while sitting. Exhale as deeply as possible into the count, trying to count to a larger number. It is allowed to help yourself with your hands, pressing on the chest during exhalation (or do the exercise with an assistant).

1. Pronunciation of vowel sounds on exhalation (2-3 min.).

Performed while standing. Sounds are pronounced loudly. Try to lengthen the expiratory phase.

1. Diaphragmatic breathing (6 repetitions).

At the expense of 1-2-3, a deep breath is taken with the “stomach”: the diaphragm bends down - the stomach protrudes. At the expense of 4-5-6, an exhalation is made: the diaphragm goes up, the stomach is drawn in.

Dynamic exercises (each - 6 repetitions):

1. Leaning forward from a prone position.

The upper body rises and leans forward (exhale). At the moment of tilting, the arms are brought back.

1. Pressing the legs to the chest.

Starting position - lying on your back. While inhaling, raise your arms and stretch them up (perpendicular to the body) as much as possible, the chest is expanded, the abdomen protrudes. As you exhale, lower your arms, pull your legs to the body, knees to your chest, grab your legs with your hands. Repeat.

1. Turns while sitting on a chair.

Spread your knees to the sides. Raise your arms to chest level, open your elbows, and your hands under the chin. On inhalation, turn to the left. On exhalation, they return to their original position. Further on inhalation - turn to the right. Exhale - starting position.

1. Stretching while standing.

Raise your hands up and stretch strongly, trying to bring your hands back a little. Look at outstretched arms. At the moment of stretching, an inhalation is made. On exhalation: the arms drop, one of the legs bends at the knee, is grasped with both hands and rises as high as possible to the chest.

1. Walking (2-3 min.)

It is important to monitor the depth of breathing and rhythm. The exhalation should be 2 times larger steps than the inhalation. In the future, with good control over breathing, the exercise can be supplemented by raising (inhaling) and lowering (exhaling) the arms.

One of the options for walking, if your physical condition allows, is to climb stairs. On inhalation, 2 steps are overcome, on exhalation - 4.

Respiratory gymnastics with emphysema Strelnikova

Recall that the lungs with emphysema require controlled active prolonged exhalation. Thus, Strelnikova's technique for emphysema is not effective.

The technique developed by A.N. Strelnikova was created by her for the treatment of asthmatics. Its high clinical efficacy has been confirmed in complex treatment

When chronic diseases lungs, accompanied by emphysema, self-massage and therapeutic exercises are useful. They improve respiratory function. These methods should be used with the permission of a doctor during a period when there is no exacerbation of the respiratory disease. If shortness of breath increases, there are swelling in the legs, general weakness - Therapeutic exercises and self-massage should be stopped and be sure to consult a doctor.

Self-massage

It prepares the body for performing a complex of medical gymnastics: metabolic processes in the respiratory muscles weakened by the disease, their elasticity improves, the mobility of the ribs increases. Reflex self-massage helps to increase blood circulation in lung tissue, which has a beneficial effect on the respiratory function. Massaged first bottom part back, then the back of the head, neck and chest, and if the patient has weakened abdominal muscles, then the abdomen.
Self-massage of the back. Stand up, feet shoulder-width apart, bend back without tension, rub the back of the hands vigorously from the spine to the sides. The hands, then left, then right, participate in the rubbing alternately and at the same time move from bottom to top from the waist to the shoulder blades and then from top to bottom (Figure 1).
Self-massage of the back of the head. With the ends of the fingers of both hands, rub the back of the head in a circular manner. In this case, the fingers make rotational movements towards the little finger (Figure 2).
Self-massage of the neck. Move the chair to the table, sit sideways to it. Bend your arm at a right angle, put it on the table. With the palm of the other hand, stroke from the back of the head towards the shoulder joint (Figure 3). Then rub this area with a sliding motion of the fingers. Then kneading is done. The fingers of the massaging hand are placed on the neck, closer to the back of the head. Pressing them, they produce rotational movements, at the same time moving the hand from the back of the head to the shoulder joint.
The other side of the neck is also massaged.
Only men do breast self-massage. Sit on a chair, bend your left hand freely, put it on your left thigh. Place the palm of your right hand tightly on the left side of your chest. Vigorous stroking is performed (Figure 4). Do the same on the right side of the chest. Then squeeze the pectoralis major muscle without touching the nipple. The basis thumb and palms, without pressing hard on the muscle, slide from the sternum to the armpit (Figure 5).
After this, kneading is done. The muscle is tightly grasped with the hand and, moving the hand forward, gently knead between the thumb and four other fingers, while slightly shifting it to the sides (Figure 6).
Rubbing the sternum. With the base of your palms, rest on the pectoral muscles. The hands are slightly bent and with the fingertips produce a rectilinear (top to bottom and bottom to top) rubbing of the sternum (Figure 7). Then do a circular rubbing, while the fingers perform rotational movements towards the little finger (Figure 8).
After that, start rubbing the intercostal muscles. It follows
perform especially carefully. Attach the tips of the bent fingers of the right hand to the intercostal spaces of the left side of the chest. Pressing slightly, make a straight rubbing from the sternum to the armpit (Figure 9).
The same technique is performed in a spiral manner: the hand vibrates when sliding along the intercostal spaces.
Circular rubbing is also done with the tips of the fingers, making rotational movements with them towards the little finger.
When self-massage of the intercostal muscles, it is necessary to ensure that the fingers do not leave the intercostal spaces, and rubbing is carried out along all intercostal arches.
To rub the costal arch, lie on a bed or a couch, put a small pillow under your head, and bend your legs at the knees. With the fingers of both hands, grab the lower edge of the ribs, squeeze it as if in forceps near the sternum. Perform a straight rubbing from the sternum to the sides (Figure 10).
Women are allowed to rub the sternum, as well as the intercostal spaces of the lower third of the chest and costal arch.
Each self-massage technique is performed 3-5 times.
Self-massage of the breast ends with vigorous stroking (see Figure 4).
If the abdominal muscles are weakened, it is advisable to self-massage the abdomen. Initially, self-massage is carried out without effort for
5-6 minutes, then 7-10 minutes.
We remind you: the skin must be clean. Talc is used for better glide. Self-massage can be done energetically on relaxed muscles, more easily and superficially on tense ones.

Physiotherapy

Complex physical exercise is designed to facilitate the development of the most economical and complete skill - breathing, in which both the diaphragm and the chest are involved. Under the influence of special physical training, it is possible to increase the vital capacity of the lungs, strengthen the respiratory muscles, increase the mobility of the diaphragm and ribs, and improve blood circulation. Breathing exercises contribute to the expansion of the bronchi and bronchioles, better sputum production. Systematic exercises, undoubtedly, have a general strengthening effect, increase the body's resistance to colds. And this, in turn, prevents exacerbation chronic bronchitis, pneumoscleroea, bronchial asthma and other respiratory diseases.
Therapeutic exercises should be done in a well-ventilated area, and in the summer, in good weather, and outdoors. While performing the exercises, one must carefully monitor the breathing, especially the exhalation. It should be longer than inhalation and be accompanied by a tightening of the abdomen. The pronunciation of the sounds "y", "f", "s" helps to lengthen the exhalation. The exhalation is performed more fully when the chest is squeezed from the sides by the hands.
During the first two weeks, exercises are done while lying and sitting. It is recommended to repeat them 2-4 times at a slow pace, without significant muscle tension, without holding your breath. After every 2-3 exercises, you should rest for one to two minutes. As you master the movements and get used to physical activity the number of repetitions of each of them increases to 5-7 and exercises in a standing position are included.
Physical activity should not cause fatigue, the appearance or increase of shortness of breath, chest discomfort and palpitations.
The body is hardened by rubbing the body with water at room temperature (25-30 degrees) after gymnastics, followed by vigorous rubbing with a dry towel.

A set of exercises

Lying on your back
1. Bend your legs, one palm on the chest, the other on the stomach (photo 1). Inhale slowly through the nose, protruding the abdomen, and then, continuing to inhale, expand the chest. Exhale through the mouth, closing the lips in a "tube". Breathe out more slowly than inhale - first lowering the chest, and then pulling in the stomach.
You can intensify the exhalation if you press your hands on the costal edge.
2. Bend your legs, arms along the body. Inhale, sticking out your stomach, and then lifting your chest high. Exhale, pulling your knee to your chest with your hands. Then do the same, pulling up the other knee.
3. Bend your legs, arms to the sides. "Dump" the knees to the right, then to the left, without lifting the foot from the support. Breathing is arbitrary.
Lying on the right side
4. Right hand under the head, left on the thigh, bend legs. Raise your left hand, stretch - inhale. Lower your hand aa the costal edge and press on it, exhaling (photo 2).
5. Right hand under the head, left forward, bend legs. Straighten your left leg - inhale; pull it up with your left hand to your chest, drawing in your stomach - exhale.
Do the same exercises from a lying position on the left side.
Sitting on a chair
6. Hands to the shoulders, put the legs bent at the knees shoulder-width apart. Spread your elbows to the sides - inhale. Exhaling air through the lips with a "tube", pronounce the sound "oo-oo-oo", bringing the elbows in front, bending over and lowering his head (photo 3).
7. Bent at the knees, put your feet shoulder-width apart, hands on your knees. Circular movements body alternately to the right and left. Inhale - trunk backward, exhale - trunk forward.
8. Bent at the knees, put your feet shoulder-width apart, hands on your knees. Stand up, hands on the belt - inhale; sit down, hands on your knees, relaxing - exhale.
9. Put your hands down, put your legs bent at the knees shoulder-width apart. Lean to the left, trying to touch the floor with your hand, pulling your right hand to the armpit - inhale. Return to starting position - exhale. The same in the other direction.
10. Put your knees bent at shoulder width apart, hands on your knees. Hands slide up the thighs, the sides of the abdomen to the chest, elbows to the sides - inhale. Then the hands slide in the opposite direction. On exhalation, the sound "w-w-w" is pronounced (photo 4).
Standing
11. Grasp the back of the chair, legs together. To rise on your toes, bending, - inhale. Sink on your heels, raising your toes and half bending forward - exhale.
12. Feet shoulder-width apart, arms down. Raise your hands through the sides up - inhale; lower your arms, bending over or half bending forward, I relax, - exhale.
13. Feet shoulder-width apart, arms down. Swing your arms to the sides. Free breathing (photo 5).
14. Cover the lower edge of the chest with a double folded towel. Hold the towel with your right hand for the left end and with your left hand for the right (crosswise). Without releasing the ends of the towel, stretch your arms forward - inhale. Dissolve the arms bent at the elbows to the sides, pulling on a towel and squeezing the chest with it - exhale (photo 6).
15. Walk slowly for 2-3 minutes. Inhale in 2-3 steps, exhale in 3-5 steps. As you exhale, draw in your stomach, relaxing your arms and shoulders.