Dosing of exercise in the exercise. Forms of study of therapeutic physical culture

11.03.2021

In this video you will learn the basic rules of therapeutic physical education.

Text video abstract:

Therapeutic physical education (LFC) is not a replacement direct treatment if you have an aggravation, but an addition to a complex treatment.

Rehabilitation (recovery). For example, we present time for a cut in a segment of 2 cm, and rehabilitation and recovery - it will be a meter 2. Treatment is directed only to remove the symptoms, exacerbation, pain. But if the symptoms left, it does not mean that the spine is completely healthy. To do this, you need to deal with rehabilitation, restoration, it is necessary for this much more time and regular training is necessary.

The use of special exercises to restore the muscular skeleton of the spine. These are not exercises that are offered in fitness in order to pump some part of the body, improve relief, increase endurance. These are special medicinal exercises in order to restore and carry out the right rehabilitation.

The main rules of therapeutic physical education

Duration of one lesson from 15 to 40 minutes. It depends on the department. If this is the cervical spine, then for starters enough 10-15 minutes and no more. This department is smaller, the muscles are smaller and fatigue above. For breast and lumbar departments, the time is more, because there are more muscles, and they have more endurance, and it is necessary to work properly all the elements. Therefore, it is possible to increase the time to 30-40 minutes, but no more to prevent fatigue. It is important even to d duration, and regularity! Once a day for 20-30 minutes to occupation.
The complex of therapeutic exercises is divided into 3 parts. Workout, main part and hitch. The warm-up is needed in order to warm up all the joints, ligaments and muscles. You can not start special work while you did not warm up your body. As well as in order to cheer up the nervous system, distract from domestic affairs and tuned to work. The main part is special exercises aimed at restoring a certain department. After that, the hitch for gradual relaxation, exit the training process, we return the pulse and breathing to the original state, smoothly moving towards rest.
Regularity of occupations - Daily, 1-2 times a day.
"Are the breaks in training?". Breaks can be done at the weekend, but you can also do every day. For those who get tired daily to engage, annoying and do not want at all, then after five days, you can take a break for the weekend as a gift, but it only does it, which has long been doing (from 1 month or more). If you are just starting to engage, then breaks are better not to do, so that the muscles and ligaments can get used to the daily burden. And when the body is accustomed to, it will already react differently, and then you can make breaks.
Alternation of strengthening and relaxation exercises (breathing exercises and stretching, in unloading positions). Why is it important? Because if you do exercises only to strengthen, you can simply overload your muscles. And if you do only to relaxation exercises, it will not give the desired effect at all.
Gradual inclusion in the work of all target muscular groups (especially concerns the lumbar spine). The lumbar department is not only back muscles, it is a lot of muscles that surround our body. And it is very important correctly and competently gradually include them in the work. Starting from one muscular group, adding the following groups, and complicating exercises. This approach eliminates the overtraining, no harm in improving the effectiveness of classes.
Exacerbation of the cervical department - We use only isometric (static) exercises.

Denial of responsibility

Information in the articles is intended solely for general familiarization and should not be used for self-diagnosis of health problems or for therapeutic purposes. This article is not a substitute for medical advice from a doctor (neurologist, therapist). Please refer to the doctor first to know the reason for your health problem.

The main forms of medical physical culture are: therapeutic gymnastics, independent task classes, morning hygienic gymnastics, medical walking, ternshur, sports exercises and sports games, physical culture-mass exercises.

Physiotherapy It solves mainly special tasks in the treatment of one or another disease. Classes can be carried out by individual, small group and group methods. Individual classes are conducted with severely ill, most often in hospital conditions. Multi-group classes - in the Cabinets of therapeutic physical education and in wards with the same type of patients (6-8 people). Group classes (15-20 people) - with patients close to the diagnosis, functional adaptability to loads and age. Duration of individual sessions - from 7 to 20 min., Group - from 15 to 60 minutes.

Classes of medical gymnastics are carried out according to a generally accepted scheme and consist of three sections: preparatory, main and final. Claiming should include a combination of general and local exposure. In case of damage and diseases, when local exposure is required, a certain time is given in the main part of the lesson for special exercises aimed at restoring mobility, strength and coordination of the movements of the damaged part of the body or improving local blood circulation, etc.

It should be noted that when conducting classes with patients receiving soothing or narcotic drugs are not required in the preparatory part of the lesson to give exercises to increase the tone. It is also not necessary to always include in the final part of the lesson so-called soothing exercises.

The physiological burden curve depends on the nature and phase of the development of the disease. For example, in a patient myocardial infarction, the jurisdiction of the pulse at the end of occupations should not exceed the initial data by more than 15-20%, and in obesity (without cardiovascular pathology) is permissible to increase the pulse 100% or more. The peak of a physiological curve in classes with healthy people who suffered neurith facial nerve should have to prepare part of the lesson.

A widely used class of classes that complement the studies of therapeutic gymnastics are independent classes on the task. They are some well-continued exercises (there may be a local action), sometimes household and applied. The fulfillment of individual tasks requires a conscious relationship of patients and control from medical personnel.

Morning hygienic gymnastics - A type of occupation in which secrets and exercises that have improving influence on the patient are predominantly used. The load should not be large, the number of exercises in the class - 6-8, the duration of the occupation is not more than 15-20 minutes.

Medical walking It can be used to restore a normal gait after injuries and diseases of the musculoskeletal system and nervous or other systems (see Terrenkur) or the formation of compensatory mechanisms in violation of walking or in order to adapt the body to loads. The dosage is determined by the length of the step, the speed of movement and the length of the distance.

Terrene - Treatment of metered walking on a special (with a gradual lift) track. Used in the treatment of diseases of cardiovascular, respiratory and nervous systems, metabolic disorders, etc., mainly in the resorts. Changing the load is achieved by changing the length of the passable path, walking speed, the angle of lifting (steepness of the tracks, the number of stops for recreation and its duration).

Sports Exercises and Sports Games It is used to enhance the impact on individual systems and organs, restoring overall performance, etc. The choice of the nature of the exercises and the methods of their conduct makes it possible to provide a solution to various tasks.

Physical Instrument - Mass Exercises Used in sanatorium practice. It is irregularly held events: physical culture holidays and evenings, riding a sleigh, rolling games and entertainment.

In the ancient societies, it was noted that exercise affects human health. And correctly selected training complexes help in the treatment and prevention of many diseases.

In China, the respiratory gymnastics is still developed and successfully applies, in India - Yoga. The techniques for the use of medical and hypocratic physical education are known.

In subsequent years, the use of LFC has developed and improved, and in modern society has become the necessary part of almost any treatment.

Rules and forms

Therapeutic physical education is used in the form of training in order to obtain therapeutic effects. It should be carried out under the overall rules:

regularity of classes;
reasonable duration;
alternations of classes and rest;
a gradual increase in physical exertion in the treatment process;
combination of physical exercise and proper breathing;
compliance with hygiene;
an individual approach to each patient.

Forms of physical education depends on the purpose of therapeutic effects - a tousing, trophic, in the formation of compensation or normalization of the functions of the body.

Hygienic gymnastics or morning charging. Performed for a tonic effect. It can be used for all patients, with the exception of those in a coma. Long-term exercises (no more than 15 minutes) in a heated room or outdoors, you can under music.
Physiotherapy. A set of exercises formed taking into account the specific disease. May contain various classes - in bed, on the street, in water.
Pleasure walking, metered for each patient. It is used for patients with diseases of the respiratory organs, hearts and vessels in order to gradually adapt to the loads. The dosage is made by the speed of walking, overcome distance, local relief (plains, lifting, descents).
Swimming, sports games, tourism for limited distances, etc.

Physiotherapy

This is the main form of physical training, used in almost all diseases. Exercises are developed individually for small and large groups.

According to the individual plan, classes are performed by severely ill. If the patient's condition is improved, it can be entered into a group.

Small groups (up to 5 people) are selected, based on the sameness of the disease.

Large groups (up to 15 people) are made up of patients at one stage of cure, for similar purposes. Classes are appointed in the office for LFK or on an open site.

Important! The group method brings the greatest effect due to the simultaneous impact on a large number of patients.

For classes, a plan must be drawn up, according to which the training is divided into introductory exercises, the main, final.

The introductory part is warm-up and prepares patients to the main complex of sociability. There is a mood of the body into physical activity, optimization of the interaction between the nervous system and muscles. It is about 10-15% of the total extension of the classes.

The main part is aimed directly on the solution of therapeutic tasks. Exercises affect the problematic organs and parts of the body and in general to strengthen the body. The duration of the main section is 75-80%.

The final part consists of exercises intended for a smooth reduction in exercise. It takes the remaining part of classes.

The ratio of the time of the exercise to the total duration of the workout must be:

patients in the hospital - 50% (at the beginning of classes - 25%);
patients in the sanatorium - 80%.

In addition to classes in the group, patients can be complemented by the medical course with individual classes to increase the effectiveness of the exercise.

Efficiency mark

During training, you need to organize patient monitoring. Response reactions are measured and studied during exercise. At the same time, on the basis of indicators such as pulse, arterial pressure and respiratory frequency, a graph is built - a physiological curve.

It displays the influence of the sports load on the condition of the body. The graph has the form of peaks and reductions where the peaks correspond to the most frequent cuts of the heart, and the decline is to slow down the pulse during respiratory gymnastics, rest, relaxing the muscles of the body.

Important! Evaluation of the effectiveness of classes is needed even in order to regulate, as necessary, physical exertion. The optimal dosage of exercises is necessary for the correct impact on the body. Overdose may worsen the patient's condition, the lack of load weakens the effect produced.

Methods for tracking the effect of the FFC are depending on the type of disease, the form of therapeutic physical education. They reduce the assessment of the patient's condition - changes in the pulse rate, heart and vessels, the operation of the respiratory system, the appearance of fatigue or shortness of breath.

Functional and diagnostic methods include trial and analyzes, based on the type of disease, for example:

in traumatology - measurement of the circumference of legs and arms, dynamometry, myotonometry;
diseases of the vascular system and heart - pulsometry, electrocardiography;
pathology of respiratory organs - pneumotheometry, spirography.

All results obtained are compared relative to the time of measurements (at the beginning of classes, their development and end).

Types of control of efficiency

Phase control. It is carried out before starting training and at the end. It consists of a deep examination of the patient using the methods of functional diagnostics to assess the activities of the heart, the vessels, the nervous system, the respiratory organs, the musculoskeletal system. Diagnostic methods depend on the nature of the disease.
Current control. Conducting observations during treatment once a week using the simplest diagnostic methods - control of the pulse, blood pressure, ECG, etc.
Express control. Measurement of the body's reaction to a specific physical activity. It can be carried out using advanced research methods or by the abbreviated program. External manifestations are necessarily evaluated - fatigue, well-being, pulse is maintained.

Contraindications for medical physical education

Disease in acute form.
Increased temperature, heat.
The presence of strong pain.
The possibility of bleeding.
Conservative therapy of malignant neoplasms.
Incixation of the body.
Mental pathology, oligophrenia in severe form.
The existence of foreign objects in dangerous proximity to vessels or nerve trunks.

The value of physical education in complex treatment

Therapeutic physical education, as an important part of therapy, is applied without restriction of age, with any diseases and traumatic injuries. It is based on the use of regulatory mechanisms to activate adaptive, protective, compensatory functions of the body in order to participate in overcoming the disease. The dominant role of movement contributes to the overall restoration and support of health.

The tonic effect of physical training is the most universal. With any disease, they are used to activate the excitation in the nervous system, normalization and improve the functioning of the vascular system, heart, respiratory organs, accelerating the metabolism and immunobiological reactions. As a result of the choice of exercises, certain groups of muscles are involved, the work of the internal organs is improved.

The trophic effect of the FFC is to stimulate regeneration processes. If the actual regeneration of the organ is impossible, training accelerates the formation of scar tissue. Faster compensatory hypertrophy occurs.

In connection with the improvement of blood supply under the influence of physical education, the resorption of non-viable elements of tissues is activated. With different pathologies, oxidative processes slow down. Muscle activity, stimulating all forms of metabolism, accelerates and oxidative reactions.

The normalizing effect of therapeutic physical education is expressed in the braking of the circumstances of the convention and reflex interactions, which have a pathological nature, and return to the normal life of the body.

The compensatory effect is observed in pathologies of a specific function. Special exercises contribute to the use of healthy systems to compensate for the activities of amazed. LFC stimulates these processes, speeding up and improving them.

Output

Competently designed and systematically performing exercises of therapeutic physical education will help the speedy rehabilitation in the event of serious diseases. Will be excellent prevention to strengthen the body, improving immunity, endurance.

Individual approach To the patient in accordance with its motor capabilities and condition.
Consciousness - the meaningful attitude of the patient to the proposed physical exercises, the direct active participation of the patient itself in the process of performing physical exercises and control the correctness of their implementation, which is achieved by a skillful explanation of the methodologist.
Visuality - Display of physical exercises in combination with an explanation.
Systematism - Regularity of classes with a gradual and consistent increase in load: from simple exercises to more complex, from the known to unknown (at each occupation, include one complex new exercise or 2 simple).
Principle of fixing skills - Do physical exercises constantly not to lose the results achieved.
Cyclic Alternation of exercises with rest.

Forms of therapeutic physical culture

Hygienic (morning) gymnastics Prepares the body to daylight after sleep, which reduces the activity of nervous processes and muscle tension. During sleep, the pulse and breathing becomes less often, the activity of nervous processes is reduced, the intestinal peristalsis slows down, the processes of digestion slow down, the metabolism is reduced. Hygienic gymnastics is intended to activate all these processes. Classes are held before breakfast in the absence of contraindications (the doctor defines) in a heated room in a light, not constraintful clothing movements for 15-20 minutes, preferably under the accompaniment of music.
The gym complex consists of 10-15 exercises from various source provisions for all muscle groups, including coordination exercises, flexibility, relaxation that corrective posture, self-massage. The load must comply with the state of health, age, sex, physical development. For men, it is recommended to include power exercises: with dumbbells, extenders, with moderate static stress; For women - exercises for the development of flexibility, strengthening the muscles of the abdominal press, the pelvic bottom; Elderly should avoid power exercises, widely use breathing exercises and muscle relaxation, self-massage of the head and neck to improve the blood supply of brain vessels, children need to include exercises for posture correction, on the development of flexibility, coordination of movements and equilibrium.
Physiotherapy - the main form, including independent practices of patients (fractional load), in which predominantly gymnastic exercises with therapeutic and prophylactic goal are used.
Walk (Pedestrian, skiing, bicycles, boats).
Middle Tourism - Hiking for 1-3 days reduce the voltage of the nervous system, improve the vegetative functions.
Wellness running (coward), during which all skeletal muscles are involved and the nervous system is experiencing significant tension.

Methods of organization of classes

Individual (with severe patients).
Group (according to the principle of the uniform nature of the disease or injury and the level of the functional state of the body).
Independent.

Each lesson includes three sections: introductory, primary and final. Introductory section (warm-up) consists of several overall exercises that consistently cover all muscles takes 10-20% of the total time. Main section It takes 60-80% of the total time, consists of special exercises in relation to this disease, which necessarily alternate with overall exercises. Final section It takes 10-20% of the total time. The load is gradually reduced in order to normalize the increased activities of cardiovascular and respiratory systems (slow walking in combination with in-depth breathing).

Modes of movements Sets the attending physician strictly individually.

For hospitals

Mode I.

Strict bedding Prescribed heavy patients - light massage, passive exercises for limbs with incomplete and complete amplitude of movements 2-3 times a day for 5-10 minutes and every hour deep static breathing.
Advanced bedding prescribed with a general satisfactory condition of the patient. Active meals and active toilet, independent turns on the side, the transition to the position is sitting in bed 2-6 times a day for 5-40 minutes, elementary exercises for limb with breathing exercises.

Mode II.

Semi-US - stay in the ward outside the bed sitting 50% of the time, movement on the floor, slow walking (at a speed of 60 steps per minute) at a distance of 100-150 m. Therapeutic gymnastics is performed according to individual readings: in the initial position lying, sitting, standing, can be with Items weighing up to 0.5 kg. Gradually include the exercises for the muscles of the body. The duration of classes is 20-25 minutes.

Mode III

Free - Walking within the hospital, to a distance of 1 km at a speed with rest every 200 m at a speed of 60-80 steps in 1 minute. Classes are carried out in the LFC Hall for 25-30 minutes. Use objects weighing up to 1 kg, games.

Adult pulse frequency should not exceed 108 in adults and in children - 120 shots in 1 minute.

For polyclinic, sanatorium and in resorts

Gentle (for exhausted, overwater and recovering) - similar to free regime. Also allowed dosed walking through the equal terrain at a distance of 1.5-3 km in a slow and middle pace, resting every 10-20 minutes, swimming with the use of supporting funds for 10-20 minutes.
Shangly trainee - The physical activity is complicated, exercises are performed for 30-45 minutes, with objects (weighing up to 3 kg), on projectiles. Dosed walking on the equal terrain on average and fast pace for an hour at a distance of up to 4 km, terrenkur with a rise of 5-10 degrees for a distance of 2-3 km for 1 hour with rest every 10-15 minutes, swimming for 10 -30 minutes. Use boating with rowing, volleyball, badminton, tennis.
Training The regime is prescribed to persons without pronounced deviations in a state of health and physical development, that is, practically healthy people. The physical activity is large, prescribe dosage walking and running. Sports are carried out according to general rules. It is permissible to increase the pulse up to 120-150 strokes in 1 minute (in the elderly up to 120-130 shots in 1 minute), an increase in systolic blood pressure up to 150 mm Hg. Art., Reduced the minimum - up to 55 mm Hg. Art.

Therapeutic physical culture is shown in almost all diseases.

Common contraindications The use of therapeutic physical education are:

common severe condition of the patient;
the risk of bleeding;
unbearable pain when performing physical exercises;
feverish and acute inflammatory diseases;
malignant tumors.

Prescribed the physical physician, the physician specialist chooses a technique, determines the nature of classes, dosage and controls the execution of physical exercises. The procedures are carried out by the regulatory instructors, guided by the recommendations of the doctor relative to the nature of the disease.

The magnitude of the physical activity Must correspond to the state of the patient and its physical capabilities. The total intensity of physical training depends on the individual tolerance of the patient to the physical exertion.

In the selection and use of the secrets and special exercises aimed at actions, the clinical manifestations of the disease or injury and the methodical principle are from a healthy organ to the patient. The optimal combination of the total and private (local) is used in the FFC with any pathology, but it is especially important to take into account in orthopedics, traumatology and neurology. The overall load should be distributed evenly and consistently for all muscles to prevent fatigue and improved blood circulation. Adjust the load, guided by the physiological curve - the pulse rate during the lesson, which is registered graphically. Dosing depends on the number and location of the muscles involved in the exercises, the form of movement, amplitude, forces, rhythm, the rate of movements, the duration of occupation and the complexity of exercises. For each patient determine:

density of classes (the time of actual exercise, expressed as a percentage of the total time of classes) in stationary patients should not be higher than 50% (in the first days of classes is 20-25%), in other cases a density is admissible to 80-90%;
(ANDP) Source Positions (Lying, Sitting, Standing). Ip lying on the back, on the stomach, it provides a stable equilibrium, the maximum relaxation of skeletal muscles, makes it easier to perform exercises, prescribed patients in bed mode, with spinal diseases. SP sitting excludes significant static stress of the muscles of the lower extremities, creates freedom of movements of the limbs, neck and torso, prescribe a weak patient and for diseases of the lower extremities. IP standing is characterized by a high location of the center of gravity and a small support area. Equilibrium is maintained with the direct participation of various parts of the nervous system due to the reduction of many muscles of the body. The most stable is the position standing with a wide layout of the legs;
number of muscle groupsparticipating in the exercise selection of exercise For them, the ratio of respiratory exercises to the constructive and special, aimed at restoring disturbed functions (1: 1, 1: 2, 1: 3, 1: 4, 1: 5). Starting with exercises for small muscle groups. When performing complex exercises, the load increases. The more breathing exercises, the smaller the load. For the development of muscle force (paresis and hypotrophy) use isometric exercises with high voltage and dynamic exercises that are slow, but with a large resistance;
number of repetitions of each exercise, pace (slow, medium, fast) and amplitude of movements in the joints;
duration of classes. The total duration of individual classes - 5-20 minutes, group - 15-40 minutes;
independent classes - Performing special exercises throughout the day;
using game exercises, music - To create positive emotions, items and shells in order to change the load. So, exercises with a gymnastic stick reduce the tension of the muscles of the sick hand and increase the load for the muscles of a healthy hand.

Normally, during classes, it is possible to enhance the load intensity, there are no unpleasant sensations or pains for the sternum, the freight of the usual rate of respiration, disorders of coordination, pallness, and the rhythm of the heart. Immediately after classes, "muscle joy" is felt, well-being should be good. The recovery time of the heart rate and hell to starting values \u200b\u200bin healthy people should not exceed 3 minutes. In the break between loads there may be light fatigue, but no more than 2 hours, there are no sleep and appetite disorders, local fatigue is saved for no more than 12 hours.

TO forms of the study of therapeutic physical culture relate:

morning hygienic gymnastics;

classes of medical gymnastics (group and individual);

independent lessons;

medical walking;

terrenkur;

sports exercises and sports games;

mass forms of physical culture work (physical education, competitions).

Morning hygienic gymnastics It is carried out directly after sleep in hospitals (hospitals, clinics, hospitals), sanatoriums and independently at home.

Morning hygienic gymnastics has a general consensus effect, increases metabolism, improves the activity of cardiovascular and respiratory systems, contributes to a faster transition from sleep to wakefulness. The duration of classes depends on the contingent of patients and conditions (in the ward, on the playground) and averages 10-20 minutes. In the conditions of sanatorium-resort treatment, morning gymnastics should be carried out on an open area, with musical accompaniment, if possible, combining with a walk and subsequent water procedure.

Classes of medical gymnastics - main form of classes LFK. Therapeutic gymnastics is carried out in hospital, clinic, sanatoriums (in hospital and sanatoriums usually daily, and in the clinic every other day). The duration of individual classes is 10 - 15 minutes, group - 30 - 45 minutes. Classes of medical gymnastics decide the tasks of the general strengthening of the body (general connivorous influence, prevention of complications, especially under bed mode) and special medical challenges that depend on the diagnosis, the disease stage, etc.

If possible, patients should be combined into general groups, depending on the nature of the disease and the stage of its flow, as group classes can be carried out more emotionally and interestingly, including exercises with projectiles, games.

The study of the medical gymnastics consists of introductory, main and final parts.

Input part It is 10 - 20% of the time of all classes. Exercises of the introductory part have a tonic effect on the patient's body, create positive emotions, contribute to the preparation of the body to the burden in the main part of the lesson. To the means of the introductory part include elementary exercises for the upper and lower extremities and the torso, breathing exercises, walking, attention exercises, sedentary games.

Main Part Claims of therapeutic gymnastics are given 60-80% of the time. The tasks of the main part are specified depending on the disease. The main attention is paid to improving trophic, forming compensation or restore function. Tools of the main part: generalizing and special exercises for this disease. The proportion of the latter depends on the motor mode of the patient. In addition, walking, exercises on projectiles, games, applied exercises can be used.

Final part It takes 10-20% of the time of all classes. The problem of the final part is to reduce the physiological burden, the normalization of the function of cardiovascular and respiratory systems. Funds: gymnastic exercises with minor load, walking, breathing exercises, attention and relaxation exercises.

Independent classes. To increase the effectiveness of therapeutic physical culture, independent classes can be recommended. A special complex of physical exercises pre-shows the instructor, then the patient performs them in its presence. The complex should be performed 3-5 times a day (in the hospital or at home). Such tasks acquire a particular importance in injuries of the musculoskeletal system, diseases of the central and peripheral nervous system.

Medical walking It is carried out in the form of a dosage walk or walks. Features of therapeutic walking are to be able to accurately dispense the load at the distance, speed, number and duration of stops for recreation. Especially accurate dosage with a gradual increase in load when walking should be observed with the myocardial infarction, diseases of the vessels of the lower extremities. In hospitals, medical walking is recommended during the free motor regime.

Under the conditions of sanatorium treatment, depending on climatic zones and conditions of terrain, therapeutic walking is assigned to certain schemes using various routes in accordance with the patient's mode. Since therapeutic walking is easily dosed, it can be widely used for independent classes in various medical institutions and home conditions.

Walks are applied in cases where the accurate load dosage is required. They increase the overall tone and metabolism, improve the function of nervous, cardiovascular and respiratory systems, strengthen the musculoskeletal system.

Terrene (Dosed climb) is a kind of dosed walk. However, the ascent of the mountain has a greater impact on the body, as it is carried out by crossed and mountainous areas. Terrenkura routes are developing in advance of gradually increasing difficulties (distances and angle of lifting).

Sports Exercises and Sports Games Widely used in sanatoriums and rehabilitation centers. This form of exercises is characterized by high emotionality, and sports game and the difficulty of dosage load. Therefore, the classes with some games (volleyball, tennis, badminton) and sports exercises (swimming, rowing, walking on skis) should be carried out under the guidance of an instructor of therapeutic physical culture, which teaches the technique of the exercise data, conducts a refereeing, doses the load. Independent classes, which also widely use exercises and games with a small load (croquet, kegelban) are also widely prepared patients.

In the process of performing sports exercises and sports games, along with therapeutic tasks (general strengthening of the body, improving motor capabilities, health improvement) are solved and pedagogical (upbringing courage and decisiveness, perseverance, sense of collectivism, etc.).

Mass forms of physical education work Characteristic for holiday homes, sanatorium, clinic. These events include: physical education, rolling games and entertainment; Thematic evenings, which are conducted episodically and often learn to festive days; "Schools of Health." Their task is the propaganda of physical culture and therapeutic physical culture; Attraction of patients to daily exercise practices, promotion of outdoor activities. In the "Schools of Health" there are cycles of classes, during which they explain the therapeutic effect of exercises, demonstrate the main exercises of hygienic and therapeutic gymnastics, traine them.

Before holding holidays, a large organizational work is carried out (for 10-15 days); Their content depends on the local conditions of sanatorium-resort institutions, the composition of the rest and patients.

In recreation homes and sanatoriums, rowing, volleyball, towns, badminton, delivery of individual norms of the GTO can be held. Competitions contribute to wider involvement of vacationers and patients in physical culture class, but you can only participate in them with the permission of the doctor. Competitions are held at the championship of the holiday home or sanatorium and between holiday homes and sanatoriums. The timing of the competition, the position and program are determined in advance.