Pulmonary tuberculosis , physiotherapy
Pulmonology / / August 12, 2017
Tuberculosis - a specific infectious disease that affects various organs and systems, with the most frequent localization of the main process in the respiratory tract.In the organs and tissues there are various specific and non-specific disorders as a result of a complex relationship between the pathogen, the reactivity of the organism and diverse influences of the environment.Currently, most noted for chronic tuberculosis, in which the remission periods may alternate with periods of exacerbation of the process.
The complex of measures aimed at the treatment of pulmonary tuberculosis in all its forms, a significant place is occupied by diet and hygienic mode, namely, a balanced diet, hardening of the body and graduated exercise.
Physiotherapy is a method of functional and pathogenetic therapy in complex treatment of patients with pulmonary tuberculosis, is of great importance also as a method of helping to carry out the correction of existing violations of basic body functions, and as a powerful tool
For the most rapid elimination of tuberculosis intoxication, functional disorders and rehabilitation of patients should be promptly and systematically appoint a special exercise.It should be borne in mind that the body of the patient with pulmonary tuberculosis has a certain functional reserves to be used to expand and to successfully address the major medical problems.
Clinical observations show that as a result of tuberculosis intoxication first and most affected the functional state of the respiratory and circulatory systems.So, before you assign patients gymnastics, it is necessary to conduct research, give an idea about the state of external respiration and circulation: spirographic, ECG and, if possible definition of stroke and minute volume of circulation.
therapeutic effects of exercise on the body of the patient due to the influence of the central nervous system through the functional state of individual organs and systems of the patient.Timely, possibly earlier, and systematic therapeutic exercises makes it possible to improve the patients rhythm and increase the depth of respiration, increase ventilation and gas exchange lungs, which helps to improve respiratory function (increased tidal volume and vital lung capacity, increases reserve volume inspiratory and reserve volumeexhalation).In addition, therapeutic exercises aimed at improving the function of the circulatory system, which manifests an increase in stroke volume of the left ventricle of the heart and increase the minute volume of blood circulation, as well as to strengthen the neuro-psychiatric and respiratory muscles of patients.This is particularly, but for patients who in the course of treatment to be surgery.Physiotherapy improves the overall resistance of the organism, positively influences the metabolism, improves blood circulation and lymph circulation, helps to stop symptoms of intoxication, and oxygen starvation.All this leads to a certain positive changes in the body of the patient, resulting in enhanced redox processes, rational use of oxygen to tissues, complete withdrawal of the decay products.
Physiotherapy in pulmonary tuberculosis is almost shown the vast majority of patients.It should be administered at the earliest possible time and with the indispensable account of the general state of the patient and the nature of the basic process with him.
main objectives of therapeutic exercises in patients with pulmonary tuberculosis should be considered:
1) improvement of respiratory function and increased respiratory reserve;
2) improving the functional state of the cardiovascular system and its functional reserves;
3) a decrease in the severity of symptoms of intoxication;
4) strengthening the physical and neuro-psychological condition of the patient;
5) mastery of patients who are to operative treatment, breathing and physical exercises necessary for them in the early postoperative period;
6) training of patients with the basic rules of the use of therapeutic exercises outside the facility.
complexes of medical gymnastics are made taking into account the functional methods of investigation of these patients.Complexes should be divided into an introduction, main and final part of the mandatory inclusion of special breathing exercises in them.It is advisable to start with the individual classes of 1-2, and then combine the patients in small groups (3-5 people) to be able to promptly fix fatigue or unwanted patient's response to an increase in load or a change in exercise.Before, during and after the training necessary to control the subjective condition, heart rate and respiration, blood pressure of the patient.The data obtained will allow the instructor conducting the activity in a timely manner to change the nature of the exercises, the number of repetitions and tempo.
Based on the problems of complex and rational treatment of patients for Therapeutic exercises it is advisable to divide the weak, medium and strong group.By the weak group includes patients with unstable general condition due to the recently transferred aggravation of the main process, the presence of signs of fatigue.For this group of complex Therapeutic exercises should be based on the use of simple physical exercises for all muscle groups, alternated with breathing exercises.The rate of movement - slow.The number of repetitions of each exercise 2-3.
By the middle group is necessary to include patients with stable general condition, absence of intoxication symptoms and underwent the aggravation of the process at least 3 months.ago.The complex of therapeutic exercises for this group is based on the use of exercises of medium difficulty with sports equipment (sticks, clubs, balls, gymnastic benches).Physical exercise with muscle tension alternate with breathing exercises.The pace of exercise - average.The number of repetitions of each exercise 4-6 times.
to a strong group includes patients with well-compensated state and specific physical preparation.The principle of the occupation, the execution technique does not differ from those for the middle group of patients, but the pace of execution and increased physical activity.
A special group should be allocated elderly patients, physiotherapy sessions which should be carried out to alleviate the complexes with a predominance of respiratory exercises.
Physiotherapy is contraindicated in patients who have marked:
- exacerbation of tuberculous process, accompanied by symptoms of intoxication (fever, severe cough with copious sputum, leukocytosis and accelerated ESR);
- abundant hemoptysis and pulmonary hemorrhage;
- respiratory and cardiovascular failure.
separate group for which in the overall complex of therapeutic measures necessarily includes, physiotherapy, surgical contingent of patients with pulmonary tuberculosis.Conducting medical gymnastics in the group is emphasized.Before surgery, patients are taught deep breathing through the nose, prescribe an exercise program that promotes the mobility of the chest and diaphragm, effective cough training techniques at the end of exhalation.If patients expectoration of sputum makes it easy tapping his hands on the chest.Therapeutic exercises should be started in the first hours after the operation.The predominant exercises at this time are breathing.Physical exercises for the hands, forearms and legs are executed in the early hours, in slow motion, 2-3 times each.It is now established that the contraction of the muscles during exercise activates the breathing and this, together with an effective expectoration of sputum helps to avoid such terrible postoperative complications, as is the hypostatic pneumonia.In the early postoperative period before therapeutic exercises are quite certain tasks:
- the prevention of pulmonary complications improved ventilation, unfolding the remainder of the lung;
- improved respiratory function and cardiac activity;
- prevention of disorders of the gastrointestinal tract;
- phlebothrombosis prevention by improving venous circulation;
- prevention of limitation of mobility of the shoulder joint on the operated side.
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All these tasks can be successfully completed if Physiotherapy will begin in the first hours after the operation.In addition to the physiological effect on the patient's tuberculosis organism in the postoperative period, physiotherapy and has a significant positive psychological impact as improving the patient's mood and instills confidence in the successful outcome of the operation.Complexes of therapeutic exercises for all groups of patients must include breathing exercises, under the influence of which the activity is improving all the breathing apparatus.
Depending on the method of distinguish the following exercises:
1) static thoracic breathing.Held supine or sitting, at the expense of the instructor or the metronome, elongated exhale;
2) static diaphragmatic breathing.Held as a supine or sitting, to monitor the correct implementation of this type of breathing the hand is placed on the anterior abdominal wall, which must be lifted during inhalation;
3) dynamic breath.Held in conjunction with exercise;for example, at a breath - farming hand in hand, the extension of the body, while exhaling - lowering the hands, bending the body.
In general, complex therapeutic and preventive measures in patients with pulmonary tuberculosis physiotherapy occupies a special place and has a great value for their rehabilitation.
12 Aug, 2017
12 Aug, 2017