ORGANIZATION OF CLASSES WITH STUDENTS OF THE SPECIAL MEDICAL GROUP AT THE UNIVERSITY

Tokareva Alexandra Vladimirovna
Saint Petersburg State University
Assistant of the Department of Physical Culture and Sports

ORGANIZATION OF CLASSES WITH STUDENTS OF SPECIAL MEDICAL GROUP IN UNIVERSITY

Tokarev Alexandra Vladimirovna
St. Petersburg State University
Assistant, Department of Physical Education and Sport

According to the Order of the State Committee of the Russian Federation for Higher Education dated July 26, 1994. № 777, the distribution of students into medical groups is carried out on the basis of a medical examination by a medical commission. Currently, in higher educational institutions for physical education, the following medical groups are distinguished: basic, preparatory and special.

At St. Petersburg State University, students of preparatory and special groups "A" are united in the 3rd "health-improving" block, and those exempted from physical education for medical reasons (special group "B") are assigned to the 4th "additional" block.

To the preparatory medical group include practically healthy students with some morphological and functional deviations or poorly prepared physically; included in risk groups for the onset of pathology or with chronic diseases in the stage of persistent remission for at least 3-5 years.

Students assigned to this group are allowed to engage in physical culture according to the curriculum, subject to the gradual mastering of a complex of motor skills and abilities associated with the presentation of increased demands on the body, a more strict dosage of physical activity and the elimination of contraindicated movements.

Special medical group is divided into: "A" and "B".

To special group "A" include students with disabilities in the state of health of a permanent (chronic disease, congenital malformations in the stage of compensation) or temporary.

Students assigned to this group are allowed physical education with restriction of physical activity and the exclusion of contraindicated physical exercises. In the classroom, the nature and severity of deviations in health, physical and functional development must be taken into account.

To special group "B" includes students who have significant deviations in the state of health of a permanent and temporary nature, without pronounced disorders of well-being and admitted to attending theoretical classes.

Physical culture for students with deviations in the state of health in universities in the country as a whole includes theoretical, practical, including advisory and methodological classes as a mandatory minimum. In the content of the course for students of the special medical department, special attention is paid to the means for eliminating deviations in the state of health and physical development. Practical lessons are conducted taking into account the performance and functional capabilities of students.

At St. Petersburg State University, in the "Recreation" block, classes are held according to a special methodology in the following sports: aerobics (fitball, stretching, fitness), martial arts (wushu), skiing, athletics (running), swimming, Nordic walking, tourism ( pedestrian), badminton, special programs in the direction of "Health systems", general physical training.

Exemption from physical education classes for health reasons can only be temporary (for the period of illness). Students freed from practical classes for a long period are engaged in groups of an additional block (main module), where they master theoretical and methodological material, as well as checkers and chess.

The main tasks of physical education in special medical groups are:

• promoting the versatile development of the body, maintaining and strengthening health, eliminating functional deviations and deficiencies in physical development;
• increasing the level of physical performance, the development of professionally important physical qualities;
• formation of the need for systematic physical exercise, instilling healthy lifestyle skills;
• mastering basic motor skills and abilities;
• acquiring knowledge and skills of hardening, methods of conducting independent studies, conducting self-control and self-massage.

According to the special literature, at present among the student environment, the most common diseases include disorders of the cardiovascular system and the musculoskeletal system (up to 80% of deviations), the respiratory system, the organs of vision, the genitourinary, digestive systems, etc.

Table 1 shows, depending on the prevalence of diseases, approximate indications and contraindications for physical education with students with deviations in health.

Table 1

Preserving and strengthening health, increasing the adaptive capabilities of the body of students of special medical groups during the period of study at a university is an important component of higher education, since it is during this period that the foundation for the success and longevity of the future professional activities of young specialists is laid.

In any school there is a subject that almost all students like - physical education lessons. Depending on the physiological, as well as the physical condition, children are divided into physical health groups, of which there are only three: basic, preparatory and special.

Formation

The children's doctor of the educational institution forms groups for physical education based on the conclusions and recommendations of specialist doctors who take part in the preventive medical examination of children. This takes into account:

• the presence of a disease;
• its stage;
• the severity of the disease;
• risk of complications.

If necessary, the child is sent for additional types of examinations or for consultation with doctors of a medical and physical education dispensary. Children who have not undergone a preventive medical examination are not allowed to engage in physical education.

Adult health groups

Citizens who have reached the age of 21 are subject to compulsory medical examination, which is carried out with the aim of early detection and prevention of certain dangerous diseases, determining the level of physical activity, and also collecting information about the presence of bad habits in an individual. After passing the appropriate types of examinations, which depend on the age category, the health group is determined. There are no clear criteria for the distribution of health by physical culture groups in adults. Individuals attributed to the second health group are recommended regular exercise therapy. Further, a decision is made to refer the patient to specialist doctors - this is the second stage of clinical examination.

Criteria for dividing into health groups

After passing a medical examination, all children, depending on their condition, are assigned a health group. The basis for inclusion in a particular group is the data obtained from the results of examinations and the conclusions of medical specialists. The main criteria are:

• genetic factors (information obtained from the legal representatives of the child and his close relatives is analyzed and summarized);
• anthropometry and physical development;
• body resistance.

As the child grows up, the health group can change, there are five of them:

• the first is healthy individuals;
• the second is practically healthy, i.e. children with minor functional disabilities;
• the third is in the stage of compensation. Severe violations are observed, which are manifested with an exacerbation of the underlying pathology;
• the fourth is subcompensation. In this case, there is a failure of the functions of the organs that are affected by the disease;
• the fifth is decompensation. This category includes children with the status of "disabled".

Depending on the level of health, physical development and fitness, as well as functional capabilities, a physical education group is determined.

Health groups for physical education

In the child's outpatient card, a mark must be made to which physical culture health group he is assigned:

Factors that are taken into account when determining a physical culture group

Determination of the functional capabilities of an individual's body is important in determining the physical culture group of schoolchildren's health, and especially the cardiovascular system. For this, tests with a physical dosed load are used. During its implementation, the following is recorded:

• arterial pressure;
• pulse;
• face skin color;
• breath;
• sweating;
• changes in well-being and other signs of fatigue.

Comparing all the factors, the reaction of the body and the level of physical fitness are assessed. The results obtained are processed and analyzed together with the results of examinations and the conclusion of specialists. Further, the children's doctor determines the physical health group in children.

The main group for physical education

It includes children with the first and partially with the second health group. These are children who have no abnormalities in health and have appropriate physical fitness according to the age category. And also children who have functional, that is, insignificant deviations of the state of health (mild asthenic manifestations, overweight, allergic reactions, etc.) and keep up with their peers. Minors assigned to the main physical health group fulfill all physical education curricula in full, they can engage in sports sections, take part in tournaments, holidays, sports days and competitions. Nevertheless, one should not forget about some contraindications to sports. For example, with myopia, ski jumping, weightlifting and some other sports are not recommended.

Preparatory group for physical education

This physical health group includes children who are lagging behind their peers in physical development and have insignificant deviations in health. For example, after acute diseases, as well as during their transition into a chronic course. Classes in this group will help to raise physical fitness to the required level. Minors study together with the children of the main group, however, excessive loads are categorically contraindicated for them.

3 physical health group

This group includes children who, for health reasons, need physical education according to a special program.

It includes children who have pronounced deviations in health, which are reversible (the first subgroup, or it is also denoted by the letter A) and irreversible (the second subgroup is B). Let's take a closer look at each of them:

• First (A). Minors in this subgroup have temporary or permanent health problems. They need to limit the intensity and volume of physical activity. Children are recommended to perform exercises according to special individual programs that are developed in conjunction with medical workers. Regular physical activity, together with therapeutic and prophylactic measures, can significantly improve the condition of the child, and he can be transferred to the preparatory group. However, this is only possible after a medical certificate issued after a medical examination.
• Second (B). This subgroup includes children with significant health deviations. Some of them require significant restrictions on the intensity and volume of physical activity, as well as the implementation of individual and special therapeutic exercises under the supervision of a healthcare professional. Their implementation is possible in a health care institution or a preschool (school) educational institution. When certain results are achieved, some children may be transferred to subgroup A.

Exemption from physical education

In some cases, the child is not able to attend physical education lessons for health reasons. The basis for this is an official document received at the clinic at the place of residence of the child. A medical worker's certificate of exemption from physical education is issued:

• The sole treating doctor. For a period of two to four weeks after suffering minor illnesses, such as acute respiratory viral infections, tonsillitis, pneumonia and others.
• By decision of the medical commission of a medical organization. For a period of more than a month after severe pathologies (diseases of the liver, stomach, tuberculosis, etc.), surgical interventions or injuries (brain bruises, fractures). Exemption from physical education can be issued for a period of the entire academic year for medical reasons. A special commission in the polyclinic is presented with a discharge summary from the hospital and the conclusion of a medical worker, entered into the child's outpatient card with appropriate recommendations. On the basis of the submitted documents, the medical commission makes a decision, the results of which are communicated to the legal representative of the child. In each case, the issue is resolved individually.

A correctly selected set of exercises and regular exercises, regardless of which physical health group your child belongs to, will help keep all the muscles of the body in good shape and develop correctly.

Physical culture classes are designed to provide a minimum level of physical activity for students with a health-improving purpose. In the classes themselves, the intensity of the load can be very, very high. Only a practically healthy student can successfully cope with it. However, the statistics of recent years are disappointing. The health status of high school students - future applicants - is steadily deteriorating. And this means that every year the number of students with certain restrictions on physical activity will increase. This is a serious fact that cannot be ignored, especially considering that the teacher bears responsibility for the life and health of students in physical education classes. One of the prerequisites for admission and physical education at the university is the provision of students with a medical certificate with a doctor's conclusion about the state and health group. Such medical examinations are organized by the universities themselves. These activities are not strictly regulated in relation to the number of medical examinations, the contingent to undergo it, etc. As a result, there is currently no unified structure for conducting medical examinations in universities. In some of them, students are examined only in the first year, in some - students of the first and second years, in some - students from the first to fourth years, etc.

In general, medical admission to physical education classes is a separate and problematic topic at the present time. The recently introduced innovations concerning the prohibition of complete exemption from practical training are not entirely clear. On the one hand, of course, it is necessary to involve young people in physical activity as much as possible. However, there are situations when such activities cannot be recommended under any circumstances. We are talking about such serious diagnoses as heart failure, serious vision problems, severe asthma, etc. After all, almost the main goal of health-improving classes is to strengthen the health of students, but not to deteriorate it, and even more so not to provoke attacks of illness.

Another questionable point is the concealment of his diagnosis at the request of the student. Of course, information about human diseases should be strictly confidential and should under no circumstances become public domain. However, the teacher should be aware of the problems of his students, since it is he who is responsible for them in the lesson. In addition, depending on a particular diagnosis, an individual set of exercises can be drawn up for a particular student, or the student can be exempted from those tasks that will be contraindicated for him. But such decisions are possible only if the teacher is fully and timely informed about the state of health of his students.

It also seems timely to note the not always high-quality medical examination in universities for admission to physical education classes. Due to the large flow of students, such examinations are often carried out superficially and are based on the information provided from those medical institutions where the student was previously observed. As a result, there are situations when students with serious diagnoses did not receive a mark in the final certificate that they were assigned to a special medical group. And on the contrary, those whose health conditions were quite suitable for exercising in the general group were entitled to relief of the load, because were assigned to a special group. One of the main factors of this problem is the catastrophic shortage of medical personnel and extremely low salaries, which does not at all contribute to changing the situation for the better. And the system of university medical examination itself needs to be improved. Perhaps, it would be necessary to create several state medical centers exclusively for students, to which people receiving higher education could apply for any qualified medical assistance, including for admission to physical education classes.

It is this problem that has caused the need for physical culture practitioners to conduct a special questionnaire survey with first-year students at the beginning of each academic year regarding their health status. Students are explained for what purposes the teacher collects confidential information of a medical nature, the students are informed of the importance of timely information and health problems, as well as possible indulgences in the course of practical training. And if it turns out that the future student has health problems that have not been reflected or not sufficiently reflected in the medical report, the teacher is forced to make a decision on dosing the load for such a contingent, and in some cases - and the question of admission to practical training. classes.

Based on the results of a medical examination at the university, each student receives a medical certificate in the form of a certificate indicating the health group to which it belongs, based on the main indicators of the state of health at the time of the commission's visit and on the basis of medical documents indicating the presence of any health problems or their absence.

Traditionally, there are three main groups of health: basic, preparatory and special.

The main group of health includes students who do not have serious contraindications to physical education. It is assumed that such students can choose any kind of sport for themselves or engage in groups of general physical training without any restrictions on the intensity of the load, the complexity of the exercises performed and passing the control test standards for the result.

The preparatory health group includes students with minor deviations in health, which, in general, do not interfere with regular physical education, but still assume a number of restrictions, depending on the diagnosis. This can be partial or complete exemption from passing control standards (with asthma, with problems with the heart, joints), exemption in the process of training from running or jumping exercises (for example, with progressive myopia), etc. In this case, self-control over their own well-being is necessary on the part of the student himself. It is especially not permissible to perform exercises that are contraindicated for him according to the existing diagnosis.

The special group includes students with significant and very serious health problems. The overwhelming majority of students assigned to this group have limitations (sometimes very serious), but they can still go in for physical education. Of course, they are exempted from passing any standards. They are freed from increased peak loads during the lesson itself - mainly, this applies to running and jumping series of exercises. However, the decision to limit the load or completely eliminate it should be made by the teacher on the basis of the diagnosis in each case individually. It is necessary to say a few words about the group of trainees who, under no circumstances, can be admitted to practical physical culture lessons. These are students for whom even moderate physical activity can lead to death (for example, heart disease), as well as disabled people for whom it is not possible to perform typical physical exercises (for example, with amputation of limbs or with blindness). Of course, an individual approach should be provided for such a contingent of students. Tasks should be adequate to the state of health of the students. The execution of theoretical tasks is allowed.

Test questions.

1. What are the conditions for admission to practical classes in physical culture at the university?

2. What problems do teachers and students face in the process of medical examination in universities?

3. What health groups can you list?

4. Give a description of each of the health groups.

Assessment of the medical group for physical education for students with disabilities.

The first step to successfully solving the problem of choosing the correct dosage of physical activity during physical exercises for students is their distribution into three medical groups - basic, preparatory and special. Allocation is done in advance by a pediatrician, adolescent doctor or general practitioner at the end of the school year. The doctor makes the final decision after an additional examination at the beginning of the upcoming academic year. The main criterion for including a student in a particular medical group is to determine the level of his health and the functional state of the body. For distribution to a special medical group, it is also necessary to establish a diagnosis with the obligatory consideration of the degree of impairment of body functions. In case of difficulty in resolving the issue, it is necessary to consult a WFD specialist.

On the basis of a joint medical and pedagogical conclusion, the student is assigned to one of the medical groups.

To the main medical group(I group of health) includes students without deviations in health and physical development, having a good functional state and physical fitness corresponding to age, as well as students with minor (more often functional) deviations, but not lagging behind their peers in physical development and physical fitness. Those assigned to this group are allowed to train in full according to the curriculum of physical education with the use of health-improving technologies, preparation and passing of tests of individual physical fitness. Depending on the characteristics of the physique, the type of higher nervous activity, functional reserve and individual inclinations, they are recommended to engage in a certain type of sports in sports clubs and sports, in the groups of CYSS and DYUKFP with preparation and participation in competitions, etc.

In this case, one should remember about the relative contraindications to sports. for example, with myopia or astigmatism, you cannot engage in boxing, diving, ski jumping, alpine skiing, weightlifting and motor sports; perforation of the eardrum is a contraindication to all types of water sports; with a round or round-concave back, cycling, rowing, boxing, which aggravate these postural disorders, are not recommended. Other sports are not prohibited.

To the preparatory medical group ( II health group) includes practically healthy students with certain morphological and functional deviations or physically poorly prepared; included in the risk groups for the onset of pathology or with chronic diseases in the stage of persistent clinical and laboratory remission for at least 3-5 years. Those referred to this health group are allowed to study physical education curriculum on condition of a more gradual mastering of a complex of motor skills and abilities, especially those associated with the increased demands on the body, a more careful dosage of physical activity and the elimination of contraindicated movements (health-correcting and health-improving technologies).

Test trials and participation in sports events are allowed only after an additional medical examination. These students are not allowed to participate in most sports and sports competitions. However, additional activities are highly recommended to improve general physical fitness in an educational institution or at home.

The special medical group is divided into two: special "A" and special "B". The final decision to send a student to a special medical group is made by a doctor after an additional examination.

Special group A (health group III) includes students with distinct deviations in the state of health of a permanent (chronic diseases, congenital malformations in the stage of compensation) or of a temporary nature or in physical development, which do not interfere with the performance of ordinary educational or educational work, however, requiring restrictions physical activity. Those referred to this group are allowed to engage in health-improving physical education in educational institutions only according to special programs (health-correcting and health-improving technologies), agreed with the health authorities and approved by the director, under the guidance of a teacher of physical culture or an instructor who has completed special training courses.

In health-improving physical education, the nature and severity of deviations in the state of health, physical development and the level of functional capabilities of the student must be taken into account. at the same time sharply limit exercises for speed, strength, acrobatic; outdoor games of moderate intensity; walks (skiing in winter) and outdoor activities. Progress is assessed by attendance at health-improving fictional classes, attitude towards them, the quality of the exercise complexes - homework, the ability and skills of healthy lifestyle elements, the ability to exercise self-control of health and functional capabilities.

Special group B (group IV of health) includes students who have significant deviations in the state of health of constant chronic diseases in the stage of subcompensation) and of a temporary nature, but without pronounced disturbances in their well-being and admitted to attendance at torretic classes in educational institutions. It is recommended for those assigned to this group that exercise therapy classes are mandatory in the departments of physical therapy of the local polyclinic, a medical and physical dispensary. Regular self-study at home according to the complexes suggested by the exercise therapy doctor is permissible. Obligatory is the strict implementation of the regime and other elements of a healthy lifestyle. Progress is assessed by attendance at health-improving fictional classes, attitude towards them, the quality of the exercise complexes - homework, the ability and skills of healthy lifestyle elements, the ability to exercise self-control of health and functional capabilities.

Parents should systematically monitor the fate of children in all therapeutic, prophylactic, valeological measures. these students cannot be ignored by physical education teachers and the management of an educational institution.

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