In this article, information is not only about physical therapy for neuroses, therapeutic exercises for neuroses and breathing exercises. It is about how to stay healthy in the conditions created by our civilization and technological progress - that is, about a healthy lifestyle in conditions of survival. In order to qualitatively understand this issue, the book by Galina Sergeevna Shatalova “Choosing a Path” is presented, which can be downloaded. I have included several videos on the subject of "Neuroses" in the article, which will help you get the most useful and necessary information, which will undoubtedly strengthen the desire for health. Understand well the causes of neurosis, the essence of neurosis and methods of treatment and prevention. This is relevant not only because neurosis negatively affects the quality of life of a person and his family and environment, but also because constant stress and bad mood exhaust the body and lead to a decrease in immunity and even serious diseases.

At the end of the article, music for meditation and relaxation.

Therapeutic exercise for neuroses.

Therapeutic exercise for neurosis in complex treatment aims to restore the central nervous system, to harmonize the processes of inhibition and excitation in the central nervous system, to increase the adaptive capabilities of the body. are taken into account individual characteristics personality, comorbidities, and age of the patient.

In the hospital and the clinic, therapeutic exercises for neuroses are carried out by a group method with musical accompaniment. General strengthening exercises are included, including with dumbbells, breathing exercises and relaxation; stretching, balance, coordination exercises are useful. General strengthening exercises alternate with relaxation exercises. Walking, health path, slow running, board games (chess, checkers, backgammon), playing towns, sports games (volleyball, basketball), skiing, cycling, swimming, rowing, training on simulators, occupational therapy are shown.

Fishing, picking up mushrooms and berries, clay modeling, needlework, dancing are useful.

There are no restrictions in physiotherapy exercises for neuroses. The main thing is to observe the gradualness of the loads and the regularity of classes, preferably according to the daily routine. The greatest benefit will bring classes in nature with a good mood and a desire to be healthy.

This is a video of the club "Vita", created on the initiative of Galina Sergeevna Shatalova in Yekaterinburg, about the morning workout of the next health school group. Pay attention to what a friendly and positive atmosphere is present among people who want to be healthy and lead a healthy lifestyle.

Early morning, the very first warm-up of the new group. People are embarrassed at first, but then they loosen up, a single field of kindness, openness and joy appears. Shackled and uncertain movements gradually become confident, rhythmic, harmonious. The body is relaxed, the tension is gone, smiles shine on the faces.

For the treatment of neuroses, this is the best environment.

Therapeutic gymnastics for neuroses.

I offer you another video, which presents a brief demonstration of exemplary exercises of therapeutic exercises for neuroses.

Ideal for the treatment of neurosis

Pay attention to the alternation of exercises for the spine and relaxation. Emphasis on inhalation and exhalation.

Read the articles for more information on the subject of "Neuroses":

Heart reserve. Dosing of physical activity.

As with vegetative-vascular dystonia, with hypertension and other diseases, you need to know your heart reserve in order to properly dose the load on the heart.

Let us briefly repeat the necessary formulas.

one). Counting the pulse at rest for 1 minute after a short rest.

2). Maximum heart rate during exercise = 180 - age.

3). Heart reserve (100%) = Maximum exercise heart rate - Resting heart rate in 1 minute.

The reserve of the heart is determined in order to dose the load downward. It must be remembered that with neurosis, the adaptive capabilities of the body are reduced. In case of neurosis, we will use not 100, but 80% of the reserve of the heart, so that the condition does not worsen due to fatigue.

I'll give you an example. Age 46 years.

Pulse at rest 66 beats per minute.

180 - 46 = 134 beats. per minute is the maximum allowable heart rate.

134 - 66 = 68 beats per min - 100% of the reserve of the heart.

68: 100 * 80 = 55 beats per minute is 80% of the reserve of the heart.

4). Resting heart rate + 80% heart reserve = dosed load for a given person.

66 + 55 = 121 beats in min.

During training, you need to breathe only through your nose. If you want to breathe through your mouth, then the body is overloaded, the cells do not have enough oxygen (this can happen due to a lack of carbon dioxide in the blood, red blood cells cannot give oxygen to the cells, because with a lack of carbon dioxide, there are too strong bonds between red blood cells and oxygen molecules).

Breathing exercises in neurosis.

Read the article “Put your nerves in order”, which has a simple breathing energy exercise with a calming healing effect.

The body should be relaxed, the mind should be concentrated on internal sensations with the expectation of a specific goal - harmonization of the body, relieving tension, controlling one's emotions. You need to tune in and experience a feeling of bliss and pleasure.

“The sitting posture on a chair can be extremely productive for both passive and active forms of breathing exercises. It is especially important not to forget about the position of your body. There are no trifles here. There should be a right angle between the thigh and lower leg. The back is straight, relaxed, hands lie on the hips with the thumbs inward. Keep your head straight and calm. This posture can be used for many breathing exercises."

Full rhythmic breathing can cause side effects, especially in people who are overly irritable and suffer from high blood pressure. They are encouraged to breathe while sitting with the movement of their hands. This is a calming exercise. Therefore, at the slightest sign of irritability, stop all other exercises and move on to this (seated exercise with hand movement).

Breathing is accompanied by a sluggish, relaxed movement of the hands. When inhaling, they slowly, in the rhythm of breathing, rise to about shoulder level. When exhaling, they also slowly lower to their original position. Moreover, when inhaling, the hands move a little differently than when exhaling, which is clearly seen from the drawings. When exhaling, they seem to be half-open, when inhaling, they are limply lowered.

Starting position for a calming breathing exercise while sitting with the movement of the hands.

Inhale, hands rise smoothly, hands are relaxed.

Slow exhalation, hands gently fall down; the hands are half open, the fingers are slightly apart.

“People who are easily excitable can unconsciously perceive even a simple holding of breath during inhalation and, especially, during exhalation, as a spontaneous convulsive phenomenon. This will cause an unwanted rush of blood, overexcitation of the central nervous system; can also cause not only insomnia, but also more undesirable consequences. This should certainly be remembered by people suffering from neurasthenia and hypertension. They should refrain from holding their breath after exhaling. At first, until health returns to normal, they should only inhale, hold after inhalation and exhale.

In the book by G. S. Shatalova “Choosing a Path”, the entire third chapter is devoted to breathing exercises.

Healthy lifestyle.

With all my heart I welcome the system of natural healing of Galina Sergeevna Shatalova, which is described in her kind and smart books. One of them is "Path Choice". After reading this book, you will understand by what laws the human body lives, in what conditions you need to exist in order to stay healthy, happy and live long, get detailed information on how to put into practice all the recommendations for changing your lifestyle. I welcome her kindly - a strict conversation with patients, since Galina Sergeevna is a military surgeon, a neurosurgeon with vast experience in medical practice, which in practice has tested and scientifically proved what a person needs for a healthy body and spirit. She cured many terminally ill people from the most serious diseases.

The system of natural healing relies on three important components:

one). Spiritual health - (spiritual health in the recovery system has highest value. It implies the absence of selfishness, tolerance, the desire for unity with nature in the broadest sense of the word, understanding the laws of the unity of all living things and the principles of living ethics, universal love. They are formulated in the commandments of the New and Old Testaments. A spiritually healthy person is one who lives not personally for himself at the expense of others, but as an equal with concern for others. Living according to the laws of goodness is the only way for mankind to survive.)

2). Mental health (this is a harmonious combination of conscious and subconscious, providing both the stability of the body in terms of survival, and adaptability to changing conditions environment.)

3). Physical health (Respiration, nutrition, movement, hardening (thermoregulation) play a role in maintaining physical health.)

The main condition for the system of natural healing of the body is the simultaneous use of all health factors, and not just one thing, that is, an offensive on all “fronts”. If you want to be healthy and achieve longevity, then you need to lead an appropriate lifestyle. The book by Galina Sergeevna Shatalova "Choosing a Path" will help you to understand and take a different look at the very important components of human health. Read the book on the SVITK.RU Library website.

neuroses.

Neuroses are functional disorders of mental activity arising under the influence of psycho-traumatic factors and manifested in violation of higher forms of behavior, a decrease in mental and physical performance, limiting the adaptive capacity of the body to various influences, contributing to the occurrence of somatic diseases.

Neurosis has a variety of manifestations, which are largely determined by the characteristics of the individual. Painful disorders in neuroses never reach a psychotic level and do not lead to severe maladjustment; patients retain a critical attitude towards existing disorders.

The main forms of neuroses are neurasthenia, hysteria and obsessive-compulsive disorder. Often there is a combination of these neuroses and pronounced vegetative-vascular functional disorders, which explains the poor health of a person and the variety of complaints. In such patients, any other diseases are more severe.

The main cause of neurosis is unfavorable psychogenic factors (irritants) that cause overstrain and disruption of higher nervous activity.

Reducing resistance to stress and the emergence of neuroses contribute to:

2). bad habits,

3). distance from nature, apartment-city lifestyle.

4). violations of biorhythms resulting from changes in work activity, severance of family ties, violations of the regime of rest and nutrition;

five). a large workload of duties combined with a lack of time.

6). information overload and, conversely, information deficit; a long search for solutions to problems, including conflict situations; reassessment of existing ideas about life.

7). negative feelings and emotions: disappointment and hopelessness, resentment, envy and others. Unjustified containment of emotions and one's needs is essential.

8). age-related hormonal changes in the body.

It should be noted that under the action of the same unfavorable psychogenic factors, neurosis does not occur in all people, but only in individuals. This means that in the occurrence of neurosis, the properties of the organism itself are essential: the type of higher nervous activity (cholerics and melancholics are more often susceptible) and congenital psychopathy.

Neurosis is more common in people with

rapid exhaustion of nervous processes (asthenic type);

prone to violent, unrestrained reactions and with high suggestibility (hysterical type);

self-doubt, fixing attention on certain thoughts and actions (anxious and suspicious type).

forms of neuroses.

There are several forms of neurosis, which depends on the nature of the psychogenic irritant and on personality traits: neurasthenia, hysteria and obsessive-compulsive disorder.

Neurasthenia (asthenic neurosis - nervous exhaustion, overwork). A disease characterized by increased irritability along with rapid mental fatigue. Patients react to ordinary stimuli (loud sound, creaking of doors, the appearance of another person) with inadequate reactions: they raise their voice, shout; they have palpitations, hypertension, headache. Along with incontinence, mental and physical exhaustion quickly sets in, attention and memory are weakened; sleep is disturbed (insomnia at night and drowsiness during the day), appetite, functional disorders of the intestine (constipation or diarrhea), sexual activity decreases. There are stable features of asthenization: apathy, indifference, weakness (“hands down”, you don’t want to do anything).

Hysteria is a form of neurosis in which patients tend to attract the attention of others.

There may be symptoms of various diseases, of which the patient with hysteria is well aware. All these symptoms disappear instantly if it can be proved that he is perfectly healthy. This is due to the high suggestibility and suspiciousness.

Mental disorders can be manifested by memory loss (amnesia), confusion, delusions, and rarely hallucinations. There may be disturbances of sensitivity and movement in a wide variety of forms. For example, catatonia - immobilization in a pretentious position, paralysis and paresis.

There are numerous manifestations of vegetative functions: shortness of breath (according to the patient, it is difficult for him to inhale), swallowing disorders, nausea and vomiting, changes in blood pressure and pulse, and many others.

Thus, hysteria is a form of neurosis, which is characterized by a variety of mental changes, disorders of sensitivity, movements and autonomic functions with a satisfactory general condition of the patient. In hysteria, the control of the functions of subcortical formations by the cerebral cortex is weakened.

Hysterical attack. There is hysterical excitement, which is caused by psychotrauma (as a rule, this is a discrepancy between the expected and reality, some kind of dissatisfaction). An attack of hysterical excitement looks demonstratively, theatrically, in order to attract the attention of the public; accompanied by hysterical laughter, sobs; often there may be hysterical convulsive seizures and hysterical syncope (hysterical syncape). A patient with hysteria during a faint falls so as not to bruise and not be injured. That is, he prudently calculates how to fall and not hit. Nausea and vomiting are possible, after an attack - sudden weakness.

Help with a hysterical attack. No need to fuss. It is enough to stand by, doing nothing. You can put a pillow under your head. When the attack is over, give drops of tincture of valerian or motherwort in hot water. If the person’s condition, in your opinion, causes concern, then call an ambulance; especially if the attack happened in a public place (and hysterical attacks most often occur in public places in the presence of a large number of people).

Remember that your excessive attention to the patient during a hysterical attack, active participation in providing assistance and fuss around him can increase the manifestations of hysteria and even contribute to the frequency of attacks and the deepening of this neurosis, since it is in this way that the patient achieves his goal - attracting attention.

Obsessive-compulsive disorder (obsessive-compulsive neurosis) is a form of neurosis, which is characterized by the appearance of constant insurmountable, against the wishes of the patient, fears, memories, doubts or actions. Obsessive fears (phobias) can be very diverse: fear of closed or, conversely, open space, fear of getting sick with a serious illness, fear of heights, and many others. Fears can be so strong that they completely paralyze the patient's consciousness, that is, he cannot think about anything else. Obsessive actions are associated with obsessive fears and doubts: for example, because of fear of some kind of infection, a person repeatedly washes his hands, boils dishes, etc. It is considered pathological when these fears and actions are unjustified. In connection with the fixation of attention on fictitious stimuli disturbing the patient's imagination, a person performs his duties at home or at work abnormally. So, for example, a woman after childbirth hardly approaches the child, spending most of her time and energy on putting things in order and sterile cleanliness in the apartment. Or a person does not get a job, fearing that he will not be able to cope with his usual official duties.

For all forms of neurosis, it is characteristic that a person is aware of the painfulness of his condition, understands the meaninglessness of his fears and doubts, but cannot get rid of them, cannot control his feelings and emotions. It is clear that all this affects the quality of his life, prevents him from living a full life and working normally.

Any neurosis is characterized by a decrease in the functionality of the central nervous system, its rapid fatigue, inadequacy of reactions to various stressful stimuli, which reduces the adaptive nature of behavior. For example, what used to cause a reaction does not now; or there is an overreaction to a weak stimulus; or to a strong stimulus - a weak reaction.

Let me present to your attention the TV program “Conversations with a Psychologist”, in which the psychotherapist Elman Osmanov talks about neuroses.

Psychomotor agitation.

Sometimes, against the background of neurosis, psychomotor agitation occurs - a sudden complex pathological state of arousal of mental activity under the influence of a strong traumatic factor, which is expressed in the acceleration and intensification of movements, speech, thinking, emotions (a state close to panic).

A person does not control himself, can be a danger to others and to himself. Call an ambulance. You can’t discuss his condition with other people, you need to convince him of your own goodwill, speak politely to “You” and calmly as if nothing is happening: you can’t ask about his condition, you need to talk about something that does not relate to this situation.

Be sure to remove all sharp and cutting objects, do not lose vigilance, as the patient's behavior can change dramatically. We must be prepared to prevent a possible suicide attempt.

I say this because everything happens in life. Neurosis can masquerade as various diseases. Even an experienced doctor will need some time to determine the diagnosis of neurosis, psychosis or other disease.

Psychopathies.

I consider it necessary to pay attention to the innate predisposition to neuroses. Below is a quote from V. I. Dubrovsky’s book “Therapeutic exercise”.

Psychopathy is a congenital, slightly reversible, pathological warehouse of the personality, covering the entire mental constitution, in which adaptation to the environment is disturbed. Psychopaths are distinguished not only by disharmony of character, but also by a much greater vulnerability compared to ordinary people, increased sensitivity to internal (age crises), somatogenic, psychogenic and social factors. These properties determine the diversity of the dynamics of psychopathy, the main forms of which are phases and pathological reactions.

There are the following types of psychopathy: schizoid, psychasthenic, asthenic, afferent, paranoid, hysterical, excitable. Emotionally obtuse psychopaths have also been described.

Schizoid psychopaths - unsociable, preferring solitude, reserved people who avoid violent manifestations of feelings, etc. The basis of the schizoid temperament is a combination of excessive sensitivity and coldness (psychasthenic proiftion).

Psychasthenic psychopaths are distinguished by a tendency to doubt, lack of inner confidence in the truth of feelings and the correctness of their judgments and actions, indecision in choosing a line of behavior, etc.

Asthenic psychopaths are characterized by general nervous weakness, timidity, excessive sensitivity and impressionability, which is found primarily in unusual situations that go beyond everyday situations. A distinctive feature of asthenics is increased fatigue.

Affective psychopaths are personalities of the cycloid circle, sociable, friendly, good-natured. One of their main features is emotional lability, mood instability, sometimes reaching the level of regular affective disorders.

Paranoid psychopaths are people of one-sided, but persistent affects that take precedence over logic and reason, wayward, frank, distrustful, etc.

Hysterical psychopaths are distinguished by the desire to appear more significant than they really are, to experience more than they are able to survive, and so on. Among the painful manifestations in hysterical psychopaths, various autonomic and hysterical paroxysms (spasms, aphonia, tremor of the fingers and toes, etc.) predominate.

Excitable or emotionally stupid psychopaths adjoining them - personalities are quick-tempered, irritable, devoid of a sense of compassion, cruel and gloomy. The forms of response most characteristic of them are attacks of anger, rage for any most insignificant reason, sometimes accompanied by an affectively narrowed consciousness and sharp motor excitement.

Comprehensive rehabilitation of psychopathy includes medical and pedagogical measures aimed at correcting the personality. The hospital provides drug therapy (psychotropic drugs), psycho- and occupational therapy (sculpting, drawing, board games, choral singing, group viewing of films, etc.), diet, vitaminization, exercise therapy in a group method, accompanied by music, outdoor games.

Prevention of psychopathy begins with proper obstetric care and other measures. Subsequently, rational education in the family, school, physical education and sports with parents and children is of great importance. It is necessary to envisage a number of social and pedagogical measures in relation to the so-called difficult children. The family should have a friendly atmosphere, adherence to diet, sleep. Before going to bed - taking a shower, airing the room, etc.

I attach great importance to the normal course of pregnancy: the child must be desired, the parents must be healthy and lead a healthy lifestyle. Previous abortions have an adverse effect on subsequent pregnancies.

And after the birth of a child, you need to instill in him a positive attitude towards life and cultivate good feelings; the baby should grow up in the magical field of love of parents for each other and, of course, for him.

Tension headache.

Headache often accompanies an existing neurosis due to muscle tension with strong psycho-emotional experiences. Under stress, the muscles of the collar zone and neck, as well as the muscles of the head, are primarily tensed. Dr. Sperling talks about muscle tension headache.

I also recommend watching Dr. Sperling's short and informative video lecture on stress. It is necessary to realize the impact that strong and prolonged stress has on the human body in order to think about whether it is necessary to be treated when nervousness, anxiety and other disorders of mental balance appear. Watch the video about stress in the article "Therapeutic exercise for hypertension."

How to behave with a "neurasthenic"?

Living and communicating with a "neurasthenic" is not easy. Sometimes the question of divorce comes up. First you need to try to cure neurosis, which responds well to physiotherapeutic procedures (massage, exercise therapy, electrosleep, halochamber (salt cave) and others); medications; talking to a psychologist helps. It is also necessary to reconsider the way of life: bring rhythm into your life (daily routine, music, physical education, timely maintenance of order in the house, etc.); a healthy lifestyle (eliminate bad habits, include a healthy diet, physical education, healthy good sleep, rest, and more); and cultivate a positive attitude towards life and towards people.

For Orthodox believers, the question of divorce is not worth it. Divorce is carried out only in case of treason. The best medicine for a "sick" soul is confession. A person must be aware that because of the manifestations of his negative emotions and actions, not only the people around him suffer, but first of all he himself. Confession helps to return to adequacy, understand the pattern of life problems and look for the cause of misfortunes in oneself.

How to deal with an unbalanced person? Talk to him as if he is perfectly healthy: politely, calmly, patiently, with understanding; be sure to listen to him in order to give him the opportunity to understand what is happening to him and find out what is bothering him. A kind word heals, you need to find these kind words, for example, “nothing, we will break through” or “everything will be fine, we will cope with the problem.” The most important thing is to try not to be an additional irritant for the "neurasthenic", not to say words and not to do things that unnerve him (within reasonable limits), not to respond to rude treatment in the same way, otherwise there will be a skirmish - a pronounced conflict. Learn to calm a "nervous" person, find an approach to him. No need to hide the truth; it is necessary to speak sincerely, benevolently, considering every “little thing”. But do not allow permissiveness.

Neurosis must be treated, because with a long course of neurosis, the nervous system is depleted, there is a risk of psychosomatic diseases.

“The human body was created as the highest resource of nature and, thanks to the plastic properties of its central nervous system, it is able to self-repair and improve itself. If only the appropriate conditions were created.”

It is required to eliminate annoying stress factors and ensure contact with nature with love for it, a positive attitude and good mood, daily routine, a healthy lifestyle; physical therapy is needed for neurosis, massage and other physiotherapy procedures, spa treatment.

Therapeutic gymnastics for neurosis will be of great benefit if you learn how to move correctly.

“The main thing in movement is the ability to liberate the muscles, trust them, give them the opportunity to contract freely and relax in a natural rhythm. Then only those of them that are absolutely necessary at a given moment for a given character of movement will work. The rest will have the opportunity to rest. But this must be learned, and learned by everyone. The system of natural healing includes exercises, the purpose of which is to teach a person the art of movement against the backdrop of relaxation. (G.S. Shatalova "Choice of the path").

Exercises for neurosis stimulate the production of endorphins, harmonize the nervous system and the whole body as a whole, providing a therapeutic effect in conjunction with proper nutrition, breathing, hardening and spiritual work on oneself in order to cultivate good positive feelings, emotions, thoughts and actions. Life according to the laws of good makes a person happy and mentally healthy.

Chapter 19 exercise therapy for neuroses

Neurosis- this is a long and pronounced deviation of higher nervous activity from the norm due to overstrain of nervous processes and changes in their mobility. At the heart of pathophysiological changes in neuroses are violations of: the processes of excitation and inhibition; relationships between the cortex and subcortex; normal relationships of the 1st and 2nd signal systems. Neurotic reactions usually occur to relatively weak, but long-acting stimuli, leading to constant emotional stress.

In the development of neuroses, an important role is played by a critical overstrain of the main nervous processes - excitation and inhibition, an excessive requirement for the mobility of nervous processes. Neuroses in people have a social nature, their occurrence and development are determined by psychogenic disorders. Experiences, various negative emotions, affects, anxious fears, phobias (fears), as well as constitutional predisposition are important.

Neurosis can also develop secondarily, on the basis of past illnesses and injuries.

Experts distinguish three main forms of neurosis: neurasthenia, hysteria and psychasthenia (compulsive disorder).

Neurasthenia (asthenic neurosis). It is the most common type of neurosis and is characterized by a weakening of the processes of internal inhibition, increased mental and physical fatigue, absent-mindedness, and a decrease in working capacity. At the initial stage of neurasthenia, a person becomes irritable, does not tolerate emotional and physical stress; he has tearfulness, touchiness, dissatisfaction with himself. Patients do not tolerate bright light, harsh noise, loud speech, temperature changes. Mental activity is hampered by constant headache, throbbing or noise in the head. There are also palpitations, excessive sweating, sleep disturbance (drowsiness during the day, and insomnia at night).

In most cases, neurasthenia has a favorable outcome - especially in cases where it is possible to resolve the situation that caused emotional stress.

At psychasthenia (compulsive disorder) the 2nd signaling system predominates with congestive excitation in the cerebral cortex. This disease is characterized by inertness of cortical processes, their low mobility. In the brain, foci of pathological stagnation are formed - “sick points”. Psychosthenia is characterized by obsessive thoughts, ideas, obsessive fears, or phobias (fear of space, position, transport, etc.). Obsessive compulsive disorder, unlike other neuroses, is characterized by a protracted course - especially in people prone to suspiciousness and anxiety.

At hysteria (hysterical neurosis) the functions of the subcortex and the influence of the 1st signaling system predominate. Violation of the coordination of the cortex and subcortex contributes to increased excitability, mood swings, mental instability, etc.

Hysteria is characterized by movement disorders (hysterical paresis and paralysis, hyperkinesis, tics, tremors), autonomic disorders and sensitivity disorders.

There may also be seizures in the form of various crises (hypertensive, cardiac), asthma attacks, prolonged sobbing (usually in public). Often these seizures are similar to epileptic ones, but unlike the epileptic, hysterics do not cause serious injury to themselves.

The treatment of neuroses is complex: the creation of a favorable environment, the elimination of a traumatic situation; or softening the patient's response to it; restorative treatment; the use of tranquilizers, psychotherapy, physiotherapy exercises.

Tasks of exercise therapy for neurasthenia:

– training of the process of active braking;

– normalization (strengthening) of the excitatory process.

Exercise therapy classes should be carried out in the morning, during the minutes; For the most debilitated patients, it is better to start the first few days with 10-minute sessions. The amount of load and the number of exercises should be minimal at first and increase gradually. Initially, simple exercises should be included in the classes; in the future, you can use exercises with more complex coordination of movements. An increase in the emotional tone of patients is achieved by using sports games according to simplified rules (volleyball, table tennis, croquet, golf, gorodki) or elements of various games.

Patients with neurasthenia benefit from walks, close tourism, and fishing; they contribute to the unloading of the neuropsychic sphere, ensure the switching of patients from daily activities to other activities, and have a training effect on the cardiovascular and respiratory systems.

Tasks of exercise therapy for hysterical neuroses:

– decrease in emotional excitability;

- development of the inhibitory process in the cerebral cortex;

- creating a stable calm mood.

Classes should include exercises for attention, accuracy of execution, coordination and balance. The pace of movements should be slow; the voice of the methodologist and the musical accompaniment should be calm. In the classroom, you should predominantly use the method of explanation, rather than showing exercises. It is advisable to use whole combinations of gymnastic exercises. In addition, exercises in balance, jumping, throwing, some games (relay races, towns, volleyball) are recommended.

With hysterical contractures and paralysis, exercises should be addressed to muscle groups not involved in them. To achieve differentiated inhibition, it is necessary to simultaneously perform various movements of the left and right hand or foot.

The group involved should include no more than 10 people. Commands should be given slowly, smoothly, in a conversational tone. The exercise therapy instructor must notice and correct all the mistakes of those involved.

Tasks of exercise therapy for psychasthenia:

- activation of vital processes;

- "loosening" of the pathological inertia of cortical processes;

- removing the patient from the oppressed moral and mental state, facilitating his communication with others.

In the classroom, emotional exercises are used, performed at a fast pace. It is recommended to use emotionally colored exercises that are well known to the patient, without focusing on the accuracy of their implementation. Errors should be corrected by showing the correct performance by one of the patients. In this regard, it is advisable to include convalescent patients in the group, more emotional and with good plasticity of movements.

In obsessive states of great importance is the appropriate psychotherapeutic preparation of the patient, explaining the importance of performing exercises to overcome feelings of unreasonable fear. It is necessary to use the game method of conducting classes more widely, as well as performing exercises in pairs. The methodologist's voice and musical accompaniment should be cheerful.

An increase in the pace of movements contributes to an increase in emotional tone. This category of patients is characterized by a slow pace: at first, from 60 to 120 movements per minute, then from 70 to 130, and in subsequent classes - from 80 to 140. In the final part of the lesson, it is necessary to slightly reduce the load and its emotional coloring.

The most beneficial for patients with neurosis is a sanatorium regimen. Rehabilitation measures in sanatorium-resort conditions have a general strengthening effect on the body, contribute to its hardening, increase efficiency and psychological stability. For this purpose, walks, excursions, sports games, swimming pool activities, elements of sports, and tourism are widely used. The arsenal of means necessarily includes general massage, various types of psychotherapy and physiotherapy (oxygen therapy, water procedures, sulfide and iodine-bromine baths).

Control questions and tasks

1. Describe the main disturbances in the central nervous system in neuroses.

2. Neurasthenia and its clinical manifestations.

3. Psychasthenia and its characteristic features.

4. Hysteria and its characteristic features.

5. What are the tasks and means of exercise therapy for neurasthenia?

6. What are the tasks and methods of exercise therapy for hysteria?

7. What are the tasks and methods of exercise therapy for psychasthenia?

Neurosis Treatment of neurosis in children and adults

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Gymnastics for neuroses

Gymnastics for neuroses

Under the general name "neuroses" (the modern term is "neurotic disorders") several functional disorders of the psyche are combined. The causes of these serious diseases are very different: complications of other diseases, side effects of medications, prolonged overwork, stress and nervous overload, etc. The practical experience of doctors shows that an integrated approach is most effective for treating neuroses, which includes creating favorable conditions, taking special drugs, psychotherapy and exercise therapy (LFK). However, often physical activity is completely undeservedly neglected.

Neurosis: main forms and symptoms

Three main forms of neurotic disorders are diagnosed. Each of them differs in symptoms and requires specific treatment, which includes a special set of therapeutic exercises.

• Neurasthenia is manifested in increased excitability, irritability, fatigue and absent-mindedness.

• Hysteria is accompanied by aggressive behavior, an obsessive desire to provoke conflict and be the center of attention, unstable self-esteem.

• Psychasthenia consists in constant obsessive experiences, low self-esteem, self-doubt, and heavy thinking.

Therapeutic exercise for neuroses

Therapeutic gymnastics coordinates the functioning of the signaling systems, the cortex and subcortex of the brain, positively stimulates and calms the nerves. These features allow the use of exercise therapy, including for the treatment of neurotic disorders.

At the beginning of treatment, classes are held individually. Due to the characteristics of this type of disorder, it is impossible to pay the patient's attention to his possible failures and exercise errors. During training, you need to try to distract the patient from difficult experiences, stimulate a positive mood, form activity and perseverance.

At the initial stage, the training program should consist of simple exercises that do not require much muscle effort and increased concentration. In the future, the load is gradually increased. All exercises should be done calmly and slowly. First, the sessions continue for a minute, and then - for a minute.

With psychasthenia, fast, rhythmic, emotional exercises are performed. Sessions of therapeutic exercises are best done with cheerful music (at the beginning of the lesson, it should be leisurely, then its pace gradually accelerates). The movements of people suffering from this form of mental disorder are stiff and awkward. It is necessary to try to emotionally involve patients, arouse their interest in classes and a speedy recovery - this will allow them to calm down and be liberated. As the treatment progresses, it is necessary to introduce collective game and competitive elements into the complex of exercises.

For the treatment of neurasthenia, exercises are selected that allow you to control the processes of inhibition and excitation of the nervous system. The musical accompaniment of the classes should also be appropriate - leisurely compositions are best suited, lyrical melodies are periodically replaced by cheerful ones and vice versa. In this case, the therapeutic effect will increase if exercise therapy sessions are supplemented with regular morning exercises.

In the treatment of hysteria, exercises are performed for coordination of movements, attention, balance and accuracy of execution. Classes begin at a high pace - 140 movements per minute, and gradually slow down to 80. As the treatment progresses, the speed of the exercises decreases proportionally. Music is selected calm and melodic. You can end the sessions with smooth dances.

To enhance the therapeutic effect, the course of exercise therapy should be accompanied by breathing exercises. In the rehabilitation of patients with respiratory neurosis, the latter is used as one of the main means.

The parts of the brain responsible for the respiratory system are closely connected with the autonomic nervous system. Due to this, the implementation of appropriate exercises allows you to stimulate the processes of excitation and inhibition, and in the future - to normalize them.

In the course of therapeutic exercises, it is necessary to monitor the general condition of the patient, to prevent deterioration of health (as well as exacerbation of other diseases) and overwork. Each set of exercises should be developed by a competent specialist, taking into account the individual characteristics of the patient. Gymnastics can be done independently at home. However, group sessions cannot be neglected, since this type of interaction is extremely important in the treatment of neuroses.

Therapeutic exercises for panic attacks

Panic attacks are unexplained, very distressing attacks of anxiety that are accompanied by intense fear and various somatic symptoms (eg, sweating, choking, nausea, insomnia, rapid pulse). Sometimes patients mistakenly find a relationship between certain behavior and/or environment and seizures. In reality, panic attacks occur spontaneously, but in this case they will be additionally provoked by the corresponding situations. Such attacks often accompany neurotic disorders.

In the treatment of panic attacks, a vicious practice has developed, which consists in the fact that all methods are ignored, except for taking psychotropic drugs. However, in this case, great results can be achieved by an integrated approach, which includes physiotherapy exercises.

The nature of panic attacks is very complex, and the possible causes are sometimes not at all obvious. Therefore, treatment can only be prescribed by an experienced psychiatrist after a thorough diagnosis. Self-treatment in this case almost never brings positive results, on the contrary, it will be more difficult to cope with the problem in the future, and there is also a high probability of serious complications.

Neurosis - Therapeutic exercises for diseases of the nervous system

Neuroses are functional diseases of the nervous system that develop under the influence of prolonged overexertion of the nervous system, chronic intoxication, severe trauma, long illness, constant alcohol consumption, smoking, etc. Predisposition to this disease and the characteristics of the nervous system are also of some importance. The main forms of neurosis: neurasthenia, psychasthenia and hysteria.

Neurasthenia is, by definition of IP Pavlov, a weakening of the processes of internal inhibition, which is manifested by a combination of symptoms of increased excitability and exhaustion of the nervous system. Neurasthenia is characterized by fatigue, irritability, excitability, poor sleep, decreased memory and attention, headaches, dizziness, disorders of the cardiovascular system, frequent mood swings for no apparent reason.

Psychasthenia occurs mainly in people of the mental type (according to I. P. Pavlov) and is characterized by the development of processes of congestive excitation (foci of pathological congestion, the so-called sore points). A person is overcome by painful thoughts, all kinds of fears (whether he closed the apartment, turned off the gas, the expectation of trouble, fear of the dark, etc.). With psychasthenia, frequent nervousness, depression, inactivity, autonomic disorders, excessive rationality, tearfulness, etc. are noted.

Hysteria is a form of functional disorder of the nervous system, accompanied by disorder mental mechanisms and as a result, a violation of the normal relationship between the first and second signal systems with a predominance of the first. Hysteria is characterized by increased emotional excitability, mannerisms, bouts of convulsive crying, convulsive seizures, a desire to attract attention, speech and gait disorders, and hysterical "paralysis".

The treatment of neurosis is complex: the creation of favorable conditions, drug physiotherapy and psychotherapy, physiotherapy exercises.

Physiotherapy exercises are especially indicated for neurosis, as it increases the strength of nervous processes, promotes their alignment, coordinates the functions of the cortex and subcortex, the first and second signal systems.

Exercises are chosen depending on the form of neurosis.

In case of neurasthenia, for example, physical therapy is aimed at increasing the tone of the central nervous system, normalizing autonomic functions and involving the patient in a conscious struggle with his illness.

The tasks of physiotherapy exercises for psychasthenia: increase emotional tone and excite automatic and emotional reactions; in hysteria - to strengthen the processes of inhibition in the cerebral cortex.

With all forms of neurosis, it is important to distract yourself from difficult thoughts, develop perseverance, activity, and evoke positive emotions in yourself.

Due to the increased resentment and emotionality of a person in a state of neurosis at the beginning of classes, attention should not be fixed on mistakes and shortcomings in the performance of exercises.

In the first period of classes, it is advisable to conduct them individually. Apply simple general developmental exercises for large muscle groups that do not require intense attention; perform them at a slow and medium pace. In the future, exercises with more complex coordination of movements can be included in the classes. Classes should be quite emotional. Patients with neurasthenia and hysteria need more explanation of exercises, patients with psychasthenia - show.

In the treatment of hysterical "paralysis" distracting tasks are used (for example, they are asked to change the starting position). So, with "paralysis" hands use exercises with one or more balls. With the involuntary inclusion of a "paralyzed" hand in the work, it is necessary to pay the attention of the patient to this.

As you master the exercises with simple coordination, the exercises include exercises to maintain balance (on the bench, balance beam), as well as climbing, on the gymnastic wall, various jumps, and swimming. Walking, walking, fishing also contribute to the unloading of the nervous system, relieve irritation, strengthen the cardiovascular and respiratory systems.

The duration of classes in the first period is 10-15 minutes at the beginning, and as you adapt - 35-45 minutes. If the load is well tolerated, then in the second period, exercises are introduced into the classes that develop attention, accuracy of movements, coordination, dexterity, and speed of reaction. To train the vestibular apparatus, exercises are performed with closed eyes, circular movements of the head, torso tilts, exercises with a sudden restructuring of movements while walking, running. Widely used outdoor games, walking, skiing, cycling, volleyball, tennis.

Neurasthenia

With neurasthenia, therapeutic exercises “train” the process of active inhibition, restore and streamline the excitatory process. Physiotherapy exercises, in addition to the mandatory morning exercises, should be carried out in the morning for 15-20 minutes. Starting position - sitting. In the first week of classes, general developmental exercises are performed 4-6 times in a row, and breathing exercises - 3 times. As you master the exercises, the number of repetitions increases up to 10 times, and the duration of classes - up to 30-40 minutes.

During the exercise, pain may occur (palpitations, dizziness, shortness of breath) - this must be taken into account and the load must be adjusted so as not to get tired. To do this, you need to stop exercising and take a break. Exercises should be varied - then they will not get bored and you will not lose interest in physical education.

Psychasthenia

Psychasthenia is characterized by anxious suspiciousness, inactivity, focusing on one's personality, on experiences. Therapeutic physical training helps to bring the patient out of an oppressed moral and mental state, distract him from painful thoughts, and facilitate communication with people.

Emotional, fast paced exercises are recommended. The music accompanying the classes should be cheerful, its pace should be moderate, turning to fast. It is necessary to widely use games, relay races, elements of competitions, dances.

In the future, to overcome feelings of inferiority, low self-esteem, shyness, it is advised to include exercises to overcome obstacles, to maintain balance, and strength exercises in classes.

Patients with psychasthenia are characterized by non-plastic motor skills, clumsiness of movements, awkwardness. They tend to not know how to dance, so they avoid and dislike dancing. In obsessive states, appropriate psychotherapeutic preparation is of great importance. It is important to understand that exercise will help overcome feelings of unreasonable fear.

To increase the emotional tone, exercises are used in pairs, with overcoming resistance, games; to suppress feelings of indecision, self-doubt - exercises on shells, to maintain balance, jumps.

In order to excite automatic reactions and raise the emotional tone, it is necessary to accelerate the pace of movements: from 60 movements per 1 minute (this is a slow pace characteristic of psychasthenics) to 120, then from 70 to 130 and subsequently from 80 to 140. The final part of the classes includes exercises, contributing to some decrease in emotional tone. After doing therapeutic exercises, a good mood should arise.

An approximate set of exercises for psychasthenia

1. Walking in a circle alternately in one direction and the other, with acceleration - 1-2 minutes.

2. Walking in a circle on toes alternately in one direction and the other, with acceleration - 1 min.

3. Starting position - standing, arms along the body. Relax all muscles.

4. Starting position - the same. Alternately raise your hands up (starting from the right), accelerating movements - from 60 to 120 times in 1 minute.

5. Starting position - feet shoulder-width apart, hands clasped into a "lock". At the expense of 1-2, raise your arms above your head - inhale; at the expense of 3-4 lower through the sides - exhale. Repeat 3-4 times.

6. Starting position - arms extended in front of the chest. Squeeze and unclench your fingers with acceleration - from 60 to 120 times in 1 minute. Run 20-30 s

7. Starting position - feet shoulder-width apart, hands clasped into a "lock". At the expense of 1, raise your arms above your head - inhale; at the expense of 2, sharply lower down between the legs, exhaling loudly. Repeat 3-4 times.

8. Starting position - legs together, hands on the belt. At the expense of 1-2 sit down - exhale; stand up at the expense of 3-4 - inhale. Repeat 2-3 times.

9. Starting position - standing on toes. At the expense of 1, go down on your heels - exhale; at the expense of 2, rise on your toes - inhale. Repeat 5-6 times.

10. Exercises in pairs to overcome resistance:

a) starting position - standing facing each other, holding hands, bent at the elbows. In turn, each resists with one hand, and straightens the other. Repeat 3-4 times;

b) starting position - standing facing each other holding hands. Leaning against each other with your knees, sit down, (arms straight), then return to the starting position. Repeat 3-4 times;

c) the starting position is the same. Raise your hands up - inhale, lower - exhale. Repeat 3-4 times;

d) and, p. - the same. Put your right foot on the heel, then on the toe and make three stomps with your feet (dance pace), then separate your hands and clap your hands 3 times. The same with the left foot. Repeat 3-4 times with each leg.

11. Starting position - standing facing the wall 3 m from it, holding the ball. Throw the ball with both hands so that it hits the wall and catches it. Repeat 5-6 times.

12. Starting position - standing in front of the ball. Jump over the ball, turn around. Repeat 3 times on each side.

13. Exercises on shells:

a) walk along the bench (log, board), maintaining balance. Repeat 2-3 times;

b) jumping from the gymnastic bench. Repeat 2-3 times;

c) starting position - standing at the gymnastic wall, holding hands extended forward at shoulder level, by the ends of the rack. Bend your elbows, press your chest against the gymnastic wall, then return to the starting position. Repeat 3-4 times.

14. Starting position - standing, arms along the body. At the expense of 1 - 2, rise on your toes - inhale; at the expense of 3-4 return to the starting position - exhale. Repeat 3-4 times.

15. Starting position - the same. Alternately relax the muscles of the arms, torso, legs.

Hysteria

Hysteria, as already mentioned, is characterized by increased irritability, emotional instability, frequent and rapid mood swings, tearfulness and loudness.

Physical therapy in hysteria helps to get rid of emotional instability and "explosions" of irritability, increases activity, enhances conscious-volitional activity, creates a stable calm mood.

Classes should include exercises for attention, accuracy of performance, coordination and balance (on different areas of support), dance steps to pleasant melodic music, then move on to smooth dances (waltz, slow foxtrot). The pace is slow. It is necessary to calmly, but accurately perform all movements.

The first classes begin with an accelerated pace characteristic of this group of patients - 140 movements per 1 minute and reduce it to 80, subsequently - from 130 movements to 70, then from 120 to 60.

The so-called differentiated inhibition is developed with the help of simultaneously performed, but different movements for the left and right hands, left and right legs. They also include strength exercises on shells at a slow pace with a load on large muscle groups.

As already mentioned, patients with neurasthenia are characterized, on the one hand, by increased excitability, and on the other, by increased exhaustion, which is a manifestation of the weakness of active inhibition and the disorder of the excitatory process. These patients are easily injured, often fall into a depressed state.

When prescribing exercise therapy, first of all, it is necessary to find out the causes of the appearance of neurasthenia, tk. without removing these causes, the treatment will be ineffective explaining to the patient the causes of the ailment, his active participation in his treatment provide significant assistance in eliminating the disease.

For patients with neurasthenia, the use of exercise therapy with its regulatory effect on various processes in the body is literally a pathogenetic form of treatment. In combination with the ordering of the daily routine, drug treatment, and physiotherapy, a gradual increase in load improves the functions of blood circulation and respiration, restores the correct vascular reflexes, and improves the activity of the cardiovascular system.

When organizing and conducting therapeutic exercises with patients with neurasthenia, the target setting should be based on the need to train and strengthen the processes of active inhibition, restoration and regulation of the excitatory process.

The means and methods of therapeutic exercises for this group of patients should take into account all these features.

First of all, based on the increased fatigue of patients, the lack of a feeling of cheerfulness in freshness, especially after sleep and in the first half of the day, therapeutic exercises, in addition to the obligatory morning, hygienic gymnastics, should be carried out in the morning, the dosage of the duration and number of exercises should increase very gradually and start with minimal loads.

With the most weakened, asthenic patients, it can be recommended to start classes for several days with a general 10-minute massage, passive movements lying in bed or sitting.

The duration of the lessons is no more than 10 minutes. It is recommended to include repeated breathing exercises.

In view of the abundance of somatovegetative disorders and complaints, preliminary psychotherapeutic preparation and removal of very frequent cases of iatrogeny are required; in the process of training, the methodologist should be prepared to ensure that, without fixing the patient's attention on various painful sensations (for example, palpitations, shortness of breath, dizziness), regulate the load so that the patient does not get tired, so that he can stop the execution without any embarrassment exercise and fail. There is no need to demand the accuracy of the exercises, but gradually the patient needs to be more and more involved in classes, more and more to increase interest in them, diversify the exercises, introduce new means and forms of exercises.

In some cases, especially at the beginning of the application of therapeutic exercises, the reaction to the load may be increased, and therefore it should be strictly commensurate with the adaptive capabilities of patients.

It should also be taken into account that it is difficult for patients to focus attention - it quickly weakens. Patients do not believe in themselves, in connection with which they shy away from performing difficult tasks; if they fail at something, they proceed to solve a similar problem in the future without faith in success. Knowing this, the methodologist should not give unbearable exercises to the sick. It is necessary to complicate them gradually, to explain and show very well.

At the beginning of classes, patients may be absent-minded, disinterested. Therefore, the methodologist should, first of all, educate them in a positive attitude towards physical exercises. It is necessary to develop a training methodology in advance and conduct it purposefully, in a relaxed manner.

Lessons can be done both individually and in groups.

When the patient is overworked, individual sessions are held to establish close contact with him, to identify his individual reactivity and to select adequate physical exercises. Such patients are recommended to self-study after a preliminary explanation of the content of the exercise. at the same time, periodic monitoring is carried out, adjustments are made to the methodology for conducting exercises.

One of the very important elements of classes should be not only their musical accompaniment, but also the use of music as a healing factor, as a means of sedation, and stimulating, exciting. When selecting musical melodies, the tempo of the musical accompaniment of classes, it is recommended that music be soothing, of moderate and slow tempo, combining both major and minor sounds. You should choose simple melodic music, you can use beautiful arrangements of folk songs.

The scheme of lessons of therapeutic gymnastics for patients with neurasthenia.

1. Introduction. Introduction to the lesson. A gradual increase in difficulty and the number of exercises, a gradual increase in effort.

2. The main part. Further gradual complication of exercises and efforts. Increased emotional tone.

3. Final part. Gradual decrease in physical effort and emotional tone.

Methodology.

The duration of the lesson at first is relatively small 15-20 minutes, but then it is gradually increased and brought up to 30-40 minutes. The exercises are very simple at first, not requiring any physical effort. Gradually, starting from the 5th-7th lesson, elements of the game are introduced into the lesson, especially ball games, and in winter also skiing.

The introductory part lasts 5-7 minutes. In the future, its duration does not increase; the total duration of the lesson is extended only at the expense of the main part. The lesson begins with walking in a circle, at first at a slow pace, then the pace accelerates somewhat.

Walking continues for 1 minute. Free movements: arms from 4 to 10 times, body - each from 4 to 10 times, legs - each from 4 to 10 times, sitting and lying exercises - each from 4 to 10 times.

The main part, as already mentioned, is gradually changing both towards complication and towards longer duration. In the first 5-7 lessons, exercises with gymnastic sticks are included, each 4-12 times, on the gymnastic bench - from 2 to 8 times. In summer, ball games are included, especially rounders, and in winter - skiing. The duration of the ball game should not exceed 10-15 minutes. Walking on skis should not exceed 30 minutes, the distance should not exceed 2-3 km, the pace of walking should be walking, attempts to walk with a fast, athletic step should be stopped. There should be no steep ascents or descents. You can organize skiing from the mountains, but only gently sloping.

In the final part of the lesson, you need to gradually reduce the number of movements of those involved, make them slower. Breathing exercises are applied (from 4 to 8 times). After the lesson, you should carefully inquire about the well-being of patients, and during the course of therapeutic physical culture, periodically find out the state of sleep, appetite, emotional balance, and if some indicators worsen, find out if they are associated with an overdose of therapeutic exercises.

It is recommended to use exercises with alternate muscle contraction and relaxation, breathing exercises, exercises for the upper and lower extremities should be performed at an average pace, with a small amplitude. In the future, swing exercises for the limbs, exercises that require some tension, exercises with overcoming resistance are added. Hand exercises should be combined with exercises for the body; exercises that require speed and significant muscle tension - with breathing exercises. In the main part of the lesson, various exercises with the ball in a playful way should be introduced - the ball in a circle with various ways of throwing, relay games with the transfer of balls and other objects, relay combinations with jogging, with various tasks (jumping over a gymnastic bench, climbing over an obstacle) . These exercises should be alternated with relaxation exercises and breathing exercises.

During the entire course of treatment, the most serious attention should be paid to the emotional side of the classes. The instructor's team should be calm, demanding, accompanied by short and clear explanations, should contribute to the manifestation of cheerfulness and good mood in the process of training.

In addition to outdoor games, it is recommended to use various sports games: croquet, skittles, towns, volleyball, tennis. Depending on the patient's condition, his fitness, individual reactions (pulse, fatigue, irritability, behavior in a team), games such as volleyball and tennis should be dosed, allowing a game with a time limit (from 15 minutes to 1 hour), short pauses should be introduced and breathing exercises, simplified rules of the game.

Of the sports-applied exercises that help overcome feelings of insecurity, fear and other neurotic reactions in patients, it is recommended to use exercises in balance on a narrow and elevated support area (bench, log, etc.), climbing, jumping, jumping, and jumping into water with gradual complication, swimming, exercises in throwing balls, etc. The special benefit of skiing in winter and regular walking and short-range tourism in summer, spring and autumn should be emphasized. They have a training effect on the circulatory system, respiration and increase the functional adaptability of the patient's body to various physical loads. Skiing educates and develops confidence, determination and has a beneficial effect on the function of the vestibular apparatus. Skiing has a positive effect on the neuropsychic sphere of patients with neurasthenia, which is associated with favorable environmental conditions. Active muscular activity in the frosty air increases the overall tone and creates a cheerful mood. The beauty of changing landscapes, especially in sunny weather, and silence evoke joyful emotions in patients, contributing to the unloading of the nervous system from the usual type of professional activity.

In summer, autumn and spring, regular dosed walks in the air at various times of the day, depending on the patient's work regime, acquire great therapeutic and prophylactic significance. Of particular benefit are walks outside the city, which have a positive effect on the neuropsychic sphere, distracting the patient from "going into the disease."

For these patients, strict regulation of the regimen is useful, especially the alternation of sleep and wakefulness, as well as the alternation of active forms of exercise therapy with passive outdoor recreation.

Depending on the interests of the patient, it is also possible to recommend fishing and hunting, which cause joyful emotions and actively influence the restructuring of the neuropsychic sphere.

With the hyposthenic form of neurasthenia, the training methodology is somewhat different; the main goal of using therapeutic exercises in this variant of neurasthenia is the careful training of the excitatory process, and only then the strengthening of active inhibition. Even in those cases when patients themselves begin to participate too actively in therapeutic physical culture, such excesses must be limited in a timely manner, since an overdose during hyposthenia can significantly worsen the condition of patients. Therapeutic physical culture in the hyposthenic form of neurasthenia is also shown to improve somatic indicators.

Most patients, due to severe exhaustion, spend most of the day in bed or sitting. Therefore, they easily experience detraining phenomena, when even getting out of bed causes a significant increase in heart rate, shortness of breath.

It is expedient to carry out the first 5-7 days of exercise in the ward, without bringing patients into the hall, and some should first be advised to practice while sitting in bed. The duration of the lesson is 5-10 minutes; only after 5-7 days of classes can you increase the duration of the lesson to 20-30 minutes.

The introductory part in the first week of classes, in fact, exhausts the entire lesson plan. It consists of very slow floor exercises performed without any tension (4-8 times). Walking can be recommended starting from the second week of classes, it should be slow, small steps. As with the hypersthenic variant, with hyposthenia, the duration of the introductory part of the lesson does not exceed 5--7 minutes.

The main part of the lesson joins the introductory only starting from the 2nd week of the lesson. The duration of the main part in the 2nd week is 5-7 minutes, then it is gradually lengthened to 12-15 minutes. In this part, simple exercises are performed with a volleyball (7-12 times), gymnastic sticks (6-12 times). times, throwing a basketball into the basket).

When prescribing therapeutic physical culture to such patients (with severe asthenia and a sharp violation of adaptation to physical exertion), it is necessary to further limit physical activity, that is, to prescribe the most lightweight, simple exercises in construction. During the procedure, pauses for rest are included, exercises are introduced in light initial positions (lying and sitting), for the purpose of general toning, they include corrective exercises and with dosed tension, which alternate with breathing exercises. Exercises are also used to develop the function of the vestibular apparatus. Classes are conducted individually or in small groups.

If expressed in scientific terms, it should be said that neurosis is a mental illness, which is characterized by various kinds of disorders. That is why it is worth considering what this violation is and what kind of psychological work is being done with neuroses.

In general, such a diagnosis as - neurosis is not unambiguous, the fact is that at the present time its origin is influenced by a lot of reasons. In order to better understand the problem, consider the main causes that affect the occurrence of the problem:

1. stressful situations. The fact is that most often the causes of any kind of mental disorders are two factors: depression, and its duration. In general, minor stressful situations temper a person’s character, but this should be only in moderation. But depression, it will not only aggravate the situation, but also provoke psychoses.
2. Prolonged fatigue. The presented symptom is observed in those people who work excessively and practically do not rest. The deterioration of the condition occurs due to the fact that the stress accumulates for a long time and often it is simply not noticeable. Problems begin to appear at the moment when the allowable limit is overcome. It must be remembered that even if the work brings great pleasure, it becomes very tiring, therefore, in order to avoid neurosis, everyone should at least rest a little.

In general, there are many more reasons for the occurrence of the presented violation, the above are just the main ones.

Manifestation of pathology:

1. Excessive fatigue. This is not only a consequence, it is also a cause.
2. Focusing on stressful situations. Most people react to stressful situations extremely negatively, and in some cases fearfully. The fact is that it is at such moments that the level of resistance to stress becomes less and the person ceases to think sensibly and does what he does not want.
3. Decreased brain performance. The reason for this trouble is simple - a person has been focused on negative emotions for a long time, due to which the brain is simply not able to switch to other tasks. Scientists have proven that a person is not multitasking, since this “function” is inherent only in computers. That is why, with anxiety, most of the attention goes in the negative direction.

Exercise therapy for neuroses

Initially, it should be noted that exercise therapy for neuroses is very useful in its most diverse directions. Any of the selected types of classes must take place in a calm environment, without excessive physical or emotional stress. In addition to all this, it is necessary that physiotherapy exercises be carried out exclusively according to the prescription of a specialist with his special recommendations. This is due to the fact that it is the doctor who can choose necessary exercises for a specific case.

It is wonderful when the prescribed physical education is performed in the fresh air. The fact is that it is the exposure to natural sunlight and the sounds of wildlife that will have a beneficial effect on improving the patient's condition. Strengthening physical activity should be carried out gradually. During the treatment period, a person needs not only physical activity, but also psychological (to divert attention from negative thoughts).

A significant place is occupied by respiratory gymnastics in neuroses. Such physical education can be divided among themselves into static (when during the action the arms and legs of a person remain motionless) and dynamic (in this embodiment, moving parts of the human body take part). In the process of carrying out such exercises, the work of all internal organs and tissues in the body is significantly improved.

A very important aspect is that physiotherapy exercises should be carried out only with an experienced instructor. A great option would be to carry out such exercises, for example, in a pool or on a pond. The fact is that it is water exercises that bring great benefits to the human body, relaxes, distracts from unnecessary negative thoughts and emotions, and also provides a kind of massage on the tissues and organs of the human body.

Many people think - “Well, why can’t I choose a set of exercises for myself? There's so much on the internet right now." But you should not do this, because it is better to contact a specialist and follow his recommendations until the condition is completely stabilized. You can not be excessively tired after the exercises, as the feeling of fatigue will only worsen the situation. All loads should be carried out gradually.

It should be remembered that the prescribed physiotherapy exercises will directly depend on the general condition of a person.

Thus, when hysterical, you need to choose active activities, but only those that will be aimed at braking, during the exercises you should use calm music. You should not be inclined to intense games due to the fact that this can further unbalance an already shattered mental state.

Patients with such a diagnosis are better off undergoing treatment in a sanatorium. The thing is that it is in such conditions that not only drug treatment will be carried out in conjunction with exercise therapy, but also extra work with a psychologist.

Breathing exercises for neurosis

Before you directly start working on the exercises, you need to master the correct breathing technique. In order to do this, you need to sit or stand in such a way that your back is straight and your mouth is closed. Breathing should be done through the nose. We take a deep breath, during which there is a feeling that the air enters all the respiratory organs and imagine that the stomach begins to stretch.

Having already reached the maximum in the exercise, you need to hold your breath for a few seconds and slowly begin to exhale the air. This is done in reverse order. Initially, the air should come out of the chest and lastly from the abdomen. This type of breathing is called complete and in order for everything to work out, you need to practice a little.

Many people are accustomed to breathing chest breathing (the case when the air fills only the chest space). This type of breathing is superficial and greatly limits the real possibilities of a person. In eastern countries, such breathing is considered not normal.

You need to practice the full breathing technique and you don’t need to panic if your head starts to feel dizzy at first, you shouldn’t immediately say to yourself - I can’t, this is a normal phenomenon for an unaccustomed organism. The thing is that in this way the body will respond to a large amount of oxygen, which begins to enter the body.

Heart reserve. Dosing of physical activity

In the process of conducting physiotherapy exercises, it is simply necessary to clearly dose the loads depending on the age criteria of the patient, his pulse at rest, the diagnosis, and also on the doctor's prescription. With neurosis and in the process of its treatment, taking into account the entire reserve of the heart, it is by no means possible to use it more than 100%. That is why it is worth strictly adhering to the appointments of specialists that relate to stress, especially if there are already problems with the heart or with the respiratory system. In addition to full control of the pulse, one should carefully monitor the general condition of the person and be sure to pay attention to the possible appearance of shortness of breath, skin color, sweating, coordination of movements, and the presence of pain.

In order to avoid all sorts of problems in the rehabilitation process, you must strictly adhere to the recommendations and in no case overdo it with classes.

And in general, in order to avoid the pathology presented, you do not need to overwork, because everyone needs rest, do not be nervous, as this adversely affects the state of the whole organism. You need to live and enjoy everything around you and then everything will be fine!

If it is easier to relate to life, then you can easily avoid nervousness. But if stress occurs, then just do physiotherapy exercises and the stress will immediately pass. The main thing is not to be lazy and regularly engage in sports activities.

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Therapeutic exercise for diseases of the nervous system

Introduction

1. Therapeutic exercise for neurosis

2. General principles of the methodology of therapeutic physical culture

2.1 Neurasthenia

2.2 Psychathenia

2.3 Hysteria

Conclusion

Bibliography

exercise physical education neurosis psychasthenia hysteria

Introduction

Therapeutic physical culture (or exercise therapy for short) is an independent medical discipline that uses the means of physical culture to treat diseases and injuries, prevent their exacerbations and complications, and restore working capacity. The main such means (and this distinguishes exercise therapy from other methods of treatment) are physical exercises - a stimulator of the vital functions of the body.

Therapeutic exercise is one of the most important elements of modern complex treatment, which is understood as an individually selected complex of therapeutic methods and means: conservative, surgical, medication, physiotherapy, nutritional therapy, etc. Complex treatment affects not only pathologically altered tissues, organs or systems organs, but for the entire body. The proportion of various elements of complex treatment depends on the stage of recovery and the need to restore the person's ability to work. A significant role in complex treatment belongs to therapeutic physical culture as a method of functional therapy.

Physical exercises affect the reactivity of the whole organism and involve the mechanisms that participated in the pathological process in the overall reaction. In this regard, physical therapy can be called a method of pathogenetic therapy.

Exercise therapy provides for the conscious and active performance by patients of appropriate physical exercises. In the process of training, the patient acquires skills in using natural factors of nature for the purpose of hardening, physical exercises - for therapeutic and prophylactic purposes. This allows us to consider classes in therapeutic physical culture as a therapeutic and pedagogical process.

Exercise therapy uses the same principles of physical exercise as physical culture for a healthy person, namely: the principles of comprehensive impact, application and health-improving orientation. According to its content, therapeutic physical culture is an integral part of the Soviet system of physical education.

1. Therapeutic exercise for neuroses

Neuroses are functional diseases of the nervous system that develop under the influence of prolonged overstrain of the nervous system, chronic intoxication, severe trauma, prolonged illness, constant alcohol consumption, smoking, etc. A certain role in the occurrence of neuroses can be played by the constitutional predisposition and characteristics of the nervous system.

There are the following main forms of neurosis: neurasthenia, psychasthenia and hysteria.

Neurasthenia is based on "a weakening of the processes of internal inhibition and is clinically manifested by a combination of symptoms of increased excitability and exhaustion" (IP Pavlov). Neurasthenia is characterized by: fatigue, increased irritability and excitability, poor sleep, decreased memory and attention, headaches, dizziness, disruption of the cardiovascular system, frequent mood swings for no apparent reason, etc.

Psychasthenia occurs mainly in people of the mental type (according to I. P. Pavlov) and is characterized by processes of congestive excitation (foci of pathological congestion, the so-called sore points). Patients are overcome by painful thoughts, all kinds of fears (whether he closed the apartment, turned off the gas, fear of some kind of trouble, darkness, etc.). With psychasthenia, nervous states, depression, inactivity, autonomic disorders, excessive rationality, tearfulness, etc. are noted.

Hysteria is a functional disorder of the nervous system, accompanied by insufficiency of higher mental mechanisms and, as a result, a violation of the normal relationship between the first and second signal systems, with the former predominating. Hysteria is characterized by: increased emotional excitability, mannerisms, bouts of convulsive crying, convulsive seizures, a desire to attract attention, speech and gait disorders, hysterical "paralysis".

The treatment of neurosis should be comprehensive: the creation of optimal environmental conditions (hospital, sanatorium), drug treatment, physio-, psycho- and occupational therapy, therapeutic physical culture.

Therapeutic physical culture has a direct impact on the main pathophysiological manifestations in neurosis, increases the strength of nervous processes, helps to equalize their dynamics, coordinate the functions of the cortex and subcortex, the first and second signal systems.

2. General principles of the methodology of therapeutic physical culture

The method of therapeutic physical culture is differentiated depending on the form of neurosis. With neurasthenia, it is aimed at increasing the tone of the central nervous system, normalizing autonomic functions and involving the patient in a conscious and active struggle with his illness; with psychasthenia - to increase the emotional tone and excite automatic and emotional reactions; in hysteria - to enhance the processes of inhibition in the cortex of the cerebral hemispheres.

With all forms of neurosis, an individual approach to the patient is necessary. The instructor must be authoritative, evoke positive emotions, exercise a psychotherapeutic effect on patients in the classroom, distract them from difficult thoughts, develop perseverance and activity.
Physical therapy classes are conducted individually and in groups. When forming groups, it is necessary to take into account gender, age, degree of physical fitness, functional state of patients, concomitant diseases.

In the first half of the course of treatment (I period), it is advisable to conduct classes individually to establish contact with patients. Given their increased sensitivity and emotionality, at the beginning of classes, attention should not be fixed on mistakes and shortcomings in the exercise. In this period, simple and general developmental exercises for large muscle groups are used, performed at a slow and medium pace and not requiring intense attention. Classes should be quite emotional. Commands should be given in a calm, clear voice. For patients with neurasthenia and hysteria, exercises should be explained to a greater extent, for patients with psychasthenia, they should be shown.

In the treatment of hysterical "paralysis" distracting tasks are used in changed conditions (in a different starting position). For example, with “paralysis”, the hands use exercises with a ball or several balls. It is imperative to draw the patient's attention to the involuntary inclusion of the "paralyzed" hand in the work.

As sick exercises with simple coordination are mastered, the exercises include balance exercises (on a bench, balance beam), as well as climbing on a gymnastic wall, various jumps, and swimming. Walking, close tourism, fishing during this period also help to unload the nervous system from ordinary stimuli, strengthen the cardiovascular and respiratory systems.

The duration of classes in the first period is 10--15 minutes at the beginning, and 35--45 minutes as you adapt. If the patient tolerates the load of the 1st period well, then in the 2nd period, exercises are introduced into the classes that help improve attention, coordination, increase the speed and accuracy of movements, develop dexterity, speed of reaction. To train the vestibular apparatus, exercises are used with closed eyes, with a sudden restructuring of movements on command during walking, running, circular movements of the head, torso tilts. Mobile and lightweight sports games, walking, short-range tourism, skiing, cycling, volleyball, tennis, etc. are widely used. The second period takes place mainly in sanatorium-and-spa treatment.

2.1 Neurasthenia

As already mentioned, neurasthenia is characterized by increased mental and physical fatigue, irritability, impaired attention and memory, lack of a sense of vigor and freshness, especially after sleep, somatovegetative disorders. Pathophysiologically, these phenomena should be considered as a manifestation of the weakness of active inhibition and the rapid exhaustion of the excitatory process. The tasks of therapeutic physical training are to train the process of active inhibition, restore and streamline the excitatory process. Therapeutic exercises (in addition to the obligatory morning hygienic gymnastics) should be carried out in the morning. The duration and number of exercises should be minimal at first and increase very gradually.

With the most debilitated patients, it is recommended to start the session with a general 10-minute massage, passive movements lying in bed and sitting during the first few days. The duration of subsequent lessons is 15-20 minutes. Then it is gradually brought up to 30-40 minutes. Starting from the 5th - 7th lesson, elements of the game are introduced into the lesson (including with the ball), and in winter - skiing.

In view of the abundance of somatovegetative disorders in patients, their preliminary psychotherapeutic preparation is required. In the process of training, the methodologist must take into account possible painful sensations (palpitations, dizziness, shortness of breath) and regulate the load so that the patient does not get tired, so that he can stop exercising for a while and rest without any hesitation. At the same time, it is necessary to involve him more and more in classes, to increase interest in them due to the variety of exercises and methods of conducting classes.

Musical accompaniment should be an important element of the lessons. Recommended music is soothing, moderate and slow tempo, combining major and minor sounds. Such music plays the role of a healing factor.

2.2 Psychasthenia

Psychasthenia is characterized by anxious suspiciousness, inactivity, focus on one's personality, on experiences. The pathophysiological basis of these features of patients with psychasthenia is the pathological predominance of the second signaling system, the presence of foci of congestive excitation in it, and the inertia of cortical processes. The obsessive states often observed in this case (obsessive thoughts, actions, drives) are a reflection of the excessive inertness of the foci of excitation, and the obsessive fears (phobias) are a reflection of inert inhibition.

The tasks of therapeutic physical training are to "loosen" the pathological inertia of cortical processes and suppress the foci of pathological inertia by the mechanism of negative induction.

These tasks can be solved by exercises that are emotional in nature, fast in pace, performed automatically. The music that accompanies the classes should be cheerful, performed at a pace that changes from moderate to faster, up to allegro. Classes are very good to start with marches and marching songs. It is necessary to widely introduce game exercises, games, relay races, elements of competitions into the complex of physical exercises.

In the future, to overcome feelings of inferiority and low self-esteem, shyness, it is recommended to include exercises to overcome obstacles, balance, and strength exercises in classes.

When forming a group for classes, it is advisable to include several recovering patients, emotional, with good plasticity of movements. This is important because patients with psychasthenia are characterized by non-plastic motor skills, clumsiness of movements, and awkwardness. They tend to not know how to dance, so they avoid and dislike dancing. In obsessive states of great importance is the appropriate psychotherapeutic preparation of the patient, explaining the importance of performing exercises to overcome feelings of unreasonable fear.

To increase the emotional tone, resistance exercises performed in pairs, mass game exercises, exercises with a medicine ball are used; to overcome feelings of indecision, self-doubt - exercises on shells, in balance, jumping, overcoming obstacles.

During classes, the methodologist should by all means contribute to increasing the contact of patients with themselves and with each other.
The task - to excite automatic reactions and raise the emotional tone of patients - is achieved by accelerating the pace of movements: from the slow pace characteristic of these patients of 60 movements per minute to 120, then from 70 to 130 and in subsequent classes from 80 to 140. In the final part of the lesson, exercises that contribute to some decrease in emotional tone. It is necessary that the patient leaves the therapeutic gymnastics hall in a good mood.

An approximate set of exercises for psychasthenia

1. Building in a circle facing inward. Pulse rate counting.

2. Movement in a circle alternately in one direction and the other, holding hands, with acceleration.

3. Movement in a circle on toes alternately in one direction and the other, with acceleration.

4. I. p. - the main rack. Relax, take the position of "at ease".

5. I. p. - the main rack. Alternately raise your hands up (starting from the right) with an acceleration of 60 to 120 times per minute.

6. I. p. - feet shoulder width apart, hands in the castle. 1--2 - raise your arms above your head - inhale, 3--4 - lower your arms through the sides - exhale. 4-5 times.

7. I. p. - hands forward. Squeeze and unclench your fingers with acceleration from 60 to 120 times per minute. 20--30 s.

8. I. p. - feet shoulder-width apart, hands in the castle, 1 - raise your hands above your head - inhale, 2 - sharply lower your hands between your legs with a cry of "ha". 4-5 times.

9. I. p. - legs together, hands on the belt. 1--2 - sit down - exhale, 3--4 - get up - inhale. 2-3 times.

10. I. p. - standing on toes. 1 - get down on your heels - exhale, 2 - rise on your toes - inhale. 5-6 times.

11. Resistance exercise in pairs:

a) standing facing each other, hold hands, bending them at the elbow joints. In turn, each one resists with one hand, and unbends the other at the elbow joint. 3--4 times;

b) standing facing each other, holding hands. Resting your knees on the knees of a friend, sit down, straightening your arms, then rise. 3-4 times.

12. Medicine Ball Exercises:

a) standing in a circle one after another. Passing the ball back over the head. 2--3 times;

b) throwing the ball to each other with two hands at a distance of 3 m.

13. I. p. - standing in front of the ball. Jump over the ball, turn around. 4-5 times.

14. Exercises on shells:

a) balance - walk along the bench, log, board, etc. 2-3 times;

b) jumping from a gymnastic bench, from a horse, etc. 2-3 times;

c) climb the Swedish wall, grab the top rail with your hands, while hanging, take your legs away from the wall to the right and left, 2-3 times. Get down, holding hands and leaning on your feet.

15. I. p. - the main rack. 1--2 - rise on toes - inhale, 3--4 - go down on a full foot - exhale. 3--4 times

16. I. p. - the main stand. Alternately relax your arms, torso, legs.

17. I. p. - the main stand. Pulse count.

2.3 Hysteria

Hysteria, as already mentioned, is characterized by increased emotivity, emotional instability, frequent and rapid mood swings. The pathophysiological basis of hysteria is the predominance of the first cortical signaling system over the second, the lack of balance and mutual coherence between the subcortical system and both cortical systems. The task of therapeutic physical culture in hysteria is to reduce emotive lability, increase the activity of conscious-volitional activity, remove the phenomena of positive induction from the subcortex and create differentiated inhibition in the cerebral cortex.

The implementation of these tasks is achieved with the help of targeted physical exercises. The pace of movement should be slow. It is necessary to calmly, but persistently demand the exact execution of all movements. Classes should include a specially selected set of simultaneous (but different in direction) exercises for the right and left sides of the body. An important methodological technique is to perform memory exercises, as well as according to the explanation of the methodologist without showing the exercises themselves.

The group should be no more than 10 people. Commands should be given slowly, smoothly, in a conversational tone. All errors must be noted and corrected. Classes are held in the absence of unauthorized persons.

A decrease in emotional tone is achieved by slowing down the pace of movements. The first lessons begin with an accelerated pace characteristic of this group of patients - 140 movements per minute and reduce it to 80, in subsequent lessons - from 130 movements to 70, then from 120 to 60.

Differential inhibition is developed with the help of simultaneously performed, but different tasks for the left and right hands, left and right legs. The inclusion of active-volitional acts is achieved by performing strength exercises on apparatus at a slow pace with a load on large muscle groups.

Conclusion

"If you want to live - know how to spin." Live in modern world akin to an endless run. The time in which we live is the time of the accelerated rhythm of life. Take a quick shower, eat a quick sausage, and run to work. At work, everyone also runs. Save time, time is money.

In the modern world, there are a lot of factors that have a negative attitude on the human psyche. These can be problems at work that are systematic and persistent, the lack of an established personal or family life, and many others. Against the background of constant worries about the problematic area, many people develop neuroses.

Physical exercises affect the emotional sphere of the patient, they make him feel cheerful, joyful, distract from various painful experiences, help eliminate uncertainty, anxiety, fear, various "neurotic" manifestations and create a more balanced state. To cheer up a sick person is half to cure him (S.I. Spasokukotsky). In addition, positive emotions that arise especially during the game method of conducting physical exercises excite the functional activity of the body and create favorable conditions for the rest of the nervous system from the monotonous physical and mental labor activity.

The systematic use of physical exercises in the treatment of patients with functional disorders of the nervous system increases their neuropsychic resistance to various environmental stimuli. Physical exercises contribute to balancing the internal properties of the body with the conditions of the external environment, and the central nervous system plays a leading role in this balancing. The use of therapeutic physical culture enriches the conditioned reflex activity of the nervous system of patients.

In conclusion, it should be emphasized that patients with various types neuroses, it is recommended to continue classes at home in the form of morning hygienic gymnastics (the complex should be compiled by a doctor, taking into account the characteristics of impaired functions in this patient), attend health groups, play volleyball, walk more, ride a bike, ski and skate.

Bibliography

1. Moshkov V.N. "Therapeutic physical culture in the clinic of nervous diseases" - Moscow: Medicine, 1982

2. Vinokurov D.A. "Private methods of therapeutic physical culture" - Moscow: Medicine, 1969

3. Kirpechenko A.A. "Nervous and Mental Diseases" - Tutorial- MN.: Vyssh.shk., 1998 Electronic edition.

4. Kozlova L.V. "Fundamentals of Rehabilitation" - Rostov n\D: "Phoenix", 2003

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abstract

List of keywords: neurosis, therapeutic physical culture, neurasthenia, hysteria, psychasthenia, physical exercises, dosage, mode, individual and group lessons, activity, psychotherapy, rest, intensity.

The purpose of the course work: to reveal the essence of neuroses as borderline diseases of the central nervous system, to explore the main issues of the methodology for the use of exercise therapy and other means of physical rehabilitation in the complex treatment and prevention of neuroses.

Research methods: analysis of scientific methodical literature.

Practical significance: the research of this work can be used in their professional activities by specialists practicing in the field of exercise therapy and physical rehabilitation.

Introduction

1. The concept of neuroses and mental disorders

1 Neurasthenia

1.2 Hysteria

3 Psychasthenia

Exercise therapy for these diseases

2 Features of exercise therapy for neuroses

3 Features of exercise therapy for neurasthenia

4 Features of exercise therapy for hysteria

5 Features of exercise therapy for psychasthenia

Disease prevention

Conclusion

Introduction

Treatment and prevention of borderline mental illness (neurosis) is one of the urgent problems of modern medicine.

This problem is quite well covered in the scientific and methodological works of many authors.

A significant contribution to the development of this issue was made by: Kopshitser I.Z., Shukhova E.V., Zaitseva M.S., Belousov I.P. and etc.

In order to write this work, I collected and analyzed information from the scientific and methodological literature on this issue.

After analyzing this information, the following main questions were identified: concepts of neuroses; indications, contraindications and the mechanism of action of exercise therapy in neurosis, features of the exercise therapy technique in various forms of neurosis; the use of other PR methods in the treatment of neuroses; prevention of neurosis by methods of exercise therapy.

When developing these questions, it was possible to find out that correctly delivered physical education is a powerful factor influencing GNI, which is widely used for the prevention and treatment of all types of neuroses.

While working on a course project, I found out that there is a close connection between physical therapy, used in neuroses, with psychology and pedagogy.

When collecting information for work, I managed to find out that the use of exercise therapy is often more justified therapeutically than the use of many medications.

However, unfortunately, exercise therapy is not widely used for the prevention and treatment of neuroses in medical institutions.

1. The concept of neuroses and mental disorders

Functional disorders of the central nervous system include those diseases in which there are no anatomical structural lesions of the nervous system, but functions are significantly impaired. These diseases have a common name - neuroses.

The scientific theory of the development of neuroses was created by I.P. Pavlov. He understood neuroses as chronic deviations of higher nervous activity from the norm of a functional nature, which occurred as a result of an overstrain of nervous processes (excitation and inhibition) or a change in their mobility.

Neurosis is one of the most common types of psychogenic reactions, characterized by mental disorders (anxiety, fear, phobias, hysterical manifestations, etc.), the presence of somatic and autonomic disorders.

Neurotic reactions usually occur to relatively weak, but long-acting stimuli, leading to constant emotional stress.

Neuroses arise as a result of the cumulative action of hazards of both mental and somatic origin and the undoubted influence of environmental conditions. In the occurrence of neuroses, the constitutional predisposition on the basis of the congenital weakness of the nervous system matters.

For the development of neuroses, overwork, overstrain of nervous activity is essential.

The pathophysiological basis of neurosis is: a) disruption of the processes of excitation and inhibition, b) disruption of the relationship between the cortex and subcortex, c) disruption of the normal correlation of signal systems.

Neuroses usually arise on the basis of affects, negative emotions, experiences associated with a number of social, domestic and family relationships. Neuroses can also develop a second time, against the background of previous diseases, injuries. They often lead to a decrease in working capacity, and in some cases to its loss.

What happens in the nervous system in this case?

First of all, changes in higher nervous activity can be expressed in a decrease in the strength of nervous processes. This occurs mainly in cases of overvoltage of one of the processes. In this case, even weak stimuli become superstrong for nerve cells. Nervous processes become inert, inactive. As a result, the foci of the inhibitory or irritable process remain in the cortex for a long time, dominating the entire activity of the organism. Finally, due to the weakness of the cortical cells that carry out higher nervous activity, the cortex loses the function of the highest regulator of all other parts of the brain, in particular, subcortical formations. There is a disintegration of the function of the non-specific system of the brain, which leads to a violation of the adaptive (adaptive) abilities of a person and, accordingly, the appearance of vegetative-endocrine and other disorders. Often suffers from the activity of the heart, blood vessels, gastrointestinal tract. The patient is concerned about the heartbeat, interruptions in the work of the heart. Your blood pressure becomes unstable. Appetite is disturbed, heartburn, nausea, unstable stools, etc. appear. Due to the weakening of cortical processes and their mobility in patients, the change from the irritable process to the inhibitory one occurs very slowly. As a result, at the same time, the cells of the cortex can be either in a state of inhibition, or on the verge of transition from one state to another, or in a state of excitation. Such a phase state of the cortical cells, that is, a state intermediate between wakefulness and sleep, causes a change in their reactivity to various stimuli. If a healthy cerebral cortex gives a response to one or another stimulus the greater, the stronger the stimulus was, then with neurosis this law is violated. In mild cases, both strong and weak stimuli give a reaction of the same magnitude; in severe cases, weak stimuli can cause a more violent reaction than strong ones.

The GND disorders observed in neuroses manifest themselves differently depending on the type of GND. In persons with an average type (without the predominance of one or another signal system), neurasthenia often develops; in persons of an artistic type (with a predominance of the first signal system in the GNI) - hysteria; in the mental type (with a predominance of the second signal system) - psychasthenia.

Neurosis most often occurs in persons with a weak type of nervous processes. Of course, they can also arise and develop in people with a strong manifestation of nervous processes and predominantly unbalanced (cholerics), in whom the processes of excitation predominate over the processes of inhibition. Less often, neuroses are observed in individuals with a strong and balanced type of GNI.

Such people become ill if the irritant is too strong or their nervous system has been weakened by some serious illness or severe overwork.

It has been proven that even a very severe illness cannot cause changes characteristic of a neurosis, but can make the nervous system more vulnerable. Especially often such violations occur with a disease of the endocrine glands.

Depending on the excitatory and inhibitory processes, the following types of neuroses are distinguished: neurasthenia, hysteria, psychasthenia. Pure types of these neuroses are rarely diagnosed.

1.1 Neurasthenia

Neurasthenia is the most common of all types of neuroses.

Neurasthenia is a disease that occurs as a result of excessive tension in the strength or duration of the nervous system, which exceeds the limits of endurance, which is based on a weakening of the process of internal inhibition and is clinically manifested by a combination of symptoms of increased excitability and exhaustion.

Neurasthenia develops most often under the influence of prolonged mental trauma.

Predisposing factors to the occurrence of this neurosis are non-compliance with the regime of work and rest, fatigue, under-recovery of the body from day to day, long-term, unpleasant emotional stress. Of particular importance are constant lack of sleep, intoxication, the transfer of such chronic infections as tuberculosis, chronic purulent inflammation, etc.

Neurasthenia develops gradually. It is characterized, on the one hand, by increased excitability, and, on the other hand, by increased exhaustibility of nervous processes.

Increased excitability of the nervous system is manifested in great irritability, inadequate emotional reactions to minor influences. In the neurological status of patients, there is an increase in tendon and skin reflexes with the expansion of zones. Severe vegetative disorders are observed (excessive sweating, lability of dermographic reactions, sharply positive ortho-clinostatic tests). Patients with neurasthenia cannot stand sharp sounds, strong odors, bright light, and are extremely sensitive to pain and temperature stimuli. There is also an increased sensitivity to sensations from the internal organs, which is expressed in numerous complaints of palpitations, shortness of breath, pain in the head, heart, stomach, limbs, etc. These sensations are usually not perceived by healthy people.

With increased excitability in neurasthenia, the rapid exhaustion of nervous processes is combined, which is manifested by difficulty in concentrating attention, weakening of memory, decreased performance, and impatience. With neurasthenia, as a rule, the state of health worsens, appetite and sleep are upset. The patient has an anxious attention to his condition, lack of confidence in his abilities, he loses interest in life; suspiciousness, obsessive states may occur.

The disease leaves an imprint on the appearance of the patient: his gait is relaxed or impetuous, his expression is sadly concentrated, his body position is hunched over.

Pathophysiological basis of neurasthenia.

Neurasthenic symptoms are due to the weakening of the processes of internal inhibition and excitation in the cerebral cortex.

It must be borne in mind that inhibition moderates excitation. Cells restore their energy resources only when they are in a state of inhibition. Sleep is based on internal inhibition. Since internal inhibition is disturbed (weakened) during neurasthenia, it is understandable why sleep during neurasthenia acquires a superficial character. This, in turn, leads to the fact that the performance of nerve cells is not fully restored, hence the patients feel tired very soon during work.

Violation of attention is explained by the weakening of the processes of inhibition. When a person starts to perform a task, a focus of excitation appears in the cerebral cortex, around which inhibition develops. If the focus of excitation is weak, then the negative induction around it is also insufficient. This leads to the fact that the conditions for the emergence of new foci of excitation are preserved. Therefore, every slight noise begins to distract the patient from the main occupation.

During neurasthenia, two stages are distinguished:

) hypersthenic,

) hyposthenic.

Hypersthenia is characterized by a weakening of the processes of inhibition and the predominance of excitation processes. This stage of neurasthenia is the most common.

Hypersthenia is characterized by the relative preservation of the adaptation of patients to physical activity. Violations in the emotional sphere are expressed in irritability, incontinence, anxiety, and emotional lability. Due to increased excitability, patients have poor self-control and often conflict with others. Their sleep is disturbed - they fall asleep badly and often wake up, they often complain of headaches.

In this category of patients, a number of vegetative-dystonic phenomena take place, and disorders of the cardiovascular system (pain in the heart, tachycardia, increased blood pressure and etc.). Persistent red dermographism, increased excitability of vasomotors, and increased sweating are usually noted. Various vegetative asymmetries are often observed (data from oscillography, capillaroscopy, skin temperature, etc.), especially on the part of blood pressure.

Hypostenia is characterized by the development of diffuse inhibition. The phenomena of asthenia, weakness, and a pronounced decrease in adaptation to physical exertion come to the fore. Patients seem to have lost their stamina and faith in their own strength. A sharp decrease in working capacity is characteristic, which is associated with increased fatigue, both mental and physical. Emotional reactions are pale. Patients are usually lethargic, slow, seek solitude.

Their memory is reduced for both distant and recent events. They constantly experience a feeling of oppression, anxiety, expectation of unpleasant events, they do not trust doctors, they are reluctant to answer questions, they are highly suspicious, impressionable, they listen to painful sensations, overestimate the severity of their condition and, therefore, often require various repeated examinations.

Patients complain (more pronounced) of cardiovascular events. Almost as a rule, they have arterial hypotension, a decrease in vascular lability; they complain of pain and dysfunction of the heart, heaviness in the head, dizziness, unsteady gait, etc. Strengthening of inhibitory functions in the cerebral cortex also extends to the subcortical vegetative centers, causing a decrease in their function.

The prognosis for neurasthenia is favorable. The disease is curable. The cure comes the faster, the sooner the causes that caused the disease are eliminated.

All violations of the functions of the internal organs are not associated with changes in the organs themselves and can be easily eliminated during the treatment of a nervous disease and will not occur in the future.

Hysteria affects both men and women equally. The disease most easily occurs in people with a weak nervous system.

Usually the cause of the development of the disease is a traumatic situation. They matter and internal factors associated with constitutional predisposition, with a number of somatic disorders. Hysteria can be the result of improper upbringing, conflicts with the team, etc.

Hysteria is characterized by increased emotivity, emotional instability, frequent and rapid mood swings.

The pathophysiological basis of hysteria is the predominance of the first cortical signaling system over the second, the lack of balance and mutual coherence between the subcortical system and both cortical systems, which leads to their dissociation and a tendency to diffuse inhibition of the cortex, including primarily the second cortical signaling system, and to positive induction to the subcortical region.

In hysteria, the emotional life of the patient prevails over the rational.

Hysteria is manifested by motor and sensory disorders, as well as disorders of autonomic functions that mimic somatic and neurological diseases.

The variety of symptoms that are observed in hysteria is due to increased suggestibility and self-suggestibility, the patient's ideas about various diseases.

The main symptoms of hysteria are divided into four groups: hysterical seizure, disorder of consciousness in hysteria, somatic disorders and character traits.

Hysterical fit. The onset of a hysterical seizure is more often dependent on some external conditions, especially if they are associated with moments that traumatize the patient's psyche, or if the present situation is somewhat reminiscent of unpleasant experiences of the past. With a hysterical fit, it is not possible to establish any sequence in the movements of patients. This is due to the fact that the nature of the movements often reflects the content of the experiences that the patient has. Consciousness in this case is never completely obscured, one can only speak of a narrowing of the field of consciousness. Therefore, the reaction of patients to the external environment to a certain extent is preserved.

The duration of a hysterical seizure can be from several minutes to several hours. The seizure is always longer if there are people around the patient. Hysterical seizures, as a rule, are more often noted during the day and much less frequently at night. Patients usually do not receive severe injuries.

Disorder of consciousness in hysteria. For hysteria, a twilight state of consciousness is typical. At this time, patients perceive the environment from a certain angle. Everything that happens around is evaluated by patients not as it really is, but in connection with ideas about previous experiences. If the patient imagines that he is in the theater, then he takes all the people around him for spectators or actors, all the surrounding objects - for those that you usually have to meet in the theater. The duration of this state can be calculated in minutes or many hours.

The state of puerilism belongs to hysterical disorders of consciousness. It seems to the patient that he is a small child: an adult begins to play with dolls or jump on a stick. In the manner of speaking, in behavior, patients imitate small children.

The same group of disorders of consciousness includes a picture of pseudodementia (false dementia). Such patients give ridiculous answers to the simplest questions. At the same time, the simpler the question, the more often you can get a ridiculous answer. The facial expression seems to be deliberately stupid: the patients goggle their eyes, intensely wrinkle their foreheads. If with puerilism the patient imagines himself a child, then with pseudodementia he is mentally ill.

Disorders of consciousness such as puerilism and pseudodementia last for weeks, months. somatic disorders. In the area of ​​the somatic sphere, there are various disorders of hysterical origin. The nature of these disorders is associated with the ideas of patients: as the patient imagines this or that somatic or nervous disease, so will its manifestations.

With hysteria, motor and sensory disorders are common. Of the motor disorders, paresis and paralysis (monoplegia, paraplegia, hemiplegia), hyperkinesis are observed. In hysterical paralysis, muscle tone is unchanged, tendon reflexes are not disturbed, there are no pathological reflexes, and there is no atrophy. In other words, in the clinical picture of paralysis there are no signs of an organic lesion of the central or peripheral nervous system. A peculiar movement disorder in hysteria is the so-called astasia - abasia, the essence of which is that the patient cannot stand and walk while maintaining all movements and coordination in the legs during examination in bed. Hyperkinesias in hysteria are of a diverse nature: trembling of the hands, feet, and the whole body.

For a sensitivity disorder (more often anesthesia), it is characteristic that the boundaries of the distribution of sensitivity disorders are not associated with the anatomical location of sensitive conductors. For example, with hysterical hemianesthesia, the border of the sensitivity disorder runs strictly along middle line, during anesthesia in the hands, the sensitivity is violated by the type of "gloves in the legs - in the type of" socks "," stockings ".

In addition, hysterical speech disorders are observed: mutism (dumbness), stuttering, aphonia (silence of the voice) or deaf-muteness (surdomutism). There is hysterical blindness (amaurosis), blepharospasm.

Hysterical temperament. There is increased emotionality. The behavior of patients is closely dependent on their emotional sphere. Their emotions have a significant influence on the flow of ideas.

Character traits include their tendency to fantasize, to lie. When they tell non-existent stories, they are sometimes so carried away that they themselves begin to believe in their plausibility. By any means, these patients strive to be the center of attention.

Patients have an increased love for bright colors. Many of them prefer to dress up in such toilets that draw the attention of others.

Disorders of autonomic functions are often observed: increased sweating, impaired thermoregulation, spasms of smooth muscles. Shortness of breath, tachycardia, cough are noted; disorders of the functions of the gastrointestinal tract (vomiting, intestinal paresis, hiccups), urination, sexual disorders.

Such patients are highly emotional, passionately experience grief and joy, easily move from laughter to sobs and vice versa. For the most insignificant reasons, their mood fluctuates dramatically. Patients are characterized by a tendency to fantasize, to exaggerate, unconscious deceit.

The behavior of patients is characterized by theatricality, mannerisms, devoid of naturalness. Patients are egocentric, their attention is entirely concentrated on their experiences, they seek to arouse sympathy from others. Very typical of hysteria flight into sickness . Violations take on a character conditional pleasantness or desirability . These phenomena can become protracted.

All these disorders have their own physiological basis. Schematically, this can be represented as follows: in the cerebral cortex or subcortical formations, foci of excitatory or inhibitory processes appear, which, according to the law of induction, are surrounded by a process opposite in sign, as a result of which they become decisive for a particular function. Paralysis, for example, is a consequence of the transition of a group of cells into a state of inhibition.

Hysterical neurosis often occurs in mild forms. The signs of the disease are limited to a hysterical temperament and excessive manifestations of the reactivity of patients - a tendency to hysterical crying in traumatic circumstances, dysfunction of internal organs. In more severe cases, the course of the disease is complicated by various combinations of the symptoms described above. Under the influence of treatment or elimination of a traumatic situation, significant improvements can occur in the condition of patients. However, a new mental trauma can again lead to severe disorders.

3 Psychasthenia

Psychasthenia usually develops in people of the thinking type.

It is characterized by the predominance of the second signaling system with the presence of congestive excitation processes in the cerebral cortex. With psychasthenia, there is inertia of cortical processes, their low mobility.

Psychasthenia is manifested by anxious suspiciousness, inactivity, focus on one's personality, on experiences.

The pathophysiological basis of psychasthenia is the pathological predominance of the second cortical signal system over the first, the presence of foci of congestive excitation in it, the inertness of cortical processes, the pathological detachment of the second signal system from the first and through it from the subcortex. The observed obsessive states are a reflection of the excessive inertness of the foci of excitation, and the obsessive fears are a reflection of inert inhibition.

Patients are closed, their emotional mobility is lowered. In patients, increased rationality comes to the fore, an extreme poverty of instincts and drives is noted. The patient often experiences painful doubts and hesitations, does not believe in his own strength, he is overwhelmed by endless reasoning, with which he replaces quick and decisive actions.

Psychasthenics are characterized by a lack of a sense of the real, a constant feeling of the incompleteness of life, complete worthlessness of life, along with constant fruitless and distorted reasoning in the form of obsessions and phobias. Compulsion is characteristic, manifested in three forms: obsessions, obsessive movements, obsessive emotions.

A distinctive feature of these states is that they arise, as it were, in addition to the desire of the patient, who, realizing the absurdity of these states, is, however, unable to get rid of them. Obsessive fears (phobias) include, for example, fear of open spaces, fear of approaching misfortune, fear of water, heights, cardiophobia, etc.

With obsessive actions, we are talking about violent counting, the desire to touch all the windows that the patient passes by, etc.

Patients tend to decrease attention.

Gradually, self-doubt and difficulties in actions increase and manifest themselves in various unpleasant sensations: pain, muscle weakness, up to transient paresis of any muscle group causing stuttering, writing spasm, urination disorders, etc.

Often there may be functional disorders of the cardiovascular system, manifested by tachycardia, extrasystole.

All signs of psychasthenic neurosis appear in patients due to nervous overstrain and may disturb them for a long period. As a result of treatment, they are gradually eliminated, but due to the imbalance of the signaling systems and the weakness of the nervous processes, the new task that life will put before the patient may be unbearable for him, and disorders of higher nervous activity may begin again. If the disease develops in adulthood or old age, then it proceeds relatively easily and is much easier to treat.

With psychasthenia, the symptoms of obsession are so painful for patients that they often make them completely disabled, especially during periods of exacerbation of the disease. Treatment and rest can restore the normal state of nervous processes for a long time, in connection with which the attitude of patients to the environment becomes more correct, their ability to work is restored, and they can take their appropriate place in society.

2. Exercise therapy for these diseases

Physical exercises used in diseases of the nervous system have a versatile effect on the body through nervous and humoral mechanisms. The nervous mechanism is the main one: it not only determines the reaction of the whole organism, but also determines all human behavior in the process of doing exercises.

As a result of the disruption of higher nervous activity, strict coordination in the work of all organs and systems of the body weakens or is sharply violated. Clinically, this is manifested by disturbances in the interaction between mental and systems and usually leads to a decrease in motor activity, which worsens the patient's condition.

Hypokinesia adversely affects the functional state of the whole organism, persistent disorders of the cardiovascular and respiratory systems occur, which favors the further progression of the disease. This implies the need for the use of physical exercises to influence the patient's body as a whole.

Physical exercises contribute to the normalization of the relationship between various body systems. As a result of the restructuring of the relationship between individual systems, the efficiency increases and the functions of various organs improve. Thus, dosed muscular work should be considered as a good regulator of the activity of internal organs.

Physical exercise has a positive effect on the state of the cardiovascular, respiratory and muscular systems. During classes, the amount of circulating blood increases, the blood circulation of the brain increases, the outflow of lymph and venous blood improves, metabolism improves, the return of oxygen from the blood to tissues, muscles, and the heart increases, redox processes accelerate. Physical exercise correlates the activity of all systems, raises the tone of the body and contributes to the restoration of disturbed somatic functions in patients with neuroses.

The action of physical exercises should be considered as the influence of an organized system of stimuli, acting mainly on the motor analyzer, increasing the tone, which in turn affects other parts of the brain. An increase in the tone of the cerebral cortex favorably affects the course of neurosis.

In addition, physical exercises create a background for increasing the effectiveness of complex treatment. The systematic performance of physical exercises improves proprioceptive afferentation and thereby contributes to the normalization of cortical activity and motor-visceral relationships, helps to equalize the ratio of the two signaling systems, and eliminates the main symptoms of the disease. This gives grounds to consider therapeutic physical culture as a method of pathogenetic therapy for patients with neuroses. In addition, physical exercise increases the effectiveness of medicines and other therapeutic agents.

In the process of treatment, the coordinating activity of the nervous system improves, the body's adaptation to the load increases. In the process of physical training, the processes of excitation and inhibition are balanced, which leads to an improvement in the state of many body systems and, in particular, the muscular apparatus. Redox processes in the tissues of the body proceed more perfectly. Physical exercises lead to the strengthening of muscular-visceral-cortical connections and contribute to a more coordinated functioning of the main body systems. This increases the activity of the body's defenses, its compensatory mechanisms and resistance to stress.

Positive emotions increase muscle performance. An important role in increasing the tone of the nervous system is played by positive emotions that arise in the process of performing physical exercises.

Positive emotions distract the patient from painful experiences, improve the activity of the heart, lungs and other internal organs.

The emotional state is reflected in the behavior and motor acts of a person. .

Physical exercises have a positive effect on the human psyche, strengthen his volitional qualities, emotional sphere, and increase organization. .

When performing physical exercises, the interaction of mental, vegetative and kinesthetic factors is carried out.

It is proved that the verbal influence on the patient in the process of classes can affect the function of internal organs, metabolism. With a certain methodology for conducting exercise therapy, it can be considered as one of the methods of active psychotherapy.

Physical exercises have a general hygienic, restorative, tonic effect on the patient's body. They increase the tone of the central nervous system, contribute to the normalization of autonomic functions, divert the patient's attention from his painful sensations.

Physical exercise causes an increase in afferent impulses from the proprioreceptors of the musculoskeletal system in the central nervous system. Reaching the cerebral cortex, the impulses contribute to the alignment of the dynamics of the main nervous processes, the normalization of cortical-subcortical relationships, as well as the restoration of nervous trophism. Activation various departments motor analyzer, including motor neurons of the spinal cord, increases the biopotential of the muscles, their performance, normalizes muscle tone, which is especially important when weakening (paresis) or complete absence (paralysis) of voluntary movements.

The active volitional participation of the patient in physical exercises contributes to the mobilization of the body's reserve capabilities, the improvement of conditioned reflex activity.

The importance of exercise therapy is increasing due to the need for follow-up after discharge from the hospital for maintenance treatment in an out-of-hospital setting. Exercise therapy can and should be one of the means that support remission.

Exercise therapy is an excellent means of involving patients in labor processes (to destroy the fixation of a painful stereotype).

For patients with neuroses, exercise therapy has pathogenetic significance.

It has been proven that afferent impulses cause a change in the excitability of the cerebral cortex in a differentiated way: short and intense physical stresses increase the excitability of the cortex, and prolonged muscle tension decreases it. Some exercises contribute to the stimulation of predominantly cortical processes with the participation of the second cortical signaling system (development of target movements), others stimulate the extrapyramidal and cortical signaling systems (automation of movements). Such differentiation does not depend on physical culture as such, but on the methodology of its application.

Restoration of functions disturbed due to a pathological process by the method of physical exercises is a medical and educational system that provides for the conscious and active participation of the patient in the complex process of exercise.

With neurosis, patients often experience depression of the psyche, lethargy. Under the influence of conscious-volitional performance of physical exercises, psychogenic inhibition decreases and even disinhibition is achieved, due to an increase in the excitability of the nervous system.

Under the influence of systematic training, the function of the conductive nerve pathways and peripheral receptors improves. Training, eliminating peripheral inhibition, as if pushes back the decline in performance. The neuromuscular apparatus becomes more stable.

When performing physical exercises, various reflex connections (cortico-muscular, cortico-vascular, cortico-visceral, muscular-cortical) are enhanced, which contributes to a more coordinated functioning of the main body systems.

Observations show that the effect of therapeutic exercises is expressed in an increase in the lability of the nervous system.

Training leads to a decrease in the consumption of energy substances during the period of muscle activity, and redox processes improve.

Under the influence of physical exercises, the content of hemoglobin and erythrocytes in the blood increases, the phagocytic function of the blood increases.

With the systematic use of physical exercises, the muscles are strengthened, their power and efficiency increase.

1 Indications and contraindications

Exercise therapy has wide indications for the so-called functional disorders of the nervous system (neurosis).

The use of exercise therapy for neuroses is justified by the simultaneous effect of physical exercises on the mental sphere and on somatic processes. With the help of physical exercises, it is also possible to influence the regulation of the processes of excitation and inhibition in the cerebral cortex, the alignment of autonomic disorders and have a positive effect on the emotional sphere of the patient.

Exercise therapy for neuroses is a method of functional pathogenetic therapy, as well as an important general hygienic and prophylactic agent.

In general medical practice, there are almost no contraindications against the use of exercise therapy. Contraindications include neurosis, accompanied by affective outbursts, convulsive seizures; excessive mental or physical fatigue, a state of mental disorders, severe somatic disorders.

Elderly age is not a contraindication for the use of exercise therapy

2 Features of exercise therapy for neuroses

Therapeutic physical culture is understood as the application of physical exercises and natural factors of nature to patients for a faster and more complete restoration of health, working capacity and prevention of the consequences of the pathological process.

Therapeutic physical culture is a therapeutic method and is usually used in combination with other therapeutic agents against the background of a regulated regimen and in accordance with therapeutic tasks.

The main factor of therapeutic physical culture acting on the patient's body is physical exercise, i.e. movements specially organized (gymnastic, sports-applied, game) and used as a non-specific stimulus for the purpose of treatment and rehabilitation of the patient. Physical exercises contribute to the restoration of not only physical, but also mental strength.

A feature of the method of therapeutic physical culture is also its natural biological content, since in medicinal purposes one of the main functions inherent in any living organism is used - the function of movement.

Any set of physical exercises includes the patient in active participation in the treatment process, as opposed to other treatment methods, when the patient is usually passive and medical procedures are performed by medical personnel.

Therapeutic physical culture is a method of non-specific therapy, and physical exercises serve as a non-specific stimulus. Neuro-humoral regulation of functions always determines the general reaction of the body during physical exercises, and therefore therapeutic physical culture should be considered a method of general active therapy. Therapeutic physical culture is also a method of functional therapy. Physical exercises, stimulating the functional activity of all the main body systems, eventually lead to the development of the patient's functional adaptation.

Therapeutic physical culture, especially in a neurological clinic, should be considered a method of pathogenetic therapy. Physical exercises, influencing the reactivity of the patient, change both the general reaction and its local manifestation.

A feature of the method of therapeutic physical culture is the use of the principle of exercise - training by physical exercises. The training of a sick person is considered as a process of systematic and dosed use of physical exercises for the purpose of general improvement of the body, improvement of the functions of one or another organ, disturbed by the disease process, development, education and consolidation of motor skills and volitional qualities. From a general biological point of view, the fitness of a sick person is regarded as an important factor in his functional adaptability, in which systematic muscular activity plays a huge role.

The main means of therapeutic physical culture are physical exercises and natural factors of nature.

Physical exercises are divided into: a) gymnastic; b) applied sports (walking, running, throwing balls, jumping, swimming, rowing, skiing, skating, etc.); c) games - sedentary, mobile and sports. Of the latter, croquet, bowling alley, gorodki, volleyball, badminton, tennis, basketball elements are used in the practice of therapeutic physical culture. With lesions of the nervous system, gymnastic exercises are most often used.

Physical exercises are used in the form of complexes of exercises of varying complexity, duration and intensity.

The dosage of exercises is possible:

) by the duration of the treatment procedure in minutes;

) by the number of repetitions of the same exercise;

) by the number of different exercises during one lesson;

) by the speed and rhythm of the exercises;

) according to the intensity of physical activity;

) by the number of procedures during the day.

Individualization of physical exercises, depending on the physical and mental state of patients, on the characteristics of the clinic, is possible in methodological techniques by applying:

1)massage;

2)passive movements, including lying and sitting;

)joint movements with the methodologist (movements of the patient, performed with the active assistance of the methodologist);

)active movements

One of the important aspects of the individualization of the exercise therapy methodology is the nature of the command and instruction.

In some cases, depending on the task, the instruction and the issuance of the command are accompanied by a visual demonstration of the physical exercise, in others they are limited to only verbal instructions without showing.

Physical therapy is used in various forms:

1)morning hygienic gymnastics;

2)recreational games and sports-applied exercises (volleyball, tennis, skiing, skating, etc.);

)physiotherapy.

The limits of the therapeutic possibilities of exercise therapy for neuroses are different. Morning hygienic gymnastics and sports and applied games in the complex of general events are mainly of general hygienic and health-improving significance. Sports and applied games can also be a good remedy subsequent reinforcing and remission maintenance therapy.

As for therapeutic gymnastics, long courses of specially selected sets of exercises are already pathogenetic; the effectiveness of therapeutic exercises is to improve both the somatic and mental state up to practical recovery.

Therapeutic gymnastics is carried out according to the scheme adopted in exercise therapy.

The scheme of the lesson of therapeutic gymnastics.

1.Introductory part (5-15% of the total time)

Tasks: mastering the attention of patients, inclusion in the lesson, preparation for subsequent, more complex and difficult exercises.

2.Main part (70-80%)

Tasks: overcoming the inertia of patients, excitation of automatic and emotional reactions, development of differential inhibition, activation of active-volitional acts, dispersal of attention to numerous objects, increase in emotional tone to the required degree, solution of the set medical problems.

3.Final part (5-15%).

Tasks: the necessary reduction of general arousal and emotional tone. Gradual decrease in pace and physical activity. In some cases - physical rest.

Methodically correct carrying out of procedures of medical gymnastics is possible only if the following principles are observed:

The nature of the exercises, physiological load, dosage and starting positions should correspond to the general condition of the patient, his age characteristics and the state of fitness.

All procedures of therapeutic gymnastics should affect the entire body of the patient.

The procedures should combine general and special effects on the patient's body, so the procedure should include both general strengthening and special exercises.

When drawing up the procedure, one should observe the principle of gradual and consistent increase and decrease in physical activity, maintaining the optimal physiological "curve" of the load.

When selecting and applying exercises, it is necessary to alternate the muscle groups involved in the performance of physical exercises.

When carrying out therapeutic exercises, attention should be paid to positive emotions that contribute to the establishment and consolidation of conditioned reflex connections.

In the course of the treatment course, it is necessary to partially update and complicate the exercises used daily. 10-15% of new exercises should be introduced into the procedure of therapeutic gymnastics in order to ensure the consolidation of motor skills and consistently diversify and complicate the methodology.

The last 3-4 days of the course of treatment should be devoted to teaching patients the gymnastic exercises that are recommended for them for subsequent homework.

Volume methodological material in the procedure should correspond to the patient's movement regimen.

Each exercise is repeated rhythmically 4-5 times at an average calm pace with a gradual increase in the excursion of movements.

In the intervals between gymnastic exercises, in order to reduce physical activity, breathing exercises are introduced.

When combining respiratory phases with movement, it is necessary that: a) inhalation correspond to the straightening of the body, spreading or raising the arms, the moment of less effort in this exercise; b) exhalation corresponded to the flexion of the body, the reduction or lowering of the arms and the moment of greater effort in the exercise.

The procedure should be carried out in an interesting and lively manner in order to evoke positive emotions in patients.

Classes should be held regularly, daily, always at the same hours, if possible in the same environment, as a rule, in tracksuits, comfortable pajamas or shorts and a T-shirt. Breaks in classes reduce efficiency.

Carrying out therapeutic exercises requires patience and perseverance; it is necessary to systematically and persistently achieve positive results, to overcome the negativism of patients.

At the first failures to involve the patient in occupations it is not necessary to refuse the further attempts; an important methodological technique in these cases will be only the presence of such a patient in the classes of other patients, to excite orienting and imitative reflexes.

Classes should begin with simple and short sets of exercises, with a very gradual complication and an increase in their number. Fatigue of patients, which usually adversely affects the results, should be avoided. The duration of the classes varies depending on individual characteristics; they should be started, depending on the condition of the patients, from 5 minutes and brought up to 30-45 minutes.

Classes should be accompanied by music. However, music should not be a random element of classes, but should be selected purposefully. Musical accompaniment of therapeutic exercises should be a factor that creates the emotional interest of the patient; a factor organizing movement, training memory and attention, stimulating activity and initiative in some cases, restraint and orderliness of movements in others.

Before and after the end of each lesson, it is necessary to take into account the general somatic condition of the patient, including the pulse rate, respiration rate and, if necessary, blood pressure.

The stay of unauthorized persons in the classroom with sick neuroses is undesirable.

It is very important to take into account the effectiveness of exercise therapy. The best criterion for effectiveness is the positive dynamics of the clinical picture, which is recorded by the attending physician in the medical history.

In the treatment of patients with neurosis, one has to meet with a variety of clinical course, variability of neuropsychiatric disorders, which makes it impossible to compile unambiguous sets of exercises. The effectiveness of treatment with physical exercises largely depends on taking into account the individual characteristics of patients, their emotional and volitional orientation and attitude to treatment. All this requires great ingenuity, pedagogical tact and patience from the teacher of physical therapy, which significantly expands the indications for the use of physical therapy.

One of the objectives of treatment is to normalize the dynamics of the main nervous processes and autonomic functions. The second task is to strengthen the neuro-somatic state and increase the mental tone and efficiency of patients.

The tasks of the first period of application of exercise therapy will be the general improvement and strengthening of the patient, improving coordination of movements, distraction from thoughts about the disease, instilling the skill of correct posture, establishing pedagogical contact with the patient. In the first period of treatment, exercises for all muscle groups are widely used to develop coordination of movements, improve posture. Exercises should evoke positive emotions, for which games are successfully used.

In the second period, special exercises are introduced, which should help improve memory and attention, speed and accuracy of movements, and improve coordination.

In addition to general developmental exercises, which are gradually given with an ever-increasing load, exercises are used for dexterity and speed of reaction, educating the will, the ability to overcome obstacles. Coordination exercises become more difficult, jumps, jumps (overcoming fear of heights), running, jumping rope exercises are added. Exercises are used that cause a sharp braking process (a sudden stop or a quick change in body position on command, etc.), mobile and sports games are used. To train the vestibular apparatus, exercises are introduced with closed eyes (walking with turns), circular movements of the head and torso from the initial sitting position, etc.; exercises with resistance, with weights, with shells and on shells.

At the beginning of classes, simple exercises are used, performed at a calm pace, without tension, with the participation of small muscle groups. Such exercises normalize the activity of the cardiovascular and respiratory systems, streamline the movements of the patient. The number of repetitions of exercises ranges from 4-6 to 8-10 with frequent rest breaks. Breathing exercises (static and dynamic) are widely used; they should contribute not only to the restoration of proper breathing, but also to the normalization of cortical processes.

As the patient adapts to the load, it increases due to the complication of exercises: exercises with dosed tension, with weights, complex in coordination, requiring a quick switch of attention (throws the ball at a target with a change in direction) are introduced.

With increased excitability of the patient, it is impossible to demand the exact fulfillment of the task at the beginning of classes, one should not fix his attention on mistakes and shortcomings in the performance of exercises. With a decrease in the patient's activity, lethargy, lethargy, self-doubt, it is necessary to demand the exact fulfillment of tasks, very gradually increasing their complexity; include mindfulness exercises.

In the treatment of neurosis, the following forms of conducting classes are used: individual, group, homework.

The method of training for neurosis is chosen based on the characteristics of the disease, taking into account gender, age, general physical fitness, emotional tone of the patient, functionality, and the nature of work. It is better if the first lessons are individual. This allows you to establish closer contacts with patients, identify his mood, reaction to the proposed exercises, select adequate physical exercises, take complaints into account, instill a number of skills necessary for group classes.

After a period of familiarization with the patient, he should be transferred to a group for classes.

Group classes for those suffering from neurosis are most useful, because. favorably affect the emotional tone of the patient, contribute to the rest of the overstrained nervous system. It is recommended to form mixed (according to the type of neurosis) groups, because at the same time, the influence of patients on each other will not be of the same type, reinforcing the existing painful manifestations. Group classes in this case should not be standard for everyone. It is necessary to take into account the individual characteristics of patients, which should be reflected in the methods of training, in the dosage of physical exercises, in the form of their implementation.

The size of the group depends on many factors. But the main one is clinical indications. The general methodological setting is that in those cases when it is necessary to increase the patient's activity, get him out of a state of lethargy, overcome negativism, inertia, obsession, the group can be large, even up to 20 people, if active inhibition training is required, reduce excessive excitability of the patient, to overcome emotional excitability, the group should be small, no more than 5-6 people.

There are also many peculiarities in the acquisition of groups. One has to take into account both the clinical picture of the mental state and the somatic state of the patient; one has to keep in mind both the prescription of the disease, and the fact that some of the patients are already trained, and some are just starting classes, etc.

The course of treatment in the group lasts up to two months.

Group classes should be held at least 3 times a week, preferably with musical accompaniment, which always causes positive emotions, especially necessary for patients with neuroses.

It is important to ensure that the load corresponds to the functional capabilities of each student, and does not cause overwork.

Self-study is used when it is difficult for the patient to regularly visit medical institutions or when he has completed hospital treatment and is discharged for aftercare at home.

While doing therapeutic exercises at home, the patient should periodically come to the doctor and methodologist to control the correctness of the exercises and receive repeated instructions for further classes.

Self-study increases the activity of patients and ensures the stability of the therapeutic effect in the future.

When conducting physical exercises, it is necessary to take into account the nature of the patient's work, home conditions. Patients in a state of overwork should build classes with the expectation of rest. In this case, breathing exercises are combined with physical exercises well known to the patient. The end of classes should be calm.

Patients without overwork are offered unfamiliar physical exercises with weights, stuffed balls, complicated coordination of movements, relay races.

The selection of exercise therapy in the lesson of therapeutic exercises depends on clinical manifestations disease, somatic and neuropsychic state of the patient.

In addition to gymnastic exercises, walks, close tourism, health paths, elements of sports and outdoor games (volleyball, towns, table tennis) and the widespread use of natural factors are recommended. A good therapeutic effect is the inclusion of games in every lesson. Classes should be carried out, if possible, in the fresh air, which helps to strengthen the nervous system, improve metabolism in the body.

During the classes, the methodologist should exercise a psychotherapeutic effect, which is an important healing factor, distract the patient from painful thoughts, cultivate perseverance and activity in him.

The work environment should be calm. The methodologist sets specific tasks for patients, selects exercises that are easy to perform and positively perceived. He is obliged to maintain the confidence of patients in their capabilities, to approve with the correct exercise. It is useful to conduct conversations with patients for their correct attitude to exercise therapy. switching the patient's attention to solving specific problems contributes to the normalization of the dynamics of nervous processes, the appearance of a desire to move. In the future, the patient's attention is directed to participation in labor activity, the development of a correct assessment of his condition.

In addition to various exercises, patients with neuroses are recommended hardening procedures - sun therapy, air baths, water procedures.

The regulation of the regime is important: the alternation of sleep and wakefulness, physical exercises and passive rest in the air or walks.

In the complex treatment of neurosis, they also use: drug treatment, occupational therapy, psychotherapy, electrosleep, landscape therapy, walks, massage, physiotherapy, hydrotherapy, etc.

Skiing, cycling, fishing, picking mushrooms and berries, swimming, rowing, etc. have a positive effect on neuroses.

With neuroses, sanatorium-and-spa treatment is indicated in local sanatoriums using all means of complex therapy, as well as treatment in the resorts of the Crimea and the North Caucasus.

2.3 Features of exercise therapy for neurasthenia

As already mentioned, patients with neurasthenia are characterized, on the one hand, by increased excitability, and on the other, by increased exhaustion, which is a manifestation of the weakness of active inhibition and the disorder of the excitatory process. These patients are easily injured, often fall into a depressed state.

When prescribing exercise therapy, first of all, it is necessary to find out the causes of the appearance of neurasthenia, tk. without removing these causes, the treatment will be ineffective explaining to the patient the causes of the ailment, his active participation in his treatment provide significant assistance in eliminating the disease.

For patients with neurasthenia, the use of exercise therapy with its regulatory effect on various processes in the body is literally a pathogenetic form of treatment. In combination with streamlining the daily routine, drug treatment, and physiotherapy, a gradual increase in load improves the functions of blood circulation and respiration, restores the correct vascular reflexes, and improves the activity of the cardiovascular system.

When organizing and conducting therapeutic exercises with patients with neurasthenia, the target setting should be based on the need to train and strengthen the processes of active inhibition, restoration and regulation of the excitatory process.

The means and methods of therapeutic exercises for this group of patients should take into account all these features.

First of all, based on the increased fatigue of patients, the lack of a feeling of cheerfulness in freshness, especially after sleep and in the first half of the day, therapeutic exercises, in addition to the obligatory morning, hygienic gymnastics, should be carried out in the morning, the dosage of the duration and number of exercises should increase very gradually and start with minimal loads.

With the most weakened, asthenic patients, it can be recommended to start classes for several days with a general 10-minute massage, passive movements lying in bed or sitting.

The duration of the lessons is no more than 10 minutes. It is recommended to include repeated breathing exercises.

In view of the abundance of somatovegetative disorders and complaints, preliminary psychotherapeutic preparation and removal of very frequent cases of iatrogeny are required; in the process of training, the methodologist should be prepared to ensure that, without fixing the patient's attention on various painful sensations (for example, palpitations, shortness of breath, dizziness), regulate the load so that the patient does not get tired, so that he can stop the execution without any embarrassment exercise and fail. There is no need to demand the accuracy of the exercises, but gradually the patient needs to be more and more involved in classes, more and more to increase interest in them, diversify the exercises, introduce new means and forms of exercises.

In some cases, especially at the beginning of the application of therapeutic exercises, the reaction to the load may be increased, and therefore it should be strictly commensurate with the adaptive capabilities of patients.

It should also be taken into account that it is difficult for patients to focus attention - it quickly weakens. Patients do not believe in themselves, in connection with which they shy away from performing difficult tasks; if they fail at something, they proceed to solve a similar problem in the future without faith in success. Knowing this, the methodologist should not give unbearable exercises to the sick. It is necessary to complicate them gradually, to explain and show very well.

At the beginning of classes, patients may be absent-minded, disinterested. Therefore, the methodologist should, first of all, educate them in a positive attitude towards physical exercises. It is necessary to develop a training methodology in advance and conduct it purposefully, in a relaxed manner.

Lessons can be done both individually and in groups.

When the patient is overworked, individual sessions are held to establish close contact with him, to identify his individual reactivity and to select adequate physical exercises. Such patients are recommended to self-study after a preliminary explanation of the content of the exercise. at the same time, periodic monitoring is carried out, adjustments are made to the methodology for conducting exercises.

One of the very important elements of classes should be not only their musical accompaniment, but also the use of music as a healing factor, as a means of sedation, and stimulating, exciting. When selecting musical melodies, the tempo of the musical accompaniment of classes, it is recommended that music be soothing, of moderate and slow tempo, combining both major and minor sounds. You should choose simple melodic music, you can use beautiful arrangements of folk songs.

The scheme of lessons of therapeutic gymnastics for patients with neurasthenia.

Introductory part. Introduction to the lesson. A gradual increase in difficulty and the number of exercises, a gradual increase in effort.

Main part. Further gradual complication of exercises and efforts. Increased emotional tone.

Final part. Gradual decrease in physical effort and emotional tone.

Methodology.

The duration of the lesson at first is relatively small 15-20 minutes, but then it is gradually increased and brought up to 30-40 minutes. The exercises are very simple at first, not requiring any physical effort. Gradually, starting from the 5th-7th lesson, elements of the game are introduced into the lesson, especially ball games, and in winter also skiing.

The introductory part lasts 5-7 minutes. In the future, its duration does not increase; the total duration of the lesson is extended only at the expense of the main part. The lesson begins with walking in a circle, at first at a slow pace, then the pace accelerates somewhat.

Walking continues for 1 minute. Free movements: hands from 4 to 10 times, body - each from 4 to 10 times, legs - each from 4 to 10 times, sitting and lying exercises - each from 4 to 10 times.

The main part, as already mentioned, is gradually changing both towards complication and towards longer duration. The first 5-7 lessons include exercises with gymnastic sticks, each 4-12 times, on the gymnastic bench - from 2 to 8 times. In summer, ball games are included, especially rounders, and in winter - skiing. The duration of the ball game should not exceed 10-15 minutes. Walking on skis should not exceed 30 minutes, the distance should not exceed 2-3 km, the pace of walking should be walking, attempts to walk at a fast, athletic pace should be stopped. There should be no steep ascents or descents. You can organize skiing from the mountains, but only gently sloping.

In the final part of the lesson, you need to gradually reduce the number of movements of those involved, make them slower. Breathing exercises are applied (from 4 to 8 times). After the lesson, you should carefully inquire about the well-being of patients, and during the course of therapeutic physical culture, periodically find out the state of sleep, appetite, emotional balance, and if some indicators worsen, find out if they are associated with an overdose of therapeutic exercises.

It is recommended to use exercises with alternate muscle contraction and relaxation, breathing exercises, exercises for the upper and lower extremities should be performed at an average pace, with a small amplitude. In the future, swing exercises for the limbs, exercises that require some tension, exercises with overcoming resistance are added. Hand exercises should be combined with exercises for the body; exercises that require speed and significant muscle tension - with breathing exercises. In the main part of the lesson, various exercises with the ball in a playful way should be introduced - the ball in a circle with various methods of throwing, relay games with the transfer of balls and other objects, relay race combinations with jogging, with various tasks (jumping over a gymnastic bench, climbing over an obstacle). These exercises should be alternated with relaxation exercises and breathing exercises.

During the entire course of treatment, the most serious attention should be paid to the emotional side of the classes. The instructor's team should be calm, demanding, accompanied by short and clear explanations, should contribute to the manifestation of cheerfulness and good mood in the process of training.

In addition to outdoor games, it is recommended to use various sports games: croquet, skittles, towns, volleyball, tennis. Depending on the patient's condition, his fitness, individual reactions (pulse, fatigue, irritability, behavior in a team), games such as volleyball and tennis should be dosed, allowing a game with a time limit (from 15 minutes to 1 hour), short pauses should be introduced and breathing exercises, simplified rules of the game.

Of the sports-applied exercises that help overcome feelings of insecurity, fear and other neurotic reactions in patients, it is recommended to use exercises in balance on a narrow and elevated support area (bench, log, etc.), climbing, jumping, jumping, and jumping into water with gradual complication, swimming, exercises in throwing balls, etc. The special benefit of skiing in winter and regular walking and short-range tourism in summer, spring and autumn should be emphasized. They have a training effect on the circulatory system, respiration and increase the functional adaptability of the patient's body to various physical loads. Skiing educates and develops confidence, determination and has a beneficial effect on the function of the vestibular apparatus. Skiing has a positive effect on the neuropsychic sphere of patients with neurasthenia, which is associated with favorable environmental conditions. Active muscular activity in the frosty air increases the overall tone and creates a cheerful mood. The beauty of changing landscapes, especially in sunny weather, and silence evoke joyful emotions in patients, contributing to the unloading of the nervous system from the usual type of professional activity.

In summer, autumn and spring, regular dosed walks in the air at various times of the day, depending on the patient's work regime, acquire great therapeutic and prophylactic significance. Of particular benefit are walks outside the city, which have a positive effect on the neuropsychic sphere, distracting the patient from "going into the disease."

For these patients, strict regulation of the regimen is useful, especially the alternation of sleep and wakefulness, as well as the alternation of active forms of exercise therapy with passive outdoor recreation.

Depending on the interests of the patient, it is also possible to recommend fishing and hunting, which cause joyful emotions and actively influence the restructuring of the neuropsychic sphere.

With the hyposthenic form of neurasthenia, the training methodology is somewhat different; the main goal of using therapeutic exercises in this variant of neurasthenia is the careful training of the excitatory process, and only then - the strengthening of active inhibition. Even in those cases when patients themselves begin to participate too actively in therapeutic physical culture, such excesses must be limited in a timely manner, since an overdose during hyposthenia can significantly worsen the condition of patients. Therapeutic physical culture in the hyposthenic form of neurasthenia is also shown to improve somatic indicators.

Most patients, due to severe exhaustion, spend most of the day in bed or sitting. Therefore, they easily experience detraining phenomena, when even getting out of bed causes a significant increase in heart rate, shortness of breath.

The first 5-7 days of exercise should be carried out in the ward, without bringing patients into the hall, and some should first be advised to practice while sitting in bed. The duration of the lesson is 5-10 minutes; only after 5-7 days of classes can you increase the duration of the lesson to 20-30 minutes.

The introductory part in the first week of classes, in fact, exhausts the entire lesson plan. It consists of very slow floor exercises performed without any tension (4-8 times). Walking can be recommended starting from the second week of classes, it should be slow, small steps. As with the hypersthenic variant, with hyposthenia, the duration of the introductory part of the lesson does not exceed 5-7 minutes.

The main part of the lesson joins the introductory only starting from the 2nd week of the lesson. The duration of the main part in the 2nd week is 5-7 minutes, then it is gradually lengthened to 12-15 minutes. In this part, simple exercises are performed with a volleyball (7-12 times), gymnastic sticks (6-12 times). throwing a basketball into a basket).

When prescribing therapeutic physical culture to such patients (with severe asthenia and a sharp violation of adaptation to physical exertion), it is necessary to further limit physical activity, that is, to prescribe the most lightweight, simple exercises in construction. During the procedure, pauses for rest are included, exercises are introduced in light initial positions (lying and sitting), for the purpose of general toning, they include corrective exercises and with dosed tension, which alternate with breathing exercises. Exercises are also used to develop the function of the vestibular apparatus. Classes are conducted individually or in small groups.

The task of therapeutic physical culture in relation to this group of patients is to achieve a decrease in emotive lability through targeted physical exercises, to increase the activity of conscious-volitional activity; pathophysiologically, this means increasing the activity of the second cortical signaling system, removing the phenomena of positive induction from the subcortex, and creating differential inhibition in the cerebral cortex.

The implementation of these tasks is achieved, first of all, by a slow pace of movements, a calm but persistent requirement for the accuracy of performing exercises and a specially selected set of simultaneous, but different in direction, exercises for the right and left sides. An important methodological technique is to perform memory exercises, as well as according to the methodologist's story without illustrations of the exercise itself.

The scheme for constructing lessons in therapeutic gymnastics in hysteria.

Introductory part. inclusion in the lesson. Decreased emotional tone.

Main part. Focusing on the task at hand.

Development of differentiated braking. Inclusion of active-volitional acts.

Final part. Decreased emotional-volitional activity. Complete physical rest.

The duration of the lesson is 45 minutes.

Methodology.

In order to avoid induction by emotive patients, the group should not include more than 10 people. The command is given slowly, smoothly, conversational type.

Calm, but strict demands on the accuracy of the exercises. All errors are noted and corrected.

The demand for accuracy should be gradually increased.

Classes are held in the absence of unauthorized persons. A decrease in emotional tone is achieved by slowing down the pace of movements. The first lessons begin with an accelerated pace characteristic of this group - 140 movements per minute and reduce it to 80, subsequent lessons start at 130 and slow down to 70, then from 120 to 60 per minute. Differential inhibition is developed by simultaneously performed, but different tasks for the left and right arms and legs. The inclusion of active-volitional acts is achieved by performing strength exercises on apparatus at a slow pace with a load on large muscle groups.

It is advisable to use various chains of movements, gymnastic combinations. You can use mindfulness exercises. In addition to gymnastic exercises, exercises in balance, jumping, throwing, some games (relay races, towns, volleyball) are recommended.

In conclusion, the patients perform exercises lying on a rug or on a folding bed (their goal is to reduce their emotional tone as much as possible), and, finally, a complete physical rest is given for 1.5 minutes, during which the patient lies on the bed or sits on the floor, relaxed, with head down and eyes closed.

A methodologist in therapeutic physical culture, who conducts classes according to this method, should know that this method for emotionally labile patients is difficult, difficult to perform, as it requires the mobilization of active attention and concentration. Therefore, its success is achieved slowly, not immediately. Impatient, excitable and explosive patients may have “breakdowns”, up to a complete refusal to exercise. It is necessary to persevere and firmly strive to continue the studies.

To facilitate the fulfillment of the assigned tasks, it is necessary to interest the patients, the first time classes can be accompanied by music. However, music should also be selected such that would help concentration of attention; it should be calm, melodic, attracting the attention of patients, cheerful in nature, with a clear rhythm; the tempo of the music should gradually slow down in accordance with the task facing the methodologist. An important element is the performance of memory exercises, without a command. At first, it can be recommended to combine this or that exercise with certain music so that the music later becomes a conditional signal to perform the exercise; by increasing the number of melodies and combining them with certain exercises, one can achieve a significant increase in attention. However, the task is that in the end the patient performs the exercises without a command and without music accompaniment; this greatly trains attention, memory, promotes orderliness of motor skills, a decrease in emotional lability, and excessive haste.

A particularly good effect is achieved when patients consciously seek to perform versatile tasks and learn to use motor skills to master their emotions. One of these methodological techniques is the conscious, active-volitional performance of all actions (in everyday life) "quietly and slowly."

Hysterical paralysis is based on functional disturbances in the zone of the motor analyzer, inhibition of certain sections of it, weakness of the irritant process in the second signal system. Therapeutic measures should be aimed at eliminating these changes.

The use of exercise therapy for hysterical paralysis has a positive effect on emotional condition the patient, helps to eliminate uncertainty in recovery, involves the patient in a conscious and active struggle with the disease. Passive movements of the paretic limbs cause a flow of impulses to the motor analyzer and bring it out of the state of inhibition. Active movements in healthy limbs also affect.

Therapeutic exercises for hysterical paralysis should be combined with the impact on the patient through the second signal system, with his persistent conviction of the need to perform movements. It is very important to get the patient to help the methodologist in performing passive movements in the paralyzed limbs, and then try to independently reproduce the movements. The patient must be convinced of the preservation of his function of movement and the absence of paralysis. Recommended group classes in therapeutic exercises, rhythmic exercises with a change in pace. In classes, strong emotional stimuli should be avoided, but it is important to use games that require the concentration of attention of intensive work of muscles that are not involved in contractures and paralysis. Gradually, the paralyzed limb is included in the movement.

2.5 Features of exercise therapy for psychasthenia

Patients with psychasthenia are suspicious, inactive, focused on their personality, inhibited, depressed.

The possibilities of the therapeutic effect of physical exercises in psychasthenia are very diverse and effective.

The main mechanism of the impact of physical exercises is to "loosen" the pathological inertia of the cortical processes, to suppress the foci of pathological inertia by the mechanism of negative induction.

The implementation of these tasks corresponds to physical exercises that are emotionally saturated, fast in pace, performed automatically.

The music accompanying the classes should be cheerful, from slow and moderate tempos, as well as movements, should move to faster ones up to “allegro”.

It is very good to start classes with marches and marching songs (Dunaevsky's march from the movie "Circus"). Most often and most of all, it is necessary to introduce game exercises, short relay races, elements of competitions into the complex of physical exercises.

In the future, in order to overcome the feeling of low value and low self-esteem, shyness, so characteristic of people with a psychasthenic warehouse, it is recommended to introduce exercises to overcome obstacles, to balance, and strength exercises.

When forming a group for classes, it is advisable to include in the group several recovering patients with good emotionality, with good plasticity of movements. This is important because, as experience has shown, patients in this group are characterized by non-plastic motor skills, clumsiness of movements and awkwardness. They tend to be unable to dance, avoid and dislike dancing.

In the presence of obsessive phenomena, fears, the appropriate psychotherapeutic preparation of the patient, an explanation of the importance of overcoming the feeling of unreasonable fear of doing exercises, is of great importance.

Thus, a feature of the therapeutic physical culture of this group is its combination with psychotherapy and music. These three factors, in a complex complement each other, give a good effect.

Scheme of building classes for patients with psychasthenia.

Introductory part. Introduction to the lesson. Excitation of automatic in emotional reactions.

Main part. Dispersion of attention to numerous objects and acceleration of automatic reactions. Increase emotional tone to the maximum.

Z. Final part. Incomplete decrease in emotional tone. The duration of the lesson is 30 minutes.

Methodology.

The number of patients being treated is 12-15 people. The team is live. Excessive exactingness and strictness to mistakes and great accuracy in performing exercises are harmful.

Errors should be corrected by demonstrating good exercise performance by one of the patients. It is not recommended to make comments to those patients who do not succeed in this exercise.

With the tone of the command, the timbre of the voice, a lively response to the positive emotions of the patients, active participation in their emotional upsurge, the methodologist should help to increase the contact of the patients with themselves and with each other. The task of stimulating automatic reactions into emotional tone is achieved by accelerating the rate of movements: from the slow rate characteristic of these patients of 60 movements per minute to 120, then from 70 to 130 movements and in subsequent sessions from 80 to 140 movements per minute. To increase the emotional tone, resistance exercises in pairs, mass game exercises, exercises with a medicine ball are used.

To overcome feelings of indecision, shyness, self-doubt - exercises on shells, balance, jumping, overcoming obstacles.

In the final part of the lesson, exercises are carried out that contribute to an incomplete decrease in emotional tone. It is necessary that the patient leaves the therapeutic gymnastics hall in a good mood.

In patients without significant asthenia, the duration of the lesson can immediately be 30-45 minutes. Of these, the introductory part accounts for 5-7 minutes, the main part - 20-30 minutes, the final part - 5-10 minutes.

In the introductory part, the lesson begins with walking in a circle (1 minute), and then floor exercises follow with arms (8 times), trunk (8 times), legs (8 times) and sit and lie down (8 times).

The main part is built quite differently, in each lesson the set of exercises changes. In the main part, you need to widely use exercises with a volleyball (15 times), gymnastic sticks (8-12 times), jump ropes (16 times). Particular attention should be paid to exercises that require sufficient firmness, self-confidence, precise coordination of movement, balance, frequent changes in excitation and inhibition. These include exercises with throwing a basketball into the basket (10 times), walking along the rail of the gymnastic bench, first with open and then with eyes closed (4-5 times). Subsequently, if possible, you need to increase the height of the rail or switch to walking on a balance beam. Walking on a rail or log should be gradually complicated by performing various exercises during the passage: hitting a hanging ball, various free movements, turns, overcoming obstacles. Of the game exercises, competitions in high jumps, bast shoes, volleyball (both with and without a net) are favorable, and in winter - skiing from the mountains with gradually more difficult descent conditions, skating, sledding from the mountains.

In the final part of the lesson, an incomplete decrease in emotional tone is achieved by its short duration (1 minute), by performing a small number of dynamic breathing exercises for relaxation. It should end with a survey of well-being.

When combined with asthenia, the scheme for constructing a course of treatment and lessons changes somewhat. In this case, the duration of the lesson at first does not exceed 5-7 minutes and only gradually increases to 20-30 minutes. The lesson is built on the same principles.

Classes with patients with psychasthenia should be carried out using a game method, including games, elements of sports exercises and competitions, and excursions in classes. In the process of training, it is necessary to distract the patient's attention from obsessive thoughts, to interest him in the exercises.

Some features of the use of physical exercises in classes with patients with psychasthenia are associated with the presence of obsessive fears (phobias) in them. In the presence of phobias, obsessions, psychotherapeutic preparation of the patient is necessary, which is of particular importance for overcoming the feeling of unreasonable fear of doing exercises.

So, with a phobia of heights, in addition to the above features of the lesson, you need to gradually force them to perform such exercises that instill confidence in the patient, remove the fear of heights. These include walking on a log with a gradual increase in the height at which these exercises are performed, jumping from any elevation with a gradual increase in its height.

With cardiophobic syndrome, first of all, you need to get acquainted in great detail not only with the mental, but also with the physical condition of the patient. Classes of therapeutic physical culture should be preceded by detailed somatic studies, consultation with an experienced therapist. You should also carefully study the features in which a cardiophobic attack appears, in particular, the connection of these attacks with some situation ( physical activity, height, excitement, fatigue, etc.) In accordance with these data, a scheme of therapeutic exercises is built. Of course, we are talking about people who have a violation of the coronary circulation (or any other cardiovascular pathology, accompanied or not accompanied by heart pain) is completely absent, but the patient has an intense fear of a heart attack, a fear of dying from myocardial infarction. Especially indicated for the treatment of therapeutic physical culture of persons who have<приступы>heart pain associated with excitement. At first, patients do not participate in the exercises at all, but only attend the classes of other patients. Only then can you gradually involve them in therapeutic exercises. The first lessons are very short and are limited only by slow walking in a circle (without floor exercises) and some floor exercises with legs (4-8 times) and torso (4-8 times). Then the duration of the lesson can be increased by exercises with gymnastic sticks, walking on the gymnastic bench and its rail, with the gradual addition of additional exercises while walking. With the successful completion of these exercises, starting from the 3rd week, you can introduce free movements with your hands, throwing a volleyball (10-15 times), and at the end of the course (4-5 weeks) exercises with ropes, game exercises with a volleyball, bouncing, long jumps, skiing on the plain.

The tactics of the physical culture methodologist and the attending physician in case of heart pain in the patient during the exercise are quite complicated. On the one hand, you need to listen to such complaints, but if there is confidence that these pains are not supported by some somatic basis, you should boldly recommend the patient not to pay attention to pain, focus on the correct implementation of the recommended exercises, especially that the exercises themselves exclude the possibility of deterioration from the side of the cardiovascular apparatus.

A peculiar technique is prescribed for fear of physical stress. Most often, this obsessive fear appears in people with a postoperative wound, when doctors give advice at first not to lift weights, not to do any hard physical work at all. In the future, despite the good course of the postoperative period, the fear of lifting weights, physical stress is fixed and then a course of special exercises should be carried out.

At first, patients perform only floor exercises with their hands (the duration of the lesson is 5-7 minutes) and walking. A week later, in the main part of the lesson, exercises with sticks (4-8 times), free movements of the body, legs, sitting and lying (8-12 times) are introduced. After another week, you can add exercises on the gymnastic bench, throwing a volleyball, skiing (without steep ascents and descents, no more than 30 minutes).

Later, in the main part of the lesson, they introduce exercises with ropes, bouncing, playing volleyball, and finally, throwing a medical ball of increasing severity.

From what has been said above, the need for a thorough acquaintance with the characteristics of the patient, the structure of his experiences, clearly follows. This rule, valuable in general for all types of patients, becomes especially necessary here. Therefore, the methodologist for physical therapy should get acquainted with the medical history in detail, find out all the nuances of obsessive fears, “rituals” of the patient, in a conversation with the attending physician, jointly outline a scheme for the application of remedial physical culture, and also constantly keep in touch with the attending physician and evaluate changes together, occurring in the structure of the disease, to plan further training programs, taking into account the changes that have occurred.

An important result of the application of therapeutic exercises to patients with psychasthenic syndromes is the possibility of using motor skills to work the patient on himself; hence the transition from therapeutic gymnastics in a group in a hospital to its use at home; at the same time, there is an undoubted positive effect from the participation of these patients in the game in volleyball teams, in cycling competitions, and, where the state of health allows, in football training and competitions.

Dances, especially collective dances, are of great positive significance for these persons.

3. Disease prevention

Disease prevention is an extremely important task.

Preservation of health in the conditions of labor activity of people is facilitated by: optimal working hours, annual labor leave, compliance with safety regulations and labor protection rules, annual medical examination of workers in order to identify the initial symptoms of diseases for faster and more effective treatment.

For the prevention and treatment of neurosis, sanatorium-and-spa institutions and rest houses are widely used.

In order to prevent the development of neuroses, it is necessary to eliminate from childhood those factors that contribute to the formation of a person with a weak type of GNA.

The prevention of neurosis is an extremely important task.

Considering the connection between the development of neurosis in children with toxicosis of pregnancy in their mothers, the state of their nervous system, proven by many scientists, it is necessary to carefully monitor the health of the expectant mother, create a calm environment at home so that your child is born strong and healthy.

Since the formation of the type of higher nervous activity begins from infancy, it is necessary from the first days to create conditions for strengthening and training the most vulnerable process of higher nervous activity - the process of inhibition. To this end, the mother must strictly adhere to the feeding regimen of the child, not indulge his cry and whims.

Of exceptional importance is the fight against childhood infections, strict adherence to the terms of aftercare. It must be remembered that the weakening of the nervous system of a child who has undergone a serious illness creates a favorable background for the development of neurosis.

Particular attention should be paid to children in critical periods of their development. At the age of three or four, a child begins to form his own "I", therefore, the constant obstacle to developing initiative, pulling children back makes them withdrawn, indecisive. At the same time, it is necessary to avoid the second extreme - to allow everything. This leads to indiscipline, to non-recognition of prohibitions. Calm, even and firm exactingness of parents contributes to the assertion of their authority and disciplines children.

A child from 3-4 years old must be taught independently, to serve himself: dress, wash, eat, fold toys. In the future, he must be taught how to clean his dress, shoes, make a bed, clear the table, etc. In each individual case, the child’s capabilities should be assessed and not given overwhelming orders, as this can also lead to a neurotic state. It is always necessary to strictly monitor the daily regimen, nutrition, the use of the time allotted for the child for outdoor activities, sleep.

Of great importance is the timely teaching of the child the skills of personal hygiene and hardening. He must, together with adults (but according to the complex appropriate for him), do morning hygienic gymnastics, which contributes to the fight against lethargy, makes him dexterous and strong. Daily wiping the body with water or washing up to the waist, in addition to the habit of personal hygiene, develop resistance to colds in him.

It is very important to protect the child from gross influences on his psyche. It must be remembered that quarrels and scandals of parents or a break in family relations have a very painful effect on the nervous system of children. You should not tire them with an excessive amount of impressions: frequent visits to the cinema, watching TV shows, long or frequent stays of kids in the menagerie, circus, fast driving, etc.

Very important in the formation of personality is the correct sexual education of the child. He should not be allowed to have a sexual feeling, which can be caused by immoderate caress, careless touch while bathing, etc. Children should not be taken to bed with adults or put to bed with other children. We must try to develop in the child a calm, natural attitude towards the issue of having children, which usually begins to interest him at the age of 3-7. These questions must be answered in a way that is understandable to the child.

Children are brought up especially successfully in a team: in nurseries, kindergartens, schools, where this is led by experienced specialists. However, being in a children's team does not relieve parents of responsibility for raising a child.

If, in order to prevent neurosis in childhood The main attention is paid to the creation of a strong type of higher nervous activity in a child, then for the prevention of neurosis in adults, the main thing is to prevent the causes that cause a weakening of the basic nervous processes. This is where overwork plays an important role.

In production, appropriate conditions have been created for this. During the lunch break, the workers rest and do industrial gymnastics. But people of certain professions, as well as pupils and students, continue to work at home. In such cases, it is important to observe occupational hygiene, with the correct organization of which overwork does not develop.

The main condition for this is the planning of work.

It is very important to diversify your work in such a way: to alternate mental work with reading fiction or a walk, or, even better, playing sports. Every one and a half to two hours, a 5-10 minute break should be taken. It is good to fill it with gymnastics or sports games.

Sports games, as well as sports in general, contribute to the preservation of health and the development of human endurance. They not only strengthen muscles, improve blood circulation and metabolism, but also largely normalize the work of the cerebral cortex, contribute to the fitness of the main nervous processes. Sports should be practiced by all people, regardless of age. There are many examples when people of advanced age, who have been involved in sports for a long time, retained their health, clarity of mind, cheerfulness, normal working capacity and good mood.

It is especially valuable to combine sports with water procedures - wiping, dousing, cool showers, sea bathing, as well as taking air baths, sleeping in the air.

Given the importance of sleep, which protects nerve cells from exhaustion, one should steadily take care of its usefulness. Chronic lack of sleep contributes to the weakening of nerve cells, resulting in the development of signs of chronic overwork - irritability, intolerance to strong sound stimuli, lethargy, fatigue.

An adult needs to sleep 7-8 hours a day. Sleep should not only be sufficiently long, but also deep. It is necessary to strictly observe the regime - go to bed at the same time.

A sharp excitement before bedtime or prolonged work can serve as an obstacle to falling asleep quickly. Going to bed with a full stomach is very harmful. Dinner is recommended 2-3 hours before bedtime. In the room where they sleep, there should always be fresh air - you need to accustom yourself to sleep with the window open. Saturation of nerve cells with oxygen is a very important factor for health.

No less important for the normal functioning of nerve cells is the quality and diet. It should be sufficiently high-calorie and varied in the selection of products. Fats and carbohydrates are the main energy substance of working cells, and therefore they are especially necessary in cases of intense work. Proteins are the basic substance, living matter for higher nervous activity. In cases of restriction of protein intake into the body, the strength of nervous processes decreases. The diet should also include various minerals: phosphorus, iron, potassium, calcium, iodine, etc. These substances in the form of salts, oxides or chemical elements are found in meat, milk, liver, cheese, egg yolk, bread, cereals, beans, fruit juices, vegetables, green parts of plants, yeast and other products. The content of mineral substances in food can also determine the state of excitatory and inhibitory processes. Vitamins are just as important.

We should not forget that drinking alcohol and smoking contribute to the emergence of neuroses. Both lead to slow poisoning of the nervous system, causing severe changes in itself and in a number of other organs and systems.

Conclusion

As a result of the analysis of scientific and methodological literature on the topic of the course work, I came to the conclusion that neurosis is a functional disease of the central nervous system that occurs as a result of an overstrain of nervous processes.

There are the following types of neuroses: neurasthenia, hysteria, psychasthenia.

The use of exercise therapy for neuroses is justified by the simultaneous effect of physical exercises on the mental sphere and on somatic processes.

Exercise therapy for this disease is a method of both pathogenetic and functional therapy, as well as an important general hygienic and prophylactic agent.

The great advantage of exercise therapy is the possibility of strict individualization and dosing of physical exercises.

The selection of exercise therapy means depends on the age, gender, form of neurosis, professional activity, somatic and neuropsychic state of the patient.

The main means of exercise therapy in the treatment of neuroses are: physical exercises, games, walks, natural factors of nature, etc.

There are various forms of exercise therapy: morning hygienic gymnastics, games, therapeutic exercises.

In the treatment of neurosis, there are two periods of exercise therapy: sparing and training.

In psychoneurological practice, the following forms of conducting classes are used: individual, group, independent.

There are special methods of exercise therapy for various forms of neuroses.

During the classes, the exercise therapy methodologist should exercise a psychotherapeutic effect on the patient and widely use pedagogical methods and principles in his practice.

Exercise therapy for neurosis should be carried out with musical accompaniment.

From all of the above, it follows that exercise therapy in the treatment of neuroses should find wider application in the practice of medical institutions.

neurosis disease psychasthenia hysteria

List of sources used

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Moshkov V.N. Therapeutic physical culture in the blade of nervous diseases. - M.: Medicine, 1972. - 288 p.

Shukhova E.V. Treatment of neuroses at the resort and at home. - Stavropol: Book publishing house, 1988. - 79 p.

Morozov G.V., Romasenko V.A. Nervous and mental diseases. - M.: Medicine, 1966, - 238 p.

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