Physiotherapy, exercise therapy, breathing exercises for pneumonia

Physiotherapy stimulates recovery mechanisms in acute pneumonia. In cases of severe intoxication and fever, physiotherapy is not performed; only mustard plasters, cupping, and alcohol-oil compresses are allowed.

Inhalation therapy

Inhalation therapy can be used to improve the drainage function of the bronchi, the ventilation function of the lungs, and for anti-inflammatory purposes. Inhalations should be prescribed taking into account individual tolerance and not in the most acute period. However, inhalations of bronchodilators can be used in case of bronchospastic reactions regardless of the period of the disease.

Bioparox can be recommended for anti-inflammatory and antibacterial purposes. This is a dosed aerosol preparation with a wide spectrum of action (effective against gram-positive and gram-negative coccal flora, gram-positive rods, mycoplasma). Bioparox reduces hypersecretion and decreases productive cough in bronchitis, decreases irritative cough in laryngitis and tracheitis. The preparation is inhaled every 4 hours, 4 breaths per inhalation.

Anti-inflammatory herbal decoctions (chamomile, St. John's wort) can be used in the form of inhalations. Inhalations of euphyllin, euspiran, novodrin, solutan, etc. are used to relieve bronchospasm and improve the drainage function of the bronchi (see "Treatment of chronic bronchitis").

Acetylcysteine inhalations are used to liquefy and better remove sputum. Ultrasonic inhalers should be used to prepare aerosols.

During the period of emerging recovery, aeroionotherapy with negatively charged ions is advisable (they enhance ventilation, increase oxygen consumption, and have a desensitizing effect).

Electrophoresis

For anti-inflammatory purposes and to accelerate the resorption of the inflammatory focus, electrophoresis of calcium chloride, potassium iodide, lidase, and heparin is used on the area of localization of the pneumonic focus.

In case of bronchospastic syndrome, electrophoresis of euphyllin, platiphylline, magnesium sulfate on the chest is prescribed; in case of cough and chest pain - electrophoresis of novocaine, dicaine.

UHF electric field

The UHF electric field accelerates the resorption of the inflammatory focus, reduces exudation, enhances capillary blood circulation, has a bacteriostatic effect, and reduces intoxication. UHF is prescribed to the inflammatory focus in a low-thermal dose and is combined or alternated with calcium chloride or potassium iodide electrophoresis.

It should be remembered that UHF currents promote the development of pneumosclerosis. Therefore, in the development of pneumonia against the background of chronic bronchitis, the UHF field is contraindicated.

Inductothermy

Inductothermy is the effect of a high-frequency magnetic field on the body (short-wave diathermy). The procedure enhances blood and lymph circulation, increases metabolism, relaxes smooth and striated muscles, has an analgesic, anti-inflammatory and antiseptic effect. Inductothermy is prescribed to patients with widespread inflammation in the lungs. In case of protracted pneumonia, inductothermy is combined or alternated on the chest and adrenal glands.

After inductothermy, to speed up the resorption of the inflammatory infiltrate, it is advisable to prescribe electrophoresis of heparin and nicotinic acid.

Ultra-high-frequency electromagnetic field (microwave therapy)

Microwave oscillations are used in two ranges - centimeter (UHF therapy) and decimeter (UHF therapy).

SMV therapy is performed by the Luch-58 device and helps resolve inflammatory infiltrate in the lungs. The depth of penetration into tissue is 3-5 cm. Foci located at a greater depth are not accessible to the effect. SMV therapy is often poorly tolerated by patients with coronary heart disease.

UHF therapy is performed by the devices "Volna-2", "Romashka", "Ranet" and has advantages over other methods.

During treatment with decimeter waves, the tissues are exposed to an electromagnetic field of ultra-high frequency (433-460 MHz) and low power (up to 70-100 W). UHF therapy is characterized by a high degree of absorption of ultra-high frequency energy, deep penetration into tissues (7-9 cm), which provides a pronounced anti-inflammatory effect and a positive effect on the function of external respiration. UHF therapy allows concentrating parallel beams and providing only a local effect. The procedure is well tolerated even by patients with coronary heart disease.

UHF therapy can be prescribed in the first 2-7 days after the body temperature has dropped to normal or subfebrile numbers. The chest is affected in the projection of the inflammatory focus for 10-15 minutes daily. The course of treatment is 19-12 procedures.

Applications, acupuncture

In the phase of pneumonia resolution, the patient is recommended paraffin, ozokerite, mud applications, as well as various acupuncture techniques: acupuncture, electroacupuncture, laser puncture. Under the influence of acupuncture, vegetative-somatic disorders are normalized, the compensatory-adaptive capabilities of the body are increased, which contributes to the fastest resorption of the inflammatory focus, the elimination of bronchospastic manifestations, and the normalization of the function of the mucociliary apparatus.

Acupuncture is not indicated for patients with fever, intoxication, pulmonary and cardiac failure, or severe morphological changes in the lungs.

Therapeutic physical culture

When doing exercise therapy, the mobility of the chest improves, the vital capacity increases, the work of the circulatory system and the supply of tissues with oxygen improves, the body's defenses increase, ventilation and drainage function of the bronchi improve. All this ultimately accelerates the resorption of the inflammatory focus in the lungs.

Physical therapy is prescribed on the 2nd-3rd day of a decrease in body temperature, if the patient’s condition is satisfactory.

In the acute period of pneumonia, treatment is carried out by position. The patient is recommended to lie on the healthy side for 3-4 hours a day. This position improves aeration of the diseased lung. To reduce the formation of adhesions in the diaphragmatic-costal angle, it is recommended to lie on the healthy side with a bolster under the rib cage. The prone position reduces the formation of adhesions between the diaphragmatic pleura and the posterior chest wall, the supine position - between the diaphragmatic pleura and the anterior chest wall.

Thus, during the acute period of the disease, it is necessary to change position during the day.

While the patient is on bed rest, when the body temperature decreases, static breathing exercises are prescribed to increase inhalation and exhalation and improve the discharge of sputum (deep inhalation through the nose and slow exhalation through the mouth, lightly pressing with the hands on the chest and upper abdomen to increase exhalation).

As the patient's condition improves, breathing exercises are combined with exercises for the limbs and trunk, and then breathing exercises with resistance are included to increase the strength of the respiratory muscles. Dosed compression of one or another section of the chest is performed in accordance with the initial strength of the respiratory muscles.

It is better to perform breathing exercises in a sitting or standing position.

As the patient's clinical condition improves, general strengthening physical exercises are prescribed, and later walking and sports-applied exercises (walking, ball games, exercise machines, cycling) are included.

All exercises of therapeutic gymnastics necessarily include a set of breathing exercises taking into account the following rules: inhalation corresponds to straightening the body, spreading or raising the arms, exhalation - bending the body, bringing together or lowering the arms.

Training of diaphragmatic breathing in a lying or standing position is of great importance. The patient stands with legs wide apart; moving his arms to the sides, he inhales, then, moving his arms forward and bending down, he exhales slowly, during which he should draw in the abdominal muscles.

If the patient is lying on his back, he places his hands on his stomach and makes a long exhalation, blowing air out through his mouth; at this time, he presses his hands on the anterior abdominal wall, intensifying the exhalation.

Breathing exercises to increase the strength of the diaphragm should be accompanied by sounds or short, successive series of exhalation movements (pushes), during which the abdominal muscles tense and the diaphragm contracts at the same time.

Massage of the difficult cell

Chest massage significantly improves microcirculation in the lungs, drainage function of the bronchi, promotes the resorption of inflammatory infiltration in the lungs. Massage is used at all stages of the disease, taking into account body temperature, intoxication, and the state of the cardiovascular system.

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