Therapeutic physical training for gastrointestinal diseases in children

Physical exercise influences digestion through the central nervous system via motor-visceral reflexes. Specific physical exercises improve blood circulation in the abdominal organs, helping to reduce congestion and restore normal motor function.

Objectives of therapeutic exercise:

• general health improvement and strengthening of the patient's body;
• impact on neurohumoral regulation of digestive processes;
• improving blood circulation in the abdominal cavity and pelvic organs, preventing adhesions and microcirculation disorders;
• strengthening the abdominal muscles, increasing intra-abdominal pressure, stimulating the motor function of the gastrointestinal tract;
• development of full breathing;
• positive impact on the patient's neuropsychic sphere, increased emotional tone.

Indications for physiotherapy:

• hernias of the esophageal opening of the diaphragm;
• splanchnoptosis (pubescence of internal organs);
• chronic gastritis with normal and increased secretion and with secretory insufficiency;
• gastric ulcer and duodenal ulcer;
• colitis and enterocolitis;
• biliary dyskinesia.

In therapeutic gymnastics, along with general strengthening exercises, special complexes for the abdominal press and respiratory muscles are used. In a standing position, forward and sideways bends, turns, exercises for the legs (flexion, extension, abduction, lifting) are done.

In the lying position, the exercises are performed in two versions. The first version is the least stressful and convenient for gradually increasing the load on the abdominal muscles. In this version, the torso is fixed, and the legs are mobile. In the second version, the patient lies on his back, the legs are motionless, all exercises are performed with body movements. These are the most stressful exercises, their implementation is facilitated by using the hands. These exercises should be used in the middle of the course of treatment, i.e. after preliminary training.

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Physiotherapy for hiatal hernia

Therapeutic gymnastics is performed no earlier than 2 hours after eating. The exercises are performed in a supine position with the head end raised and standing. Exercises are used for the arms, legs, neck and torso - lateral bends and turns to the right and left. Forward bends of the torso are strictly prohibited. Diaphragmatic breathing is widely used with an emphasis on an extended exhalation.

The tension of the abdominal muscles causes a simultaneous contraction of the diaphragm, so special attention is paid to exercises to relax muscle groups (for example, in the supine position, swinging of bent legs to the sides, exercises in voluntary relaxation of the abdominal muscles are shown). These exercises are performed in the first half of the course of treatment. Then include exercises with moderate tension of the anterior abdominal wall. Therapeutic gymnastics is performed twice a day. In addition to therapeutic gymnastics, dosed walking, swimming and other forms of therapeutic exercise are recommended. Sports that require bending the body forward are excluded.

Physiotherapy for splanchnoptosis

Physical exercises tone the abdominal and pelvic floor muscles. The training strengthens the muscular corset, which significantly affects the retention of the abdominal organs. During the first 2-3 weeks, exercises are performed only in a lying position on an inclined plane with the foot end of the couch raised (to return the abdominal organs to a higher position). Special exercises for the abdominal muscles and pelvic floor alternate with general strengthening and breathing exercises.

After 5-7 weeks, it is necessary to pay attention to corrective exercises to form correct posture, which promotes the physiological arrangement of internal organs.

Exercises are performed at a calm pace, without jerks and sudden movements. Movements that cause shaking of the body (jumps, jumps) are excluded. Massage of the abdominal muscles is also recommended.

Physiotherapy for chronic gastritis

The method of therapeutic exercise depends on the nature of secretory activity. In case of gastritis with decreased secretion, moderate load, general strengthening exercises, special exercises for the abdominal muscles in the initial sitting and lying positions are necessary. Complex types of walking are used. Therapeutic gymnastics are performed 25-30 minutes before taking mineral water to improve blood circulation in the stomach. Walks, walking excursions, short-distance tourism, bathing, swimming, rowing, skating, skiing, massage of the anterior abdominal wall are recommended.

Therapeutic gymnastics for gastritis with normal and increased secretion in the first half of the course of treatment is aimed at strengthening the body and normalizing increased reactivity in general and in response to stress in particular. Physical exercises are performed rhythmically, at a calm pace. In the second half of the course of treatment (after 10-15 days), exercises with a greater load are used, and the load on the abdominal muscles should be limited. Therapeutic gymnastics are carried out between the daytime intake of mineral water and lunch, since mineral water with this sequence of intake has an inhibitory effect on gastric secretion. Walks, excursions, bathing, swimming, skiing, skating are recommended. Massage of the back muscles on the left, the lower edge of the costal arch on the left and the epigastric region is indicated.

Therapeutic exercise for gastric ulcer and duodenal ulcer

Physiotherapy exercises for peptic ulcer disease help regulate excitation and inhibition processes in the cerebral cortex, improve digestion, blood circulation, respiration, oxidation-reduction processes, and have a positive effect on the patient's neuropsychiatric state. When performing exercises, the stomach and duodenum are spared. Exercises are not performed in the acute period. Exercises are prescribed 2-5 days after the acute pain has stopped. During this period, the procedure should not exceed 10-15 minutes. In a lying position, exercises are performed for the arms and legs with a limited range of motion. Physical activity is increased gradually. To prevent the adhesion process, exercises for the muscles of the anterior abdominal wall, diaphragmatic breathing, simple and complex walking, rowing, skiing, outdoor and sports games are used.

Contraindications to the appointment of therapeutic physical training: bleeding, penetrating ulcer, occurrence of acute pain during exercise.

Therapeutic exercise for bowel diseases

Therapeutic exercise is used for chronic colitis, enterocolitis, and diseases with severe intestinal motility disorders. Special abdominal exercises are selected taking into account the characteristics of the pathological process.

In case of spastic constipation, much attention is paid to the choice of starting positions that promote relaxation of the anterior abdominal wall (standing on all fours, lying on the back with bent legs), the use of exercises with a load on the abdominal press and exercises where the moment of effort is expressed (raising and lowering straight legs in a lying position) is limited. On the contrary, with the predominance of intestinal atony, emphasis is placed on exercises for the abdominal muscles in various starting positions with strength elements and a significant load.

To increase the load, increase the number of repetitions of each exercise, and then add new exercises. Other forms of therapeutic exercise include walking tours, dosed cycling, and skiing. A combination of therapeutic gymnastics with massage is effective.

Therapeutic exercise for biliary dyskinesia

Depending on the nature of functional disorders of gallbladder contractility, dyskinesia is divided into hyperkinetic and hypokinetic. Clarification of the clinical form is necessary for a differentiated approach to the construction of a method of therapeutic gymnastics. It is necessary to ensure an effect on the central and peripheral nervous mechanisms of regulation of gallbladder functions, improve blood circulation in the abdominal cavity, create conditions for facilitating the outflow of bile from the gallbladder (in the hypokinetic form), improve bowel function (fight against constipation), and have a general strengthening and healing effect on the patient's body as a whole.

In the hypokinetic form, average general physical activity is recommended. The starting positions are varied. Exercises from a lying position on the left side are prescribed to improve the outflow of bile. Forward bends of the body and rotations should be used with caution, as they can cause nausea, belching, and vomiting.

In the hyperkinetic form, the first sessions are low physical activity, with subsequent increase to medium. Avoid pronounced static tension of the abdominal muscles. Breathing exercises on the right side are recommended to improve blood supply to the liver. Before the session, passive rest for 3-7 minutes in a lying position is necessary. While resting, you can perform self-massage of the abdominal muscles.

Therapeutic exercises for chronic gastritis with secretory insufficiency

Introductory section, starting position - sitting. Elementary exercises for arms and legs combined with breathing (1:3). The goal is to adapt the body to physical activity. Duration 5 min.

• Main section: starting position - sitting and standing.
• Exercises for arms, legs and torso, breathing exercises. Duration 5 min.
• Walking is simple and more complex (with high hip lifts, ski steps, etc.). Duration: 3-4 min.
• Starting position - lying on your back with your torso fixed. Exercises for your arms and legs. Duration: 10-12 min. Goal: increasing intra-abdominal pressure, strengthening the muscles of the anterior abdominal wall.
• Final section. Walking combined with arm movements and breathing exercises. Duration 2-4 min.

Therapeutic exercises for chronic gastritis with normal and increased secretion

• Introductory section: walking with a change of pace, movement of arms, legs and breathing exercises. Duration 3-5 min. The goal is to prepare the body for physical activity.
• Main section: starting position - sitting and standing. Exercises for arms and legs without gymnastic apparatus and with a gymnastic stick, media pinball. Duration 5 min. Goal - increasing overall tone, improving the functions of the main organ systems, coordination of movements. Starting position - standing at the gymnastic wall. Exercises for arms, legs, torso. Duration 5-7 min. Outdoor games such as relay races 10-12 min. Goal - changing the patient's emotional state.
• Final section: starting position - sitting. Elementary exercises combined with breathing. Duration 2-3 min. Goal - reducing the overall load.