Health improvement technologies for physical rehabilitation service to junior schoolchildren with autonomic disorders

PhD, Associate Professor I.N. Bakai1
PhD, Associate Professor N.V. Karpova1
PhD, Associate Professor V.P. Kartashev1
A.N. Studneva1
1Russian State Social University, Moscow

Keywords: schoolchildren, vascular dystonia, physical rehabilitation.

Introduction. Autonomic disorders can be detected in almost all children, starting from the neonatal period. Their prevalence rate ranges from 15 to 80%, occurring 2.5 times more often in girls than in boys. Moreover, in different age periods, it is only the degree of severity that varies. In contrast to adults, children diagnosed with autonomic imbalance have more pronounced somatic disorders. At the same time, it is always more difficult to suspect a life-threatening organic pathology in children [6].

The article presents the technologies for physical rehabilitation service to primary schoolchildren (7-10 years) diagnosed with vascular dystonia, with due regard to their vegetative tone and including special, respiratory, conditioning exercises, as well as relaxation exercises with the use of a variety of modern health-improving and rehabilitation equipment.

Methods and structure of the study. The effects of physical rehabilitation facilities on the functional state of children were determined using the following means and methods: functional diagnostics of the cardiovascular system  (heart rate and blood pressure monitoring), anthropometric measurements (body weight, body length, chest circumference), assessment of physical fitness of children. In addition, the following control exercises were used: 30 m run from standing start, 90 m run, 3x10m shuttle run (s), medicine ball throw (cm), standing long jump (cm), one-leg standing test (s), bows front (cm) [1, 5].

Children diagnosed with vascular dystonia are attributed to a special health group and they are trained by a special program. Special health group is made of those children whose state of health requires physical exercise by a separate program with due regard to their health condition (III-IV health groups). Physical education classes for the special health group children are compulsory and are included in the structure of educational loads in the academic process [2].

It is based on the content of general program, the practical section of which excludes physical exercises that may cause overstrain, for example, physical exercises that lead to the maximum and proximal stresses of cardiovascular and musculoskeletal system [3]. The program includes special exercises with a health-improving effect. The special program does not contain any regulatory requirements, although provides that a certain level of physical fitness should be achieved for successful development [2]. Gymnastics (conditioning and special exercises) holds a special place during physical education classes, since it helps to successfully improve the basic motor qualities and develop motor skills. Moreover, gymnastic exercises and the methodology for their implementation make it possible to accurately determine in advance the optimal load on the body of those involved and the expected educational effect, which is very important when working with this category of children. The program includes breathing exercises that should be used in each training session. Muscle relaxation exercises are widely used to reduce fatigue and increase physical working capacity. At the same time, rope climbing, pull-ups and acrobatic exercises associated with exertion, prolonged strain causing a long breath holding are completely excluded from gymnastic practices in a special health group. Particular attention is given to strictly graded exercises - walking and running, as they help to train and strengthen cardiovascular system and respiratory system. Long and high jumps are limited (from a short run, from three steps, not more than two, three jumps in one training session, etc.). Speed, strength, and endurance exercises are limited as well. Running and jumping games, as well as distance running, are reduced.

The importance of outdoor games can hardly be overestimated as they include simple and natural movements that do they not cause severe fatigue (loads alternates with short rest breaks), which makes them a good means of emotional and physiological impact on schoolchildren [2, 4].

The technologies for physical rehabilitation service to schoolchildren diagnosed with vascular dystonia is designed for 3 months and consists of the following rehabilitation measures: therapeutic gymnastics (conditioning, special, breathing exercises, relaxation exercises, outdoor games, fitball exercises), simulator exercises, therapeutic massage, therapeutic swimming with the elements of rhythmoplastics and water aerobics, used depending on the type of vegetative tone. In addition, such children are recommended to do a daily morning hygienic gymnastics for 8-12 min; which in the group is carried out 2 times a week for 25 min under the supervision of a physical training instructor, with 3-min Physical Education breaks during conditioning classes. The developed physical rehabilitation course for children diagnosed with vascular dystonia consists of 3 periods.

Preparatory period (1 month). The main purpose during this period is to help children adapt to physical activity, new movements, regular exercise, as well as learn special exercises. At this stage, therapeutic gymnastics is implemented: special exercises, conditioning exercises, and simulator exercises. The training sessions are held 3 times a week and last 25 minutes each.

Main period (1 month). At this stage, therapeutic massage (TM) is implemented in addition to therapeutic gymnastics where the number of repetitions increases, the requirements for the accuracy of exercise performance are raised, and the duration of the training sessions increases. The main emphasis must be placed on the correct execution of special exercises aimed to correct each type of disorder (hyper- or hypotonic vegetative tone). The training sessions are held 4 times a week (Weeks 1 and 3 - therapeutic gymnastics and therapeutic massage, Weeks 2 and 4 - therapeutic gymnastics and simulator exercises), therapeutic gymnastics - 30 min, therapeutic massage - 15 min, exercises on the training simulators - 25 min.

Training period (1 month). The main task during this period is to consolidate the technique and sequence of exercises, maintain a comfortable vegetative tone for children, preserve the results achieved and develop the independent physical training skills. At this stage, depending on the type of vegetative tone, therapeutic swimming with the elements of rhythmoplastics and water aerobics is introduced. The training sessions are held 4 times a week: Monday, Friday - therapeutic exercises - 35 min, Tuesday, Thursday - therapeutic massage - 15 min, followed by therapeutic swimming - 30 min.

Tables 1 and 2 represent the structure of the physical rehabilitation course for schoolchildren diagnosed with vascular dystonia with due regard to the type of vegetative tone and weekly cycle.

Table 1. The structure of the physical rehabilitation course for children with vascular dystonia used in general education institutions

Training week

Training groups, weekdays

Increased vegetative tone

Decreased vegetative tone

Mon

Tue

Wed

Thu

Fri

Mon

Tue

Wed

Thu

Fri

Period

Preparatory period (1 month)

Week 1

TG

 

SE

 

TG

TG

 

SE

 

TG

Week 2

TG

 

SE

 

TG

TG

 

SE

 

TG

Week 3

TG

 

SE

 

TG

TG

 

SE

 

TG

Week 4

TG

 

SE

 

TG

TG

 

SE

 

TG

Main period  (1 month)

Week 1

TG

TM

 

TM

TG

TG

TM

 

TM

TG

Week 2

TG

SE

 

SE

TG

TG

SE

 

SE

TG

Week 3

TG

TM

 

TM

TG

TG

ЛМ

 

TM

TG

Week 4

TG

SE

 

SE

TM

TG

SE

 

SE

TG

Training period (1 month)

Week 1

TG

TM,TS

 

TM, TS

TG

TG

TM, TS

 

TM, TS

TG

Week 2

TG

TM, TS

 

TM, TS

TG

TG

TM, TS

 

TM, TS

TG

Week 3

TG

TM, TS

 

TM,

TS

TG

TG

TM, TS

 

TM, TS

TG

Week 4

TG

TM, TS

 

TM, TS

TG

TG

TM, TS

 

TM, TS

TG

 

Legend. Here and in Table 2: TG – therapeutic gymnastics, SE – simulator exercises, TM – therapeutic massage, TS – therapeutic swimming.

Table 2. Differences between physical rehabilitation means for children diagnosed with vascular dystonia depending on the type of vegetative tone

Increased vegetative tone

Decreased vegetative tone

Simulator (elliptical trainer)

Simulator (stepper)

TG (relaxation exercises)

TG (dynamic exercises)

TM (relaxation technique)

TM  (tonic technique)

TS  (elements of rhythmoplastics)

TS  (elements of water aerobics)

Results and discussion. Implementation of the presented physical rehabilitation methodology in the general education institution for the 7-10 year-old children diagnosed with vascular dystonia revealed the improvement in their vegetative functions, normalization of vegetative tone, improvement in heart rate, blood pressure, pulse pressure, positive age-related dynamics of anthropometric indicators, improvement of their physical fitness level as proved by the results of all motor tests carried out after applying the physical rehabilitation technique. There was also a decrease in the number of children’s complaints of feeling unwell.

Conclusions. The developed technology for physical rehabilitation service to primary (7-10 year-old) schoolchildren diagnosed with vascular dystonia, depending on the type of vegetative tone, has a positive effect on the cardiovascular system, autonomic nervous system, helps stabilize vegetative tone and improve somatic health. In view of the positive results obtained, we can conclude that this physical rehabilitation methodology can be applied to children diagnosed with vascular dystonia to increase the effectiveness of physical rehabilitation.

References

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Corresponding author: irinasyazina@mail.ru

Abstract

The article analyzes benefits of health improvement technologies for physical rehabilitation service to primary (7-10 year-old) schoolchildren with autonomic disorders including vascular dystonia. Presently autonomic disorders are ranked among the most common ‘modern civilization specific’ diseases of this age group, with a special role in the disease propagation played by the so-called micro-social factors of the relevant childcare establishments (kindergartens and schools) i.e. children’s adaptation challenges, mental stresses and physical inactivity. The functionality tests in the adaptation periods found a high incidence of autonomic regulation stresses and overstresses, with the disorders reported to stay for 3-4 school quarters. It is not unusual that the autonomic functionality disorders are neither diagnosed nor corrected in a timely manner. It should be emphasized that autonomic disorders are widely variable in their symptoms and growth mechanisms and, hence, difficult for cure. A big role in the vascular dystonia treatment therapy is played by non-pharmacological and alternative therapeutic methods. As soon as a vascular dystonia diagnosed in a child, the therapy shall be focused on the general balance rehabilitation and nervous system functionality correction actions, and this is the reason why the physical rehabilitation methods for children with vascular dystonia are in high priority nowadays.