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medical physical training.

Employment LFK it is spent from first days after hospitalisation of the patient to a traumatologic hospital. For each patient it is made individuyoalnyj a complex of medical gymnastics before operative treatment.

In the preoperative period in complex LFK it is included respiratory exercises of static type (naduvanie a ball, a deep inspiration with an exhalation through the water filter, thorax compression on an exhalation) and obshcherazvivajushchie uprazhyonenija for muscles of a back, a stomach and a shoulder girdle, and also obshcherazvivajushchie and special exercises for all joints of the intact extremity. For interfacing joints of the injured extremity it is recommended ideomotornuju gymnastics, that is represented, imagined exercises, which vyyopolnjajutsja at first by activly healthy extremity, then mentally — povrezhyodennoj. We prescribe also isometric gymnastics for muscles of an anticnemion and foot of the injured extremity.

In the postoperative period early activation of patients is spent. Special methods of regenerative treatment are referred not only on preventive maintenance of postoperative complications, but also on active vosstanovleyonie impellent functions taking into account a stage reparativnyh processes in a regimen of progressively increasing load with an early full axial load on koyonechnost. In the first days after a surgical intervention we allow vozmozhyonost suffered to adapt for new conditions. About 2 days after operation of employment LFK included static and dynamic dyhayotelnye and obshcherazvivajushchie the exercises covering all muscular grupyo
py, and also «vascular gymnastics». For this purpose the patient (in a dorsal decubitus) lifts and 5 - 7 minutes keep the injured extremity above body level. After reduction of an edema the patient lowers an extremity from a bed to floor level. At occurrence of an edema and heavy feeling in stop and an anticnemion, the patient lifts again and keeps the injured extremity above body level. Exercises carry out to 5 repetitions on one approach utyorom and in second half of day.

For restoration of functions of the bottom extremities widely used active movements by fingers of feet, a back and plantar flexion, circular movement by stops in kontrlateralnoj extremities, ideomotornye exercises. The axial load on the operated extremity was excluded. Because at the given pathology of an atrophy muscles of an anticnemion and stoyopy more often are exposed, in employment included isometric strains of these muscles. Walking on crutches without a load on the injured extremity resolved from 3rd day poyosle operations.

During a foot immobilisation it is recommended isometric ritmicheyoskoe reduction ikronozhnoj muscles, active and passive movements in susyotavah fingers, shposne-phalanx joints, joint Lisfranka, knee and coxofemoral joints of the injured extremity. Taking into account positive nejroreflektornogo influences it is without fail recommended aktivyonye and passive movements in joints kontralateralnoj extremities, including over - and podtarainyj joints and joint SHopara. Exercises are carried out 3 times a day on 10 - 15 minutes on one procedure. Duration of one protseyodury it is gradually enlarged to 30 - 40 minutes, frequency of procedures to 6 times in suyotki.

In postimmobilizatsionnom the period it is prescribed active and passive movements in talocrural, podtarannom and joint SHopara, knee-bends, walking with a serial leg to forward department of feet, on heels, vnu trenny and naruzhyonyj foot edge. We spend exercises with burdening, with espanderom.

4.4.2.

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Scientific source Ivanov PETER VALENTINOVICH. OPTIMIZATION of TACTICS of SURGICAL TREATMENT And POSTOPERATIVE AFTERTREATMENT of PATIENTS With CALCANEUS FRACTURES. The dissertation on competition of a scientific degree of the candidate of medical sciences. Kazan -.

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