Purpose: to highlight the main provisions of a comprehensive physical rehabilitation program for students of special medical group based on violations of the motor capacity. Material: testing 24 students of special medical group and the same number of their healthy peers on standardized tests of physical qualities. To reflect the movement disorders applied functional movement screen. Results: a program of rehabilitation of the students included: lifestyle modification; morning hygienic gymnastics; kinesitherapy (using yoga fitness, functional training); aerobic exercise (swimming, Nordic Walking, jogging, aerobics wellness); massage. First presented a unified approach to working with students of special medical groups -selection based on load capacity motor disorders according to the results of tests of functional movement screen. The complexity of the impact of the program involves the impact on the physical, social and mental health components. Conclusions: the author's program of physical rehabilitation of students of special medical group is complex.
Резюме. У статті розглядається дуже важливе питання інтеграції онлайн-навчання у вищих навчальних закладах. У зв’язку із розвитком пандемії задля забезпечення карантинного режиму усі навчальні заклади було переведено в режим онлайн-навчання з використанням онлайн-платформ, таких як ZOOM, Microsoft TEAMS, Google Classroom та інші. Проаналізувавши світовий досвід навчання у різних університетах, зокрема і в медичному університеті, ми побачили, що у Європі наші колеги-викладачі давно практикують змішаний тип навчання. А саме: частина лекцій та семінарських занять, усі домашні завдання, атласи, книги, відеоматеріали та відеолекції студент отримує у своєму особистому кабінеті або класі (який знаходиться на серверах університету). Викладачі мають доступ до цих особистих кабінетів та можуть відстежувати прогрес студентів, а саме: кількість опрацьованого матеріалу, чи переглянуті відео повністю, чи здані домашні завдання, чи вирішені тести. Практична частина, а саме відпрацювання певних навиків, які є необхідними кожному студенту-медику у своїй майбутній медичній практиці, відбувається циклом у різних відділеннях та лікарнях. Така схема змішаного навчання дозволяє студентові опрацьовувати теоретичний матеріал у зручний для нього час. Українські університети до періоду пандемії були виключно на офлайн формі навчання. І, на жаль, в умовах жорсткого карантину, реалізувати змішану форму навчання вкрай важко, зважаючи на певні загальнодержавні обмеження. Існувала така ймовірність, що студенти-медики продовжать навчання онлайн з осіннього семестру. Було б доцільно з боку керівництва першочергово провести детальний та ретельний інструктаж щодо освоєння онлайн-платформ для якісного проведення пар, лекцій чи семінарських занять.
The adolescents aged between 15 and 17 with postural disorders in the sagittal plane, who live in mountainous regions in the Carpathians, achieve less than their peers with similar postural disorders, who live in plain regions. The research aims to develop the comprehensive programme for correcting postural disorders in the sagittal plane among pupils, who live in mountainous regions in the Carpathians, using physical rehabilitation, and establish the links between empirical data of the experiment and neurosciences to develop methods of complex psychophysical and neurophysiological diagnostic and rehabilitation of adolescents with such disorders in further research. The research is based on a detailed observation of 319 adolescents aged between 15 and 17 from mountainous regions of the Ukrainian Carpathians and 94 pupils from plain regions with postural disorders in the sagittal plane. The research methods are the following: an analysis of the scientific and specialized literature; surveys and questionnaires; pedagogical tests; methods for determining the indicators of physical development, functional readiness and functions of the spine; methods of mathematical statistics, namely, the Ruffier-Dickson test, Otto test, Schober test, Thomayer test, Fleischmann test, Sedin test and spinal index, inclinometer measurements. The pupils who suffer from the stoop and round spine have shown a decrease in average values in the angles of lordosis and kyphosis curves; pupils who suffer from flat back – an increase in the angles of the sacral bone, lordosis and kyphosis curves; pupils who suffer from the round and concave back – a decrease in the angles of the sacral bone, lordosis and kyphosis curves. The implementation of the author’s programme for physical rehabilitation has made it possible to achieve a statistically significant improvement in most of the analyzed indicators. Finally, the article extrapolates the results of the experiment to their neurophysiological and neuromedical application in terms of enhancing anamnesis and taking into account post-correction data in subsequent medical treatment.
The Aim is to determine the level of functional ability of abdominal muscles in patients of different ages after LCH in the long-term rehabilitation period. Materials and methods. Lovett's manual muscle testing (MMT) was performed on 113 patients after laparoscopic cholecystectomy (LCH), who were undergoing rehabilitation at the Morshyn kurort resort complex in 2020 and 2021. The average age of patients was 52,96±0,62 years. Patients were divided into 3 groups according to three age categories: group A - women aged 18 to 44 years (n = 14); group B - aged 45 to 59 years (n = 79); group C aged from 60 to 74 years (n = 20). Inclusion criteria: patients after LCH from 1 month to 1 year after surgery. Exclusion criteria: patients who have contraindications to testing: early postoperative period; pregnancy; severe circulatory failure, the presence of patients with neuropsychiatric pathology; peptic ulcer of the stomach and, or duodenum with bleeding, patients' refusal to participate in the study. Methods. Evaluators were blinded during testing. Methods of synthesis, analysis and mathematical statistics. Indicators under study: functional ability of torso flexion and rotation muscles. In order to assess the effect of LCH on the functional ability of the abdominal muscles, MMT was performed according to the Lovett method. The results of the study. The results of the assessment of the functional ability of the abdominal muscles of patients after LCH in the long term indicate a decrease in the strength of the abdominal muscles in patients of three groups. Analyzing the results, it was found that the functional ability to bend the torso was the best in the youngest group A 2.86 ± 0.20 points. Slightly lower level of torso flexion was in group B 2.44 ± 0.07 points and the worst in the oldest group C - 2.20 ± 0.11 points. A statistically significant difference was found between the three groups in this indicator. In all three groups, the level of functional flexion of the abdominal muscles of patients after LCH was low. However, it was found that in three age groups there is an asymmetry in the level of muscle strength - in all patients the muscles that perform the function of torso rotation on the right are weaker than the muscles on the left side. In all three groups, there was a greater statistically significant difference between the strength of the functional ability of the abdominal muscles to rotate on the left than on the right. This result indicates that even minor surgery with minor damage to muscle fibers and fascia reduces the functional capacity of the abdominal muscles. LCH leads to an asymmetry in the strength of the external and internal oblique muscles of the abdominal press - a statistically significant decrease in the functional state of these muscles on the right compared with the strength of the muscles on the left in all age groups. Conclusions. The low level of functional ability of the abdominal muscles of patients after LCH in the long term requires the inclusion in the protocols of rehabilitation physical therapy and occupational therapy. Accordingly, physical therapy and occupational therapy programs at this stage should include techniques to increase the strength of the abdominal muscles, due to the postponed surgery, recovery and improvement of motor capacity.
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