Excursion of the chest (G. Funtikov). Assessment of respiratory excursion of the chest How is chest circumference measured?

Rice. 3. Weight indicators for 10th grade students in %

Rice. 4. Chest circumference of 10th grade students in %

Table 1 shows the indicators of height, weight, chest circumference, as well as chest excursion of 10th grade students.

For girls of average body type, height is calculated using the following formula: Height=6*age+76, and for boys - Height=6*age+77. Deviations from average physical values should not exceed ±2.5 cm for boys and ±3.5 cm for girls. If the height obtained in the calculation is 20% more or less than the average, this may indicate endocrine disorders. Normal chest excursion is 6 to 9 cm.

ChapterII. Determination of harmonious physique

The owner of a proportional figure is considered to be a person whose all indicators are less than half, and whose waist circumference is no more than half his height. The harmony of the physique is determined by the indicator of chest development, calculated by the formula:

Chest circumference x 100

Height

With a normal physique, the value of harmonious physique is 50-55%. If this ratio is less than 50%, the physique is weak, and if it is more than 50%, it is strong.

Analysis of the results of calculations of the harmonious physique of 10th grade students showed that the majority of 10th graders - about 60% - have a normal physique, 36% - weak, 4% - strong. The data is shown in Fig. 5 and Table 2.

Rice. 5. Body harmony of 10th grade students in %

Table 2 shows not only indicators of harmonious physique (PH), but also the state of posture of 10th grade students, which will be discussed in Chapter 3.

Physical education of children and adolescents is carried out in a specific environment, the factors of which are both socio-economic and environmental conditions (E.A. Kriksunov, 1997).

Therefore, the physical condition of children, on the one hand, can be considered as a result of the influence of these conditions, and with the targeted influence of physical education - as a result of counteracting negative environmental conditions. However, we must not forget that each person is capable of independently strengthening his health and improving physical development (V.P. Pokhlebin, 1992).

Figure 6 shows that 50% of students do not monitor their health - this is a very alarming indicator, especially for this age group. 38% do not pay enough attention to their physical development: perhaps they lack theoretical knowledge to use more advanced techniques; or it is influenced by lack of time with significant school loads, lack of willpower. And finally, only 4% of schoolchildren take their lifestyle seriously and use various methods to preserve and improve their health.

Schoolchildren who are not concerned about their health at all can be advised to start small: say, do morning exercises every day, start a hardening program and do physical exercise in their free time. Psychologically, it is the most difficult to take the first step, but without it it is unthinkable to take your own health seriously.

The largest number of 10th graders should engage in individual physical improvement: play sports taking into account the individual characteristics of the body. The first step has already been taken, you should continue in the same direction.

Those schoolchildren who are serious about their health can continue to carry out their health programs.

Rice. 6. Attitude of 10th grade students to their health in %

Chapter 3. Determining correct posture

Throughout a person’s life, the ratio between organic and inorganic substances in bone tissue changes. The bones of a child have more organic substances, while those of older people have more mineral substances.

With curvature of the lumbar spine, it can develop lordosis(from the Greek lordos - curved). In this case, the spine and chest are curved, which leads to dysfunction of the respiratory and digestive systems. As a result of these diseases, a person’s metabolism decreases, increased fatigue, and headaches appear (L. P. Anastasova et al., 1997).

When posture is impaired, various pathological changes occur in the musculoskeletal system, curvature of the spine occurs, which can lead to various diseases.

Therefore, it is very important to observe hygienic rules of behavior, especially at a young age (the formation of correct posture in a person stabilizes by the age of 18). And first of all, a person must monitor his posture (Appendices 2,3).

At the second stage of work, 10th grade students determined the state of their posture (in anthropometry this method is called somatoscopic). To do this they used the formula:

A= shoulder width*100%

the size of the arch of the back,

Where A– posture indicator.

The results are shown in Table 2 (see Chapter 2) and Fig. 7.

These data were compared with the average statistical data:

100-110% - normal posture;

Less than 90 or more than 125% - severe violation of posture;

90-100% or 110-125% - slight violation of posture.

From Fig. 7 shows that 42% of students have a pronounced violation of posture.

36% - minor postural disorders. Normal posture is found in 22% of tenth graders.

The reason may be that in the lyceum all the desks and chairs are almost the same standard size (Sanitary rules and regulations, 2001).

Rice. 7. State of posture of 10th grade students in %

Chapter 4. Determination of physical activity, risk factors, health level and degree of adaptation to the environment

The physical development and health of students depends on many factors. The attitude of teenagers to their health is of great importance: playing sports, morning exercises, proper nutrition. In order to determine risk factors in the development of morbidity, 10th grade students were offered several tests: “Risk Factors”, “Physical Activity”, “Health” - V.A. Ivanchenko, 1994, P.P. Morev, 1993, V. Mikhailov, A. Palko, 1987 (Appendix 4, Appendix 5, Appendix 6). Test results are in Table 3.

I. Preparation for the procedure:

1.Introduce yourself to the patient, explain the purpose and course of the procedure.

Make sure that the patient has informed consent for the upcoming procedure.

II. Performing the procedure:

2. Place a measuring tape on your back along the lower corner of the shoulder blades, and on the front surface of the chest at the level of the 4th ribs; in men, this line coincides with the line of the nipples, and in women, above the mammary glands.

3. Take three measurements:

With quiet breathing;

At maximum inspiration;

With maximum exhalation.

III. End of the procedure:

4. Record all three readings in centimeters on the temperature sheet.

Remember:

Normally, the difference in readings at maximum inhalation and exhalation is:

1. For women – 4-9 cm.

2. For men – 6-12 cm.

The chest circumference for men is 88-92 cm, for women – 83-85 cm. Indicators vary depending on physical development.

The values of height, weight, chest circumference are necessary to obtain various indicators (indices).

1. Height and weight indicator. Characterizes body weight that is proportional to height. To calculate it, body weight in kilograms is multiplied by 100 and divided by height in centimeters.

The average height and weight indicator is 32-40. A higher score indicates overweight. Lower - about insufficient weight.

2. Index of proportionality between height and chest circumference. To calculate it, chest circumference, expressed in centimeters, must be multiplied by 100 and divided by height, expressed in centimeters. Normally, this index is 50-55 (for normosthenics), an index of less than 50 indicates narrow-chestedness (for asthenics), and more than 55 indicates broad-chestedness (for hypersthenics).

3. Pinier index. It is calculated by subtracting from the height, expressed in centimeters (L), the sum of the chest circumference, expressed in centimeters (T), and body weight, expressed in kilograms (P), i.e. L-(T+P).

For normosthenics, the Pignier index ranges from 0 to 20,

For asthenics from 20 to 50

For hypersthenics - below 0

PHYSIOMETRIC INDICATORS.

Physiometric indicators include lung capacity and muscle strength.

Vital capacity (VC) is determined using a spirometer.

Spirometry is a method for determining the function of the respiratory apparatus. Based on the spirometer readings, one can judge the function of the cardiovascular system.

Average vital capacity indicators for adult men are 3.5–4 liters (3500-4000 cm3), for women – 2.5-3 liters (2500-3000 cm3).

With age, vital capacity indicators change and the indicators of patients suffering from respiratory and circulatory diseases change significantly. The study is carried out 3 times in a row and the best result is noted.

TECHNOLOGY FOR PERFORMING SIMPLE MEDICAL SERVICES - SPIROMETRY:

1. Place a custom sterile mouthpiece on the spirometer.

2. Position the patient facing the spirometer.

3. The patient takes the spirometer in his hand.

4. Invite the patient to take 1-2 inhalations and exhalations first.

5. Invite the patient to take the deepest breath possible, pinch his nose and slowly exhale as much as possible through the mouthpiece.

6. Determine the volume of exhaled air using the scale.

7. Write down the data in the medical history.

Dynamometry– measurement of muscle strength. The determination is carried out using a hand-held dynamometer in kilograms.

TECHNOLOGY FOR PERFORMING SIMPLE MEDICAL SERVICES - DYNAMOMETRY.

1. Invite the patient to take the dynamometer in his hand with the dial facing inward.

2. Extend your arm to the side, in a strictly horizontal position.

3. Compress the dynamometer as much as possible.

The method of anthropometric research is widely used to determine the physical development of people involved in physical education and sports. This method of studying the human body is mainly based on taking into account quantitative, external morphological indicators. However, a number of anthropometric studies (spirometry, dynamometry) also provide insight into the functions of various systems and organs. In general, indicators of physical development reflect the functional state of the body and are important for assessing health and performance.

The technique for conducting anthropometric studies is not complicated. They are usually carried out by nurses. However, like any other scientific research method,

anthropometry requires skills and compliance with certain conditions that ensure the correctness and accuracy of the indicators. These basic conditions for carrying out all anthropometric changes are:

Carrying out research using a single unified methodology;

Conducting primary and repeated studies by the same person and with the same tools;

Study at the same time of day (best in the morning on an empty stomach);

The subject must be without clothes or shoes (only underpants are allowed).

Determination of weight. Weighing is carried out on ordinary decimal medical scales, which must be verified and adjusted before use. The scale platform must be exactly horizontal to the floor (this is checked by a plumb line or a water “eye” installed on the scales). The scales must be sensitive to a weight of 100 g. The correctness of the scales is checked by periodically weighing the branded weights (at least 30 kg). The subject must stand motionless in the middle of the scale platform. On the site, it is advisable to mark with paint the footprints where the subject should stand.

Height measurement. Height is measured with a conventional wooden stadiometer or a metal anthropometer of the Martin system.

Measuring standing height using a wooden stadiometer is carried out as follows: the subject stands on the stadiometer platform with his back to the stand with a scale and touches it with three points - the heels, buttocks and the interscapular space. The head should not touch the stadiometer 1, but should be slightly tilted so that the upper edge of the external auditory canal and the lower edge of the orbit are located in one line parallel to the floor.

The measurer stands at the side of the person being examined and lowers a tablet sliding along a centimeter scale onto his head. The counting is carried out along the lower edge of the tablet. It is necessary to ensure that the person being examined stands without tension; Women with high hairstyles should have their hair down when measured.

Height measurement in a sitting position is carried out using the same wooden stadiometer, which has a folding bench fixed at a distance of 40 cm from the floor. The measurement is carried out as follows: the person being examined sits deeper on the bench with his back to the stadiometer stand,

The head touching the stadiometer is possible if the subject has a dolichocephalic skull shape.

Measuring height with an anthropometer. Martin's metal anthropometer consists of 4 folding hollow metal rods. A muff with a cutout slides along the rod, on which divisions are applied with an accuracy of 1 mm. At the upper end of the anthropometer, a second coupling with a measuring ruler is fixedly attached. The upper rod of the anthropometer can be used separately as a compass to determine the width of body parts. The entire device can be disassembled into parts and put into a case, it can be easily transported and carried, which makes using the anthropometer very convenient.

It is carried out with a rubberized measuring tape in three positions: at rest, with full inhalation and maximum exhalation. The difference between the amount of inspiration and output is called chest excursion; this is an important indicator of the state of respiratory function.

Methodology for studying chest circumference. The subject is asked to spread his arms to the sides. The measuring tape is applied like this. so that in the back it passes under the lower angles of the shoulder blades, and in front in men and children of both sexes up to 12-13 years old - along the lower segment of the nipple, in women - above the mammary gland at the place of attachment of the 4th rib to the sternum; After applying the tape, the subject lowers his hands. You should check that the tape is applied correctly. For convenience, it is recommended to conduct the study in front of a mirror, to which the subject’s back is turned. You can see in the mirror whether the tape is applied correctly at the back.

The chest circumference at rest in adult men is 88-92 cm, in women 83-85 cm. The excursion of the chest, depending on the height of the subject and the volume of the chest, is 6-8 cm in adult men, 3-6 cm in women.

As a result of regular exercise, especially sports, the chest excursion can increase significantly and reach 12-15 cm.

Spirometry is a method by which the vital capacity of the lungs is determined. The measurement is carried out with a water spirometer, which consists of two hollow metal cylinders inserted one into the other. The spirometer capacity is usually 7 liters.

Research methodology. The subject stands facing the spirometer and takes the mouthpiece with the rubber tube in his hands. Then, after taking 1-2 inhalations and exhalations, he quickly takes in the maximum amount of air and smoothly blows it into the mouth. The study is carried out three times in a row; mark the best result. In this case, each subject must use an individual glass mouthpiece. After use, mouthpieces are boiled.

Spirometry is a good method for determining respiratory function. By spirometry indicators one can, to a certain extent, judge the function of the cardiovascular system.

With age, lung vital capacity changes.

The average vital capacity of the lungs for an adult man is 3500-4000 cm3, for women - 2500-3000 cm3.

In athletes, especially rowers, skiers, and swimmers, the vital capacity of the lungs can reach 5000-6000 cm3 or more.

The amount of lung capacity depends on height and body weight, and therefore it is important to determine the so-called vital indicator, which is the ratio between the vital capacity of the lungs and body weight. For an adult, this indicator should not be lower than 60. The norm for an adult athlete is considered to be 62-68.

Dynamometry is a method by which the muscle strength of the hands and the strength of the back extensor muscles are determined.

A hand-held dynamometer is an ellipsoidal steel plate, the squeezing of which indicates muscle strength, expressed in kilograms.

Research methodology. The dynamometer is held in the hand with the dial facing inward (the button faces the fingers). The arm is pulled to the side and the dynamometer is squeezed as much as possible. Manual strength is noted for each hand separately. The study is carried out 3 times for each hand.

and record the best result. Average right hand strength for adult men is 40-45 kg, for women - 30-35 kg; the average strength of the left hand is usually 5-10 kg less.

Deadlift strength is examined with a special spring dynamometer. The subject stands on a step with a hook on which the chain from the dynamometer is attached. You should stand so that 2/3 of each sole extends beyond the metal base (usually it is embedded in a wooden platform). Legs should be straightened and placed side by side. The torso is bent, the chain is attached to the hook so that the hand from the device is at the level of the track. After this, the subject, without bending his arms and legs, slowly unbends, stretching the chain to failure. Usually a one-time study is sufficient. Deadlift strength in adult men is on average 130-150 kg, in women - 80-90 kg.

Scope of anthropometric studies. In mass medical studies of athletes, they are usually limited to determining weight, height, chest circumference, vital capacity of the lungs, muscle strength of the hand and back strength.

For a more complete and special examination, the scope of research can be expanded and include determining the circumference of the shoulder, forearm, thigh, lower leg, abdomen, neck and the diameter of the chest, its anterior-posterior size, the diameter of the pelvis, etc. These measurements are made when using a measuring tape and a thick compass. Of great interest, in particular, is the determination of body proportions. All these Fig. 13. measurement of deadlift forces. research can significantly expand our understanding of the degree and characteristics of the physical development of the athletes being examined.

The results of anthropometric studies are assessed using the methods of standards, correlation, profiles, and indices.

Assessment using the standards method is the most accurate and objective. The assessment of the physical development of athletes using this method is carried out by comparing (contrasting) the obtained data with the average - standard - values established on a large number of subjects of the same sex, age and height.

By processing a large number (usually the number of subjects is expressed in thousands) of anthropometric studies using the method of variation statistics, the average value - “median” (M) and standard deviation - sigma (±a) are determined. The resulting standard values are tabulated to assess physical development, which are very convenient to use. The data obtained from the measurements are compared with the corresponding indicators of anthropometric standards. If the measured value coincides with that indicated in the table of standards or differs from it in one direction or another by no more than the value of the “average deviation” shown here (±1/2o), then the assessment can be considered satisfactory. If the obtained value differs from the average indicated in the table by more than one standard deviation, then the corresponding individual characteristic should be considered large or small, depending on which direction from the average value it is deviated. If the obtained value differs from the average given in the table by more than two deviations (±a), then the assessment of the characteristic being studied is considered very good or very bad, which thereby indicates extreme variations.

It should be borne in mind that the standard method involves the processing of materials obtained from homogeneous populations of subjects: students, schoolchildren, workers, collective farmers, discharge athletes, etc., living in the same geographical and climatic conditions, in the same city or the same terrain.

Currently, such tables of standards are available not only in republican research institutions, but also in many sports and other organizations and educational institutions. These tables were developed by local experts.

It is also important to take into account the time when anthropometric standards were developed, since it is well known that the physical condition of the population of the USSR is improving from year to year and the old anthropometric standards obtained are no longer suitable for use.

Below, just as a sample, we provide a table for assessing the physical development indicators of athletes.

For the purposes of scientific processing of materials and evaluation of the results of anthropometric studies, some authors consider the correlation method to be the most rational. It is based on the ratios of individual anthropometric indicators, which are calculated mathematically using the correlation coefficient; they determine the so-called regression coefficient. The latter shows by what amount one characteristic changes when another changes by one unit. Using the regression coefficient, you can build a regression scale, i.e. find out what weight, chest circumference, etc. should be for a given height.

The profile method is based on variation-statistical processing of survey results. It allows you to display the obtained data graphically. Usually, for this purpose, grids are prepared in advance, on which digital indicators are plotted.

As an example, we provide a sample anthropometric profile. The disadvantage of this method is the difficulties associated with the production of a large number of meshes and the work of drawing profiles; therefore, apparently, this method is not widely used at present.

The method of indices (indicators) is a set of special formulas with which it is possible to evaluate individual atropometric indicators and their relationships. A number of indicators are of interest and have known practical significance.

The height-weight indicator characterizes the proportional (relative to height) body weight.

The most common and most primitive is the Broca's index, but in which a person's weight should be equal to his height minus 100 units. This formula is applied with Brooksch's amendments; for people with a height of 165 to 170 cm, 105 units should be subtracted, with a height of 175-185 cm, PO units; this indicator is unsuitable in childhood and adolescence.

Another common indicator is the Quetelet weight-height index, obtained by dividing weight in grams by height in centimeters; this indicator shows how many grams of weight are per centimeter of height (an indicator of fatness). On average, 1 cm of height should account for 400 g of weight. An indicator of 500 g and above indicates signs of obesity, an indicator of 300 g and below indicates a decrease in nutrition.

Index of proportionality between height and chest circumference. The most common indicator of this kind is the chest indicator. To calculate it, chest circumference in centimeters is multiplied by 100 and divided by height in centimeters; Normally this index is 50-55. An index of less than 50 indicates a narrow chest, and more than 50 indicates a wide chest.

The Erisman index is widely used; it is determined by subtracting half the height from the chest circumference at rest; Normally, the chest circumference should be equal to half height.

If the chest circumference exceeds half the height, this indicator is indicated by a plus sign, but if the chest circumference lags behind half the height, it is indicated by a minus sign. The average values of this indicator for a well-developed adult athlete are 5.8, for a female athlete -3.8 cm.

General physical development index. An example of this type of index is the Pinier index. It is calculated by subtracting from the height indicator in centimeters (L) the sum of the chest circumference in centimeters (T) and body weight in kilograms (P), i.e. L-(T---P); the smaller the balance, the better the physique. Body type at 10-15 is strong, at 16-20 good, at 21-25 average, at 26-30 weak, at 31 or more very weak.

Theoretically, the index is compiled incorrectly, since unlike quantities are compared not in their ratios, but through simple addition or subtraction. In people of short stature, but with a lot of weight, the indicator will always be high; this index is completely unsuitable for children and adolescents.

Most indices are compiled mechanically and therefore do not withstand scientific criticism. The state of physical development using indices should be assessed with great caution. For this reason, apparently, interest in the use of indices in medical and physical education practice has sharply decreased in recent years. However, many prominent therapists (A.L. Myasnikov and others) recommend in their manuals certain indices for the purposes of clinical anthropometry.

INDICATIONS: admission of the patient to the hospital; assessment of physical development

CONTRAINDICATIONS: patient's serious condition;

EQUIPMENT: vertical stadiometer (horizontal - for children under 1 year); temperature sheet; clean disinfected oilcloth 30x30 cm; gloves;

MANDATORY CONDITION: determination of the height of an adult patient is carried out after removing shoes and headgear.

1. Introduce yourself kindly and respectfully to the patient. Obtain informed consent.

2. Place a disinfected oilcloth on the stadiometer platform (under the patient’s feet).

3. Stand to the side of the patient and raise the stadiometer plate above the patient’s expected height.

4. Invite the patient to stand in the middle of the stadiometer platform so that he touches the vertical bar of the stadiometer with the back of his head, shoulder blades, buttocks, and heels.

5. The patient's head should be in such a position that the outer corner of the eye and the upper edge of the auricle are on the same horizontal line.

6. Carefully lower the stadiometer board onto the patient’s crown.

7. Determine on the scale the number of centimeters from the platform to the tablet. Inform the patient about the measurement results.

8. Remove the oilcloth and treat it and the surface of the stadiometer twice with a rag moistened with disinfectant. solution.

9. Remove gloves, disinfect, wash and dry your hands.

4. Document the execution of the manipulation.

PECULIARITIES:

In children under 1 year of age, to measure body length, use a horizontal stadiometer, which is installed on a flat, stable surface with the scale facing you. Place a diaper (without covering the scale or interfering with the bar). Place the child so that the top of the head tightly touches the fixed bar of the stadiometer. Straighten your legs by lightly pressing on your knees. Bring the movable bar to your feet, bent at a right angle. Determine your height using the stadiometer scale in centimeters. Remove the child from the stadiometer.

Body length in children from 1 year to 3 years is measured with a vertical stadiometer, only instead of the lower platform of the stadiometer, its folding bench is used. Counting in centimeters is carried out on the left scale.

Chest circumference measurement

INDICATIONS: determine the circumference of the chest at rest, in a state of maximum inspiration and exhalation, assessment of physical development.

EQUIPMENT: measuring tape, 70% ethyl alcohol or 0.5% alcohol solution of chlorhexidine; gauze napkins; temperature sheet; gloves;

1. Introduce yourself kindly to the patient. Obtain informed consent.

2. Invite the patient to undress to the waist and stand facing the nurse, the patient’s arms should be lowered down along the body. Breathing should be calm.

3. Place a measuring tape on the patient’s chest so that from behind it passes under the lower angles of the shoulder blades, in front along the 4th rib along the nipple line (in men) or above the mammary gland (in women).

4. Determine the circumference of the chest at rest, maximum inspiration, full exhalation.

1. Write down the data on the temperature sheet:

OGK at rest – ___ cm.

OGK inhalation – ___ cm.

OGK exhalation – ___ cm.

2. Inform the patient of the measurement results.

3. Wear gloves. Disinfect the measuring tape: wipe with a gauze cloth moistened with 70% ethyl alcohol or 0.5% alcohol solution of chlorhexidine

4. Remove gloves, disinfect, wash and dry your hands.

Many diseases and injuries lead to dysfunction of the affected system, limiting the patient’s physical capabilities (the ability to move independently, care for oneself), impairing the ability to work and often leading to disability.

Therefore, determining the functional state of the affected system is extremely important in rehabilitation and assessment of its effectiveness.

For this purpose, along with clinical studies, special methods are used to quantify the effectiveness of rehabilitation treatment.

These include: anthropometry (measurement of mass, range of motion, muscle strength, vital capacity of the lungs, etc.) and functional tests.

Anthropometry (somatometry)

Anthropometry reflects the quantitative characteristics of indicators of physical development, and carried out over time, allows one to evaluate the effectiveness of medical rehabilitation.

During anthropometric studies, the subject must be naked. The technique and methodology of anthropometry require certain practical skills. Accuracy, accuracy, attentiveness, and the ability to handle anthropometric instruments, check them and perform metrological control are required.

Mass measurement

To measure body weight, medical scales with a sensitivity of up to 50 g are used. Weighing must be done at the same time, in the morning, on an empty stomach. The subject stands in the middle of the scale platform with the locking bolt lowered. The examiner must lift the locking bolt and move the weight along the lower bar of the rocker arm from the zero division to the free end until the rocker arm begins to swing significantly in relation to the level of the beak-shaped protrusion. Following this, you need to move the weight in the same direction along the top bar until it is balanced and then lower the locking bolt. The mass of the subject is derived from the sum of two numbers, fixed by moving weights along the lower and upper bars.

Height measurement

Height is measured using a stadiometer or anthropometer. The height meter consists of a two-meter vertical bar with centimeter divisions, along which a horizontal tablet moves. The stand is fixed on the platform. To measure height in a standing position, the subject stands on the platform of a wooden stadiometer so as to touch the vertical bar (stand) of the stadiometer with his heels, buttocks, and interscapular area; the head should be in such a position that the line connecting the outer corner of the eye and the tragus of the ear is horizontal. After the subject has assumed the correct position, a sliding coupling with a horizontal plate is carefully lowered from above the stand until it comes into contact with the head. The number on which the tablet is fixed shows height in centimeters (determined by the readings of the right scale). Height is measured with an accuracy of 0.5 cm.

Chest circumference measurement

The chest circumference is measured using a centimeter tape with the subject in a vertical position. The tape is placed behind the lower corners of the shoulder blades for people of both sexes. In front, in men, along the lower segment of the isola, in women, above the mammary gland at the level of attachment of the 4th ribs to the sternum. When applying a measuring tape, the subject moves his arms to the sides. The measurer, holding both ends of the tape in one hand, checks with his free hand whether it is applied correctly. Measurements are taken with arms down. The chest circumference is measured at maximum inspiration, full exhalation and during a pause. To catch the moment of pause, the subject is asked a question and measurements are taken while answering. The difference between the sizes of the circles in the inhalation and exhalation phases determines the degree of mobility of the chest (excursion, scope).

Measurement of vital capacity of the lungs

Measuring the vital capacity of the lungs (VC) - spirometry, is carried out as follows: the subject first takes a deep breath, then exhales. Taking another deep breath, he takes the tip of the spirometer into his mouth and slowly exhales into the tube until it stops.

Measuring muscle strength

Measuring muscle strength - dynamometry. Dynamometry values characterize the strength of the muscles of the hands, back extensors, etc. Muscle strength is measured using dynamometers, hand and deadlift. Hand muscle strength (grip strength) is measured using a hand dynamometer. The subject, in a standing position, grabs the dynamometer with his hand, without tension in the shoulder, stretches his arm to the side and squeezes the dynamometer with maximum force (it is not allowed to move from the place and bend the arm at the elbow joint).

Back muscle strength measurement(extensors) or deadlift strength is produced by a deadlift dynamometer. When measuring standing strength, the dynamometer handle should be at knee level. The subject stands on a special stand, bending at the waist, grasps the dynamometer handle with both hands and then gradually, without jerking, without bending his knees, straightens with force until failure. Contraindications for measuring standing strength are: pregnancy, menstruation, the presence of hernias, the absence of one hand or several fingers, the presence of Schmorl's hernia, severe arthrosis.

In practical healthcare, the most convenient and objective method for assessing anthropometric data is the index method, which consists of comparing, as a rule, two indicators.

Quetelet weight-height index is the ratio of mass in grams to height in centimeters. In women this figure is 300-375 g/cm, in men - 350-400 g/cm.

Erisman index- the difference between the chest circumference at pause and 0.5 height. For women, the index is normally 3-5 cm, for men - 5-7 cm.

Chest span- the difference between the circumference of the chest during inhalation and exhalation. In women, the range is 5-7 cm, in men - 7-9 cm.

Life index- ratio of vital capacity (in ml) to body weight (in kg). In women this figure is 50-60 ml/kg, in men - 60-70 ml/kg.

Strength index- the ratio of dynamometry to body weight as a percentage. The strength index of the hand is: for women - 50%, for men - 75%, the deadlift index is: for women - 140-160%, for men - 200-220%.

Functional tests and tests

Functional methods are special research methods used to assess and characterize the functional state of the body.

Functional test is a load used to assess changes in the function of various organs and systems.

The following requirements apply to functional tests:

the test must be a stress test, i.e. it should cause sustainable changes in the system under study;
the sample must be equivalent to the loads in living conditions;
the sample must be standard, reliable, reproducible;
the test must be objective, when different people, using a certain test and examining the same group of people, obtain the same results;
a test must be informative or valid when the assessment obtained from examining the group as a whole coincides with the sports results of the tested individuals;
the sample must be harmless.

Indications for functional tests:
1) determination of physical readiness for sports, physical education or CT;
2) examination of professional suitability;
3) assessment of the functional state of the cardiovascular, respiratory and other body systems of healthy and sick people;
4) evaluation of the effectiveness of training and rehabilitation programs.

Contraindications to functional tests:
1) seriously ill patient;
2) acute period of the disease;
3) elevated body temperature;
4) bleeding;
5) severe circulatory failure;
6) rapidly progressing or unstable angina;
7) hypertensive crisis;
8) vascular aneurysm;
9) severe aortic stenosis;
10) severe cardiac arrhythmia (tachycardia over 100-110 beats/min, group, frequent or polytopic extrasystoles, atrial fibrillation, complete blockade, etc.);
11) acute thrombophlebitis;
12) severe respiratory failure;
13) acute mental disorders;
14) impossibility of performing a test (diseases of the joints, nervous and neuromuscular systems that interfere with testing).

Indications for stopping testing:
1) progressive chest pain;
2) severe shortness of breath;
3) excessive fatigue;
4) pallor or cyanosis of the face, cold sweat;
5) impaired coordination of movements;
6) slurred speech;
7) excessive increase in blood pressure, inappropriate for the age of the subject to increase the load;
8) decrease in systolic blood pressure;
9) deviation on the ECG (supraventricular or ventricular paraxysmal tachycardia, the appearance of ventricular extrasystole, conduction disturbances, etc.)

Classification of functional tests

I. According to the systemic principle (depending on the functional state of which of the body systems is being assessed), they are divided into tests for the respiratory, cardiovascular, nervous and muscular systems.
II. By the time of testing (depending on the period in which the output signal is recorded: directly during the exposure or immediately after it). In the first case, adaptation to the influencing factor is assessed, in the second - the nature of the recovery processes.
III. By type of input influence:
1) physical activity;
2) change in body position in space;
3) straining;
4) changes in the gas composition of inhaled air;
5) temperature effects;
6) administration of medications;
7) change in barometric pressure;
8) nutritional loads, etc.
IV. According to the intensity of the applied loads;
1) with low load;
2) with average load;
3) with a large load: a) submaximal, b) maximum.
V. By the nature of physical activity:
1) aerobic;
2) anaerobic.
VI. Depending on the number of applied loads:
1) one-time;
2) two-stage;
3) three-moment.

Types of physical activity used during functional tests:
A. Continuous load of uniform intensity.
B. Stepwise increasing load with rest intervals after each step.
B. Continuous operation of uniformly increasing power.
D. Continuous, stepwise increasing load without rest intervals.

When choosing specific research methods, preference should be given to those in which the results have a quantitative (numerical) and not just a descriptive (for example, better-worse, more-less) expression. Only those tests for which a rating scale or standards are given (the so-called proper values) are suitable for practical use. Strict adherence to the examination instructions (test procedure) is extremely important.

Pirogova L.A., Ulashchik V.S.