Functional tests and control methods during physical rehabilitation of the patient. Functional test Functional tests in physical culture

When studying the effect of physical activity on various organs and systems of the body, functional tests are often used to assess the functional state of a person.

The assessment of the functional state of the external respiratory system is carried out by the value of maximum pulmonary ventilation (MVV), which is influenced by the state of the respiratory muscles and the strength of their endurance.

Assessment of functional readiness is carried out using physiological tests (tests) of the cardiovascular system and respiratory system. This is a one-time test with squats (20 squats in 40 s) and heart rate in 15 s, recalculated to 1 minute immediately after the end of the squats. 20 pulse beats or less - excellent, 21 - 40 - good, 41 - 65 - satisfactory, 66-75 - bad.

Stange's test (holding your breath while inhaling). The average is 65s.

Genchi test (holding your breath while exhaling). The average is 30s.

Checking the impact of physical activity used in physical education classes is a reliable means of indicating deviations in the state of health or a decrease in indicators of physical development and physical fitness. For this purpose, you can use methods of medical and pedagogical control:

· pulsometry;

· spirometry;

· breath-holding tests after a sigh (after exhalation);

· determination of blood pressure and other methods.

Thus, an important component of a comprehensive medical examination of students, along with an assessment of their health status, is testing of general performance. With the help of testing, the functional capabilities of the body are determined, weak links in adaptation to physical activity are identified, the diagnosis of deviations in the state of health is clarified, and the dynamics of the functional state is monitored at certain stages of the educational process, which allows making the necessary adjustments to the course of the educational process.

In the practice of physical education, during a comprehensive examination, tests or batteries of tests are used to determine physical condition or physical (functional) readiness.

Test

Test- this is an assessment of the physical condition or physical fitness (ability) of the student.

There are three groups of tests:

1. Control exercises - these can be running distances, or the time of running distances.

2. Standard functional tests are registration of heart rate, assessment of the speed of running distances at a heart rate of 160 beats/min.

3. Maximum functional tests.

With the most stringent standardization, the test results must have sufficient reliability, i.e. a high degree of agreement between results when the same people are repeatedly tested under the same conditions.

To increase the reliability of the test, it is necessary to increase its length, i.e. increase the number of episodes. Since the reliability coefficient is variable, it is always necessary to indicate how and on whom the test is performed.

The most important characteristic of the test is its information content. Test informativeness is the degree of accuracy with which the test measures the property it is used to assess. Information content is sometimes called validity. The information content of the test involves answering two specific questions:

What does this test measure?

· How accurately does it measure?

When conducting testing, the following test order must be observed:

1. For flexibility.

2. For speed.

3. On strength.

4. For speed endurance.

5. For strength endurance

6. For physical performance.

7. For general endurance.

The ability to assess the physical condition of subjects is significantly expanded if physiological parameters are recorded during the use of test programs

4. Self-control: its methods, indicators and evaluation criteria

Self-control(individual control) is a system of monitoring the state of one’s health, physical development, physical performance and their changes under the influence of physical education and sports.

The main tasks of self-control are:

a) Be aware of your attentive attitude to your health.

b) Master the technique of self-observation, learn to clearly and correctly record individual control indicators.

c) Learn to correctly analyze, evaluate and draw conclusions based on the results of self-control.

d) Strive to gain new knowledge about your body and health, necessary for proper physical education.

The method of self-control during physical exercise consists of observation and analysis of objective and subjective indicators of the state of the body.

Subjective indicators are those individual sensations of a person at a given moment according to the level of the state of his body, which he can adequately reproduce.

To subjective indicators relate:

1. Well-being – reflects the state of the whole organism and, mainly, the state of the central nervous system. Rated as good, fair, bad. With proper, systematic and regular exercise, there is a feeling of vivacity, cheerfulness, energy, desire and need to perform physical activity.

2. Performance – a person’s ability to perform motivated activities at a given level of efficiency for a certain time. Marked as high, medium and low performance.

3. Dream – duration, depth and disturbances are assessed, that is, difficulty falling asleep, nightmares, insomnia, etc.

4. Appetite – its presence is noted, namely good, satisfactory, bad. In the deep stages of overwork, there is a lack of appetite.

5. Painful sensations – are recorded according to their location, nature (sharp, blunt, cutting) and strength of manifestation.

Towards objective indicators include those that can be measured and quantified:

1. Anthropometric – height, weight, chest circumference.

2. Functional – heart rate, respiratory rate, blood pressure, vital capacity of the lungs.

3. Strength indicators individual muscle groups, dynamometry of the right and left hands, deadlift.

4. Results in control exercises and tests .

The other day, my colleague said that she was “tortured” by a sports doctor. And one of the tests was a test with squats. I made it myself today. Hmm, everything somehow recovered even in the first two minutes. I admit a mistake. But it's still nice :)
If you’re very interested, then below the cut we’ll see how it’s all done.


and very
Assessment of the functional abilities of the human body using functional tests.

The function of organs and systems, primarily the heart, which plays a leading role in the life of the body, is in most cases assessed on the basis of examinations at rest. At the same time, the reserve capabilities of the heart can only manifest themselves during work that exceeds the usual load in intensity. This applies both to athletes, for whom dosing the load is impossible without determining physical performance, and to persons who do not engage in physical education and sports. Hidden coronary insufficiency may not manifest itself clinically and electrocardiographically in daily conditions. Physical activity is the physiological stress that makes it possible to determine the level of reserve capabilities of the body.
Setting load tests:
a) determination of the functional capabilities of the body;
b) determination of performance and ability to engage in various sports;
c) assessment of cardiovascular, respiratory, etc. reserves. systems;
d) determining the likelihood of developing cardiovascular diseases, primarily identifying preclinical forms of coronary insufficiency, as well as predicting these diseases;
e) objective assessment of the dynamics of the effectiveness of training programs for students;
f) development, based on a functional examination, of optimal preventive, therapeutic, surgical and rehabilitation measures for diseases of the cardiovascular system;
f) assessment of the functional state and effectiveness of physical rehabilitation after injuries, acute and chronic diseases
Classification of functional tests
1. By type of load (physical exercise, changing body position, holding your breath, etc. All of them must be clearly dosed. Physical exercise is most often used.
2. By the number of loads:
a) one-stage: test with 20 squats (Martine test);
2-, 3-moment, combined tests, for example the Letunov test (20 squats in 30 seconds, 15-second running at maximum speed in place and 3-minute running at a moderate pace, 180 steps per minute) (video 3) .
3. By type of indicators to be studied: circulatory system, respiratory system, autonomic nervous system, endocrine system, etc.
4. By the time of recording the initial signal, that is, by the time of studying the response to the load:
a) directly during the load (for example, the submaximal test PWC170), in which the immediate response to the load during execution is studied (power testing);
b) after the load (test with 20 squats, Harvard steppe test), when the indicators are studied at the end of the load, that is, the nature of the recovery processes in the body is examined (recovery testing)
5. By type of load:
a) standard (squatting, running, jumping, lifting loads, etc.), which are performed at a certain pace;
b) dosed (measured W, kgm/min, 1 W/min = 6.12 kgm/min);
6. By the nature of the load:
a) uniform load (climbing steps during the Harvard step test);
b) gradually increasing load at intervals (submaximal test PWC170);
c) continuously increasing load (Navacchi test)
7. By load intensity:
a) submaximal test (submaximal test PWC170);
b) maximum test - tests with maximum load (Navakki test), they are used only for highly qualified athletes

Rules for conducting functional tests
1. Study the function of the body as a whole, individual functional systems or organs at rest. The results obtained are evaluated and compared with the necessary standard indicators characteristic of the corresponding age, gender, height, body weight, etc. In these cases, the assessment must be made very carefully due to the large individual differences and variability of normal values.
2. They study the function of the whole organism, individual functional systems or organs under conditions of standard or dosed physical activity.
3. Evaluate the results of the research obtained. The information obtained is necessary both for the selection of physical exercises and their dosage, and for studying the functional ability of the subject, his reserve capabilities.
4. The selected loads must correspond to the motor status of the subject
5. The sets of indicators that are recorded should be relatively accessible for observation, sufficiently sensitive to physical stress and reflect the integral functions of the body of the subject.
When performing stress tests, the usual assessment of their results is carried out by recording heart rate, and less often, blood pressure. If necessary, these indicators are supplemented by recording an ECG, FCG, measuring gas exchange, pulmonary ventilation, some biochemical constants, etc.

EXERCISE TESTS
During mass preventive examinations, stage-by-stage medical monitoring of athletes and lower-level athletes, tests with moderate physical activity are used: tests with 20 squats or 60 jumps in 30 seconds; 15-second run in place at maximum speed, raising your hips high; running in place for 3 minutes at a pace of 180 steps in 1 minute, etc. Each of them can be used either independently or in different combinations. For example, Letunov's combined test includes 20 squats, a 15-second run at maximum speed and a 3-minute run at a pace of 180 steps per minute.
Recently, the Ruffier test has been used - 30 squats in 45 seconds. .

Test with 20 squats (Martine test)
Characteristics of a test with 20 squats in 30 seconds according to the classification of functional tests: this is a test in which physical exercises are used, one-shot, the state of the cardiovascular system is studied, indicators are collected after performing the load, the load is standard, uniform, of medium intensity.
Methodology for testing with 20 squats in 30 seconds. The Martinet test is performed on practically healthy individuals. Therefore, after eliminating contraindications (presence of complaints, diseases, decreased functionality, etc.), they begin to conduct the test.

Collection of initial data. The subject sits with his left side facing the doctor and places his left hand on the table. A blood pressure cuff is placed on his left shoulder according to generally accepted rules. After 1.5-2 minutes, the patient’s pulse is counted on the radial artery for 10 seconds until it stabilizes, that is, the same number is repeated 2-3 times. After this, blood pressure is measured. The obtained indicators are entered into the medical control card.

Evaluation of initial data. Normally, the heart rate (HR) fluctuates within 72±12 beats per minute. Heart rate below 60 beats. For 1 minute, that is, bradycardia, can be assessed in different ways. In trained athletes, bradycardia indicates economization of cardiac activity, but it can occur with overtraining and certain heart diseases. The absence of complaints about overtraining and heart disease makes it possible to evaluate bradycardia as a result of an increase in the tone of the parasympathetic part of the autonomic nervous system, which occurs in trained people.
A heart rate greater than 84 is assessed as negative at rest. This may be the result of heart disease, intoxication, or overtraining in athletes.
The resting pulse should be rhythmic. There may be respiratory arrhythmia, that is, an increase in heart rate during inhalation and a decrease in heart rate during exhalation. This phenomenon is assessed as physiological. It depends on the reflex influence of the receptors on the center of the vagus nerve. This is not a contraindication for the test. Often, after the test, respiratory arrhythmia is not recorded. Variable pulse numbers (10,12,12,11,12,12) may indicate lability of the nervous system in the absence of a history of cardiac arrhythmias.

Assessment of blood pressure indicators. Blood pressure is above 129/79 mm Hg. assessed as elevated, below 100/60 mm Hg. - as reduced. Elevated blood pressure numbers can be a manifestation of a disease (hypertension, chronic nephritis, etc.), symptoms of overwork or irregularities (smoking, drinking alcohol, etc.)

Low blood pressure in athletes can be physiological (hypotension due to a high degree of training), or it can be a manifestation of a disease (hypotonic syndrome, intoxication from a source of chronic infection - caries teeth, chronic tonsillitis, etc.). Hypotonic states can occur due to overwork, as evidenced by the athlete’s complaints of weakness, fatigue, headache, etc.
Carrying out a test. If there are no contraindications, the test begins. During a practical lesson, before conducting a test, students need to learn how to count and continuously record the pulse every 10 s for
1 minute and quickly measure blood pressure (in 30-40 s).
Before the test, the patient is explained how he should perform a squat: deep squats are performed at a pace
2 squats in 3 s (the rhythm is set by a metronome or a doctor), when squatting you need to raise your arms forward, when standing up you need to lower them.
After performing 20 squats in 30 seconds: in the first 10 seconds, count the pulse and record it under the first minute at the level of 10 seconds. Then, until the end of the first minute, they measure it and register it at the blood pressure level under the first minute. It is also necessary to calculate the respiratory rate for 15 seconds and, multiplying this number by 4, write it down under the first minute at the breathing level.

Starting from 2 minutes, the pulse is counted and recorded continuously until it returns to the original level and stabilizes at this level (repeated 2-3 times). After the pulse has recovered and stabilized, blood pressure is measured and recorded at the blood pressure level under the minute at which it was stopped being measured. If blood pressure has not returned to its original level, it continues to be measured and recorded every minute until it is restored. At the end of the test, the respiratory rate is calculated and recorded in the table (the method is the same as for 1 minute after exercise).

Evaluation of sample results. The evaluation criteria are changes in heart rate, blood pressure response and the time of their recovery to initial values. They make it possible to assess the adaptive ability of the circulatory system to physical activity. The heart responds to physical activity by increasing cardiac output. Adaptation to the load of the heart of a trained person occurs to a greater extent due to an increase in stroke volume and to a lesser extent due to an increase in heart rate (HR). In an untrained or insufficiently trained person, it is the other way around: mainly due to an increase in heart rate and, to a lesser extent, due to an increase in stroke volume.
To evaluate the sample, the following indicators are used: pulse excitability, pulse recovery time, blood pressure response, blood pressure recovery time, change in respiratory rate.

Pulse excitability, that is, the percentage of heart rate increase after exercise, is determined by subtracting the difference between the heart rate before and after exercise, which is determined as a percentage. To do this, we draw up a proportion where the pulse before the load is taken as 100% in our case 10), and by how much the pulse increased after the load (that is, 16-10 = 6) as X
10 = 100%
16-10 = x% x=60%
Thus, the pulse after exercise increased by 60% relative to the initial one. A normal reaction to a test of 20 squats is considered to be an increase in heart rate within 60-80% of the initial value. The more efficient the heart, the more perfect the activity of its regular mechanisms, the less the pulse quickens in response to dosed physical activity. An increase in heart rate above normal indicates irrational activity of the heart, which can be caused by diseases (primarily the heart), detraining, and overwork in athletes or athletes.
The pulse recovery time makes it possible to determine the progress of recovery processes after exercise. It is determined by the first indicator of a renewed and stable pulse. In our case it is
1 minute 50 seconds, that is, it is necessary to indicate the number of minutes and seconds during which a stable resumption of the pulse occurred. Normally, the pulse recovery time is no more than 2 minutes 40 seconds. An increase in the pulse recovery time indicates a slowdown in the recovery processes of the heart. Most often this is combined with an increase in pulse excitability, which indicates a decrease in the reserve capacity of the heart and is assessed as an unfavorable reaction. An increase in one of these indicators is not a mandatory sign of a decrease in the reserve capacity of the circulatory system; it may be the result of a dysfunction of the regulatory mechanisms of the circulatory system (with neurocirculatory dystonia, detraining, overtraining, etc.).
In addition to the recovery time of the pulse, it is necessary to monitor how the recovery proceeds - gradually or in waves and to what numbers.
During the process of pulse recovery, the so-called “negative pulse phase” may occur, when the pulse in the first 2-3 minutes becomes lower than the initial one by 1-3 beats per 10 seconds. This slowdown in heart rate lasts for at least three 10-second periods, and then increases again and gradually returns to normal. The “negative phase” of the pulse is associated with insufficient activity of various parts of the nervous system, primarily the sympathetic and parasympathetic parts of the autonomic nervous system, which leads to a change in the sequence of recovery processes. Such deviations are recorded in persons with a labile nervous system, with neurocirculatory dystonia, in athletes with overtraining, after neuropsychic overstrain. If after exercise the negative phase of the pulse persists for more than 3 minutes, then the reaction is assessed as unsatisfactory.
While studying the process of heart rate recovery, a situation may occur when the heart rate before the load was higher (for example, 14,14,14 in 10 seconds), and after the load it decreased to lower numbers (for example, 12,12,12 in 10 seconds) and stabilized at this value.. Such cases can be recorded in individuals with a labile nervous system, in this case it is an increase in the tone of the sympathetic part of the autonomic nervous system. Physical activity helps to normalize its functional state and the pulse resumes to the true heart rate of the examiner.

Assessment of blood pressure (BP) response to the Martinet test. In this case, it is necessary to separately evaluate changes in systolic, diastolic and pulse pressure. Various combinations of changes in these indicators may occur. The most rational response to blood pressure is characterized by an increase in systolic blood pressure by 15-30% (with an initial systolic blood pressure of 120 mm Hg, this is no more than 40 mm Hg). Diastolic pressure remains unchanged or decreases by 10-15 percent (no more than 10 mmHg with average values).
As a result of an increase in systolic and a decrease in diastolic blood pressure, pulse pressure increases, which is the most favorable reaction. This indicates an increase in cardiac output and a decrease in peripheral vascular resistance, which is the most favorable reaction because the minute volume of blood circulation increases.
The percentage increase in pulse pressure is determined in the same way as the excitability of the pulse. According to the example, the blood pressure before the load was
120/80 mm Hg, pulse - 40 (120-80). Blood pressure after exercise was 140/75 mm Hg, pulse was 65 (140-75), that is, pulse pressure increased by 25 mm Hg. Art. (65-40). We make up the proportion: 40 - 100%
25 - x% X = 62%.
Thus, the excitability of the pulse is 60%, the increase in pulse pressure is 62%. The synchronicity of changes in these indicators indicates good adaptation of the body to the load performed. A decrease in pulse pressure indicates an irrational response of blood pressure to physical activity and a decrease in the functional ability of the body.
The recovery time of blood pressure is determined by the minute at which it returned to its original level after the exercise. In our example it is 3 minutes. Norm - 3 min.
An increase in blood pressure above normal and an extension of its recovery time can be recorded in individuals with hypertension, neurocirculatory dystonia of the hypertensive type, in practically healthy individuals with the potential for hypertension (pre-illness stage), after significant physical exertion, after alcohol abuse and smoking. . Our studies have shown that after drinking alcohol in practically healthy young people 18-20 years old, elevated blood pressure is recorded at rest for 2-3 days, and an upward deviation in the blood pressure response to the Martinet test is recorded for 4-6 days.
Conclusion based on the results of a test with 20 squats. When assessing the response to a functional test, Martin needs to compare changes in pulse and blood pressure in order to identify the mechanisms through which adaptation to the load occurs.
Comparing pulse excitability with an increase in pulse pressure makes it possible to determine the synchronicity of these changes. A rational response to physical activity is characterized by synchronous dynamics: the excitability of the pulse should coincide with an increase in systolic pressure, expressed as a percentage. This indicates an adequate response to physical activity.
Based on the nature of changes in the studied indicators after performing 20 squats in 30 seconds, the following are distinguished: favorable, unfavorable and transitional types of reaction. According to the classification, there are 5 main types of reaction of the cardiovascular system to the Martinet test:
- normotonic,
- hypertensive,
- dystonic,
- hypotonic (asthenic)
- stepped.
Types of reaction that do not fit into the 5 main types by some of the indicators are classified as transitional.

Normotonic type. Favorable types of reactions include the normotonic type. It is characterized by the fact that adaptation to the load occurs due to an increase in pulse pressure, which indicates an increase in the stroke volume of the heart. An increase in systolic pressure reflects an increase in left ventricular systole, a decrease in the minimum indicates a decrease in the resistance of arteriolar tone, which provides better blood access to the periphery. Heart rate increases synchronously with pulse pressure. With a normotonic type of reaction:
1. Pulse excitability - up to 80%
2. Pulse recovery time - up to 2 minutes. 40 sec
3. Changes in blood pressure: systolic (SBP) - up to + 40 mm Hg
diastolic (DBP) - 0 or up to - 10
4. Blood pressure recovery time - up to 3 minutes.

Unfavorable types of reactions to the Martinet test. What is common to all unfavorable types is that adaptation of the cardiovascular system to stress occurs mainly due to an increase in heart rate. Therefore, all unfavorable types are characterized by an increase in pulse excitability by more than 80%; accordingly, the pulse recovery time will be longer than normal (more than 3 minutes).
Unfavorable types of reactions include hypertonic, dystonic, hypotonic (asthenic), and stepwise types of reactions. As mentioned above, the first two points of the test assessment (pulse excitability and its recovery time) for all unfavorable types of reactions are the highest standards, so the difference between them will manifest itself in the blood pressure response to the load.
In the hypertensive type: SBP increases significantly more than normal, DBP also increases.
In the dystonic type: SBP increases significantly, DBP decreases significantly, an “infinite tone phenomenon” may occur when, when measuring blood pressure, a pulsation is felt even when the pressure gauge needle drops to zero.
In the hypotonic (asthenic) type: SBP and DBP change slightly, pulse pressure decreases or remains unchanged.
The stepped type is characterized by a stepwise increase in blood pressure, when immediately after the load it does not change (or changes slightly), and in the next minutes after the load it increases.
The respiratory rate after the test should change synchronously with the pulse: normally, 3-4 heart beats correspond to one respiratory movement. The same pattern should persist after the Martinet test.
Form 061/у unified. Each indicator in the section “Functional tests of the heart and lungs” has its place and is measured in units generally accepted for the Martinet test: pulse rate - per 10 s., respiratory rate - per 1 min., blood pressure (BP) - in mm Hg. Art. Therefore, when registering a sample, it is necessary to indicate only numbers, without units of measurement.
After the test, it is necessary to note the nature of the pulse (rhythmic, satisfactory filling, arrhythmic) and auscultatory data of the heart in a standing position, and, if necessary, lying down.
Thus, the algorithm for performing a functional test with 20 squats includes the following sequence of actions:
1. Collection and evaluation of initial data.
2. Explaining the technique of performing the test to the patient.
3. The patient performs a test with 20 squats in 30 seconds.
4. Study and registration of the studied indicators in the first minute after the load.
5. Study and registration of the studied indicators during the recovery period.
6. Evaluation of the results obtained.
7. Conclusion based on the test results.
Using a test with 20 squats in practical medicine. The Martinet test is used for mass examinations of people involved in physical education and lower-level athletes. In clinical practice, it can be used to study the functional capabilities of the cardiovascular system of people of different age categories. Practical experience has shown that persons under 40 years of age without significant deviations in health can be given 20 squats in 30 seconds, up to 50 years old - 15 squats in 22 seconds, over 50 years old - 10 squats in 15 seconds. The functional characteristics of the cardiovascular system are considered satisfactory if, when evaluating the test, its results fit into the normotonic type of reaction described above.
You can use the Martinet test for diagnostic purposes: to determine the cause of tachycardia at rest. If after the test the indicators fit into an unfavorable type of reaction, then tachycardia is predetermined by diseases of the cardiovascular system. Sometimes before the load the pulse is labile and its recovery occurs in waves, a negative phase of the pulse may occur, and often the pulse after the load stabilizes at values ​​lower than before the load. This makes it possible to assume that tachycardia at rest is predetermined by disturbances in the functional state of the nervous system. If before the load the heart rate indicators are higher than normal, after the test all indicators fit into the normotonic type of reaction, but the pulse is restored to the original numbers (as before the load, increased) - it can be assumed that tachycardia at rest is predetermined by hyperfunction of the thyroid gland. Subsequent targeted in-depth examinations will make it possible to exclude, and more often, confirm the results of functional tests.

ROUFIER'S TEST
The Rufier test is widely used in sports medicine. It makes it possible to assess the functional reserves of the heart.
Methodology. The number of pulsations in 15 seconds is counted for the subject, who is in a lying position for 5 minutes (P1). Then he is asked to perform 30 squats in 45 seconds (when squatting, hands forward, when standing up, lower them). After this, the subject lies down and his pulse is calculated for the first 15 seconds (P1) and the last 15 seconds (P3) of the 1st minute after the load. The results obtained are substituted into the formula:

Ruffier index = 4 /P1 + P2 + P3 / - 200
10

The functional reserves of the heart are assessed using the table:

Assessment of functional reserves of the heart
Ruffier index value
Athletic heart
0,1 <
The average person's heart:
Very good
Fine

0,1-5,0
5,1-10,0
Heart failure

medium degree
10,1-15,0
high degree
15,1-20,0

For example: P1 = 16, P2 = 26, P3 = 20

Ruffier index = 4 (16+26+20) - 200
10
Conclusion: Ruffier Index = 5.8. Average Man's Heart: Good

To evaluate the sample, the Ruffier-Dixon index is also used, which is a variant of the previous one:
Ruffier-Dixon index = /4Р2 - 70/ + /4Р3 - 4Р1/
Evaluation of results: cardiac functionality:

from 0 - 2.9 - good 6.0-8.0 - below average
3.0-5.9 - average 8.0 - more - bad.
Use of Ruffier's test in practical medicine. The test results make it possible to determine the reserve functionality of the heart. In this case, the initial level of heart rate is taken into account, which (in the absence of diseases) indicates the economy of the heart at rest. The pulse rate immediately after exercise characterizes the adaptive ability of the heart to physical activity, and its frequency at the end of the first minute indicates the speed of recovery processes of the cardiovascular system after exercise. The test can be used for diagnostic purposes; it is simple, accessible, and highly informative.

TESTS WITH CHANGES IN BODY POSITION
Functional tests with changes in body position include orthostatic and clinostatic tests.
An orthostatic test is to study changes in heart rate after moving from a lying position to a standing position.
Methodology. After a 5-minute stay in a lying position, the subject is counted the pulse rate for 15 seconds, then asked to stand up slowly and, already in a standing position, the pulse is counted twice for
15 s:
Sample evaluation. Each of the obtained indicators is multiplied by 4, determining the pulse rate for 1 minute.
An increase in heart rate by 10-16 beats per minute after standing up and its stabilization at a level that is 5-8 beats higher than the initial one after 3 minutes of standing indicates a satisfactory functional state of the sympathetic part of the autonomic nervous system. A higher pulse rate immediately after a change in position indicates increased sensitivity, and after 3 minutes - an increased tone. The latter is observed in insufficiently trained individuals and in individuals with a labile nervous system.
A lower level of heart rate indicates a decrease in the sensitivity and tone of the sympathetic and an increase in the sensitivity and tone of the parasympathetic part of the autonomic nervous system. A weaker reaction, as a rule, accompanies the development of training. Such individuals are less sensitive to the negative influence of extreme situations of an internal and external nature.
Clinostatic test. It is carried out in the reverse order relative to the orthostatic one. After 5 minutes of standing, the pulse rate is counted for 15 seconds, then the subject slowly moves to a lying position, and in this position the pulse is counted 2 times in 15 seconds: immediately and after 3 minutes of being in the lying position.
Sample evaluation: each of the obtained indicators is multiplied by 4 and compared with each other. The normal reaction is a decrease in heart rate by 8-14 beats per minute immediately after the transition to a prone position and a decrease in this reaction by 6-8 beats after 3 minutes. A greater decrease immediately after a change in position indicates increased excitability, and after 3 minutes - an increased tone of the parasympathetic part of the autonomic nervous system. An increase in heart rate indicates a decrease in the reactivity and tone of the parasympathetic part of the autonomic nervous system
Practical use. Tests with changes in body position are most often used to study the functional state of the autonomic nervous system. Repeated testing during training makes it possible to prevent the occurrence of a state of overtraining in which a violation of the functional state of the autonomic nervous system is one of the first signs. In weakened individuals, tests with changes in body position can be used to determine the functional state of the cardiovascular system during a period when other (more intense) loads are contraindicated.

BREATH HOLD TESTS
Of the breath-hold tests, the most commonly used are the Stange and Genchi-Sabraze tests.
Stange's test. Methodology: the subject, in a sitting position, takes a deep (not maximum) breath, pinches his nose with his fingers and holds his breath as long as he can. The delay time is noted with a stopwatch, which will stop at the moment the exhalation begins. It is not recommended to take a maximum deep breath, because this contributes to stretching of the lungs, irritation of the vagus nerve, which can lead to accelerated irritation of the respiratory center and a reduction in the time of breath holding.
Sample evaluation. In healthy but untrained individuals, the breath holding time (inspiratory apnea) ranges from 40-60 s in men and 30-40 s in women. Trained athletes can hold their breath: 60-120 for a man and 40-95 for a woman, and some of them for several minutes.

Genci-Sabraze test. Procedure: after normal (not excessive) exhalation, the subject pinches his nose with his fingers and holds his breath as much as possible. The duration of the breath hold is noted with a stopwatch, which will stop when the inhalation begins.
Sample evaluation. The duration of breath holding in healthy untrained individuals during the Genchi-Sabraze test (expiratory apnea) ranges from 25-40 s in men and 15-30 s in women. Athletes have 50-60 s for men and 30-50 s for women.
Use in practical medicine. Cardiopulmonary apnotic tests provide information about the functional state of the cardiorespiratory system. In this case, it is necessary to pay attention to the dependence of the test results on the volitional qualities of the person being studied. The ratio between the inspiratory and expiratory apnotic pause is 1:2. If there are abnormalities in the state of the cardiovascular system, the duration of breath holding is reduced by 50 percent or more. The ratio between these pauses can reach 1:1. Indicators of apnotic tests worsen in diseases of the respiratory and cardiovascular systems.

Description: algorutm fynkcionalnuh prob v sportivn med

I. By the nature of the input influence.

There are the following types of input influences used in functional diagnostics: a) physical activity, b) change in body position in space, c) straining, d) change in the gas composition of inhaled air, e) administration of medications, etc.

The forms of its implementation most often used as an input influence are diverse. This includes the simplest forms of specifying physical activity that do not require special equipment: squats (Martinet test), jumping (GCIF test), running in place, etc. In some tests conducted outside laboratories, natural running is used as a load (test with repeated loads ).

Most often, the load in tests is set using bicycle ergometers. Bicycle ergometers are complex technical devices that provide for arbitrary changes in pedaling resistance. The resistance to pedal rotation is set by the experimenter.

An even more complex technical device is the “treadmill”, or treadmill. This device simulates the natural running of an athlete. The different intensity of muscular work on treadmills is set in two ways. The first of them is to change the speed of the “treadmill”. The higher the speed, expressed in meters per second, the higher the intensity of the physical activity. However, on portable treadmills, an increase in load intensity is achieved not so much by changing the speed of the “treadmill” as by increasing its angle of inclination relative to the horizontal plane. In the latter case, running uphill is simulated. Accurate quantitative accounting of load is less universal; It is required to indicate not only the speed of movement of the “treadmill”, but also its angle of inclination relative to the horizontal plane. Both devices considered can be used when carrying out various functional tests.

When testing, nonspecific and specific forms of influence on the body can be used.

It is generally accepted that various types of muscular work, given in laboratory conditions, belong to nonspecific forms of influence. Specific forms of influence include those that are characteristic of locomotion in this particular sport: shadowboxing for a boxer, throwing stuffed animals for wrestlers, etc. However, this division is largely arbitrary, so that the reaction of the body’s visceral systems to physical activity is determined mainly by its intensity, and not by its form. Specific tests are useful for assessing the effectiveness of skills acquired during training.

Changing body position in space- one of the important disturbing influences used in orthoclinostatic tests. The reaction that develops under the influence of orthostatic influences is studied in response to both active and passive changes in the position of the body in space. It assumes that the subject moves from a horizontal position to a vertical position, i.e. rises.

This version of the orthostatic test is not valid enough, since, along with changing the body in space, the subject performs certain muscular work associated with the standing up procedure. However, the advantage of the test is its simplicity.

A passive orthostatic test is performed using a rotary table. The plane of this table can be changed at any angle to the horizontal plane by the experimenter. The subject does not perform any muscular work. In this test we are dealing with the “pure form” of the effect on the body of a change in the position of the body in space.

As an input effect to determine the functional state of the body, it can be used straining. This procedure is performed in two versions. In the first, the straining procedure is not quantitatively assessed (Valsalva maneuver). The second option involves dosed straining. This is achieved using pressure gauges into which the subject exhales. The readings of such a pressure gauge practically correspond to the value of intrathoracic pressure. The amount of pressure developed during such controlled straining is dosed by the doctor.

Changes in the gas composition of inhaled air in sports medicine most often involves reducing the oxygen tension in the inhaled air. These are the so-called hypoxemic tests. The degree of reduction in oxygen tension is dosed by the doctor in accordance with the purposes of the study. Hypoxemic tests in sports medicine are most often used to study resistance to hypoxia, which can be observed during competitions and training in mid- and high-altitude areas.

Introduction medicinal substances It is used as a functional test in sports medicine, usually for the purpose of differential diagnosis. For example, to objectively assess the mechanism of occurrence of systolic murmur, the subject is asked to inhale amyl nitrite vapor. Under the influence of such exposure, the operating mode of the cardiovascular system changes and the nature of the noise changes. By assessing these changes, the doctor can talk about the functional or organic nature of systolic murmur in athletes.

By type of output signal.

First of all, samples can be divided depending on which system of the human body is used to assess the response to a particular type of input. Most often, in functional tests used in sports medicine, certain indicators are studied of cardio-vascular system. This is due to the fact that the cardiovascular system reacts very subtly to a wide variety of influences on the human body.

External respiration system is the second most frequently used method in functional diagnostics in sports. The reasons for choosing this system are the same as those given above for the cardiovascular system. Somewhat less frequently, other systems are studied as indicators of the functional state of the body: nervous, neuromuscular apparatus, blood system, etc.

According to the time of the study.

Functional tests can be divided depending on when the body's reactions to various influences are studied - either directly during exposure, or immediately after cessation of exposure. For example, using an electrocardiograph, you can record heart rate throughout the entire time during which the subject performs physical activity.

The development of modern medical technology makes it possible to directly study the body’s reaction to a particular influence. And this serves as important information about diagnosing performance and fitness.

There are more than 100 functional tests, but currently a very limited, most informative range of sports medical tests is used. Let's look at some of them.

Letunov's test . The Letunov test is used as the main stress test in many medical and physical education clinics. The Letunov test, as conceived by the authors, was intended to assess the adaptation of the athlete’s body to speed work and endurance work.

During the test, the subject performs three loads in succession. In the first, 20 squats are done, performed in 30 seconds. The second load is performed 3 minutes after the first. It consists of a 15-second run in place, performed at a maximum pace. And finally, after 4 minutes, the third load is performed - a three-minute run in place at a pace of 180 steps per minute. After the end of each load, the recovery of heart rate and blood pressure is recorded in the subject. This data is recorded throughout the entire rest period between loads: 3 minutes after the third load; 4 minutes after the second load; 5 minutes after the third load. The pulse is counted in 10-second intervals.

Harvard step test . The test was developed at Harvard University in the USA in 1942. Using the Harvard step test, recovery processes after dosed muscular work are quantitatively assessed. Thus, the general idea of ​​the Harvard step test is no different from the S.P. test. Letunova.

In the Harvard Step Test, physical activity is set in the form of climbing a step. For adult men, the height of the step is taken to be 50 cm, for adult women - 43 cm. The subject is asked to climb the step for 5 minutes with a frequency of 30 times per 1 minute. Each ascent and descent consists of 4 motor components: 1 - lifting one leg onto a step, 2 - the subject stands on the step with both legs, taking a vertical position, 3 - lowers the leg with which he started climbing to the floor, and 4 - lowers the other leg onto floor. To strictly measure the frequency of ascents to and from steps, a metronome is used, the frequency of which is set to 120 beats/min. In this case, each movement will correspond to one beat of the metronome.

Test P.W.C. 170 . This test was developed at Karolinska University in Stockholm by Sjostrand in the 50s. The test is designed to determine the physical performance of athletes. The name PWC comes from the first letters of the English term for Physical Working Capacity.

Physical performance in the PWC 170 test is expressed in the magnitude of the power of physical activity at which the heart rate reaches 170 beats/min. The choice of this particular frequency is based on the following two provisions. The first is that the zone of optimal functioning of the cardiorespiratory system is limited to the pulse range from 170 to 200 beats/min. Thus, with the help of this test it is possible to establish the intensity of physical activity that “brings” the activity of the cardiovascular system, and with it the entire cardiorespiratory system, to the area of ​​optimal functioning. The second position is based on the fact that the relationship between heart rate and the power of physical activity performed is linear for most athletes, up to a heart rate of 170 beats/min. At higher heart rates, the linear relationship between heart rate and exercise power is disrupted.

Bicycle ergometer test . To determine the value of PWC 170, Sjöstrand asked subjects on a bicycle ergometer a step-like physical load of increasing power, up to a heart rate of 170 beats/min. In this form of testing, the subject performed 5 or 6 loads of varying power. However, this testing procedure was very burdensome for the subject. It took a lot of time, since each load was performed for 6 minutes. All this did not contribute to the widespread use of the test.

In the 60s, the value of PWC 170 began to be determined in a simpler way, using two or three loads of moderate power.

The PWC 170 test is used to examine highly qualified athletes. At the same time, it can be used to study individual performance in beginners and young athletes.

Sample optionsP.W.C. 170 . Great possibilities are presented by variants of the PWC 170 test, in which bicycle ergometric loads are replaced by other types of muscular work, similar in their motor structure to loads used in natural conditions of sports activity.

Running test based on the use of athletics running as a load. The advantages of the test are methodological simplicity, the ability to obtain data on the level of physical performance using loads that are quite specific for representatives of many sports - running. The test does not require maximum effort from the athlete, it can be carried out in any conditions in which smooth athletic running is possible (for example, running in a stadium).

Test using a bicycle carried out in the natural conditions of cyclists training on a track or road. Two bike rides at moderate speed are used as physical activity.

Swimming test also methodologically simple. It allows you to assess physical performance using loads specific to swimmers, pentathletes and water polo players - swimming.

Test using cross-country skiing Suitable for studying skiers, biathletes and combined athletes. The test is carried out on flat terrain, protected from the wind by forest or bushes. It is better to run on a pre-laid ski track - a closed circle 200-300 m long, which allows you to adjust the speed of the athlete's movement.

Rowing test proposed in 1974 by V.S. Farfel and his staff. Physical performance is assessed in natural conditions when rowing on academic vessels, kayaking or canoeing (depending on the narrow specialization of the athlete) using telepulsometry.

Ice skating test for figure skaters it is carried out directly on a regular training ground. The athlete is asked to perform a figure eight (on a standard skating rink, a full figure eight is 176 m) - the simplest element and most typical for figure skaters.

Determination of maximum oxygen consumption . The assessment of maximum aerobic power is carried out by determining the maximum oxygen consumption (VO2). This value is calculated using various tests in which the maximum oxygen transport is achieved individually (direct determination of MIC). Along with this, the value of the IPC is judged on the basis of indirect calculations, which are based on data obtained during the athlete’s performance of non-maximum loads (indirect determination of the IPC).

The MPC value is one of the most important parameters of an athlete’s body, with the help of which the overall physical performance of an athlete can be most accurately characterized. The study of this indicator is especially important for assessing the functional state of the body of athletes training for endurance, or athletes for whom endurance training is of great importance. In this type of athletes, monitoring changes in VO2 max can provide significant assistance in assessing the level of training.

Currently, in accordance with the recommendations of the World Health Organization, a methodology has been adopted for determining MOC, which consists of the subject performing a physical activity that gradually increases in power until the moment when he is unable to continue muscular work. The load is set either using a bicycle ergometer or on a treadmill. The absolute criterion for the test subject to achieve the oxygen “ceiling” is the presence of a plateau on the graph of the dependence of the amount of oxygen consumption on the power of physical activity. The observation of a slowdown in the growth of oxygen consumption with a continued increase in the power of physical activity is also quite convincing.

Along with the unconditional criterion, there are indirect criteria for achieving the IPC. These include an increase in blood lactate levels above 70-80 mg%. In this case, the heart rate reaches 185 - 200 beats/min, the respiratory coefficient exceeds 1.

Tests with straining . Straining as a diagnostic method has been known for a very long time. It is enough to point out the straining test, which was proposed by the Italian doctor Valsalva back in 1704. In 1921, Flack studied the effect of straining on the body by measuring heart rate. To dose the straining force, any manometric systems are used, connected to a mouthpiece into which the subject exhales. As a pressure gauge, you can use, for example, a device for measuring blood pressure, to the pressure gauge of which a mouthpiece is connected with a rubber hose. The test consists of the following: the athlete is asked to take a deep breath, and then exhale is simulated to maintain the pressure in the manometer equal to 40 mm Hg. Art. The subject must continue dosed straining “until failure”. During this procedure, the pulse is recorded at 5-second intervals. The time during which the subject was able to perform the work is also recorded.

Under normal conditions, the increase in heart rate compared to the initial data lasts approximately 15 s, then the heart rate stabilizes. If the quality of regulation of cardiac activity is insufficient in athletes with increased reactivity, heart rate may increase throughout the test. In well-trained athletes, adapted to straining, the reaction to increased intrathoracic pressure is insignificant.

Orthostatic test . The idea of ​​using a change in body position in space as an input to study the functional state apparently belongs to Schallong. This test allows you to obtain important information in all those sports in which an element of sports activity is a change in body position in space. This includes artistic gymnastics, rhythmic gymnastics, acrobatics, trampolining, diving, high and pole vaulting, etc. In all these types, orthostatic stability is a necessary condition for athletic performance. Usually, under the influence of systematic training, orthostatic stability increases.

The Shellong orthostatic test is an active test. During the test, the subject actively stands up when moving from a horizontal to a vertical position. The reaction to standing up is studied by recording heart rate and blood pressure values. Carrying out an active orthostatic test consists of the following: the subject is in a horizontal position, while his pulse is repeatedly counted and his blood pressure is measured. Based on the data obtained, the average initial values ​​are determined. Next, the athlete stands up and remains in a vertical position for 10 minutes in a relaxed position. Immediately after moving to a vertical position, heart rate and blood pressure are recorded again. These same values ​​are then recorded every minute. The reaction to an orthostatic test is an increase in heart rate. Due to this, the minute volume of blood flow is slightly reduced. In well-trained athletes, the increase in heart rate is relatively small and ranges from 5 to 15 beats/min. Systolic blood pressure either remains unchanged or decreases slightly (by 2-6 mm Hg). Diastolic blood pressure increases by 10 - 15% relative to its value when the subject is in a horizontal position. If during a 10-minute study systolic blood pressure approaches the initial values, then diastolic blood pressure remains elevated.

Functional tests used in sports medicine can be used during medical and pedagogical observations to analyze the training microcycle. Tests are carried out daily at the same time, preferably in the morning, before training. In this case, you can judge the degree of recovery from the training sessions of the previous day. For this purpose, it is recommended to carry out an orthotest in the morning, counting the pulse while lying down (even before getting out of bed), and then while standing. If it is necessary to evaluate the training day, an orthostatic test is performed in the morning and evening.

Functional tests can be one-stage, when one load is used (for example, running in place for 15 seconds, or 20 squats, etc.).

Two-moment - when two loads are given (for example, running, squats).

Three-moment (combined) tests are based on determining the adaptation of the circulatory apparatus to loads of different nature (when three tests (loads) are given sequentially one after another, for example, a squat, a 15-second run, and a 3-minute run in place).

Simultaneous tests are used for mass examinations of people involved in physical education in groups of general physical training and in health groups, as well as people embarking on the path of sports improvement, to quickly obtain indicative information about the functional state of the circulatory system. More significant changes in the function of the cardiovascular system are caused by two-stage tests, but their value is reduced by the identical nature of repeated loads. This disadvantage is compensated by the combined three-moment Letunov test.

Indications for functional tests:

1) determination of a person’s physical preparedness for physical education and sports, exercise therapy;

2) examination of professional suitability;

3) assessment of the functional state of the cardiovascular system, respiratory, nervous and other systems of healthy and sick people;

4) assessing the effectiveness of rehabilitation and training programs;

5) predicting the likelihood of the occurrence of certain deviations in the state of health during physical education.

Requirements for functional tests:

1) the load must be specific to the person training;

2) the test must be carried out with the maximum intensity possible for the test subject;

3) the sample must be harmless;

4) the sample must be standard and easily reproducible;

5) the sample must be equivalent to the load under living conditions;

Absolute contraindications:

· severe circulatory failure;

· rapidly progressing or unstable angina;

active myocarditis;

· recent embolism;

· vascular aneurysm;

· acute infectious disease;

thrombophlebitis;

· ventricular tachycardia and other dangerous rhythm disturbances;

· pronounced aortic stenosis;

· hypertensive crisis;

· severe respiratory failure;

· impossibility of performing the test (diseases of the joints, nervous and neuromuscular systems that interfere with the test).

Relative contraindications:

1) supraventricular rhythm disturbances such as tachycardia;

2) repeated or frequent ventricular extrasystole;

3) systemic or pulmonary hypertension;

4) moderately severe aortic stenosis;

5) significant expansion of the heart;

6) uncontrolled metabolic diseases (diabetes, myxedema);

7) toxicosis of pregnant women.

Main testing tasks:

1) study of the body’s adaptation to certain influences

2) study of recovery processes after cessation of exposure.

Types of influences used during testing

b) change in body position in space;

c) straining;

d) change in the gas composition of inhaled air;

d) medications.

Most often used as an input effect. The forms of its implementation are diverse. These are, first of all, the simplest tests that do not require special equipment. Nevertheless, these tests characterize recovery processes and allow us to indirectly judge the nature of the reaction to the load itself. Such tests include: the Martinet test, which can be used in both children and adults; Ruffier and Ruffier-Dixon tests; S.P. Letunov's test, intended for a qualitative assessment of the body's adaptation to performing speed work and endurance work. In addition to simple tests, various tests are used in which the testing load is set using special devices. In this case, according to the mechanism, tests with physical activity can be divided into:

Dynamic

Static

Mixed (dynamic and static loads)

Combined (physical activity and another type of influence, for example, pharmacological);

Changing body position in space– orthostatic (transition from a lying position to a standing position) and clinostatic tests.

Straining– this procedure is performed in 2 versions. In the first, straining is not quantitatively assessed (Valsalva maneuver). The second option involves dosed straining. It is carried out using pressure gauges into which the subject exhales. The pressure gauge readings practically correspond to the intrathoracic pressure value. Tests with dosed straining include the Buerger test and Fleck test.

Changes in the gas composition of inhaled air– most often consists of reducing the oxygen tension in the inhaled air. Hypoxemic tests are most often used to study resistance to hypoxia.

Medications– the administration of medicinal substances as a functional test is used, as a rule, for the purpose of differential diagnosis between normal and pathological conditions.

One of the objective criteria of human health is the level of physical performance (PP). High performance is an indicator of stable health, and vice versa, its low values ​​are considered a risk factor for health. As a rule, high RF is associated with higher physical activity and lower morbidity, including the cardiovascular system.

Physical performance- complex concept. It is determined by a significant number of factors: the morphofunctional state of various organs and systems, mental status, motivation, etc. Therefore, a conclusion about its value can only be drawn on the basis of a comprehensive assessment. In the practice of clinical medicine, to date, assessment of RF is carried out using numerous functional tests, which involve determining the “reserve capabilities of the body” based on the responses of the cardiovascular system.

Assessment of general physical performance.

The concept of physical performance (PP) is widespread in labor physiology, sports, aviation and space physiology. The concept of “physical performance” is part of general performance. General performance is quite difficult to separate from mental activity, since the processes occurring in the body under any type of load are basically similar.

It should be remembered that the concepts of “endurance” and “training” have an independent meaning, are not synonymous with physical performance and are only one of its parameters that characterize work activity in a given mode.

Physical capabilities acquired in one type of activity are used in other types. Transfer is based on this effect fitness, when, under the influence of external factors, all systems of the body adapt, and not just those to which this influence was directed. True, such a transfer is possible only in types of physical activity that are similar in the structure of movements. Practice has shown that an increase in achievements in one type of physical exercise can be accompanied by a significant decrease in results in other exercises, even those that are similar in biomechanical structure.

In the case of excessive physical activity, adaptation processes may be accompanied by excessive activation of energy processes in the body. The biological “price” of such adaptation can manifest itself in direct wear and tear of the functional system on which the main load falls, or in the form of negative cross-adaptation, that is, deterioration in the activity of other systems associated with this load.

Physical performance has its own specific characteristics and differences. According to the theory of functional systems by P.K. Anokhin, in the body they form at a fairly high speed functional systems, which include a complex of those anatomical and functional systems of the body, which, in their totality, ensure the achievement of the set goal.

The formed functional system exists only for the time necessary to solve the task, provides the necessary motor reaction, as well as hemodynamic and autonomic support with all available unconditioned reflexes and temporary connections. Persons with a low level of RF do not have a sufficient reserve (“bank”) of reflexes, and are not able to perform significant physical work.

The development of the necessary “bank” of reflexes is achieved by repeated repetition of a given muscular work, that is, training. As a result, a multi-link regulatory system is formed in the body, ensuring adequate implementation of the necessary muscle efforts.

Along with the formation motor skills, conditioned reflex skills are also formed vegetative systems, providing the very possibility of performing movements. In each specific case, the formed functional system has its own specific differences, which are manifested in the relationships and interactions of all body functions.

Currently, different authors put different content into the concept of “physical performance” (in English terminology - Physical Working Capacity - PWC). However, the main meaning of each of the formulations comes down to the potential ability of a person to perform maximum physical effort.

Thus, physical performance is the ability to perform specific work, where physical (muscular) efforts are the main ones to achieve the final result.

The level of physical performance is determined by the efficiency of performing a given job, that is its maximum execution in the minimum possible time.

Assessing physical performance is a complex issue. In general, physical performance is determined by the results of sports medical testing, correlating these results with an assessment of the functional state of the body at rest. If sports medical testing is, in fact, a simple task, then assessing the functional capabilities of the body requires significant intellectual and organizational efforts.

Physical performance is determined using functional tests with physical activity - stress tests. The Working Group on Stress Testing, created by the American College of Cardiology and the American Heart Association, has identified 7 main areas, each of which has many classes and subclasses of indications for the use of stress tests. The main applications of stress tests are:

Mass examinations of the population to identify heart diseases associated, among other things, with significant physical activity;

Identification of individuals with a hypertensive response to exercise;

Professional selection for work in extreme conditions, or for work requiring high physical performance.

Tests with dosed physical activity are used very widely for a wide variety of purposes, but the rationale for their use is the same: physical activity is the ideal and most natural type of influence, allowing one to assess the usefulness of the body’s compensatory and adaptive mechanisms, and, in addition, to assess the degree of functional usefulness of the cardiovascular and respiratory systems.

2.2 Functional tests and control methods during physical rehabilitation of the patient

The effectiveness of exercise therapy is directly related to the adequacy of the physical activity used, corresponding to the functional state of the patient’s body, therapeutic exercises based on a targeted effect on the damaged organ or system.

To assess the functional state of the body, interviewing the patient is of great importance, which allows you to determine his motor capabilities and identify signs of chronic coronary or heart failure based on his tolerance of everyday stress.

For those who experience everyday physical activity, slow walking causes heart pain, shortness of breath, weakness and palpitations, exercise tests are not performed and their motor abilities are rated as low, according to the survey. For patients who easily carry out the entire volume of exercise within the framework of everyday life, and pain in the heart, shortness of breath and weakness appear only during fast walking or moderate-intensity running, or are absent during any physical activity, physical tests are performed to assess the functional state and reserves of the cardiorespiratory system load.

Physical stress tests make it possible to determine physical performance and resolve the issue of the permissible total load when practicing various types of exercise therapy. Functional tests reveal the degree of dysfunction of a particular organ; with the help of functional tests, a particular method of therapeutic exercises is selected, and special exercises are dosed.

The choice of functional test and load model is determined by:

1) the nature of the disease, the degree of dysfunction of the affected organ or system;

2) the presence of concomitant diseases;

3) degree of physical fitness;

4) age and gender;

5) the stage of physical rehabilitation (hospital, clinic);

6) the ultimate goals of exercise therapy, a course of physical training.

Exercise tests.

Testing using physical activity in exercise therapy is based on various principles. The physical testing program is intended: I) to assess the functional state and reserves of the cardiovascular and respiratory systems in order to determine the total load when prescribing exercise therapy and selecting a physical training program; 2) assessment of physical performance to determine the patient’s suitability for various activities; 3) assessing the effectiveness of physical rehabilitation programs for those recovering from acute illnesses and for patients with chronic diseases of internal organs.

Two types of tests with physical activity are used: 1) tests, during which changes and recovery times in the parameters of the cardiorespiratory system are determined after standard physical activity; 2) submaximal tests, when using which data on the cardiovascular and respiratory systems can be obtained directly during dosed exercise, as well as during the recovery period.

The first type of tests includes various dynamic tests with jumping, squats, running and walking in place, which take into account changes and recovery times in heart rate, breathing, and blood pressure. Although these tests do not solve any of the above-mentioned problems of physical testing, they are widely used in practice due to their simplicity and accessibility.

The main purpose of recovery tests is to determine the response of the cardiovascular system to physical activity. The most standardized is the Martinet test with 20 squats in 30 s. This test is carried out in persons with diseases of internal organs at the stage of full compensation, when determining a medical group for physical education in educational institutions, when admitting them to classes in general physical training groups and in “Health” groups. Using the test, it is possible to determine the recovery time of the functions of the circulatory and respiratory systems after a specific load. At the same time, a shorter recovery period (up to 3 minutes) indicates better physical fitness; when performing a load, a physically prepared patient has a lower pulse rate. Pulse rate and blood pressure are compared with baseline values: the smaller the discrepancy, the better the function of the cardiovascular system. A test with 20 squats is assessed taking into account changes in heart rate (HR) in the first 10 seconds after the first minute after exercise and blood pressure as a percentage of the initial value, and the correspondence of the percentage of increase in heart rate with the degree of changes in all main parameters characterizing blood pressure is compared.

The types of reactions of patients to physical activity are usually divided into physiological, intermediate and pathological (unfavorable). Pathological reactions to stress during regular physical training can turn into physiological ones. An increase in heart rate in the range of 50-75%, an increase in systolic pressure by no more than 15-30% with a decrease in the minimum by 10-25% and an increase in pulse pressure by no more than 50-70% characterizes the normotonic type of reaction. This reaction is physiological and is regarded as favorable. The percentage increase in heart rate during this reaction corresponds to pulse pressure, which reflects the change in systolic and diastolic pressure and indirectly characterizes the increase in stroke volume of the heart.

Conclusion

Therapeutic physical culture is a scientific discipline. Exercise therapy as a branch of clinical medicine studies the rational use of physical culture and the changes that occur in patients under the influence of physical exercise.

The integration of social, biological, physiological, hygienic and pedagogical knowledge with modern achievements of clinical medicine formed the basis of the theoretical positions of exercise therapy and is logically combined with the differentiated development of its methods.

The biological basis of exercise therapy is movement - the most important natural biological stimulus of the body. The role of the social factor in exercise therapy is determined by its influence on human health. The influence of scientific and technological progress and urbanization, the role of diseases of civilization, etc. are taken into account. Exercise therapy contributes to the creation of an optimal ecological environment that is in accordance with the biological, mental and aesthetic needs of people. When using exercise therapy, the direct connection between man and nature expands.

The physiological basis of exercise therapy provides for a nosological approach to the most important diseases and an organ-system approach to differentiating specific issues. It reflects the tasks of preventive and hygienic medicine and has broad indications for use.

The hygienic foundations of exercise therapy are determined by its health-improving effects on patients. At the same time, the achievements of hygiene in physical exercise and sports, as well as the hygienic foundations of training, are taken into account. The hygienic aspects of exercise therapy strengthen its connection with the formation of a healthy lifestyle.

Pedagogical and methodological principles of training in exercise therapy are applied taking into account the condition of patients. They use the basics of teaching physical exercises, developing motor skills and developing physical qualities. The importance of dosed physical training and its focus (general and special training) are taken into account.

In assessing the therapeutic effect of physical exercise, it should be taken into account that their therapeutic effect is based on the ability to stimulate physiological processes in the body. The stimulating effect of physical exercise on the patient is carried out through the nervous and humoral mechanisms. The nervous mechanism is characterized by the strengthening of those nerve connections that develop between the functioning muscular system, the cerebral cortex and subcortex and any internal organ. These connections between the receptor apparatus and the central nervous system are determined not only by its functional state, but also by the state of the humoral environment.

That is why it is so important to carry out individual selection of physical exercises based on the results of functional tests.

Bibliography

1. Therapeutic physical culture: Directory / Epifanov V.A., Moshkov V.N., Antufieva R.I. and etc.; Ed. V.A. Epifanova. – M. Medicine, 1987.

2. Medical rehabilitation: A guide for doctors/Edited by V.A. Epifanova. - M. Medpress-inform, 2008.

Information about the work “Drawing up and justification of an individual set of physical exercises and available means of physical education, indicating the approximate dosage”

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