What is the child's health group? Criteria for determining whether a child belongs to a particular group. Recommendations of specialists for different health groups

In-Depth Research. During it, the state of health of the child during the periods of epicrisis is assessed, followed by recommendations from specialists for the further full development of the baby.

Identification of various diseases in the early stages and improvement of the child, the purpose of which is to prevent the formation of a chronic disease.

The pediatrician determines the health group, taking into account all the examinations of specialists.

There are several criteria for assessing the health status of a child:

Criterion 1 - whether deviations are observed in early ontogenesis.

2nd criterion - development in the physical plane.

3 criterion - neuropsychic development.

4th criterion - the body's resistance to various painful factors.

5th criterion - the state of organs and systems.

6 criterion - whether there are chronic diseases or congenital diseases.

Thus, the definition of a health group occurs based on the criteria listed above. So, the child has a 2nd health group. What does this mean?

Characteristics of 2 health groups

You need to understand that a health group is nothing more than the state of health of a child and its predisposition to various diseases, as well as the presence of congenital diseases. Health group 2 includes children who have minor health problems. They, as a rule, get sick more often, for example, acute respiratory infections, overweight or the likelihood of allergies may be present.

Group 2 health in newborns is most common. Because at present, completely healthy children are not born, even if the mother does not suffer from any diseases. A person's attitude to a particular health group is established not only in but also accompanies him throughout his life.

Two more subgroups are distinguished among children who were assigned to group 2

2-A are children who have biological, genetic and social factors for the development of diseases, but they are healthy according to other criteria.

Genetic factors are the presence of relatives with various diseases that can be passed down from generation to generation. For example, diabetes, heart disease, allergies and others.

Biological factors are deviations that arose during pregnancy and childbirth in the mother. These are fast or vice versa long births, caesarean section, prolonged presence of the fetus without amniotic fluid, placental pathology, malposition of the fetus, and so on.

Social factors include smoking, parental alcoholism, parental work in hazardous industries, chronic diseases of the mother, too early or late pregnancy. The presence of infections that can be sexually transmitted, the threat of premature birth or miscarriage in the mother. Poor nutrition during pregnancy and violation of the general regimen.

2-B - these are children who have morphological and functional changes. Newborns who belong to this subgroup suffered some disease in the first days or hours of life and after discharge from the hospital they still have some deviations. Such babies often get sick, there are anomalies of the constitution and other deviations in health.

When discharged from the hospital, a risk group is indicated, and, judging by it, the pediatrician must draw up a plan for observations, examinations, and carry out preventive measures (hardening, vaccinations). If necessary, drug treatment is prescribed.

It is necessary to observe children who belong to subgroup 2-B at home for up to three months.

So, what is health group 2, and how can young children and preschoolers be attributed to it?

There are a number of deviations by which one can judge the state of health of the child:

Multiple pregnancy.

Immaturity is postponed, prematurity.

CNS damage.

Hypotrophy 1 degree.

Infection in the womb.

Low weight at birth.

Overweight at birth (4 kg or more).

The initial period of rickets, 1st degree of rickets and its residual effects.

The presence of anomalies in the constitution.

Changes that relate to the cardiovascular system, changes in blood pressure, pulse.

Frequent illnesses, including respiratory.

Gastrointestinal disorders - lack of appetite, abdominal pain, etc.

2 health group in a child is not yet an indicator that all deviations should be present in the medical record. Just one or more is enough. The health group is determined by the most severe deviation.

All parents can easily find out which health group their child belongs to. Each local doctor owns this information, and even a nurse will be able to give explanations. After all, the child's health group is not a medical secret.

Monitoring the health of children in children's institutions

Information about children from 2 gr. health must be at the nurse of the children's institution. If a child belongs to this group, then at physical education lessons he is offered a set of exercises specially designed for such children. Loads for them should be lower. But this does not mean giving up sports. If there is a 2nd health group in a child, then such children are often prescribed physiotherapy exercises.

In addition, medical supervision is necessary for children who belong to this group. Since they have a high risk of developing various pathologies. The main method that allows you to get an assessment of the health status of children is a preventive examination, which is carried out by doctors.

There is also an algorithm for determining health groups in children aged 3 to 17 years. Children are examined:

At 3 years old (before entering kindergarten);

At 5 and a half or 6 years old (one year before elementary school);

At the age of 8, when the child finishes the 1st grade of school;

At age 10, when the child enters secondary school;

At 14-15 years old.

If, as a result of the examination, the child's health indicators are related to the classes and groups of diseases allocated by the Ministry of Health of the Russian Federation, then he is referred to a certain health group.

Physical education with children of 2 health groups

In order for physical education lessons to be effective and without risk to the health of schoolchildren, the latter are assigned to one of three groups (basic, preparatory and special). The division is made by a pediatrician or therapist at the end of the school year, but the specialist makes the final verdict only after a second examination before the start of the next school year.

If a child has the 2nd health group in physical education, then he belongs to the preparatory medical group. These are practically healthy children, but having certain deviations, poorly prepared physically. Schoolchildren can be engaged but with the condition of gradual assimilation of the necessary motor skills and abilities. The dosage of physical activity is observed, contraindicated movements are excluded.

If a child has a 2nd health group, then he is forbidden to perform test tasks in the classroom and participate in sports events. But experts strongly recommend conducting additional physical education classes at home or at school.

The tasks of schoolchildren with 2 health groups:

Strengthening and improving health;

Improving physical development;

Mastering important motor skills, qualities and skills;

Improving the adaptation of the body to physical activity;

Hardening and increasing the body's resistance to disease;

Formation of interest in constant physical education, development of volitional qualities;

Raising a positive attitude towards a healthy lifestyle;

Mastering a set of exercises that have a beneficial effect on the state of the child's body, taking into account the existing disease;

Compliance with the correct regime of rest and work, hygiene, good nutrition.

Conclusion

Thus, the 2nd group of health in a child is not a sentence. It should not be considered inferior or terminally ill. The child's belonging to this group means that he needs sensitive care, you need to constantly monitor his health in order to avoid unpleasant consequences.

Children with this health group lead a normal life and develop well, they are no different from other kids.

Adult health groups

I group- citizens who have not been diagnosed with chronic non-communicable diseases (pathological conditions), which are the main cause of disability and premature death; there are no risk factors for these chronic non-communicable diseases or there are these risk factors with low or medium total cardiovascular risk, and which do not need dispensary observation for other diseases (conditions).

Such citizens are provided with a brief preventive consultation, correction of risk factors by a general practitioner, doctor (paramedic) of the department (office) of medical prevention or a health center.

II group- citizens who have not established chronic non-communicable diseases (pathological conditions), which are the main cause of disability and premature death, have risk factors for these chronic non-communicable diseases and a high or very high total cardiovascular risk that do not need dispensary observation for other diseases (conditions).

Such citizens undergo correction of risk factors for chronic non-communicable diseases in the department (office) of medical prevention or a health center, if necessary, prescription of drugs for medical use for the purpose of pharmacological correction of risk factors is carried out by a general practitioner. Subject to dispensary observation by a doctor (paramedic) of the department (office) of medical prevention.

III group- citizens with diseases that require dispensary observation or the provision of specialized, including high-tech medical care, as well as citizens with a suspected disease that requires additional examination (At the end of the examination, the citizen's health group may change).

Such citizens are subject to dispensary observation by a general practitioner, other medical specialists with medical, rehabilitation and preventive measures. Citizens with risk factors for chronic non-communicable diseases are corrected in the department (office) of medical prevention or a health center.

Children's health groups

I group- healthy children, physically and mentally developing normally, without functional abnormalities. Children of this group during the observation period may rarely get sick, but at the time of the examination they must be healthy, the body's resistance must be high. In fact, the first health group combines absolutely healthy babies, but children with this health group are very rare, literally a few. During my years of practice, I only exhibited this health group a couple of times.

II group- healthy children, but with functional and some morphological abnormalities, with reduced resistance to diseases. Such children should not have chronic diseases, but may suffer acute diseases more than 4 times a year.

The second group has several subgroups, and the whole group includes healthy children, but with some nuances. Group "A" includes healthy babies, but either there is a burdened heredity, or the mother's pregnancy and childbirth took place with complications. Group "B" includes children who are often ill, with some functional abnormalities with a possible risk of developing chronic diseases.

The remaining groups include sick children with various diseases according to their severity. Such children are necessarily on medical examination with specific specialists. For them, special programs for recovery and treatment are being developed. So the third group includes babies with developmental defects in the compensation stage, if the defects are in the subcompensation stage, then such children already belong to the fourth health group, and the decompensation stage is the fifth health group.

III group- children with chronic diseases in a state of compensation (that is, in a state without exacerbation, not showing themselves in any way). This group includes children with congenital pathology or chronic diseases, in which there may be rare and not severe exacerbations of the underlying disease. The resistance of the organism in such children is somewhat reduced. Such diseases, in which the 3rd group will be put, include chronic gastritis or duodenitis, ZhDVP, chronic bronchitis, pyelonephritis, anemia, obesity, stuttering, flat feet and adenoids.

IV group- children with chronic diseases in a state of subcompensation. This group includes children with congenital pathology or chronic diseases, in which, after an exacerbation of the underlying disease, the general condition and well-being are disturbed for a long time. The resistance of the organism in children is sharply reduced. These are epilepsy, hypertension, thyrotoxicosis, progressive scoliosis.

Group V- children with chronic diseases in a state of decompensation. These are children with severe disabilities who do not walk, cancer patients and other serious conditions. Children in this group have severe malformations or chronic diseases with significantly reduced functionality. These children usually do not attend child and adolescent general institutions and often have disabilities.

6.2. The concept of health groups and medical groups

In the Russian Federation, there is a system for the early detection of children in need of therapy and the further organization of their life. In particular, annual medical examinations of students allow them to be divided into medical groups in accordance with four criteria:

Presence or absence of chronic diseases;

The nature of the functioning of the main functional systems of the body;

The degree of resistance to adverse effects;

The level of physical development and the degree of its harmony.

health groups. In accordance with the specified criteria, the following health groups are distinguished:

Group 1 - healthy, normally developing, without functional abnormalities. This includes schoolchildren without chronic diseases, who did not get sick or rarely got sick during the observation period and have normal, age-appropriate physical and neuropsychic development. This group includes 20-25% of schoolchildren, and this content of the first group has not changed over the past 50 years. But now the characteristics of the health of these children are not entirely objective, since the first group most often includes those who simply have not been diagnosed, although their adaptive capabilities are undoubtedly reduced, i.e. they are in the "third state".

Group 2 - healthy, with functional or minor morphological abnormalities. These are schoolchildren who do not suffer from chronic diseases, but have some functional and morphological abnormalities, as well as often (four or more times a year) or for a long time (more than 25 days for one disease). This group has rather vague criteria, so assigning a particular student to it is often the competence (or incompetence) of a doctor.

Group 3 - patients in a compensated state: having chronic diseases or congenital pathology in a state of compensation with rare and mild exacerbations of a chronic disease without a pronounced violation of the general condition and well-being.

Group 4 - patients in a subcompensated state: having chronic diseases or congenital pathology in a state of subcompensation with violations of the general condition and well-being after an exacerbation, with a protracted nature of convalescence after acute diseases.

Group 5 - patients in a decompensated state: with severe chronic diseases in a state of decompensation and with significantly reduced functionality; as a rule, they do not attend general educational institutions, but study either in specialized schools or at home and are observed according to individual schemes.

A comprehensive assessment of the state of health and distribution by health groups is given by a pediatrician.

Children and adolescents assigned to different groups require a differentiated approach to the organization of physical education or physiotherapy exercises. So, for children of the first health group, educational, labor and sports activities are organized without any restrictions in accordance with state programs for physical education for the corresponding age category. Children of the second health group as a risk group need increased attention from doctors. With them it is necessary to carry out special measures for hardening, exercise therapy, diet therapy; they need to organize a rational mode of life in accordance with their state of health. Children with the third, fourth and fifth health groups should be under the constant supervision of doctors, their motor regimen is limited by certain contraindications (but should be an obligatory part of the lifestyle), and the duration of rest and sleep is lengthened for them.

After distribution by health groups, children recognized as fit to study in a general education school are divided into medical groups, belonging to each of which determines the mode of physical education that best suits their state of health. The correct distribution of children into medical groups for physical education is an important part of the work of a pediatrician and a physical education teacher.

Distribution of schoolchildren by medical group produced by a pediatrician on the basis of the "Regulations on medical control over the physical education of the population of the USSR. Order No. 826 dated 09.XI.1966.

On the basis of data on the state of health, physical development and physical fitness of children, all students involved in state programs are divided into four groups: basic, preparatory, special and group of therapeutic physical culture.

To the main medical group include schoolchildren without deviations in the state of health, as well as those with minor deviations with sufficient physical development.

To the preparatory group include children without deviations in the state of health with insufficient physical development, as well as with minor deviations in health. The group with deviations in the state of health includes students with chronic diseases. The largest population in this group is made up of schoolchildren with focal infections of the oral cavity, nasopharynx, paranasal sinuses, etc. Chronic tonsillitis (20–40% of students), dental caries (almost 90%), etc. are especially common. It is known that chronic inflammation in the nasopharynx and oral cavities change the general reactivity of the body, reduce its protective functions and natural resistance to infections. Such children often get sick during the rise of acute respiratory viral infections (ARVI) and influenza, they often have exacerbations of chronic tonsillitis, otitis, sinusitis. The focus of infection in the nasopharynx can provoke bronchitis, pneumonia, their transition to a chronic form.

To a special medical group include schoolchildren with deviations in the state of health of a permanent or temporary nature, requiring limited physical activity or certain contraindications in the means of physical culture used. The special medical group also includes schoolchildren suffering from other diseases due to which at this time it is necessary to significantly limit physical activity (after tuberculosis, with a significant lag in physical development and physical fitness, with acute gastrointestinal diseases with malnutrition, five to six months after hepatocholecystitis, as well as viral hepatitis).

The contingent of the special medical group also includes schoolchildren for whom physical activity is not dangerous, but they cannot be engaged in the general program due to defects in the musculoskeletal system: ankylosis, contractures, severe muscle atrophy, after traumatic injuries, chronic infectious polyarthritis, accompanied by limited mobility of the joints, with residual effects of poliomyelitis, as well as severe deformity of the spine I - II degree.

For schoolchildren of preparatory and special medical groups, it is envisaged to limit the amount of physical activity, the degree of which depends on the state of health of this student, his illness and other criteria for the state of the body. Thus, special medical groups are made up of students for whom the physical activity received in physical education classes is contraindicated or requires significant limitation. Therefore, the physical education of schoolchildren of a special medical group is carried out according to a specially developed program that corresponds to the characteristics of the contingent involved in this medical group.

To the group of physiotherapy exercises include children (most often belonging to the fourth and fifth health groups) who have certain pronounced health disorders and are exempted from physical education at school. Such groups should work directly at medical institutions under the supervision of an appropriate specialist.

Thus, no child attending a general education institution should be completely exempted from physical education. If such a situation exists, the doctor who made such a decision should be responsible for it.

In accordance with the above Order of the Minister of Health of the USSR No. 826 of 09.11.1966, until now, the distribution of schoolchildren by medical groups is carried out according to table 13 below.

Table 13

Approximate indications for determining the medical group for certain deviations in the state of health in children and adolescents

It should be noted that the above table confirms once again: with rare exceptions, usually associated with acute conditions, there cannot be children who are completely exempted from physical education! This fully applies to those cases when the child starts school after suffering an acute illness or condition (cold-infectious, trauma, etc.). At the same time, the following terms are recommended for his release from physical education in the medical group in which he is constantly engaged (Table 14).

Table 14

Approximate timing of the resumption of physical exercises after an illness

The given terms relate only directly to physical education at school, however, during the indicated periods, the student must engage in physical exercises according to the schemes of physical therapy directly under the supervision of the relevant specialist and the attending physician.

Thus, in accordance with the results of medical examinations or (in acute conditions and after them) the conclusions of the attending physician, students are divided into medical groups for physical education directly at school.

Physical education in medical groups. Physical education classes in medical groups directly in educational institutions are carried out according to the relevant programs.

Main group. Here, classes are held according to the state program of physical education in full, delivery of certain standards is provided, classes in sports sections and participation in competitions are allowed. The result of the successful development of the program is an assessment determined by the relevant criteria.

Preparatory group. Classes are held according to the general program of physical education, subject to its more gradual completion with a delay in passing control tests (standards) and norms for up to one year. Directly in the classroom, schoolchildren of this group need more careful monitoring by a physical education teacher and a medical worker of an educational institution. In addition to the compulsory physical education lessons for such students, classes in the general physical training section are recommended. The final grade, in contrast to the students of the main group, is mainly determined by the physical education teacher in accordance with the individual criteria established for this stage of education.

Special Medical Group. Classes are held according to a special program or certain types of the state program, the training period is extended, and the standards are replaced by the implementation of individual tasks. The main form and means of work of a special medical group are physiotherapy exercises.

Transfer from one group to another is carried out during the annual medical examination of schoolchildren. The transition from a special medical group to a preparatory group is possible subject to the positive dynamics of the results of treatment and success in physical education.

Physical education is a compulsory subject in the school curriculum. Parents have no doubts about the need for this subject, as a rule, does not arise. After all, for children who are at their desks all day long, it does not hurt to move a little.

Physical education is a set of physical exercises that contribute to the healthy development of the child. Sports activities are useful for most children, but some schoolchildren (for health reasons) are prohibited from intense physical activity. That is why, all children who are preparing to go to school are required to undergo a complete medical examination. Based on the results of this examination, a record appears in the medical record of the future student about his belonging to a certain medical group for physical education.

Any medical health group requires periodic confirmation. Some parents confuse the concepts of "exercise therapy" and "health groups". They don't quite understand what the difference is. Therefore, we decided to bring some clarity to this issue. Physical therapy classes can only be conducted by an exercise therapy doctor, and a physical education lesson with students from special groups is conducted by a school teacher who has previously undergone the necessary training. In the course of training, he studies health-improving methods, learns to draw up individual sports programs for children suffering from certain diseases. Training takes place in specialized exercise therapy centers.

Classification of medical health groups in children by physical education - table

How physical education health groups are classified

How to determine which health group in physical education a child has?

Criteria for evaluation:

• The presence of functional disorders.
• Chronic diseases. current stage of the disease.
• The state of the main systems of the child's body.
• The coherence of the immune system.
• Harmonious development of the child in accordance with his age.

The health group is determined in the medical facility.

1. To determine a comprehensive assessment, the child must be examined by all "narrow" specialists. Some children are additionally assigned to consult an allergist. For example, if a child has a history of Dermatitis.
2. Then, you need to go through research and pass all the tests assigned to the child by specialists. Only after that, you can contact your local doctor. As a rule, future students undergo medical examination in kindergarten, where they determine the appropriate group. For older students, the group is determined based on the results of the medical examination, which they must undergo annually.

Sometimes inexperienced doctors play it safe and write in the certificate a group that does not correspond to the state of health of the child. At first glance, a minor mistake often becomes an insurmountable obstacle to admission to prestigious schools. Therefore, the table below will help parents make sure that the doctor makes the right decision. In case of disagreement, parents can always challenge the results by contacting the head physician of the medical institution for advice.

If during the medical examination none of the "narrow" specialists noted deviations in the development of the child, then the main group should be indicated in the certificate.

Diseases in a child and a health group

The main health group in physical education - tolerances and prohibitions

Students belonging to the main group are healthy and do not have any deviations in physical development. They are engaged in the usual school curriculum, they can attend any sections, take norms, take part in sports competitions.

Additional health group for physical education at school

This group allows you to do physical education at school together with the whole class. However, the intensity of exercise in this group is different. The teacher selects special complexes of sports exercises in accordance with the recommendations of the doctor. All restrictions are indicated in the medical record of the student.

For example, one child should not go to the pool, another should not tumble and bend over sharply, the third should not jump or run for long distances. The certificate indicates the period of its validity. After that, the child is transferred to the main group. To participate in competitions, to pass the TRP standards, a doctor's permission is required.

Special group "A" and "B" in physical education At school

1. Physical education lessons for students from group "A" are held separately from the whole class.
2. Classes with them are held according to specially designed individual programs. However, they are given the opportunity, together with the class, to attend theoretical classes in physical education, make reports and write essays.
3. Special groups involve classes with trained physics teachers who have been trained in exercise therapy centers.
4. A set of exercises for children is developed strictly in accordance with medical recommendations.
5. All exercises are done on special rugs.
6. Students may not take part in sports activities, but their presence as fans is encouraged.
7. They cannot be engaged in sports sections.

Features of children's classes in the special group "B" in physical education:

1. Pupils who have group “B” indicated in the certificate are completely exempted from physical education lessons at school, they are engaged only in medical institutions.
2. Classes are held according to individual programs and under the strict supervision of a physiotherapist.
3. Such students are allowed to attend only theoretical classes on this subject, taking place within the walls of the school.
4. The exercise therapy doctor develops the set of exercises they need. These exercises can also be done at home.
5. The physical therapy doctor advises parents and gives them the necessary recommendations.

marks

Many parents are concerned about the question: “How will physical education grades be given to children who are forced to study in an additional or special group?” There are no issues with students from the main group. After all, they receive marks based on the results of passing standards. Many parents do not even imagine that physical education textbooks exist today. Previously, such textbooks were not published. Most often, when giving grades, teachers ask children from the additional and special groups to write an essay, make a report, and make a presentation on healthy lifestyles. In addition, the fizruk, evaluating the student, focuses on his attendance at theoretical classes. A student cannot remain completely without a mark in this subject.

And it remains for us to wish your children health and excellent sports results.

P indicators of the health status of children and adolescent groups are:

• general morbidity,
• infectious diseases,
• health index,
• percentage of long-term and frequently ill,
• prevalence and structure,
• percentage of persons with normal physical development;
• the percentage of persons with disabilities in mental and physical development.

Control over the state of health of students in the class is carried out by the class teacher together with a medical worker.

in the classroom magazine The final page summarizes student health information during the school year in the form of the following metrics:

• Health index - the percentage of children who were not ill during the school year (normally 70 - 80%, in fact - 17-30%).
• The number of frequently ill children (more than 3 - 4 times per year).
• The number of children with chronic diseases and the list of these diseases (a feature of recent years is the increase in the number of "adult diseases": chronic gastritis, gastric ulcer, hypertension, etc.).

Information about the health status of students in the class and school is discussed at the pedagogical council and, together with a medical worker and the Center for State Sanitary and Epidemiological Surveillance, a comprehensive plan is drawn up to protect the health of schoolchildren.

Every year, millions of children and adolescents undergo medical examinations. The purpose of these examinations is to identify persons in need of medical and recreational activities. In addition, they make it possible to determine the need for medical personnel and the network of medical institutions (HCIs). Taken together, their results characterize the state of health of the entire younger generation.

A comprehensive assessment of the health status of each child or adolescent with assignment to one of the “health groups” is given with the obligatory consideration of all the listed criteria. This grouping allows for a comparative assessment of the health status of various contingents, both at the time of the examination and during dynamic control, to verify the effectiveness of ongoing preventive and therapeutic measures.

The main 5 groups of children's health.

There are five groups of children's health. Depending on belonging to a particular health group, children and adolescents need a differentiated approach in the development of a complex of therapeutic and preventive measures.

The first group - healthy children, with normal development and a normal level of functions - children without chronic diseases; not sick or rarely sick during the observation period; having normal, age-appropriate, physical and neuropsychic development (healthy children, no deviations).

For persons belonging to the first health group, educational, labor and sports activities are organized without any restrictions. The pediatrician carries out their preventive examination at the scheduled time, and medical appointments usually consist of general health measures that have a training effect on the body.

The second group - healthy children, but with functional and some morphological abnormalities, as well as reduced resistance to acute and chronic diseases - children who do not suffer from chronic diseases; having some functional and morphological deviations; often (4 times a year or more) or long-term (more than 25 days for one disease) ill (healthy, with morphological abnormalities and reduced resistance).

Children and adolescents in the second health group (the so-called risk group) require more attention from doctors. This contingent needs a complex of recreational measures aimed at increasing the body's resistance by non-specific means:

• 2) hardening by natural factors of nature;
• 4) additional fortification of food, etc.

The terms of repeated medical examinations are set by the doctor individually, taking into account the direction of deviations in the state of health and the degree of resistance of the body.

The third group - children with chronic diseases in a state of compensation, with preserved functional capabilities of the body - children with chronic diseases or with congenital pathology in the stage of compensation, with rare and not severe exacerbations of a chronic disease, without a pronounced violation of the general condition and well-being (patients in compensation).

Fourth group- children with chronic diseases in a state of subcompensation, with reduced functionality - persons with chronic diseases, congenital malformations in a state of subcompensation, with impaired general condition and well-being after an exacerbation, with a protracted period of convalescence after acute diseases (patients in a state of subcompensation).

The fifth group - children with chronic diseases in a state of decompensation, with a significantly reduced functionality of the body - children with severe chronic diseases in the stage of decompensation, with a significant decrease in functionality (patients in a state of decompensation). As a rule, children of this group do not attend children's institutions and are not covered by mass medical examinations.

Children and adolescents of the 3rd, 4th and 5th health groups are under dispensary observation by doctors of various specialties, they receive one or another therapeutic and preventive care, due to the existing pathology and the degree of compensation. In children's institutions, a gentle day regimen is created for them, the duration of rest and night sleep is extended, the volume and intensity of physical activity are limited, etc. If necessary, they are sent to special children's and adolescent institutions, where, taking into account the characteristics of the pathology, treatment and education are purposefully carried out.

Examples:

Functional heart murmur, tachycardia, bradycardia, sinus arrhythmia, extrasystole, lowering blood pressure (8-12 years old up to 80-85 mm Hg, 13-16 years old - up to 90-95 mm Hg) - 2nd health group. Vegetovascular dystonia - 3rd health group. Hypertension - 4th health group. Congenital heart disease - 3rd or 4th health group. Dental caries, malocclusion - 2nd or 3rd health group. Chronic gastritis, colitis - 3rd or 4th health group. Dysmenorrhea - 3rd group of health.

Allergic reactions (repeated skin-allergic reactions to food, drugs, etc.) - 2nd health group. Eczema, dermatitis - 3rd or 4th health group. Logoneurosis, enuresis, tics - 3rd or 4th health group. Myopia of a weak degree, astigmatism - the 2nd group of health. Myopia of medium and high degree - 3rd or 4th health group. Violation of posture - 2nd group, scoliosis - 3rd or 4th group.