Therapeutic exercises >>>> Exercise after myocardial infarction (first stage)

Exercise after myocardial infarction (first stage).

The task of restorative physical education in the post-infarction period is to create conditions in order to form in a person such a level of physical activity capabilities that will allow him to independently perform a number of household physical activities, allowing himself to be served:

independent climbing or descending stairs;
independent walking;
independent hygiene procedures;
independence from outside help in ordinary situations.

The physical activity program for myocardial rehabilitation is subdivided into stationary and post-stationary periods, and the post-station period of rehabilitation implies a person's stay in a medical sanatorium of the appropriate direction or within the framework of home conditions, where a person who has had a myocardial infarction will be looked after.

The set of exercises after myocardial infarction is designed for several stages of physical rehabilitation and a stepwise transition within one stage from lighter exercises to more and more complicated ones in order to gradually introduce the heart muscle into the work process.

It is physically necessary to load the myocardium in order to establish a good blood supply to the tissues of the heart muscle, to enhance their trophism, which will contribute to the healing (scarring) of the myocardial muscles and will allow to continue life without lying in bed, but actively and fully. In this case, the word usefulness will be determined by the general state of the myocardium during time intervals and its state at the current moments.

There are a number of contraindications for carrying out loads on the heart muscle if there are signs of ill health in a person's state of health. At the stationary stage of rehabilitation, contraindications to physical activity are:

the presence of angina attacks,
sinus tachycardia (indicates the presence of circulatory disorders), wheezing and shortness of breath at rest or with the slightest movement,
the presence of heart rhythm disturbances,
the presence of an acute phase of pulmonary edema or attacks of cardiac asthma.

Complications of myocardial infarction are unconditional obstacles to carrying out therapeutic exercises to restore the myocardium:

rare or frequent episodic extrasystole,
atrioventricular block of the first degree,
pericarditis,
insufficient blood supply to the limbs,
hypotension,
pacemaker migration or paroxysmal rhythm disturbances,
hypertensive crisis or persistently high blood pressure,
acute aneurysm of the heart,
thromboendocarditis.

The whole complex of restorative physical education in the post-infarction period provides for four steps within the stationary stage of recovery (the first stage), and three steps within the framework of the post-stationary physical recovery (the second stage).

The steps are counted by day:

he first stage of the first stage (stationary stage) takes the first - third day after a heart attack,
the second stage of the first stage lasts from the fourth to the tenth day after the heart attack,
the third stage - from the tenth to the eighteenth day after a heart attack,
the fourth stage - from the eighteenth to the forty-fifth day after a heart attack.

The restoration of motor activity begins at the stage of bed rest. During this period, the person is required to be able to make turns on the side (left and right), is 10-15 minutes with a state with raised legs, with a raised headboard - such exercises are done 3-4 times a day, starting from the first day after the transferred heart attack.

A set of exercises for limbs in a supine position (start from 2-3 days after myocardial infarction):

Exercise 1. Starting position lying with the head of the bed lowered. Foot work. Legs are extended on the bed, alternately bending the foot of the left and right legs, without bending the knees, stretching the toes. The exercise is repeated in 1-2 sets, 10 times in each set. Every day, increase the number of exercises for each foot one time in each set.

Exercise 2. Starting position lying with the head of the bed lowered. The arms are extended along the body. Without bending your arms at the elbow, alternately push-ups the left and right hand into a fist with effort. The exercise is repeated in 1-2 sets of 10 push-ups for each hand in each set. Add one push-ups on each hand every day for each set.

Exercise 3. Starting position lying with the head of the bed raised. Repeat exercise 1 in two sets.

Exercise 4. Starting position lying with the head of the bed raised. Repeat Exercise 2 in two sets.

Exercise 5. Starting position lying with the head of the bed lowered. Hands are extended along the body, palms are extended outward. Bend your right arm at the elbow and without raising your elbows and forearms, grasp your right shoulder with the palm of your right hand. Bend the left arm at the elbow, without raising the elbow and forearm, grasp the left shoulder with the palm of the left hand. Repeat the exercise with alternating hands in two approaches, each with 10 exercises for each hand.

Exercise 6. Starting position lying with a raised headboard. Repeat Exercise 5 in two sets.

Exercise 7. Starting position lying with the head down. The legs are bent at the knees, the feet rest against the surface of the bed. Raise your left leg and place it on the bent knee of your right leg. Return to starting position. Raise your right leg and place it on the knee of your left leg. Take the starting position. Repeat the exercise in one approach 4 times on each leg. Every day, increase the number of times by one for each leg.

Exercise 8. Starting position lying with a raised head. Repeat Exercise 7 for each leg in one approach, 4 times for each leg, every day, increase the number of times by one for each leg.

Exercise 9. Starting position lying with the head raised. The arms are extended along the body. Raise your left hand and stretch it to your left knee. Lower your hand to the starting position. Raise your right hand and stretch it to your right knee. Lower your hand to the starting position. Repeat the exercise 1-6 times for each hand in one approach. Add once per hand every day.

Exercise 10. Starting position lying with a raised head. The arms are extended along the body. The legs are bent at the knees and form a right angle. Raise your left hand and stretch it to your right knee, lower your hand to its original position. Raise your right hand and stretch it to your left knee, lower your hand to its original position. Repeat the exercise 1-6 times for each hand in one approach. Increase the number of exercises for each hand one time every day.

Exercise 11. Starting position lying with the head of the bed lowered. The arms are extended along the body, the legs are straight. Raise your right hand up and put it behind your head, raise your head from the bed by 4 inches and hold out in this position for 1-5 seconds. Lower your hand to the starting position. Raise your left hand and place it behind your head. Raise your head from the bed by 4 inches and hold out in this position for 1-5 seconds. Lower your hand to the starting position. Repeat the exercise 1-6 times in one approach, adding one time to each hand every day.

Exercise 12. Starting position lying with a raised headboard. Legs straight arms extended along the body. Raise a straight leg from the bed to a height of 8 inches and hold out for 1-5 seconds. Lower your leg to the starting position. Change the leg and repeat the exercise pattern. Repeat the exercise 2-6 times on each leg in one approach, alternating legs. Add once per leg every day.

Exercise 13. Starting position lying with the head of the bed lowered. Legs straight, arms at right angles to the body to spread apart. Turn on the right side and place a straight outstretched left hand on a straight outstretched right hand. Take the starting position. Turn on the left side, put a straight outstretched right hand on a straight outstretched left hand. Take the starting position. The exercise should be performed from once for each hand in one approach, every day add the number of turns by one for each hand.

Exercise 14. Starting position lying with the head of the bed lowered. Arms are extended along the body, Legs are straight. Bend your knees. Raise your left bent leg and hold out for one or two seconds. Lower your leg to the starting position. Raise your right bent leg and hold out for one or two seconds. Lower your leg to the starting position. Repeat the exercise from one time to one approach, adding every day one time to each leg.

Exercise 15. Breathing exercise. Starting position lying with the head of the bed lowered. Legs are straight, Hands are extended and spread apart, forming a right angle with the body. Raise both arms without bending them at the elbows and stretch out in front of you parallel to one another, while exhaling, spread your arms to their original position, while inhaling. Repeat the exercise from one time to one approach, adding one two times every day.

At the first stage with bed rest, it is necessary to control the pulse rate after each exercise (should increase by no more than 20 beats), control the pressure level (systolic - an increase of no more than 20-40 points of mercury column, diastolic - no more than 10 - 12 points of mercury column). The pressure must not drop!

Take a break after each exercise. At the first symptoms of angina pectoris, arrhythmias, shortness of breath, decreased pressure (and not increased), dizziness, general weakness, pale skin, signs of any kind of poor health, the exercise complex is stopped for a day and is expected to recover. And only after the disappearance of the listed symptoms on the next day or after two to three days, physical activity is resumed again.

This set of exercises for bed rest after a heart attack is designed for a gradual renewal of the load on the heart muscle already at the stage of hospital bed rest or home bed rest.

The complex of exercises of the second stage of the first stage of physical rehabilitation of the heart muscle after myocardial infarction >>> (exercises in a sitting position) is switched only when the entire complex of exercises of the first stage is performed without deterioration of health (even the slightest deterioration).