A set of exercises and massage for young children. Physical exercises and massage in pediatrics Conducting basic massage techniques for young children

Gymnastics and general massage have a regulating effect on the functions of the central nervous system, breathing, blood circulation, digestion, hematopoiesis. Under their influence, oxidative, trophic, and heat-regulating processes are stimulated and metabolism improves.

Gymnastics and massage for baby

Gymnastics and massage should be used in conjunction with all other educational activities(diet, sleep, wakefulness, etc.).

Massage and gymnastic exercises are the most beneficial and expedient way to educate a child in correct and accurate movements. In the absence of targeted education, the development of movements in a child is delayed, and their quality noticeably deteriorates.

When choosing special exercises For a child, it is necessary to take into account not only age characteristics, but also the characteristics of his individual development. At each age stage, the child exhibits two types of reactions:

1) predominant, stronger, but tending to fade;

2) emerging, still very weak, but nevertheless tending to a steady increase.

For example, in the first 3 months of life, children have pronounced hypertension in the flexor muscles of the upper and lower limbs. Against this background, balancing of the extensor muscles arises and gradually increases.

Since hypertension of the flexor muscles continuously decreases during the normal development of the child, the first reaction is progressive. Promoting this reaction (relaxation of the flexor muscles) should be considered appropriate. Remedies that contribute to this include daily warm baths and light stroking massage, causing muscle relaxation; stimulating the child’s independent movements associated with extension, for which the main motor background of this age is used - innate reflexes. In the first months of life, it is advisable to use only reflexes that are associated with extension in exercises in order to prevent strengthening of the already predominant flexors.

If balancing flexors and extensors upper limbs happens in a timely manner, then the prerequisites are created for the development of manual skill, which will give the child the opportunity to reach for an object, take it, and then, holding on, pull himself up, raising his torso. Thus, with the timely development of small muscles, the prerequisites are created for the development of large muscles, which provides the child with the ability to change position.

Physical exercises are prescribed for everyone healthy child, starting from 1.5-2 months of age. By this time, the child’s body adapts to the conditions of extrauterine existence, a certain lifestyle is established, and thermoregulation is improved.

For infants, exercises should be very simple and easy to do.

There are no contraindications to prescribing gymnastic exercises and massage to a healthy child in accordance with his age and individual characteristics.

Gymnastics and massage are carried out in a room at a temperature of 20-22°C. In summer, exercises must be performed with an open window or in the air at the same temperature.

The lesson itself is carried out on a table covered with a flannelette blanket folded in four, on top of which an oilcloth and a clean sheet are laid.

Classes are carried out once a day 45 minutes before or 45 minutes after feeding.

The hands of the nurse (or mother) should be clean, dry and warm.

The child is undressed; his body should be warm.

During the lesson, it is necessary to maintain a cheerful mood in the child, talk to him, encourage him to be active, smile, and use toys. While performing certain exercises, the nurse should carefully monitor the child’s reaction. If there is a negative reaction (deterioration in mood, crying), the procedure should be interrupted and the child should be calmed down.

The child should not be overtired. All movements must be done rhythmically, calmly and smoothly (without violence), repeating each one 2-3 times.

Massage and gymnastic exercises under the supervision of a doctor and a visiting nurse should be carried out by parents or other caregivers trained in massage and gymnastics techniques.

Basics of general methods of massage and gymnastics for young children

The development of motor activity of an infant occurs in two directions - statics and motor skills. In accordance with this, groups of exercises for children of this age are determined: they include exercises for developing coordination, balance, as well as breathing movements. To develop the respiratory activity of young children, passive and reflex exercises are used.

Passive exercises performed not by a child, but by a massage therapist (nurse, mother). They are designed to use the natural motor phase of the child’s muscles: flexion when a certain group of muscles contracts and extension when they relax.

Passive exercises should not be used until the child is 3 months old, since if there is existing flexor hypertension, performing them is associated with the danger of violence against the child! After 3 months of life, when complete balancing of the flexor and extensor muscles of the upper extremities occurs, passive movements for the arms can be gradually introduced, starting with the simplest ones and moving on to more complex ones. Balancing of the flexor and extensor muscles of the lower extremities is achieved between the 4th and 5th months of life, which makes it possible to introduce passive movements for the legs.

Reflex exercises. To strengthen the muscles of the neck and torso, you can use reflex exercises designed for movements that occur according to the type of unconditioned motor reflexes. Innate motor reflex reactions appear in response to irritation of receptors in the skin, muscles, and nervous system. First, in the hanging position on the stomach, the child tilts his head back. After about a month (by 4 months), in the same position, his whole body begins to bend, forming an arch, open upward. This movement is an energetic stimulation and strengthening of the vestibular apparatus. From 4 months, in a hanging position on his back, the child tilts his head forward, straining the muscles of the front surface of the body. By regularly giving the indicated positions (holding the child hanging on his stomach, on his back), you can strengthen the muscles of the neck and torso. In the future, on the basis of these innate reflexes, it is possible to create conditioned connections in response to signal stimuli such as pulling the legs, sound signals, grasping, etc.

Exercises with assistance - passive-active. This includes movements that are performed by the child independently only partially, for example, sitting down when pulling the child by the arms or hands; standing with support under the arms, etc.

Active exercises- voluntary exercises that the child does independently.

Massage- one of the types of passive gymnastics. Its essence consists of mechanical irritations rhythmically and systematically applied to the child’s body.

Massage can be general or local. General massage has a significant and varied effect on the child’s body. There are five main massage techniques:

1. Stroking.

2. Rubbing.

3. Kneading.

4. Effleurage.

5. Vibration.

Stroking. When stroking, the skin is freed from epidermal scales, which leads to the opening of the ducts of the sebaceous and sweat glands. This method improves breathing and nutrition of the skin (skin vessels dilate, arterial and venous circulation improves), and its firmness and elasticity increases.

Up to 3 months, children are massaged exclusively by stroking. After 3 months, other massage techniques are added: kneading, effleurage. General stroking massage lasts up to 6 months. In the future, it is necessary mainly in case of turgor disturbance and muscle tone, and also as a rest between exercises.

The massage begins with stroking. It alternates with other techniques and ends the massage. When stroking, one or both hands of the massage therapist fit tightly to the massaged surface, glide slowly, calmly, rhythmically. Stroking is always performed taking into account venous and lymphatic outflow (along the way). Types of stroking:

Embracing. Performed with two hands. With one hand, the massage therapist holds the limb by the hand or foot, and with the other, he covers the limb between the thumb and the other four fingers.

Alternate stroking. It is performed with two hands in such a way that when one hand finishes the movement, the second one replaces it.

Cross-shaped stroking. It is performed with two hands, the fingers of which are intertwined.

Spiral stroking. Performed by the base of the palm, or the terminal phalanx thumb, or the other four fingers, or the entire palm. When stroking in a spiral manner, while maintaining the main direction of movements, additional spiral movements are described.

Stroking with weights. Performed with two hands. One hand, palm or back, lies on the massaged area, the second is on top and applies pressure, helps to perform stroking.

Trituration aims to influence mainly the musculoskeletal system of the child. This technique improves the nutrition of tendons, tendon sheaths, and mucous bursae; elasticity and contractility of muscles increase.

When rubbing, the skin is slightly stretched with your fingers. Not only the skin is rubbed, but also the tissues underlying it. Rubbing is performed in different directions. Types of rubbing:

Longitudinal rubbing. Performed thumbs both hands. The fingers lie tightly in parallel on the massaged surface and rub it, moving in opposite directions.

Rubbing with fingertips. Performed with one or two hands. The fingers are bent, the ends are directed into the skin of the massaged area. Movements in different directions.

Spiral rubbing. It is performed similarly to spiral stroking, but more energetically with shifting the skin and rubbing it in different directions.

Row-like rubbing. Used for back massage. From the neck to the buttocks, rubbing is performed with the ends of the fingers of both hands, which slide over both. sides of the spine. From the buttocks to the neck, rubbing is performed with the back of the hands.

Sawing. Two hands work. The brushes are located parallel to the costal surface and rub the area, moving in opposite directions.

Kneading is aimed at increasing blood supply and improving nutrition of the massaged area. Mainly used for deep muscle massage. Muscles or individual muscle bundles are grabbed by the massage therapist’s fingers, slightly retracted and kneaded in different directions. Types of kneading:

Longitudinal kneading. Movements are performed along muscle fibers.

Transverse kneading. The muscle warms up in a transverse direction relative to the muscle fibers.

Double ring. Performed with both hands while massaging the shoulder muscles. The shoulder is covered between the thumb and the other four fingers. The brushes, moving in opposite directions, seem to twist the three- and biceps muscles and thereby knead them.

Effleurage, as a special type of massage, helps reduce excitability peripheral nerves, improving blood supply, and therefore muscle nutrition. Tapping also affects deeper-lying internal organs. This technique is performed by lightly tapping individual parts of the body (richer in muscles) with the ends of the fingers of both hands. In the youngest children, this technique in the form of rhythmic patting is performed with the palmar surface of the fingers of one or the other hand of individual parts of the body, most often the back, hips, less often back surface shins. Types of effleurage:

Tapping with fingertips. The blows are delivered with two hands, the fingers of which are bent.

Effleurage of the palmar surface.

Pat. It is performed with two hands, the fingers of which are gathered into a “soft fist” and perform movements reminiscent of kneading dough.

Chopping. The blows are applied with the rib surface of the hand.

Vibration consists of transmitting uniform shocks quickly following each other to the body. This technique in early age used very rarely.

The following sets of exercises for different age groups very conventional and schematic. Each subsequent age complex, gradually becoming more complex, involves maintaining the exercises of all previous complexes.

A set of exercises for children aged 1.5 to 12 months

The complex consists of general massage techniques (stroking) and active movements based on innate unconditioned reflexes.

1. Massage-stroking the arms, legs, back, abdomen (a, b, c, d).

A set of exercises for children aged 1.5 to 3 months

2. Active movements - exercises for the feet, reflex extension of the spine, reflex crawling (e, f, g).

Passive movements are gradually introduced into the complex for this age due to a decrease in muscle hypertension.

1. Back massage (kneading) (a).

2. Moving your arms to the sides and crossing them on your chest (b).

3. Turning onto the stomach - reflex (c).

4. Deflection of the head back in a suspended position on the stomach (g).

5. Flexion and extension of the arms (e).

A set of exercises for children aged 3 to 4 months

6. “Sliding” steps (imitation of bicycle movements) (f).

In the period from 4 to 6 months, it is necessary to introduce simple active movements. Special attention should be given to exercises in grasping, holding objects, swinging, etc. To do this, during gymnastics exercises for the hands must be combined with the education of the act of grasping. At first, the child himself must hold on to the finger of his sister-teacher; later (after 6 months) rings are used for the same purpose. At the same age, it is necessary to stimulate the child’s first attempts to change body position as preparation for crawling. Consequently, the system of exercises should anticipate the new things that inevitably arise in the child.

A set of exercises for children aged 4 to 6 months

1. “Hovering” in a prone position (a).

2. Raising the upper body from a position on the stomach with support from the arms extended to the sides (b).

3. Crawling with assistance (exercises to stimulate crawling) (c).

4. Flexion and extension of the legs (alternately and together) (d).

The second half of a child’s life is a period of mass emergence of conditioned connections that are developed on the basis of unconditioned and conditioned reflexes. Therefore, if exercise before were carried out according to the type of innate reflex in response to an unconditioned stimulus, then in this period the exercises are carried out in response to conditioned stimuli. Such signals can be a slight tug on the legs, visual signals (rings, a stick), and then speech signals (sit down, stomp, take the rings, etc.).

At the age of 10 to 12 months, standing without support and walking develop. New elements of the technique appear - squatting. In this regard, appropriate squatting exercises are introduced. A variety of verbal instructions are introduced, which displaces the signals of the first signaling system (such as pulling the legs, turning the pelvis, etc.).

A set of exercises for children aged 6 to 12 months

1. Sitting down with your arms out to the sides (a).

2. Sitting down (exercise for arm flexors) (b).

3. Tilt of the torso (c).

4. Straightening the body (d).

5. Sitting down with support from your hands (e).

6. Squat (e)

8. Walking on all fours (h).

Always take into account the baby’s mood during classes and his reactions. Remember: exercise should evoke only positive emotions. If the child is capricious (especially crying), you should not insist. Choose another time!

Increase physical activity gradually. In order not to overtire the baby, conduct the lesson in 2-3 doses during the day. If he is calm, walks, is not angry, has pink skin, warm arms and legs, the load can be increased. It can also be adjusted - make classes shorter and longer, repeat exercises more or less times, diversify the pace and range of movements, alternate exercises of different complexity and rest.

Exercise with your baby every day at the same time, 30 minutes before feeding or 45-60 minutes after it. You shouldn't exercise before bed.

Before starting classes, at the end and throughout the day, stroke and rub your baby’s fingers and hands. It is very useful, when playing with a child, to place a small toy with an uneven surface in his palm and then, as it were, take it away.

Your hands should be warm, dry, and clean during exercise.

The room in which you study should be well ventilated, the air temperature in it is +20...22°.

While studying, focus all your attention on the child. Other people and noise are not welcome in the room. Speak quietly, calmly, kindly.

It will be great if quiet melodic music is played (Tchaikovsky, Mozart, Schubert, Vivaldi): all children, and especially those with disorders of the central nervous system, are very receptive to music.

The colors that are in his environment have a significant impact on the baby’s psyche and mood. Restless, noisy children with increased motor activity are calmed by light green and blue tones. For those who are calm (especially phlegmatic and lethargic), bright, contrasting colors are good - the color of mother’s clothes, toys, pieces of furniture.

In order for the baby to fall asleep better and faster, it is advisable to have dim lighting of blue or cyan light; it is turned on when preparing for bed.

Massage and gymnastics for babies. Adapted techniques

As already mentioned, hypertonicity that is not eliminated in time will slow down the development of motor skills, and this means motor awkwardness, clumsiness, and disturbances in posture and gait. Such a baby is unlikely to become a welcome participant in children's games, which means he will begin to feel rejected and inferior; his psyche will suffer... In addition, he will lag even further behind in motor development, because collective children's games are no Swedish walls and there is no substitute for exercise equipment!

Delay not eliminated by massage motor development will slow down the formation of intelligence: a baby who has not learned to sit by six months is forced to spend hours looking at the square of the ceiling, while sitting he would look at many new wonderful things around. The inability to crawl and walk when the time has come deepens this “intellectual” hunger and delays the child’s exploration of the world around him.

The massage therapist himself?

"Massage? Yes, I can easily do it myself!” Mothers who are inclined to this point of view will have to be disappointed. To become a massage therapist (like a pianist!), you need an experienced “maestro” to “set” your hands. And it is often impossible to do without thorough medical training. Massage is performed by qualified physical therapists, as well as trained special training paramedical workers. It’s better to invite them.

But if (unfortunately it happens) parents and child are left to their own devices: there is a six-month waiting list for massage at the clinic, and the family budget cannot afford a paid specialist, or there is simply no qualified massage therapist in your town or village, you will have to deal with the baby yourself. Adapted techniques for some exercises will help you.

ADAPTED METHODS FOR SOME EXERCISES

Remember the rules

A newborn has a difficult task - to adapt to the world into which he finds himself. Therefore, in the first 4 weeks, doctors do not complicate the life of these babies with additional stress. They begin in the second month, and after six months the importance of massage gradually fades into the background, and gymnastics begins to take up more and more time.

A child’s poor health is an absolute contraindication to classes! Wait until he finally recovers.

Usually children like massage and gymnastics. They easily learn the exercises and, as they get older, diligently “help” you. If your baby shows displeasure at first, don’t be upset. Distract him with a toy, calm him down with a kind word, take him in your arms. You will have to be patient: the child will get into the rhythm of the classes and get used to the procedures gradually. If you don’t like a particular exercise, do it last or reduce the number of repetitions. Do not be overzealous - the baby will remember the unpleasant sensations, and especially the pain, for a long time. Redness of the skin, if it occurs under your hands, should be moderate and uniform. There should be no red spots and, of course, no bruises on the child’s body!

Classes are good every day in the morning, an hour before feeding or two hours after it, at a temperature of 20-22 ° C, in a bright, well-ventilated room without drafts.

Do massage and gymnastics on the changing table, which can be freely approached from three sides.

Before starting classes, wash your hands thoroughly with soap. Take off your watches, rings, bracelets - anything that could scratch your baby. There should be no wounds or abrasions on your hands, and your nails should be cut short.

Do not use ointments and creams.

The child remains naked during the massage, the first part of the complex. But for gymnastics, equip him like a real athlete - in a shirt or T-shirt with short sleeves and panties or diapers.

Exercises on the ball

Exercise 1.

Starting position (ip) - the child lies with his stomach on an inflatable ball; legs are bent in the form of “frog legs” and pressed against the ball. Your assistant holds the baby's legs in this position, and you take the baby's hands in your hands and pull him towards you, and then return him to the starting position. Repeat 10 times. Don't forget to put a diaper on the ball!

Exercise 2.

I. p., as in exercise 1. Your assistant straightens the child’s palms so that all fingers become straight, and presses them to the ball. You hold the baby by the shins and pull them towards you, then return him to the i. n. Repeat 10 times.

Exercise 3.

I. p., as in exercise 1. The baby’s palms are pressed to the ball by your assistant, who holds it, and your task is to take the baby’s feet in your hands and, turning him down on the ball, place his feet on the horizontal surface of the table covered with a diaper. The baby’s body remains on the ball, but you make sure that the support is on the entire foot: the tucked toes need to be straightened. Do not place the baby on the inner or outer edges of the feet. The contact of the feet with the surface of the table is short-term: without pausing, move the ball to the starting position. Repeat 10 times.

Exercise 4.

I. p., as in exercise 1. Take the child’s hands in yours and tilt the ball so that the baby touches the surface of the table with open palms. Make sure he doesn't hit his forehead! Repeat 10 times.

Exercise 5.

The child lies with his back on the ball. You hold it by the sides and gently rock it from side to side and back and forth - 10 times in each direction. Exercise helps relax muscles.

If you notice that the baby is constantly arching to the right or left, lying on his stomach or on his back, that is, the muscle tone on one side is higher than on the other, perform exercise 6.

Exercise 6.

Place the child sideways on the ball: if it bends to the right - on the right side, if to the left - on the left. Smoothly swing the ball along the axis of the child's body. Repeat 10 times.

Exercises on the ball help the baby relax and facilitate further massage.

Back massage

Cover the table with a flannel blanket folded several times and place a diaper on top of it. Roll up a thick diaper and place it under the baby's chest. Your assistant stretches the baby's hands forward, pressing them to the table surface with outstretched palms.

1. Stroking performed with the back of closed fingers from bottom to top of the back, starting with the buttocks, which are also massaged. Repeat 5-6 times.

2. Trituration performed with the back of closed fingers, their middle phalanges, in a circular motion up the back, starting from the buttocks. Repeat 4 times.

3. Stroking (see exercise 1).

4. Kneading . Use your closed knuckles to make spiral movements from bottom to top of your back. Repeat 3-4 times.

5. Finish the back massage stroking (see exercise 1).

Hand massage

Massage only the outer surface of the arms - first the shoulders (between the elbow and shoulder joints), then the forearms (between the wrist and elbow joints).

1. Stroking Perform from bottom to top with the palmar surface of closed fingers. Repeat 5-6 times.

2. Trituration - in the same direction and order. Repeat 5-6 times.

3. Stroking (see exercise 1).

4. Kneading , as with a back massage, do it from the bottom up. Repeat 3-4 times.

5. Stroking (see exercise 1).

Breathing exercises

I. p. - on the back. Take the child by the hands and cross his arms on his chest, alternately placing the left and the right on top. Repeat 4 times. Then simultaneously raise both of the baby’s arms up, place them behind the baby’s head so that they lie on the table surface parallel to each other. Then lower your arms, extend them along your hips. Repeat V ^>-----<_i 4 раза.

Abdominal massage

Using the palm of your right hand, stroke your abdomen in a clockwise direction 10-12 times.

Foot massage

The technique and sequence are the same as for hand massage. Only the anterior outer surfaces of the thighs and legs need to be massaged.

Leg exercises

And p. - on the back.

1. Bend the baby’s legs at the hip and knee joints, close them, bringing the shins closer together. Your thumb holds the knee, and four fingers on the side grasp the baby's pelvis. Having placed your hands on the baby’s legs in this way, rotate the pelvis to the sides. Repeat 10 times in each direction.

2. Alternately bend and straighten the baby’s left arm and right leg 10 times. Then do the same with his right arm and left leg.

3. Breeding the legs at the hip joints. Repeat 10 times. Your efforts to overcome the child's resistance should be moderate. This exercise is not one of children's favorites.

Attention! Children with hip dysplasia can perform leg exercises only with the permission of an orthopedic doctor.

Turns from back to stomach

I. p. - on the back. Your assistant lifts the child's right arm up and holds it in that position.

You take the baby's left hand in your left hand, and hold the baby's right thigh with your right. The assistant presses the palm of the child's right outstretched hand to the table, straightening his fingers. You cross his left leg over his right, and the baby turns onto his tummy. Make 10 turns to the right and left.

Stomach crawling

I. p. - on the stomach. Your assistant takes the child by the hands, you take the legs. The assistant pulls the baby's right arm forward, straightening his fingers and pressing his palm to the table surface. You bend the baby's left leg and pull it towards the tummy. Then you do the same with the baby’s left arm and right leg, after which you return to the previous movement. This is how 10-20 “crawling” movements are performed. If the baby does not hold his head well, you will need another assistant who will support it with his palms from the sides so that the baby's head is in the midline.

Starting from 4 months, the child should master the following movements: sitting down while holding a stick, standing on all fours, squats and bending on a stick.

Sitting down

I. p. - on the back. The baby's arms are extended along the body. Your assistant presses the palm of the child's right hand to the table a few centimeters from his body. You hold the baby's legs with one hand so that they do not bend or come off the table, and with the other you lift him by the back and force him to sit with support on his right arm. At the same time, the baby’s body deviates slightly to the right, the arm bends slightly at the elbow. This way you teach your child to sit down. Having mastered the stereotype of this movement, he will perform the exercise more and more actively and by six months he will be able to do without your help. Do 10 squats using your right arm and the same number using your left arm.

Sitting with a stick

I. p. - on the back. The fingers of both hands of the baby (thumbs - from below, the rest - from above) cover a stick with a diameter of 2-3 cm. Since the child usually holds on too weakly and can let go of the stick at any moment, hold his fists with your hands, at the same time forcing him to lift his back from the table and sit down baby. Your assistant secures the baby's legs as in the previous exercise. At the same time, he must ensure that the child does not hit the back of his head on the surface of the table when lying on his back. Repeat 10 times.

Standing on all fours

I. p. - on the stomach. Place your palm under the baby's chest, lifting him up, and with the other hand bend his legs at the knee and hip joints. At this time, the assistant presses the child’s outstretched palms to the table surface at shoulder width. Let him stay in this position for about a minute. At first, when balance reactions have not yet been developed, it will be difficult for the baby to maintain a position on all fours, but over time, stability comes.

Squat on stick

Place the stick on the table, cover it with a folded diaper several times. Take the child under your arms. Have your assistant position your baby's feet shoulder-width apart so that the stick is positioned exactly in the middle between his toes and heels. The feet should not move during squats. Repeat 10 times.

Tilts on a stick

The baby's feet are fixed as in the previous exercise. Hold the baby's legs in front with your left hand so that they do not bend at the knees, and place your right hand under the chest and abdomen. Tilt the child's torso. Repeat 10 times.

Crawling on all fours

Performed from six months of age. If at six months the child is not yet able to stand on all fours, you need to wait to do the exercises until he learns to do this. The technique for crawling on all fours is the same as crawling on your stomach.

Rotation

It has a beneficial effect on the vestibular apparatus and the autonomic nervous system. Take the “Health” or “Grace” disk, place a folded diaper on it several times, place a basin on top - preferably a medium-sized metal one. Line the inside of the basin with a blanket and diapers so that the baby can recline in it, like an astronaut in his chair. Smoothly, without jolts, rotate the basin clockwise for 30 seconds. When you stop, look into the child’s eyes: his eyeballs oscillate in the horizontal direction. Don't be alarmed - this is nystagmus, a normal physiological phenomenon that occurs in anyone who looks from a moving cabin at a stationary surrounding. Wait until the nystagmus disappears and rotate the basin in the opposite direction for another half a minute. In the future, gradually increase the rotation time to 5 minutes.

AGE PURPOSE OF GYMNASTIC EXERCISES AND MASSAGE FOR CHILDREN from 1.5 months to 3 years (according to K. D. Gubert and M. G. Ryss)

№	Purpose	Age	Indications, physiological justifications and targets	Contraindications
1.	Hand massage	1.5-4 months.	In connection with hypertension of the extremities to promote timely balancing of antagonists	Inflammation and irritation of the skin.
2.	Foot massage	1.5-6 months.	Same	Same
3.	Laying on the stomach	1.5-4 months.	For the development of back muscles	Lack of protective reflex.
4.	Back massage	1.5 - 14 months.	To strengthen and prepare the back muscles for exercise
5.	Abdominal massage	Same	To strengthen the abdominal muscles and relieve gas from the intestines	Same
6.	Foot massage	1.5 months -6 months	To strengthen the muscles and ligaments of the foot and develop support function	Same
7.	Exercises for the feet (reflex movements)	Same	To stimulate active foot movements using the plantar reflex	Same
8.	Spinal extension in the lateral position (reflex)	1.5-3 months.	To strengthen the back muscles using the spinal talent reflex	Same
9.	Reflex crawling	1.5-3 months.	To strengthen the extensors of the lower extremities in order to balance antagonists. Using the Bauer crawling phenomenon	Disappearance of the Bauer phenomenon
10.	Embracing movement	3-10 months	In the absence of hypertension of the muscles of the upper extremities, to strengthen the muscles of the shoulder girdle	Hypertension of the upper limb flexor muscles
11.	Turn from back to stomach with hand support	3-6 months	Developing the skill of changing body position using the reflex of the location of body parts	Child's passivity, head tilt
12.	Tilt of the head back in a hanging position on the stomach	3-4 months	To strengthen the back muscles in cultivating the balance reflex using the position reflex	Passivity of the child, hanging head
13.	Vibration chest massage	3-10 months	To stimulate deep inhalation	Skin inflammation and irritation
14.	Arm flexion and extension	Same	In the absence of hypertension of the muscles of the upper extremities, to strengthen the muscles of the arms and shoulder girdle	Hypertension of the upper limb flexor muscles
15.	"Sliding Steps"	4-14 months	In the absence of hypertension of the muscles of the lower extremities, to develop support function
16.	“Hovering” in a prone position	4-6 months	To cultivate the balance reflex, instead of exercise No. 1 1 (as a calmer one)	Child's passivity
17.	Raising the upper parts of the body from a position on the back with arms extended to the sides	Same	Developing the skill of changing body position, using the emergence of the child’s movement in this direction
18.	Flexion and extension of legs together and alternately	4-10 months	In the absence of hypertension of the muscles of the lower extremities, to strengthen the muscles of the legs and develop walking skills	Hypertension of the lower extremity flexors
19.	"Hovering" in a supine position	4-6 months	To strengthen the abdominal muscles and develop the balance reflex using the position reflex
20.	Turn from back to stomach while holding legs	6 -10 months	Instead of exercise No. 1 1 (as more complex)	Passivity of the child, throwing back the head
21.	Exercise to encourage crawling	6 months - before mastering crawling	In the absence of hypertension of the muscles of the lower extremities, to develop skills in moving the body	Impaired muscle tone of the lower extremities (hypertonicity)
22.	Sitting down with support from both arms out to the sides	6 -10 months	Instead of exercise No. 17 after preliminary strengthening of the cervical muscles and abdominal muscles with other exercises (No. 11 and 19)	Passivity of the child, throwing his head back
23.	Circular movements with hands	6-14 months	In the absence of hypertension of the muscles of the upper extremities and mastering exercises No. 10 and 14 to strengthen the muscles of the shoulder girdle	Upper limb flexor hypertension
24.	Raising straight legs	6 -10 months	In the absence of hypertension of the muscles of the lower extremities, to strengthen the abdominal muscles	Hypertension of the lower extremity flexors
25.	Tense arching	Same	With normal muscle tone to develop coordination in the work of the flexors and extensors of the spine	Violation of muscle tone, as well as the child’s passivity, throwing his head back
26.	Raising the body from a position on the stomach with the support of the child by the hands	Same	To strengthen the back muscles and develop the skill of changing body position from horizontal to vertical	Passivity of the child if the head lags behind the movement of the hands
27.	Squatting (exercise for arm flexors)	6-14 months	With the active participation of the child (presence of flexion in the elbow joint)	Passivity of the child when the arms remain straight when pulling up
28.	Flexion and extension while sitting or standing, with rings	10-14 months	Instead of No. 14 after mastering sitting or standing without support	Lack of ability to sit or stand for a long time without support
29.	Raising the body from a prone position to a vertical position with the support of the child by the arms (or with rings)	Same	If the child stands up on his own, clinging to objects, instead of exercise No. 26	Lack of ability to stand up while clinging to a stationary object
30.	Torso tilt and straightening	10 -18 months	With the ability to stand without support, to strengthen the back muscles	Lack of ability to stand without support
31.	Raising straight legs to the stick (according to verbal instructions)	Same	Instead of passive exercise No. 24	Same
32.	Squat while holding a child's hands (with rings)	10-14 months	If you have the ability to stand without support, to strengthen the muscles of the lower extremities	Same
33.	Sitting down with support from one hand or independently with fixation of the lower limbs and returning to the starting position	10-18 months	Instead of exercise No. 22 as a further complication *	Child's passivity
34.	Stressful arching from a sitting position on mother's lap	10 months -3 years	Instead of exercise No. 25, because the child is too heavy
35.	Flexion and extension of arms while standing, in pairs	14-18 months	Instead of exercise No. 28, to develop the ability to coordinate your movements with the movements of a friend
36.	Tense bending of the spine from a position on the stomach (with a stick)	14 months -3 years	To strengthen the shoulder girdle and interscapular muscles and improve posture

Massage and gymnastic exercises are the most beneficial and expedient way to educate a child in correct and precise movements. In the absence of targeted education, the development of movements in a child is delayed, and their quality noticeably deteriorates.

When choosing special exercises for a child, it is necessary to take into account not only age characteristics, but also the characteristics of his individual development. At each age stage, the child exhibits two types of reactions: predominant, stronger, but tending to fade; emerging, still very weak, but nevertheless tending to a steady increase.

For example, in the first 3 months of life, children have pronounced hypertension in the flexor muscles of the upper and lower extremities. Against this background, balancing of the extensor muscles arises and gradually increases.

Since hypertension of the flexor muscles continuously decreases during the normal development of the child, the first reaction is progressive.

Promoting this reaction (relaxation of the flexor muscles) should be considered appropriate. Remedies that contribute to this include daily warm baths and light stroking massage, causing muscle relaxation; stimulating the child’s independent movements associated with extension, for which the main motor background of this age is used - innate reflexes.

In the first months of life, it is advisable to use only reflexes that are associated with extension in exercises in order to prevent strengthening of the already predominant flexors.

If the balancing of the flexors and extensors of the upper extremities occurs in a timely manner, then the prerequisites are created for developed manual skill, which will give the child the opportunity to reach for an object, take it, and then, holding on, pull himself up, lifting the torso.

Thus, with the timely development of small muscles, the prerequisites are created for the development of large muscles, which provides the child with the ability to change position.

Physical exercise is recommended for every healthy child starting from 1.5-2 months of age. By this time, the child’s body adapts to the conditions of extrauterine existence, a certain rhythm of life is established, and thermoregulation is improved.

For infants, exercises should be very simple and easy to do.

Contraindications There is no way to prescribe gymnastic exercises and massage to a healthy child in accordance with his age and individual characteristics. Gymnastics and massage are performed in a room at a temperature of 20–22 °C. In summer, exercises must be performed with an open window or in the air at the same temperature.

The lesson itself is carried out on a table covered with a flannelette blanket folded in four, on top of which an oilcloth and a clean sheet are laid.

Classes are carried out once a day 45 minutes before or 45 minutes after feeding. The hands of the nurse (or mother) should be clean, dry and warm. The child is undressed; his body should be warm. During the lesson, it is necessary to maintain a cheerful mood in the child, talk to him, encourage him to be active, smile, and use toys. While performing certain exercises, the nurse (or mother) should carefully monitor the child’s reaction. If there is a negative reaction (worsening of mood, crying), the procedure should be interrupted and the child should be calmed down. The child should not be overtired.

All movements must be done rhythmically, calmly and smoothly (without violence), repeating each one 2-3 times.

Basics of general methods of massage and gymnastics for young children

Passive exercises are performed not by the child, but by a massage therapist (nurse, mother). They are designed to use the natural motor phase of the child’s muscles: flexion when a certain group of muscles contracts and extension when they relax.

Passive exercises should not be used before 3 months of a child’s life, since if there is existing flexor hypertension, their implementation is associated with the danger of violence against the child.

After 3 months of life, when complete balancing of the flexor and extensor muscles of the upper limbs occurs, passive movements for the arms can be gradually introduced, starting with the simplest ones and moving on to more complex ones.

Balancing of the flexor and extensor muscles of the lower extremities is achieved between the 4th and 5th months of life, which makes it possible to introduce passive movements for the legs.

Reflex exercises. To strengthen the muscles of the neck and torso, you can use reflex exercises designed for movements that occur according to the type of unconditioned motor reflexes.

Innate motor reflex reactions appear in response to irritation of receptors in the skin, muscles, and nervous system. First, in the hanging position on the stomach, the child tilts his head back. After about a month (by 4 months), in the same position, his whole body begins to bend, forming an arch, open upward. This movement is an energetic stimulation and strengthening of the vestibular apparatus. From 4 months, in a hanging position on his back, the child tilts his head forward, straining the muscles of the front surface of the body.

By regularly giving the indicated positions (holding the child hanging on his stomach, on his back), you can strengthen the muscles of the neck and torso.

In the future, on the basis of these innate reflexes, it is possible to create conditioned connections in response to signal stimuli such as pulling the legs, sound signals, grasping, etc.

Exercises with the help of someone (passive-active). These include movements that are performed by the child independently only partially, for example, sitting down when pulling the child by the arms or hands; standing with support under the arms, etc.

Active exercises are voluntary exercises that the child does independently.

Massage– one of the types of passive gymnastics. Its essence lies in mechanical irritations rhythmically and systematically applied to the child’s body.

Massage can be general or local. General massage has a significant and varied effect on the child’s body. There are 5 main massage techniques:

1) stroking;

2) rubbing;

3) kneading;

4) effleurage;

5) vibration.

Stroking. When stroking, the skin is freed from epidermal scales, which leads to the opening of the ducts of the sebaceous and sweat glands.

This method improves breathing and nutrition of the skin (skin vessels dilate, arterial and venous circulation improves), and its firmness and elasticity increases.

Up to 3 months, children are massaged exclusively by stroking. After 3 months, other massage techniques are added: kneading, effleurage. General stroking massage lasts up to 6 months.

In the future, it is necessary mainly in cases of impaired muscle elasticity and muscle tone, as well as as a rest between exercises.

Stroking is always performed taking into account venous and lymphatic outflow (along the way). Kinds stroking:

1) coverage. Performed with two hands. With one hand, the massage therapist holds the limb by the hand or foot, the second hand covers the limb between the thumb and the other four fingers;

2) alternate stroking. It is performed with two hands in such a way that when one hand finishes the movement, the second replaces it;

3) cross stroking. Performed with two hands, fingers intertwined;

4) spiral stroking. Performed with the base of the palm, or the terminal phalanx of the thumb, or the other four fingers, or the entire palm. When stroking in a spiral manner, while maintaining the main direction of movements, additional spiral movements are described;

5) stroking with weights. Performed with two hands. One hand with the palm or back surface lies on the massaged area, the second is on top and applies pressure, helps to perform stroking.

Rubbing is aimed primarily at affecting the child’s musculoskeletal system. This technique improves the nutrition of tendons, tendon sheaths, and mucous bursae; the elasticity and contractility of muscles increases.

When rubbing, the skin is slightly stretched with your fingers. Not only the skin is rubbed, but also the tissues underlying it.

Trituration performed in different directions.

Kinds rubbing:

1) longitudinal rubbing. Performed with the thumbs of both hands. The fingers lie tightly in parallel on the massaged surface and rub it, moving in opposite directions;

2) rubbing with fingertips. Performed with one or two hands. The fingers are bent, the ends are directed into the skin of the massaged area. Movements in different directions;

3) spiral rubbing. It is performed similarly to spiral stroking, but more energetically with shifting the skin and rubbing it in different directions;

4) rake rubbing. Used for back massage. From the neck to the buttocks, rubbing is performed with the ends of the fingers of both hands, which slide along both sides of the spine. From the buttocks to the neck, rubbing is performed with the back of the hands;

5) sawing. Two hands work. The brushes are located parallel to the costal surface and rub the area, moving in opposite directions.

Kneading is aimed at increasing blood supply and improving nutrition of the massaged area.

Mainly used for deep muscle massage.

Muscles or individual muscle bundles are grabbed by the massage therapist’s fingers, slightly retracted and kneaded in different directions.

Kinds kneading:

1) longitudinal kneading. Movements are performed along muscle fibers;

2) transverse kneading. The muscle warms up in a transverse direction relative to the muscle fibers;

3) double ring kneading. Performed with both hands while massaging the shoulder. The shoulder is covered by the thumb and four other fingers. The hands, moving in opposite directions, seem to twist the triceps and biceps muscles and thereby knead them.

Effleurage as a special type of massage helps to reduce the excitability of peripheral nerves, improve blood supply, and, consequently, muscle nutrition.

Tapping also affects the deeper internal organs.

This technique is performed by lightly tapping individual parts of the body (richer in muscles) with the ends of both fingers.

In the youngest children, this technique in the form of rhythmic patting is performed with the palmar surface of the fingers of one or the other hand of individual parts of the body, most often the back, hips, less often the back surface of the lower leg.

Kinds effleurage:

1) tapping with fingertips. The blows are delivered with two hands, the fingers of which are bent;

2) palmar effleurage;

3) pat. Performed with two hands, the fingers of which are gathered into a “soft fist”, making movements reminiscent of kneading dough;

4) chopping. The blows are applied with the rib surface of the hand.

Vibration consists of transmitting uniform shocks to the body in rapid succession. This technique is used very rarely at an early age.

Methods of massage and gymnastics at the age of 1.5–3 months

Since children of this age have pronounced muscle tone in the flexors of the limbs, massage efforts should be aimed at relaxing these muscles.

Active movements are carried out taking into account innate reflexes, mainly musculocutaneous and protective.

Of the innate reflexes, it is necessary to pay attention to extension, avoiding movements of the flexor muscles.

In children of this age, it is necessary to pay attention to relaxing the flexors using stroking.

Sequence of the procedure:

1) hand massage (stroking);

2) foot massage (stroking);

3) laying on the stomach;

4) back massage (stroking);

5) abdominal massage (stroking);

6) foot massage (rubbing);

7) exercises for the feet (reflex movements);

8) extension of the spine (reflex) in a position either on the right or on the left side;

9) laying on the stomach;

10) reflex crawling.

The child lies on his back during the procedure.

The child should take a warm bath every day, you need to evoke positive emotions in him during the procedure and communication.

Methods of massage and gymnastics at the age of 3–4 months

With normal development in a child of this age, the physiological increased tone of the arm flexors disappears, but hypertonicity of the leg muscles may still remain. At this age, you can begin to carry out passive movements for the arms. At the age of 3–4 months, due to the strengthening of the neck muscles, innate position reflexes appear.

On the lower extremities, stroking is used to relax the flexors where there is hypertonicity.

If a child makes the first attempts to change his body position (turning over from his back to his stomach), then he should be helped.

By 3 months, the crawling phenomenon disappears, and exercises for the lower extremities can be used.

The procedure is carried out in the following sequence:

1) hand massage;

2) grasping movements with the arms (passive exercise);

3) foot massage (stroking, rubbing, kneading);

4) turn on your stomach to the right (reflex movement);

5) back massage (stroking, rubbing, kneading);

6) reflexive movement of the head back in position

on the stomach;

7) abdominal massage (stroking);

8) foot massage (rubbing, patting);

9) exercises for the feet (reflex);

10) vibration massage of the entire chest;

11) passive exercise for arms and legs for flexion and extension;

12) turn on your stomach to the left.

Thus, it is necessary to promote complete balancing of the flexors and extensors of the limbs, the first skills for changing body position; provide conditions for the development of arm muscles by hanging various toys and objects for grasping at the height of outstretched arms.

Methods of massage and gymnastics at the age of 4–6 months

At the age of 4 to 6 months, the child begins to balance the tone of the flexors and extensors of the lower extremities, so it is necessary to introduce passive movements for the lower extremities.

Strengthening the anterior cervical muscles by 4 months occurs thanks to exercises based on the food reflex with turns and raising the child's head.

In this age period, you can introduce active exercises to change body position (from a lying position to a sitting position) with support from the hands.

When performing the exercises, it is necessary to maintain the rhythm of the movements while counting out loud (one, two, three, four).

Mandatory exercise – back, abdomen and feet, upper limbs.

1) grasping movements with the arms, passive cross movements in front of the chest;

2) foot massage;

3) imitation of bicycle movements, “sliding steps” on the table surface;

4) turn from back to stomach to the right, back massage (all techniques);

5) “hovering” in a prone position (reflex movement);

6) abdominal massage (stroking clockwise, along the oblique abdominal muscles);

7) lifting the child’s upper body from a supine position with support from both arms extended to the sides;

8) foot massage (reflex movements);

9) flexion and extension of the arms (“boxing”);

10) bending and straightening the legs together and in turn;

11) reflex exercise on the back, “hovering”;

12) chest massage;

13) turn from back to stomach.

All massage techniques are performed in a lying position.

The main task is the further development of the arm muscles, changing the position of the body and turning it; preparation for crawling; When placed on the stomach, rhythmic sound signals should be given for auditory development.

Methods of massage and gymnastics at the age of 6-10 months

During this period, you can introduce exercises for both the small muscles of the hand and the large muscles of the limbs, which are difficult to coordinate movements. The child is able to hold the body in certain positions for a longer period of time, sit without support, stand with support, and crawl. During this period, the child develops an understanding of speech, which must be facilitated.

Conditioned signals and verbal instructions (sit, give, take, give, hold tight) should be widely used; all signals must be carried out on the basis of unconditioned reflexes.

Sequence of procedures:

1) grasping movements with hands, with rings;

2) flexion and extension of arms and legs with verbal instructions, stroking and rubbing;

3) turn from back to stomach to the right (by the legs) with verbal instructions;

4) back massage (all manipulations);

5) with support from both hands, sitting down with verbal instructions;

6) circular movements with hands;

7) raising straight legs with verbal instructions;

8) reflex movement along lines along the spine with bending;

9) turn from back to stomach to the left with verbal instructions;

10) lifting from a lying position on the stomach with support from the hands with verbal instructions;

11) sit-down exercise for arm flexors with verbal instructions;

12) massage of the chest and abdomen (all techniques with vibration;

13) breathing exercises, squeezing while exhaling from the sides.

Position the child lying down, and during some exercises – sitting. It is necessary to stimulate the child to crawl, strive to strengthen the muscles for sitting and standing, cultivate conditioned motor reflexes with understanding of speech and coordination of movements, and maintain rhythm in performing movements. Massage should precede exercise.

Methods of massage and gymnastics for children aged from 10 months to 1 year

During this period, standing without support takes shape and walking develops.

The child is developing new motor skills (for example, squatting), so more squatting exercises are recommended.

In this period, the child has a connection with actions and objects, their names, which are related to gymnastics. More verbal instructions should be introduced.

Sequence of the procedure:

1) flexion and extension of the arms in a sitting position, standing with objects;

2) “bicycle” movement with verbal instructions;

3) turn from back to stomach according to verbal instructions;

4) back massage (all techniques);

5) from a prone position, lifting to a vertical position with support from hands or objects (rings);

6) bending forward (pressing the child by the knee joints with his back);

7) abdominal massage (all techniques);

8) raising straightened legs to a landmark (sticks, toys) with verbal instructions and approval;

9) exercise for arm flexors (squatting);

10) tense arching while holding the child by the legs, getting an object from the floor with verbal instructions;

11) squatting with hands supported, using objects;

12) sitting down with support either by one or the other hand or independently with a return to the starting position;

13) circular movements of hands with objects.

The main task is to stimulate the implementation of exercises according to verbal instructions. It is necessary to use various objects - rings, sticks, toys, give the child the opportunity to practice climbing and walking skills, but, taking into account the individual characteristics of the child, start new movements from a lying position, and then (complicating them) - sitting, standing. Massage is a rest after gymnastic exercises, so it should be done immediately after them.

Physical activity in young children is a powerful factor contributing to the proper development of the child. The creation of physiologically based methods of performing gymnastics and massage at an early age is based on knowledge of the state and development of skeletal muscles in children.

In the first 3 months of life, there is a sharp hypertonicity of the flexors of the upper and lower extremities, but their balancing by antagonist muscles gradually increases. Gymnastics and massage promote the development of extensors and muscle relaxation.

The child's independent movements associated with extension should be stimulated. This is possible when using congenital ovaries in children. These include a number of food (sucking, swallowing, salivation); protective and defensive, such as turning or raising the head from a position on the stomach in a child in the first weeks of life; vascular; a series of positions (postures) and arrangement of parts or balances (labyrinthine, cervical). In children up to 2"/2-3 months, there is a foot (crawling phenomenon). It refers to cutaneous amnesia. In these ahs, the irritant is touching the skin, and the response is expressed by contraction of the corresponding muscles. In the first case (the crawling phenomenon) - extensor muscles , with spinal e Talent - extensors of the spine.In the first months of life, it is advisable to use only those associated with extension in order to avoid strengthening the flexors, the tone of which already predominates.

The sequence of procedures: 1) grasping movements with hands, with rings, speech; 2) flexion and extension of arms and legs with verbal instructions, stroking and rubbing (Fig. 165-169);

Rice. 165. Hand massage (stroking).

Rice. 166. Foot massage (stroking).

Rice. 167. Foot massage (rubbing).

Rice. 168. Massage of the legs (rubbing).

Rice. 169. Reflex crawling.

3) turn from back to stomach to the right (by the legs) with verbal instructions; 4) back massage (all manipulations, Fig. 170-173);

Rice. 170. Reflex extension of the spine

Rice. 171. Back massage (stroking).

Rice. 172. Back massage (kneading).

Rice. 173. Back massage (vibration).

5) with support from both hands, sitting down with verbal instructions; 6) circular movements with hands; 7) raising straight legs with verbal instructions; 8) reflex movement along lines along the spine with bending; 9) turn from back to stomach to the left with verbal instructions; 10) from a lying position on the stomach with the support of the hands, lifting with verbal instructions; 11) sit-down exercise for arm flexors with verbal instructions; 12) massage of the chest and abdomen (all techniques with vibration, Fig. 174, a); 13) breathing exercises, exhalation compression from the sides (Fig. 174.6).

Rice. 174. Abdominal massage.

a - stroking; b - compression on exhalation from the sides.

Methodical instructions. The position of the child is lying and during some exercises - sitting. Encourage the child to crawl. Strive to strengthen the muscles for sitting and standing, develop conditioned motor skills with understanding of speech and coordination of movements. Maintain rhythm in performing movements. Massage should precede exercise.

MASSAGE AND GYMNASTICS TECHNIQUE AT AGE 10 MONTHS - 1 YEAR

During this period, standing without support takes shape and walking develops. The child is developing new motor skills (for example, squatting), so more squatting exercises are recommended. In this period, the child has a connection with actions and objects, their names, which are related to gymnastics. More verbal instructions should be introduced.

The sequence of the procedure: 1) flexion and extension of the arms in a sitting position, standing with objects; 2) “bicycle” movement with verbal instructions; 3) turn from back to stomach according to verbal instructions; 4) back massage (all techniques); 5) from a prone position, lifting to a vertical position with support from hands or objects (rings); 6) bending forward (the methodologist presses the child by the knee joints with his back); 7) abdominal massage (all techniques); 8) raising straightened legs to a landmark (sticks, ) with verbal instructions and approval); 9) exercise for arm flexors (squatting); 10) tense arching while holding the child by the legs, getting an object from the floor with verbal instructions; 11) squatting with hands supported, using objects; 12) sitting down with support either by one or the other hand or independently with a return to the starting position; 13) circular movements of hands with objects.

Methodical instructions. The main task is to stimulate exercises according to speech instructions. Use various objects - rings, sticks,... Give the child the opportunity to practice climbing and walking skills, but, taking into account the child’s individual capabilities, start new movements from a lying position, and then (complicating them) while sitting or standing. Massage is a rest after gymnastic exercises, so it should be done immediately after them.

Massage and gymnastics in early childhood

Physical activity in young children is a powerful factor contributing to the proper development of the child.

The creation of physiologically based methods of performing gymnastics and massage at an early age is based on knowledge of the state and development of skeletal muscles in children.

Gymnastics and massage should be used in conjunction with all other educational measures (diet and sleep patterns, organization of wakefulness, etc.).

Gymnastics and general massage have a regulating effect on the functions of the central nervous system, breathing, blood circulation, digestion, and hematopoiesis. Under their influence, oxidative, trophic, thermoregulatory processes are stimulated, and metabolism improves.