Angina pectoris: is it possible to do morning exercises? Exercise therapy for ischemic heart disease: a set of permitted exercises, recommendations. Basic rules of exercise therapy

Everyone knows these clinical forms coronary disease heart disease (formerly called “angina pectoris”), such as angina pectoris or myocardial infarction, resulting from spasm of the coronary vessels and disturbances in the blood supply to the heart.

Performing available gymnastic exercises in quiet intervals between attacks will help improve your condition, prevent the occurrence of critical situations and further aggravation of the disease. Depending on the tolerance of physical activity during angina pectoris (that is, the appearance of pain in the heart or pathological changes in the electrocardiogram), 4 functional types are distinguished.

The first functional type includes patients who tolerate physical activity well. They rarely have angina attacks, and heart pain occurs only when performing unusually heavy loads or under significant neuropsychic stress. They are capable of performing muscular work with a power of more than 100 W. Patients with coronary heart disease with the first functional class can walk for a long time at any pace. Many of them also do slow running.

The second functional type includes patients with rare attacks of angina pectoris (that is, appearing during muscular work), occurring, for example, when brisk walking, going up to the 2nd-3rd floor. Their exercise tolerance ranges from 50 to 100 watts. They tolerate walking well at a moderate pace. To increase their performance and improve their condition, they can train in walking at a leisurely pace twice a day for 30-40 minutes.

The third functional type includes people with coronary heart disease with frequent attacks of angina pectoris that occur during minor muscle strains, for example, climbing the 1st floor, walking at a moderate pace on level ground, etc. Their tolerance to physical activity is less than 50 W. They tolerate walking well at a slow pace and can do it for 40-60 minutes.

Representatives of the fourth functional type are characterized by frequent attacks of angina at rest and stress. Thus, pain can occur even with minor loads, say, walking 100-150 m. Long walks can be recommended for them, but with mandatory rest periods.

Let us recall that among a number of risk factors for “angina pectoris” is limitation of physical activity. Adequate physical exercise will help expand the coronary vessels, improve the nutrition of the myocardium (heart muscle), improve the emotional and mental state, and activate metabolic processes and ultimately help the body resist the development of atherosclerosis, against which coronary heart disease usually occurs.

Below is approximate complex exercises available for patients with the first or second functional type. If during exercise you suddenly feel pain or discomfort in the heart area, you should reduce the load or even interrupt the exercise.

1. Sitting on a chair, hands down. Stretch your arms to the sides to shoulder level, take a deep breath, lower them down and exhale. Repeat 3-5 times.
2. While sitting, keep your hands on your waist. Raise your right arm across the side to shoulder level, inhale, return to the starting position, exhale. Same thing for the left hand. Repeat 3-5 times.
3. Standing, spread your legs, bend your arms horizontally at the elbows and hover in front of your chest. Rotate the body with arms raised - inhale, return to the starting position, exhale. Repeat 4-6 times.
4. Normal walking (30 seconds), then with a slight acceleration (1 minute).
5. Standing, legs slightly to the sides, arms also to the sides and raised at shoulder level. Perform first in one direction, then in the other, circular movements with your shoulders. Repeat 5-7 times forward and backward.
6. Standing, hands on the back of the head in a lock. Place your left foot to the side on your toe, tilt your body to the left, straighten up and take the starting position. Same thing with the right leg. Repeat 3-5 times.
7. Standing, hands rest on the back of the chair. Sit down - exhale, stand up - inhale. Repeat 4-6 times.
8. Standing, hands on waist. Spinning the head with full amplitude to the right, then to the left. Perform 3-5 times in each direction.
9. Walking is simple, alternating with acceleration (3 minutes).
10. Simple walking (30 sec), then high lifting thighs (30 sec).
11. While standing, alternately bend the body to the right, then to the left while bending the arm of the opposite side (the so-called “pump” exercise), the amplitude is maximum. Repeat 4-6 times in each direction.
12. While standing, we hold our hands in front of us and spread them slightly. We raise left leg and touch the right palm, returning to the starting position. Same thing with the right leg. Repeat 4-6 times.
13. We lie on our stomach, stretch our arms along the body and rest our palms on the floor. We raise our straightened legs one by one. Perform 4-6 times with each leg.
14. Sitting on a chair, we clasp our hands in a “lock” and hold them on our knees. Turn your palms out, raising your arms in front of you to shoulder level. Repeat 6-8 times.
15. Sitting on a chair, right leg in front, left leg under the chair, hands resting on the seat. Changing the position of the legs. Perform 8-10 times.

Physical activity for coronary heart disease

According to modern medical data, a large number of factors can contribute to the development of IHD (coronary heart disease). Among the most common and “aggressive” ones are poor heredity, alcohol abuse, smoking, chronic stress, metabolic disorders due to poor nutrition, chronic fatigue, and physical inactivity. Of course, it is almost impossible to get rid of a hereditary predisposition to IHD, and you cannot completely protect yourself from stress. But you can adjust your lifestyle so as to avoid the other factors mentioned above. First of all, you should quit smoking, optimize your diet and ensure proper physical activity on the body.

The benefits of physical activity:

• Regular physical activity allows you to stay toned and in good shape.
• With regular physical activity the amount of “useful” lipids in the blood increases, which helps reduce the risk of developing atherosclerosis.
• The likelihood of blood clots is reduced.
• Blood pressure is normalized, which helps reduce the risk of cerebral hemorrhage (stroke).
• Exercise promotes weight loss and prevents the development of diabetes.
• Regular exercise helps improve mood, normalize sleep, and make it easier to cope with stressful situations.
• Thanks to regular physical activity, the risk of developing osteoporosis is reduced - the most common cause bone fractures in old age.

Regular physical activity is beneficial for everyone, as it allows you to protect yourself from the development of many unpleasant diseases. But, unfortunately, due to a change in lifestyle and regular physical exercise We are often pushed only by the disease itself.

Only certain types of physical activity are suitable for patients with coronary heart disease.

IHD develops as a result of acid starvation, which leads to the formation of atherosclerotic plaque. The plaque causes the artery that supplies the heart to narrow, causing less oxygen-rich blood to reach the heart muscle. In this case, the intense work of the heart becomes difficult and, under heavy loads, angina pectoris develops - a painful attack of the heart muscle.

Naturally, angina attacks require limited physical activity. Often, in order to get rid of angina, it is necessary to resort to medication, or even surgical method treatment. In the case of a severe heart attack - a heart attack, patients even begin to be afraid of physical activity and, in an effort to “protect” the heart, often limit movement to the point of giving up walking.

For patients with angina and those who have had a heart attack, physical activity can have twofold meaning:

• On the one hand, excessive physical activity and intense physical activity can provoke attacks of angina pectoris and lead to a second heart attack - such excessive activity should be avoided.
• On the other hand, moderate physical activity and periodic exercise (no more than 40 minutes 5 times a week) are very beneficial.

Moderate physical activity helps increase the level of good cholesterol, which prevents the further development of atherosclerosis, reduces the rate of development of heart failure, strengthening the cardiovascular system. Regular exercise aerobic type contribute to the normalization of the functioning of collateral blood flow - an interarterial connection that serves to redistribute blood flow, which helps to increase the amount of oxygen-rich blood reaching the heart muscle.

As medical studies show, physical activity in patients who have had a heart attack helps reduce the risk of a second heart attack by 7 times, and reduce mortality by 6 times, compared with patients who prefer to reduce physical activity as much as possible.

Therefore, for patients who have had a heart attack, performing normal household activities (light daily housework) is mandatory. After an inpatient course of treatment, it is preferable for such patients to undergo a course of physical rehabilitation under the supervision of specialists in a cardiological sanatorium. If rehabilitation in a sanatorium is impossible for one reason or another, it is necessary to undergo a course of physical rehabilitation on an outpatient basis under the supervision of a cardiologist.

The easiest option for physical activity in this case is daily walking. At the same time, you should not overload yourself: the walk should take place at a slow or moderate pace (depending on how you feel), for half an hour to an hour, but not less than 5 days a week. If during a walk you feel weak or tired, you need to take a break - sit down on a bench or return home at a slow pace. Don't be upset - you will be able to go through more and more during the rehabilitation process. However, an increase in physical activity, just like the beginning of physical exercise, after hospitalization must be agreed upon with a physical therapy specialist or the treating cardiologist.

Physical activity should never lead to another attack of angina. During exercise, severe shortness of breath or rapid heartbeat is unacceptable. During physical activity, you need to monitor your heart rate - its frequency should increase in accordance with the increase in load. In this case, the optimal increase in heart rate should be determined by the attending physician on an individual basis, according to the severity of coronary artery disease and associated pathologies.

In the first stages of physical rehabilitation, heart rate can increase by no more than 20 - 30%, approximately 15 - 20 beats per minute. If the loads are tolerated without complications, an increase in heart rate can be allowed by more than 30%, however, no more than the value calculated using the following formula: 200 - the patient’s age. For example, for a patient with coronary artery disease aged 60 years, the maximum permissible heart rate should not exceed 140 beats per minute.

Leading Russian specialist in the field of rehabilitation of patients with heart diseases, Professor D.M. Aronov, developed recommendations for physical activity, depending on the functional class (severity of manifestation) of the disease. According to the tables below, developed by Professor D.M. Aronov, it is possible to determine the permissible load in each specific case.

Remember that, depending on the severity of the manifestation, angina is divided into four functional classes, where I is mild angina, in which attacks occur only during very intense physical activity, and IV is the most severe angina, in which an attack occurs at the slightest physical activity and even at rest. Prohibited loads are marked with a “—” sign, and permitted loads with a “+„ sign. The number of “+” signs indicates the permissible intensity and volume of loads.

Daily physical activity

Exercise therapy for diseases of the cardiovascular system

It is known that the heart ensures the movement of blood through the vessels. But the force of contraction of the left ventricle alone is not enough to ensure normal functioning of the heart. Extracardiac factors play a major role in blood circulation. For heart diseases vascular system Along with drug treatment, therapeutic exercises are recommended. Exercises allow you to maximize the effect of extracardiac (non-cardiac) circulatory factors and contribute to the normalization of impaired functions. Therapeutic exercise is often used for diseases of the circulatory system in the acute period, as well as during recovery, and is subsequently used as maintenance therapy.

To the main contraindications to physical therapy exercises should include: acute phase of rheumatism, endo-, myocardium; serious disturbances of the cardiac conduction system and rhythm; circulatory failure in the third stage, acute heart failure.

Methods of influence

The method of exercise therapy directly depends on the characteristics of the course of the disease, as well as the degree of insufficiency of the coronary and general circulation. Physical exercises, starting positions and the amount of load are selected based on the motor mode assigned to the patient.

The effect of exercise therapy in diseases of the cardiovascular system

Myocardial infarction: exercise therapy

Myocardial infarction is focal or multiple necrosis of the heart muscles, which is caused by acute coronary insufficiency. The tissue susceptible to necrosis is replaced by a scar after some time. A heart attack is characterized by severe pain in the heart area, increased heart rate, decreased blood pressure, drowsiness, and suffocation. An ECG allows you to determine the location of the infarction and its severity. The first three days are characterized by an increase in body temperature, acceleration of ESR, and the appearance of leukocytosis.

Rehabilitation of patients with myocardial infarction is divided into three stages. At each stage the patient undergoes a course physical therapy.

The main form of physical therapy at the first stage is massage, walking up the stairs, and measured walking. If the patient’s course of a heart attack is not complicated, then classes can begin on the 2-3rd day, by which time the acute signs of a heart attack have subsided. The timing of the start of classes, as well as the load, is determined strictly individually and directly depends on the nature of the stage and the severity of post-infarction angina.

Forms of therapeutic physical education at the second stage: therapeutic exercises, walking in strictly defined dosages, walks and exercises on exercise machines, walking on stairs, lightweight elements of games, applied sports exercises, massage, occupational therapy. The classes are practically no different from those conducted in the hospital at the first stage. The pace of classes and the number of repetitions are accelerated, exercises are used gymnastic wall, exercises with various objects. The procedures are carried out in groups, the duration of the lesson is 30 minutes.

Exercise therapy at the third stage: physical exercises recommended for people with poor health, reduced physical performance. Therapeutic walking is used, walking along the stairs, which involves climbing to the 3-5th floor, 2-3 times, lightweight sport games and exercises, massage.

Arterial hypertension is a fairly common disease characterized by increased blood pressure. There are three stages of hypertension.

The first stage involves an increase in blood pressure without involvement of target organs. The second stage – blood pressure is increased and target organs are involved: kidneys, fundus, heart. The third stage is increased blood pressure and damaged target organs: kidney failure, stroke, heart attack, heart failure.

Tasks Exercise therapy for arterial hypertension are lowering blood pressure, preventing crises, and generally improving the patient’s condition. Exercise therapy for arterial hypertension includes: dosed walking, therapeutic exercises, general exercise equipment, therapeutic swimming and physical exercises in the pool, massage.

Heart defects: exercise therapy

Physical therapy for heart defects– a combination of active and breathing exercises. Classes are conducted at a slow pace, without intensification, lasting 10-15 days. In the next 2-3 weeks, patients are prescribed therapeutic exercises.

Coronary heart disease: exercise therapy

Means of physical therapy for coronary heart disease: therapeutic exercises, physical exercises in water, swimming, dosed walking.

Doing exercises

A set of exercises for coronary heart disease :

1. Starting position – hands on the belt, standing above the seat of the chair. We move our hands to the sides - inhale, return our hands to the belt - exhale.
2. The starting position is the same. We raise our hands up and inhale, bend forward and exhale.
3. Starting position: standing by a chair. Sit down - exhale, stand up - inhale.
4. Starting position - sitting, bend your right leg - clap, return to the starting position. Do the same with the left leg.
5. Starting position – sitting on a chair. Do not hold your breath, squat in front of the chair, then return to the starting position.
6. The starting position is the same, legs straight, arms forward. Bend your legs at the knees, place your hands on your belt, then return to the starting position.
7. Starting position – standing. We move our right leg back, arms up – inhale, starting position – exhale. Repeat for the left leg.
8. Starting position – standing, hands on waist. Perform tilts to the right and left.
9. Starting position – standing, hands in front of the chest. We move our arms to the sides - inhale, starting position - exhale.
10. Starting position – standing. We move our right leg and arm forward. The same with the left leg.
11. Starting position – standing, arms up. We sat down, then returned to the starting position.
12. The starting position is the same, arms up, hands in the lock. We rotate the body.
13. Starting position – standing. Take a step forward with your left foot - arms up, return to the standing position. Repeat for the right leg.
14. Starting position – standing, hands in front of the chest. Make turns left and right with arms outstretched.
15. Starting position – standing, hands to shoulders. Perform alternate straightening of arms.
16. Walking in place.

It is known that the basis of angina is a disorder of the coronary circulation, which provides nutrition to the heart. The most pronounced manifestations of angina occur against the background of atherosclerosis of the coronary vessels, although atherosclerosis is not a prerequisite for the occurrence of angina attacks. The latter is based on spasm of the coronary vessels of neurogenic origin; at the same time, sclerotic vessels are more prone to spasms.

Attacks of angina are considered as a special case of psychoneurosis involving the cardiovascular system (G.F. Lang, V.F. Zelenin, E.M. Gelshtein, etc.). It has now been proven that the initial mechanism for the occurrence of angina attacks is cortical and subcortical impulses, leading to disruption of coronary blood flow and the development of acute myocardial ischemia.

Predisposing factors of development should be considered psychoneurosis, overexcitation with negative emotions, coronary sclerosis, hypertension, smoking, mental and physical stress, etc.

Patients suffering from angina pectoris (angioneurotic form due to coronary sclerosis, hypertension, etc.) are treated with great success in local cardiac sanatoriums, where, compared to the resort environment, the whole complex of climatic factors is milder and more familiar to the patient.

Considering that the disease is based on psychoneurosis with cardiovascular manifestations, it is very important to use the conditions of the patient’s stay in a sanatorium as a factor contributing to the creation of environmental reflexes that switch the patient’s nervous system to other types of irritation than in the conditions of professional activity and at home. The development of new complexes of conditioned reflexes (distracting, switching reflexology) leads to the creation of a new “healthy” dynamic stereotype (V.F. Zelenin). The conditions of the sanatorium regime and the whole environment with beautiful nature are the most successful “switching” therapy.

In these conditions, therapeutic physical culture is important as a factor that contributes not only to the switching of nervous perceptions to others, but also as a means of improving the neuro-humoral regulation of the heart and adapting the coronary circulation to the requirements of the moment.

Studying the issue of the use of therapeutic physical culture in cases of chronic coronary insufficiency allows us to consider the therapeutic effect of this method in the context of its leveling effect on the clinical manifestations of cardiovascular psychoneurosis in connection with the establishment of cortico-visceral relationships. Here one should also keep in mind the reflex influences from the working skeletal muscles, aimed at expanding the coronary vessels. To the nervous influences it is necessary to add the effect of the products of muscle activity on the expansion of peripheral vessels, as well as the influence of adrenaline on the endings of the sympathetic nerve in the myocardium, which is also manifested in the vasodilatory effect of the coronary vessels.

Here it is necessary to take into account that the number of capillaries in the myocardium is twice the number in skeletal muscles(B.V. Ognev, V.N. Savin, L.A. Savelyeva); this should be seen as an expression of the morphological adaptation of the coronary blood flow to the metabolic conditions and energy needs of the myocardium (V.V. Panin and F.3. Meyerson).

In addition, if at rest the coronary blood flow is 200-250 ml per minute, then with severe physical activity and an increase in the cardiac output, the coronary blood flow reaches 3-4.6 l, while the mass of blood flowing per minute through the coronary vessels is 10 -15 times the mass of the heart (A.V. Lebedinsky and V.I. Medvedev). It should also be taken into account that the amount of blood flow in the heart is 10-12 times greater than in other tissues of the body. Such a high adaptability of the coronary circulation to different levels of functional activity of the myocardium expresses it characteristic feature(V.V. Parin and F.3. Meerson), which must be taken into account in the conditions of implementing dosed physical training within the framework of therapeutic physical culture.

Clinical observations on the use of therapeutic physical culture in chronic coronary insufficiency (L.S. Girshberg, A.M. Markov and G.P. Kareva, V.N. Moshkov, A.V. Nechaev and K.G. Rozanov, L. S. Oganesyan and others) show that positive effect, apparently due to the vasodilating effect of physical exercise on the coronary system, occurs only with strictly adequate load, which causes a significant improvement in blood supply to the heart and increased myocardial contractions.

However, it should be taken into account that in a number of patients with severe coronary sclerosis exercise stress can cause an angiospastic reaction, accompanied by insufficient blood supply to the myocardium (N.A. Kurshakov).

Dupler advises using passive and active exercises, as well as massage, for cardio-vascular diseases, starting them as early as possible. Observations by domestic authors confirm that regular dosed use of therapeutic exercises and walking (mainly) contributes to the expansion of the functional adaptation of the heart muscle to increasing loads and angina attacks in the vast majority of patients develop much less frequently, and are less intense in their course (they allow one to do without the use of therapeutic measures ). The extreme diversity of forms, nature of the course and depth of damage to the cardiovascular system as a whole in chronic coronary insufficiency necessitates strictly individual use of dosed physical activity.

Any physical activity painful or discomfort in the heart area, behind the sternum, etc., is inadequate for a given patient and should be replaced with one that does not cause the above phenomena.

Therapeutic physical training should be used in the treatment of patients with angina pectoris in quiet intervals between attacks. The degree of physical activity in therapeutic physical culture procedures may vary depending on the frequency and severity of attacks and the general condition of the patient. Thus, in case of coronary insufficiency with the presence of angina syndrome due to hypertension, the technique is determined by the entire feature of the clinical manifestations of hypertension.

Particular caution when conducting therapeutic physical training is necessary in patients with severe sclerotic changes in the coronary vessels of the heart. It is also advisable to use dosed physical activity for angina pectoris under the control of vasodilators, in particular nitroglycerin. It is advisable to take the latter before physical activity, which allows you to increase its dosage.

Among the means of therapeutic physical culture for angina pectoris, therapeutic exercises and walks, alternating with passive rest of patients, are of primary importance. Gymnastic exercises, depending on the patient’s condition, are used in various starting positions (lying, sitting and standing). Therapeutic gymnastics procedures can be prescribed approximately the same as for patients who have suffered myocarditis or a heart attack. The exercises for the procedures are selected to be simple; they should be performed rhythmically, freely, without tension, and with a large range of motion. Required condition is a strict gradualism in increasing and decreasing physical activity and alternating gymnastic exercises with breathing exercises. The load in the therapeutic gymnastics procedure should not be concentrated; between exercises it is necessary to introduce short pauses for rest.

In the first days of classes, the starting positions for exercises are mainly used lying and sitting. First, exercises are selected that involve only the distal parts of the limbs in movement. If the patient’s well-being is satisfactory, the total load gradually increases due to the inclusion of exercises for larger bodies in the therapeutic gymnastics procedure. muscle groups, changes in starting positions and less frequent use of breathing exercises.

It should be remembered that exercises with power voltage for patients with angina pectoris are strictly contraindicated. It should also be taken into account that accelerating the pace of exercises in the procedures should be carried out in strict sequence. Rhythmically and calmly performed simple gymnastic exercises in the second half of the course of treatment, patients can be supplemented with exercises in throwing inflatable balls, first performed in at a relaxed pace and then in a playful way.

The amount of physical activity in therapeutic exercise procedures, depending on the patient’s condition, can vary significantly. So, if a patient periodically experiences angina attacks, therapeutic exercises are prescribed according to the method for second-degree circulatory failure. During exercises, special monitoring is necessary for patients in whom angina attacks develop due to physical stress. In other cases, in the absence of pain in the heart area, when the diagnosis of coronary sclerosis is made on the basis of an electrocardiogram revealing coronary insufficiency (decreased and sometimes increased segment S-T electrocardiogram taken after physical activity), the method of therapeutic exercises is the same as for first-degree circulatory failure.

Measured walks are used mainly on level ground. Their distance is determined individually depending on the manifestations of angina syndrome and the patient’s ability to move. The total load during walking increases by daily (or every 2-3 days) adding 200-300 m to the path length. If you have a good response to quiet walking, you can recommend accelerating the pace of walking for 20-50 m, followed by deep breathing.

Expanding the requirements for the myocardium can be achieved by reducing stops along the walking route. Before each rest stop in a sitting position, be sure to take 5-6 deep breaths.

The dosage of physical activity should be such as not to cause pain in the heart area. So, with angina pectoris, it should be somewhat less than that which can cause pain; In addition, breathing exercises are a means of dosage.

In case of angina at rest, which most often develops against the background of coronary sclerosis, the use of therapeutic physical exercise should be carried out with even greater caution. It is necessary to prescribe physical therapy for angina pectoris in quiet intervals between attacks, taking into account the form and severity of the disease.

So, with a mild attack of angina pectoris, especially in the angioedema form, you can start therapeutic exercises the next day. For psychogenic angina without atherosclerotic soil, which is more common in young people and patients with hypertension, therapeutic exercises should be used from the 3-5th day after the attack. In case of angina at rest, it is necessary to start therapeutic exercises much later, after 6-12 days, depending on the patient’s condition, the disappearance of the pain syndrome and the exclusion of the presence of a fresh heart attack.

When determining the dosage of physical activity, it is very important to know the anamnesis data, which allows us to take into account the patient’s reactivity to various household stresses, as well as the degree of his adaptability to physical activity due to preliminary training (classes). physical culture, physical work). Anamnesis data must be compared with the clinical manifestation of the disease.

When using therapeutic exercises and dosed walks in sanatoriums for patients with angina, it is necessary to take into account the time of occurrence of the attack. It is better to carry out therapeutic exercises between 11 a.m. and 2 p.m. If attacks occur in the evening or at night, quiet walks before bed should be recommended.

It is also necessary to take into account weather conditions at different times of the year. So, in cold, windy and damp weather it is necessary to dress appropriately, and therapeutic exercises should be carried out in a ventilated room. If during classes therapeutic exercises or walking, pain occurs in the heart area, behind the sternum, it is necessary to include a rest pause, use coronary dilators and reduce the amount of load.

Angina pectoris is a pathological pain syndrome, manifested under the influence external factors(excessive physical activity, eating, stressful conditions, etc.) and characterized by a pronounced feeling of discomfort in the chest.

Previously, this disease was called “angina pectoris” in official medical reference books; currently this name is preserved in folk medicine. May be accompanied by . The pain syndrome is characterized by an unexpected sudden onset and irradiation to adjacent areas of the human body: neck, between the shoulder blades, left shoulder, jaw.

The duration of the attack, as a rule, does not exceed 15 minutes. You can speed up the process of relieving pain by stopping the activity that caused the pain and taking a drug from the pharmacological group of nitrates, which has a short-term effect.

Below we will consider a set of breathing and physical exercises for performing in a hospital setting and at home in order to prevent the occurrence of pain and emergency relief of an attack without the use of drug therapy.

The feasibility and importance of breathing exercises and physical exercises for angina pectoris

Non-drug therapy after diagnosing angina pectoris is aimed at reducing the risk of development by changing the patient’s usual lifestyle.

• It is advisable to completely quit smoking or minimize the use of tobacco. This is aimed at indirectly restoring the functions of the cardiovascular system through influence through the respiratory system of the human body.
• Moderate physical activity aimed at combating physical inactivity and, as a result, stimulating the functioning of the cardiovascular and respiratory systems.
• The appointment of an indefinite therapeutic diet associated with a decrease in the daily diet of salt, as well as fried and spicy foods, is indicated.

These recommendations, together with therapeutic physical culture and a complex of breathing exercises are aimed at ensuring a favorable prognosis for angina pectoris and stopping the transition of the syndrome to coronary heart disease with the subsequent risk of myocardial infarction.

Therapeutic exercise and breathing exercises not only have a beneficial effect on all body systems by improving blood flow and accelerating metabolic processes, but also make it possible to simultaneously suppress

Contraindications for angina pectoris

The main contraindications for angina are related to preventing the development of hypertension. In this regard, it is important to avoid excessive physical activity, the use of psychostimulants (coffee, ginseng, eleutherococcus, foods high in hot pepper and salt and so on). The presence of angina pectoris syndrome in most cases indicates weakness of the blood vessels, and therefore it is not recommended to make sudden movements (including quickly getting out of bed when waking up, etc.). In most cases, it is not recommended to prescribe spa treatment.

Therapeutic physical training for angina pectoris: a set of exercises recommended by experts

When prescribing a set of physical exercises, it is important to observe the basic principles based on the fundamental axiom “do no harm”:

• Gymnastics for angina pectoris involves the selection of individual loads depending on the stage of the disease and the frequency of pain attacks: the more severe the course of the pathology, the less physical activity and the duration of the exercises.
• It is mandatory to divide the set of exercises into three parts: warm-up, main group of exercise therapy and cool-down. A warm-up allows you to prepare the body for performing exercises, the main group provides an optimal effect on the body’s systems, a cool-down allows you to consolidate the effect obtained and exit exercise therapy without pressure drops.
• When prescribing exercises, it is important to adhere to the rule of no sudden movements during exercise therapy.

Important! Prescribing a set of physical exercises is important in the first and second stages of the disease. When diagnosing the third stage, it is recommended that in the first months you can get by with normal walking and increasing the time spent in the fresh air.

Warm-up

• You need to lay a rug on the floor and lie down on it. Take three deep breaths in and out, tuning into the exercises.
• Raise your torso perpendicular to the floor. Right hand up - tilt to the left, left hand up - tilt to the right. Ten cycles and a minute break. Repeat three times.
• Lie down again. Bend your knees - straighten your legs. Do ten times and rest for one minute. Repeat three times.

Important! If you have difficulty performing these exercises on the floor, you can warm up on a chair. Avoid sudden movements - concentrate on stretching.

Basic set of exercises

• Squats with arms extended forward: from 10 to 30 times. It is recommended to divide the total number of squats into three cycles, with a one-minute break between each cycle. This statement is true for all of the exercises below.
• Feet shoulder-width apart, torso tilted forward perpendicular to the floor, arms to the sides, and make cable turns left and right to the maximum possible limit. Quantity: 10 to 50 times.
• Feet shoulder-width apart, left arm up - tilt to the right, right hand up - tilt to the left. For each hand we do 10 – 30 times.
• Running in place (optimally use treadmill, but you can do without it) with gradual acceleration over 10 minutes.

Important! To achieve optimal results, it is advisable not only to perform a set of exercises daily, but also to make adjustments to your daily regimen: instead of driving a car, it is better to walk, instead of using the elevator, it is better to go up to the required floor on your own.

Hitch

Return to the mat. Sit down, stretch your legs forward, and bring your heels together. Without bending your knees, try to reach your feet with your palms and touch your knees with your head. Do it slowly, stretch. Then lie down on the mat, recover, and bring your breathing back to normal.

Important! If pain or other discomfort occurs prior to exercise, exercise therapy must be stopped immediately, sit or lie down on the mat and restore breathing with deep inhalations and exhalations. If the pain does not stop, you need to drink nitrate short term actions to stop the attack.

Gymnastics and exercises for angina pectoris: additional materials

It is permissible to introduce any exercises into exercise therapy for angina if the rules regarding the absence of sudden movements when performing a set of exercises and avoid overloading the patient are observed. Priority should be given to stretching exercises and only then to strength training.

Breathing exercises: the most popular and reliable techniques

Breathing control is one of the important components when performing physical exercises and Everyday life for warning

Strelnikova's technique

The Strelnikova method includes a large number of exercises, the most interesting of which are techniques aimed at emergency relief. An example of an exercise according to Strelnikova to relieve an attack of angina:

• Sit on a chair or kneel on the floor, close your eyes.
• Take a powerful, sharp breath with a strong-willed muscular compression of the chest.
• Without holding your breath, exhale slowly.
• Repeat until the pain subsides.

Important! If there is no relief within 10 minutes, you should urgently call a doctor. After an attack, temporary rest is recommended.

Bubnovsky's technique

IN breathing techniques Bubnovsky’s emphasis is on breathing using the diaphragm, that is, minimizing chest breathing. It is worth noting that chest breathing is rejected by almost all experts as the most harmful. Example for angina pectoris:

• Lay out a mat, sit on your knees on it, close your eyes, feel the diaphragm (the place between the chest and abdomen).
• Inhale slowly, counting to 5 and expanding the diaphragm with muscle effort; hold your breath, counting to 3, fixing the diaphragm widened; exhale slowly, counting to 5 and drawing in the diaphragm with muscle effort. Repeat this cycle 20 - 50 times (depending on your level of training).
• Get into dog pose, relax your stomach and breathe intensely and quickly - first for one minute, then gradually increasing the time of intense breathing to 5 - 10 minutes.

Important! If you feel dizzy when breathing intensely, you need to stop the exercise and reduce the time of breathing practices the next day.

Buteyko technique

The Buteyko technique is based on reducing the frequency and increasing the quality of human breathing. The main points of the Buteyko technique:

1. The number of inhalation-exhalation periods per minute should not exceed 16.
2. Breathing should be through the nose. Mouth breathing is harmful and dangerous to health.
3. Breathing should be light and slow.
4. The inhalation should be at least two times shorter than the exhalation.
5. It is recommended to hold your breath after inhaling.

An example of a Buteyko exercise:

• Sit on a chair, straighten your back, place your palms on your knees, close your eyes.
• Inhale for 10 seconds, hold your breath for 20 seconds and exhale for 20 seconds. These time intervals are achieved gradually; in the first stages of training, it is important to maintain a 1:2:2 ratio, varying the number of seconds in a way that will be more comfortable for the patient.

Important! Buteyko breathing practice should not be violent or cause tension. Accustoming yourself to easy breathing using the “inhale - hold your breath - deep exhale” system should be gradual.

Will yoga help as a breathing exercise?

Yogic practices have much in common with the breathing systems developed by Bubnovsky and Buteyko. In particular, the breathing method “inhale - hold - exhale”. However, yoga uses less gentle techniques, and the use of these practices for angina pectoris is not recommended due to insufficient knowledge of the subject by the official medical community.

It is advisable to combine breathing practices and exercise therapy to achieve the best preventive and therapeutic effect. It is also recommended to practice breathing techniques according to Buteyko or Bubnovsky when performing massage in the heart area in order to stabilize the pulse rhythm.

Since ancient times, people have used breathing exercises, and their popularity has not fallen over the centuries, but has only become more and more in demand.

Breathing exercises has a beneficial effect on the entire body, not only helping to increase immune resistance to various diseases, but also completely healing it.

Breathing exercises are nothing more than a set of various exercises that involve breathing and are performed in order to prevent or treat various diseases of the cardiovascular system, respiratory system, vegetative-vascular dystonia, diabetes mellitus, reproductive system, or for losing excess weight.

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Main goals

The respiratory system supplies air to the body to enrich it with oxygen and consists of a number of important organs, following one after another: the nasal and oral cavity. These are followed by the pharynx and larynx, and then the trachea and lungs. In the latter, the respiratory system is completed by bronchi and bronchioles.

Each of these organs is not only directly interconnected with neighboring organs in the system, but also plays a separate role.

Breathing exercises help cleanse the channels for delivering oxygen to the blood.

Its main tasks are:

• growth of functional accumulations in the respiratory system;
• transformation of various organs and functional systems.

Breathing exercises are useful not only as individual exercises, but also as an addition to sports activities.

There are several types of breathing exercises:

The basis of any of the above breathing exercises includes relaxing and toning exercises. Moreover, they are selected individually, based on the desired results.

The main functions of breathing exercises are:

• elimination of sputum and prevention of its appearance in the lungs, as well as “staging” correct breathing- through the nose;
• activation of metabolic processes, as well as positive influence on the cardiovascular and endocrine system;
• normalization of nervous processes;
• growth of general tone, hardening, as well as resistance to various diseases of the respiratory system;
• increasing the size of the chest and strengthening the diaphragm;
• saturation of all cells in the human body with oxygen necessary for their normal functioning.

Breathing exercises for angina using the Buteyko method

Thanks to the world-famous physiologist Buteyko, in 1952 his method of treating asthma, angina pectoris, and hypertension became known to medicine. Moreover, the method was very effective.

The method was based on the fact that the cause of the above diseases is excessive ventilation of the lungs (otherwise, hyperventilation).

Speaking in simple language, people simply have a dysfunctional respiratory system. During the course of the disease, the patient experiences difficulty breathing and begins to breathe more often and harder, thereby making some effort when breathing and spending extra energy on it.

This type of breathing is not normal for human body, and the current rhythm leads to frequent contractions of the lungs and vascular stenosis. As a result, improper functioning of the respiratory system leads to oxygen starvation of the organs of the entire body.

Carbon dioxide in the blood is not able to leave it quickly due to vascular stenosis. Consequently, it accumulates in the blood stream and lingers there. This all leads to abnormal functioning of all organs, and the disease progresses much faster.

Breathing exercises for angina using the Buteyko method are very effective, since it is aimed at normalizing the functioning of the respiratory system, and, consequently, the normal supply of oxygen to all organs of the body.

The technique is based on a person’s ability to control and control their respiratory muscles in order to be able to reduce the breathing frequency so much as to feel discomfort (lack of air).

Breathing with the lungs should be rare, but at the same time deep, as they say, throughout the chest. Such measured and calm breathing entails a decrease in vascular stenosis, as well as a decrease in the frequency of contractions. Wherein nervous system relaxes and blood vessels dilate. All this leads to the enrichment of all organs with the required oxygen content.

Gymnastics of the respiratory system, carried out according to the Buteyko system, was recognized as the most effective and self-regulating. Thanks to it, the patient can improve his health and get rid of angina pectoris.

Benefits of exercise

Breathing exercises have a positive effect on the central nervous system. However, its main effect is aimed at the group of muscles involved in the breathing process.

Such muscles, like any other, can be developed quite quickly, spending a little time. In this case, these muscles should be regularly exposed to a load that they can withstand. However, to achieve positive results, it is necessary to give a very heavy load.

As a rule, older people, as well as those who have little or no training, have shallow breathing. At the same time, the intercostal muscles do not undergo the proper load and do not work as efficiently as they should. As a result, there is a decrease in the mobility of the joints of the costovertebral and costothoracic type.

The difference between the chest circumference readings during inhalation and exhalation is called excursion. With age, excursion readings undergo a decline. The reason for this is the problems described above in the body. So, if at a young age the excursion is about 8 centimeters, then at 40 years of age its indicators decrease to 5, and at 60 years of age this value is 2 centimeters.

Performed breathing exercises for angina help not only get rid of this disease, but also help maintain, and in some cases restore, previously lost mobility. In addition, breathing exercises, by enriching the blood with oxygen, help improve its composition.

There are many sets of breathing exercises. Therefore, you can easily choose the most effective and acceptable one for you.

Anyone can experience shortness of breath during any physical exercise. As a rule, it is formed when the work being done is very intense or difficult, which begins to require as much energy from the cardiovascular and respiratory systems as they are not able to provide.

The resulting shortness of breath is the first sign that your body is little or not trained at all, or does not have enough endurance. Various exercises will lead to an effective result if the nature of the movements performed coincides as closely as possible with the functioning of all zones of the respiratory system.

How to do the exercises

When performing breathing exercises, you must follow a number of rules:

• The most important rule that must be followed when performing breathing exercises is to perform all breathing movements with all the lungs, and not use only their upper zone. To ensure that your breathing is performed correctly, you need to take a vertical position, straighten your back and put one hand on your chest and the other on your stomach. As you take a deep breath, notice what came up first. If your stomach first rises, and then your chest, then you are breathing correctly.
• Breathing exercises should be performed twice a day, preferably in the morning and evening.
• To obtain maximum effectiveness, exercises are performed on an empty stomach. It is especially important to follow this rule for those who have hypertension and gastrointestinal diseases.
• You can exercise not only at home, but also on the street. When performing gymnastics outdoors, especially when walking, do not forget that you need to alternate between inhaling and inhaling. At the same time, inhale through the nose and exhale through the mouth.
• When doing classes at home, you should ventilate the room in advance or open the window.
• Find the right atmosphere. Nothing should distract you: turn off the intercom, telephone, dim the lights in the room. You can turn on relaxing music

Contraindications

Despite the fact that breathing exercises bring many benefits, it also has contraindications.

So, it cannot be done:

• nursing mothers and pregnant women;
• people with a hiatal hernia;
• patients with cardiovascular diseases;
• during exacerbation of chronic diseases;
• patients with inflammatory processes in the pelvic area;
• persons with adenomyosis.

By performing breathing exercises and following all the prescribed rules, you can get rid of not only angina, but also a number of other diseases.

I suffered greatly from angina pectoris (angina pectoris), the most common form of coronary heart disease. Its main manifestation is attacks of squeezing, pressing pain in the chest. Angina occurs suddenly, lasts from several minutes to half an hour, has varying intensity, and can radiate to the left arm, shoulder blade, shoulder or neck. An angina attack is often accompanied by a feeling of fear. Do not give in to it and try to immediately relieve the heartache. To do this, always have validol on hand. If an angina attack occurs while walking, and there is no validol, you should immediately stop, relax and breathe evenly. Soon the pain will subside.

After another treatment in the hospital, the attending physician told me: “That’s it, now you won’t be able to live without nitroglycerin.”

But despite the verdict, I decided not to give up, began to read various publications on medical topics, apply the recommended methods for treating angina pectoris, and eventually settled on breathing exercises according to the yoga system.

To breathe correctly using this method, you need to stand or sit on a chair with a straight back, relax, think about something pleasant (I always think about the sea), inhale air through your nose and hold it in your chest so that it feels comfortable. Exhale through your mouth and at the same time as you exhale, lightly hit the left and right sides with your arms bent at the elbows, like wings. chest. Perform this breathing for 10 minutes, first once a day, and after a week - in the morning, lunch and evening.

I breathed this way for a month, then took a 10-day break, and after that I repeated the treatment course. And so she was treated intermittently for six months. During this exercise, when you hold your breath, oxygen is directly sent to the heart muscle, relieving tension. You need to be careful at first to avoid dizziness. Perform yoga breathing exercises until complete recovery. You yourself must feel when the angina attacks stop, since each person is individual. After this, undergo a medical examination.

In addition to performing breathing exercises for angina pectoris, you need to walk daily in the fresh air near a pond, in a forest or park, inhaling Fresh air, enriched with oxygen.

It’s very good to do this with someone so that while walking you can have a conversation and get positive emotions.

After recovery, stress should be avoided, as it can lead to relapse of the disease. One day, having already recovered, I ran to catch up with the trolleybus (there was such a need) and suddenly I felt that I wouldn’t make it. Immediately, according to the yoga system, I inhaled air through my nose, held my breath, and thus solved the stressful situation - the trolleybus did not leave without me.

It is very important to learn to forgive everyone, constantly wish people health, goodness, and not remember grievances (mentally burn them in fire). Do not harbor anger, since most diseases are the result of negative thoughts, deeds and emotions. You can't live in the past, you have to live in the future.

Smile more, laugh, have fun, dance, listen to music and remember that all our organs need to be treated only with good thoughts and that everyone can be their own healer. You can and should talk to each organ affectionately, as if you were talking to a part of yourself.

For example, if your heart hurts or tachycardia occurs, immediately place your right palm under your left chest on the heart area, close your eyes, think about this organ with gratitude that it has selflessly served you for so many years and thanks to it you live, and mentally to calm your heart , say: “Everything is fine, calm down. The heart beats rhythmically. I am surrounded by nature, the elements: sun, air, water, earth. I live in harmony with my organs, including the most important organ - the heart. Calm down, dear, we will live together in harmony for a long time.” Gently stroke the area, pressing your hand tightly to your chest, with your lungs. in a circular motion so that the palm moves slowly, always clockwise. Say a kind word to your heart, wish it good luck and end your communication with the words: “So be it. Amen!"

Even the ancients considered the heart to be the center of reason, love and selflessness. Take care of him!

Ivanova Valentina Nikolaevna

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