Everyone knows such clinical forms of coronary heart disease (the former name is "angina pectoris"), such as angina pectoris or myocardial infarction, resulting from spasm of the coronary vessels and disorders as a result of the heart's blood supply.

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

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

The second functional type includes patients with rare attacks of angina pectoris (that is, those that appear during muscular work), which occur, for example, when walking too fast, climbing 2-3 floors. Their exercise tolerance is in the range of 50 to 100 watts. They tolerate walking at a moderate pace well. To improve their performance and improve their condition, they can train walking at a leisurely pace twice a day for 30-40 minutes.

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

Representatives of the fourth functional type are characterized by frequent attacks of angina at rest and exertion. So, pain can occur even with minor loads, say, walking 100-150 m. They can be recommended long walks, but with obligatory periods of rest.

Recall that among a number of risk factors for "angina pectoris" is the restriction of motor activity. Adequate physical exercises will help expand the coronary vessels, improve the nutrition of the myocardium (heart muscle), improve the emotional and mental state, activate metabolic processes and, as a result, help the body resist the development of atherosclerosis, against which coronary heart disease usually occurs.

Below is an exemplary set of exercises available for patients with the first or second functional type. If during the lesson you suddenly feel pain or discomfort in the region of the heart, then you should reduce the load or even interrupt the lesson.

1. Sitting on a chair, hands down. Spread your arms to the sides to shoulder level, take a deep breath, lower down - exhale. Repeat 3-5 times.
2. Sitting, keep your hands on your waist. Raise your right hand across the side to shoulder level, inhale, return to the starting position, exhale. The same for the left hand. Repeat 3-5 times.
3. Standing, legs apart, arms bent horizontally at the elbows and hung in front of the chest. Rotate the body with the spread of the arms - 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 the shoulders. Repeat 5-7 times forward and backward.
6. Standing, hands on the back of the head in the castle. Put the left foot to the side on the toe, tilt the body to the left, straighten up and take the starting position. The same with the right leg. Repeat 3-5 times.
7. Standing, hands rest on the back of a chair. Sit down - exhale, stand up - inhale. Repeat 4-6 times.
8. Standing, hands on the waist. Head circling with full amplitude to the right, then to the left. Run 3-5 times in each direction.
9. Walking is simple in alternation with acceleration (3 minutes).
10. Walking is simple (30 sec), then with a high elevation of the hip (30 sec).
11. Standing, do alternate body tilts to the right, then to the left with bending the arm of the opposite side (the so-called "pump" exercise), the amplitude is maximum. Repeat 4-6 times on each side.
12. Standing, we hold our hands in front of us and spread them a little. We raise the left leg and touch the right palm, return to the starting position. The same with the right leg. Repeat 4-6 times.
13. We lie down on the stomach, stretch our arms along the body and rest our palms on the floor. Alternately raise straightened legs up. Run 4-6 times with each leg.
14. Sitting on a chair, we weave our hands into a “lock”, we hold them on our knees. Turn your palms out, raising your hands 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. Run 8-10 times.

Physical activity in 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" are poor heredity, alcohol abuse, smoking, chronic stress, metabolic disorders due to malnutrition, chronic overwork, and physical inactivity. Of course, it is almost impossible to get rid of a hereditary predisposition to coronary artery disease, and it is impossible to completely protect yourself from stress. But you can adjust your lifestyle so as to avoid the other factors mentioned above. First of all, it is worth giving up smoking, optimizing nutrition and ensuring proper physical activity on the body.

Benefits of physical activity:

• Regular exercise keeps you fit and in good shape.
• With regular physical activity, the amount of “useful” lipids in the blood increases, which helps to reduce the risk of developing atherosclerosis.
• Reduces the likelihood of blood clots.
• Blood pressure normalizes, which helps reduce the risk of cerebral hemorrhage (stroke).
• Physical activity promotes weight loss and prevents the development of diabetes.
• Regular exercise improves mood, normalizes sleep and makes it easier to endure stressful situations.
• Regular physical activity reduces the risk of osteoporosis, the most common cause of bone fractures in old age.

Regular physical activity is beneficial for everyone and everyone, as it helps to protect oneself from the development of many unpleasant diseases. But, unfortunately, we are often pushed to change our lifestyle and regular exercise only by the disease itself.

For patients with coronary heart disease, only certain types of physical activity are suitable.

IHD develops as a result of acid starvation, which leads to the formation of atherosclerotic plaque. Plaque narrows the artery that supplies blood to the heart, resulting in less oxygen-rich blood reaching the heart muscle. In this case, the intensive work of the heart becomes difficult and, under heavy loads, angina pectoris develops - a painful attack of the heart muscle.

Naturally, angina attacks require restriction of physical activity. Often, in order to get rid of angina pectoris, it is necessary to resort to medical, and even surgical treatment. In the case of a severe heart attack - a heart attack, patients completely begin to be afraid of physical exertion and, in an effort to "save" the heart, often limit movement up to the refusal to walk.

For patients with angina and those who have had a heart attack, exercise can have a dual meaning:

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

Moderate physical activity increases 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 aerobic exercises contribute to the normalization of the functioning of collateral blood flow - an inter-arterial junction that serves to redistribute blood flow, which helps to increase the amount of oxygen-rich blood that enters the heart muscle.

According to medical studies, physical activity in patients who have had a heart attack reduces the risk of a second heart attack by 7 times, and reduces 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, the performance of 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 not possible 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 reboot yourself: the walk should take place at a slow or moderate (depending on how you feel) pace, for half an hour - an hour, but no less than 5 days a week. If during the walk you feel weak or tired, you need to take a break - sit on a bench or return home at a slow pace. Do not be upset - in the process of rehabilitation, you can go through more and more. However, an increase in motor loads, just like the beginning of physical exercises, after a hospital, must be agreed with an exercise therapy specialist or the attending cardiologist.

Physical activity in no case should lead to another attack of angina pectoris. During exercise, strong shortness of breath or a rapid heartbeat is unacceptable. During physical exertion, you need to monitor the pulse - 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 concomitant pathologies.

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

Leading Russian specialist in the field of rehabilitation of patients with heart disease, 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 allowable load in each specific case.

Remember that depending on the severity of the manifestation, angina pectoris is divided into four functional classes, where I is mild angina, in which attacks occur only with very intense physical exertion, and IV is the most severe form of angina, in which an attack occurs with the slightest physical activity and even at rest. Prohibited loads are marked with a “-” sign, permitted loads are marked with a “+” sign. The number of signs “+” displays 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 only the force of contraction of the left ventricle is not enough to ensure the normal functioning of the heart. Extracardiac factors play an important role in blood circulation. In diseases of the cardiovascular system, along with drug treatment, therapeutic exercises are recommended. Classes allow you to maximize the effect of extracardiac (non-cardiac) circulatory factors and contribute to the normalization of impaired functions. Physiotherapy exercises are quite often used for diseases of the circulatory system in the acute period, as well as during recovery, and are used later as maintenance therapy.

To the main contraindications to exercise therapy should be attributed: acute phase of rheumatism, endo-, myocardium; serious violations of the conducting system of the heart 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 regimen assigned to the patient.

The effect of exercise therapy in diseases of the cardiovascular system

Myocardial infarction: exercise therapy

Myocardial infarction - focal or multiple necrosis of the muscles of the heart, which is caused by acute coronary insufficiency. The tissue subject to necrosis after a while is replaced by a scar. A heart attack is characterized by severe pain in the region of the heart, increased heart rate, decreased blood pressure, drowsiness, and suffocation. ECG allows you to determine the localization of a heart attack and severity. The first three days are characterized by an increase in body temperature, an 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 of physical therapy.

The main form of physical therapy at the first stage is massage, walking up the stairs, dosed walking. If the patient's course of a heart attack is not complicated, then classes can be started from 2-3 days, by which time the acute signs of a heart attack subside. 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, the severity of postinfarction angina.

Forms of physical therapy at the second stage: therapeutic exercises, walking in strictly defined dosages, walking and exercising on simulators, walking up the stairs, light elements of games, sports and applied exercises, massage, occupational therapy. Classes are practically no different from those that were held in the hospital at the first stage. The pace of classes, the number of repetitions are accelerating, exercises are used at the 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 are used that are recommended for people with poor health, reduced physical performance. It is used therapeutic walking, walking up the stairs, involving the ascent to the 3rd-5th floor, and 2-3 times, lightweight sports games and exercises on simulators, massage.

Arterial hypertension is a fairly common disease, which is characterized by an increase in blood pressure. There are three stages of AH.

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

tasks Exercise therapy for arterial hypertension are lowering blood pressure, preventing crises, general improvement in the patient's condition. Exercise therapy for arterial hypertension includes: dosed walking, therapeutic exercises, general exercise equipment, therapeutic swimming and exercise in the pool, massage.

Heart defects: exercise therapy

Therapeutic exercise for heart defects- a combination of active and breathing exercises. Classes are held at a slow pace, without intensification, duration 10-15 days. In the next 2-3 weeks, patients are prescribed therapeutic exercises.

Ischemic heart disease: exercise therapy

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

Exercise

A set of exercises for coronary heart disease :

1. Starting position - hands on the belt, standing above the seat of the chair. We take our hands to the sides - inhale, return our hands to the belt - exhale.
2. The starting position is the same. Raise your hands up and inhale, lean forward - exhale.
3. Starting position - standing at the chair. Sit down - exhale, stand up - inhale.
4. Starting position - sitting, bend the right leg - cotton, return to the starting position. Do the same with the left leg.
5. Starting position - sitting on a chair. Do not hold your breath, sit down in front of the chair, then return to the starting position.
6. Starting position - the same, legs straightened, arms forward. We bend our legs at the knees, put our hands on the belt, then return to the starting position.
7. Starting position - standing. We take the right leg back, arms up - inhale, starting position - exhale. Repeat for the left leg.
8. Starting position - standing, hands on the belt. Perform tilts to the right and left.
9. Starting position - standing, hands in front of the chest. We take our hands to the sides - inhale, starting position - exhale.
10. Starting position - standing. Move the right leg and arm forward. The same with the left leg.
11. Starting position - standing, arms up. Sit down, then return to the starting position.
12. Starting position - the same, hands at the top, hands in the castle. We carry out the rotation of the body.
13. Starting position - standing. Take a step forward with your left foot - arms up, return to I.P. Repeat for the right leg.
14. Starting position - standing, hands in front of the chest. Perform turns to the left and right with the spread of the hands.
15. Starting position - standing, hands to shoulders. Perform alternate straightening of the arms.
16. Walking in place.

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

Respiratory gymnastics has a beneficial effect on the entire body, not only contributing to an increase in immune resistance to various diseases, but also completely healing it.

Respiratory gymnastics is nothing more than a set of various exercises in which breathing is involved, and performed in order to prevent or treat various diseases of the cardiovascular system, respiratory organs, vegetovascular dystonia, diabetes mellitus, the reproductive system, or for shedding excess weight.

• All information on the site is for informational purposes and is NOT a guide to action!
• Give you an ACCURATE DIAGNOSIS only DOCTOR!
• We kindly ask you DO NOT self-medicate, but book an appointment with a specialist!
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Main goals

The respiratory system is engaged in the supply of air to the body to enrich them with oxygen and consists of a number of important organs, following one after another: the nasal and oral cavities. They are followed by the pharynx and larynx, and then the trachea and lungs. In the latter, the bronchi and bronchioles complete the respiratory system.

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

Breathing exercises help to clear 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 separate exercises, but also as an addition to sports activities.

There are several types of breathing exercises:

Bodyflex	With this form, breathing is performed in 5 stages, interspersed with physical exercises. Breathing in this way, they try to maximize the effect of physical exercises on the body as a whole. This technique is mainly used for body shaping or to eliminate excess weight.
Oxysize	Breathing is carried out cyclically and continuously throughout the session, performing it simultaneously with other exercises. In this case, the chest expands, as a result of which the body consumes more oxygen, and it, in turn, is a catalyst and participates in the metabolic processes of nutrients.
jianfei	Very popular in China. With this form, all forces are directed to burning fat cells located in problem areas. The technique includes three main exercises: “wave”, “frog”, and also “lotus”, which are available for any person who seeks to normalize their health.

At the heart of any of the above breathing exercises are relaxing and tonic 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 the "staging" of proper breathing - through the nose;
• activation of metabolic processes, as well as a positive effect on the cardiovascular and endocrine systems;
• normalization of nervous processes;
• an increase in general tone, hardening, as well as resistance to various kinds of diseases of the respiratory system;
• enlargement of the chest in size and strengthening of the diaphragm;
• saturation of all cells in the human body with oxygen necessary for their normal functioning.

Breathing exercises for angina according to the Buteyko method

Thanks to the world-famous physiologist Buteyko, in 1952 medicine became known for his method of treating asthma, angina, and hypertension. 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).

In simple terms, people simply do not have a functioning respiratory system. During the course of the disease, the patient experiences difficulty in breathing, and begins to breathe more often and more forcefully, thereby making some effort when breathing, and spending extra energy on it.

Such breathing is not the norm for the human body, and the current rhythm leads to frequent contraction of the lungs and vascular stenosis. As a result, improper functioning of the respiratory system leads to oxygen starvation of the organs of the whole organism.

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. All this leads to abnormal functioning of all organs, and the disease progresses much faster.

Respiratory gymnastics for angina pectoris according to the Buteyko method is 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 the ability of a person to own and control his respiratory muscles in order to be able to reduce the frequency of breathing 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, in the entire chest. Such measured and calm breathing entails a decrease in vascular stenosis, as well as a decrease in the frequency of contractions. In this case, the nervous system relaxes, and the blood vessels dilate. All this leads to the enrichment of all organs with the necessary oxygen content.

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

The Benefits of Exercise

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

Such muscles, as, indeed, any other, can be developed quite quickly, while spending a little time. In this case, you should regularly work on these muscles with a load that they can withstand. However, in order to achieve positive results, it is necessary to give a very heavy load.

As a rule, older people, as well as those who are poorly or not at all trained, have shallow breathing. At the same time, the intercostal muscles do not undergo the proper load and work as efficiently as they should. As a result, there is a decrease in the mobility of the joints of the costal-vertebral and costal-thoracic type.

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

Performed breathing exercises with angina helps not only to get rid of this disease, but also helps to preserve, and in some cases, restore previously lost mobility. In addition, breathing exercises, due to the enrichment of blood with oxygen, help to improve its composition.

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

During any physical exercise, anyone can experience shortness of breath. As a rule, it is formed when the work being done is very intense or heavy, which begins to request as much energy from the cardiovascular and respiratory systems as they are not capable of giving.

The resulting shortness of breath is the first sign that your body has little or no training, or insufficient endurance. Various exercises will lead to an effective result if the nature of the movements performed coincides as much as possible with the functioning of all zones of the respiratory system.

How to do the exercises

When doing breathing exercises, you need to follow a number of rules:

• The most important rule to follow when performing breathing exercises is to perform all respiratory movements with all the lungs, and not use only their upper zone. To boil the correctness of your breathing, 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 went up first. If the stomach initially rose, and then the chest, then you are breathing correctly.
• Breathing exercises should be done twice a day, preferably in the morning and evening.
• For maximum efficiency, gymnastics is performed on an empty stomach. It is especially important to observe this rule for those who have hypertension and gastrointestinal diseases.
• You can do it not only at home, but also on the street. When doing gymnastics on the street, especially when walking, do not forget that you need to alternate inhalation and inhalation. 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.
• Choose the right atmosphere. Nothing should distract you: turn off the intercom, telephone, dim the light in the room. You can turn on relaxing music

Contraindications

Despite the fact that breathing exercises bring many benefits, they also have contraindications.

So, it cannot be done:

• lactating mothers and women in position;
• people with a hernia of the esophagus;
• patients with cardiovascular diseases;
• with exacerbation of chronic diseases;
• patients with inflammatory processes in the pelvic area;
• people with adenomyosis.

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

Often, doctors recommend exercise therapy for their patients with coronary artery disease. This method of treatment helps to normalize the work of the respiratory and cardiovascular systems, heal the body and adapt it to the influence of external factors, including emotional unrest, depression, stress, weather conditions.

Each group of the disease has its own method of exercise therapy with a certain set of exercises.

Permissibility of exercise by patient group

There are the following groups of the disease in patients suffering from coronary artery disease:

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• We kindly ask you DO NOT self-medicate, but book an appointment with a specialist!
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It is important for patients with coronary artery disease not to overexert themselves. There are 3 categories of severity of the disease, which determine the allowable load for the patient:

initial stage	The patient does not notice any symptoms of coronary insufficiency. The patient can perform exercise therapy for no more than 25 minutes. The developed set of exercises can involve all muscle groups. Dynamic breathing exercises are also applicable for this category of patients.
typical stage	The disease under normal load is asymptomatic. But due to physical exertion, some signs of the disease begin to appear. The patient may feel unwell during fast walking, climbing stairs. Emotional stress also contributes to the manifestation of symptoms of coronary insufficiency. Patients of this group need to perform all the exercises of the complex in a calm rhythm. Only large muscle groups can be involved. When doing breathing exercises, you should take breaks. The patient needs to monitor the pulse during exercise. It should not increase by more than 10%. Exercise therapy can be done no longer than 20 minutes.
Pronounced stage	The patient feels the symptoms of the disease even at rest. People belonging to this group are at increased risk. It is necessary to limit physical activity due to possible thromboembolism due to overexertion. All exercises should be done with incomplete amplitude if small and medium muscle groups are somehow involved in them. After 2-3 exercises, you need to pause. The entire complex of exercise therapy can not last longer than 15 minutes. If the patient has shortness of breath, heart aches, symptoms of renal heart failure or tachycardia appear, then he should immediately stop exercising.

Approximate classes in the post-infarction period

Many patients watch exercise therapy videos for IHD, this allows you to visually see how this or that exercise is performed. We must not forget that physical activity must be alternated with breathing exercises.

Patients who have had a heart attack can perform the following set of exercises:

1. Lie on your back on the floor or mat. Arms and legs should be spread apart. First, bend your fingers on your hands, then on your feet. You need to complete this complex several times, and then bend your fingers and toes together. It is important to breathe at a normal pace, relaxed. Exercise must be done 6 times.
2. Remaining in the same position, you need to start breathing exercises. Slowly you need to inhale and exhale 3 times.
3. Without changing position, it is necessary to spread the legs. Next, you should move them so that the socks look either outward or inward. You need to do the exercise at an average pace, without stopping your breath.
4. Lying on the floor, you need to raise your shoulders as you inhale, and lower them as you exhale. In total, you need to do 3 approaches. Breathing should also be even.
5. The patient remains in the same position. He should raise his arms, bending them at the elbows, and his legs, bending them at the knees. Next, you should make circular movements with your hands, then with your feet. No more than 6 repetitions in total. After a few days of training, you can rotate all the limbs at the same time. The pace doesn't have to be fast. Breathing remains even throughout the exercise.
6. Stay on the floor and bend your knees. On the exhale, you need to lift the pelvis up, and on the inhale, lower it to the floor. This exercise must be done 3 times without stopping your breath.
7. Lying with legs bent as in the previous exercise, you need to lower your legs, closing your knees together, then in one direction, then in the other. Only 2 approaches. This exercise is performed at an average pace. Breathing remains even and calm.
8. Remaining in the same position, you need to spread your knees to the sides while inhaling, and close them as you exhale. In total, you will need 2-3 repetitions at an average pace.

Gymnastics should be done 3-4 times a day for 20 minutes each. If the cardiogram displays good indicators, then the patient will be able to increase the number of approaches to 10.

After about 2 weeks of such daily practice, the patient usually progresses to the next level of exercise. The patient can already turn on his right side and climb the stairs without the help of others.

Then the person begins to master motor functions. It is important that at the same time the heart rate is normal. There should be no shortness of breath and pain in the heart when doing exercises.

At this stage, the patient re-learns to sit, get up from a chair, walk up the stairs and perform other movements. The complex helps to develop the shoulder and hip joints.

The patient uses a rubber ball and a stick to recover. He also performs coordination, attention and balance exercises. You can't walk too much at once. It is better to limit yourself to 100 steps, sometimes resting.

In this case, exercise therapy is no longer performed lying down, but sitting or standing. First, the patient does two physical exercises, then one breathing exercise. You can take up to 40 minutes for a lesson, the number of repetitions is 3-4.

When the patient can walk on his own, the 3rd rehabilitation period begins, in which other exercises must be performed. Exercise therapy at this stage helps to train the heart and restore the respiratory system.

Much attention is paid to walking. You need to start from a flat surface, later master the descents, and at the very end - the ascents. The first day should be limited to 500 meters. It is important to rest every 5 minutes. Every day you need to add another 100-200 meters to the path traveled the day before, until the distance reaches one kilometer.

All stages of exercise therapy take place in a medical institution. If the doctor allows, you can walk 2 kilometers daily. After discharge, the patient needs to continue to do exercises. The patient should visit the doctor every 2 weeks.

A year after the start of the recovery period, the patient can include in the classes more complex exercises, cycling, skiing. Then he can start going to the gym. An increase in the load must be agreed in advance with the radiation doctor so as not to harm your health.

We must not forget that physical activity should be increased gradually.

What treatments are still effective

In addition to exercise therapy, there are other ways to help patients with coronary artery disease. These include:

Doctors advise patients with coronary artery disease to consume honey, nuts, rose hips, pumpkin seeds, lemon, soy products, raisins, and fermented milk products. If the patient is obese, he needs to give up fatty meat, butter and margarine. In general, it is not recommended to eat foods high in animal fats, but vegetable fats will only benefit. Such eating behavior will help to significantly reduce the cholesterol content in the blood. We must not forget about the vitamins and trace elements necessary for the normal functioning of the body.

Patients with coronary artery disease are prescribed the following drugs without fail: Means containing nitroglycerin or its derivatives. These medicines help relieve spasm of the coronary vessels, thereby facilitating the flow of blood with oxygen and nutrients to the heart. Medicines that improve the composition and reduce blood clotting. These drugs prevent blood clots from forming. These drugs include aspirin. Doctors also prescribe medications to patients that lower blood cholesterol levels and speed up metabolic processes. Vitamins, in particular E, P and ascorbic acid, are often added to the prescribed drug complex. It is impossible to choose medicines on your own in any case, this should be done by an experienced doctor.

Physiotherapy

Particular attention during the recovery period of the patient is given to physiotherapy. The selection of suitable procedures is carried out by a physiotherapist. Most often, patients are prescribed:

Balneotherapy	the patient takes health baths with the addition of various chemical elements and other substances; they can lower, for example, radon, iodine into the water; this method has its own contraindications; taking such baths is prohibited for people with pain, high blood pressure, arrhythmia; for angina, sparing four-chamber baths are used.
electrosleep	The technique of this method is based on the effect of low-frequency impulses on the brain.
Shcherbak's galvanic collar	Therapy with galvanic current.
electrophoresis	in this case, drugs are administered using an electric current; this method is used in conjunction with painkillers and sedatives.
Laser therapy	This method is based on the use of light energy from laser radiation for treatment.

It is important to remember that all these rehabilitation procedures must be carried out under the supervision of a doctor. It is possible to overcome coronary artery disease by strictly following the recommendations.

Approximate complex of therapeutic exercises for coronary heart disease

If the patient belongs to the 1st or 2nd functional type, then he can use the following exercise therapy complex:

1. Sitting on a chair, you need to put your hands down. On inspiration, they should be raised, forming an angle of 180 degrees, and on exhalation, lowered to their original position. The number of repetitions is from 3 to 5.
2. Remaining seated, put your hands on your waist. It is necessary to alternately unbend your arms and raise them to the parallel with the floor. The number of repetitions is from 3 to 5.
3. Getting up from a chair, you need to spread your legs shoulder-width apart. The arms should be bent at the elbows and raised to chest level (forearms pressed to the chest). On inspiration, you need to turn the body to the side, and spread your arms. Exhalation is done after returning to the starting position. The number of repetitions is from 4 to 6.
4. Walk at a normal pace for 30 seconds, then another 1 minute at an accelerated pace.
5. You need to stand so that there is a small distance between your legs. Hands rise up to shoulder level. Next, you need to move your shoulders in a circle, then forward, then back. Repeat the entire cycle - from 5 to 7.
6. You should stand up, put your hands on the back of your head, closing your fingers in the lock. The left leg is taken to the side and placed on the toe. The body leans towards the abducted leg, and then returns to its original position. With the second leg you need to do the same. The number of repetitions is from 3 to 5.
7. You need to stand next to the chair, holding it with your hands. During exhalation, a squat is performed, while inhaling - lifting up. The number of repetitions is from 4 to 6.
8. You should stand up, put your hands on your waist. It is necessary to rotate the head to the right and then to the left (full circle). The number of repetitions is from 3 to 5.
9. Walking with temporary acceleration for 3 minutes.
10. Half a minute of normal walking, then the same thing, only with raising the hip.
11. You need to stand up so that your feet are shoulder-width apart. Next, tilts are made to the left and right. The opposite arm should be bent. The number of repetitions is from 4 to 6.
12. You should stand up with your arms raised to shoulder height in front of you. Next, you need to raise your left leg, touching the toe of the palm of your right hand. Do the same with the other leg. The number of repetitions is from 4 to 6.
13. First you need to lie on your stomach, stretching your arms along the body, palms down. Next, you need to raise your legs up in turn, without bending them at the knees. The number of repetitions is from 4 to 6.
14. You need to sit on a chair, clasping your hands in a lock on your knees. Then you need to raise your hands to shoulder level, turning your palms in the opposite direction. The number of repetitions is from 6 to 8.
15. You need to sit on a chair, putting your right foot forward, and put your left foot under the chair. Hands should lean on the seat. The exercise is to change the position of the legs. The number of repetitions is from 8 to 10.

If the patient suddenly feels pain in the heart, then you need to either finish the exercises, or perform them with a minimum load.

Breathing exercises

Breathing exercises can be done during a heart attack. You need to start with the "Pump" exercise.

Sit on the edge of the bed with your hands resting on your knees. Next, you need to tilt your head to your chest, but not much. Then you need to lean forward a little. You can inhale air only with your nose after tilting forward.

Exhalation is done with a straight back. After every 2 slopes, you need to rest for 5 seconds, and then start over. If health allows, instead of 2 slopes, you can do 4 or 8. More repetitions cannot be done.

In total, the exercise will take 10-15 minutes. After such gymnastics, a feeling of lightness should come. Then you need to rest for half an hour, and then perform the exercise again if the condition has not improved after the first approach. The total time can be increased up to 20-30 minutes.

If this does not help, then the patient is doing something wrong. Then you need to drink medicine or call an ambulance.

To be ready for an attack, it is better to start doing Strelnikova's breathing exercises without waiting for a critical condition. First you need to master a set of 4 exercises:

• "Palms";
• "Shoulders";
• "Cat";
• "Pump".

Each should be done 12 sets in the morning and evening. The duration of one cycle is no more than half an hour. If the first day went well, you can double the number of exercises in each approach, and then quadruple.

After that, you need to add other exercises in the following sequence:

• "Turn the head";
• "Ears";
• "Pendulum head";
• "Rolls";
• "Big pendulum";
• "Hug your shoulders";
• "Steps".

“Hug your shoulders” is a rather difficult exercise for patients suffering from coronary artery disease. It must be done very carefully.

This set of breathing exercises gives excellent results. It helps prevent coronary artery disease, prevent a heart attack.

With angina pectoris

Angina pectoris (angina pectoris)- pathology of the neurohumoral apparatus that regulates blood circulation. The disease occurs as a result of overload of various kinds, chronic stress, short-term negative emotions, overeating at night, exposure to cold, wind.

Main symptoms: periodic pain behind the sternum at rest (rest angina pectoris) or during exertion (angina pectoris). Resting angina may occur during sleep under the influence of dreams, may be accompanied by coronary thrombosis, myocardial infarction and death.

Main direction of therapy. IN attack are prescribed: bed rest, vasodilating and sedative drugs, diet therapy. outside attack- dosed motor mode, exercise therapy and massage.

Physical exercise expand the vessels that feed the myocardium, improve its contractile function. They also calm the central nervous system, removing pathological impulses. Exercise therapy is carried out 2–3 years after an attack of pain according to an individual method in the initial position, the least painful, in the form of elementary exercises for the arms and legs and breathing exercises. Particularly careful is the load during rest angina, since in this case the heart vessels are affected by atherosclerosis, they are inelastic. If there is no deterioration in the patient's condition, then more complex gymnastic exercises using apparatus, walking with lengthening the distance and changing the terrain should be included.

Massage It is very useful, as it helps to relieve pain attacks, psycho-emotional stress, increase microcirculation, and prevent attacks of heart pain. Massage of the collar area, back (to the lower corners of the shoulder blades), chest is carried out. Apply stroking, rubbing and kneading. In the region of the heart, the palmar surface of the entire hand is vibrated (starting from the sternum, the hand slides towards the spine). The position of the patient is sitting. Techniques are excluded: chopping, tapping. The upper limbs are also massaged (first the right hand, then the left). The duration of the massage is 5-8 minutes. Course - 10-15 procedures. With a preventive purpose, 2-3 courses are carried out in the interictal period. Massage has a pronounced analgesic effect in angina pectoris.

Innovative complex of exercise therapy for angina pectoris

1. "Walking" (sitting). The pace is average. 30-60 steps.

2. Sipping. I. p.- hands behind head. Hands up - inhale, hold your breath (2-4 s). I. p.- exhale. 6–8 times.

3. Turn to the right, right hand to the side - inhale, fixation in the extreme position. I. p.- exhale. 3-5 times in each direction.

4. I. p.- hold on to the seat of the chair with your hands. With an exhalation, bend either the left or the right leg, pulling the thigh to the stomach with fixation for 1–2 s. 3-5 times with each leg.

5. Thoracic breathing with a delay in inhalation for 2–4 s and subsequent stepped exhalation (4–6 s). Repeat 3-5 times.

6. Alternately raising the arms up, fixing in the extreme position - inhale; And. P.- exhale. The pace is average. 4-6 times for each hand.

7. Tilts with paradoxical breathing. Tilt to the left (forced breath), right hand up (above the head). I. p.- exhale. The same on the other side. 3-5 times in each direction.

8. Leaning on the back of the chair and holding on to the seat, slowly stretch your legs, fix in the extreme position for 2-3 seconds, straighten your torso, take a breath, And. P.- exhale (flexion-extension to perform without lifting the heels from the floor). 4-6 times.

9. Bend your arms to your shoulders, bringing your shoulder blades together, turning your chest - inhale. I. p. - exhale. 4-6 times.

10. Slowly step over with your feet in place (to a height of 5-10 cm from the floor) for 1-1.5 minutes

11. Sitting with muscle relaxation meditative relaxation 30 s.

I. p.- standing.

1. Walking 1–2 min. The pace is slow, then medium. Further, the rhythms of breathing are performed in coordination with the rhythm of movement.

2. Movements with paradoxical breathing. I. p.- legs apart, arms to the sides. Cross your arms in front of your chest, grabbing your shoulders with your palms - inhale. I. p.- exhale. The pace is slow. 10-15 times.

3. Tilts with paradoxical breathing. I. p.- legs apart, hands behind the head. Tilts to the left and right while inhaling, while straightening - exhale. The pace is slow. 5–8 times.

4. I. p. – O. With. Holding on to the back of a chair, exhale 2-3 springy semi-squats. I. p.- breath. The pace is slow. 8-10 times.

5. Rising on toes, hands on the belt, while inhaling, sequential (lower, middle, upper parts) filling of the chest. I. p.- slow exhale. 4-6 times.

6. I. p.- legs apart, fingers clenched into a fist. Alternate raising hands forward. The pace is average. 8-10 times.

7. I. p.- legs apart. Turn left (right), arms to the sides, fixation in the extreme position - inhale. I. p.- exhale. The pace is average, 3-6 times in each direction.

8. I. p.- sideways to the back of the chair; one hand on the back of the chair, the other on the belt. Slowly bend one leg, lifting the knee forward, then, unbending, take it to the side. Return to And. P. Repeat 4-5 times.

9. Movements with paradoxical breathing. I. p.- legs apart, hands to the shoulders. Hands up, bend over and look at them - exhale. I. p.- breath. The pace is slow. 4-6 times.

10. Slow walking. 1–2 min.

11. Rest sitting. Meditative relaxation 1–2 min.

I. p.- standing. Breathing is free.

1. Walking on toes. The pace is average. 1–1.5 min.

2. Alternate slow bending of the arms to the shoulders, fix the extreme position, return to And. P., clench your fingers into a fist for 2–3 s. The pace is average. 10-12 times.

3. I. p.- legs apart, hands on the belt. Slowly leaning forward (gradual inhalation), arching your back and fixing the extreme position, forced exhalation. I. p. - inhale.

4. I. p.- legs apart, hands forward, fingers clenched into a fist. Leaning forward to imitate repulsion with ski poles on the exhale. I. p.- breath. 8-12 times.

5. Movements with paradoxical breathing. I. p.- legs apart, hands behind the head. Hands up, bend your back - exhale. I. p.- breath. The pace is slow. 6–8 times.

6. I. p. – O. With., hands down, fingers clenched into a fist. Slowly bend your arms to your shoulders and straighten them to the sides. 8-10 times.

7. I. p.- legs apart, hands behind the head. Turns to the sides, simultaneously extending the arms to the side. The pace is average. 3-5 times in each direction.

8. Rhythmic meditative breathing. On 3-4 counts - inhale, on 4-5 - exhale. 30–40 s.

9. I. p. – O. With. Lunge with the leg of the same name slightly bent at the knee joint to the side, arms to the sides. The pace is average. 3-5 times in each direction.

10. I. p.- legs apart, hands down. Slow circular movements of the shoulder girdle forward and up - inhale; back down - exhale. 8-10 times.

11. Walking in place with deep breathing. 1.5–2 min.

12. Meditative relaxation 2-3 minutes, sitting rest with alternate relaxing movement of the muscles of the head and neck, face, shoulder girdle, arms, torso, legs.

Innovative complex of physical exercises for angina pectoris against the background of atherosclerosis

1. I. p.- lying on your back with a high position of the head. Free flexion and extension of the arms in the elbow joints 5-6 times. When straightening your arms - inhale, do not tear your elbows from the bed. Breathing is free.

2. I. p.- Same. Shifts stroking the feet against each other, without lifting the heels from the bed. 30 s. Breathing is free.

3. I. p.- Same. Flexion and extension of the feet 6-8 times. Breathing is arbitrary.

4. I. p.- Same. Rotational movements of the feet in one direction, without lifting the heels from the bed. 20 s in each direction.

5. I. p.- the same, hands in front of the chest. Spread your arms to the sides - inhale, return to And. P.- exhale. 3-4 times.

6. Lying on your back, legs bent at the knees with the support of the feet. Meditative walking lying. 10–20 times. Increase the pace and amplitude gradually. Breathing is free.

7. I. p.- Same. Turning the torso in one direction, put the legs in the other (twisting). Perform without tension 4-5 times in each direction. Breathing is arbitrary.

8. I. p.- sitting on the edge of the couch, hands on the belt. Meditative breathing of medium depth 40 s.

9. I. p.- standing. Calm walking for 1.5-2 minutes.

10. I. p.- sitting on a chair with support on the back, hands on the belt. Expand your shoulders, bend in the lower back, bring the shoulder blades together - inhale; return to And. P.- exhale. 4-6 times.

11. I. p.- the same, arms to shoulders, legs straightened. Alternate slow bending of the leg with taking it to the side - inhale, And. P.- exhale. 3-4 times with each leg.

12. I. p.- sitting on a chair, legs bent and slightly apart, brushes grab the knees. After a preliminary inhalation, slowly tilt the torso forward with the elbows apart to the sides - exhale; And. P.- breath. 4-5 times. Do not take your hands off your knees.

13. I. p.- Same. Walking for 10-15 minutes, alternating every 3-5 minutes (as you feel) sitting on a chair and getting up; then meditative walking with deep breathing for 15-20 minutes, rest sitting for 1-2 minutes. Depending on how you feel, the number of getting up from a chair and walking can be increased or decreased.

14. I. p.- sitting on a chair with support on the back. Rhythmic meditative breathing. Rest 2–3 min.

A characteristic feature of modern society is hypodynamia - a violation of the functioning of the body due to a lack of physical activity. The development of the transport network, the automation of production and the increase in the number of "intellectual" workers led to the fact that people began to lead a sedentary lifestyle. Unfortunately, this factor negatively affected the health of the human cardiovascular system. Diseases such as angina pectoris, stroke, heart attack began to occur more and more often. Therapeutic exercise for IHD is an important component of the rehabilitation of patients who have had heart disease.

Benefits of physical activity in ischemic heart disease

For physical rehabilitation, doctors prescribe light exercises at the very beginning of the post-infarction period. The purpose of such exercises is to restore breathing and bring the patient out of a difficult condition.

It must be remembered that therapeutic exercises for IHD are prescribed strictly by a specialist. Excessive physical activity and too intense loads can adversely affect the state of health and lead to a relapse of an attack.

Regular physical activity is beneficial for everyone. For healthy people, it helps prevent the occurrence of diseases, and for those who have already suffered heart disease, physical education reduces the recovery period and prevents the development of relapse.

Physical activity in CHD helps:

• keep muscles in good shape;
• reduce the level of atherogenic lipids in the blood (cholesterol, low density lipoprotein, etc.), thereby reducing the risk of atherosclerosis;
• normalize blood pressure;
• prevent the formation of blood clots;
• improve the quality of life, improve mood;
• normalize sleep;
• prevent obesity and reduce the risk of developing diabetes.

According to medical research, people who engage in physical therapy after a heart attack are 7 times less likely to suffer a relapse of such a heart attack and reduce the likelihood of death by 6 times. Exercise therapy for coronary heart disease can improve the overall health of the patient. Regular exercise improves blood flow, minimizes the effects of heart failure, and strengthens the cardiovascular system.

Features of physical education in IHD

For patients suffering from coronary heart disease, not all types of physical activity are suitable. The type of load and its intensity are determined by the attending physician based on a specific clinical picture.

For patients who have had heart disease, the nature of exercise therapy may be of decisive importance:

1. With moderate activity, the course of recovery is accelerated, the strength and endurance of the body increase.
2. With excessive exercise, angina pectoris can occur, which often leads to a second attack.

The priority areas of physical education are exercises aimed at developing endurance. These include quiet walks, cycling, housework, dancing. Loads should gradually increase. In this case, the heart rate should increase by no more than 15-20 beats per minute.

Indications and contraindications

Ischemic heart disease is a pathological condition that is characterized by failures in the blood supply to the myocardium, due to damage to the coronary vessels. The reason for this situation is the lack of oxygen entering the heart with blood. Indications for performing therapeutic exercises are an acute form of coronary artery disease (with a myocardial infarction) and chronic (with periodic attacks of angina pectoris).

Contraindications of exercise therapy for coronary artery disease:

• frequent attacks of angina pectoris;
• acute disorders in the coronary circulation;
• advanced stages of heart failure;
• persistent arrhythmia;
• aneurysm of the heart.

For patients suffering from angina pectoris, doctors recommend conducting therapeutic training in between attacks. So, with a mild attack, simple exercises can be done already on the second day, with an average - on the fourth, with a severe one - on the eighth.

Rules for performing physical exercises for IHD

Physical education for patients with coronary heart disease is carried out only after the condition has been stabilized.

At first, it is advisable to engage in breathing exercises and exercises aimed at the activity of individual muscle groups. Then, in the clinic, a submaximal test is performed to identify the permissible intensity and volume of loads in the framework of post-infarction rehabilitation.

The test ends when the heart rate rises to 120 beats per minute or when there are clear signs of intolerance. The heart rate recorded at the end of testing becomes the threshold value and subsequent physical activity should not exceed 75% of the value established empirically.

At first, the optimal loads will be: therapeutic exercises, walking, exercise bike, swimming, jogging.

Prohibited loads are marked with a “-” sign, permitted loads are marked with a “+” sign. The number of signs “+” displays the permissible intensity and volume of loads.

Daily physical activity

Types of homework

Type of activity	Function class
	I	II	III	IV
Sawing	+	-	-	-
Hand drill operation: comfortable posture uncomfortable posture	++ ++	+ -	- -	- -
Working with a vacuum cleaner	++	+	-	-
Washing vertical surfaces (windows, walls, cars): comfortable posture uncomfortable posture	++ +	+ -	- -	- -
Dusting	+++	+++	++	+
washing dishes	+++	+++	++	+
Wash: comfortable posture uncomfortable posture	++ +	+ -	- -	- -
Sewing, embroidery	+++	++	+	-

Works on the backyard

Type of activity	Function class
	I	II	III	IV
Earthworks (loosening the soil, digging the earth, digging holes)	++	+	-	-
Carrying loads by hand (water, sand, cement, bricks, fertilizers, etc., in kg)	up to 15	up to 8-10	until 3	-
Transportation of goods on a wheelbarrow (kg)	up to 20-25	up to 15	up to 6-7	-
Watering: hose large watering can (10 kg) small watering can (3 kg)	+++ +++ +++	++ ++ ++	+ - +	- - -
Landing: trees seedling	++ +++	+ ++	- +	- -
Harvesting: from the trees from the bushes	+++ +++	++ +++	+ +	- -

A set of exercises for coronary heart disease

Exercises for the treatment of coronary artery disease include a combination of breathing exercises with physical activity. Physical education can be carried out in a clinic or at home based on the recommendations of the attending physician. During classes, it is necessary to monitor breathing - it should be calm and even.

Here are some examples of exercises that speed up rehabilitation after heart disease:

1. The patient lies on a hard horizontal surface with arms and legs wide apart. Then slowly bend and unbend the fingers. The exercise is repeated 5-6 times.
2. In the supine position, the patient does breathing exercises - alternates deep slow breaths with exhalations. The number of repetitions is 3-4 times.
3. Lying on his back and stretching his legs, the patient alternately pulls the sock towards himself and away from himself. The exercise is repeated 5-6 times.
4. Sitting on a chair, the patient lowers his arms along the torso. Then, inhaling deeply, raises his hands up, exhaling - down. The number of repetitions is 5 times.
5. In the sitting position, the patient fixes his hands on his belt. Then alternately unbends his arms and returns them to their original position. The number of repetitions is 5-6 times.
6. The patient assumes a standing position and performs 3 slow head rotations in one direction and 3 in the other.
7. In a standing position, the shoulders are alternately raised and lowered. The number of repetitions is 5-6 times.
8. The patient puts his hands on his belt and makes 3 circular rotations of the body in one direction, 3 in the other.
9. The patient stands next to the chair, hands leaning on its back. Then slowly sits down on a chair when inhaling and rises to its original position when exhaling. The number of repetitions is 4-5 times.

What physical activity is optimal for patients who have had a heart attack?

In the post-infarction state, they will help to achieve a better recovery of the endurance load, in combination with exercises for flexibility and strength. So, for example, it is better to alternate walking and cycling with walking up an inclined surface, while developing strength and endurance. Work at home or in the garden can be alternated with dancing or swimming.

It should be remembered that any load is introduced gradually. An increase in motor activity must necessarily be agreed with a specialist. Otherwise, such physical education can only worsen the state of health and provoke a second attack.

Postinfarction rehabilitation should be comprehensive. This means that one increase in activity is not enough here. For a complete recovery of the body, drug therapy is additionally carried out, the patient's diet and lifestyle are adjusted. In difficult cases, rehabilitation may include surgical correction.