RU2311164C1 - Method for hydrokinesitherapy in premature neonatals and those at perinatal cns pathology - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: the present innovation deals with reconstructive therapy to form mobile functions in neonatals. It is necessary to carry out hydrokinesitherapy in premature neonatals and those at perinatal CNS pathology. Trainings should be carried out on the ground and in water, gradually, depending upon the age. It is important to accustom them to water, fulfill arm balances in water, diving, movements, physical exercises and games. Trainings should be carried out in three stages: the first stage for babies aged 2 wk - 3 mo in a portable swimming pool where a baby is alone; the second stage for children aged 3 mo -1 yr in a shallow swimming pool where a child is together with an adult; the third stage for children aged 1 -3 yr in a swimming pool together with an adult. Every training consists of 3 parts: aqueous, main and final. The main and the final parts should be carried out in water, at the end of the final part it is necessary to go to the sauna at 60°C for about 3-5 min. The innovation is simple, physiological, stimulates the flow of nervous impulses along different levels of nervous system by favoring the maturation of reflector arches and activation of silent cerebral areas. As a result, premature neonatals gain motor habits and coordination characteristics quicker being natural to their calendar age.

EFFECT: higher efficiency.

5 ex

Description

The invention relates to medicine, namely to rehabilitation treatment, can be used to form the motor functions of a child.

There are publications in the literature on the use of the aquatic environment for physical education classes, medical procedures in children of the first year of life. At the same time, they mainly pay attention to such features as the natural buoyancy of infants under the age of 3 months, a physiological increase in the tone of skeletal muscles. The aquatic environment provides gravitational unloading to the child’s body, creating resistance, provides smooth movements, staying in water calms, creates a pronounced psychotherapeutic effect. As a result, it is possible to form motor coordination characteristic of age. Water acts on the baro-, thermo-, mechanoreceptors and forms a powerful sensory flow of various modality into the central nervous system. It is known that the sensory influx from integumentary tissues, the musculoskeletal system at the initial stages of development plays a leading role in the maturation of brain functions.

A child born earlier than the due date or with a congenital pathology of the central nervous system, getting into the aquatic environment, gets the opportunity to continue the formation of motor coordination inherent to his conceptual age or level of development.

Currently, there are a number of methods of therapeutic and recreational training of infants in the aquatic environment.

V.A. Guterman proposed a method of teaching swimming to babies with breath-holding by the method of "watering-immersion" [Guterman V.A. Swimming infants. - M .: GUZM, 1978. - 192 p.].

The disadvantage of this technique is that it is addressed only to healthy children.

The method proposed by Rozina L.V., Mikhailov V.P., takes into account the characteristics of children with natal injury of the cervical spine [RF Patent No. 2199993, M. cl. A 61 H 1/00, BI No. 7, 2003, p 327. "A method for restoring motor disorders in a newborn with spinal pathology"]. The method includes the restoration of motor functions associated with impaired functioning of the muscles involved in the extension of the head and neck, violation of the neck-tonic reflexes, by conducting water procedures with immersion in water and a set of exercises.

The disadvantage of this method is that it provides only for the correction of existing pathological changes, not taking into account the further motor development of the child. Another drawback is that the doctor conducts classes during treatment sessions, and the development of the child in the first weeks and months of life requires daily classes. At this age, the care of the mother or both parents is always preferable to the participation of an outsider.

The closest is the method of hydrokinesitherapy of infants proposed by N. Yanushanets [Yanushanets N. Swim earlier than walking. - St. Petersburg: Peter, 2003. - 192 p.]. The method includes a methodology for classes with healthy children from 14 days to 3 years in the bath and pool and includes 4 courses: 2 courses in the bath and 2 courses in the pool. Classes in the bath for children from 14 days to 6 months and from 6 months to 1 year and classes in the pool for children from 6 months to 1 year and from 1 to 3 years. During the first course, they master basic support, preliminary exercises on land, the child gets used to the water, masters diving, movements in the aquatic environment. During the second course, the child learns exercises and games, learns to walk in the water. During the third year, the child learns to independently perform the exercises, learns to use swimming devices, use the side as a support, and participate in group games with parents and other children. During the fourth year, children improve motor stereotypes and communication skills, studying in groups.

The disadvantages of this method:

1. Children under 6 months are engaged in the bath, performing only the simplest exercises. This limits the development of their motor abilities, creates difficulties for assisting them in performing the exercises. Taking into account the dynamics of the physical development of infants, when training in a small volume of water, the gravitational dependence increases and the effect of weightlessness is lost.

2. Preliminary exercises on land do not include the movements necessary for swimming.

3. Classes do not include actions performed by the “stand”, “go” command. These elements are important for the formation of the functions of standing, walking, as well as for the proper organization of classes, the development of discipline from an early age when practicing in water.

4. Classes do not contain the final part necessary for the gradual reduction of physical activity and bringing the body to a calm state.

The objective of the invention is the correction of existing pathological disorders in premature infants, infants with perinatal pathology of the central nervous system (CNS) and the further development of motor functions of children through classes in the aquatic environment and on land.

The task is achieved by the following sequence of actions.

Hydrokinesitherapy of preterm infants and infants with perinatal CNS pathology is performed. Classes are held on land and in water, in stages, depending on age. They teach water, perform water supports, diving, movements, physical exercises, games. Classes are held in three stages: the first stage for children aged 2 weeks to 3 months in a portable pool, where the child is alone; the second stage for children aged 3 months to 1 year, in a shallow pool where the child is with an adult; the third stage for children aged 1 year to 3 years, in the pool, where the child is with an adult. Each lesson consists of three parts: introductory, main and final. The prologue begins with massage and performs exercises on land and in water. The main and final part of the classes is carried out in water, at the end of the final part they visit a sauna with a temperature of 60 ° C for 3-5 minutes. At the first and second stages of the introductory part after the massage, classes are held on land, during which the child learns the exercises "dry swimming", which he will continue to perform in water, with the pronunciation of the names of the exercises for adults. Exercises to be performed: from the starting position on the back, legs are straight, an adult grabs the child’s ankles in the back and bottom, and when the legs move, the “crawl” alternately raises and lowers straight legs; when the legs move, the “breaststroke” simultaneously bends both legs at the knees and hips, then spreads the knees to the sides, quickly straightens the legs; when moving the legs, the "bicycle" alternately bends and extends the legs; then the adult, holding the child’s hands, performs circular movements with them, bending, abducting and bringing both hands, smoothly lifts the child by the hands up to the “vise” position, slowly lowers the child down, smoothly raises the child by the legs up to the “vise” position and slowly lowers, maximally spreading the child’s legs to the sides, holds 3-5 seconds, bends the child’s legs in the knee joints and spreads to the sides, alternately pulls the heels to the bosom; in the position on the right side, holds the child by the left hand and leg and gently stretches the left side, bringing them closer to the support plane, repeats the exercise in the position on the left side. At the third stage, the introductory exercises that do not require the participation of an adult, the child performs independently. At the first and second stage, all exercises in water are performed with support, and at stage 3, children who have learned to swim perform exercises on their own under the control of adults. A set of exercises in the water includes: exercises for the formation of cervical and vestibular tonic reflexes: with the support of the "column" of the child, vertically supporting the back and back of the head, lower it into the water; with the support of the "pillow" is lowered into the water in the position of the child on his back; with the support of the "string bag", the "bucket" is lowered into the water, first in the supine position, then in the chest position; dipped in water with support for straight arms. Warm up in water is carried out, performing exercises, accompanied by the words of the team or the names of the exercises. Exercises for the formation of a support reflex: support "column", the team - "stand." Exercises for the formation of step-by-step automatism: guiding a child forward with a step over, legs, the command is "let's go." Exercises for toning axial muscles: a swing exercise with the support of a string bag with the words “back”, “tummy”, when the child alternately slides on his back and abdomen. Exercises to reduce intracranial traction pressure and correction of the spine: "snake" with the support of the "pillow", which carry out arcuate movements on the surface of the water; “swing” with support for straight arms, “snake” on the back, support “bucket”, “swing” with support for straight arms and “snake” with support for straight arms. The main part of the lesson includes swimming, diving and playing in the water. In this case, swimming includes: exercises for the development of a support reflex: an “arrow” on the back, when the child performs a push with his feet from the end of the pool, he is carried out to the other end by a “shuttle”; an "arrow" on the chest, when the child performs a push with his feet from the end of the pool, he is led to the other end with the support of the "pillow"; exercises for the development of axial muscle tone: “watch” with the support of the “column”, when the pendulum moves with the lower part of the body in the sagittal and frontal plane, pronouncing “tic-tac”, “stirrer” with the support of the “column” when the lower body is performed circular movements in one direction and the other; exercises for lowering intracranial pressure, correction of the spine and the formation of cross coordination of arms and legs: the figure-eight in the position on the chest, with the support of the string-bag, with the “swim” command, guide the child along the oval in one direction and the other, forming a figure of eight, " figure "eight" on the back, with the support of the "bucket" at the "swim" command, guide the child along the oval in one direction and the other, forming a figure eight. Exercises to increase resistance to hypoxia with diving. In the first month of life, a breath hold is formed, for which, after the “diving” command, the adult pours the child’s head from the bucket from above, in the second and third month after the “diving” command, the adult immerses the child with the head in water and holds it underwater at the moment of breath holding ; from three months after the “dive” command, at the moment of immersion and piloting the child under water, the child is released for several seconds, who floats by inertia, then picks up the child, while gradually increasing the time of immersion. Exercises for the formation of coordination of movements: perform vertical jumps into the water upside down, at the command "dive" jumps with the head dipping into the water, support the child, at stage 3, vertical jumps from the side perform support with straight arms: the child stands on the side of the pool, capturing with the toes the edge of the rim, performs a bounce downside down, then repeats with a left and right turn. Exercises for the development of cervical and vestibular tonic reflexes. From the squat position, the jump downside down, the recession into the water is performed with support for straight arms, when sitting on the side, the child's legs lean against the pool wall, leaning forward and, losing balance, resting the legs on the wall, the child recesses into the water, entering it legs. Games in water to improve motor stereotypes and communication skills include: exhaling in water, immersing the mouth in it to form bubbles; getting items from the bottom of the pool, capturing and holding small, then medium, then large items in water; turns in the water while lying, standing. After each exercise, standing, walking is repeated so that rest is more than half of the entire activity. In the final part, they reduce physical and emotional stress, at the end of the lesson, children perform relaxation exercises in the water, perform breathing exercises: in the first and second stages, the adult slowly stretches the child's arms up, the child reflexively takes a breath; the adult slowly crosses the child’s arms on the chest, the child exhale reflexively; the adult slowly pulls the direct contralateral limbs to each other, the child exhales reflexively; the adult slowly extends his arm up and his leg down; the child reflexively takes a breath; the adult slowly pulls the bent contralateral limbs to each other, the child exhales reflexively; the adult slowly extends his arm up and his leg down; the child reflexively takes a breath; the adult slowly spreads the child’s straight arms to the sides, the child reflexively takes a breath; the adult slowly crosses the child’s arms on the chest, the child exhale reflexively. Adults perform smooth postings of the child in the position on the chest and on the back in a straight line, in an oval, in a circle in both directions, at the third stage, the children calmly swim.

The novelty of the method:

1. Children from 3 months to 1 year of age are engaged in a shallow pool, but in a large volume of water in order to maintain a state of weightlessness. Therefore, in dynamics, they can perform fairly complex movements, improve motor skills and acquire new skills.

2. Each lesson consists of three parts: introductory, main and final.

3. The introductory part begins with a massage and preliminary exercises on land, which include movements necessary for swimming. This makes learning movements in water easier.

4. The main and final parts are held in water. At the end of the final part, a visit to the sauna.

5. Classes include building elements: teams "stand", "go." This contributes to the formation of standing and walking functions, gives the child a break between completing more complex motor tasks, and forms discipline.

6. The adult tells the infant the command and the name of the exercise. This contributes to the development of speech of the baby, accustoms to execute commands given by voice.

7. A set of exercises in the water, performed in the main part of the lesson, allows you to form: cervical, vestibular tonic reflexes, support reflex. To shape the tone of axial muscles, stepwise automatism. Reduce intracranial pressure and adjust the spine, form cross-coordination of arms and legs. Develop resistance to hypoxia.

8. Classes contain the final part, including exercises for relaxation in the water and a visit to the sauna. This is necessary to return the baby's body to its original state and warm.

9. When diving at the moment of immersion and posting under water, the baby is released with a gradual increase in the time of swim due to inertia. This helps to increase the body's tolerance to hypoxia, optimization of redox processes in the body.

10. In the final part, they reduce physical and emotional stress, at the end of the lesson, children perform relaxation exercises in the water, perform breathing exercises, and calmly swim. The technique can be used in work with both healthy and infants with perinatal damage to the central nervous system.

The advantages of the proposed method: physiology, the active participation of the infant, the possibility of use in the family after training parents, the ability to use for the formation of motor skills of healthy and sick children. As a result of the application of the proposed method in children with perinatal CNS pathology, acting on peripheral receptors, we stimulate the flow of nerve impulses at different levels of the nervous system, contributing to the maturation of reflex arcs and activation of silent areas of the brain. In fact, classes in the aquatic environment with deeply premature babies with central nervous system damage prolong their physiological stay in gravitational unloading with the possibility of targeted external exposure. As a result, premature babies acquire the motor skills and coordination faster in their calendar age.

The method is as follows.

Infants are divided into groups according to their state of health: premature babies with motor retardation, babies with perinatal CNS pathology, and healthy babies.

Classes are built in three stages, taking into account age:

1. At the age of 2 weeks to 3 months, classes are held in a portable pool. The child is in the pool alone. Methodist and mom are out of the pool. An adult helps a child complete the required tricks.

2. At the age of 3 to 12 months, classes are held in a shallow pool. Children are in the pool with adults (parents), who help them complete some of the receptions, encourage children to complete some of the receptions on their own. The methodologist, being on land, controls the process.

3. From 1 to 3 years old, a group of children is in the pool with adults. Adults interest children in completing tasks, control the correctness of their actions, and regulate relations between children. The methodologist, being on land, controls the process.

Premature infants with perinatal CNS pathology undergo the same training stages more slowly. The criterion for the transfer of the baby from stage to stage is the development of the program of the previous stage.

The methodology for conducting classes at each stage provides an introductory, main and final part.

The prologue is held on land and in water. On land perform massage in accordance with age and leading exercises. The main part is carried out in water, the final part includes exercises in water and a stay in the sauna.

At the first stage, the introductory part contains massage and exercises on land for 5 minutes, in water - for 3 minutes. The main part contains a lesson in water for 10 minutes. The final part includes a lesson in water for 2 minutes, staying in a sauna at a temperature of 60 ° C for 5 minutes.

At the second stage, the introductory part contains massage, a lesson on land for 3 minutes, in water for 5 minutes. The main part contains a lesson in water for 15 minutes. The final part includes a lesson in water for 5 minutes, in a sauna at a temperature of 60 ° C - for 5 minutes.

In the third stage, the introductory part contains massage, a lesson on land for 5 minutes, in water for 5 minutes. The main part contains a lesson in water for 20 minutes. The final part includes a lesson in water for 5 minutes, in a sauna at a temperature of 60 ° C - for 5 minutes.

The lead exercises “dry swimming” are performed on land, at stages 1 and 2 they include passive movements with the pronunciation of the name of the exercises that the child will perform in water. Since at this age we cannot explain to the child how to perform the exercises, we, using existing reflexes and trace effects, program the musculoskeletal system to perform these exercises in water. At the third stage, the introductory exercises that do not require the participation of an adult, the child performs independently.

1. Movement of the legs "crawl": starting position (IP) lying on the back, legs straight. An adult covers the back and bottom of the child's ankle joints (GSS) and makes alternately raising and lowering the straight legs. 10-12 times.

2. Movement of the legs "breaststroke": IP is the same. Grasping the child’s legs in the GSS area, the adult simultaneously bends both legs in the knee (KS) and hip joints (TBS), then spreads the knees to the sides, quickly straightens the legs, returning to the PI. 8-10 times.

3. The movement of the legs "bicycle". IP is the same. Having clasped the child’s legs in the GSS area, the adult performs alternating bending and extension of the legs in the CS, TBS. 10-12 times.

4. Circular movements of the hands. IP is the same. Holding the child’s hands, the adult makes circular movements in the PS: bending, abduction and adduction of both hands at the same time. 10-12 times.

5. Lifting the arms from the IP lying on your back. The adult, holding the child by the hand, smoothly raises him to the "vise" position, slowly lowers it into the PI.

6. Lifting the legs from the IP lying on your back. The adult, holding the child by the GSS, smoothly raises him to the "vis" position, slowly lowers him into the PI.

7. Lifting one leg from the IP lying on your back. The adult, holding the child by the GSS, smoothly raises him to the "vis" position, slowly lowers him into the PI.

8. Breeding straight legs. IP is the same. The adult, holding the child by the GSS, spreads his legs with a smooth movement, keeping him in the maximum dilution position for 3-5 s, makes springy movements, slowly returns to the PI.

9. Breeding bent legs. IP is the same. The adult, holding the child by the GSS, smoothly bends the legs in the CS, bends and spreads in the TBS, alternately gently pulls the heels to the bosom, holding in this position for 3-5 seconds, slowly returns to the PI.

10. Pulling. SP lying on the right side. The adult holds the child by the left hand and the GSS area, gently stretches the left side, bringing the left arm and leg closer to the support plane. Repeat lying on the left side.

The second part of the lesson in the water. When swimming with children, the following manual supports are used:

1. Support "column". An adult holds the child vertically facing him: thumbs under the nipples, the rest support the back and back of the child.

2. "Pillow". SP on the back. The palms of an adult form a kind of pillow: the ulnar edges of the palms and little fingers are tightly connected, the thumbs in the abduction position.

3. A string bag is carried out in PI on a back and on a breast. In the IP on the back of the head of the child rests on the distal thirds of the forearms of an adult, whose palms are under the back of the child. The adult's thumbs cover the area of the child’s shoulder joints or upper arms. In the PI on the chest, the adult's hands are under the breast of the child, the chin rests on the wrist joint area.

4. One-handed bucket support is performed in the PI on the back and chest. The nape or chin of the child rests on the tenar, 1 and 5 fingers slightly fix the head, 2-4 fingers support the chest or back.

5. Two-handed support for straight arms: an adult holds the child by the arms of straight arms.

Warm up in the water

1. The adult slowly lowers the child into the water. Column support. The team is standing. The child's feet rest on the bottom of the pool, the child stands for 10-15 seconds. Exercise forms the reflex of support, accustoms the child to discipline, gives the opportunity to rest between the execution of other, more stressful exercises.

2. "Come on." The child goes a few steps. We make sure that the child is fully supported by each foot, then he steps over. Exercise forms step automatism in the conditions of gravitational unloading.

3. "Swing". Support "string bag". The child glides alternately on his back and abdomen 8-10 times. The adult says: “back”, “tummy”. Exercise tones the axial muscles of the front and back surfaces of the body due to the massage effect of water.

4. The Snake. In the IP on the back, support "pillow", arcuate movements 8-10 times. The baby’s ears and chest are under water. The exercise is aimed at stretching and correcting the spine, reducing intracranial pressure, tones the muscles of the back.

5. "Swing". 8-10 times with support for straight arms.

6. The Snake. In the IP on the back, support "bucket" 8-10 times.

7. "Swing". 8-10 times with support for straight arms.

8. The Snake. In the IP on the back, support for straight arms.

Main part

The main part includes: swimming, diving, games in the water.

Swimming

1. "Arrow". SP on the back. The child performs a push with his feet from the end of the pool, posting to the other end with a “shuttle” 8-10 times. Exercise forms a push with the lower extremities: bending of both legs and extension with repulsion by the feet. It forms a conditioned reflex in the child: execute a push at the command of the “arrow”.

2. "Arrow". PI on the chest. The child performs a push with his feet from the end of the pool, wiring to the other end, support "pillow" 8-10 times.

3. "Watch." IP standing, support "column". We carry out the movement of the pendulum in the sagittal and frontal plane, pronouncing “tick-tock”. Only the lower body works, 10-12 times. An exercise performed in the frontal plane tones the axial muscles of the lateral surface of the body: oblique muscles of the abdomen, leading and abducting muscles of the hips. When performing movements in the sagittal plane, the muscle tone of the front and rear surfaces of the body increases.

4. The Mixer. IP standing, support "column". We perform circular body movements in one and the other direction 8-10 times. Only the lower body works. Exercise tones the axial muscles of the trunk and lower extremities.

5. "Eight" in the chest on the chest, support "string bag". At the command "swim", we swim along the oval in one direction and the other, forming an eight 6-8 times. With his free hand, an adult helps the child to row with his hands or feet, if necessary. Exercise, like the "snake", is aimed at stretching and correcting the position of the spine, reducing intracranial pressure, in addition, it forms a coordinated cross movement of the arms and legs.

6. "Eight" in the IP on the back, support "bucket". At the command "swim", swim along the oval in one direction and the other, forming a figure of eight, 6-8 times. With his free hand, an adult helps the child to row with his hands or feet.

Diving

1. In the first month of life after the “dive” command, an adult pours a bucket of water over the child’s head. We form a breath hold.

2. In the second and third month after the command "dive" at the time of delay, the adult immerses the child with his head in the water and spends under water. We form the skill of staying under water, hydrostatic pressure affects the whole body of the child.

3. From three months after the command we "dive" at the moment of immersion and piloting the child under water for a few seconds we release the child who is floating by inertia. Then we pick up the child. We form the skill of independent swimming under water.

4. Vertical jumps in the water upside down: at the command “we dive” jumps with the head immersed in water. The exercise is performed with support. Exercise forms coordination of movements, a conditioned reflex of performing movement on command.

5. At stage 3, vertical jumps from the side are performed with support for straight arms. I.P. standing on the side of the pool, grab the edge of the side with your toes, jump down with your feet, also with a left turn, right; take the squat position and jump downside down. Exercise forms coordination of movements, vestibular and cervical tonic reflexes.

6. The recession into the water is performed with support for straight arms: FE sitting on the side, legs rest against the pool wall. Leaning forward and, losing balance, resting your feet on the wall, make a recession into the water, entering it with your feet. Exercise forms coordination of movements, vestibular and cervical tonic reflexes in more difficult conditions.

Water games

1. Exhale in water, immersing the mouth in it to form bubbles. Training the respiratory system.

2. Removing items from the bottom of the pool. Training of coordination of movements, the ability to move in water, complete the task, improving the cervical and vestibular tonic reflexes.

3. Capture and retention of small, then medium, then large objects in water. Shaping function formation.

4. Turns in the water while lying, standing. Training of coordination of movements, improvement of cervical and vestibular tonic reflexes.

After each exercise, standing, walking is repeated so that rest is more than half of the entire workout.

In the final part, reduce physical and emotional stress. At the end of the lesson, children calmly swim and perform breathing exercises for relaxation, adults perform smooth postings of children in a position on the chest and on the back in a straight line, in an oval, in a circle in both directions. Use the following respiratory relaxation exercises in the PI on the back:

1. The adult slowly stretches the child's arms up, the child reflexively takes a breath. The adult slowly crosses the child’s arms on the chest, the child exhale reflexively.

2. The adult slowly pulls the direct contralateral limbs to each other (hand to foot). The child exhales reflexively. The adult slowly extends his arm up and his leg down. The child reflexively takes a breath.

3. The adult slowly pulls the bent contralateral limbs to each other (knee to elbow). The child exhales reflexively. The adult slowly extends his arm up and his leg down. The child reflexively takes a breath.

4. The adult slowly spreads the child's straight arms to the sides, the child reflexively takes a breath. The adult slowly crosses the child’s arms on the chest, the child exhale reflexively.

5. The lesson ends with a visit to the sauna with a temperature of 60 ° for 3-5 minutes, until the child is completely warm.

At stages 1 and 2, children perform all exercises in water with support. At stage 3, children who have learned to swim perform part of the exercises on their own under the control of adults.

Example 1. Dima P., 19.02. 04 year of birth. Diagnosis: perinatal CNS damage of hypoxic origin, myotonic syndrome with a delay in psychomotor development and the threat of cerebral palsy. The child began classes in the pool from the age of six months. At the beginning of classes, the child did not hold his head, did not turn over from his back to his stomach, there were no attempts to sit down, he reacted negatively to strangers and to collective classes with children of his age.

Classes in the pool were carried out according to the described method. After 2 months, the child became contactable, accessible feedback, enjoyed the lessons, learned to hold his head, mastered the coups from back to stomach, sat with support. He mastered standing and walking in the water with the support of his mother.

At the age of 15 months, the child stands and walks with support, walks up the stairs, can independently lie on the water on his chest and back in arm ruffles, performs commands with his legs and arms, dives with the help of his mother, holding his breath for 3-4 seconds.

Example 2. Katya A., 07.20.04 year of birth. Diagnosis: birth injury of the cervical spine in the form of blocking C ₀ -C ₁ , torticollis on the left, motor impairment syndrome. Engaged in swimming from 2 months of age. At the beginning of classes, she threw back her head, could not stay on the water, drowned on the side of the block, weak grasping reflex on the side of the block (torticollis), weak support.

After a month of psychomotor development, she was age-appropriate. Went to 10 months. Vocabulary from the year amounted to 14 words. At the age of 1 year, the girl independently rests on the water in arm ruffles on her chest, on her back for unlimited time, on a command performs movements with her legs, arms, push from the side, she consciously participates in training games in water. Fulfills a request to get a toy from the bottom.

Example 3. Lisa P., born on 08/14/04. Diagnosis: prematurity. The gestation period is 32 weeks. Body weight at birth 1.8 kg. On breastfeeding. Engaged in swimming from the conceptual age of 42 weeks, the calendar - 10 weeks. Body weight by this age was 4 kg. At the time of the start of classes, she did not hold her head well, diffuse myotonic syndrome persisted. Engaged in swimming according to the described technique. After 2 months of training, muscle tone corresponds to the calendar age, the child holds his head well, turns over from the stomach to the back equally in both directions, holds the toy in his hand, is emotionally active. That is, according to the psychomotor development, the girl corresponds to the calendar age.

Example 4. Anfisa A., 03.25.04 year of birth. Diagnosis: healthy. Engaged in swimming from a month old. The physical and neuropsychic development of the child is ahead of the age norm: she went at the age of 8 months. By year, the vocabulary was 15.

At the age of 1 year, the girl independently rests on the water on her chest, on her back in arm ruffles for unlimited time, on a command performs movements with her legs, arms, push from the side, she consciously participates in training games in the water, without support performs jumping into the water from the stairs with immersion. Fulfills a request to get a toy from the bottom.

Example 5. Arseny M., 05.06.01 year of birth. Diagnosis: healthy. Engaged in swimming from 3 months. At the beginning of classes, psychomotor development corresponded to age.

At the age of 1 year, the child independently swam on his chest, on his back without supporting equipment for 3-5 s, on command he independently performed movements with his legs, arms, push from the side, consciously participated in training games in the water, without support performed diving with side with diving, self-emerged.

By 2 years, the above-mentioned skills were supplemented by a breath hold of up to 8 s, an orientation under water was formed, the child learned to make turns in the water, and after diving, could swim for about 2 meters on his own.

By the age of 3, the child independently swam on his chest, on his back without any time limit, and mastered the movements with legs and arms in the style of “crawl” and “breaststroke”. A five-meter pool floated in free style. A distance of 3 m swam under water. The child's psychomotor development proceeded slightly ahead of the age norm.

The method is used for 2 years on the basis of sports complexes "Vityaz" and "Spring", Novokuznetsk

Claims (1)

The method of hydrokinesitherapy of premature infants and infants with perinatal central nervous system pathology, including classes on land and in water, in stages depending on age, including accustoming to water, performing supports, diving, movements, physical exercises, games in water, characterized in that the classes are carried out in three stages: the first stage for children aged 2 weeks to 3 months in a portable pool, where the child is alone; the second stage for children aged 3 months to 1 year, in a shallow pool where the child is with an adult; the third stage for children aged 1 year to 3 years, in the pool, where the child is with an adult; each lesson consists of three parts: introductory, main and final; the introductory part begins with massage and performs exercises on land and in water, the main and final part of the classes is carried out in water, at the end of the final part they visit a sauna with a temperature of 60 ° C for 3-5 minutes; at the first and second stages of the introductory part after the massage, classes are held on land, during which the child learns the exercises "dry swimming", which he will continue to perform in water, with the pronunciation of the names of the exercises performed for adults: from the starting position on the back, legs straight, adult covers the back and bottom of the ankle joints of the child and with the movement of the legs "crawl", makes alternately raising and lowering the straight legs; when the legs move, the “breaststroke” simultaneously bends both legs at the knees and hips, then spreads the knees to the sides, quickly straightens the legs; when moving the legs, the "bicycle" alternately bends and extends the legs; then the adult, holding the child’s hands, performs circular movements with them, bending, abducting and bringing both hands, smoothly lifts the child by the arms up to the “b” position, slowly lowers the child down, gently lifts the child by the legs up to the “b” position and slowly lowers, maximally spreading the child’s legs to the sides, holds 3-5 s, bends the child’s legs in the knee joints and spreads to the sides, alternately pulls the heels to the bosom; in the position on the right side, holds the child by the left hand and leg and gently stretches the left side, bringing them closer to the support plane, repeats the exercise in the position on the left side; at the third stage, the introductory exercises that do not require adult participation, the child performs independently; at the first and second stage, all exercises in water are performed with support, and at stage 3, children who have learned to swim perform exercises on their own under the control of adults; a set of exercises in the water includes: exercises for the formation of cervical and vestibular tonic reflexes: with the support of the "column" - vertically supporting the child behind the back and back of the head, lower it into the water; with the support of the "pillow" is lowered into the water in the position of the child on his back; with the support of the "string bag", the "bucket" is lowered into the water, first in the supine position, then in the chest position; dipped in water with support for straight arms; warm-up in water is carried out, performing exercises, accompanied by the words of the team or the names of the exercises, exercises to form the support reflex: support "column", the team - "stand"; exercises for the formation of step-by-step automatism: guiding the child forward with crossing legs, the team - "go"; exercises for shaping the tone of axial muscles: a swing exercise with the support of a string bag with the words “back”, “tummy” when the child alternately slides on his back and stomach; exercises to reduce intracranial traction pressure and correction of the spine: "snake" with the support of the "pillow", in which arcuate movements on the surface of the water; “swing” with support for straight arms, “snake” on the back, support “bucket”, “swing” with support for straight arms and “snake” with support for straight arms; the main part of the lesson includes: swimming, diving and playing in water, while swimming includes: exercises to develop the support reflex: an “arrow” on the back, when the child pushes his feet from the end of the pool, he is carried out to the other end of the pool by “shuttle” by bending both legs and their extension with repulsion by the feet; an "arrow" on the chest, when the child performs a push with his feet from the end of the pool, he is led to the other end with the support of the "pillow"; exercises for the development of axial muscle tone: “watch” with the support of the “column”, when the pendulum moves with the lower part of the body in the sagittal and frontal plane, pronouncing “tic-tac”, “stirrer” with the support of the “column” when the lower body is performed circular movements in one direction and the other; exercises for lowering intracranial pressure, correction of the spine and the formation of cross coordination of arms and legs: the figure eight is in the position on the chest, with the support of the string string, and on the swim command, the child is led along the oval in one direction and the other, forming a figure eight, " figure "eight" on the back, with the support of the "bucket" on the command "swim" conduct the child in an oval in one direction and in the other direction, forming a figure eight; exercises to increase resistance to hypoxia: perform diving, hold the breath in the first month of life, for which, after the “dive” command, the adult pours water over the child’s head from the bucket, in the second and third month after the “dive” command, at the time of holding the breath, an adult immerses a child with his head in water and spends it under water; from three months after the command “we dive”, at the moment of immersion and piloting the child under water, for a few seconds they release a child who floats by inertia, then picks up the child, while gradually increasing the time of immersion; exercises for the formation of coordination of movements: perform vertical jumps into the water upside down, at the command "dive" jumps with the head dipping into the water, support the child, at stage 3, vertical jumps from the side perform with support for straight arms: the child stands on the side of the pool, capturing with the toes the edge of the rim, performs a bounce downside down, then repeats with a turn to the left and right; exercises for the development of cervical and vestibular tonic reflexes; from the squat position, the jump downside down, the recession in the water is performed with support for straight arms, when sitting on the side, the child's legs lean against the pool wall, leaning forward and, losing balance, resting the legs on the wall, the child recesses into the water, entering it legs; games in the water to improve motor stereotypes and communication skills include: exhaling into the water, immersing the mouth in it to form bubbles; getting items from the bottom of the pool, capturing and holding small, then medium, then large items in water; turns in water while lying, standing; after each exercise, standing, walking is repeated so that rest is more than half of the entire activity; in the final part they reduce physical and emotional stress, at the end of the lesson the children perform relaxation exercises in the water, perform breathing exercises: in the first and second stages, the adult slowly stretches the child's arms up, the child reflexively takes a breath; the adult slowly crosses the child’s arms on the chest, the child exhale reflexively; the adult slowly pulls the direct contralateral limbs to each other, the child exhales reflexively; the adult slowly extends his arm up and his leg down; the child reflexively takes a breath; the adult slowly pulls the bent contralateral limbs to each other, the child exhales reflexively; the adult slowly extends his arm up and his leg down; the child reflexively takes a breath; the adult slowly spreads the child’s straight arms to the sides, the child reflexively takes a breath; the adult slowly crosses the child’s arms on the chest, the child exhale reflexively; adults perform smooth postings of the child in the position on the chest and on the back in a straight line, in an oval, in a circle in both directions, at the third stage, the children calmly swim.