RU2337618C1 - Method of differentiated estimation of person's posture - Google Patents

Abstract

FIELD: medicine; orthopedy.

SUBSTANCE: faults in posture of the person are examined according to registration of reference marks position fixed on body integuments in points of projection of parts of basic skeleton and muscular groups forming a posture concerning external coordinate-scale reference points in frontal and sagittal planes crossing vertical axis of the body. Thus perform examination in free, habitual for the surveyed person pose, standing or sitting. Thereat the reference marks are executed extensional and fastened on the top part of a skull, edge of a mandible bone, acanthas of 5 and 7 cervical vertebra, acanthas 3, 6, 9 and 12 thoracal vertebra, 3 and 5 lumbar vertebra, heads of both humeral bones, spits of both femurs, knee joints, crests of scapulas, wings of haunch bones and a thoracal bone, malleolar mamelons of fibular bones; and also on prominent parts of cluneal and gastrocnemius muscles. Thus define fault in posture on degree of deviations of reference marks position concerning central vertical axis of a body which are passing through the centre of gravity of a body and through a malleolus at examination in a standing position or through a femur spit at examination in a sitting position, and depending on size of reference marks deviations from vertical axis of a body in comparison with standard sizes for each age and sex group and taking into account correction on subjective shifts concerning coordinate-scale reference points at registration from one point and the subsequent computer processing, make a conclusion about character and degree of faults in posture.

EFFECT: increase of measurement accuracy of size of faults in posture at children.

1 tbl, 3 dwg, 1 ex

Description

The invention relates to medicine and relates to studies of the human body, namely the determination of violations of the normal structure of the bone skeleton, the development of the main muscle groups that determine posture, and the rationale for choosing tactics for the correction of the musculoskeletal system of the body of children and adolescents.

The need for this invention is due to the fact that during mass examinations of students of general educational institutions, it is revealed that only 30-35% of the examined can be attributed to the number of practically healthy children (health group 1); and the group of children with high risk factors for the development of chronic pathology and severe functional impairment (health group 2) includes the majority (65-70%) of the examined children.

A comprehensive monitoring survey of students found that by the beginning of schooling, children often have pronounced signs of physical development failure and up to 30-40% of them do not have a good enough health level, and during school hours the number of students with reduced health indicators rises to 85-90%, while 78-82% of them show various disorders in the formation of the bone supporting skeleton and the most important muscle groups of the body that determine posture. A variety of posture disorders worsen the conditions of activity of internal organs, reduce the level of children's health and the ability to perceive and assimilate the materials of educational disciplines. This is manifested in a decrease in the body's resistance to adverse environmental factors, in the deterioration of performance indicators, morbidity and behavior.

Examinations revealed that posture disorders in children with the onset of puberty develop in connection with pronounced changes and asymmetries in the tone of the muscles forming the posture, which are adversely affecting the state of health. Specialists in adaptive physical education believe that the correction of posture of bone skeleton in students should be carried out not only by stimulating the development of certain muscle groups, but also by optimizing a uniform natural muscle tone.

There are various methods for assessing and correcting postural disorders, consisting in the diagnosis of violations of the statics and dynamics of the musculoskeletal system according to the visual assessment of displacements of the general and partial centers of gravity of the human body, horizontal parallelism disorders, mentally drawn through standard bone landmarks, comparing the distance between attachment points individual muscles, changes in the volume and smoothness of motor acts (Vasilieva L.F. Visual diagnosis of disorders of statics and dynamics of musculoskeletal human apparatus. Ivanovo, 1996. - 112 p.). The described methods for assessing violations of the statics and dynamics of the musculoskeletal system do not allow, with the desired degree of reliability, to provide a qualitative and quantitative assessment of the revealed violations, to determine their causes and optimal correction methods,

There is also a method of differentiated assessment of the condition of the musculoskeletal system according to the patent of the Russian Federation 2165233 (MKI: АВВ 5/00), based on a visual assessment of pathological manifestations according to palpation examination of a person in a supine position and diagnosis of posture by signs of orthostatic synergy and locomotor stabilization synergies. The method of assessing posture according to the patent of the Russian Federation 2165233 allows you to make only a subjective idea of violations of posture and cannot be recommended for mass practical examinations of children and adolescents for moral and ethical reasons.

A known method for assessing the optimality of the physical development of adolescent youth of draft age according to the patent of the Russian Federation 2162295 (MKI: А61В 5/00), which includes determining the absolute indicators of body fat and muscle mass of the recruits and based on determining the state of posture and the optimality of physical development by the magnitude and ratio of absolute parameters fat and absolute muscle mass. The method according to the patent of the Russian Federation 2162295, due to the characteristics of the examination, does not allow a quantitative idea of the nature and severity of posture disorders in the subjects.

A known method of measuring parts of the human body according to the patent of the Russian Federation 2230487 (MKI A61B 5/107), which consists in evaluating the obtained photographs obtained when photographing a part of the body from certain points of view, and in the field of view have a reference object with a reference segment of a known length and a setting device viewing angle in an unchanged spatial relation to the body region (Claims RF Patent 2230487 (MKI A61B 5/107). Method for measuring a body region of a person, characterized in that the supporting object is placed with a supporting with a segment of a predetermined length and a device for adjusting the angle of sight in an unchanged spatial relation to the body region, by means of the device of the angle of sight, a camera oriented in the first direction of sight perpendicular to the reference segment is placed in the first removable position A, in which it captures the body region with the supporting object, and the first picture is taken, by means of the device for adjusting the angle of sight, the camera is oriented in the second direction of sight perpendicular to the reference the cut, in the second removable position D, in which it captures the body region with the supporting object, and take the second picture, from the length of the reference segment of the images of the reference segment in the pictures, set the values of the distances from the shooting positions to the reference object as the first base distance XI and the second base distance X2 and images of this contour line based on a predefined basic model R for each shooting position A, D define the base plane r1, r2, in which the reference segment lies, and which pass the perpendicular Vividly to the direction of the camera’s sight, from the base distance XI, X2 and the image of the contour line K1, K2 for each shooting position A, D, we get the projection a1, a2 of the contour line that corresponds to the projection of the contour line onto the base plane, and from the projection a1, a2 of the contour lines , the base distances XI, X2 and the base model R create an individual model M of the body area. The differences according to claim 1: ... put on a coating that increases contrast; according to claim 1 and 2: ... establish the length of the individual model; according to claim 3: ... one of the points is the end of the body; according to claim 1-5: ... the supporting object is fixed on the body area, preferably by gluing).

The disadvantages of the method of measuring parts of the human body according to the patent of the Russian Federation 2230487 are that it is applicable for examination for violations of the normal structure of only certain parts of the body (for example, after amputation of an extremity when preparing a stump for prosthetics), significant difficulties in practical application, laboriousness, the need for the acquisition of sophisticated equipment and specially trained personnel and therefore it is not applicable for mass screening of students.

Known methods for assessing posture in children according to visual data are characterized by low accuracy, subjectivity of the data obtained, the complexity and significant complexity of the necessary calculations, which creates almost insurmountable difficulties in their implementation in secondary schools. A significant drawback of the methods of visual assessment of posture is that they do not take into account the importance in the formation and maintenance of normal posture of the muscular system of the body and the mechanisms of controlling the motor act (Anokhin P.K. Essays on the physiology of functional systems. M .: Medicine, 1975, - 448 p. .).

Thus, according to the analysis of known methods for determining posture, we can state the following:

1) There is a pronounced tendency to worsen the health status of students, including in terms of posture and development of the musculoskeletal system.

2) Known methodological methods for the qualitative and quantitative determination of the nature of posture disorders and the root causes of their development are not sufficiently developed and therefore do not allow solving a number of problems in protecting human health.

3) The methods used in educational institutions for the prevention and correction of posture disorders are methodologically insufficiently developed and therefore differ in low efficiency.

As a prototype, a method for determining the biological age by indicators of the state of posture and maturation of the bone skeleton according to the patent of the Russian Federation 2188573 (MKI: АВВ 5/00) is used. The method for determining the biological age of children and adolescents by determining the maturation of the bone skeleton is different in that the skeleton asymmetry is determined using computer surveyor according to the formulas:

- in boys:

BV = 5.509 + 0.139 * SHL + 0.017 * PL + 0.057 * IP-0.134 * PP-0.179 * PT-0.173 * RP-0.092 * PT;

- in girls:

BV = 7.148 + 0.071 * SHL + 0.071 * PL + 0.077 * IP-0.128 * PP-0.242 * PT-0.042 * RP-0.419 * RT;

where BV - biological age, srvc. years, HL - cervical lordosis, mm,

PL - lumbar lordosis, mm, PI - curvature of the spine, mm,

PP - a distortion of the shoulders, degrees, PT - a distortion of the pelvis, degrees,

RP - rotation of the shoulders, degrees, RT - rotation of the pelvis, degrees.

The obtained data on individual biological age are compared not with the chronological age (CV) of a given child, but with due BV, which characterizes the population development standard according to the formula:

DBV (boys) = 8.25 + 0.24 * XB; DBV (girls) = 9.07 + 0.17 * XB, conv. of the year.

The value of BV - DBV characterizes how the subject is different from the standard,

The value of BV / DBV characterizes how many times BV more or less than the standard.

The known method for the diagnosis of posture disorders in terms of the development of the bone skeleton using a computer topograph according to the patent of the Russian Federation 2188573 has certain disadvantages that make it impossible to use it in the practice of secondary schools, in particular:

- according to the integral indicator of biological age, it is impossible to draw up a quantitative and qualitative conclusion on the nature and degree of postural disorders;

- it is impossible to assess the nature of development of the most important muscle groups that determine the state of posture with the desired reliability;

- it is impossible to give a scientific justification for the most effective methods of correcting detected violations using adequate physical exercises for children and adolescents with impaired posture.

To eliminate the above disadvantages and improve methods for diagnosing postural disorders and developing recommendations for the correction of unwanted shifts, it is proposed:

1) to develop a methodology for compiling reliable qualitative and quantitative characteristics of postural disorders taking into account the condition of the bone supporting skeleton and the level of development involved in the formation of posture of the most important muscle groups,

2) determine the root causes of postural disorders and poor development of the most important muscle groups that form the posture,

3) to develop principles for choosing effective methods for correcting posture disorders using specially selected complexes of physical exercises.

The proposed method for determining posture is based on modern scientific ideas about the relationships and interconnections of all the most important parts of the human body and their role in ensuring health (V.I. Dubrovsky, V.N. Fedorova. Biomechanics. M .: VLADOS. - 2003. - 672 p. .).

In accordance with modern scientific views, to obtain reliable qualitative and quantitative characteristics of postural disorders, it is proposed:

1) to study the state of posture and the level of muscle tone of the muscle groups forming the posture by the location indicators of reference points on the skin of a person in a calmly relaxed state (without increased tension of the muscles of the body and lower extremities,

2) to study the state of posture in humans by the position of reference marks on the skin according to measurements in two mutually perpendicular planes: sagittal and frontal, intersecting the vertical axis of the body passing through the center of gravity of the person’s body (Reference: the center of gravity of men’s body is 15 mm 5 lumbar vertebrae behind the antero-lower edge of the body, in women - 55 mm in front of the antero-lower edge of the 1 sacral vertebra);

3) for a reliable judgment on the nature of posture by the state of the skeleton and the muscle groups that form the posture, it is necessary to take into account the peculiarities of the constitutional structure of the examined people. So, it is known that in children, adolescents and adults, normosthenic, asthenic and hypersthenic physique posture varies significantly, and to identify violations it is necessary to focus on different criteria;

4) the determination of posture disorders in subjects with the desired degree of reliability is possible by the position of reference marks protruding above the skin that are fixed on the skin and correspond to important points of the bone skeleton and are involved in the formation of posture of muscle groups. The following points of the projection of the skeleton bones can be attributed to the locations of the reference marks protruding above the skin: 2 - on the ankles of the fibula (left and right), 2 - on the trochanter of the femur, 2 - on the heads of the humerus, 2 - on the corners of the lower jaw, 1 - on the crown of the head, 1 - on the sternum, 7-10 on the projection of the spinous processes of the cervical, thoracic and lumbar vertebrae (on every second or third), 2 - on the shoulder blades, 2 - on the wings of the pelvic bones, on the large pectoral and gluteal muscles . The tags are made voluminous so that when they are placed at the projection sites of the spinous processes of the thoracic and lumbar vertebrae in the dorsal hollow between the muscles, they are visible when photographing both in profile and from the back;

5) according to the degree of deviation of reference marks from the standard values established for the subjects of each age-gender and constitutional group, a conclusion on the type, degree and most important causes of posture disturbances in the examinee can be drawn up within certain acceptable limits and determine the optimal technologies for normalizing the revealed deviations;

6) the conditional vertical axis passing through the center of gravity of the body is taken as a reference value for determining calculations. For the convenience of calculation, it is conventionally believed that in a person standing in a free pose, the vertical axis of the body passes through the middle of the ankle joint, in a person sitting in a free pose, it passes through the spit of the femur.

The proposed method for the differential diagnosis of posture disorders and the selection of optimal correction tactics, which consists in determining the positions of the parts of the bone skeleton and muscle groups relative to external coordinates, is characterized by the condition of the examined person being in his usual position (with a normal tone of muscles forming posture) standing and sitting, postural disorders are determined by the degree of deviation of reference marks in the sagittal (in profile) or frontal planes (view from the back) from vertically the axis of the body passing through the center of gravity of the body, and the reference marks are three-dimensional and attach them (glued) to the skin of the body in places corresponding to the most important points of the bone skeleton characterizing the posture, in particular on the upper part of the skull, the angle of the lower jaw bone, spinous processes 5 and 7 cervical vertebrae, spinous processes of 3, 6, 9 and 12 thoracic vertebrae, 3 and 5 lumbar vertebrae, heads of both humerus bones, trochanters of both femurs, knee joints, scapular crests, wings of the pelvic bones and sternum, lod zhechnyh ledges fibula; as well as on the protruding parts of the gluteal and calf muscles; moreover, the judgment on the nature and severity of posture disorders is based on the degree of deviation of reference marks on the human body from physiological bends recognized as normative for each age and gender group of the subjects: when exceeding the standards for deviations in the sagittal plane in the thoracic spine, posture is considered kyphotic or flat, with deviations in the lumbar spine is considered lordotic posture, with deviations in the sagittal plane consider the subject suffering from scoliosis; according to the degree of violation of parallelism of horizontal lines (for example, one shoulder or wing of the pelvic bone is located above the other) and the volume of the muscle groups forming the posture (the long muscles of the back and gluteus muscles), they conclude that the corresponding muscles are poorly developed or the muscle tone is unbalanced; The state of posture is evaluated according to the photo-recording data (using a digital camera) of the position of the reference marks on the human body when photographing in profile and from the back, taking into account the corrections for the visually perceived shift in the position of the reference points when photographing from one point. Subsequent computer processing of photographs of the examined person with a fixed position of reference marks when the person is in profile and in the face (view from the back), an analysis of the state of posture is carried out: the type and degree of detected violations are ascertained.

The layout of reference marks on the skin of the human body is shown in Fig.3.

To implement the proposed method, the Osankomer device, a camera with the ability to digitally record images, a personal computer, and a specialized computer analytical program are used.

The proposed method for diagnosing posture disorders is recommended to be carried out in a specially equipped room, for example, in the school’s medical office or in the office of a medical medical institution equipped with the Osankomer device, height meter, scales and a personal computer, in the following order:

1) on the skin of the body of the person being examined (for example, a child) in the form for sports at a predetermined point, attach (stick) reference volumetric marks coated with a reflective film; moreover, the marks are placed so that the most important of them are visible when photographing both in profile and from the back;

2) in a child, the height (in cm) is measured using a height meter and, using weights, body weight (in kg). Individual and standardized indicators of anatomical and physiological development for each age and gender group of students should be recorded in the computer's memory. The computer’s analytical program contains data on the name, date of birth of the child and the date of the examination, growth indicators (cm) and body weight (kg), these data are necessary to determine the constitutional features of the body of the subject and introduce the necessary correction factors for determining posture disorders;

3) the examined person (child) is installed in a free pose, habitual for him, standing or sitting without excessive muscle tension in the Osankomer device, which has coordinate-scale rails;

4) using a camera with digital registration of photographs of the examined person (child), photograph in profile and from the back from a distance of 2-3 meters so that reference marks on the child’s body and coordinate-scale slats are visible. Posture examination technology with computer data analysis allows posture photo-registration quickly enough for a significant team;

5) the obtained photographs are entered into the memory of a personal computer and subjected to analysis, during which the images of children are set strictly vertically in accordance with the provisions of coordinate-scale landmarks;

6) to use a specialized computer program for analyzing photographs of the usual posture of the examined students, the central vertical axis of the body is determined (when analyzing in profile and in the face from the back), “tied” (sent to the computer memory of the specialized program) using a computer “mouse” marks on the skin of the examined child and calculates the degree of deviation of the position of the reference marks of the skeleton and the most important muscle groups relative to the central vertical axis of the body;

7) when comparing deviations of the position of reference marks on the body of the examined child from the vertical axis of the body with the standard values for each age and gender group stored in a computer database, determine the nature and severity of posture disorders, the most important causes of the revealed violations and the tactics of corrective action. Approximate standard values of posture indicators in boys of 12 years of age are presented in the table;

8) when the reference points deviate from normative positions, assessed both when the subject is standing and sitting, and when taking pictures in profile and face, conclusions are drawn regarding the nature, severity and main causes of posture disturbances, as well as about the preferred tactics of corrective action;

9) when computer analysis determines the degree of deviation of reference marks from the vertical axis of the body in the sagittal and frontal planes: while analyzing the severity of deviations in the sagittal plane with predominant changes (exceeding physiological norms) in the cervical and upper thoracic spine conclude pronounced stoop ; with deviations mainly in the thoracic region, they conclude that the subject has kyphosis; with deviations in the lumbar region - the presence of lordosis; when analyzing photo-registration data in the frontal plane and detecting deviations exceeding the physiological norm, they conclude that the subject has scoliosis;

10) in a computer analysis of posture photo-registration data, one can also draw a conclusion about the poor development of the muscle groups forming the posture or about the imbalance of the muscle tone of the right and left half of the body;

11) according to the number and severity of assessed indicators identified during the examination of children and adolescents, there are 3 groups of disorders and 3 severity levels:

Group 1 - with kyphosis: norm, initial, middle and strong degree;

2 group - with lordosis: norm, initial, middle and strong degree;

3 group - with scoliosis: norm, initial, middle and strong degree;

12) after determining the nature, severity and causes of posture disturbances in the person being examined (for example, normal posture, stoop, sunken chest, displacement of the pelvic part of the skeleton forward or backward due to violations of muscle tone, etc.) according to the degree of deviation of the reference position labels from standardized age-gender standard values come to the conclusion about the advisability of correcting posture by means of physical education;

13) according to the results of the diagnostic examination, a computer analytical program in an automated mode issues recommendations to physical education teachers and sports trainers on the type of exercises for correcting detected violations.

Table
Approximate standard values for assessing the state of posture in boys of 12 years of age by the position of reference points on the skin Marking points - indicators of the state of posture in the skeleton and the development of muscle groups Norm * incline. from vertik. axis, in% of growth Sagittal plane ** Frontal plane Degree of Postural Disorders Degree of Postural Disorders one 2 3 one 2 3 When examining while standing Top of the head + 1- + 2 + 2- + 3 + 3- + 4 > +5 + 2- + 3 + 3- + 4 > +5 Nape -6-8 -4-6 -2-4 <-2 -4-6 -2-4 <-2 Jaw angle 0 + 2 + 2 + 3 + 3 + 4 > +4 + 2 + 3 + 3 + 4 > +4 4 cervical vertebra -2-3 -1-2 0-2 > 0 -1-2 0-2 > 0 7 cervical vertebra -3-4 -2-3 -1-0 > 0 -2-3 -1-0 > 0 3 thoracic vertebra -3-4 -2-3 -1-0 > +3 -2-3 -1-0 > +3 6 thoracic vertebra -3-4 -2-3 -1-0 > +2 -2-3 -1-0 > +2 9 thoracic vertebra -3-4 -2-3 -1-0 > +2 -2-3 -1-0 > +2 12 thoracic vertebra -2-3 -1-2 0-2 > +2 -1-2 0-2 > +2 3 lumbar vertebra -2-3 -1-2 0-2 > +2 -1-2 0-2 > +2 5 lumbar vertebra -2-3 -1-2 0-2 > +2 -1-2 0-2 > +2 Humeral head 0 + 1 + 1 + 2 + 2 + 3 > +3 + 1 + 2 + 2 + 3 > +3 Sternum + 2 + 3 + 3 + 4 + 4 + 5 > +5 + 3 + 4 + 4 + 5 > +5 Shoulder blade -8-10 -6-8 -4-6 > -4 -6-8 -4-6 > -4 Skewer of the femur 0-2 -1 + 1 -1 + 2 <-1 -1 + 1 -1 + 2 <-1 Knee-joint 0-2 0 + 1 + 1 + 2 > +2 0 + 1 + 1 + 2 > +2 The ankle of the fibula. bones 0-2 0 + 1 + 1 + 2 > +2 0 + 1 + 1 + 2 > +2 Gluteal muscles -3-6 -2-3 -2-1 <-1 -2-3 -2-1 <-1 Calf muscles -3-5 -2-3 -3-4 <-4 -2-3 -3-4 <-4 Skew of the pelvis, degrees 0-1 2-5 6-8 > 9 2-5 6-8 > 9 Warp shoulders, degrees 0-1 2-5 6-8 > 9 2-5 6-8 > 9 Mark position Norm When examining while sitting Top of the head + 1- + 2 + 2- + 3 + 3- + 4 > +5 + 2- + 3 + 3- + 4 > +5 Nape -6-8 -4-6 -2-4 <-2 -4-6 -2-4 <-2 Jaw angle 0 + 2 + 2 + 3 + 3 + 4 > +4 + 2 + 3 + 3 + 4 > +4 4 cervical vertebra -2-3 -1-2 0-2 > 0 -1-2 0-2 > 0 7 cervical vertebra -3-4 -2-3 -1-0 > 0 -2-3 -1-0 > 0 3 thoracic vertebra -3-4 -2-3 -1-0 > +3 -2-3 -1-0 > +3 6 thoracic vertebra -3-4 -2-3 -1-0 > +2 -2-3 -1-0 > +2 9 thoracic vertebra -3-4 -2-3 -1-0 > +2 -2-3 -1-0 > +2 12 thoracic vertebra -2-3 -1-2 0-2 > +2 -1-2 0-2 > +2 3 lumbar vertebra -2-3 -1-2 0-2 > +2 -1-2 0-2 > +2 5 lumbar vertebra -2-3 -1-2 0-2 > +2 -1-2 0-2 > +2 Humeral head 0 + 1 + 1 + 2 + 2 + 3 > +3 + 1 + 2 + 2 + 3 > +3 Sternum + 2 + 3 + 3 + 4 + 4 + 5 > +5 + 3 + 4 + 4 + 5 > +5 Shoulder blade -8-10 -6-8 -4-6 > -4 -6-8 -4-6 > -4 Skewer of the femur 0-2 -1 + 1 -1 + 2 <-1 -1 + 1 -1 + 2 <-1 Skew of the pelvis, degrees 0-1 2-5 6-8 > 9 2-5 6-8 > 9 Warp shoulders, degrees 0-1 2-5 6-8 > 9 2-5 6-8 > 9 Notes:
^* - when analyzing photographs in the sagittal plane (in profile), corrections are introduced for the position of the point of view relative to the coordinate network,
^** - the data according to the norm are determined taking into account the error in measuring the position of the marks relative to the coordinate network,
^*** - deviations from the vertical axis of the body in the sagittal plane back are indicated by negative (-) values, forward deviations by positive (+) values; deviations from the vertical axis of the body in the frontal plane to the right are indicated by positive (+) values, deviations to the left by negative (-) values.

An example of a conclusion based on the results of an examination of the state of posture and the muscle groups of the body forming the posture is given below.

Student: Andrei Peninsula, grade 4 “A”.

Birth Date Oct. 17, 1996

Date of examination March 18, 2007

Calendar age 11.345 days.

Anthropometry data: height 125 cm. Body weight 43.5 kg. Ketle Index

Posture Diagnosis Lordosis of the cervical spine 2 degrees. Kyphosis of the thoracic spine - 1 degree. Right-sided scoliosis of the thoracic spine of the 1st degree Likely Cause of Postural Disorders Violations of the formation of the bone skeleton due to improper landing at the school desk. Weak development with signs of asymmetry in the tone of the muscle groups of the left half of the body Recommendations for teachers Transplant at the training table corresponding to the anatomical size of the body and recommend that you independently monitor the maintenance of proper posture Recommendations to the teacher of FC Reduce the number of strength exercises and the overall load on physical education lessons. Introduce enhanced exercises for the development of muscles in the right half of the body

The effectiveness of the proposed method was tested in the course of scientific research with the participation of pedagogical collectives and students of secondary schools in Moscow and Moscow Region, students of Moscow City Pedagogical University and Moscow Regional Pedagogical University.

The theoretical justification for the selection of corrective physical exercises are the physiological laws of the formation of the posture of children and adolescents. The complex of general developmental exercises includes exercises for large muscle groups that counteract the bending of the skeleton. The main task should be striving to achieve the effect of optimizing the general tone of muscle groups, ensuring the formation of proper posture.

The proposed method allows to increase the accuracy of measuring the value of posture deformities in children, providing an opportunity to assess the state of posture and flexibility of the spine and muscle groups forming the posture in 1.5-2.0 minutes.

The novelty and advantages of the proposed method and device for differentiated evaluation are as follows:

1) the possibility of a comprehensive quantitative assessment of violations of not only the bone skeleton, but also ensuring the formation of posture of muscle groups;

2) the assessment is carried out according to the determination of the position of reference marks relative to the vertical axis of the body passing through the center of gravity of the body in the sagittal and frontal planes;

3) the severity of the assessment is carried out according to the degree of deviation of the position of reference marks from the normative and criterion positions, taking into account the constitutional features of the body of each individual person being examined;

4) violations of the provisions of the pelvis and shoulder girdle are determined by the magnitude of the degrees of inclination;

5) with bends of the spine in the frontal plane exceeding the limits of physiological norms, depending on the severity of localization and the degree of deviation, a conclusion is made about one degree or another of impaired posture and its primary localization: kyphosis or lordosis;

6) with bends of the spine in the sagittal plane passing through the vertical axis of the body, exceeding the limits of the physiological norm, depending on the degree of deviation, a conclusion is made about this or that degree of scoliosis;

7) according to the results of a posture examination with a qualitative and quantitative assessment of the revealed violations, the specialist makes a conclusion about the weak development or asymmetry of muscle tone of one or another half of the body and selects the most effective corrective physical exercises to correct the revealed posture disorders.

The proposed method and device can be used in the work of school doctors and physical education teachers to assess the state of posture of students, as well as in children's medical institutions to determine the nature of disorders of the supporting skeleton and justify the choice of wellness correction programs.

Figure 1 shows the posture of a person in the ready position for anthropometric examination 1, calmly relaxed state 2 and tension when standing at the command "quietly" 3.

Figure 2 shows the voltage diagrams of the main functional muscle groups at various standing positions of the body: 1 - anthropometric position, 2 - calmly relaxed position, 3 - stressed position (muscle groups are selected that provide their voltage to maintain the established position at the time of examination).

From the diagrams shown in FIGS. 1 and 2, significant differences in posture are seen when examining a person who is in a state of readiness for anthropometric measurement (position 1), in a calmly relaxed state (position 2) and in a stressed state (position 3). From the above diagram it is clear that in order to get a reliable idea of posture, the examination must be carried out in the usual calmly relaxed position.

Literature

1. Anokhin P.K. Essays on the physiology of functional systems. M .: Medicine, 1975, - 448 p.

2. Vasiliev S.V. Fundamentals of age and constitutional anthropology. M.: ROW, 1996 .-- p. 160.

3. Vasilieva L.F. Visual diagnosis of violations of the statics and dynamics of the musculoskeletal system of a person. Ivanovo, 1996 .-- 112 p.

4. Zaitseva V.V. An individual approach to physical education and its implementation on the basis of computer technology: a textbook for students, undergraduates and graduate students of the RSAFK. M .: RIO RGAFK, 1998 .-- 84 p.

5. Kuchma V.R. Assessment of the physical development of children and adolescents in hygienic diagnostics of the “Public Health - Environment” system. M., 2003 .-- 316 p.

6. Panasyuk T.V., Isaac S.I., Komissarova E.N. Anthropological monitoring of preschoolers. M .: Physical culture. 2005.

7. RF patent 2165233. A method for the differential assessment of the clinical pathology of the musculoskeletal system (MKI A61B 5/00).

8. RF patent 2162295. A method for assessing the optimal physical development of adolescent youth of military age (MKI A61B 5/00).

9. RF patent 2230487. A method for measuring a region of a human body (MKI A61B 5/107).

10. RF patent 2188573. A method for determining posture and biological age in terms of bone skeleton maturation (MKI A61B 5/00).

Claims (1)

The method of differentiated assessment of human posture disturbance according to the registration data of the position of the parts of the supporting skeleton fixed on the skin integument and the reference mark muscle groups forming the posture relative to external coordinate-scale landmarks in the frontal and sagittal planes intersecting the vertical axis of the body, characterized in that the examination carried out in a free, familiar to the examined position, standing or sitting, and reference marks are voluminous and fasten them on the top of the skull, angle of the lower jaw bone, spinous processes of the 5th and 7th cervical vertebrae, spinous processes of the 3rd, 6th, 9th and 12th thoracic vertebrae, 3th and 5th lumbar vertebrae, heads of both humerus bones, trochanters of both femurs, knee joints, scapular crests, wings of the pelvic bones and chest bone, ankle protrusions of the fibula, as well as on the protruding parts of the gluteal and calf muscles, and posture disorders are determined by the degree of deviation of the position of reference marks relative to the central vertical axis of the body passing through the center of gravity of a and through the ankle during examination in a standing position or through a trochanter of the femur during examination in a sitting position, depending on the magnitude of deviations of reference marks from the vertical axis of the body in comparison with standard values for each age and gender group and subject to adjustments for subjective biases relative to the coordinate-scale landmarks when shooting from a single point and subsequent computer processing, they conclude about the nature and degree of posture disturbances.

Images