RU2800254C1 - Method of rehabilitation of patients with diseases of the joints of the lower extremities - Google Patents

Abstract

FIELD: medicine, therapeutic physical culture (TPC).

SUBSTANCE: invention can be used for the rehabilitation of patients with diseases of the joints of the lower extremities. Physical exercises are performed in the form of classes carried out for 8 weeks 3 times a week for 60 minutes. Physical exercises are also performed daily 1 hour before bedtime for 10 minutes. Classes are held 3 times a week on weekdays every other day. Each class is carried out in a group under the guidance of a TPC instructor and includes five consecutive complexes: exercises to relieve tension from the deep muscles of the spine, exercises for the ankle joint, exercises for the knee joint, exercises for the hip joint, and exercises for stretching the spine. Daily exercise 1 hour before bedtime is carried out independently, in which a set of exercises is performed to relieve tension from the deep muscles of the spine.

EFFECT: method provides expanding the possibilities of rehabilitation of patients with diseases of the joints of the lower extremities with a pronounced and persistent clinical effect, strengthening and restoring the muscles of the spine, joints of the lower extremities, and normalizing blood circulation due to the implementation of the claimed sets of exercises.

1 cl, 1 tbl, 12 ex

Description

The invention relates to medicine, namely to the field of therapeutic physical culture (exercise therapy) and can be used for the rehabilitation of patients with diseases of the lower limb joints.

One of the most common diseases with a steady upward trend is degenerative-dystrophic damage to the joints of the lower extremities - arthrosis, which accounts for about 70% of rheumatological diseases. Most of all, deforming arthrosis affects people aged 40-60 years, regardless of gender (women and men get sick the same way), the percentage of cases is 10-15%. The reasons for the appearance may be age-related factors due to the constant self-renewal of cartilage tissue. At a young age, the rate of death of obsolete articular cells is equal to the rate of birth of new cells. Over the years, the process of cell renewal slows down, and the cartilage tissue begins to thin out, and the production of synovial fluid decreases. As a result, the articular cartilage begins to thin and break down, leading to degeneration and destruction of the joint. In addition, there are other causes of this disease:

- increased physical activity (overweight, increased load with “unheated” joints in athletes);

- joint injuries;

- congenital or acquired deformities of the musculoskeletal system (rickets, kyphosis, scoliosis, improper bone fusion after injuries with the appearance of limb deformity: O-shaped and X-shaped deformity of the legs).

Thus, the risk of occurrence and development of the disease among the population is quite high. Statistics state that after 10-11 years from the onset of the disease with deforming arthrosis, almost 100% of cases lead to disability, where the main method of treating patients will be the operation of arthroplasty.

More than 450,000 such operations are performed annually in the world, according to statistics from developed countries, there is 1 arthroplasty per 1,000 people, which does not always go without complications.

The development of the degenerative-dystrophic process leads to significant disturbances in statics and locomotion, the severity of which depends on the duration and severity of the disease. The defeat of one joint involves other parts of the musculoskeletal system in this process, limiting the fulfillment of the requirements of everyday life by 36%, professional activities - by 67%, social functions - by 25%

Therefore, the development of a method for the rehabilitation of patients with diseases of the joints of the lower extremities at the initial stages of the disease is so relevant.

The human body is a complete interconnected system. If the work of at least one organ is disrupted, a reflex effect occurs on other organs and systems. The functional features in the work of the diseased organ are compensated by other human organs, they begin to work with a load at the limit of their capabilities, being involved in the degenerative-dystrophic process, if we are talking, among other things, about the joints of the lower extremities.

When diagnosing arthrosis of one of the joints of the lower extremities (hip, knee, ankle), one should take into account the root cause - various chronic diseases of the spine (with the exception of injuries). Therefore, in the preparation of complexes, it is necessary to use exercises both on the spine and on all joints of the lower extremities, in order to avoid the involvement of “healthy” joints in the disease process. The maximum possible recovery of the diseased joint occurs by improving the tone, that is, the nutrition of the joints and periarticular tissues. The nutrition of any joint will depend not only on the coordinated work of all the muscles and ligaments responsible for the movement in this joint, but also on the muscles and ligaments of the “neighboring” joints that provide full-fledged movement. Only if this relationship is present, their pumping function (contraction - relaxation) is performed, and tissues (bone, cartilage) and joints receive a sufficient amount of minerals for their existence, which affects its mechanical strength [Knees hurt. S. Bubnovsky. M., Eksmo, 2010. 187 p., The truth about the hip joint. S. Bubnovsky. M., Eksmo, 2011. 187 p.].

The following are the methods closest to the claimed invention for the treatment of deforming arthrosis of the hip joint with therapeutic exercises, and this pathology is given the greatest attention (49.3% of cases of arthrosis occur in this particular joint).

A known method of inertial gymnastics for the hip joint (method of Nikolai Mikhailov) [patent RU No. 2186556, IPC A61H 1/100, 2002, publ. 10.08.2002 Bull. No. 22] which is based on active physical exercises, which are carried out due to moderately sharp, high-quality jerky movements of the trunk, pelvis, hips to the possible limits of mobility of the hip joints and the sensation of moderate pain in them. The disadvantage of this method is that jerks and sudden movements of body parts occur in the area of the anatomical barrier, and this is an extreme degree of tissue tension, which can be traumatic. In addition, the patient's expectation of "moderate" pain can be quite uncomfortable.

A known method of unloading the hip joint [patent RU No. 2358676, IPC A61B 17/56, A61H 1/00, publ. 06/20/2009 Bull. No. 17], which is carried out through exercises aimed at strengthening the muscles of the hip joint of the rehabilitated limb. The disadvantage of this method is the narrowly localized focus of physical exercises only on the rehabilitated limb.

A known method [patent RU No. 2286124, IPC A61N 1/00, publ. 27.10.2006 Bull. No. 30] which is based on a differentiated appointment of therapeutic exercises, which is carried out using a questionnaire-scale that determines the degree of pain of the patient in the hip joint and performing therapeutic exercises on it. The disadvantage of this method is the lack of restorative range of motion, it is intended to a greater extent to relieve pain, and not for the prevention and treatment of the hip joint.

A known method [patent RU No. 2186556, IPC A61N 1/00, publ. 10.08.2002 Bull. No. 22] based on moderately sharp movements of the torso, pelvis, hips, leg swings.

There is also a method [patent RU No. 2234301 IPC A61N 1/00, publ. 20.08.2004 Bull. No. 23], which is based on stretching the spine, stretching the muscles of the legs, by tensing the muscles of the thigh, when performing rotational movements in the hip joint.

All of the above methods include rehabilitation measures aimed at treating only the hip joint, not taking into account the relationship with the joints that compensate for the problems of the diseased joint, but all of them determine the need to include the muscles and ligaments of the spine in the process of recovery.

Known methods of treatment of arthrosis of the knee joint, this pathology accounts for 27.2% of cases of arthrosis.

A known method of physical rehabilitation of patients with comorbid pathology, combining cardiovascular disease with arthrosis [patent RU No. 2684240, IPC A61H 3/00, publ. 04/04/2019 Bull. No. 10], is based on physical activity with a sparing regimen for the knee joints: walking backwards. Walking backwards is associated with less stress on the joints of the lower extremities due to the lack of contact of the heel with the ground at the beginning of the stance phase, it also acts as one of the few natural ways to strengthen the quadriceps femoris muscle, which provides knee extension, which is significant for patients with arthrosis of the knee joints [Rehabilitation medicine. Epifanov V.A. Directory. M.; GEOTAR - Media, 2007 - 592 p.]. The method ensures the preservation of the training potential of walking while reducing the load on the knee joints. The disadvantage of this method is the absence of the effect of increasing the range of motion in the knee joint, but the muscles of both lower extremities are actively strengthened. In addition, walking implies a certain time of going to work from home, which is not always convenient for working patients, as well as non-standard walking can attract increased attention from others, which is also not very comfortable for patients.

A known method of rehabilitation for total knee arthroplasty in the pre- and postoperative periods [patent RU No. 2538133, IPC A61H 1/00, A63B 21/00, publ. 01/10/2015 Bull. No. 1], which is based on the use of special medical and rehabilitation simulators, but with the obligatory inclusion in the work of the ankle joint for proper nutrition of the joints and uninterrupted metabolism. The disadvantage of this method is the inaccessibility of use both financially and physically (lack of specially equipped rooms).

Unlike the hip and knee joints, the ankle joint is the least susceptible to degeneration, its disease occurs in 5% of cases of arthrosis, and disability occurs 7 times less than with arthrosis of the hip joint. However, arthrosis of the ankle joint may be one of the causes of premature disability.

A known method of oscillatory training for the ankle joint [patent RU No. 2282428, IPC A61H 1/00, publ. 27.08.2006 Bull. No. 24], in which all movements are performed with moderately sharp, rocking-shaking movements of the lower leg and foot to the possible limits of mobility in the ankle joints and the sensation of moderate pain in them. The disadvantage of the method is that the described percussion movements reach a hard stop until moderate pain is felt, which corresponds to the anatomical barrier in the joint and can in some cases lead to injury, and the expectation of “moderate pain” can adversely affect the quality of the exercise. In addition, the implementation of complexes 3-4 times a day is not always possible for working patients.

A known method of complex treatment of the joints of the lower extremities [patent RU 2281746, IPC A61H 1/00, A61H 7/00, publ. 20.08.2006 Bull. No. 23], which is based on performing a certain set of steps in weighted shoes, the weight of which is from 10 to 20 kg, which will undoubtedly strengthen the muscles of the lower extremities, but will not give the necessary load to the ligaments and joints separately, limiting itself only to sprain in the joint due to additional weight. Also, the disadvantage of this method will be a limited contingent of those involved. For patients with spinal problems, walking with such weights is contraindicated, in addition, additional equipment is required.

All the above inventions, patented as methods of physical rehabilitation of patients with diseases of certain joints of the lower extremities, are intended for patients with one of the pathologies of arthrosis: hip, knee, ankle joints. Therefore, there is no comprehensive approach that provides not only treatment, but also the prevention of diseases of "neighboring" joints. Also, when selecting exercises, the need to use all anatomically possible movements characteristic of each joint is not taken into account.

The hip joint is characterized by: flexion-extension, abduction-adduction, outward-inward turns, circular movements. The knee joint is characterized by: flexion-extension, circular movements. The ankle joint is characterized by: flexion-extension, abduction-adduction, supination-pronation, circular movements. All these features of each joint must be taken into account when compiling a set of exercises for the rehabilitation of patients with diseases of the joints of the lower extremities.

Even healthy joints in everyday life do not always perform the movements that are available to them, which means that the diseased joint is obviously limited in movement, which is associated with malnutrition of the joint in the initial stages of the disease and the further development of pathological restructuring of its structures with a decrease in the joint space, proliferation of osteophytes and thinning of the articular cartilage. It should also be borne in mind that most often joint problems begin with a disease of the spine. Therefore, exercises to restore the function of the spine should be an integral part of the rehabilitation of the joints of the lower extremities.

Thus, the claimed invention has no close analogues, and is a single program of physical rehabilitation of patients with diseases of the joints of the lower extremities, consisting of sets of exercises covering problem areas: the spine, joints of the lower extremities, taking into account their anatomically possible movements.

The task to which the claimed invention is directed is to create a set of exercises aimed at ensuring the prevention and treatment of the joints of the lower extremities of patients in the initial stages of the disease.

The technical result of the invention is to expand the possibilities of rehabilitation of patients with diseases of the joints of the lower extremities with a pronounced and persistent clinical effect, which also provides strengthening and restoration of the muscles of the spine, joints of the lower extremities, regardless of the location of the disease, normalization of blood circulation due to the adaptive development of the circulatory system, neuromotor innervation.

The technical result is achieved due to the fact that in the method of rehabilitation of patients with diseases of the joints of the lower extremities, physical exercises are performed in the form of classes conducted for 8 weeks 3 times a week for 60 minutes, and daily 1 hour before bedtime for 10 minutes, while 3 times a week, classes are carried out on weekdays every other day, and each lesson is carried out in a group under the guidance of an exercise therapy instructor and includes the implementation of 5 consecutive complexes performed in different initial positions, while the first is a set of exercises to relieve tension from the deep muscles of the spine, the second is a set of exercises for the ankle joint, the third is a set of exercises for the knee joint, the fourth is a set of exercises for the hip joint, and the fifth, which is a set of exercises for stretching the spine, and a daily exercise 1 hour before bedtime is carried out independently, in which a set of exercises is performed to relieve tension from the deep muscles of the spine.

Degenerative-dystrophic damage to the joints is predetermined by a disease of the spine, and first of all, muscle spasm. Therefore, in the method of rehabilitation of patients with diseases of the joints of the lower extremities, it is necessary to initially relieve tension from the muscles of the back, and only then begin to develop and strengthen the joints, which is why the first set is a set of exercises to relieve tension from the deep muscles of the spine.

In the human body, the entire muscular sphere is divided into two groups according to function. The first group - skeletal muscles or tonic (deep muscles), is constantly in tension, even when a person sleeps, it is closely connected with the median structures of the brain and the old cortex, responsible for the autonomic, neuroendocrine and emotional functions of the human body. In modern man, deep muscles are constantly in a state of pathologically increased tonic tension.

The second group is the muscles responsible for the instantaneous application of force (phasic). In a modern person, they are pathologically weakened, as a result of which they reduce the strength of their contraction, acquire dystrophic signs - the nutrition of the vertebrae and intervertebral discs is disturbed, carried out by deep intervertebral discs, inside which blood vessels pass. Causes can be muscle injury, weakening (hypotrophy) of the muscles, long sitting (postural stress).

Accordingly, these muscles need to be strengthened. But without relaxing the first muscle group, the work of the second muscle group will not be effective. In addition, an increase in tonic tension may occur, accompanied by a high density of muscle fibers, which straightens the physiological curves of the spine.

To relax deep muscles, relieve tension, it is most effective to use a set of exercises that are performed with an almost horizontal position of the spine, which provides the most gentle load, but allows you to perform the function of warming up the body and move on to performing articular complexes, starting with the complex for the ankle joint, as the least energy-consuming, which means that the load on the body will increase gradually. Since this is the smallest joint of the considered pathologies, then the movements in it according to the execution technique will be more accessible to patients at the beginning of the session, many of whom have not previously been involved in exercise therapy. Therefore, the process of working into the load will pass without negative emotions.

The second complex is a complex for the ankle joints. After working with the ankle joints, they proceed to the implementation of complexes for the knee, and then the hip joints.

To make the process of restoring joint mobility more effective, the methodological principle will help, in which exercises, where it is necessary to turn on the legs alternately, begin to do with a “healthy” leg. Often, patients subconsciously protect themselves from constant discomfort or pain in the joint, not giving the diseased joint a full load. As a result, the joint “forgets” what and how to do. The “muscle motor memory” of a healthy leg will help you complete the proposed exercises to the fullest.

The sequence of performing all complexes: for the ankle joint, for the knee joint, for the hip joint, does not depend on the localization of pain in the joint. First of all, it is based on the methodical principle “from simple to complex”, which allows patients to adequately perceive the technique of performing exercises, most of which, before this rehabilitation course, did not in any way connect their lives with physical education.

The method includes sets of exercises combined into a single program of physical rehabilitation aimed at relieving tension from the deep muscles of the spine, restoring the range of motion in the joints of the lower extremities using all anatomically determined movements in a particular joint, relieving pain, stretching the spine, which allows to stop the inflammatory process, improve joint trophism, restore muscle strength, eliminate contracture in the joints.

Implementation of the invention.

The method of rehabilitation of patients with diseases of the joints of the lower extremities is implemented as follows.

Classes are carried out in a group for 8 weeks 3 times a week on weekdays every other day, while the duration of one lesson is 60 minutes, and is carried out under the guidance of an exercise therapy instructor, in the form of 5 consecutive complexes, and daily in the form of a set of exercises to relieve tension from the deep muscles of the spine, carried out 1 hour before sleep for 10 minutes, performed by patients independently. In order to avoid getting used to the load, reducing its effectiveness, as well as monotony, which reduces the interest of patients in classes, joint complexes are performed in different classes in one of two different versions, including with a change in the starting position.

On the 1st of the 3 lessons of the week, the first set of exercises is first performed to relieve tension from the deep muscles of the spine, which consists in performing 10 consecutive exercises, repeated 10 times, without pauses for rest between exercises:

on the first exercise in the starting position “lying on your back”, straight legs together, palms bent at the elbows of the arms under the lower back, inflate the stomach, then tighten the stomach, pressing the lower back on the palms, then return to the starting position;

on the second exercise in the initial position “lying on the back”, straight legs together, arms along the body with palms up, lower the chin to the cervical fossa while squeezing the hands into fists and stretching the heels forward, then return to the starting position;

on the third exercise in the initial position “lying on the back”, legs bent at the knees, resting on the floor, arms bent at the elbows, clasped into a “lock” behind the head, elbows directed to the sides, after that the shoulder blades are torn off the floor, directing the elbows towards the knees, while lowering the chin to the cervical fossa, then return to the starting position;

on the fourth exercise in the initial position “lying on the back”, legs bent at the knees, resting on the floor, arms bent at the elbows, clasped into a “lock” behind the head, elbows directed to the sides, after that the shoulder blades are torn off the floor, directing the elbows towards the knees, with the simultaneous lifting of one leg to the chest, elbows touching the knee, then return to the starting position, and repeat with the other leg;

on the fifth exercise in the initial position “lying on the back”, legs bent at the knees, resting on the floor, arms bent at the elbows, clasped into a “lock”, elbows directed to the sides, tear the shoulder blades off the floor, stretching the elbow to the opposite knee of the bent leg raised to the chest, return to the starting position, and repeat in the other direction;

on the sixth exercise in the initial position “lying on the back”, legs bent at the knees, resting on the floor, arms along the body, raise the pelvis, arching the lower back, return to the starting position;

on the seventh exercise in the initial position “standing on all fours”, head tilted, sit on the heels, stretching their arms forward along the support, then return to their original position;

on the eighth exercise in the starting position “standing on all fours”, the head is tilted, sit on the heels, stretching the straightened leg back, then return to the starting position, and repeat with the other leg;

on the ninth exercise in the initial position “lying on the stomach”, straight legs together, chin on the palms of the arms bent at the elbows, bend the leg at the knee joint, sliding the knee along the floor, raise it above the hip joint, then return to its original position, and repeat with the other leg;

on the tenth exercise in the starting position “lying on your back”, straight legs together, straight arms on the floor behind your head, stretch your arms and legs in opposite directions at the same time, pulling your socks “away from you” and straining your fingers, palms facing each other, then return to the starting position.

After performing the exercises of the first complex to relieve tension from the deep muscles of the spine, they proceed to the exercises of the second complex for the ankle joints, which includes 15 exercises performed in the initial position “sitting on a chair”, each of which is repeated 10 times, without pauses for rest between exercises, while:

on the first exercise - one leg is bent at the knee, the foot rests on the floor, the shin of the other leg is on its thigh, the foot is bent with the help of the arm opposite the raised leg and in this position, holding for 5 seconds, the other leg holds the raised leg in the area of the knee joint, then the foot is unbent, lingering for 5 seconds, then return to its original position, and then the exercise is performed with the other leg;

on the second exercise - the legs are straightened, the feet, together with support on the heel, bend the foot, lingering in this position for 5 seconds, unbend the foot, trying to touch the floor with the fingertips, lingering in this position for 5 seconds, then return to the starting position;

on the third exercise - the legs are bent, the feet, together with the support on the heels, alternately bend and unbend the feet, simultaneously bend and unbend the feet, then bend one foot while simultaneously extending the other foot, after which they return to their original position;

on the fourth exercise - the legs are bent, the feet, together with the support on the floor, roll from heels to toes, feet under a chair, slide on the floor, then roll from socks to heels, straightening the knees, feet slide on the floor, after that they roll from heel to toe with one foot while simultaneously rolling the other leg from toe to heel, then return to the starting position;

on the fifth exercise - one leg is bent at the knee, the foot rests on the floor, the other leg is on its knee, a gymnastic stick is placed under the upper part of the foot, the hands hold the stick shoulder-width apart, unbend the foot, resisting with the stick, bending the elbows as much as possible, then bend the foot without resistance, unbending the elbows, then return to the starting position, then perform the exercise with the other leg;

on the sixth exercise - the legs are bent, the feet are on the balls, the balls are rolled back and forth, while bending and unbending the feet, and gradually increasing the amplitude, then returning to their original position;

on the seventh exercise - one leg is bent at the knee, the foot is resting on the floor, the shin of the other leg is on its thigh, the foot is abducted and adducted with the help of a hand opposite to the raised leg, the other hand holds the raised leg in the area of the knee joint, then return to its original position, then the exercise is performed with the other leg;

on the eighth exercise - legs shoulder-width apart, feet resting on the floor, connect the toes of the feet, resting on the heels, then return to their original position and connect the heels, resting on the toes, then return to their original position;

on the ninth exercise - the legs are bent, the feet are together, the socks are spread, leaning on the heels, then the heels are bred, leaning on the socks, and thus removing the legs from each other at a count of 5, and then they are connected, returning to their original position also at the expense of 5;

on the tenth exercise - the legs are bent, the feet are together, at the expense of 5, leaning, then the toes of both legs are taken to the heels at the same time to the side, then leaning on the socks, the heels are taken to the same side, then the starting position is returned in the reverse order, after which the exercise is repeated in the other direction;

on the eleventh exercise - the legs are bent, the feet are together, the socks are moved to the side, leaning on the heels, then they return to their original position, after which they perform the exercise in the other direction;

on the twelfth exercise - the legs are bent, the feet grab the ball on the sides with the inner arches of the feet, then they slide the feet to the floor and back, firmly pressing the feet to the ball, then return to their original position;

on the thirteenth exercise - one leg is bent at the knee, the foot rests on the floor, the shin of the other leg is on its thigh, circular motions of the foot are performed with the help of the arm opposite the raised leg, 5 times in one direction and 5 times in the other direction;

on the fourteenth exercise - one leg is bent at the knee, the foot resting on the floor, the other on its knee, perform circular foot movements with resistance 5 times in one direction and 5 times in the other direction, then return to the starting position;

on the fifteenth exercise - the legs are bent, feet shoulder-width apart with support on the heels, perform circular movements with the feet 5 times outward and 5 times inward, then return to their original position.

After completing the second complex for the ankle joints, they proceed to perform the third complex for the knee joints, which includes 20 exercises performed in the initial “lying” position, with each exercise repeated 10 times without pauses for rest between exercises, while:

on the first exercise - the legs are bent at the knees, the feet are together resting on the floor, the arms are along the body, the leg is straightened at the knee joint, while the lower leg is a continuation of the thigh, the knees are placed at the same level, then they return to their original position, after which the exercise is performed with the other leg;

on the second exercise - the legs are bent at the knees, the feet are together resting on the floor, the arms along the body, perform alternate vigorous swinging in the knee joint with the lower leg up and down, then return to the starting position;

on the third exercise - legs bent at the knees, feet together resting on the floor, arms along the body, perform simultaneous vigorous swinging of the knee joints with the lower leg up and down, without separating the knees, then return to the starting position;

on the fourth exercise - the legs are bent at the knees, the feet are together resting on the floor, the arms are along the body, the legs are simultaneously straightened at the knee joints, while the lower leg is a continuation of the byrd, then they return to their original position;

on the fifth exercise - the legs are bent at the knees, feet shoulder-width apart, resting on the floor, arms along the body, perform circular rotations in the knee joint 5 times of one leg to one side and 5 times to the other side, without involving the hip joint, then repeat the exercise with the other leg, then return to the starting position;

on the sixth exercise - legs bent at the knees, feet together resting on the floor, arms along the body, perform simultaneous circular rotations in the knee joints with each leg outward, while connecting the knees in weight, then return to their original position;

on the seventh exercise - legs bent at the knees, feet together resting on the floor, arms along the body, perform simultaneous circular rotations in the knee joints on weight with two legs 5 times in one direction and 5 times in the other direction, while connecting the knees, and then return to the starting position;

on the eighth exercise - legs are straightened, feet together, arms along the body, simultaneously bend both legs at the knee joints, without separating the knees, bringing the heels closer to the buttocks, then return to their original position;

on the ninth exercise - one leg is bent at the knee, the foot is resting on the floor, the other leg is straightened, the arms are along the body, then the position of the legs is changed;

on the tenth exercise - legs are straightened, feet together, arms along the body, perform cycling movements with one leg, bringing the knee closer to the chest, then return to the starting position, then perform the exercise with the other leg;

on the eleventh exercise - the legs are bent at the knees, the feet are weighted together, the arms are along the body, the legs are straightened at the knee joints without separating the knees, while the lower leg is a continuation of the thigh, then they return to their original position;

on the twelfth exercise - legs are straightened, feet together, arms along the body, simultaneously bend both legs at the knee joints, then return to their original position;

on the thirteenth exercise - legs are straightened, feet together, arms along the body, bend one leg at the knee joint, sliding on the floor, then straighten it up, then bend the leg at the knee joint, then return to its original position, sliding on the floor, and perform the exercise with the other leg;

on the fourteenth exercise - the legs are bent at the knees, the feet are weighted together, the arms are along the body, one leg is straightened at the knee joint, while the lower leg is a continuation of the thigh, and the knees are at the same level, then they return to their original position, after which the exercise is performed with the other leg;

on the fifteenth exercise - the legs are bent at the knees, the feet are in weight together, the arms are along the body, they walk raising their knees high, after that they return to their original position;

on the sixteenth exercise - the lower leg of one leg on the lower leg of the other leg at the ankle joint, bend the legs at the knee joints in weight, then return to their original position, then change the position of the legs and repeat the exercise;

on the seventeenth exercise - the legs are bent at the knees in weight, the foot of one leg is on the ankle joint of the other leg, vigorously swinging the shins of both legs in the knee joints with the pressure of the shin of the upper leg on the lower one, then return to its original position, then change the position of the legs and repeat the exercise;

on the eighteenth exercise - legs are straightened, feet shoulder-width apart, arms along the body, bend one leg at the knee joint and place the foot on the outside of the other leg to the middle of the thigh, then return to its original position, then repeat the exercise with the other leg;

on the nineteenth exercise - the legs are straightened, the feet are together, the arms are along the body, two legs are simultaneously bent at the knee joints in weight, then they return to their original position alternately with each leg, while the feet slide along the floor;

on the twentieth exercise - the legs are straightened, the feet are together, the arms are along the body, the legs are bent alternately in the knee joint in weight, then the legs are returned to their original position at the same time, while the feet slide along the floor.

After completing the third complex for the knee joints, they proceed to the fourth complex for the hip joints, which includes 20 exercises, each of which is repeated 10 times, without pauses for rest between exercises, while:

on the first exercise in the starting position “lying on your back”, the legs are bent at the knees, the feet are supported on the floor together, the arms are along the body, the leg is straightened at the knee joint, the heel slides along the surface with effort, then they return to their original position, then bending the knee joint, bring the heel closer to the buttock, the heel slides along the surface with effort, then return to its original position, then perform the exercise with the other leg;

on the second exercise in the initial position “lying on your back”, the legs are bent at the knees, the feet are supported on the floor together, the arms are along the body, one leg is straightened at the knee joint, the heel slides along the surface with effort, at the same time the second leg is bent at the knee joint, bringing the heel closer to the buttock, then the heel slides with effort on the surface, after that they return to their original position, then they change the position of the legs and perform the exercise;

on the third exercise in the initial position “lying on your back”, the legs are bent at the knees, the feet are together in weight, the arms are to the sides, the palms are pressed to the floor, then both connected knees are placed in one direction, touching the floor with the lower knee, then they return to their original position and repeat the exercise in the other direction;

on the fourth exercise in the initial position “lying on your back”, the legs are bent at the knees, feet shoulder-width apart in support of the floor, arms along the body, spread the knees, then bring the knees together, connecting them with effort, then return to their original position;

on the fifth exercise in the initial position “lying on your back”, the legs are bent at the knees, the feet are placed in support at shoulder width, arms along the body, tilt the knee of one leg towards the heel of the opposite leg, touching the surface,

while the knee of the other leg is fixed, then they return to their original position, after which the exercise is performed with the other leg;

on the sixth exercise in the initial position “lying on your back”, the legs are bent at the knees, the feet are shoulder-width apart, the arms are along the body, then the heel of one leg is placed on the knee of the other and the thigh is retracted, then they return to their original position, then repeat the exercise with the other leg;

on the seventh exercise, in the initial position “lying on your back”, legs together, arms along the body, legs apart, heels glide along the floor with effort, return to their original position, while the heels glide along the floor without effort, then spread the legs to the sides without effort, and bring them together with effort;

on the eighth exercise in the initial position “lying on your back”, the legs are together, the toes are together, the heels are apart, the legs are spread apart, the toes are directed inward, the heels slide along the surface with effort, then return to their original position, the heels slide along the surface with effort;

on the ninth exercise, in the initial position “lying on your back”, the legs are together, arms along the body, take one leg to the side with the toe outward, the heel slides along the surface with effort, then return to its original position, turning the toes inward, the heel slides along the surface with effort, then the exercise is performed with the other leg;

on the tenth exercise in the initial position “lying on your back”, legs together, arms along the body, quickly lift one leg up, slightly above 90 °, toe “away from you”, do not bend the knee, then slowly return to its original position, then perform the exercise with the other leg;

change the starting position "lying on the back" to the starting position "lying on the stomach", and

on the eleventh exercise - the chin is placed on the back of the surfaces of the hands bent at the elbows, the legs are together, then the straight leg is lifted up, the toe is “away from you”, after that they return to their original position, and the exercise is performed with the other leg;

on the twelfth exercise - the chin is placed on the back of the surfaces of the hands bent at the elbows, the legs are bent at the knees at 90 °, together, then the thigh is raised up without extending the knee, then they return to their original position, after which the exercise is performed with the other leg;

change the initial position "lying on the stomach" to the position "lying on the side", and

on the thirteenth exercise - one arm is bent at the elbow, the hand is under the head, the other is in support in front of the chest, while the back, pelvis, legs are a straight line, then they bend the leg at the knee, bringing it closer to the chest, then take the thigh out without unbending the knee, return to its original position, then take the thigh out without extending the knee;

on the fourteenth exercise - one arm is bent at the elbow, the hand is under the head, the other is supported in front of the chest, while the back, pelvis, legs are a straight line, they take the leg to the side, the toe “away from you”, then return to its original position, the toe “toward itself”;

on the fifteenth exercise - one arm is bent at the elbow, the hand is under the head, the other is in support in front of the chest, while the back, pelvis, legs are a straight line, then they swing with a straight leg, toe “away from you”, back and forth, then return to their original position;

on the sixteenth exercise - one arm is bent at the elbow, the hand is under the head, the other is in support in front of the chest, while the back, pelvis, legs are a straight line, perform circular rotations in the hip joint with a straight leg, toe “away from you”, 5 times forward, 5 times back, then return to the starting position;

then they turn over to the other side and exercises from the seventeenth to the twentieth are performed similarly to the exercises from the thirteenth to the sixteenth.

After completing the fourth complex for the hip joints, they take the initial position “lying on their back” and lie with their eyes closed for 30 seconds.

After completing the fourth complex for the hip joints, they proceed to the fifth complex for stretching the muscles of the spine, performed in the initial “standing” position, which includes 15 exercises performed in the form of dynamic movements, each exercise, of which is repeated 10 times without pauses for rest between exercises, while:

on the first exercise - standing in the main stance, in which the heels are together, the toes apart, the knees are straight, the legs are connected with tension along the entire length, the arms are below in the "lock", the head is straight, then they raise the straight arms up, turning the palms outward, perform springy abductions of the straight arms behind the head, and proceed to the second exercise;

on the second exercise - standing in the main stance, arms bent at the elbows in the “lock” in front of the chest, head straight, then raise straight arms up, turning the palms outward, palms strictly above the head, pull the arms up, straightening and stretching the elbows, legs are tense, the stomach is pulled up;

on the third exercise - standing in the main stance, hands at the top in the "lock" strictly above the head with palms turned outward, head straight, take straight arms back, straightening and stretching the elbows, along with the body, bending in the lower back;

on the fourth exercise - standing in a 90 ° torso tilt, arms in the “lock” are straightened forward with palms turned outward, heels together, socks apart, knees straight, legs connected with tension along the entire length, head straight, eyes looking at the floor, then pull the arms forward, straightening and stretching the elbows, while the arms and torso are a straight line, the head is tilted to the level of the elbows;

on the fifth exercise - standing in the main stance, hands at the top in the “lock” strictly above the head with palms turned outward, head straight, tilt the body to the side, straightening and stretching the elbows, then perform the exercise in the other direction;

on the sixth exercise - standing in the main stance, hold the hands on the elbows of opposite hands, head straight, perform springy torso bends down, the head is tilted, the neck muscles are relaxed, bent elbows are lowered below the knees;

on the seventh exercise, standing in the main stance, hands in the “lock” below, head straight, perform springy torso bends down, head tilted, neck muscles relaxed, the inside of the palms reach the floor;

on the eighth exercise - standing, legs wide apart, arms down, the palm of one hand on the back of the other, the ends of the fingers of the hands coincide, the head is straight, tilt the body towards one leg, reach the toe of the foot with your fingers, while the ends of the fingers of the hands coincide, the knees do not bend, the head is tilted, the neck muscles are relaxed, then the exercise is performed in the other direction;

on the ninth exercise - standing in the main stance, arms hanging freely, head straight, tilting the body to the knees, clasping hands under the knees, bringing the forehead to the knees, without bending the knees, while the head is tilted, the neck muscles are relaxed;

on the tenth exercise - standing, one leg is bent at the knee, resting completely on the foot, the other is straightened forward, straight with support on the heel, arms below, the palm of one hand on the back of the other, the ends of the fingers of the hands coincide, perform springy torso tilts forward and down, the head is tilted, the neck muscles are relaxed, reach the toe of the foot with your fingers, then perform the exercise in the other direction;

on the eleventh exercise - standing, one leg is bent at the knee, resting completely on the foot, the other is straightened forward with support on the heel, hands in the "lock" below, tilt the torso forward and down, grabbing the foot in the "lock", then pull the toe "towards you", while not bending the knee, the head is tilted, the neck muscles are relaxed, after that they perform the exercise with the other leg;

on the twelfth exercise - standing with support on one leg, the other is raised on a support at 90 °, hands are below in the “castle”, the head is straight, they press with their palms turned outward on the knee, pulling the toe of the foot “on itself”, while the knee of the supporting leg is not bent, after that the exercise is performed with the other leg;

on the thirteenth exercise - standing in a deep lunge (i.e. lunge, in which the knee of one leg goes beyond the line of the foot, and the other leg is straight), hands behind the back in the "castle", head straight, perform springy flexions in the knee joint of the leg set forward, shoulder blades are brought together, elbows are straightened, then proceed to the exercise with the other leg;

on the fourteenth exercise - standing in a deep lunge, hands in the "lock" at the top with palms turned outward, head straight, perform springy abduction of the arms back, straightening and stretching the elbows, arms strictly above the head, then proceed to the exercise with the other leg;

on the fifteenth exercise - standing in a deep lunge, hands “in the lock” above the head, tilt the torso towards the leg of the same name, bent at the knee, then perform the exercise in the other direction.

The proposed complex allows you to stretch not only the muscles of the spine, but also the abdomen, pelvis, lower extremities. A sparing regimen is provided by using the patient's own weight in stretching, does not provide for excessive stretching, while remaining within the age and genetic norm. However, due to the formation of negative pressure in the intervertebral region, among other things, the compression of the disc or the pulling of the disc herniation, if any, into the holes of the spinal canal is reduced, which reduces the pressure on the nerve root, which means that the risk of pain is much less.

Normally, the vascular system of the lower extremities, pelvis, and abdomen helps the heart deliver blood through the systemic circulation. But patients with diseases of the joints of the lower extremities often deliberately limit the mobility of the lower extremities in order to avoid discomfort or pain, which increases the load on the heart muscle. And this is especially harmful for patients suffering from cardiovascular diseases.

Attention is drawn to the non-standard muscle effort in the exercises of this complex, where the initial position “main stance” is provided (heels together, socks apart, arms hanging freely). The knees should be straightened, and the legs with effort connected along the entire length. Such a starting position allows you to automatically straighten your shoulders and tighten your stomach, that is, to take the correct posture and ensure a full breathing process during exercise, and therefore improve hemo- and lymphodynamics.

The use of own weight in exercises where the torso is tilted, due to the relaxation of the cervical spine and a freely hanging head, allows not only to provide a sparing regimen, but also accessibility in performing the exercise, regardless of the age and weight of the patient.

In the event of a pathology of the spine, an inevitable companion in diseases of the joints of the lower extremities, undifferentiated motor activity constantly enhances the pathological motor stereotype, which adapts and makes the patient more resistant to the disease, allowing to reduce pain or avoid it. As a result of the lack of control over the correct position of the body, and in particular posture, the stereotype is fixed. But in the human population, there are currently no people with an invariable motor stereotype, so posture control will allow it to be modified. The combination of relaxation with stretching will allow not only to involve many muscle groups that were not previously involved in the process of motor activity, but also to relieve muscle and emotional tension, increase joint flexibility, get rid of the usual muscle stiffness, restore the symmetry of the spine, and therefore change the pathological motor stereotype for the better. The method of performing exercises in the first and fifth complexes at the 1st lesson of the week is dynamic, in which all movements and breathing are carried out at the expense of 1-2 - inhale movement, at the expense of 3-4 - exhale, return to the starting position.

In all articular complexes of exercises of the 1st lesson of the week (from the second to the fourth), breathing is arbitrary, since in everyday life the act of breathing when moving the legs occurs naturally, then the creation of conditions for the usual stereotype will be more comfortable for patients during classes, while slow movements are understood as performing exercises at the expense of 1-2, and fast movements at the expense of 1.

On the 2nd of 3 lessons of the week, the first set of exercises is first performed to relieve tension from the deep muscles of the spine, which consists in performing 10 consecutive exercises similar to the exercises of the first set of exercises to relieve tension from the deep muscles of the spine, performed at the 1st lesson of the week, but with a static delay of 15 seconds, in each accepted position until returning to the starting position, each of which is repeated 1 time, with a rest between exercises of 15 seconds.

After performing the exercises of the first complex to relieve tension from the deep muscles of the spine, they proceed to the exercises of the second complex for the ankle joints, which includes 15 exercises performed in the initial “standing” position, each of which is repeated 10 times, without pauses for rest between exercises, while:

on the first exercise, they stand facing the back of the chair at a distance of a step, feet together, hands resting on the back of the chair, the body is tilted forward, rolls from heels to toes, then returns to the starting position;

on the second exercise, they stand facing the back of the chair at a distance of a step, feet together, hands resting on the back of the chair, the torso is tilted, they lift on the toe of one leg, holding in this position for 5 seconds, the foot of the other leg, slightly bent at the knee, in weight, then perform the exercise with the other leg, then return to the starting position;

on the third exercise, they stand facing the back of the chair at a distance of a step, the feet together resting on the toes, the hands resting on the back of the chair, the torso is tilted, they perform a springy lowering of the heels to the floor without touching it, then return to their original position;

on the fourth exercise, they stand facing the back of the chair at a step distance, feet together, one leg on the toe, the other leg on the heel, hands resting on the back of the chair, the torso is tilted, then they change the position of the legs, lingering in this position for 5 seconds, then return to their original position, again lingering in it for 5 seconds;

on the fifth exercise, they stand facing the back of the chair at a step distance, the heels together, the socks are maximally apart to the sides, the hands are supported on the back of the chair, they perform squats without moving the feet, while lowering the pelvis below the level of the knees, then return to their original position;

on the sixth exercise, they stand facing the back of the chair at a step distance on one leg, the foot of the other leg bent at the knee, on the weight, hands resting on the back of the chair, perform circular motions with the foot 5 times outward and 5 times inward, then perform the exercise with the other leg, then return to the starting position;

on the seventh exercise, face close to the back of the chair, feet together, hands resting on the back of the chair, then raise the leg bent at the knee, toe “away from you”, then return to the starting position, without touching the floor, toe “toward yourself”, then perform the exercise with the other leg, then return to the starting position;

on the eighth exercise, they stand facing close to the back of the chair, the legs are shoulder-width apart, the feet are parallel, then they bring the socks inward, without lifting the feet from the floor, bring the heels inward, then continue to move the toes and heels until the feet join, then return to their original position;

on the ninth exercise, they stand facing the back of the chair at a step distance, feet together, hands resting on the back of the chair, rise on their toes, transferring body weight over the back of the chair, bend their knees, hanging on their hands, then straighten their knees, then lower their heels to the floor, then return to their original position;

on the tenth exercise, they stand facing the back of the chair at a step distance, feet shoulder-width apart with support on the heels, hands resting on the back of the chair, bring the feet inward to the joint, raising the big toes of the feet up without bending the knees, then spread the feet outward, without lowering the thumbs, and without bending the knees, returning to its original position;

on the eleventh exercise, they stand facing the back of the chair at a step distance, the feet shoulder-width apart are parallel, the hands resting on the back of the chair, transfer the position of one foot perpendicular to the other foot, sliding the heel inward along the floor, then return to the starting position, then perform the exercise with the other leg, then return to the starting position;

on the twelfth exercise, they stand facing the back of the chair at a step distance, the feet are shoulder-width apart, the arms are supported on the back of the chair, the torso is tilted, they perform squats without moving their feet, without bringing their knees together, then return to their original position;

on the thirteenth exercise, they stand facing the back of the chair at a step distance, the feet are wider than the shoulders by the size of one foot, the socks are apart, the hands are supported on the back of the chair, the knee of one leg is bent, while the knee goes beyond the line of the foot, and the knee of the other leg is straight, return to its original position, then perform the exercise with the other leg, then return to its original position;

on the fourteenth exercise, they walk in a semi-squat for 1 minute, then return to their original position;

on the fifteenth exercise, walk with a deep lunge (i.e., a lunge in which the knee goes beyond the line of the foot), sliding the feet along the floor, keeping them parallel, perform the exercise for 1 minute, then return to the starting position.

After completing the second complex for the ankle joints, they proceed to perform the third complex for the knee joints, which includes 20 exercises, while the exercises are repeated 10 times without pauses for rest between exercises, while:

on the first exercise in the initial position “sitting on a chair”, one leg is straightened forward, resting on the heel, the other leg is bent under the seat of the chair, resting on the toe, then the position of the legs is changed;

on the second exercise in the initial position “sitting on a chair”, one leg is straightened forward in weight, the toe is “away from you”, the leg is parallel to the floor, the other leg is bent under the seat of the chair in weight, then the position of the legs is changed and the exercise is performed;

on the third exercise in the initial position “sitting on a chair”, the legs are bent at the knees, the feet are together, the feet are placed apart, leaning on the inner arch, while not separating the knees, then they return to their original position;

on the fourth exercise in the initial position “sitting on a chair”, the legs are straightened with support on the feet, they grab the seat from the side with their hands, then they bend one leg at the knee joint, cling to the chair leg with the toe from the outside, then return to the starting position, after that they perform the exercise with the other leg;

on the fifth exercise in the initial position “sitting on a chair”, the legs are straightened resting on the feet, gripping the seat from the side with the hands, bending two legs at the knee joints at the same time, clinging to the legs of the chair with the socks from the inside, then returning to the starting position;

on the sixth exercise in the initial position “sitting on a chair”, the legs are bent at the knees, the feet are together, after that they are hooked simultaneously with two legs with socks on the legs of the chair from the outside on the weight, then simultaneously with two legs they are hooked with the socks on the legs of the chair on the inside on the weight, then they return to their original position;

on the seventh exercise in the initial position “sitting on a chair”, the legs are bent, the feet are together, the arms are lowered, raise the bent leg at the knee joint up, helping with the hands in the shin or ankle joint, trying to put the heel on the chair, then return to the starting position, then perform the exercise with the other leg;

on the eighth exercise in the starting position in the starting position “sitting on a chair” on the edge of the seat, the legs are bent at the knees, the feet are together, they grab the seat from the side with their hands, then they unbend one leg at the knee joint, stretch the heel forward, the toe “towards themselves”, after that they return to their original position, after that they perform the exercise with the other leg;

on the ninth exercise in the starting position “sitting on a chair”, the legs are bent, the feet are together, the arms are clasped around the back of the chair from behind, then the leg is bent at the knee joint, placing the heel on the corner of the chair seat, then they return to their original position, after which the exercise is performed with the other leg;

on the tenth exercise in the initial position “sitting on a chair” on the edge of the chair seat, legs bent at the knees, feet together, gripping the seat from the side with your hands, then lowering your pelvis forward and down, sit down in front of the chair, bending your arms at the elbow joints at 90 °, then return to the starting position;

on the eleventh exercise in the initial position “sitting on a chair” on the edge of the seat of the chair, the legs are bent at the knees, the feet are shoulder-width apart, the grip is on the side of the seat, then the pelvis is lowered in front of the chair, after which vigorous swaying is performed in the knee joints;

on the twelfth exercise in the initial position “standing” facing the back of the chair in front of the seat on one leg, the knee of the other leg on the seat closer to the back, while holding the back, then sit on the heel, inhale, then return to the starting position and exhale, then perform the exercise with the other leg;

on the thirteenth exercise in the initial position “standing” facing the back of the chair in front of the seat on one leg, the other leg bent at the knee in support, on the edge of the chair, the arms are straightened in the “lock” behind the back, then the body is tilted forward, then the leg is bent and unbent at the knee joint, then the position of the legs is changed;

on the fourteenth exercise in the initial position “sitting on a chair”, the legs are bent at the knees, the feet are shoulder-width apart, the hands are in the “lock” on the knees, step over the clasped hands “to the lock” forward with one foot, then return to the starting position, after which the exercise is performed with the other leg;

on the fifteenth exercise in the initial position “sitting on a chair” on the edge of the chair seat, the legs are straightened, the feet are connected with the soles in support on the floor, they grab the seat from the side with their hands, then bend the legs at the knee joints, bringing the heels closer to the seat, then return to their original position;

on the sixteenth exercise in the initial position “standing” facing the back of the chair at a step distance, feet wider than shoulders at a distance of one foot, feet parallel, hands holding the back, then bending the knees, and perform 5 times circular rotations in the knee joints with both legs simultaneously, towards each other, then 5 times in the opposite direction;

on the seventeenth exercise in the initial position “standing” facing the back of the chair at a step distance, legs together, feet connected, hands holding the back, bending the knees, performing circular rotations in the knee joints with both legs simultaneously 5 times in one direction and 5 times in the other direction;

on the eighteenth exercise in the initial position “standing” facing the back of the chair at a distance of a step, legs shoulder-width apart, bent at the knees, while the pelvis is at knee level, the feet are parallel, the hands are held on the back from the sides, then springy rocking up and down the pelvis, then return to its original position;

on the nineteenth exercise in the initial position “standing” facing the back of the chair at a distance of a step, the feet are wider than the shoulders at a distance of one foot, the feet are parallel, the hands are held behind the back, then half-squats are performed, without lifting the heels from the floor, then return to the starting position;

on the twentieth exercise in the initial position “standing” facing the back of the chair at a step distance, the feet are wider than the shoulders at a distance of one foot, the feet are parallel, perform semi-squats on the toes, then return to the starting position.

After completing the third complex for the knee joints, they proceed to the fourth complex for the hip joints, which includes 20 exercises (from 1 to 18 in the initial position “standing”, and 19 and 20 “standing on all fours”), each of the exercises is repeated 10 times without pauses for rest between exercises, while:

on the first exercise in the initial position “standing” close to the back of the chair, legs together, hands in support, then take the leg back and up, toe “towards you”, while the body is not tilted, then return to the starting position, then repeat the exercise with the other leg;

on the second exercise in the initial position “standing” close to the back of the chair, legs together, arms supported, then take one leg to the side-up, toe “away from you”, then return to the starting position, then repeat the exercise with the other leg;

on the third exercise in the initial position “standing” close to the back of the chair, one leg is bent at the knee, the heel is close to the buttock, the hands are in support, they take the thigh back and up without unbending the knee, then return to the starting position, then repeat the exercise with the other leg;

on the fourth exercise in the initial position “standing” close to the back of the chair, one leg is bent at the knee, the heel is close to the buttock, the hands are in support, then the thigh is taken to the side-up, then they return to their original position, after that they perform the exercise with the other leg;

on the fifth exercise in the initial position “standing” facing the back of the chair at a step distance, the leg, bent at the knee, is raised forward up to the level of the hip joint, hands are supported, then circular rotations in the hip joint are performed 5 times in one direction and 5 times in the other direction, after that the exercise is performed, with the other leg, then the leg is returned to the floor;

on the sixth exercise in the initial position “standing” close to the back of the chair, legs together, arms in support, then raise straight arms up, then tilt the torso forward, leaning palms on the seat of the chair while lifting the leg back and up, toe “away from you”, do not bend the knee of the supporting leg, then straighten, raising straight arms up, and lowering the leg to the floor, then return to the starting position, after that the exercise with the other leg ;

on the seventh exercise in the initial position “standing” facing the back of the chair at a step distance, the leg bent at the knee is raised forward and upward, one arm is supported, then the leg is moved over the back of the chair with the interception of hands 5 times to one side and 5 times to the other side, after that the exercise is performed with the other leg, then the leg is returned to the floor;

on the eighth exercise in the initial position “standing” close to the back of the chair, heels together, toes apart, then they perform a semi-squat with the knees apart, while the body is not tilted, then they return to their original position;

on the ninth exercise in the initial position “standing” close with your back to the back of the chair, legs together, hands in support, then raise the straight leg forward and upward, toe “away from you”, to the level of the hip joint, then return to the starting position, toe “to yourself”, after that, perform the exercise with the other leg;

on the tenth exercise in the initial position “standing” close with your back to the back of the chair, legs together, arms supported, then lift one leg forward and upward, toe “toward” to the level of the hip joint, then return to the starting position, toe “away from you”, then perform the exercise with the other leg;

on the eleventh exercise in the initial position “standing” close with your back to the support, legs together, arms in support, raise the leg bent at the knee to the chest, while not tilting the body, then return to the starting position, then perform the exercise with the other leg;

on the twelfth exercise in the initial position “standing” close to the back of the chair, legs together, hands in support, step forward with one foot, bending the knee, while the knee goes beyond the line of the foot, and the supporting leg is straight, then return to its original position, then perform the exercise with the other leg;

on the thirteenth exercise in the initial position “standing” close to the back of the chair, legs together, hands in support, step forward with one foot, while the knee goes beyond the line of the foot, and the knee of the other leg touches the floor, then return to its original position, change the position of the legs and perform the exercise;

on the fourteenth exercise in the initial position “standing” close with your back to the back of the chair, legs together, arms supported, then bend the knee of one leg while moving the other leg to the side on the toe, then return to the starting position, change the position of the legs and perform the exercise;

on the fifteenth exercise in the initial position of “standing” the legs together, hands to the shoulders, then raise the leg bent at the knee, touching the knee of the elbow of the arm of the same name, do not tilt the body, then return to the starting position, then perform the exercise with the other leg;

on the sixteenth exercise, in the initial position of “standing”, legs together, hands to shoulders, raise the leg bent at the knee, touching the elbow of the opposite arm with the knee, while the body is not tilted, then return to the starting position, then perform the exercise with the other leg;

on the seventeenth exercise, in the initial position of “standing”, legs together, hands below, holding a gymnastic stick with a wide grip, carry the leg over the stick, and return to the starting position, then perform the exercise with the other leg;

on the eighteenth exercise in the initial position of "standing" legs together, arms to the sides, palms down, perform circular rotations in the hip joint with the leg bent at the knee, 5 times to one side and 5 times to the other side, then repeat the exercise with the other leg;

on the nineteenth exercise in the initial position “standing on all fours”, the palms slightly in front of the line of the knees, move to the position of emphasis-lying with a jump, bending at the same time in the lower back, then return to the starting position;

on the twentieth exercise in the initial position “standing on all fours”, the palms are slightly ahead of the line of the knees, one leg to the side on the toe, then they change the position of the legs by jumping in one direction and the other.

After working out the joints of the lower extremities (complexes from the second to the fourth), and hence the muscles, finish the 2nd lesson of the week with the fifth complex for stretching the muscles of the spine, which is carried out similarly to the fifth complex for stretching the muscles of the spine performed in the 1st lesson of the week, but each of the exercises is performed 1 time with a static delay of 15 seconds in each accepted position until returning to its original position, and without pauses for rest.

With the static method of execution on the 2nd lesson of the week, when performing the exercises of the first and fifth complexes, breathing is arbitrary. In all articular complexes of exercises from the second complex to the fourth, breathing is arbitrary, since in everyday life the act of breathing when moving the legs occurs naturally, the creation of conditions for the usual stereotype will be more comfortable for patients during classes.

At the 3rd lesson of the week, the first set of exercises is first performed to relieve tension from the deep muscles of the spine, which consists in performing similar exercises of the first complex, performed at the 2nd lesson of the week, they are performed 1 time with a static delay, but for 30 seconds in each accepted position until returning to the starting position, without pauses for rest between exercises.

The second set of exercises for the ankle joints is carried out in the initial “standing” position, the exercises are performed similarly to the exercises performed in the 2nd lesson of the week, each of which is also repeated 10 times without pauses for rest between exercises, but at the same time, leg weights are used - for women, 0.5 kg, and for men, 1.0 kg for each leg.

The third set of exercises for the knee joints is performed in the initial position "lying" similarly to the exercises performed in the 1st lesson of the week, while all exercises are repeated 10 times without pauses for rest, using leg weights for women at 0.5 kg, for men at 1.0 kg for each leg.

The fourth set of exercises for the hip joints is performed in the initial position "lying": "lying on your back", "lying on your stomach" and "lying on your side", similar to the exercises performed in the 1st lesson of the week, while all exercises are repeated 10 times without pauses for rest, using leg weights for women 0.5 kg, and for men 1.0 kg for each leg.

The fifth set of exercises for stretching the muscles of the spine is performed in the initial “standing” position, similar to the exercises of the 2nd lesson of the week, but with a static delay of 30 seconds and repeating each exercise 1 time without pauses for rest between exercises.

In all sets of exercises on the 2nd day of the week's classes, breathing is arbitrary.

Is daily self-study, carried out 1 hour before bedtime, performed as a set of exercises to relieve tension from the deep muscles of the spine? duration of 10 minutes, and is carried out in the following modes:

on the first day, the exercises are performed similarly to the exercises of the 1st group lesson for a week, in the form of dynamic movements, with the repetition of each exercise 10 times without pauses for rest between exercises;

on the second day, the exercises are performed similarly to the exercises of the 3rd group lesson for a week, in the form of static movements, i.e. with a delay of 30 seconds, and repeating each exercise 1 time without pauses for rest between exercises.

With the dynamic method of performing a set of exercises to relieve tension from the deep muscles of the spine, movements and breathing were carried out at the expense of 1-2 inhale-movement, at the expense of 3-4 - exhale-return to the starting position, and with the static method of performing the complex to relieve tension from the deep muscles of the spine, breathing is arbitrary. In the future, the alternation of methods for performing the complex for relieving tension from the deep muscles of the spine, carried out 1 hour before bedtime, was alternated in the same sequence.

Weighting agents were used only when performing joint complexes (from the second to the fourth), since in the complexes for relaxation and stretching, the use of even small weights can cause excessive muscle spasm, which will not allow you to get the expected effects from the complexes.

But in the joint complexes, the use of weighting agents, on the contrary, will increase the effectiveness of the exercises used: it will increase and diversify the load, and will also contribute to the development of strength endurance, the ability to withstand fatigue in muscle work with pronounced moments of power stress, which is required not only during exercise therapy, but also in everyday life [Theory and methods of physical education. Kholodov Zh.K., Kuznetsov B.C. - M.: Academy, 2003 p. 103-106].

To increase the effectiveness of ongoing rehabilitation activities, it is necessary to periodically change the content of classes and the load in order to avoid getting used to constant classes.

Thus, the method of rehabilitation of patients with diseases of the joints of the lower extremities provides strengthening and restoration of the muscles of the spine, joints of the lower extremities, regardless of the location of the disease, normalization of blood circulation due to the adaptive development of the circulatory system, neuromotor innervation.

The claimed invention does not require special knowledge, equipment, space for classes. The availability of exercises allows you to perform sets of exercises included in the rehabilitation course of patients with diseases of the joints of the lower extremities, not only with an exercise therapy instructor in a medical institution, but also independently at home. And simultaneous classes in one group of patients with diseases of the joints of the lower extremities, regardless of the localization of the disease, will allow not only to carry out rehabilitation activities with a large coverage of those involved, but also to some extent solve the problem of a shortage of personnel (exercise therapy instructors), which is so urgent in medical institutions in cities and towns with a small population.

Examples of the invention.

In a study on the application of the method for the rehabilitation of patients with diseases of the joints of the lower extremities according to the claimed invention, 12 patients (6 men, 6 women) aged 41 to 58 years with arthrosis of the joints of the lower extremities (hip, knee, ankle) were included, in each case 4 people.

All patients, regardless of the localization of arthrosis, trained according to a single program, 3 times a week for 60 minutes each lesson on an outpatient basis under the guidance of an exercise therapy instructor in the group and daily one hour before bedtime performing independently a set of exercises used in group classes to relieve tension from the deep muscles of the spine, lasting 10 minutes, which allows you to remove muscle fatigue accumulated during the day.

Patient Inclusion Criteria:

- confirmed diagnosis by X-ray;

- the duration of the disease is not more than a year;

- lack of any treatment;

- no complications requiring hospitalization;

- the patient's ability to participate in the study for 8 weeks with a visit to group classes 3 times a week for 60 minutes.

The following were used as objective criteria in assessing the effectiveness of the ongoing rehabilitation course before and at the end:

- angle measurement (angle of flexion, degrees);

- assessment of pain intensity on a visual analogue scale (VAS, cm);

- test "squats on two legs" (number of times).

The normative assessment of amplitude movements in the joints is presented in Table 1.

The visual analog scale of pain is a straight line segment 10 cm long. Its beginning corresponds to the absence of pain - “no pain”, and the end point reflects excruciating unbearable pain - “unbearable pain”. The line can be either horizontal or vertical. The patient is invited to make a mark on it corresponding to the intensity of the pain he is experiencing at the moment. The distance between the beginning of the segment (“no pain”) and the mark made is measured in centimeters and rounded to the nearest whole number. Each centimeter on the line corresponds to 1 point. At a mark of up to 2 cm, the pain is classified as mild, from 2 to 4 cm - moderate, from 4 to 6 cm - severe, from 6 to 8 cm - the strongest, and up to 10 cm - unbearable.

As a rule, all patients easily absorb VAS.

The test "squatting on two legs" was chosen due to the fact that all joints of the lower extremities are involved in its execution.

Squatting on two legs is performed from the starting position: standing, feet shoulder-width apart, feet pointing forward, upper limbs along the body.

When the patient is ready, a command is given to perform the exercise. The patient performs the maximum number of squats on two legs, followed by a return to the starting position. The number of correctly performed squats is counted.

Exercise technique - test:

On inspiration, the patient crouches to a right angle between the lower leg and thigh, while the upper limbs are brought forward. The back is straight. After squatting on exhalation, the test person returns to the starting position.

Errors, as a result of which the exercise-test is not counted:

- heels rise from the floor during squats;

- knees during squats are turned to the sides;

- stop during squats for more than 3 seconds;

- the angle between the lower leg and thigh is more than 90 degrees.

1) The results of the effectiveness of the method of rehabilitation of patients with diseases of the joints of the lower extremities according to the claimed invention - in men and women with arthrosis of the hip joint (coxarthrosis):

Example 1

Patient: male, 47 years old.

Diagnosis: right-sided lumbodynia, right-sided coxarthrosis, 2nd degree.

Complaints: after a long walk and lifting weights, pain in the lumbar region radiating to the right hip and knee joints.

Before conducting classes according to the claimed method:

pain intensity score: 5.8

test "squatting on two legs": 14

assessment of the range of motion in the hip joint:

- flexion: 115

- extension: 158

- lead: 18.

After conducting classes according to the claimed method:

pain intensity score: 2.2 two-legged squat test:

23 evaluation of the range of motion in the hip joint:

- flexion: 103

- extension: 176

- lead: 25.

Example 2

Patient: 52 year old male

Diagnosis: S-shaped scoliosis of the 2nd degree, 2-sided coxarthrosis of the 1st degree.

Complaints: Limitation of movements in the hip joints after a long static posture, pain at the beginning of movement.

Before conducting classes according to the claimed method:

pain intensity score: 4.6

two-legged squat test: 10

assessment of the range of motion in the hip joint:

- flexion: 105

- extension: 168

- lead: 35.

After conducting classes according to the claimed method:

pain intensity score: 0

two-legged squat test: 17

assessment of the range of motion in the hip joint:

- flexion: 95

- extension: 180

- lead: 50.

Example 3

Patient: 45 year old female.

Diagnosis: coccialgia, left-sided coxarthrosis of the 2nd degree.

Complaints: pain in the sacrococcygeal region when the torso is tilted, radiating to the left hip joint.

Before conducting classes according to the claimed method:

pain intensity score: 5.5

two-legged squat test: 15

assessment of the range of motion in the hip joint:

- flexion: 117

- extension: 160

- lead: 15.

After conducting classes according to the claimed method:

pain intensity score: 1.4

two-legged squat test: 24

assessment of the range of motion in the hip joint:

- flexion: 99

- extension: 170

- lead: 25.

Example 4

Patient: 50 year old woman

Diagnosis: hyperlordosis, right-sided coxarthrosis, 1st degree.

Complaints: pain in the right pelvic joint during flexion and abduction.

Before conducting classes according to the claimed method:

pain intensity score: 5.1

two-legged squat test: 8

assessment of the range of motion in the hip joint:

- flexion: 107

- extension: 165

- lead: 22.

After conducting classes according to the claimed method:

pain intensity score: 0

two-legged squat test: 15

assessment of the range of motion in the hip joint:

- flexion: 96

- extension: 180

- lead: 50.

2) The results of the effectiveness of the method of rehabilitation of patients with diseases of the joints of the lower extremities according to the claimed invention - in men and women with arthrosis of the knee joint (gonarthrosis):

Example 5

Patient: 45 year old male.

Diagnosis: S-shaped scoliosis of the 2nd degree, gonarthrosis of the knee joint of the 1st degree.

Complaints: pain during prolonged stay in a fixed position, prolonged standing.

Before conducting classes according to the claimed method:

pain intensity score: 4.2

two-legged squat test: 17

assessment of the range of motion in the knee joint - flexion:

- flexion: 97

- extension: 165.

After conducting classes according to the claimed method:

pain intensity score: 0

two-legged squat test: 29

assessment of the range of motion in the knee joint - flexion:

- flexion: 70

- extension: 174.

Example 6

Patient: male, 54 years old.

Diagnosis: right-sided scoliosis of the 2nd degree, gonarthrosis of the left knee joint of the 2nd degree.

Complaints: pain with repetitive stereotyped movements, carrying heavy loads, muscle spasms in the legs.

Before conducting classes according to the claimed method:

pain intensity score: 6.8

test "squatting on two legs": 11

assessment of the range of motion in the knee joint - flexion:

- flexion: 105

- extension: 167.

After conducting classes according to the claimed method:

pain intensity score: 2.1

two-legged squat test: 18

assessment of the range of motion in the knee joint - flexion:

- flexion: 80

- extension: 170.

Example 7

Patient: female, 58 years old

Diagnosis: hyperlordosis, 2-sided gonarthrosis of the knee joints of the 2nd degree.

Complaints: pain during squats, limitation of movements in the knee joints, weakness in the muscles of the lower extremities.

Before conducting classes according to the claimed method:

pain intensity score: 6.2

two-legged squat test: 8

assessment of the range of motion in the knee joint - flexion:

- flexion: 115

- extension: 152

After conducting classes according to the claimed method:

pain intensity score: 3.4

two-legged squat test: 15

assessment of the range of motion in the knee joint - flexion:

- flexion: 90

- extension: 170.

Example 8

Patient: 41 year old woman

Diagnosis: left-sided scoliosis of the 1st degree, gonarthrosis of the right knee joint of the 1st degree.

Complaints: pain during fitness exercises with weights on the lower extremities, restriction during circular rotations.

Before conducting classes according to the claimed method:

pain intensity score: 4.8

two-legged squat test: 17

assessment of the range of motion in the knee joint - flexion: 92

- extension: 171.

After conducting classes according to the claimed method:

pain intensity score: 0

two-legged squat test: 25

assessment of the range of motion in the knee joint - flexion:

- flexion: 59

- extension: 179.

3) The results of the effectiveness of the method of rehabilitation of patients with diseases of the joints of the lower extremities according to the claimed invention - in men and women with arthrosis of the ankle joint:

Example 9

Patient: male, 43 years old. Diagnosis: S-shaped scoliosis of the 1st degree, arthrosis of the right ankle joint of the 1st degree. Complaints: pain in the ankle joint during long walking with irradiation to the right knee.

Before conducting classes according to the claimed method:

pain intensity score: 4.9

two-legged squat test: 18

assessment of the range of motion in the knee joint - flexion:

- plantar flexion: 106

- dorsal extension: 81.

After conducting classes according to the claimed method:

pain intensity score: 0

two-legged squat test: 26

assessment of the range of motion in the hip joint:

- plantar flexion: 138

- dorsal extension: 72.

Example 10

Patient: 51 year old male

Diagnosis: obesity of the 2nd degree, transverse flatfoot of the 2nd degree, 2-sided arthrosis of the ankle joints.

Complaints: pain during prolonged stay in a fixed position, movement restrictions during long walking.

Before conducting classes according to the claimed method:

pain intensity score: 5.6

test "squatting on two legs": 11

assessment of the range of motion in the knee joint - flexion:

- plantar flexion: 92

- dorsal extension: 82.

After conducting classes according to the claimed method:

pain intensity score: 2.1

two-legged squat test: 18

assessment of the range of motion in the hip joint:

- plantar flexion: 115

- dorsal extension: 78.

Example 11

Patient: female, 44 years old

Diagnosis: right-sided scoliosis of the 2nd degree, arthrosis of the left ankle joint of the 1st degree.

Complaints: pain during playing sports (jumping, a sharp change in direction of movement).

Before conducting classes according to the claimed method:

pain intensity score: 4.8

two-legged squat test: 15

assessment of the range of motion in the knee joint - flexion:

- plantar flexion: 104

- dorsal extension: 82

After conducting classes according to the claimed method:

pain intensity score: 0

two-legged squat test: 23

assessment of the range of motion in the hip joint:

- plantar flexion: 138

- dorsal extension: 74.

Example 12

Patient: female, 58 years old

Diagnosis: right-sided lumbalgia, arthrosis of the right ankle joint of the 2nd degree.

Complaints: pain in the lumbar region during long walking with irradiation to the right limb along the entire length.

Before conducting classes according to the claimed method:

pain intensity score: 6.1

two-legged squat test: 10

assessment of the range of motion in the knee joint - flexion:

- plantar flexion: 94

- dorsal extension: 85.

After conducting classes according to the claimed method:

pain intensity score: 1.5

two-legged squat test: 16

assessment of the range of motion in the hip joint:

- plantar flexion: 118

- dorsal extension: 79.

The results obtained showed that the application of the proposed method has a pronounced positive effect:

Firstly, the assessment of pain intensity decreased by 83% in patients with arthrosis of the hip joint, and in 50% of patients - up to 0%, in patients with arthrosis of the knee joint by 75%, and in 50% of patients up to 0%, in patients with arthrosis of the ankle joint by 83%, and in 50% of patients up to 0%. In total, for all patients who participated in the study, the pain intensity score decreased by 80%, and in 50% of patients it decreased to 0%;

Secondly, the "Squat on two legs" test improved in patients with arthrosis of the hip joint by 68%, arthrosis of the knee joint by 64%, and the ankle joint by 53%. In total, for all patients who participated in the study by 61%.

If we take into account that the standards of the two-legged squat test, depending on the age of the patient, are taken from the Ready for Labor and Defense (RLD) complex https://www.gto.ru/norms - a full-fledged program and regulatory framework for the physical education of the country's population, aimed at the development of mass sports and the improvement of the nation, then the indicators "before" and "after" the rehabilitation course should be correlated with the standards of the age groups that participated in the study.

In patients with arthrosis of the hip, the performance improved by 68%, in patients with arthrosis of the knee by 64%, and in patients with arthrosis of the ankle by 53%. In total, for all patients who participated in the study by 61%. Moreover, for men (patients No. 5 and No. 9) related to the age of 45 and 43 years, respectively, showed results that correspond to the standards of the VII stage of the TRP in the age category from 30 to 39 years (lower limit of squats 26 upper 30 times.) [https://www.gto.ra/flles/uploads/stages/62a051c39ee1a.pdf]

For women (patients No. 3, No. 8 and No. 11 aged 45, 41 and 44, respectively), the results after the rehabilitation course for the overwhelmed invention correspond to the standards of the VI stage of the TRP relating to the age from 18 to 29 years, which in fact belong to the VIII stage and above (the standard is a gold badge of 19 squats) [https://www.gto.ru/files/uploads/stages/62 a051c39ee1a.pdf];

Thirdly, the range of motion (angle of flexion) in patients with arthrosis of the hip joint improved: flexion by 11.5%, extension by 8.4%, abduction by 66%. Patients with arthrosis of the knee improved: flexion by 73%, extension by 15.2%, since initially this indicator was significantly different from the norm. In patients with arthrosis of the ankle joint, improvements were: plantar flexion by 28%, dorsiflexion by 8%, since this indicator slightly differs from the norm (see Table No. 1).

Claims (159)

A method for the rehabilitation of patients with diseases of the joints of the lower extremities, characterized by the implementation of physical exercises carried out for 8 weeks 3 times a week for 60 minutes and daily for 1 hour before bedtime for 10 minutes, while 3 times a week classes are held on weekdays every other day, each lesson is carried out in a group under the guidance of an exercise therapy instructor, which includes the implementation of 5 consecutive complexes performed in different starting positions, while on the 1st of the 3 lessons of the week, the first set of exercises is first performed to relieve tension from the deep muscles of the spine, which consists in performing 10 consecutive exercises, repeated 10 times, without pauses for rest between exercises, and including the following: on the first exercise in the starting position “lying on your back”, straight legs together, palms of arms bent at the elbows under the waist, inflate the stomach, then tighten the stomach, pressing the lower back on the palms, then return to the starting position; on the second exercise in the initial position “lying on the back”, straight legs together, arms along the body with palms up, lower the chin to the cervical fossa while squeezing the hands into fists and stretching the heels forward, then return to the starting position; on the third exercise in the initial position “lying on the back”, legs bent at the knees, resting on the floor, arms bent at the elbows, clasped into a “lock” behind the head, elbows directed to the sides, after that the shoulder blades are torn off the floor, directing the elbows towards the knees, while lowering the chin to the cervical fossa, then return to the starting position; on the fourth exercise in the initial position “lying on the back”, legs bent at the knees, resting on the floor, arms bent at the elbows, clasped into a “lock” behind the head, elbows directed to the sides, after that the shoulder blades are torn off the floor, directing the elbows towards the knees, with the simultaneous lifting of one leg to the chest, elbows touching the knee, then return to the starting position and repeat with the other leg; on the fifth exercise in the initial position “lying on the back”, legs bent at the knees, resting on the floor, arms bent at the elbows, clasped into a “lock”, elbows directed to the sides, tear the shoulder blades off the floor, stretching the elbow to the opposite knee of the bent leg raised to the chest, return to the starting position and repeat in the other direction; on the sixth exercise in the initial position “lying on the back”, legs bent at the knees, resting on the floor, arms along the body, raise the pelvis, arching the lower back, return to the starting position; on the seventh exercise in the initial position “standing on all fours”, head tilted, sit on the heels, stretching their arms forward along the support, then return to their original position; on the eighth exercise in the starting position “standing on all fours”, the head is tilted, sit on the heels, stretching the straightened leg back, then return to the starting position and repeat with the other leg; on the ninth exercise in the initial position “lying on the stomach”, straight legs together, chin on the palms of the arms bent at the elbows, bend the leg at the knee joint, sliding the knee along the floor, raise it above the hip joint, then return to its original position and repeat with the other leg; on the tenth exercise in the starting position “lying on your back”, straight legs together, straight arms on the floor behind your head, stretch your arms and legs in opposite directions at the same time, pulling your socks “away from you” and straining your fingers, palms facing each other, then return to the starting position, then they proceed to the exercises of the second complex for the ankle joints, which includes 15 exercises performed in the initial position "sitting on a chair", each of which is repeated 10 times, without pauses for rest between exercises, and includes the following: on the first exercise - one leg is bent at the knee, the foot rests on the floor, the shin of the other leg is on its thigh, the foot is bent with the help of the arm opposite the raised leg, and in this position, holding for 5 seconds, the other leg holds the raised leg in the area of the knee joint, then unbend the foot, holding for 5 seconds, then return to its original position and then perform the exercise with the other leg; on the second exercise - the legs are straightened, the feet, together with support on the heel, bend the foot, lingering in this position for 5 seconds, unbend the foot, trying to touch the floor with the fingertips, lingering in this position for 5 seconds, then return to the starting position; on the third exercise - the legs are bent, the feet, together with the support on the heels, alternately bend and unbend the feet, simultaneously bend and unbend the feet, then bend one foot while simultaneously extending the other foot, after which they return to their original position; on the fourth exercise - the legs are bent, the feet, together with the support on the floor, roll from heels to toes, feet under a chair, slide on the floor, then roll from socks to heels, straightening the knees, feet slide on the floor, after that they roll from heel to toe with one foot while simultaneously rolling the other leg from toe to heel, then return to the starting position; on the fifth exercise - one leg is bent at the knee, the foot rests on the floor, the other leg is on its knee, a gymnastic stick is placed under the upper part of the foot, the hands hold the stick shoulder-width apart, unbend the foot, resisting with the stick, bending the elbows as much as possible, then bend the foot without resistance, unbending the elbows, then return to the starting position, then perform the exercise with the other leg; on the sixth exercise - the legs are bent, the feet are on the balls, the balls are rolled back and forth, while bending and unbending the feet, and gradually increasing the amplitude, then returning to their original position; on the seventh exercise - one leg is bent at the knee, the foot is resting on the floor, the shin of the other leg is on its thigh, the foot is abducted and adducted with the help of a hand opposite to the raised leg, the other hand holds the raised leg in the area of the knee joint, then return to its original position, then the exercise is performed with the other leg; on the eighth exercise - legs shoulder-width apart, feet resting on the floor, connect the toes of the feet, resting on the heels, then return to their original position and connect the heels, resting on the toes, then return to their original position; on the ninth exercise - the legs are bent, the feet are together, the socks are spread, leaning on the heels, then the heels are bred, leaning on the socks and thus moving the legs apart at a count of 5, and then they are connected, returning to their original position also at the expense of 5; on the tenth exercise - the legs are bent, the feet are together, at the expense of 5, then, leaning on the heels, take the toes of both legs to the side at the same time, then, leaning on the socks, take the heels to the same side, then return to the starting position in reverse order, then repeat the exercise in the other direction; on the eleventh exercise - the legs are bent, the feet are together, the socks are moved to the side, leaning on the heels, then they return to their original position, after which they perform the exercise in the other direction; on the twelfth exercise - the legs are bent, the feet grab the ball on the sides with the inner arches of the feet, then they slide the feet to the floor and back, firmly pressing the feet to the ball, then return to their original position; on the thirteenth exercise - one leg is bent at the knee, the foot rests on the floor, the shin of the other leg is on its thigh, circular motions of the foot are performed with the help of the arm opposite the raised leg, 5 times in one direction and 5 times in the other direction; on the fourteenth exercise - one leg is bent at the knee, the foot resting on the floor, the other on its knee, perform circular foot movements with resistance 5 times in one direction and 5 times in the other direction, then return to the starting position; on the fifteenth exercise - the legs are bent, feet shoulder-width apart with support on the heels, perform circular movements with the feet 5 times outward and 5 times inward, then return to their original position, then they proceed to perform the third complex for the knee joints, which includes 20 exercises performed in the initial “lying” position, with each exercise repeated 10 times, without pauses for rest between exercises, while: on the first exercise - the legs are bent at the knees, the feet are together resting on the floor, the arms are along the body, the leg is straightened at the knee joint, while the lower leg is a continuation of the thigh, the knees are placed at the same level, then they return to their original position, after which the exercise is performed with the other leg; on the second exercise - the legs are bent at the knees, the feet are together resting on the floor, the arms along the body, perform alternate vigorous swinging in the knee joint with the lower leg up and down, then return to the starting position; on the third exercise - legs bent at the knees, feet together resting on the floor, arms along the body, perform simultaneous vigorous swinging of the knee joints with the lower leg up and down, without separating the knees, then return to the starting position; on the fourth exercise - the legs are bent at the knees, the feet are together resting on the floor, the arms are along the body, the legs are simultaneously straightened at the knee joints, while the lower leg is a continuation of the byrd, then they return to their original position; on the fifth exercise - the legs are bent at the knees, feet shoulder-width apart, resting on the floor, arms along the body, perform circular rotations in the knee joint 5 times of one leg to one side and 5 times to the other side, without involving the hip joint, then repeat the exercise with the other leg, then return to the starting position; on the sixth exercise - legs bent at the knees, feet together resting on the floor, arms along the body, perform simultaneous circular rotations in the knee joints with each leg outward, while connecting the knees in weight, then return to their original position; on the seventh exercise - legs bent at the knees, feet together resting on the floor, arms along the body, perform simultaneous circular rotations in the knee joints on weight with two legs 5 times in one direction and 5 times in the other direction, while connecting the knees, and then return to the starting position; on the eighth exercise - legs are straightened, feet together, arms along the body, simultaneously bend both legs at the knee joints, without separating the knees, bringing the heels closer to the buttocks, then return to their original position; on the ninth exercise - one leg is bent at the knee, the foot is resting on the floor, the other leg is straightened, the arms are along the body, then the position of the legs is changed; on the tenth exercise - legs are straightened, feet together, arms along the body, perform cycling movements with one leg, bringing the knee closer to the chest, then return to the starting position, then perform the exercise with the other leg; on the eleventh exercise - the legs are bent at the knees, the feet are weighted together, the arms are along the body, the legs are straightened at the knee joints without separating the knees, while the lower leg is a continuation of the thigh, then they return to their original position; on the twelfth exercise - legs are straightened, feet together, arms along the body, simultaneously bend both legs at the knee joints, then return to their original position; on the thirteenth exercise - legs are straightened, feet together, arms along the body, bend one leg at the knee joint, sliding on the floor, then straighten it up, then bend the leg at the knee joint, then return to its original position, sliding on the floor, and perform the exercise with the other leg; on the fourteenth exercise - the legs are bent at the knees, the feet are weighted together, the arms are along the body, one leg is straightened at the knee joint, while the lower leg is a continuation of the thigh, and the knees are at the same level, then they return to their original position, after which the exercise is performed with the other leg; on the fifteenth exercise - the legs are bent at the knees, the feet are in weight together, the arms are along the body, they walk, raising their knees high, after which they return to their original position; on the sixteenth exercise - the lower leg of one leg on the lower leg of the other leg at the ankle joint, bend the legs at the knee joints in weight, then return to their original position, then change the position of the legs and repeat the exercise; on the seventeenth exercise - the legs are bent at the knees in weight, the foot of one leg is on the ankle joint of the other leg, vigorously swinging the shins of both legs in the knee joints with the pressure of the shin of the upper leg on the lower one, then return to its original position, then change the position of the legs and repeat the exercise; on the eighteenth exercise - legs are straightened, feet shoulder-width apart, arms along the body, bend one leg at the knee joint and place the foot on the outside of the other leg to the middle of the thigh, then return to its original position, then repeat the exercise with the other leg; on the nineteenth exercise - the legs are straightened, the feet are together, the arms are along the body, two legs are simultaneously bent at the knee joints in weight, then they return to their original position alternately with each leg, while the feet slide along the floor; on the twentieth exercise - the legs are straightened, the feet are together, the arms are along the body, the legs are bent alternately at the knee joint in weight, then the legs are returned to their original position at the same time, while the feet slide along the floor, then they proceed to the fourth complex for the hip joints, which includes 20 exercises, each of which is repeated 10 times, without pauses for rest between exercises, while: on the first exercise in the starting position “lying on your back”, the legs are bent at the knees, the feet are supported on the floor together, the arms are along the body, the leg is straightened at the knee joint, the heel slides along the surface with effort, then they return to their original position, then bending the knee joint, bring the heel closer to the buttock, the heel slides along the surface with effort, then return to its original position, then perform the exercise with the other leg; on the second exercise in the initial position “lying on your back”, the legs are bent at the knees, the feet are supported on the floor together, the arms are along the body, one leg is straightened at the knee joint, the heel slides along the surface with effort, at the same time the second leg is bent at the knee joint, bringing the heel closer to the buttock, then the heel slides with effort on the surface, after that they return to their original position, then they change the position of the legs and perform the exercise; on the third exercise in the initial position “lying on your back”, the legs are bent at the knees, the feet are together in weight, the arms are to the sides, the palms are pressed to the floor, then both connected knees are placed in one direction, touching the floor with the lower knee, then they return to their original position and repeat the exercise in the other direction; on the fourth exercise in the initial position “lying on the back”, the legs are bent at the knees, the feet are shoulder-width apart in support of the floor, the arms along the body, spread the knees, then bring the knees together, connecting them with force, then return to their original position; on the fifth exercise in the initial position “lying on your back”, the legs are bent at the knees, the feet are placed in support at shoulder width, the arms are along the body, the knee of one leg is tilted towards the heel of the opposite leg, touching the surface, while the knee of the other leg is fixed, then they return to their original position, after that the exercise is performed with the other leg; on the sixth exercise in the initial position “lying on your back”, the legs are bent at the knees, the feet are shoulder-width apart, the arms are along the body, then the heel of one leg is placed on the knee of the other and the thigh is retracted, then they return to their original position, then repeat the exercise with the other leg; on the seventh exercise, in the initial position “lying on your back”, legs together, arms along the body, legs apart, heels glide along the floor with effort, return to their original position, while the heels glide along the floor without effort, then spread the legs to the sides without effort, and bring them together with effort; on the eighth exercise in the initial position “lying on your back”, the legs are together, the toes are together, the heels are apart, the legs are spread apart, the toes are directed inward, the heels slide along the surface with effort, then return to their original position, the heels slide along the surface with effort; on the ninth exercise, in the initial position “lying on your back”, the legs are together, arms along the body, take one leg to the side with the toe outward, the heel slides along the surface with effort, then return to its original position, turning the toes inward, the heel slides along the surface with effort, then the exercise is performed with the other leg; on the tenth exercise in the initial position “lying on your back”, legs together, arms along the body, quickly lift one leg up, slightly above 90 °, toe “away from you”, do not bend the knee, then slowly return to its original position, then perform the exercise with the other leg; change the starting position "lying on the back" to the starting position "lying on the stomach", and on the eleventh exercise - the chin is placed on the back of the surfaces of the hands bent at the elbows, the legs are together, then the straight leg is lifted up, the toe is “away from you”, after that they return to their original position and perform the exercise with the other leg; on the twelfth exercise - the chin is placed on the back of the surfaces of the hands bent at the elbows, the legs are bent at the knees at 90 °, together, then the thigh is raised up without extending the knee, then they return to their original position, after which the exercise is performed with the other leg; change the initial position "lying on the stomach" to the position "lying on the side", and on the thirteenth exercise - one arm is bent at the elbow, the hand is under the head, the other is in support in front of the chest, while the back, pelvis, legs are a straight line, then they bend the leg at the knee, bringing it closer to the chest, then take the thigh out without unbending the knee, return to its original position, then take the thigh out without extending the knee; on the fourteenth exercise - one arm is bent at the elbow, the hand is under the head, the other is supported in front of the chest, while the back, pelvis, legs are a straight line, they take the leg to the side, the toe “away from you”, then return to its original position, the toe “toward itself”; on the fifteenth exercise - one arm is bent at the elbow, the hand is under the head, the other is in support in front of the chest, while the back, pelvis, legs are a straight line, then they swing with a straight leg, toe “away from you”, back and forth, then return to their original position; on the sixteenth exercise - one arm is bent at the elbow, the hand is under the head, the other is in support in front of the chest, while the back, pelvis, legs are a straight line, perform circular rotations in the hip joint with a straight leg, toe “away from you”, 5 times forward, 5 times back, then return to the starting position, after that they turn over to the other side and exercises from the seventeenth to the twentieth are performed similarly to the exercises from the thirteenth to the sixteenth, after the completion of the fourth complex for the hip joints, they take the initial position “lying on their back” and lie with their eyes closed for 30 seconds, then they proceed to perform the fifth complex for stretching the muscles of the spine, performed in the initial “standing” position, which includes 15 exercises performed in the form of dynamic movements, each exercise is repeated 10 times, without pauses for rest between exercises, while: on the first exercise - standing in the main stance, in which the heels are together, the toes apart, the knees are straight, the legs are connected with tension along the entire length, the arms are below in the "lock", the head is straight, then they raise the straight arms up, turning the palms outward, perform springy abductions of the straight arms behind the head, and proceed to the second exercise; on the second exercise - standing in the main stance, arms bent at the elbows in the “lock” in front of the chest, head straight, then raise straight arms up, turning the palms outward, palms strictly above the head, pull the arms up, straightening and stretching the elbows, legs are tense, the stomach is pulled up; on the third exercise - standing in the main stance, hands at the top in the "lock" strictly above the head with palms turned outward, head straight, take straight arms back, straightening and stretching the elbows, along with the body, bending in the lower back; on the fourth exercise - standing in a torso tilt at 90 °, arms in the “lock” are straightened forward with palms turned outward, heels together, socks apart, knees straight, legs connected with tension along the entire length, head straight, eyes looking at the floor, then pull the arms forward, straightening and stretching the elbows, while the arms and torso are a straight line, the head is tilted to the level of the elbows; on the fifth exercise - standing in the main stance, hands at the top in the “lock” strictly above the head with palms turned outward, head straight, tilt the body to the side, straightening and stretching the elbows, then perform the exercise in the other direction; on the sixth exercise - standing in the main stance, the hands hold on to the elbows of opposite hands, the head is straight, springy torso bends down, the head is tilted, the neck muscles are relaxed, bent elbows are lowered below the knees; on the seventh exercise - standing in the main stance, hands in the “lock” below, head straight, perform springy torso bends down, head tilted, neck muscles relaxed, the inside of the palms reach the floor; on the eighth exercise - standing, legs wide apart, arms down, the palm of one hand on the back of the other, the ends of the fingers of the hands coincide, the head is straight, tilt the body towards one leg, reach the toe of the foot with your fingers, while the ends of the fingers of the hands coincide, the knees do not bend, the head is tilted, the neck muscles are relaxed, then the exercise is performed in the other direction; on the ninth exercise - standing in the main stance, arms hanging freely, head straight, tilting the body to the knees, clasping hands under the knees, bringing the forehead to the knees, without bending the knees, while the head is tilted, the neck muscles are relaxed; on the tenth exercise - standing, one leg is bent at the knee, resting completely on the foot, the other is straightened forward, straight with support on the heel, arms below, the palm of one hand on the back of the other, the ends of the fingers of the hands coincide, perform springy torso tilts forward and down, the head is tilted, the neck muscles are relaxed, reach the toe of the foot with your fingers, then perform the exercise in the other direction; on the eleventh exercise - standing, one leg is bent at the knee, resting completely on the foot, the other is straightened forward with support on the heel, hands in the "lock" below, tilt the torso forward and down, grabbing the foot in the "lock", then pull the toe "towards you", while not bending the knee, the head is tilted, the neck muscles are relaxed, after that they perform the exercise with the other leg; on the twelfth exercise - standing with support on one leg, the other is raised on a support at 90 °, hands are below in the “castle”, the head is straight, they press with their palms turned outward on the knee, pulling the toe of the foot “on itself”, while the knee of the supporting leg is not bent, after that the exercise is performed with the other leg; on the thirteenth exercise - standing in a deep lunge, hands behind the back in the "castle", head straight, perform springy bending in the knee joint of the forward leg, shoulder blades are brought together, elbows are straightened, then proceed to the exercise with the other leg; on the fourteenth exercise - standing in a deep lunge, hands in the "lock" at the top with palms turned outward, head straight, perform springy abduction of the arms back, straightening and stretching the elbows, arms strictly above the head, then proceed to the exercise with the other leg; on the fifteenth exercise - standing in a deep lunge, hands "in the lock" above the head, tilt the torso towards the leg of the same name, bent at the knee, then perform the exercise in the other direction, at the same time, in the first and fifth complexes, a dynamic method of execution is used, in which movement and breathing are carried out at the expense of 1-2 - inhale - movement, at the expense of 3-4 - exhale - return to the starting position, and in all joint sets of exercises, from the second to the fourth, - breathing is arbitrary, slow movements are performed at the expense of 1-2, and fast movements are performed at the expense of 1, on the 2nd lesson of the week, the first set of exercises is first performed to relieve tension from the deep muscles of the spine, which consists in performing 10 consecutive exercises similar to the exercises of the first set of exercises to relieve tension from the deep muscles of the spine, performed on the 1st lesson of the week, but with a static delay of 15 seconds, in each accepted position until returning to the starting position, each of which is repeated 1 time, with a rest between exercises of 15 seconds, then they proceed to the exercises of the second complex for the ankle joints, which includes 15 exercises performed in the initial “standing” position, each of which is repeated 10 times, without pauses for rest between exercises, while: on the first exercise, they stand facing the back of the chair at a distance of a step, feet together, hands resting on the back of the chair, the body is tilted forward, rolls from heels to toes, then returns to the starting position; on the second exercise, they stand facing the back of the chair at a distance of a step, feet together, hands resting on the back of the chair, the torso is tilted, lift on the toe of one leg, holding in this position for 5 seconds, the foot of the other leg, slightly bent at the knee, in weight, then perform the exercise with the other leg, then return to the starting position; on the third exercise, they stand facing the back of the chair at a distance of a step, the feet together resting on the toes, the hands resting on the back of the chair, the torso is tilted, they perform a springy lowering of the heels to the floor without touching it, then return to their original position; on the fourth exercise, they stand facing the back of the chair at a step distance, feet together, one leg on the toe, the other leg on the heel, hands resting on the back of the chair, the torso is tilted, then they change the position of the legs, lingering in this position for 5 seconds, then return to their original position, again lingering in it for 5 seconds; on the fifth exercise, they stand facing the back of the chair at a step distance, the heels together, the socks are maximally apart to the sides, the hands are supported on the back of the chair, they perform squats without moving the feet, while lowering the pelvis below the level of the knees, then return to their original position; on the sixth exercise, they stand facing the back of the chair at a step distance on one leg, the foot of the other leg bent at the knee, on the weight, hands resting on the back of the chair, perform circular motions with the foot 5 times outward and 5 times inward, then perform the exercise with the other leg, then return to the starting position; on the seventh exercise, face close to the back of the chair, feet together, hands resting on the back of the chair, then raise the leg bent at the knee, toe “away from you”, then return to the starting position, without touching the floor, toe “toward yourself”, then perform the exercise with the other leg, then return to the starting position; on the eighth exercise, they stand facing close to the back of the chair, the legs are shoulder-width apart, the feet are parallel, then they bring the socks inward, without lifting the feet from the floor, bring the heels inward, then continue to move the toes and heels until the feet join, then return to their original position; on the ninth exercise, they stand facing the back of the chair at a step distance, feet together, hands resting on the back of the chair, rise on their toes, transferring body weight over the back of the chair, bend their knees, hanging on their hands, then straighten their knees, then lower their heels to the floor, then return to their original position; on the tenth exercise, they stand facing the back of the chair at a step distance, feet shoulder-width apart with support on the heels, hands resting on the back of the chair, bring the feet inward to the joint, raising the big toes of the feet up without bending the knees, then spread the feet outward, without lowering the thumbs, and without bending the knees, returning to its original position; on the eleventh exercise, they stand facing the back of the chair at a step distance, the feet shoulder-width apart are parallel, the hands resting on the back of the chair, transfer the position of one foot perpendicular to the other foot, sliding the heel inward along the floor, then return to the starting position, then perform the exercise with the other leg, then return to the starting position; on the twelfth exercise, they stand facing the back of the chair at a step distance, the feet are shoulder-width apart, the arms are supported on the back of the chair, the torso is tilted, they perform squats without moving their feet, without bringing their knees together, then return to their original position; on the thirteenth exercise, they stand facing the back of the chair at a step distance, the feet are wider than the shoulders by the size of one foot, the socks are apart, the hands are supported on the back of the chair, the knee of one leg is bent, while the knee goes beyond the line of the foot, and the knee of the other leg is straight, return to its original position, then perform the exercise with the other leg, then return to its original position; on the fourteenth exercise, they walk in a semi-squat for 1 minute, then return to their original position; on the fifteenth exercise, they walk in a deep lunge, sliding their feet along the floor, keeping them parallel, perform the exercise for 1 minute, then return to their original position, then they proceed to perform the third complex for the knee joints, which includes 20 exercises, while the exercises are repeated 10 times, without pauses for rest between exercises, while: on the first exercise in the initial position “sitting on a chair”, one leg is straightened forward, resting on the heel, the other leg is bent under the seat of the chair, resting on the toe, then the position of the legs is changed; on the second exercise in the initial position “sitting on a chair”, one leg is straightened forward in weight, the toe is “away from you”, the leg is parallel to the floor, the other leg is bent under the seat of the chair in weight, then the position of the legs is changed and the exercise is performed; on the third exercise in the initial position “sitting on a chair”, the legs are bent at the knees, the feet are together, the feet are placed apart, leaning on the inner arch, while not separating the knees, then they return to their original position; on the fourth exercise in the initial position “sitting on a chair”, the legs are straightened with support on the feet, they grab the seat from the side with their hands, then they bend one leg at the knee joint, cling to the chair leg with the toe from the outside, then return to the starting position, after that they perform the exercise with the other leg; on the fifth exercise in the initial position “sitting on a chair”, the legs are straightened resting on the feet, gripping the seat from the side with the hands, bending two legs at the knee joints at the same time, clinging to the legs of the chair with the socks from the inside, then returning to the starting position; on the sixth exercise in the initial position “sitting on a chair”, the legs are bent at the knees, the feet are together, after that they are hooked simultaneously with two legs with socks on the legs of the chair from the outside on the weight, then simultaneously with two legs they are hooked with the socks on the legs of the chair on the inside on the weight, then they return to their original position; on the seventh exercise in the initial position “sitting on a chair”, the legs are bent, the feet are together, the arms are lowered, raise the bent leg at the knee joint up, helping with the hands in the shin or ankle joint, trying to put the heel on the chair, then return to the starting position, then perform the exercise with the other leg; on the eighth exercise in the initial position “sitting on a chair” on the edge of the seat, the legs are bent at the knees, the feet are together, they grab the seat from the side with their hands, then they unbend one leg at the knee joint, they stretch forward with the heel, the toe “towards themselves”, after that they return to their original position, after that they perform the exercise with the other leg; on the ninth exercise in the starting position “sitting on a chair”, the legs are bent, the feet are together, the arms are clasped around the back of the chair from behind, then the leg is bent at the knee joint, placing the heel on the corner of the chair seat, then they return to their original position, after which the exercise is performed with the other leg; on the tenth exercise in the initial position “sitting on a chair” on the edge of the chair seat, legs bent at the knees, feet together, gripping the seat from the side, then lowering the pelvis forward and down, crouching in front of the chair, bending the arms at the elbow joints at 90 °, then return to the starting position; on the eleventh exercise in the initial position “sitting on a chair” on the edge of the seat of the chair, the legs are bent at the knees, the feet are shoulder-width apart, the grip is on the side of the seat, then the pelvis is lowered in front of the chair, after which vigorous swaying is performed in the knee joints; on the twelfth exercise in the initial position “standing” facing the back of the chair in front of the seat on one leg, the knee of the other leg on the seat closer to the back, while holding the back, then sit on the heel, inhale, then return to the starting position and exhale, then perform the exercise with the other leg; on the thirteenth exercise in the initial position “standing” facing the back of the chair in front of the seat on one leg, the other leg bent at the knee, in support, on the edge of the chair, the arms are straightened in the “lock” behind the back, then tilt the body forward, then bend and unbend the leg at the knee joint, then change the position of the legs; on the fourteenth exercise in the initial position “sitting on a chair”, the legs are bent at the knees, the feet are shoulder-width apart, the hands are in the “lock” on the knees, step over the clasped hands “to the lock” forward with one foot, then return to the starting position, after which the exercise is performed with the other leg; on the fifteenth exercise in the initial position “sitting on a chair” on the edge of the chair seat, the legs are straightened, the feet are connected with the soles in support on the floor, they grab the seat from the side with their hands, then bend the legs at the knee joints, bringing the heels closer to the seat, then return to their original position; on the sixteenth exercise in the initial position “standing” facing the back of the chair at a step distance, feet wider than shoulders at a distance of one foot, feet parallel, hands holding the back, then bending the knees and performing 5 times circular rotations in the knee joints with both legs simultaneously, towards each other, then 5 times in the opposite direction; on the seventeenth exercise in the initial position “standing” facing the back of the chair at a step distance, legs together, feet connected, hands holding the back, bending the knees, performing circular rotations in the knee joints with both legs simultaneously 5 times in one direction and 5 times in the other direction; on the eighteenth exercise in the initial position “standing” facing the back of the chair at a distance of a step, legs shoulder-width apart, bent at the knees, while the pelvis is at knee level, the feet are parallel, the hands are held on the back from the sides, then springy rocking up and down the pelvis, then return to its original position; on the nineteenth exercise in the initial position “standing” facing the back of the chair at a distance of a step, the feet are wider than shoulders at a distance of one foot, the feet are parallel, the hands are held behind the back, after that they perform semi-squats, without lifting their heels from the floor, then return to their original position; on the twentieth exercise in the initial position “standing” facing the back of the chair at a step distance, feet wider than shoulders at a distance of one foot, feet parallel, perform semi-squats on toes, then return to the starting position, then they proceed to the fourth complex for the hip joints, which includes 20 exercises, each of the exercises is repeated 10 times, without pauses for rest between exercises, while: on the first exercise in the initial position “standing” close to the back of the chair, legs together, hands in support, then take the leg back and up, toe “towards you”, while the body is not tilted, then return to the starting position, then repeat the exercise with the other leg; on the second exercise in the initial position “standing” close to the back of the chair, legs together, arms supported, then take one leg to the side-up, toe “away from you”, then return to the starting position, then repeat the exercise with the other leg; on the third exercise in the initial position “standing” close to the back of the chair, one leg is bent at the knee, the heel is close to the buttock, the hands are in support, they take the thigh back and up without unbending the knee, then return to the starting position, then repeat the exercise with the other leg; on the fourth exercise in the initial position “standing” close to the back of the chair, one leg is bent at the knee, the heel is close to the buttock, the hands are in support, then the thigh is taken to the side-up, then they return to their original position, after that they perform the exercise with the other leg; on the fifth exercise in the initial position “standing” facing the back of the chair at a distance of a step, the leg bent at the knee is raised forward and upward to the level of the hip joint, hands are supported, then circular rotations in the hip joint are performed 5 times in one direction and 5 times in the other direction, after that the exercise is performed with the other leg, then the leg is returned to the floor; At the sixth exercise, in the starting position of “standing” close to the back of the chair, the legs together, the arms in the support, then raise their straight arms up, then tilt the body forward, leaning the palms on the seat of the chair with the simultaneous lifting of the leg back and there, the sock “from themselves”, the knee of the supporting leg cannot bend, then straighten up the straight arms and dropping up to the floor, then raising the straight arms up and dropped the leg. in the starting position, after which the exercise is performed with another foot; on the seventh exercise in the initial position “standing” facing the back of the chair at a step distance, the leg bent at the knee is raised forward and upward, one arm is supported, then the leg is moved over the back of the chair with the interception of hands 5 times to one side and 5 times to the other side, after that the exercise is performed with the other leg, then the leg is returned to the floor; on the eighth exercise in the initial position “standing” close to the back of the chair, heels together, toes apart, then they perform a semi-squat with the knees apart, while the body is not tilted, then they return to their original position; on the ninth exercise in the initial position “standing” close with your back to the back of the chair, legs together, hands in support, then raise the straight leg forward and upward, toe “away from you”, to the level of the hip joint, then return to the starting position, toe “to yourself”, after that, perform the exercise with the other leg; on the tenth exercise in the initial position “standing” close with your back to the back of the chair, legs together, hands in support, then raise one leg forward and upward, toe “towards you”, to the level of the hip joint, then return to its original position, toe “away from you”, then perform the exercise with the other leg; on the eleventh exercise in the initial position “standing” close with your back to the support, legs together, arms in support, raise the leg bent at the knee to the chest, while not tilting the body, then return to the starting position, then perform the exercise with the other leg; on the twelfth exercise in the initial position “standing” close to the back of the chair, legs together, hands in support, step forward with one foot, bending the knee, while the knee goes beyond the line of the foot, and the supporting leg is straight, then return to its original position, then perform the exercise with the other leg; on the thirteenth exercise in the initial position “standing” close to the back of the chair, legs together, hands in support, step forward with one foot, while the knee goes beyond the line of the foot, and the knee of the other leg touches the floor, then return to its original position, change the position of the legs and perform the exercise; on the fourteenth exercise in the initial position “standing” close to the back of the chair, legs together, arms supported, then bend the knee of one leg while moving the other leg to the side on the toe, then return to the starting position, change the position of the legs and perform the exercise; on the fifteenth exercise in the initial position of “standing” the legs together, hands to the shoulders, then raise the leg bent at the knee, touching the knee of the elbow of the arm of the same name, do not tilt the body, then return to the starting position, then perform the exercise with the other leg; on the sixteenth exercise, in the initial position of “standing”, legs together, hands to shoulders, raise the leg bent at the knee, touching the elbow of the opposite arm with the knee, while the body is not tilted, then return to the starting position, then perform the exercise with the other leg; on the seventeenth exercise, in the initial position of “standing”, legs together, hands below, holding a gymnastic stick with a wide grip, transfer the leg over the stick and return to its original position, then perform the exercise with the other leg; on the eighteenth exercise in the initial position of "standing" legs together, arms to the sides, palms down, perform circular rotations in the hip joint with the leg bent at the knee, 5 times to one side and 5 times to the other side, then repeat the exercise with the other leg; on the nineteenth exercise in the initial position “standing on all fours”, the palms slightly in front of the line of the knees, move to the position of the emphasis lying in a jump, bending at the same time in the lower back, then return to the starting position; on the twentieth exercise in the initial position “standing on all fours”, the palms are slightly ahead of the line of the knees, one leg to the side on the toe, then they change the position of the legs by jumping in one direction and the other, then they proceed to the fifth complex for stretching the muscles of the spine, which is carried out similarly to the fifth complex for stretching the muscles of the spine, performed on the 1st lesson of the week, while each of the exercises is performed 1 time with a static delay of 15 seconds in each accepted position until returning to its original position and without pauses for rest, at the same time, when performing all exercises of each complex, breathing is arbitrary, on the 3rd lesson of the week, the first set of exercises is first performed to relieve tension from the deep muscles of the spine, similarly to the exercises of the first complex, performed on the 2nd lesson of the week, which is performed 1 time with a static delay, but for 30 seconds in each accepted position until returning to the starting position, without pauses for rest between exercises, then they begin to perform the second set of exercises for the ankle joints, which is carried out in the initial “standing” position, and the exercises are performed similarly to the exercises performed in the 2nd lesson of the week, each of which is also repeated 10 times, without pauses for rest between exercises, but at the same time, leg weights are used - for women, 0.5 kg and for men, 1.0 kg for each leg, then they begin to perform the third set of exercises for the knee joints, carried out in the initial “lying” position similar to the exercises performed in the 1st lesson of the week, while all exercises are repeated 10 times, without pauses for rest, using leg weights - for women, 0.5 kg and for men, 1.0 kg for each leg, then they begin to perform the fourth set of exercises for the hip joints, which is performed in the initial position “lying”: “lying on the back”, “lying on the stomach” and “lying on the side”, similar to the exercises performed in the 1st lesson of the week, while all exercises are repeated 10 times, without pauses for rest, using leg weights - for women 0.5 kg and for men 1.0 kg for each leg, then they begin to perform the fifth set of exercises for stretching the muscles of the spine, performed in the initial position "standing", similar to the exercises of the 2nd lesson of the week with a static delay of 30 seconds and repeating each exercise 1 time, without pauses for rest between exercises, at the same time, in all sets of exercises on the 3rd day of the week’s classes, breathing is arbitrary, daily exercise 1 hour before bedtime is carried out independently, in which a set of exercises is performed to relieve tension from the deep muscles of the spine, lasting 10 minutes, and carried out in the following modes: on the first day, the exercises are performed similarly to the exercises of the 1st group lesson of the week in the form of dynamic movements with the repetition of each exercise 10 times, without pauses for rest between exercises; on the second day, the exercises are performed similarly to the exercises of the 3rd group lesson of the week in the form of static movements with a delay of 30 seconds, repeating each exercise 1 time, without pauses for rest between exercises, in addition, with the dynamic method of performing this set of exercises, movement and breathing were carried out at the expense of 1-2 - inhalation - movement, at the expense of 3-4 - exhalation - return to the starting position, and with the static method of performing the complex, breathing is arbitrary, then, the methods of performing the complex for relieving tension from the deep muscles of the spine are alternated in the same sequence.