RU2394605C2 - Method of organism rehabilitation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, namely to rehabilitation medicine, psychotherapy, psychosomatics. Influence on organism at group sessions is carried out in three stages. At the first stage rational psychotherapy is carried out, patients are informed about anatomical and physiological peculiarities of organism, influence of stress on organism, mechanisms of disease process formation in organism and ways of organism rehabilitation. At the second stage promotional and cognitive therapy, based on therapy by creative expression is carried out. At the third stage body-oriented therapy by development of introspection skills of body sensations is carried out, carried meditative, body and breathing exercises are performed.

EFFECT: method allows to achieve activation of organism adaptation abilities, increase efficiency and reduce of treatment terms in patients with severe somatic diseases, with limited physical activity.

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Description

The invention relates to medicine, namely to restorative medicine, psychotherapy, psychosomatics.

A known method of healing the body, described in US Pat. RF №2290159, according to class А61Н 1/00, А63В 23/00 “Method of healing the body (respiratory-motor complexes of exercises of the body-oriented psychological school Kupriyanova P.Yu.)”, (1).

The method is carried out by performing physical exercises with the formation of a motivational component in the ongoing process. Exercises are represented by a small and large complex of exercises containing breathing exercises to activate and strengthen the diaphragm, exercises with swinging the body of a person to relax the muscles of the neck, to stretch the muscles of the lower extremities, to relax the pelvic muscles, to static balance, stretching the spine.

The disadvantage of this method is its focus on the possible use in healthy people. An explanation of the mechanism of action of exercises on the body is carried out after class, which leads to their mechanical implementation, which reduces the effectiveness of the impact. The therapeutic effect is mainly focused on the restoration of a normal physical condition. Little attention is paid to the psycho-emotional state. Man is not regarded as a whole system of soul and body.

There is also a method of healing the body, described in US Pat. RF №2110978, according to class А61Н 1/00, А61М 21/00 “Method of exposure to the body”, (2).

This method consists in performing gymnastic exercises aimed at stretching and strengthening muscles, increasing the mobility of joints and spine. View the plot that reproduces the exercises, select music, conduct rational psychotherapy. Exercises are performed at a smooth slow pace without stress in the initial positions, giving the spine a horizontal position. The introductory and final stages are carried out lying on your back, and the main one is lying on your stomach, on your side and on all fours accompanied by light instrumental music, which has a calm sound at the opening stage, at the main - light tonic, and at the final - soothing, and after their completion is carried out by hardening procedures using water.

The disadvantage of this method is the lack of a holistic worldview system, indicating the unity of the soul and body, the interaction of man and the world. The method is aimed mainly at restoring the physical body. The impact on the emotional sphere is limited only by listening to music.

Well-known method Therapy creative expression M.E. It is stormy in the formation of ideological worldview, behavioral attitudes, aspirations to preserve and strengthen mental health by studying the characters of people, cognizing the nature of their character in creative self-expression, their mental problems in the process of studying literary works, studying the biographies of writers, composers, artists, listening to music works, viewing pictures, creating creative works, keeping a diary and notebooks, (3).

The disadvantage of this method is the concentration on the psychological state of a person. The body is considered only from the point of view of the primacy of the bodily or spiritual in the process of studying characters. There is no effect aimed at restoring the physical body.

There is also a method of healing the body, described in US Pat. RF №2196613, by class А61М 1/00 “Method of directed self-regulation of a person’s psychophysical state” (4).

The method is carried out by conducting rational psychotherapy aimed at improving the health of a person as a holistic system. Perform a physical warm-up, including massage of biologically active points, exercises for the spine, eyes, feet, meditative breathing exercises, breathing exercises according to Strelnikova and Pranayama. They carry out relaxation and set a psychological orientation to improve their personal and emotional qualities for the further manifestation of their abilities in the areas of leadership and wrestling qualities, building on the material level, achieving records and accomplishing feats, relationships, professional achievements. They suggest that the patient create the highest positive mental image that he should strive for. Perform corrective gymnastics of individual organs and parts of the body.

The disadvantage of this method is its focus on solving psychological problems without taking into account the characteristics of a person’s character, his needs in accordance with his natural character. The emphasis is on achieving the desired good, and not on the formation of mature psychological defenses. A positive mental image is offered to the patient from the outside, which is not the result of his internal work to recognize himself, which is an indicator of the low efficiency and shortness of the achieved positive result from treatment.

The aim of the invention is to activate the adaptive capabilities of the body, increase efficiency and reduce treatment time in patients suffering from severe somatic diseases with limited physical activity.

This goal is achieved by psychotherapeutic work on the mental and physical levels. The approach combines the elements of existential therapy, positive psychotherapy, non-directive therapy with metaphors, neuro-linguistic programming, psychoanalysis, affecting the causes of the development of diseases in accordance with the clinical picture, personal, characterological features. Treatment is carried out in the spirit of Therapy with creative self-expression with the search for one's own unique attitude both to the process of life, to other people, and to one's bodily manifestations.

This goal is achieved by the fact that the impact on the body in group classes is carried out in 3 stages: at the first stage, rational psychotherapy is carried out, patients are introduced to the anatomical and physiological characteristics of the body, the effect of stress on the body, the mechanisms of the formation of painful processes in the body and ways to improve the body; at the second stage, explanatory and cognitive therapy based on therapy with creative expression is carried out; at the third stage, they carry out body-oriented therapy by developing the skills of self-observation of bodily sensations, conduct meditative, bodily and breathing exercises.

The method is implemented as follows.

The therapeutic effect is carried out in group classes in 3 stages at the psychological and bodily levels, it includes explanatory-cognitive psychotherapy and introduction to a state of meditation, the implementation of meditative bodily and breathing exercises.

At the first stage, rational psychotherapy is performed. In the first lesson, the body is considered as a holistic system, they offer "to treat not the disease, but the patient." The work is carried out using metaphors. A healthy state of mind is considered as the realization of character with public benefit, understanding of the value of its unique natural properties. A healthy body is considered as devoid of excessive muscle clamps, with the possibility of free circulation of energy, given that psychosomatic disorders are intense bodily manifestations of psychological problems. They create an attitude to the need for harmonization of mental and physical state.

In the second lesson, patients are introduced to the anatomical and physiological characteristics of the body, the effect of stress on the body (stress theory G. Selye), the mechanisms of formation of painful processes in the body. Rational psychotherapy is carried out with an explanation of the essence of the disease and ongoing therapy, and they stimulate the patient to an active position in treatment.

In the third lesson, patients are introduced to the beneficial effects of positive emotional stress on the body. They inform in detail about the body's ability to recover. The lesson gives examples of the positive effects of healing emotional stress on the body, and read excerpts from the patient’s psychotherapeutic diaries. The duration of each lesson is 1-1.5 hours.

At the second stage, explanatory and cognitive therapy is carried out, based on a modified version of Therapy by creative expression of M.E.Burno. In group classes, patients are introduced to characters in the process of studying literary works, studying the biographies of writers, composers, artists, listening to musical works, viewing paintings in order to know their character, their painful disorders. It is noted that the psychological characteristics of a person are reflected at the bodily level in the form of muscle stiffness and clamps. They study the different attitude of people with different characters to physical education. They continue to learn about others and themselves, learning specific techniques for creative expression: therapy with the creation of creative works; creative communication with nature; creative communication with literature, art, science; creative immersion in the past; keeping a diary and notebooks; creative search for spirituality in everyday life; creative travel. Classes of the second stage are held 2-3 times a week, 10-12 lessons per course.

At the 3rd stage of the treatment process, a body-oriented psychotherapy is carried out, which consists in the development of self-observation skills for bodily sensations. During simple movements with a focus on internal sensations, muscle tension is detected. Exercises are performed to achieve relaxation in the muscles, finding a comfortable state of the body. Exercises are selected from a set of bodily exercises, taking into account the disease, clinical symptoms in a particular patient. Exercises are conducted to calm meditative music with a relaxing effect at the stage of detecting muscle clamps. After relaxation, at the end of the session, tonic music is listened. Further development of the skills of self-observation of bodily sensations occurs during the execution of bodily exercises with self-immersion in a shallow altered state of consciousness. Body-oriented therapy is carried out simultaneously with the second stage of treatment daily. The duration of the lesson is 1 hour. The course of treatment is 10-12 lessons.

A complex of bodily exercises performed at the 3rd stage of treatment

Body muscle relaxation exercise

In the initial position, lying or sitting, they close their eyes. Focus on breathing, tracking how air enters the airways and exits. Focus on the face, note the tension of the muscles of the face. Track the tension in the muscles of the neck. Mentally look at the spine, pay attention to the sensations in the muscles of the back. Pay attention to the tension in the muscles of the shoulders and arms. Focus on tension in the muscles of the legs. Mentally studying the body, the sensations in the right and left halves are compared. Create an image of a relaxed body.

Clamp exercises in the muscles of the head, neck and eyes

Exercise 1. Turning the head left and right as far as possible without effort and tension. During the exercise, pay attention to the tension in the muscles of the neck and shoulders.

Exercise 2. Turns the head left and right in the imagination. It is necessary to feel the sensations bright, vibrant.

Exercise 3. Head turns from side to side. Pay attention to how the movement of the shoulders and back.

Exercise 4. The gaze is fixed right in front of you. Make head movements left and right. Turns the head left-right with eye movement left-right. Pay attention to the tension in the muscles of the neck, eyes.

Exercise 5. Imagine mentally the implementation of head turns left-right. Feel the sensations bright, vibrant.

Exercise 6. Turn your head left and right as far as possible without effort and tension. Pay attention to changes in sensations in the muscles of the neck, eyes, head compared to what was noted at the beginning of the lesson.

Exercises to relax muscle tension in the shoulders

Exercise 1. Turn your head from side to side. Pay attention to muscle tension in the shoulders and back.

Exercise 2. Raise your shoulders up with your arms down. Pay attention to the sensations in the shoulder area during movement.

Exercise 3. Do circular motion with your shoulders forward, then back. Pay attention to the sensations in the shoulder area during movement.

Exercise 4. Raise the arms extended forward to the height of the shoulders, lower them down. Pay attention to the sensations in the shoulders during movement.

Exercise 5. Raise the arms extended forward above the head, lower them. Pay attention to the sensations in the shoulders during movement.

Exercise 6. Swing hands hanging along the body back and forth. Pay attention to the sensations in the shoulders and back while moving.

Exercise 7. Hands make circular movements forward, then circular movements backward. Pay attention to the sensations in the shoulders and back while moving.

Exercises to relax muscle tension in the back muscles

Exercise 1. They cross their arms in front of the chest, holding their elbows with their hands. Move your raised and crossed arms from side to side, moving your elbows as far as possible to the side. Tension in the muscles of the back during movements is noted.

Exercise 2. Move with raised and crossed arms from side to side, accompanying the movement of the elbow to the side by turning the head in the same direction. Tension in the muscles of the back during movements is noted.

Exercise 3. Move with raised and crossed arms from side to side, accompanying the movement of the elbow to the side by turning the head in the opposite direction. Pay attention to the sensations in the shoulders and back while moving.

Exercise 4. Raise the arms extended forward to the level of the shoulders, lower them down. Pay attention to the sensations in the shoulders during movement.

Exercise 5. Raise hands pressed to each other's hands to shoulder level. Keep your arms as far left and right as possible. Tension in the muscles of the shoulders and back is noted.

Exercise 6. Lying down. They put their hands on the chest so that the bent elbows look to the sides at shoulder level. Raise your elbows up and return them to the floor at shoulder level. Tension in the muscles of the shoulders and back is noted.

Exercise 7. Lying down. Hands lie along the body. Raise your hands up behind your head, touching the floor with the back of your hands. Return the hands to a position along the torso. Pay attention to the sensations in the shoulders, back during movement.

Exercise 8. Lying down. Hands lie along the body, palms down. They slide their hands on the floor, moving their shoulders up and down. Tension in the muscles of the shoulders and back is noted.

Exercise 9. Lying down. Hands are lowered behind the head so that they touch the floor with the back of the hands. They slide their hands on the floor, moving their shoulders up and down. Tension in the muscles of the shoulders and back is noted.

Exercises to Relax Your Leg Muscles

Exercise 1. Lying down. “Stop” the feet to the outside, to the floor, and then bring them back (to the heel). The movement is repeated, paying attention to the muscle tension in the legs, movement in the hip joints.

Exercise 2. Lying down. They rotate the feet in the ankle joints so that they fall outwards and return to the place (on the heel). Tension in the muscles of the legs during movements is noted.

Exercise 3. Lying down. “Stop” the feet inside, to the floor, and then return back (to the heel). The movement is repeated, paying attention to the muscle tension in the legs, movement in the hip joints.

Exercise 4. Lying down. The feet in the ankle joints are rotated so that they fall inwards and return to the place (on the heel). Tension in the muscles of the legs during movements is noted.

Exercise 5. Legs stretched out in front of him, standing on the heel, on the floor back and forth alternately. Pay attention to the tension in the muscles of the legs, buttocks, lower back.

Exercise 6. The legs are bent at the knees, the feet are placed on the floor. Alternately, the legs are tilted left and right so that when the leg is deflected inward, the foot drops to its inner edge, and when deflected outward, to the outside. Pay attention to the tension in the muscles of the legs, buttocks, lower back.

Breathing exercises

Before performing breathing exercises, patients are introduced in detail to the anatomical and physiological characteristics of the respiratory system.

Exercise 1. In a state of relaxation, they inhale to the depth of the nasal cavity, exhalation occurs passively. During inspiration, the nasal cavity is visualized and a stream of inhaled air is presented.

Exercise 2. In a state of relaxation, they inhale to the depth of the trachea (to the middle of the sternum), exhalation occurs passively. Visualize the nasal cavity, pharynx, larynx, trachea. Pay attention to the tension in the muscles of the shoulder girdle.

Exercise 3. Inhale to the depth of the main bronchi (upper chest), exhale passively. Visualize the nasal cavity, pharynx, larynx, trachea, main bronchi. Pay attention to the tension in the muscles of the shoulder girdle, upper chest.

Exercise 4. Inhale to the depths of all bronchi (chest to the diaphragm), visualizing the airways, representing the flow of air passing through the airways. Pay attention to the tension in the muscles of the shoulder girdle, upper chest, diaphragm, anterior abdominal wall.

Exercise 5. Perform the previous exercise with the visualization of exhalation, the passage of a stream of air through the bronchi, trachea, larynx, nasal cavity.

Clinical example No. 1

Patient R.A., 57 p.

Diagnosis: Atherosclerosis. Obliterating atherosclerosis of the vessels of the lower extremities IV Art. Occlusion of PBA from two sides. Ischemia of rest on the left. Trophic ulcer of the fourth finger on the left.

Complaints: pain in the left foot, pain in the calf muscles at rest, numbness, coldness in the legs, low mood, feeling of loneliness, lack of satisfaction from life. On examination, the skin of the lower extremities is pale with patches of ischemic hyperemia on the left lower leg. Hair on the lower extremities is absent, the presence of hyperkeratosis. Trophic ulcer on the fourth toe of the left foot.

On palpation, there is no pulse on the PBA on both sides.

The disease began 2 years ago. 5 years ago suffered myocardial infarction.

Smokes for 10 years.

During inpatient treatment, a course of therapy was carried out according to the proposed method. At the first stage, rational psychotherapy was carried out, aimed at creating an attitude towards the need to harmonize mental and physical condition. We were introduced to the anatomical and physiological characteristics of the body, the effect of stress on the body. Conducted rational psychotherapy with an explanation of the essence of the disease and ongoing therapy, stimulated the patient to an active position in treatment. We were introduced to the beneficial effects of positive emotional stress on the body. In the first lesson, the body was considered as an integral system. A healthy body was considered as devoid of excessive muscle clamps, which are a consequence of previous psychological problems. The stage included 3 classes.

Further, explanatory and cognitive therapy was carried out, based on Therapy of Creative Expression. There was an acquaintance with the characters in the process of studying literary works, studying the biographies of writers, composers, artists, listening to musical works, viewing paintings. The patient was aware of his character, its strong and weak features. The patient was trained in specific methods of self-help and knowledge of himself and others in creative self-expression. At the second stage, 7 lessons were held. Classes of the second stage were held 3 times a week. At the same time as the exercises of the second stage, bodily exercises of the third stage were carried out. In the individual selection of exercises from the main complex, the emphasis was on exercises, relaxing muscles of the back, legs, and breathing exercises. The exercises of the third stage were performed daily for 30 minutes. In the third stage, 12 lessons were held. After the first lesson, I became convinced of the need for a comprehensive therapeutic effect on the body. After meeting with the characters, the mood improved, the patient was able to feel the value of his character, the possibility of realizing his features with public benefit. He began to keep a psychotherapeutic diary, write psychotherapeutic stories. During the training of body and breathing exercises, the patient took an active position in the treatment process. After performing bodily and breathing exercises, the patient experienced a comfortable, relaxed bodily condition. Performing exercises to relax the muscles of the legs, he learned to significantly reduce pain in the legs.

The observation period is 6 months. The patient independently continues his creative self-expression in writing diaries and short stories, participates in staging performances in the city theater. Performs bodily exercises every other day for 30 minutes. He became more active in life, contacts, continued to work as a driver.

Clinical example No. 2.

Patient N.N., 69 l.

Diagnosis: Obliterating atherosclerosis of the vessels of the lower extremities. OCA stenosis from two sides. S. Lerisha. Occlusion of NAP on the right, BOTH on the left. Stress ischemia 10 m. Condition after stenting of the left popliteal artery in 2007

Complaints: pain in the calf muscles when walking, a feeling of numbness, coldness in the legs, a dreary mood, apathy.

On examination, the skin of the lower extremities is pale with areas of hyperkeratosis.

The disease began 10 years ago. Does not smoke for 5 years.

During treatment in a hospital, a course of therapy was carried out according to the proposed method. Rational psychotherapy was carried out with an explanation of the essence of the disease and ongoing therapy. Stimulated the patient to an active position in treatment. They introduced us to the anatomical and physiological characteristics of the body, the effect of stress on the body, the mechanisms of the formation of painful processes in the body, and the ways of healing the body. A healthy body was considered as devoid of excessive muscle clamps, which are a consequence of previous psychological problems. Then they conducted explanatory and cognitive therapy based on therapy with creative self-expression, introduced them to characters, taught self-help methods in creative self-expression. Simultaneously with the study of characters, meditative bodily and breathing exercises were performed. From the main set of exercises were selected aimed at relaxing the muscles of the legs, back, breathing exercises. Body-oriented exercises were performed daily for 30 minutes. 10 lessons were held.

Against the background of the therapeutic effect, the patient’s emotional state improved, became more sociable, took an active position in the treatment process. After getting to know the characters, he resolved a number of psychological problems that prevented the healing process from feeling the value of his character. He kept a psychotherapeutic diary, writing stories about creative communication with nature, the search for spirituality in everyday life. Having mastered the exercises for relaxing the muscles of the legs, he achieved warming of the feet and lower legs, there were observed vegetative reactions in the form of facial flushing. After performing breathing exercises, the patient experienced a feeling of free, full breathing, a comfortable, relaxed bodily condition. The observation period is 6 months. The patient independently continues body exercises for 20 minutes a day. Continues to shape a creative lifestyle. He became more active in everyday life.

The positive effect of the use of the invention is expressed in improving the condition in almost all patients. According to the SAN test, indicators of well-being, activity, and mood increased both after each lesson and after a course of treatment. According to the Luscher color test, there was a change in the emotional state corresponding to the attitude toward recovery. According to the Spielberger-Hanin test, the level of anxiety decreased. During group classes, patients are distracted from painful experiences, their mood improves. Patients are trained to independently act on uncomfortable bodily symptoms, which strengthens their faith in their own strengths. There is a restructuring of views, interests, aspirations, attitude to one’s own state and reality, a desire to overcome the disease, to realize the compensatory capabilities of the body.

The therapeutic effect helps to find spiritual harmony, to see your own path in life, to make sense. Some patients have a desire to write psychotherapeutic stories. There is a reduction in treatment time.

Information sources

1. RF patent No. 2290159, Cl. A61H 1/00, A63B 23/00, 2006.

2. RF patent No. 2110978, Cl. A61H 1/00, A61M 21/00, 1998.

3. Stormy M.E. Creative expression therapy. - M.: Academic Project, 2006. - 432 p.

4. RF patent No. 2196613, Cl. A61M 21/00, 2003.

Claims (1)

A way to improve the body by acting on the body at the mental and physical levels, characterized in that the effect on the body in group classes is carried out in 3 stages:
at the first stage, rational psychotherapy is carried out, patients are introduced to the anatomical and physiological characteristics of the body, the effect of stress on the body, the mechanisms of the formation of painful processes in the body and ways to improve the body;
at the second stage, explanatory and cognitive therapy based on therapy with creative expression is carried out;
at the third stage, they conduct body-oriented therapy by developing the skills of self-observation of bodily sensations, conduct meditative, bodily and breathing exercises.