Diseases of arterial vessels — obliterating atherosclerosis and an endarteritis result from changes in a structure of walls of vessels: they are narrowed that brings in a result to their spasms, and afterwards — to full impassability. It conducts to gangrene of extremities, mainly lower.
The disease passes four stages. On the first extremities grow cold, fingers and feet grow dumb, fast fatigue of legs, spasms of gastrocnemius muscles are noted. On the second these phenomena are more expressed, the so-called alternating lameness (the sharp gastrocnemius muscle pains when walking disappearing at a stop and rest), cyanosis and "mramornost" of skin of shins join them. At the third stage all listed phenomena are expressed more sharply, also extremity pains (especially at night) at rest develop, "mramornost" is replaced by cyanosis. At the fourth stage gangrene of fingers and feet develops. The reasons and the mechanism of development of an obliterating endarteritis the same, as at atherosclerosis.
At an endarteritis it is necessary to refuse flatly smoking and alcohol intake. Apply the vasodilating and lowering coagulability means blood to treatment, recommend systematic occupations by physiotherapy exercises and massage (at the first and second stages). If necessary do operation on vessels and delete sympathetic nodes (it reduces a tone of arteries and increases a blood stream on district vessels).
Occupations by physiotherapy exercises are necessary for strengthening of all organism, improvement of the general and peripheric circulation, and also regulation of exchange processes, especially in the affected extremities, recovery of normal blood circulation. Develop new — collateral — the vessels replacing struck.
Exercises of physiotherapy exercises at the first and second stages of an obliterating endarteritis carry out from different starting positions: lying on spin, legs are extended; lying on the edge of a bed, the affected leg is lowered on a floor; sitting with the extended legs; sitting with the extended healthy leg, struck it is lowered; standing; in walking. Very important during occupations often to change position of the affected leg: to raise it (blood outflow), to lower (rush of blood). Such change of situation promotes vasodilatation, development of the small, earlier not functioning capillaries, reduces cyanosis and "mramornost" of an extremity, kills pain.
Include the respiratory, all-developing exercises for healthy extremities and a trunk in occupations and special exercises for the affected extremities (in alternation with the all-developing and breathing exercises). The active movements for study of all joints from different starting positions belong to special exercises for the affected extremities (bending, extension, assignment aside, roundabouts); exercises on a static stress and relaxation of muscles, exercises with a frequent postural change of the injured extremity. Morning hygienic and remedial gymnastics is very important (3 — 4 times a day), besides, at the first and second stages of a disease the dosed walking is of great importance. Walking speed, distance, time of rest are defined individually.
If when performing exercises there are pains, it is necessary to be interrupted and have a rest; at emergence of fatigue when walking to reduce the speed and duration of walking. At the third stage of a disease at first carry out exercises only for healthy extremities and a trunk in combination with respiratory; in process of improvement of a state include special exercises for the affected extremities.
Approximate complex of special exercises at an endarteritis of the lower extremities
1. Nominative — lying on spin on a bed or a couch, hands along a trunk, legs are extended. To strain muscles of hips into 5 accounts and to weaken into 3 accounts. To repeat 4 — 10 times. Speed is slow. Breath is free. 2. Nominative — the same. To raise a direct leg up, a sock to itself and to hold this situation. 6 — 10 accounts to return to nominative into 4 — 6 accounts. The same other leg. To repeat 4 — 10 times each leg. Speed is average. Breath is free. 3. Nominative — the same. To bend legs to a stomach, then to straighten. If it is difficult to execute the movement by both legs at once, it is possible to bend serially legs to a stomach. To repeat 4 — 6 times. Speed is slow. Breath is free. 4. Nominative — the same (to lay down so that the affected leg was at edge of a bed or a couch). Into 4 accounts to raise a direct leg which is closer to edge, up to a right angle in a hip joint, a sock to itself, then into 8 accounts to lower, having delayed a sock, for edge of a couch or bed on a floor down and to weaken (all leg from a buttock to foot has to be lowered and relaxed). To repeat 4 — 10 times. Speed is slow. Breath is free. The same other leg, lying other party to edge of a couch or bed. 5. Nominative — the same, legs at shoulder length. At the same time into 5 accounts to execute the movement by feet from itself, drawing in fingers, and into 8 accounts the movement to itself, having unclenched fingers and having weakened foot. To repeat 4 — 8 times. Speed is average. Breath is free. 6. Nominative — the same. Into 4 accounts to lift right. a leg, shaking it, then to lower; the same left leg. To repeat 4 — 6 times each leg. Speed is average. Breath is free. 7. Nominative — sitting on a couch or a bed the right side to edge, legs are extended before themselves. To raise the right direct leg into 4 accounts and into 8 accounts to lower for edge of a couch or bed on a floor, having relaxed muscles. The same the left leg, sitting the left side to edge of a bed. To repeat 4 — 6 times each leg. Speed is average. Breath is free. 8. Nominative — being on a high stool, legs an easy fit hang down Rocking in the relaxed legs — right forward, left back and vice versa. To repeat 10 times. Speed is average. Breath is free. 9. Nominative — the same. To raise direct legs before itself, to hold this situation into 4 — 6 accounts, then to lower legs to relax, shaking legs into 6 — 8 accounts. To repeat 2 — 4 times. Speed is average. Breath is free. 10. Nominative — standing, hands on a belt. The swing movements by the right leg forward and back with the maximum amplitude. To repeat 6-10 times. Speed is average. Breath is free. The same left leg. 11. Nominative — standing. To bend the right leg in knee and coxofemoral joints (the sock is delayed), to press it hands to a stomach, to straighten a leg on weight and to return to nominative. The same left leg. To repeat 4 — 8 times each leg. Speed is average. Breath is free. 12. Nominative — the same, hands on a belt. Potryakhivaniye the raised right leg into 3 accounts. The same left leg. To repeat 4 — 6 times each leg. Speed is average. Breath is more free. Performance of exercises should not cause fatigue, pain, numbness, spasms and other unpleasant phenomena. At their emergence it is necessary to reduce a dosage, to reduce speed and to see a doctor.