Medical control. Medical control (2) - Abstract Basic concepts of medical control

4.1.1 Essence, tasks and forms of medical control

Before you start exercising on your own, you need to get recommendations on the regimen of physical mobility from your local doctor or at the district medical and physical education dispensary. Then, using the advice of doctors or physical education specialists, choose the most useful types of exercises for yourself. You should practice regularly, trying not to miss a single day. At the same time, it is necessary to systematically monitor your well-being, noting all the changes that occur in the body before and after exercise. For this, diagnostics or self-diagnosis is carried out. During its implementation, objective indicators of self-control are carefully recorded: heart rate, blood pressure, respiration, weight, anthropometric data. Diagnostics is also used to determine the trainee's fitness.

There are many functional tests, criteria, tests-exercises, with the help of which the state of the body is diagnosed during physical exertion. A special place in the occupations of health-improving physical culture of older and elderly people is occupied by medical supervision.

Before embarking on recreational training, middle-aged and elderly people should undergo a medical examination with an ECG recording before and after (or during) a functional stress test to identify possible disorders in the circulatory system.

Medical control in the process of physical culture is aimed at solving three main tasks: 1) identifying contraindications to physical training; 2) determination of Ufa for the appointment of an adequate training program; 3) control over the state of the body during classes (at least twice a year).

Due to the ability to vary the amount of training loads (starting with walking) over a wide range, absolute contraindications to recreational training are very limited: - congenital heart defects and stenosis (narrowing) of the atrioventricular orifice; - cardiac or pulmonary insufficiency of any etiology; - severe coronary insufficiency, manifested at rest or with minimal load; - chronic kidney disease; - high blood pressure (200/120 mm Hg), which cannot be reduced with antihypertensive drugs; - early period after myocardial infarction (3-6 months or more); - severe heart rhythm disturbances (atrial fibrillation, etc.); - thrombophlebitis; - hyperfunction of the thyroid gland (thyrotoxicosis).

Physical education is also temporarily contraindicated after any acute illness or exacerbation of a chronic illness.

The data obtained in the process of medical control objectively reflect the functional state of the body and the effectiveness of the use of health programs. Additional valuable information during a medical examination is also obtained by measuring blood pressure, recording an ECG at rest and after exercise, determining VC and body weight.

The Regulation on medical control over the physical education of the population defines the following main forms of work on medical control:

1. Medical examinations of all persons involved in physical education and sports.

2. Medical and pedagogical supervision during training sessions and competitions.

3. Dispensary care for individual groups of athletes.

4. Medical and sanitary support of industrial gymnastics.

5. Medical and sanitary support of competitions.

6. Prevention of sports injuries.

7. Preventive and current sanitary supervision over the places and conditions for conducting physical education classes and competitions.

8. Medical consultation on issues of physical culture and sports.

9. Sanitary and educational work with those involved in physical education and sports.

10. Agitation and promotion of physical culture and sports among the population.

The relevance and practical significance of the medical control of athletes is due to the significant physical and mental effects on the athlete, which in the sport of the highest achievements border on the ultimate human capabilities. Along with this, a significant group of athletes is identified with functional abnormalities diagnosed as pre- and pathological conditions.

Tasks of medical control:

assessment of the state of the main life support systems of the body (cardiovascular, respiratory, muscular, energy supply, autonomic regulation);

determination of the level of adaptation of the body to physical activity;

assessment of the state of physical and biological development;

examination of the prospects of young athletes;

selection of athletes (to the team) at all stages of preparation;

functional state forecasting for competitive activity;

development of models of functional readiness of athletes, etc.

Medical control provides for the assessment of the following indicators.

1. The cardiovascular system is assessed by the parameters of central hemodynamics (systolic, diastolic, pulse blood pressure, cardiac output parameters, peripheral vascular resistance, type of hemodynamics, adaptability of the circulatory system and exercise tolerance), electrocardiogram registration - ECG. This is one of the accessible and objective ways to control the functional state of an athlete. A known and applied operational method for determining fatigue by ECG A.I. Zavyalov, which allows you to monitor the increase in fatigue during training and complete the workout with the highest training effect without overwork.

2. The system of nervous autonomic regulation, which characterizes the current functional state of the body (overwork, detraining, etc.), the level of adaptation to physical activity.

3. The condition of the skeletal muscles of the body is assessed according to the data of muscle tone and electromyography parameters.

4. Systems of aerobic and anaerobic (glycolytic and creatine phosphate) energy supply of muscular activity.

5. Assessment of the state of physical and biological development.

6. Assessment of the level of physical performance (test on a bicycle ergometer).

7. Data of anthropometric observations.

Based on the results of the functional examination, recommendations are given for optimizing the functional state, possible means of rehabilitation and suggestions for correcting the training and competitive processes.

The Regulation on medical control over the physical education of the population defines the following main forms of work on medical control:

1. Medical examinations of all persons involved in physical education and sports.

2. Medical and pedagogical supervision during training sessions and competitions.

3. Dispensary care for individual groups of athletes.

4. Medical and sanitary support of industrial gymnastics.

5. Medical and sanitary support of competitions.

6. Prevention of sports injuries.

7. Preventive and current sanitary supervision over the places and conditions for conducting physical education classes and competitions.

8. Medical consultation on issues of physical culture and sports.

9. Sanitary and educational work with those involved in physical education and sports.

10. Agitation and promotion of physical culture and sports among the population.

During a medical examination, determining and evaluating the state of health and the level of physical development, the doctor thereby reveals the level of physical fitness.

Determining during the initial examination the state of health, physical development and fitness before the start of classes, the doctor decides whether it is possible to allow the subject to classes, which ones, with what load, etc.

General information

Medical control is an integral part of the healthcare system, providing medical supervision of those involved in physical education and sports. Medical control is a practical section of sports medicine.

Sports medicine is a part of clinical medicine that studies the impact of sports and physical culture on the human body. The most important component of sports medicine is sports control. Its tasks include: studying adaptation to physical loads, the social role of physical culture as a factor in improving the health of all contingents of the population; participation in the management of the training process, rationalization of organizational and managerial forms of medical support for mass health work, training of young athletes, as well as elite sports, sex and anti-doping control, etc.

Sports medicine deals with the prevention, treatment and rehabilitation of athletes.

The penetration of the ideas of physical education into medical science dates back to the end of the 18th - beginning of the 19th century. P. F. Lesgaft and V. V. Gorinevsky became the founders of the problem of physical education as a means of improving the health of the general population. At the present stage, the foundations of sports medicine and medical control were laid by S. P. Letunov and R. E. Motylyanskaya, who in the 1950s and subsequent years headed the department at the Research Institute of Physical Education in Moscow. Established in the 1950s, medical and cultural dispensaries provide medical supervision in physical education and are methodological centers for medical institutions on these issues. The 50s are marked by the beginning of the active participation of the country's athletes in the Olympic Games. A great contribution to the improvement of medical control in the 40-50s was made by V.E.Vasilyeva, D.F.Deshin, V.K.Dobrovolsky, S.M. Ivanov, G.I. Krasnoselsky, I.A. etc. In the subsequent 60-70s and to the present, the in-depth development of various sections of sports medicine, medical supervision, at the departments of medical institutes and institutes of physical education, at research institutes of physical culture and sports (V.F. Bashkirov, L. A. Butchenko, V. K. Velitchenko, G. R. Gigineishvili, N. D. Graevskaya, N. A. Zagorskaya, V. L. Karpman, G. M. Kukolevsky, F. G. Lapitsky, L. N. Markov, E.A. Pirogova, V.S. Pravosudov, S.B. Tikhvinsky, S.M. Khrushchev, D. M. Tsverava, A. V. Chogovadze and others).

The main tasks and work on medical control are:

• medical examination of all contingents of the population involved in physical culture and sports;
• clinical examination of highly qualified athletes and students of children's and youth sports schools (CYSS);
• medical and pedagogical observations of athletes in physical education classes, training and competitions;
• carrying out preventive, health-improving and, if indicated, therapeutic measures for sprrtsmen and students of the Youth Sports School, who are registered with the dispensary;
• sanitary and hygienic control over the conditions for conducting sports activities;
• prevention of sports injuries, medical examination of students of sports competitions and mass sports and recreation events;
• consultation of doctors of medical institutions, trainers, teachers and people involved in physical education and sports;
• organizational-methodical and scientific-practical work on the issues of medical support for those involved in physical culture and sports;
• sanitary and educational work.

A nurse is involved in this work under the guidance of a doctor. In the absence of a doctor, the paramedic and nurse can do almost everything on their own.

Medical examinations

Medical examinations are divided into primary, repeated and additional:

during the initial examination, they decide on admission to physical culture and sports activities;
with repeated - assess the impact of classes on the body;
an additional examination is carried out before participation in competitions, after a break in classes due to illness.

Repeated examinations are held at least once a year by all contingents of educational institutions involved in the program of physical education, and athletes: shooters, chess players and playing gorodki.

Athletes of team sports (volleyball, basketball, football, hockey, etc.) are examined twice a year. Before all competitions, boxers, athletes, wrestlers, weightlifters, swimmers, cyclists are examined.

Sports competitions are allowed only after the permission of a doctor or paramedic, issued in the form of an individual certificate or an application for admission to competitions from a sports organization, certified by a medical institution. Immediately before competitions in race walking and running for a distance of more than 20 km, cross-country skiing for 50 km or more, multi-day auto-bike races, scuba diving, a medical examination is required. Boxers and wrestlers should be inspected during the competition daily before weighing in.

In elite sports, athletes undergo biochemical studies of blood, urine, and apparatus studies with great physical exertion in order to prevent overvoltage.

Only healthy people are allowed to the sports of the highest achievements and to the Youth Sports School. Everyone can engage in physical education, depending on their health and physical fitness, they are recommended therapeutic exercises or various other physical exercises.

In educational institutions for physical education, students are divided into three groups depending on the state of health and physical development: basic, preparatory and special.

The main group is formed from persons without deviations in the state of health and physical development or with slight deviations, but not lagging behind in physical fitness. In this group, in the presence of scoliosis of the 1st degree, other minor postural disorders do not allow cycling, boxing, rowing; with myopia, you can not engage in diving and skiing from a springboard, weightlifting, skiing.

The preparatory group includes pupils and students with deviations in the state of health or physical development without pronounced functional disorders, with insufficient physical fitness for the implementation of a physical education program. These students are engaged in the main group, but the load during intensive physical exercises is reduced for them, the deadlines for passing educational standards are lengthened; they don't compete. For them, they additionally conduct classes, recreational activities and strive to prepare them for transfer to the main group.

A special group consists of students with significant deviations in health, physical development, which do not interfere with their studies at an educational institution, but in which physical education is contraindicated for them. For them, classes are conducted separately, taking into account their illness, or they receive therapeutic exercises in medical institutions. With the improvement of their health and physical fitness, the issue of their transfer to the preparatory group is decided. After suffering acute illnesses, students are temporarily released from classes and resume them at a strictly individual time, taking into account the severity of the disease (from one week to several months).

Functional tests of the cardiovascular and respiratory systems

For an objective assessment of the admissibility of various physical activities in healthy and sick people, functional tests of the cardiovascular and respiratory systems are used. .Dannye samples allow you to determine the physical performance, compensatory capabilities of the body.

Body functions can be assessed at rest, and the results compared with standard values ​​corresponding to sex, age, body weight, height, etc. For the cardiovascular system, these are the following indicators:

• pulse, blood pressure (maximum, minimum, pulse), stroke and minute blood volumes, blood flow velocity;
• instrumental research data;
• electrocardiography (ECG), rheography, etc.

The pulse is counted for 10, 15 or 30 seconds and the result is recalculated for 1 minute. In adults, the resting heart rate is in the range of 60-80 beats per minute. An increase in heart rate of more than 100 per minute is called tachycardia, a slowdown of less than 60 per minute is called bradycardia.

Physical exercise in untrained people should not cause an increase in heart rate by more than 30 bpm. Approximate heart rate is determined by subtracting from the number 220 the number of years involved. For example, for a 60-year-old person, the maximum heart rate is 220 - 60 == 160 bpm. With a gradual increase in loads, the pulse rate should not exceed 60% of the maximum (Table 19).

Table 19. Maximum allowable heart rate during exercise

When measuring blood pressure, pulse pressure can also be calculated. To do this, the minimum (diastonic) pressure is subtracted from the maximum (systolic) pressure. For example, if blood pressure is 120/80, then pulse: 120 - 80=40. In healthy young people, normal values ​​​​of systolic pressure are from 100 to 129, diastolic - from 60 to 79 mm Hg. Art. In the elderly, these values ​​are higher, in children and athletes - lower. When assessing blood pressure indicators, a load that increases pulse pressure within 5-15 mm Hg should be considered adequate. Art.

Martinet test. During mass preventive examinations, step-by-step control of those involved in physical education and sportsmen of the 2-3rd category, a test with 20 squats (Martinet test) is used. In the sitting position, the cuff of the apparatus for measuring blood pressure is applied to the left arm. After 1.5-2 minutes after applying the cuff, the pulse is continuously counted for 10 seconds, and when the same figure is repeated three times in a row, blood pressure is measured. After that, the cuff is not removed and it is proposed to perform 20 squats with throwing the arms forward in 30 s. The pace of squats is set with a metronome, then the subject sits down and counts the pulse for 10 s, after which the blood pressure is measured. At the 2nd minute, the pulse is again counted in 10-second segments up to a threefold repetition of the initial frequency (the pulse is counted for 3 minutes of the recovery period). Then blood pressure is measured again.

In healthy people, the recovery time for heart rate and blood pressure to baseline values ​​is within 3 minutes.

In all other samples of the cardiovascular system, the examination procedure is similar to that described above for the Martinet test.

Tests with a 15-second run in place at a maximum pace (maximum pace is the main test condition). Recovery to initial values ​​- within 4 minutes.

The Kotov-Demin test consists in running in place at a pace of 180 steps per minute for 3 minutes, the necessary condition is a high knee lift and active movement of the arms. Recovery period - 5 min.

Any of the above tests is used not only for mass examinations of athletes who begin playing sports, but also in the clinic for people who are not involved in physical education, to assess the function of the state of the cardiovascular system.

Letunov's test. For training athletes, a more versatile assessment is needed based on the use of multidirectional loads. The most optimal for this is the combined Letunov test, consisting of the three above-mentioned samples and performed in the sequence described at intervals of 3-4-5 minutes. Each subsequent test should be performed immediately after the recovery from the previous test is complete.

These tests are qualified as follows: Martinet test - load, 15-second run - speed, 3-minute run - endurance.

In sports and clinical practice, strictly dosed physical activity is used to assess physical performance. The most common are bicycle ergometry and steppergometry.

The advantage of these tests over standard ones is the ability to accurately dose the load and reproduce it. When carrying out these loads, the pulse is counted, blood pressure is measured and an ECG is recorded. The data of these studies are analyzed by the doctor.

There are many options for the step test. The best are the step functional test with a physical load of a given power, proposed by the Cardiology Scientific Center of the Russian Academy of Medical Sciences for patients (Table 20) and the Harvard step test for athletes.

Table 20. Determination of the load in steppergometric study using steps of different heights (number of lifts per step per minute)

The Harvard step test is based on the registration of heart rate after dosed physical activity and allows you to evaluate the course of recovery processes. Physical activity is carried out by climbing a step 50 cm high for men and 43 cm for women. The ascent time is 5 minutes, the frequency of ascents and descents with a change of legs is 30 times per minute. The pulse rate is recorded in a sitting position in the first 30 s from the 2-4th minute of the recovery period. The test results are expressed as the Harvard step test index (HST):

where t is the time of climbing the step at a given pace (300 s with a fully completed test); f 1 , f 2 , f 3 - pulse rate for the first 30 s, respectively, 2, 3 and 4 minutes of the recovery period. The total load during this step test is high, so the test can only be performed on healthy people. An estimate of the index value is presented in Table. 21.

Table 21. Evaluation of the results of the Harvard step test

Submaximal test PWC 170 (power working capacity, English - physical performance). The test is recommended by WHO to determine the physical performance of athletes and athletes. Physical performance in the PWC 170 test is expressed by the amount of load power that the subject can perform at a heart rate of 100 bpm.

In the practice of medical control, two options for conducting the test are used: on a bicycle ergometer or when climbing a step. During the test, the subject performs two loads of different power (W i and W g): on a bicycle ergometer and climbing a step, each lasting 5 minutes with a 3-minute break. At the end of each load, heart rate is determined (f 1 and f 2). It is recommended that the pulse count be recorded on an electrocardiograph, a heart rate monitor. PWCiTO is determined by the formula:

where PWCiTO is the power of physical activity at a heart rate of 170 bpm; Wi and Wz - power of the 1st and 2nd load (W or kgm / min), f 1 and f 2 - heart rate at the end of the 1st and 2nd load. In healthy young untrained men, the PWCiTO value is in the range of 120-180 W (average 2.8 W/kg), in women it is 75-125 W (2.0 W/kg). In athletes, this figure is two or more times higher.

The above tests are carried out and analyzed by a doctor.

In the practice of medical control and exercise therapy, the function of external respiration is studied - indicators of pulmonary ventilation, which include lung volumes, strength of the respiratory muscles, frequency and depth of breathing. In healthy people, the respiratory rate is 14-18 (inhalation and exhalation) per minute. Athletes - 8-16 per minute, but their breathing depth is greater.

Research on the function of external respiration is also carried out by doctors. Paramedics and nurses may perform a repositioning test (orthostatic test) and a breath-hold test.

Orthostatic test - in the position of the subject lying down, the pulse is counted at 15-second intervals and multiplied by 4 (this is the pulse rate per minute). Measure BP. After that, the subject slowly gets up, and his pulse is counted again from the 2nd minute for 15 seconds, then blood pressure is measured. The reaction is considered normal with an increase in heart rate up to 12 beats / min, with an increase of up to 18 or more - unfavorable. Also, adverse changes include large fluctuations in blood pressure and a decrease in pulse pressure.

Breath-holding tests: Stange's test - the time of holding the breath on inspiration, is carried out in a sitting position. Take a deep (not maximum) breath and use a stopwatch to record the breath holding time.

For a healthy person, this is at least 50-60 seconds, for athletes - up to 2-3 minutes.

Genchi test - breath holding time ria exhalation, the subject sits and after a normal (not maximum) exhalation holds his breath. The delay time is taken into account with a stopwatch. In healthy people, it is 25-30 s.

Types of response of the cardiovascular system to the load

The functional state of an athlete is judged by the type of reaction of the cardiovascular system to physical activity and, in particular, after a functional test.

It is known that in order to perform a critical load, working organs and tissues need more nutrients and oxygen, which are delivered to them by blood. Greater blood flow is provided by increased work of the heart (pulse quickens and systolic pressure increases).

Very important in the adaptation of the body to physical activity is the expansion of the lumen of functioning peripheral vessels and the opening of reserve capillaries. At the same time, the resistance of the peripheral circulatory system decreases and, as a result, diastolic pressure decreases. Therefore, in healthy trained people, in response to a functional test with physical activity, there is an increase in heart rate (adequately to the load), an increase in systolic pressure, not more than 150% of the original. Diastolic pressure decreases or remains at the same level; pulse pressure increases. This type of reaction is normotonic.

There are four more types of reactions, which are classified as atypical, allowing to judge the possible unfavorable functional state of athletes. The hypotonic (asthenic) type of reaction is observed in persons with a reduced tone of the cardiovascular system, which is caused by various reasons - overwork, overtraining, the initial stage of hypertension, during the recovery period after an illness, etc. Adaptation to physical activity is carried out mainly due to a sharp increase in the number of heart contractions (more than 100%, i.e., an increase in heart rate occurs inappropriately to the work done). Systolic pressure rises slightly, does not change, or sometimes even decreases. Pulse pressure goes down.

The hypertensive type of reaction is observed in persons with pronounced vasomotor changes caused by disorders in the central nervous system or the cardiovascular system due to overtraining, overstrain, the initial stage of hypertension, etc. As a result of a violation of vasomotor activity, the lumen of peripheral vessels narrows and, as a result, diastolic pressure rises. As a result, adaptation to physical activity is due to a sharp increase in systolic pressure and pulse, which is not adequate to the load.

The dystonic type of reaction is characterized by the so-called "endless tone" symptom. When measuring blood pressure after exercise, a systolic tone is constantly heard from the moment it appears until the mercury column of the tonometer drops to 0. This does not mean that the diastolic pressure is 0. The endless systolic tone is explained by the “sounding” of the vessel walls, when the sound amplitude imitates blood pulsation. This type of reaction occurs in highly trained athletes with high muscle tone (weightlifting, bodybuilding, wrestling, etc.), as well as after the athlete has tested with maximum physical activity. An endless tone, detected after 20 squats, indicates overwork. Normally, the phenomenon of "infinite tone" is heard in adolescents and young men, which is explained by the physiological characteristics of the organism in this age period.

A stepwise type of reaction occurs in athletes in a state of overwork, overtraining. When the activity of the central nervous system is disturbed, the reaction of redistribution of blood to working organs and muscles slows down. As a result, the increase in systolic pressure reaches its maximum level after the end of the load at the 3rd minute of the recovery period. Adaptation to work is due to increased heart rate disproportionately performed load. Diastolic pressure remains at the initial level or decreases slightly. In people who are not involved in sports, this type of reaction may indicate diseases of both the cardiovascular and other systems, in particular the central nervous system. The recovery time for heart rate and blood pressure to baseline in healthy people should not exceed 3 minutes.

If atypical types of the reaction of the cardiovascular system to the load are detected, a medical examination is necessary to identify the causes of their occurrence. If the identified type of reaction is a consequence of the disease, then appropriate treatment is carried out. Atypical reactions caused by incorrect construction of the training process or a violation of the training regimen require correction of the training regimen up to suspension from training until the activity of all organs and systems is completely normalized.

Prevention of sports injuries

Prevention of sports injuries is an important part of medical control. A sports injury is an injury during physical education and sports. The causes of sports injuries are violations of the training process, lack of insurance, performing complex exercises without proper preparation, violation of sanitary and technical requirements in the places of training, poor quality sports equipment, training in a state of fatigue, intentional rudeness of partners, indiscipline.

Sports injuries are divided into mild, moderate, severe and fatal.

Minor injury - minor abrasions, bruises, sprains that do not require cessation of exercise.

Injury of moderate severity - extensive abrasions, severe bruises, pronounced sprain with partial rupture of ligaments and muscles, closed fractures of the phalanges of the fingers, causing loss of sports and general performance for more than one day.

Severe sports injuries - dislocations, fractures requiring hospitalization.

Paramedics, nurses should know the features of registration and recording of sports injuries. Minor injury after assistance is recorded in the log. In case of a moderate injury, in addition to an entry in the journal, an act on a sports injury is drawn up in two copies signed by three people. The victim submits the act to a medical institution, where he receives treatment and a sick leave certificate from the date of injury. A sports injury is equivalent to a work injury. In case of a severe injury, the athlete is sent to the hospital and, in addition to the listed documents, a notice is sent to the medical and sports dispensary.

All cases of sports injuries are analyzed at the coaching council with the participation of doctors in order to identify and eliminate the causes that led to the injury.

Sports facilities control

An obligatory section of the work of medical personnel is control at sports facilities. It is necessary to check the sanitary condition of the places of employment and the conditions in which they are held: air temperature, lighting, ventilation, cleanliness in the gym, utility rooms (toilet, showers, locker rooms), the condition of the equipment, equipment, clothes, shoes of those involved, the availability of a first aid kit and its completeness. If violations are found, they should be corrected.

Medical and pedagogical observations during classes are carried out together with the coach to assess the health effect. Polling, visual observations, timing of classes with pulse counting before, during and after classes help determine the density of the lesson. In this case, only the net time spent on exercises is taken into account. For example, if in the classroom for 45 minutes there are 32 minutes of exercises, then the density will be

If the density of occupation in healthy people is less than 60%, then it is ineffective. With a properly constructed lesson, the highest heart rate should be in the middle of the lesson.

If one of the signs of pronounced overwork is detected, the session should be stopped. These signs are as follows: a sharp redness or pallor of the skin, cyanosis of the lips, a pained expression on the face, sharply rapid breathing, trembling of the hands, dizziness, headache, pain in the right hypochondrium, nausea, and sometimes vomiting.

At the competitions, the nurse, together with the judge, checks the condition of the competition sites, equipment, the provision of drinking water, toilets, changing rooms, and showers. Controls the correctness of registration of applications. The application must contain the last name, age, qualification, type of competition, doctor's opinion on admission. The signature of the doctor and the seal of the medical institution must be placed against the name of each participant and at the end of the application, after the signatures of the representatives of the sports organization, indicating the total number of athletes and the date. If violations are identified, together with the judge, take measures to eliminate them. During the competition, monitor the well-being of athletes, take measures to prevent injuries, diseases, and, if necessary, provide first aid. Medical personnel must have the necessary medicines, tools, dressings.

Medical control in the process of physical culture is aimed at solving three main tasks: identification of contraindications to physical training; determination of the FMS for the appointment of an adequate training program; control over the state of the body in the process of classes (at least twice a year).

The Regulation on medical control over the physical education of the population defines the following main forms of work on medical control:

1. Medical examinations of all persons involved in physical education and sports.

2. Medical and pedagogical supervision during training sessions and competitions.

3. Dispensary care for individual groups of athletes.

4. Medical and sanitary support of industrial gymnastics.

5. Medical and sanitary support of competitions.

6. Prevention of sports injuries.

7. Preventive and current sanitary supervision over the places and conditions for conducting physical education classes and competitions.

8. Medical consultation on issues of physical culture and sports.

9. Sanitary and educational work with those involved in physical education and sports.

10. Agitation and promotion of physical culture and sports among the population.

The system of organization of medical control.

Medical control over physical education is provided by the entire network of medical institutions of the health care system under the methodological and organizational guidance of medical and physical education dispensaries. Together with organizations that carry out physical education, medical and physical education dispensaries plan all activities for medical control on a territorial and production basis.

The order of medical examinations involved in physical education and sports is provided:

Children of preschool age who are in nurseries and kindergartens, engaged in special programs of physical education, are under the medical supervision of children's clinics and consultations;

Students of general education schools, secondary specialized educational institutions, schools of vocational training and other educational institutions, students of higher educational institutions involved in state physical education programs undergo medical examinations by doctors serving these educational institutions;

Those involved in the sports sections of physical education groups, voluntary sports societies and sports clubs, institutions, schools, secondary specialized and higher educational institutions are sent for medical examinations to medical institutions according to the territorial and production principle: district and district hospitals, city, regional, regional united hospitals and polyclinics, health centers and medical units of enterprises and institutions.

Physical education teacher, trainer, methodologist, instructor take an active part in the organization of all forms of medical control.

The teacher, together with the head of the medical institution or the doctor allocated for examination, draws up a plan and schedule for the passage of medical examinations by those involved, taking into account the contingent (students, members of the FC teams, sports sections involved in sports schools, participants in competitions, members of national teams in various sports) .

The teacher informs the trainees of the dates for medical examinations and checks their attendance.

The main purpose of medical examinations is to determine and assess the state of health, physical development and physical fitness of the examined. The data obtained allow the doctor to recommend the types of physical exercises, the amount of load and the method of application in accordance with the state of the body.

In the normal state of a person, all his organs and systems function most correctly, in accordance with the conditions of life. The activities of all bodies are interconnected, coordinated and represent a single complex process. The whole organism as a whole expediently and effectively adapts to changing conditions, strengthening the mode of activity, and is distinguished by a high level of capacity, including physical performance.

All of these features characterize the state of health as the optimal level of vital activity of the organism and adaptability to changes in the environment and load, as well as resistance to various influences.

During a medical examination, determining and evaluating the state of health and the level of physical development, the doctor thereby reveals the level of physical fitness.

Determining during the initial examination the state of health, physical development and fitness before the start of classes, the doctor decides whether it is possible to allow the subject to classes, which ones, with what load, etc.

Conducting repeated examinations, he monitors the changes in health, physical development and preparedness for the correctness and effectiveness of the course of physical education. Control over the condition of the subject to take into account the influence of physical exercises.

Additional examinations after diseases and injuries help to check the course of health recovery, after overwork or overtraining - the course of recovery of adaptive mechanisms, the level of performance, etc.

As a result of the examination, a conclusion is drawn up on the state of health, including instructions on the permissible load and other information.

Methods of medical examination.

1. Questioning is used to determine the state of health. It makes it possible to collect information about the medical and sports biography of the athlete, to learn about his complaints at the moment.

2. Inspection allows, by the sum of visual impressions, to get a general idea of ​​\u200b\u200bphysical development, to identify some signs of possible injuries and diseases, to evaluate the behavior of the subject, etc.

3. Feeling is based on obtaining tactile sensations about the shape, volume of the examined parts of the body or the examined tissue. This method determines the physical properties, size, surface features, density, mobility, sensitivity, and so on.

4. Listening to the lungs, the heart helps to conduct research by capturing the sound phenomena that occur during the work of the organs.

Introduction
There is only one way to achieve harmony by a person - the systematic performance of physical exercises. With regular physical exercises, the activity of all organs and systems is activated, muscle volume increases, metabolic processes increase, and the cardiovascular system improves. Thus, the physical fitness of those involved improves, the loads are easily tolerated, and previously inaccessible results in various types of physical exercises become the norm.

At the heart of the achievement of sports results by professional athletes and their growth are adaptive processes occurring in the body. Training and competitive activity is the basis for their improvement. But without control over the training process, over the health of an athlete, it is impossible to achieve high results without health costs. To do this, there are pedagogical and medical control. But before you control something, you need to determine what exactly and what indicators to evaluate, what are their initial levels, state. In other words, we need scientific diagnostics. Obviously, control will be more effective only if it is preceded by an objective diagnosis.

1. Diagnosis during regular physical education and sports
Diagnostics includes the theory and methods for determining the state and level of fitness of athletes, as well as the principles for determining and building a diagnosis. The basis of diagnostics is statistically analyzed information accumulated over the years, which makes it possible to compare and evaluate the results of the latest testing with similar data from previous years.

Sports and pedagogical diagnostics organically fits into the system of training athletes. It is aimed at obtaining information (diagnosis) about the physical condition and special preparedness of athletes. The diagnostic program includes a functional diagnostic examination and testing of the leading physiological systems and functions for this sport:

central nervous system,

autonomic nervous system,

cardiovascular and respiratory systems,

neuromuscular apparatus,

internal environment,

physical development,

Somatic and biological maturity (in those sports in which high sports results are achieved at a young age),

Psychophysiological state.

To solve all these problems, special research programs have been developed for professional athletes and those involved in recreational physical education. Studies are carried out at rest and during physical activity.

So, for example, a set of studies at rest includes:

Medical examination, preparation of medical and sports analysis;

Electrocardiography (with an active ortho test);

Ultrasound examination of the heart (if necessary - internal organs: liver, kidneys, etc.);

Biochemical blood test (if necessary, determination of hormonal status);

Anthropometric studies (measurement of body size), body composition (ratio of fat and muscle mass), biological age, etc.

In studies with physical loads, an important place is occupied by the selection of means and methods for setting the test load. Depending on the age, gender, specialization and qualification of athletes, physical activities of the following nature can be used:

Stepwise increasing submaximal power with limited operating time (type PWC170) and "to failure";

Limiting nature with a constant power from 1 to 7-12 minutes (such as holding the critical speed, power, speed (power) of the anaerobic threshold, etc.);

With variable speed (power) of repeated or interval character;

Modeling of competitive activity.

During the diagnostics, objective indicators of self-control are carefully recorded: heart rate, blood pressure, respiration, weight, anthropometric data. Diagnostics is also used to determine the trainee's fitness.

Assessment of the reaction of the cardiovascular system is carried out by measuring the heart rate (pulse), which at rest in an adult man is 70-75 beats per minute, in a woman - 75-80.

Generalization and analysis of studies conducted on athletes allows us to formulate the factors that determine and form the level of functional readiness of the subjects:

Physical development,

The functionality of the main physiological systems of the body,

immune status,

psychological status,

The next group of factors that form functional readiness are:

Sports activity, its specificity, correlated with the sport,

lesson duration,

Success in achieving sports results.

Another group of factors that form functional readiness is represented by the methodological foundations of the organization of the training process:

training mode,

Volume and intensity of training loads,

The ratio of means and methods for the development of physical qualities, psychophysical tension,

Calendar and rules of the competition.

The lack of control over the physical condition and preparedness of athletes, based on objective diagnostics, can lead to the development of overwork, a significant decrease in performance and, in the future, to the occurrence of diseases and injuries.

2. Medical control as a condition for admission, its content and frequency
Medical control is a system of medical support for all contingents of the population involved in physical culture, sports, and tourism. The purpose of medical control is to promote the correct use of physical culture and sports, comprehensive physical development, and the preservation of people's health.

Medical control in the process of physical culture is aimed at solving three main tasks:

1. identification of contraindications to physical training;

2. determination of the level of physical condition (UFS) for the appointment of an adequate training program;

3. control over the state of the body in the process of training (at least twice a year).

The Regulation on medical control over the physical education of the population defines the following main forms of work:

1. Medical examinations of all persons involved in physical culture and sports (primary, additional, repeated).

2. Clinical examination of those involved in physical culture, sports and tourism.

3. Medical and pedagogical supervision in the process of training sessions and competitions.

4. Implementation of health-improving, therapeutic and preventive measures in the process of physical education and sports.

5. Medical consultation on physical education and sports.

6. Conducting an analysis of the work done on medical control of those involved in physical education and sports.

7. Sanitary supervision over the places and conditions for holding competitions, physical culture and sports classes.

8. Medical and sanitary provision of training camps, competitions and mass types of physical culture.

9. Prevention of sports injuries and pathological conditions arising from irrational physical culture and sports.

10. Organization and implementation of measures to restore physical performance after the competition, after passing the standards, training physical activity, rehabilitation of athletes and athletes after injuries and diseases.

11. Sanitary and educational work among athletes and athletes.

12. Propaganda of health-improving influence of physical culture and sports among the population.

13. Advanced training of medical workers on issues of medical control.

14. Use in the work of modern diagnostic methods and the use of equipment, computer programming, functional and biochemical research methods, psychological testing, etc.
2.1 The system of organization of medical control
Medical control is provided by specialists of medical institutions, sports medicine dispensaries and, under their organizational and methodological guidance, the entire network of medical institutions. Admission to organized physical culture and sports is carried out on the basis of a medical examination using medical control methods. Permission to participate in competitions is issued by persons who have undergone appropriate training and medical supervision. Heads of physical culture groups and sports clubs, directors and rectors of educational institutions, teachers, coaches and instructors of physical culture should monitor the timely conduct of a medical examination.

Medical examination and clinical examination of those involved in physical education and sports are carried out in the following order:

Children of preschool institutions are examined by doctors serving these groups;

Students of general education schools, vocational and secondary specialized educational institutions - on the basis of medical and preventive institutions;

Students of higher educational institutions - on the basis of student clinics, medical institutions.

All of them must undergo a medical examination at least once during the academic year. Persons referred for health reasons to the preparatory and special medical groups - twice a year. The results of medical examinations are submitted no later than September 1 of the current year to educational institutions. Members of physical culture groups are examined at least once a year by doctors serving these groups, or at the place of residence. in the sports section, as well as the nature and mode of training.
2.2 Content of the survey
The main purpose of medical examinations is to determine and assess the state of health, physical development and physical fitness of the examined. The data obtained allow the doctor to recommend the types of physical exercises, the amount of load and the method of application in accordance with the state of the body. In the normal state of a person, all his organs and systems function most correctly, in accordance with the conditions of life. The activities of all bodies are interconnected, coordinated and represent a single complex process. The whole organism as a whole expediently and effectively adapts to changing conditions, strengthening the mode of activity, and is distinguished by a high level of capacity, including physical performance.

During a medical examination, determining and evaluating the state of health and the level of physical development, the doctor thereby reveals the level of physical fitness.

Determining during the initial examination the state of health, physical development and fitness before the start of classes, the doctor decides whether it is possible to allow the subject to classes, which ones, with what load, etc.

Conducting repeated examinations, he monitors the changes in health, physical development and preparedness for the correctness and effectiveness of the course of physical education. Control over the condition of the subject will take into account the impact of physical exercises.

Additional examinations after diseases and injuries help to check the course of health recovery, after overwork or overtraining - the course of recovery of adaptive mechanisms, the level of performance, etc.

As a result of the examination, a conclusion is drawn up on the state of health, including instructions on the permissible load and other information.
2.3 Methods of medical examination
1. Questioning is used to determine the state of health. It makes it possible to collect information about the medical and sports biography of the athlete, to learn about his complaints at the moment.

2. Inspection allows, by the sum of visual impressions, to get a general idea of ​​\u200b\u200bphysical development, to identify some signs of possible injuries and diseases, to evaluate the behavior of the subject, etc.

3. Feeling is based on obtaining tactile sensations about the shape, volume of the examined parts of the body or the examined tissue. This method determines the physical properties, size, surface features, density, mobility, sensitivity, and so on.

4. Listening to the lungs, the heart helps to conduct research by capturing the sound phenomena that occur during the work of the organs.

Additional valuable information during a medical examination will also be obtained by measuring blood pressure, recording an ECG at rest and after exercise, and determining body weight.

3. Pedagogical control
The methodological basis of pedagogical control can be formulated as:

Determination (preliminary study) of the degree of stability in the development of indicators of the physical condition of an athlete, their significance and influence on the process of sports improvement;

Search and development of both individual tests and complex testing programs that meet the requirements for information content, reliability and objectivity;

Development of regulatory requirements, norms, methods of statistical and pedagogical assessment of test results, control tests;

Pedagogical activity at the university makes high demands on teachers of all job categories of the department of physical education. Direct pedagogical activity requires from the teacher not only a deep knowledge of his subject, but also a certain system, a sequence of actions.

The main feature of physical education teachers is the specificity of work. The object of the teacher's activity is the personality of the student.

In addition, each student must:

Systematically attend physical education classes (theoretical and practical) on the days and hours provided for by the study schedule;

To undergo a medical examination in a timely manner, to exercise self-control over the state of health and physical development, sports fitness;

Actively acquire knowledge on the basics of the theory and methodology of physical education, using the relevant literature;

Observe a rational mode of study, rest and nutrition;

Independently perform physical exercises, regularly do morning exercises, observe the necessary weekly motor regime, using the advice of a teacher;

Actively participate in mass recreational physical culture and sports events in the study group and at the interuniversity level.

The success of teaching also depends on the contact between teachers and students. In working with students, the teacher must be able to clearly and competently express his thoughts, carefully observe the study group, feel it and find a common language with it, use visual aids correctly and illustrate the material.

To be successful, every teacher must:

Thoroughly know the material of the taught discipline in the amount of program requirements, as well as the main provisions of pedagogy and psychology of higher education;

Own the methodology for preparing and conducting relevant types of practical exercises;

Express your thoughts clearly, clearly and competently;

Have an idea about the content and volume of material taught in related disciplines, and about the place of physical culture in the general system of specialist training;

Conduct scientific work and possess the sum of practical skills necessary for a specialist to conduct an academic discipline;

Know the current level of science and current literature in the scope of practical exercises;

Represent the general development and trends in physical education and sports;

Conduct consultations within the course of practical exercises.

The course of physical culture provides for the solution of the following tasks:

Inclusion of the student in the real practice of the creative development of physical culture, its active use in the comprehensive development of the individual;

Promoting the versatile development of the body, maintaining and strengthening health, increasing the level of sociability, physical fitness, developing professionally important physical qualities and psychomotor abilities of future specialists;

Mastering a systematically ordered complex of knowledge covering philosophical, social, natural science and psychological and pedagogical topics.

Formation of students' need for physical self-improvement and maintaining a high level of health through the conscious use of all forms of physical culture and sports activities;

Formation of skills of independent organization of leisure using the means of physical culture and sports;

Mastering the basics of family physical education, everyday physical education.

Physical education in higher educational institutions is carried out in the following forms:

Training sessions:

Compulsory classes (practical, theoretical, consultations), which are provided for in the curricula for all specialties in the amount of four hours a week and are included in the curriculum during the entire period of study in excess of the established pedagogical volume of the teaching load;

Consultative and methodological classes aimed at creating methodological and practical assistance for students in organizing and conducting independent physical education classes;

Individual classes for students with poor physical fitness or who are lagging behind in mastering educational material, which are organized according to a special schedule of the department during the academic year, holidays, during the period of industrial practice;

Extracurricular activities:

Physical exercises in the mode of the school day (small forms of self-study in the form of complexes "minute of cheerfulness" and the like);

Classes in sections, informal groups and clubs for physical interests;

Mass recreational, physical culture and sports events.

The integrated use of all forms of physical education should ensure the inclusion of physical education in the lifestyle of students, the achievement of an optimal level of physical activity.

4. Self-control, its main methods, indicators, evaluation criteria, self-control diary
With regular physical exercises and sports, when deciding on the dosage of training loads, competent self-control is important. Indicators of self-control can be conditionally divided into two groups - subjective and objective. The main objective criterion of tolerability and effectiveness of training is the heart rate (HR). The value of heart rate obtained in the first 10 seconds after the end of the load characterizes its intensity. It should not exceed the average values ​​for a given age and fitness level.

The total indicator of the magnitude of the load (volume plus intensity) is the value of heart rate, measured 10 and 60 minutes after the end of the session. After 10 minutes, the pulse should not exceed 96 beats / min, or 16 beats per 10 s, and after 1 hour it should be 10-12 beats / min (no more) higher to the working value.

For example, if before the start of the run, the pulse was 60 beats / min, then if the load was adequate, 1 hour after the finish, it should be no more than 72 beats / min. If, within a few hours after training, the heart rate values ​​are significantly higher than the initial ones, this indicates an excessive load, which means that it must be reduced. A prolonged increase in heart rate (within several days) is usually observed after overcoming a marathon distance.

Objective data reflecting the total value of the training effect on the body and the degree of recovery can be obtained by daily counting the pulse in the morning after sleep, in the supine position. If its fluctuations do not exceed 2-4 beats / min, this indicates good exercise tolerance and complete recovery of the body. If the difference in pulse beats is greater than this value, this is a signal of incipient overwork; in this case, the load should be reduced immediately.

Orthostatic test is even more informative. It is necessary to count the pulse while lying in bed. Then slowly stand up and after 1 minute count the pulse again in an upright position. If the difference in heart rate in the vertical and horizontal position does not exceed 10-12 beats / min, then the load is quite adequate and the body recovers well after training. If the increase in heart rate is 18-22 beats / min, then the condition is satisfactory. If this figure is more than the indicated values, this is a clear sign of overwork, which, in addition to excessive training volume, can be caused by other reasons (constant lack of sleep, past illness, etc.).

Unsatisfactory results of the orthostatic test are usually observed in people suffering from physical inactivity and completely detrained, as well as in beginner athletes.

But not only the pulse should be paid attention. It is desirable, if possible, to also measure blood pressure before and after exercise. At the beginning of the load, the maximum pressure rises, then stabilizes at a certain level. After the termination of work (the first 10-15 minutes) decreases below the initial level, and then comes to the initial state. The minimum pressure does not change with light or moderate load, and slightly increases with intense hard work.

It is known that the values ​​of the pulse and the minimum arterial pressure normally coincide numerically. Kerdo proposed to calculate the index using the formula
IR=D/P,
where D is the minimum pressure, P is the pulse.
In healthy people, this index is close to one. In violation of the nervous regulation of the cardiovascular system, it becomes more or less than one.

It is also very important to evaluate the functions of the respiratory system. It must be remembered that when performing physical exertion, oxygen consumption by working muscles and the brain increases sharply, and therefore the function of the respiratory organs increases. The frequency of breathing can be used to judge the amount of physical activity. Normally, the respiratory rate of an adult is 16-18 times per minute.

An important indicator of respiratory function is the vital capacity of the lungs - the volume of air obtained during the maximum exhalation made after the maximum breath. Its value, measured in liters, depends on gender, age, body size and physical fitness. On average, for men it is 3.5-5 liters, for women - 2.5-4 liters.

For operational control over the intensity of the load, you can also use breathing indicators, which can be determined directly during the run. These include a nasal breathing test. If you breathe easily through your nose while running, this indicates an aerobic training regimen. If there is not enough air and you have to switch to a mixed nasal-oral type of breathing, then the running intensity corresponds to a mixed aerobic-anaerobic energy supply zone and the speed should be somewhat reduced.

The speaking test can also be used successfully. If during the run the student can easily maintain a casual conversation with a partner, then the pace is optimal. If he begins to choke and answer questions in monosyllabic words, this is a signal of a transition to the mixed zone.

There is also one rather simple method of self-control “with the help of breathing” - the so-called Stange test (after the Russian physician who introduced this method in 1913). Inhale, then exhale deeply, inhale again, hold your breath, using a stopwatch to record the breath holding time. As training increases, the breath holding time increases. Well-trained people can hold their breath for 60-120 seconds. But if you have just trained, then you will not be able to hold your breath for a long time.

No less important for self-control are subjective indicators of the state of the body (sleep, well-being, mood, desire to train). Sound sleep, good health and high performance during the day, the desire to train testify to the adequacy of training loads. Poor sleep, lethargy and drowsiness during the day, unwillingness to exercise are sure signs of overload.

Appetite after moderate exercise should also be good. It is not recommended to eat immediately after class, it is better to wait 30-60 minutes. To quench your thirst, you should drink a glass of mineral water or tea. Regular keeping of a self-control diary can be of great help to trainees, which will make it possible to identify early signs of overwork and make appropriate adjustments to the training process in time.

The diary of self-control is used to record independent physical education and sports, as well as to register anthropometric changes, indicators, functional tests and control tests of physical fitness, to monitor the implementation of a weekly motor regimen.

The diary should also note cases of violation of the regime and how they affect classes and overall performance. Regular diary keeping makes it possible to determine the effectiveness of classes, means and methods, optimal planning of the magnitude and intensity of physical activity and rest in a separate lesson.

Current self-control and periodic medical control increase the efficiency and ensure the safety of health-improving physical culture.

5. Determination of the level of the physical condition of the body (UFS)
In physically trained people, the pulse rate is much less frequent - 60 or less beats per minute, and in trained athletes - 40-50 beats, which indicates the economical work of the heart. At rest, the heart rate depends on age, gender, posture (vertical or horizontal position of the body), the activity performed. It decreases with age. The normal pulse of a healthy person at rest is rhythmic, without interruptions, good filling and tension. A rhythmic pulse is considered if the number of beats in 10 seconds does not differ by more than one beat from the previous count for the same period of time. Pronounced fluctuations in the number of heartbeats indicate arrhythmia. The pulse can be counted on the radial, temporal, carotid arteries, in the region of the heart.

The load, even a small one, causes an increase in heart rate. Scientific research has established a direct relationship between the pulse rate and the amount of physical activity. With the same heart rate, oxygen consumption in men is higher than in women, in physically fit people it is also higher than in people with low physical mobility. After physical exertion, the pulse of a healthy person returns to its original state after 5-10 minutes, the slow recovery of the pulse indicates an excessive load.

During physical activity, the increased work of the heart is aimed at providing the working parts of the body with oxygen and nutrients. Under the influence of loads, the volume of the heart increases. So, the volume of the heart of an untrained person is 600-900 ml, and for high-class athletes it reaches 900-1400 milliliters; after the cessation of training, the volume of the heart gradually decreases.

An important indicator of the aerobic capacity of the body is the level of the threshold of anaerobic metabolism (ANM). ANOT corresponds to such an intensity of muscular activity, at which oxygen is clearly not enough for complete energy supply, the processes of oxygen-free (anaerobic) energy generation are sharply enhanced due to the breakdown of energy-rich substances. With the intensity of work at the level of PANO, the concentration of lactic acid in the blood increases from 2.0 to 4.0 mol/l, which is a biochemical criterion for PANO.

The main criterion of health should be considered the value of the IPC (maximum oxygen consumption) of a given individual. It is the IPC that is a quantitative expression of the level of health, an indicator of the "amount" of health. In mass physical culture, indirect methods for determining the maximum aerobic productivity by calculation are widely used. The most informative is the PWC170 test - physical performance at a pulse of 170 beats / min. The subject is offered two relatively small loads on a bicycle ergometer (5 minutes each, with a rest interval of 3 minutes). At the end of each load (on reaching a steady state), the heart rate is calculated. The calculation is made according to the formula:
PWC170 = N1+(N2 - N1)x(170-f1/f2-f1), (1)
where N1 is the power of the first load;

N2 - power of the second load;

f1 - heart rate at the end of the first load;

f2 - heart rate at the end of the second load.
On average, the normal performance of the PWC170 test in young men is considered to be a load power of 1000 kgm / min, in women - 700 kgm / min. More informative are not absolute, but relative values ​​of the test - the power of work per 1 kg of body weight:

For young men, the average rate is 15.5 kgm / min / kg,

For women - 10.5 kgm / min / kg.

The calculated value of the IPC (l / min) is determined by the formula of V. L. Karpman for persons with a low degree of fitness:
MPC=1.7 x PWC170+1240. (2)
In a mass survey of people involved in recreational physical culture, the value of the IPC and the level of physical condition can be determined using the 1.5-mile Cooper test in natural training conditions. To complete this test, it is necessary to run at the maximum possible speed a distance of 2400 m (6 laps on a 400-meter track of the stadium).

When comparing the test results with the data obtained when determining PWC170 on a bicycle ergometer, a high degree of dependence between them was revealed:
PWC170 = (33.6 - 1.3Tk) + 1.96, (3)
where Tk is the Cooper test in fractions of a minute (for example, the test result for 12 minutes 30 seconds is 12.5 minutes),

PWC170 - measured in kgm/min/kg.
Knowing the value of the PWC170 test, according to the formula (2), it is possible to calculate the IPC and determine the level of the physical condition of the subject. The limit (threshold) value of the IPC for men is 42 ml / min / kg, for women - 35 ml / min / kg. People who have a MIC level of 42 ml/min/kg and above do not suffer from chronic diseases and have blood pressure readings within the normal range.

A quantitative assessment of the level of physical condition provides valuable information about the state of health and functional capabilities of the body, which allows you to take the necessary measures to prevent diseases and promote health. To assess the physical condition of the human body and its physical fitness, anthropometric indices, exercise tests, etc. are used.

For example, the state of the normal function of the cardiovascular system can be judged by the coefficient of economization of blood circulation, which reflects the ejection of blood in 1 minute. It is calculated according to the formula
(ADmax. - ADmin.) * P,
where BP is blood pressure,

P - pulse rate.
In a healthy person, its value approaches 2600. An increase in this coefficient indicates difficulties in the work of the cardiovascular system.

The proportions of the human body are the ratio of the sizes of its individual parts. The proportions of the body are determined primarily by the size of the bone skeleton. Body dimensions, the ratio of which integrally reflects the general level of the morphological and functional development of the body, make it possible to characterize the physical development of a person.

The most common method in wide practice for assessing the proportions of the human body is the index method. It allows using simple calculations to characterize the ratio of body parts. Typically, the smaller value is expressed as a percentage of the larger value. It is important to remember that the proportions of the body, identified with the help of indices, can only be compared with a similar body length.

The index method makes it possible to evaluate physical development in relation to individual anthropometric features and with the help of simple mathematical expressions. To determine the normal body weight, various methods are used, the so-called height-weight indices. In practice, the Broca index is widely used:
M = L -100 (kg) with a height of 155 -165 cm,

M = L -105 (kg) with a height of 166 -175 cm,

M = L -110 (kg) with a height of more than 175 cm,
where M is normal body weight.
The Quetelet index, or weight-height index, is obtained by dividing weight in (g) by height (cm) and is equal to an average of 350-400 g / cm for men, and 325-375 g / cm for women.

We can say that only in a very generalized form, the properties of the body are characterized by the length of the body, its weight and girth of the chest. To obtain a more detailed description of physical development, it is also necessary to take into account the degree of development of muscles and subcutaneous fat.

Body dimensions and their ratios in this case act as one of the most common and widely used criteria for the correspondence of biological development to its chronological (passport) age.

Weight change up to 10% is regulated by exercise, restrictions on carbohydrate intake. With excess weight over 10%, a strict diet should be created in addition to physical activity.

You can also conduct a study of static stability in the Romberg position. The body stability test is performed as follows: the athlete becomes in the main stance - the feet are shifted, the eyes are closed, the arms are extended forward, the fingers are spread apart (complicated version - the feet are on the same line, toe to heel). The time of stability and the presence of hand trembling are determined. In trained people, the stability time increases as the functional state of the neuromuscular system improves.

It is also necessary to systematically determine the flexibility of the spine. Physical exercises, especially with a load on the spine, improve blood circulation, nutrition of the intervertebral discs, which leads to the mobility of the spine and the prevention of osteochondrosis. Flexibility depends on the state of the joints, extensibility of the ligaments and muscles, age, ambient temperature and time of day. A simple moving bar device is used to measure spinal flexibility.

A quantitative assessment of the level of physical condition provides valuable information about the state of health and functional capabilities of the body, which allows you to take the necessary measures to prevent diseases and promote health.

6. Correction of the content and methods of physical exercises and sports according to the results of control
Studies have shown that in the process about a third of athletes need individual correction using biomedical agents and about 10-20% - in the correction of the training process. Recommendations on the training regimen take into account the need for its correction - an increase in aerobic capacity, speed endurance, or an increase in rest intervals in training, or a temporary decrease in the volume and intensity of the load.

For example, in rhythmic gymnastics classes of a health-improving orientation, the choice of the pace of movements and series of exercises should be carried out in such a way that the training was mainly aerobic in nature (with an increase in heart rate within 130-150 beats / min). To achieve a positive effect, the duration of the exercises should be at least 20-30 minutes, and the intensity should not be higher than the level of PANO. With an increase in heart rate to 180-200 beats / min, it is necessary to change the exercises and the pace of movements.