Assessment of the functional state of the body. Functional trials, tests Define the concept of functional trial

1. Orthostatic test (Greek orthos straight, correct, statos - standing) - a functional diagnostic test - a method for studying the functional state of the cardiovascular system, based on the determination of physiological parameters (HR) before and after the transition from a horizontal position (lying position) to a vertical (standing position) ) and identifying the difference in heart rate with a change in body position (HR2 - HR1).

This test shows the state of regulatory mechanisms, and also gives an idea of ​​the overall fitness of the body. By the difference between the pulse rate lying and standing, one can judge the reaction of the cardiovascular system to the load when the body position changes. Also, this test is used to detect orthostatic circulatory disorders that can occur in a vertical position of the body due to a decrease in venous return of blood to the heart due to its partial delay (due to gravity) in the veins of the lower extremities and abdominal cavity. This leads to a decrease in cardiac output and a decrease in blood supply to tissues and organs, including the brain.

In the supine position, the pulse is on average 10 beats less. Any deviation up or down is an early and very subtle symptom that should not be overlooked.

The method of conducting an orthostatic test:

In the morning, immediately after waking up from sleep, count the pulse for a minute and record the results in the observation diary (HR1). Usually at rest, the pulse rate is most conveniently measured on the radial artery at the base of the thumb. In this case, the right hand should take the back of the wrist of the left hand slightly above the wrist joint. Use the pads of the second, third and fourth fingers of the right hand to find the radial artery, lightly pressing on it. Having felt the artery, it is necessary to press it against the bone;

Stand on the mat and stand calmly for a minute (hands down, head straight, breathing is calm, even). Then immediately for 10 seconds. count the number of heartbeats. The resulting figure is multiplied by 6, get the number of beats per minute (HR 2).

When moving from a lying position to a standing position, an increase in heart rate up to 5 beats per 1 min - a great indicator of fitness of the body; for 6-11 beats - good fitness indicator; for 12-18 beats - satisfactory index; an increase in heart rate from 19 to 25 beats per minute indicates a complete lack of physical fitness. it unsatisfactory index. If the difference is more than 25 strokes, then we can talk about either overwork, or about disease cardiovascular system. You need to see a doctor urgently.

By comparing your indicators with the given data, draw a conclusion about the state of your cardiovascular system. The entry goes something like this: According to the orthostatic test, the state of my cardiovascular system can be assessed as ... .

2. Stange test is intended to identify the state of the respiratory system in conditions of complete filling of the lungs with air, i.e. after a full deep breath.

The method of carrying out the Stange test: sit down, relax, take a breath, then exhale deeply and inhale again, then hold your breath, holding your nose with your thumb and forefinger and fixing the breath holding time with a stopwatch. It should be at least 20-30 seconds (well-trained athletes hold their breath for 120 seconds).

With training, the breath holding time increases, however, with overwork or overtraining, the ability to hold your breath decreases sharply.

Based on the data obtained, a conclusion is drawn (the state of my respiratory system according to the Stange test can be assessed as ...).

3. Genchi test is designed to identify the state of the respiratory system in conditions of complete absence of air in the lungs, i.e. after a full exhalation.

The method of performing the test: a deep breath is taken, exhaled, inhaled; then follows a calm full exhalation and holding the breath with the nose pinched with fingers.

Based on the data obtained, a conclusion is drawn ( the state of my respiratory system according to the Gench test can be assessed as ...).

4. Harvard step test. The height of the step is 43-50 cm, the execution time is 5 minutes. Climbing frequency 30 rises per 1 minute under a metronome (tempo - 120 bpm). Climbing the steps and lowering to the floor is done with the same foot. On the step, the position is vertical with straightened legs.

After the load, the pulse is calculated while sitting at the table for the first 30 seconds. at 2, 3, 4 minutes of recovery. IGST is calculated by the formula:

IGST \u003d 100 / (1 + 2 + 3) * 2,

where 1, 2, 3 - heart rate, for the first 30 seconds. for 2, 3, 4 min. recovery - ascent time in seconds, if IGST is less than 55 - physical performance weak, 55-64 – below average, 65-79 – average, 80-89 – good, 90 and more - excellent.

5. Ruffier index. Ruffier Index (Ruffier) ​​is calculated after 30 squats for men and 24 squats in 30 seconds. for women.

JR= (f1+f2+f3-200)/10,

where f1 - heart rate in min. before exercise, in a sitting position after 5 min. recreation,

f2 - heart rate in min. immediately after the load standing,

f3 - heart rate in min. 1 minute after standing up.

An index equal to 5 or less is excellent, 5-10 is good, 11-15 is satisfactory, over 15 is unsatisfactory.

JR (Ruffier index), reflecting the adaptive capabilities of the cardiovascular system, in response to a dosed load, simultaneously characterizes the level of general endurance and quite correctly correlates with indicators of general endurance according to the Cooper test (12-minute run).

6. Serkin test. After resting while sitting, the time of holding the breath on inhalation is determined (first phase). In the second phase, 20 squats are performed in 30 seconds and holding the breath while standing is repeated. In the 3rd phase, after resting while standing for 1 minute, the time of holding the breath while sitting is determined.

Evaluation of the results of the Serkin test

7. 12 minute Cooper test used to assess the functional and physical capabilities of the body.

Assessment of general endurance for the age group 20-29 years

8. Functional test with standard load - o Evaluation of the types of response of the cardiovascular system to the functional load.

Complete 30 full foot squats in 45 seconds. Immediately after exercise, measure your heart rate (HR) for 10 seconds, then immediately measure your blood pressure (BP). At the beginning of the 2 minute rest, measure your heart rate for 10 seconds and blood pressure again. Measurements are repeated at 3, 4 and 5 minutes.

Analyze the obtained individual curves of the dynamics of heart rate and blood pressure and determine your type of response of the cardiovascular system to the proposed load, using the diagram below.

There are 5 main types of response of the cardiovascular system to the load:

1) normotonic type characterized by an increase in heart rate and an increase in pulse pressure due to a pronounced increase in SBP and a moderate decrease in DBP. An increase in stroke volume is recorded up to 115 - 120 beats / min. Further, the growth of the IOC is carried out due to the growth of heart rate. The recovery period lasts about 3 minutes;

2) hypertonic type characterized by a significant increase in heart rate and SBP. It is detected in about a third of athletes. DBP does not decrease. The recovery period increases to 4 - 6 minutes;

3) with blunt type characterized by a decrease in SBP immediately after exercise. At 2 and 3 minutes of recovery, SBP increases. There is a decrease in DBP and a significant increase in heart rate. The recovery period is delayed;

4) dystonic type characterized by the presence of the phenomenon of "endless tone" (non-disappearing sound pulsation) when determining diastolic pressure due to its significant decrease. Systolic pressure usually rises. A significant increase in pulse pressure is recorded. Recovery is slow;

5) hypotonic type The reaction is characterized by a slight rise in systolic pressure with a significant increase in heart rate and a long (more than 7 minutes) recovery period. Diastolic pressure usually rises slightly, which is why the pulse pressure does not increase, and often even decreases.

Functional state - a set of properties that determine the level of vital activity of the organism, the systemic response of the organism to physical activity, which reflects the degree of integration and adequacy of the functions of the work performed.

In the study of the functional state of the body involved in physical exercises, the most important changes in the circulatory and respiratory systems, they are of primary importance for resolving the issue of admission to sports and the “dose” of physical activity, the level of physical performance largely depends on them.

The most important indicator of the functional state of the cardiovascular system is the pulse (heart rate) and its changes.

rest pulse : measured in a sitting position while probing the temporal, carotid, radial arteries or by cardiac impulse in 15-second segments 2-3 times in a row to get reliable numbers. Then recalculation is done for 1 min. (number of beats per minute).

Heart rate at rest on average in men (55–70) beats/min., in women - (60–75) beats/min. At a frequency above these figures, the pulse is considered rapid (tachycardia), at a lower frequency - (bradycardia).

Blood pressure data are also of great importance for characterizing the state of the cardiovascular system.

Arterial pressure . There are maximum (systolic) and minimum (diastolic) pressures. Normal blood pressure values ​​for young people are: the maximum is from 100 to 129 mm Hg. Art., minimum - from 60 to 79 mm Hg. Art.

Blood pressure from 130 mm Hg. Art. and above for maximum and from 80 mm Hg. Art. and above for the minimum is called a hypertonic state, respectively, below 100 and 60 mm Hg. Art. - hypotonic.

To characterize the cardiovascular system, the assessment of changes in the work of the heart and blood pressure after exercise and the duration of recovery are of great importance. Such a study is carried out using various functional tests.

functional trials a- an integral part of the complex methodology of medical control of people involved in physical culture and sports. The use of such tests is necessary for a complete characterization of the functional state of the body of the trainee and his fitness.

The results of functional tests are evaluated in comparison with other medical control data. Often, adverse reactions to the load during a functional test are the earliest sign of a deterioration in the functional state associated with a disease, overwork, overtraining.

Here are the most common functional tests used in sports practice, as well as tests that can be used in independent physical education.

"20 sit-ups in 30 seconds". The trainee rests while sitting for 3 minutes. Then the heart rate is calculated for 15 s, converted to 1 min. (original frequency). Next, 20 deep squats are performed in 30 seconds, raising the arms forward with each squat, spreading the knees to the sides, keeping the torso in an upright position. Immediately after the squats, in a sitting position, the heart rate is again calculated for 15 s, recalculated for 1 min. An increase in heart rate after squats is determined compared to the original.

Recovery of heart rate after exercise. To characterize the recovery period after performing 20 squats in 30 seconds, the heart rate is calculated for 15 seconds at the 3rd minute. recovery, recalculation is done for 1 min. and by the magnitude of the difference in heart rate before the load and in the recovery period, the ability of the cardiovascular system to recover is estimated (table 3).

Table 3 - Assessment of the functional state of the cardiovascular system

To assess the functional state of the cardiovascular system, the most widely used are the Harvard step test (HST) and the PWC-170 test.

Conduction (GST) consists in climbing and descending from a step of a standard size at a certain pace for a certain time. GST consists in climbing a step 50 cm high for men and 41 cm for women for 5 minutes. at a pace of 30 lifts / min.

If the subject cannot maintain a given pace for the specified time, then work can be stopped, its duration and heart rate recorded for 30 seconds of the 2nd minute. recovery.

According to the duration of the work performed and the number of heartbeats, the Harvard step test index (IGST) is calculated:

,

where t– ascent time in s;

ƒ 1, ƒ 2, ƒ 3 - heart rate for the first 30 s of the 2nd, 3rd, 4th min of recovery.

Assessment of the level of physical performance according to IGST is carried out using the data given in table 4.

Table 4 - The value of the level of physical performance according to IGST

The principle of evaluation in the PWC-170 test is based on a linear relationship between heart rate and the power of the work performed, and the student performs 2 relatively small loads on a bicycle ergometer or in a step test (the method for conducting the PWC-170 test is not given, since it is rather complicated and requires special knowledge, training, equipment).

Orthostatic test . The trainee lies on his back and his heart rate is determined (until stable numbers are obtained). After that, the subject calmly gets up and the heart rate is measured again. Normally, when moving from a lying position to a standing position, an increase in heart rate by 10–12 beats per minute is noted. It is believed that its increase is more than 20 beats / min. - an unsatisfactory reaction, which indicates insufficient nervous regulation of the cardiovascular system.

When performing physical exertion, oxygen consumption by working muscles and the brain increases sharply, in connection with which the function of the respiratory organs increases. Physical activity increases the size of the chest, its mobility, increases the frequency and depth of breathing, therefore, it is possible to assess the development of the respiratory system in terms of chest excursion (ECG).

The ECG is assessed by the increase in chest circumference (ECG) during maximum inhalation after a deep exhalation.

An important indicator of respiratory function is the vital capacity of the lungs (VC). The value of VC depends on gender, age, body size and physical fitness.

In order to evaluate the actual VC, it is compared with the value of the proper VC, i.e. the one that this person should have.

Men:

VC \u003d (40 × height in cm) + (30 × weight in kg) - 4400,

women:

VC \u003d (40 × height in cm) + (10 × weight in kg) - 3800.

In well-trained people, the actual VC ranges on average from 4000 to 6000 ml and depends on the motor orientation.

There is a fairly simple way to control “with the help of breathing” - the so-called Stange test. Take 2-3 deep breaths and exhale, and then, taking a full breath, hold your breath. The time from the moment of holding the breath to the beginning of the next breath is noted. As you train, the breath holding time increases. Well trained students hold their breath for 60-100 seconds.

Determination of physical performance to restore heart rate (Ruffier-Dixon test) . As the main criteria for assessing performance in a system of tests using physical activity, followed by a study of the rate of recovery of heart rate, the standard reactions of the body to the load are taken into account, first of all: the economy of the reaction and quick recovery. The purpose of the work: to evaluate physical performance by the rate of heart rate recovery using the Rufier test. Equipment: Stopwatch. Progress of work: performance evaluation is as follows. The subject's pulse is counted while sitting at rest for 15 s. Then 30 squats are performed in 45 seconds. Then the pulse is again recorded at the first and last 15 from 1 minute of recovery. The index is calculated according to the formula and evaluated according to table 5:

,

where IR is the Rufier index;

P 1 - heart rate at rest sitting for 15 s;

P 2 - heart rate for the first 15 from the first minute of recovery;

P 3 - heart rate for the last 15 from the first minute of recovery.

Table 5 - Evaluation table for calculating the Rufier-Dixon index

The purpose of testing in physical culture and sports is to assess the functional state of body systems and the level of physical performance (training).

Testing should be understood as the reaction of individual systems and organs to certain influences (the nature, type and severity of this reaction). Evaluation of test results can be both qualitative and quantitative.

Various functional tests can be used to assess the functional state of the body.
1. Samples with dosed physical activity: one-, two-, three- and four-moment.
2. Tests with a change in body position in space: orthostatic, clinostatic, clinoorthostatic.
3. Tests with changes in intrathoracic and intra-abdominal pressure: straining test (Valsalva).
4. Hypoxemic tests: tests with inhalation of mixtures containing different ratios of oxygen and carbon dioxide, breath holding and others.
5. Pharmacological, alimentary, temperature, etc.

In addition to these functional tests, specific tests with a load characteristic of each type of motor activity are also used.

Physical performance is an integral indicator that makes it possible to judge the functional state of various body systems and, first of all, the performance of the circulatory and respiratory apparatus. It is directly proportional to the amount of external mechanical work performed at high intensity.

To determine the level of physical performance, tests with maximum and submaximal load can be used: maximum oxygen consumption (MOC), PWC 170, Harvard step test, etc.

Algorithm for completing the task: students, united in pairs, perform the following methods, analyze the results, draw conclusions from the test results and develop recommendations for optimizing performance. Before completing the tasks, work out the terminology (see the dictionary) under the section "Functional tests ...".

3.1. Determination of the level of physical performance according to the PWC 170 test

Target: mastering the methodology of the test and the ability to analyze the data obtained.
Required for work: bicycle ergometer (or step, or treadmill), stopwatch, metronome.
The PWC 170 test is based on the pattern that there is a linear relationship between heart rate (HR) and exercise power. This allows you to determine the amount of mechanical work at which the heart rate reaches 170, by plotting and linear extrapolation of data, or by calculating according to the formula proposed by V. L. Karpman et al.
A heart rate of 170 beats per minute corresponds to the beginning of the zone of optimal functioning of the cardiorespiratory system. In addition, with this heart rate, the linear nature of the relationship between heart rate and the power of physical work is violated.
The load can be performed on a bicycle ergometer, on a step (step test), as well as in the form specific to a particular sport.

Option number 1(with bicycle ergometer).

The subject sequentially performs two loads for 5 minutes. with a 3-minute rest interval in between. In the last 30 sec. the fifth minute of each load, the pulse is calculated (palpation or electrocardiographic method).
The power of the first load (N1) is selected according to the table depending on the body weight of the subject in such a way that at the end of the 5th minute the pulse (f1) reaches 110...115 bpm.
The power of the second (N2) load is determined from Table. 7 depending on the value of N1. If the value of N2 is correctly selected, then at the end of the fifth minute the pulse (f2) should be 135...150 bpm.

For the accuracy of determining N2, you can use the formula:

N2 = N1 ,

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.
Then the formula calculates PWC170:

PWC 170 = N1 + (N2 - N1) [(170 - f1) / (f2 - f1)]

The value of PWC 170 can be determined graphically (Fig. 3).
To increase objectivity in assessing the power of the work performed at a heart rate of 170 beats/min, the influence of the weight indicator should be excluded, which is possible by determining the relative value of PWC 170 . The value of PWC 170 is divided by the weight of the subject, compared with the same value for the sport (Table 8), and recommendations are given.

Option number 2. Determining the value of PWC 170 using a step test.

Progress. The principle of operation is the same as in work No. 1. The speed of climbing a step during the first load is 3 ... 12 lifts per minute, with the second - 20 ... 25 lifts per minute. Each ascent is made for 4 counts per step 40-45 cm high: for 2 counts the ascent and for the next 2 counts - descent. 1st load - 40 steps per minute, 2nd load - 90 (a metronome is set on these numbers).
The pulse is counted for 10 seconds, at the end of each 5-minute load.
The power of the loads performed is determined by the formula:

N = 1.3 h n P,

where h is the step height in m, n is the number of steps per minute,
P - body weight. examined in kg, 1.3 - coefficient.
Then, according to the formula, the value of PWC 170 is calculated (see option No. 1).

Option number 3. Determining the value of PWC 170 with placing specific loads (eg running).

Progress
To determine physical performance according to the PWC 170 (V) test with specific loads, it is necessary to register two indicators: movement speed (V) and heart rate (f).
To determine the speed of movement, it is required to accurately record the length of the distance (S in m) and the duration of each physical activity (f in sec.) Using a stopwatch.

Where V is the speed of movement in m / s.
The heart rate is determined during the first 5 seconds. recovery period after running by palpation or auscultation method.
The first run is performed at the pace of "jogging" at a speed equal to 1/4 of the maximum possible for this athlete (approximately every 100 m for 30-40 seconds).
After a 5-minute rest, the second load is performed at a speed equal to 3/4 of the maximum, that is, in 20-30 seconds. every 100 m.
The length of the distance is 800-1500 m.
Calculation of PWC 170 is made according to the formula:

PWC 170 (V) = V1 + (V2 - V1) [(170 - f1) / (f2 - f1)]

where V1 and V2 are the speed in m/s,
f1 and f2 - pulse rate after which race.
Task: to make a conclusion, to give recommendations.
After completing the task according to one of the options, you should compare the result with that in accordance with sports specialization (Table 8), make a conclusion about the level of physical performance and give recommendations for its increase.

3.2. Determination of maximum oxygen consumption (MOC)

The IPC expresses the limiting capacity of the oxygen transport system for a given person and depends on gender, age, physical fitness and the state of the body.
On average, the IPC in people with different physical conditions reaches 2.5 ... 4.5 l / min, in cyclic sports - 4.5 ... 6.5 l / min.
Methods for determining the IPC: direct and indirect. The direct method for determining the IPC is based on the performance of a load by an athlete, the intensity of which is equal to or greater than his critical power. It is unsafe for the subject, as it is associated with the maximum stress of body functions. More often, indirect methods of determination are used, based on indirect calculations, the use of a small load power. Indirect methods for determining the IPC include the Astrand method; determination according to the Dobeln formula; in size PWC 170, etc.

Choose a task, click on the picture.

Option number 1

For work you need: a bicycle ergometer, steps 40 cm and 33 cm high, metronome, stopwatch, Astrand nomogram.
Progress of work: on a bicycle ergometer, the subject performs a 5-minute load of a certain power. The load value is selected in such a way that the heart rate at the end of work reaches 140-160 beats / min (approximately 1000-1200 kgm / min). The pulse is counted at the end of the 5th minute for 10 seconds. palpation, auscultation or electrocardiographic method. Then, according to the Astrand nomogram (Fig. 4), the value of the IPC is determined, for which, by connecting the line of heart rate during exercise (scale on the left) and the body weight of the subject (scale on the right), the value of the IPC is found at the point of intersection with the central scale.

Option number 2

Students take the test in pairs.
The subject within 5 minutes climbs a step 40 cm high for men and 33 cm for women at a speed of 25.5 cycles, in 1 minute. The metronome is set to 90.
At the end of the 5th minute for 10 sec. pulse rate is recorded. The value of the IPC is determined by the Astrand nomogram and compared with the standard from sports specialization (Table 9). Given that the IPC depends on body weight, calculate the relative value of the IPC (MIC / weight) and compare with the average data, write a conclusion and give recommendations.

Option number 3. Determination of the IPC by the value of PWC 170.

Progress of work: the calculation of the IPC is carried out using the formulas proposed by V. L. Karpman:
MPC = 2.2 PWC 170 + 1240

For athletes specializing in speed-strength sports;

MPC = 2.2 PWC 170 + 1070

For endurance athletes.
Execution algorithm: determine the value of the IPC according to one of the options and compare it with the data in accordance with the sports specialization according to Table. 9, write a conclusion and make recommendations.

Option number 4. Determination of health according to the Cooper test

The Cooper test consists in running the maximum possible distance on flat terrain (stadium) in 12 minutes.
If signs of overwork occur (severe shortness of breath, tachyarrhythmia, dizziness, pain in the heart, etc.), the test is terminated.
The test results correspond to the IPC value determined on the treadmill.
The Cooper test can be used in the selection of schoolchildren in the section for cyclic sports, during training to assess the state of fitness.

Option number 5. Nowakki test (maximum test).

Purpose: to determine the time during which the subject is able to perform work with maximum effort.
Necessary equipment: bicycle ergometer, stopwatch.
Progress. The subject performs a load on a bicycle ergometer at the rate of 1 W/kg for 2 minutes. Every 2 minutes the load increases by 1 W/kg until the limit value is reached.
Evaluation of the result. High performance according to this test corresponds to a value of 6 W / kg, when it is performed for 1 min. A good result corresponds to a value of 4-5 W/kg for 1-2 minutes.
This test can be used for trained individuals (including in youth sports), for untrained individuals and individuals in the period of recovalescence after an illness. In the latter case, the initial load is set at the rate of 0.25 W/kg.

3.3. Determination of the level of physical performance according to the Harvard step test (GTS)

Physical performance is assessed by the value of the HTS index (IGST) and is based on the rate of heart rate recovery after climbing a step.
The purpose of the work: to acquaint students with the methodology for determining physical performance according to the GTS.
For work you need: steps of different heights, a metronome, a stopwatch.
Progress. Performed by students in pairs. It is compared with the standards, recommendations are made for optimizing performance by means of physical improvement. Previously, depending on gender, age, the height of the step and the climbing time are selected (Table 11).
Next, the subject performs 10-12 squats (warm-up), after which he begins to climb the step at a speed of 30 cycles per 1 minute. The metronome is set to a frequency of 120 beats / min, the rise and fall consists of 4 movements, each of which will correspond to the beat of the metronome: 2 beats - 2 steps up, 2 beats - 2 steps down.
Ascent and descent always start with the same foot.
If, due to fatigue, the subject lags behind the rhythm for 20 seconds, testing stops and the time of work at a given pace is recorded.

Note. S denotes the surface of the body of the subject (m2) and is determined by the formula:

S \u003d 1 + (P ± DH) / 100,

Where S is the surface of the body; P - body weight;
DH - deviation of the height of the subject from 160 cm with the corresponding sign.
After finishing work within 1 min. during the recovery period, the subject, sitting, rests. Starting from the 2nd minute of the recovery period, for the first 30 seconds. at 2, 3 and 4 minutes, the pulse is measured.
IGST is calculated by the formula:

IGST = (t 100) / [(f1 + f2 + f3) 2],

Where t is the duration of the ascent, in sec.
f1, f2, f3 - pulse rate, for 30 sec. at 2, 3 and 4 minutes of the recovery period, respectively.
In the case when the subject, due to fatigue, stops climbing ahead of time, the calculation of the IGST is carried out according to the reduced formula:

IGST = (t 100) / (f1 5.5),

Where t is the test execution time, in seconds,
f1 - pulse rate for 30 seconds. at the 2nd minute of the recovery period.
With a large number of subjects, Table 1 can be used to determine the IGST. 12, 13, for which in the vertical column (tens) they find the sum of three pulse counts (f1 + f2 + f3) in tens, in the upper horizontal line - the last digit of the sum and at the intersection - the value of IGST. Then, according to the standards (evaluation tables), physical performance is assessed (Table 14).
Recommendations for work. Calculate IGST using the formula and table. Compare it with the recommended values.

3.4. Modified orthostatic test

Purpose: to assess the state of orthostatic stability of the body.
Theoretical justification. The orthostatic test is used to reveal the state of latent orthostatic instability and to control the dynamics of the state of fitness in complex coordination sports. The trial is based on. the fact that when moving from a horizontal position to a vertical one, due to a change in hydrostatic conditions, the primary venous return of blood to the right side of the heart decreases, as a result of which there is an underload of the heart with volume and a decrease in systolic blood volume. To maintain the minute volume of blood at the proper level, the heart rate reflexively increases (by 5-15 beats per minute).
In pathological conditions, overtraining, overstrain, after infectious diseases, or with congenital orthostatic instability, the depositing role of the venous system is so significant that a change in body position leads to dizziness, darkening of the eyes, up to fainting. Under these conditions, the compensatory increase in heart rate is insufficient, although it is significant.
For work you need: a couch, a sphygmomanometer, a phonendoscope, a stopwatch.
Progress. Performed by students in pairs. Compare the results with the recommended ones, develop ways to optimize orthostatic stability by means of physical education. After a preliminary rest for 5 minutes. in the supine position, heart rate is determined 2-3 times and blood pressure is measured. Then the subject slowly stands up and is in an upright position for 10 minutes. in a relaxed posture. To ensure the best relaxation of the muscles of the legs, it is necessary, stepping back from the wall at a distance of one foot, lean against it with your back, a roller is placed under the sacrum. Immediately after the transition to a vertical position for all 10 minutes. at each minute, heart rate and blood pressure are recorded (for the first 10 s - heart rate, for the remaining 50 s - blood pressure).
The assessment of the state of orthostatic stability is carried out according to the following indicators:
1. The difference in the pulse, for the 1st minute. and at the 10th min. in relation to the initial value in the supine position. Blood pressure increases by 10-15%.
2. Heart rate stabilization time.
3. The nature of the change in blood pressure in the standing position.
4. State of health and severity of somatic disorders (blanching of the face, darkening of the eyes, etc.).
Satisfactory orthostatic stability:
1. The increase in heart rate is small and for the 1st minute. orthoposition ranges from 5 to 15 bpm, at the 10th minute. does not exceed 15-30 bpm.
2. Stabilization of the pulse occurs for 4-5 minutes.
3. Systolic blood pressure remains unchanged or slightly decreases, diastolic blood pressure increases by 10-15% in relation to its value in a horizontal position.
4. Feeling good and there are no signs of somatic disorder.
Signs of orthostatic instability are an increase in heart rate by more than 15-30 bpm, a pronounced drop in blood pressure and varying degrees of vegetative somatic disorders.
Task: to conduct a study of orthostatic stability using the modified orthostatic test technique.
Record the results obtained in the protocol, give a conclusion and recommendations.

3.5. Determination of special performance (according to V.I. Dubrovsky)

Option number 1. Definition of special working capacity in swimming.

It is carried out on a spring-lever simulator in the supine position for 50 seconds. The test is performed in 50-second segments in the form of strokes. The pulse is counted, blood pressure is measured before and after the test.
Evaluation of the result: an increase in the number of strokes in the dynamics of the test and the recovery time of heart rate and blood pressure indicate a good functional preparation of the swimmer.

Option number 2. Determination of special working capacity in hockey players.

The subject runs in place at the maximum pace. Total 55 sec. (15 sec + 5 sec + 15 sec + 5 sec + 15 sec). 15-second segments are performed with acceleration.
Before and after the test, heart rate, blood pressure, and respiratory rate are determined. During the test, external signs of fatigue are noted, the type of response of the body to is determined. load and recovery time is recorded.

3.6. Determination of the anaerobic capabilities of the body by the value of maximum anaerobic power (MAM)

Anaerobic capabilities (i.e., the ability to work in anoxic conditions) are determined by the energy generated during the breakdown of ATP, creatine phosphate and glycolysis (anaerobic breakdown of carbohydrates). The degree of adaptation of the body to work in oxygen-free conditions determines the amount of work that a person can perform in these conditions. This adaptation is important in the development of the body's speed capabilities.
In mass surveys, R. Margaria's test (1956) is used to determine MAM. The power of running up the stairs with maximum speed in a short time is determined.
Methodology. A ladder, approximately 5 m long, 2.6 m high, with a slope of more than 30 °, is run in 5-6 seconds. (approximate running time).
The subject is 1-2 m from the stairs and, on command, performs the test. The time is fixed in seconds. The height of the steps is measured, their number is calculated, the total height of the rise is determined:

MAM \u003d (P h) / t kgm / s,

Where P is the weight in kg, h is the height of the lift in m, t is the time in sec.
Evaluation of the result: the highest value of MAM is observed at 19-25 years old, from 30-40 years old it decreases. In children, it tends to increase.
For untrained individuals, MAM is 60...80 kgm/s, for athletes - 80...100 kgm/s. To convert to watts, you need to multiply the resulting value by 9.8, and to convert to kilocalories per minute - by 0.14.

3.7. Section control questions

Questions for a colloquium on the topic
"Testing in sports medical practice"
1. Fundamentals of testing in sports medicine, goals, objectives.
2. The concept of a "black box" in sports medical research.
3. Requirements for tests.
4. Organization of tests.
5. Classification of tests.
6. Contraindications for testing.
7. Indications for termination of the test.
8. Simultaneous samples, methodology, analysis of the result.
9. Letunov's test. Types of response to physical activity. Analysis of the result.
10. Harvard step test. Methodology, evaluation of results.
11. Determination of physical performance according to the PWC170 test. Methodology, evaluation of results.
12. Definition of the IPC. Methodology, evaluation of the result.
13. Features of medical control over young athletes.
14. Features of medical control over middle-aged and elderly people involved in physical education.
15. Self-control during physical education and sports.
16. Features of medical control over women during physical education and sports.
17. Organization of medical and pedagogical control over the physical education of schoolchildren, students of vocational schools, secondary and higher specialized educational institutions.

3.8. Literature by section

1. Geselevich V.A. Trainer's Medical Handbook. M.: FiS, 1981. 250 p.
2. Dembo A.G. Medical control in sports. M.: Medicine, 1988. S.126-161.
3. Children's sports medicine / Ed. S.B. Tikhvinsky, S.V. Khrushchev. M.: Medicine, 1980. S.171-189, 278-293.
5. Karpman V.L. and other Testing in sports medicine. M.: FiS, 1988. S.20-129.
6. Margotina T.M., Ermolaev O.Yu. Introduction to Psychophysiology: Textbook. M.: Flint, 1997. 240 p.
7. Sports medicine / Ed. A.V. Chogovadze. M.: Medicine, 1984. S. 123-146, 146-148, 149-152.
8. Sports medicine / Ed. V.L. Karpman. M.: FiS, 1987. S.88-131.
9. Khrushchev S.V., Krugly M.M. Coach about a young athlete. M.: FiS, 1982. S.44-81.

3.9. Medical and pedagogical observations (VPN)

Purpose: mastering the technique of carrying out TPN and analyzing the results obtained to correct the motor load and improve the methodology of training sessions.
Theoretical justification: VPN is the main form of joint work of a doctor, teacher or trainer. Observing a schoolchild (sportsman) in natural conditions of training (sports) activities and competitions, they clarify: the functional state of the body, the degree of stress during a specific physical load, the characteristics of his reaction in a particular period of training or competitions, the nature and course of recovery processes.
Depending on the purpose and objectives of the VPN, the following are carried out:
1. At rest - to study the initial state of the body, which is important for assessing subsequent changes in the body in the process of performing the load and for assessing the course of recovery after previous exercises, training.
2. Immediately before training or competition - to determine the characteristics of pre-work shifts in the body in pre-start conditions.
3. In the course of training sessions (after its individual parts, immediately after the completion of individual exercises, after the end of classes as a whole) - in order to study the effect of the load on the body and the adequacy of the applied load.
4. At various stages of recovery.
For work you need: a stopwatch, a sphygmomanometer, a dynamometer, a dry spirometer, a pneumotachometer, a myotonometer, research protocols.
Task execution algorithm. During the first hour of the lesson, students get acquainted with the tasks and methods of VPN. Then the group is divided into teams of 1-2 people and receives one of the tasks, studies the methodological instructions for its implementation and conducts observations during training sessions in the gym.
In the next session, each researcher makes a conclusion based on the results of their observations and recommendations for correcting the load.

Choose a task, click on the picture.,

Task number 1. Visual observations of the influence of classes on students, lesson timing.

The purpose of the work: using visual observations, to assess physical fitness, the impact of classes on the group, as well as the construction and organization of classes.

Progress. Prepare an observation map in which you need to enter the following data.
I. General information about the group:
a) characteristics of the group (sports specialization, qualifications, sports experience, training period);
b) the number of people involved (including men and women);
c) the number of people released from classes in the group (with reasons).
II. Characteristics of the lesson (training):
a) the name of the lesson;
b) main tasks, goal;
c) start time of classes, end, duration;
d) motor activity density in percent;
e) the relative intensity of the load in percent;
f) hygienic and material and technical conditions of the lesson.
Note. The motor density of the occupation is estimated as a percentage. A density of 80...90% should be considered very high, 60...70% - good, 40...50% - low.
Relative intensity J is calculated by the formula:
J = [(load heart rate - resting heart rate) / (max heart rate - resting heart rate)] 100%,
where resting heart rate - before the start of classes;
Heart rate max - is determined in a stepwise increasing bicycle ergometric test or on a treadmill or on a step with work to failure (possible from the words of the athlete).
III. Visual observations of the influence of classes on those involved.
1. State at the beginning of the lesson (peppy, lethargic, efficient, etc.).
2. During the lesson (behavior, mood, attitude to work, coordination of movements, breathing, shortness of breath, skin color, gait, facial expression).
3. Technical indicators, organization and methodology of the lesson (exercise technique - good, satisfactory, poor; technical indicators - high, medium, low; shortcomings in the construction and organization of the lesson).
4. The degree of fatigue by the end of the lesson (according to external signs).
5. Evaluation of the fulfillment of the assigned tasks.
Based on visual observations on the density of the lesson and the intensity of the load, give a general conclusion, practical suggestions and recommendations on the methodology and organization of the lesson.

Task number 2. Influence of FC classes on the body of the student by changes in heart rate.

The purpose of the work: to determine the intensity of the applied loads and their compliance with the functional capabilities of the student by the reaction of the pulse.
For work you need: a stopwatch, a research protocol.
Progress. Before training, one subject is selected from the group for the study, whose history is collected and the pulse rate is recorded by palpation on the radial or carotid artery. Further, the pulse rate is determined continuously throughout the entire session, after its individual parts, immediately after individual exercises and during the rest period between them, as well as within 5 minutes after the end of the session. In total, you need to make at least 10-12 measurements. The result of each pulse test is immediately indicated by a dot on the graph. In addition, it should be noted at what minute, after which exercise and in what part of the lesson the measurement was taken.
Registration of work
1. Draw the physiological curve of the lesson.
2. Determine the intensity of the applied loads, the correctness of their distribution in time and the sufficiency of rest according to the pulsometry data.
3. Give brief recommendations.

Task number 3. Evaluation of the impact of the lesson on the trainee by changes in blood pressure.

The purpose of the work: to determine the intensity of the performed loads and their correspondence to the functional capabilities of the body by changing blood pressure.
For work you need: a sphygmomanometer, a phonendoscope, a stopwatch, a study card.
Progress. One subject is selected from whom anamnesis is collected. It is desirable to conduct a study of pulse and blood pressure in the same subject.
The rate of change in blood pressure is the same as the pulse. With each measurement of blood pressure, two points are marked in the graph: one for the maximum, the other for the minimum pressure. At the same time, it is necessary to note at what minute, after what exercise and in what part of the lesson the measurement was made;
Registration of work
1. Draw a curve of changes in the maximum and minimum blood pressure.
2. Determine the intensity of the loads, the correctness of the distribution of rest intervals, the composition, nature and degree of changes in heart rate and blood pressure. Make a conclusion about the functional state of the body and give practical suggestions for correcting the load.

Task number 4. Determination of the student's response to physical activity by changes in VC and bronchial patency.

The purpose of the work: to determine the degree of impact of the load on the human body on the basis of observational data on changes in VC and bronchial patency.
For work you need: dry spirometer, stopwatch, alcohol, cotton swabs, pneumotachometer, research protocol.
Progress. Before the lesson, collect an anamnesis from the subject. Then, before the start of classes, measure VC according to the usual method, conduct a Lebedev test (4-fold measurement of VC with a rest interval of 15 seconds) and determine bronchial patency. During the lesson, take 10-12 measurements. Lebedev's re-test is carried out after the end of the lesson. Measurement data is plotted as a dot on the graph.
Registration of work
Draw a graph. To assess the influence of loads on the functional state of the external respiration system.
When assessing, take into account that shifts in the values ​​of VC, the state of bronchial patency are important. After the usual training sessions with the Lebedev test, the decrease in VC is 100-200 ml, and after very high training and competitive loads, there may be a decrease in VC by 300-500 ml. Therefore, a significant decrease in these indicators and slow recovery indicates the inadequacy of the applied load.

Note: indicate the time (min.), part of the lesson, after which exercise the study was conducted.

Task number 5. Determination of the student's response to physical activity by changing the strength of the hands.

The purpose of the work: To determine, by changes in the strength of the hands, the compliance of the loads performed with the capabilities of the subject.
Equipment: hand dynamometer, stopwatch, study protocol.
Progress. Having selected the subject from the group, collect an anamnesis from him. Then the strength of the left and right hand is measured. The procedure for determining is the same as in lesson No. 4. The data is plotted on a graph. At the bottom it is indicated after which abolition the measurement was made and in what part of the lesson.
1. With each measurement, two points are plotted on the graph: one is the strength of the right hand, the other is the strength of the left hand.
2. According to the curve of changes in the strength of the hands and its recovery during periods of rest, assess the severity of the load, the degree of fatigue, the length of the rest intervals, etc.
When evaluating, take into account that a significant decrease in the strength of the hands is observed in insufficiently trained athletes. One of the characteristic signs of fatigue is a decrease in the difference in the strength of the right and left hand due to a decrease in the strength of the right and some increase in the strength of the left.

Note. Indicate the time (min.), part of the lesson, after which exercises the strength of the hands was studied. The strength of the right hand is marked with a solid line, the strength of the left - with a dotted line.

Task number 6. Determination of the effect of training on the body by changes in the Romberg coordination test.

The purpose of the work: to determine the correspondence of loads to the physical capabilities of the trainee by changing the coordination test, to identify the degree of fatigue.
For work you need: research protocol, stopwatch.
Progress. For the work, the subject is selected, from whom the anamnesis is collected. Then a complicated pose of the Romberg test is performed (II - III poses). The procedure, definitions are the same as in lesson No. 2.
The nature of the change in the duration of maintaining balance in the II and III postures should be drawn up in the form of a graph: one line characterizes the dynamics of the II posture; the second - III. At the bottom it is indicated after which exercise the study was conducted and in which part of the lesson.
Recommendations for doing work
1. Draw a curve for the duration of maintaining balance in the II and III Romberg positions during the lesson.
5. Assess the degree of fatigue and the adequacy of the training load to the level of preparedness of the body using the Romberg test.
Insufficient stability in the Romberg poses is one of the signs of fatigue, overwork and overtraining, as well as diseases of the central nervous system.

Protocol for the study of the coordination function of the nervous system
during class

(1. Full name 2. Age. 3. Sports specialization. 4. Sports experience. 5. Category, 6. The period of training and its main features (systematic, year-round, volume, intensity of training). 7. Were there training in the past 8. Features of the pre-start state 9. Date of the last training 10. Feeling, complaints CNS injuries - when, what, outcome)

Notes. Indicate the time (min.), part of the lesson, after which exercise the study was conducted. The duration of maintaining balance in the II position of Romberg is marked with a solid line, in III - with a dotted line.

Task number 7. Determining the response of the student to physical activity by changing muscle tone.

The purpose of the work: to determine the contractile function and the degree of fatigue of the neuromuscular apparatus under the influence of the load by changing muscle tone.
For work you need: myotonometer, research protocol.
Progress. Before the start of training, one subject is selected from the group, whose history is collected. Then, depending on the nature of the exercises, it is determined which muscle groups the load falls on. Muscle tone is measured at symmetrical points of the limbs. The tone of relaxation and the tone of tension are determined.
Measurement of muscle tone is carried out before the session, during the entire session, after individual exercises, rest intervals and at the end of the session. In total, during classes, you need to make 10-15 measurements of muscle tone.
Recommendations for doing work
1. Draw a graph: one point corresponds to the tone of relaxation, the other - to the tone of tension.
2. According to the curve of changes in the amplitude of the tone of tension and relaxation and its recovery during periods of rest, assess the severity of the load and the degree of fatigue.
When evaluating the data obtained, the change in the amplitude of muscle hardness (the difference between the tone of tension and relaxation), expressed in myotons, is taken into account. Its decrease is associated with a deterioration in the functional state of the neuromuscular apparatus and is observed in insufficiently trained athletes or when performing excessive physical exertion.

Protocol for the study of muscle tone during the session

(1. Full name 2. Age. 3. Sports specialization. 4. Sports experience. 5. Category. 6. Periods of training and its main features (systematic, year-round, volume, intensity of training). 7. Breaks in training (when and why?) 8. Physical activity performed the day before 9. Feeling good, complaints)

Note. Indicate the time (min.) after which exercise, load or rest interval the muscle tone and part of the session are measured. The tone of relaxation is marked with a solid line, the tone of tension - with a dotted line.

Task number 8. Determination of the state of functional readiness of the body. with an additional standard load.

The purpose of the work: to determine the degree of impact of physical activity on the body of the student and to assess the level of his fitness.
For work you need: stopwatch, phonendoscope, sphygmomanometer, research protocol
Progress. Before a training session, one subject is selected 10-15 minutes in advance, whose history is taken, pulse and blood pressure are measured. Then he is asked to perform the first additional standard load. Any functional test can be used as an additional standard load, depending on the sports specialization and qualification of the subject (15-second run at a maximum pace, step test, 2 and 3-minute run in place at a pace of 180 steps per minute).
After performing an additional load, the pulse and blood pressure are determined within 5 minutes according to the generally accepted method. The same additional load is performed a second time, 10-15 minutes after the end of the workout, after measuring the heart rate and blood pressure. After performing an additional load, heart rate and blood pressure are measured within 5 minutes. The observation data are entered in the following table.

Recommendations for the design of work
1. Build a graph for changes in heart rate and blood pressure.
2. Comparing the types of responses to an additional standard load before and after training, determine the degree of impact of the training load and assess the level of fitness.

Protocol for work on assignment No. 8

(1. Full name 2. Age. 3. Kind of sport, category, experience. 4. Best results (when shown). 5. Performances in competitions in the last 1.5-2 months, the duration of various training periods and number of training sessions by period, means used 6. Breaks in training (when and why) 7. Content of the session in which the observation was made, time of the session, date 8. Feeling, mood, complaints before the session, after it)

The difference in heart rate and blood pressure before and after the test is recorded in the chart below to determine the type of response to the load. Symbols on the graph: horizontal (abscissa) - time; along the vertical (y-axis) - the difference in heart rate, maximum and minimum blood pressure at each minute of the recovery period in relation to the initial values.

To assess the impact of physical activity performed in. during the lesson, it is necessary to compare the adaptive reactions to the additional load before and after the lesson. There are three possible responses to the additional load.
1. They are characterized by slight differences in adaptive reactions to an additional load performed before and after training. There may be only small quantitative differences in the shifts in heart rate, blood pressure and recovery time. This reaction is observed in athletes in a state of good fitness, but may be in undertrained athletes with a small training load.
2. Characterized by the fact that more pronounced shifts in the response of the pulse are noted to the additional load performed after training, while the maximum blood pressure rises slightly (the "scissors" phenomenon). The duration of recovery of pulse and blood pressure increases. Such a reaction indicates insufficient fitness, and in some cases it is also observed in well-trained people after an excessively large load.
3. It is characterized by more pronounced changes in the response to an additional load after training: the pulse response sharply increases, atypical types appear (hypotonic, diatonic, hypertonic, reactions with a stepwise rise in maximum blood pressure), the recovery period lengthens. This option indicates a significant deterioration in the functional state of the athlete, the cause of which may be his lack of preparedness, overwork or excessive workload in class.
VPN are also carried out with repeated specific loads (according to the sport) to assess the level of special fitness in natural training conditions. The methodology, such observations and analysis of the results are detailed in the educational literature of the general list.

3.10. Security questions to the topic

"Medical and pedagogical observations (VPN)"
1. Definition of the concept of VPN.
2. Purpose, tasks of the VPN.
3. Forms, methods of VPN.
4. Functional tests used in HPN.
5. Samples with an additional load for HPN.
6. Samples with a specific load for HPN.
7. Analysis of the results of the VPN.
8. Evaluation of the health-improving efficiency of the load during classes.

3.11. Literature on the topic "VPN, medical control in mass physical education"

1. Dembo A.G. Medical control in sports. M.: Medicine, 1988. S.131-181.
2. Children's sports medicine / Ed. S.B. Tikhvinsky, S.V. Khrushchev. M.: Medicine, 1980. S.258-271.
3. Dubrovsky V.I. Sports medicine. M.: Vlados, 1998. S.38-66.
4. Karpman V.L. and other Testing in sports medicine. M.: FiS, 1988. S.129-192.
5. Kukolevsky G.M. Medical supervision of athletes. M.: FiS, 1975. 315 p.
6. Markov V.V. Fundamentals of healthy lifestyles and disease prevention: Textbook. M.: Academy, 2001. 315 p.
7. Sports medicine / Ed. A.V. Chogovadze. M.: Medicine, 1984. S. 152-169, 314-318, 319-327.
8. Sports medicine / Ed. V.L. Karpman. M.: FiS, 1987. S.161-220.
9. Physical rehabilitation: Textbook for in-t fiz. culture / Ed. S.N. Popova. Rostov-on-Don, 1999. 600 p.
10. Khrushchev S.V., Krugly M.M. Coach about a young athlete. M.: FiS, 1982. S.112-137.

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Functional tests make it possible to assess the general state of the body, its reserve capabilities, and the features of adaptation of various systems to physical loads, which in some cases mimic stressful effects.

The leading indicator of the functional state of the body is the general physical performance (FR), or readiness to perform physical work. The total RF is proportional to the amount of mechanical work that a person is able to perform for a long time and with a sufficiently high intensity, and largely depends on the performance of the oxygen transport system.

All functional tests are classified according to 2 criteria: the nature of the disturbing effect (physical activity, change in body position, breath holding, straining, etc.) and the type of recorded indicators (circulatory, respiratory, excretion, etc.).

The general requirement for disturbing influences is their dosage in specific quantitative quantities, expressed in SI units. If physical activity is used as an impact, its power should be expressed in watts, energy gains in joules, etc. When the characteristic of the input action is expressed by the number of squats, the frequency of steps when running in place, and the like, the reliability of the results obtained is significantly reduced.

Physiological constants with a certain measurement scale are used as indicators recorded after the test. For their registration, special equipment is used (electrocardiograph, gas analyzer, etc.).

One of the objective criteria of human health is the level of RF. High working capacity serves as an indicator of stable health, its low values ​​are considered as a risk factor for health. As a rule, high RF is associated with greater physical activity and lower morbidity, including the cardiovascular system.

In the concept of FR (in English terminology - Physical Working Capacity - PWC), the authors put different content, but the main meaning of each of the formulations is reduced to the potential ability of a person to perform maximum physical effort.

RF is a complex concept, which is determined by the morphofunctional state of various organs and systems, mental status, motivation, etc. Therefore, a conclusion about the value of RF can only be made on the basis of a comprehensive assessment. In the practice of sports medicine, FR is evaluated using numerous functional tests, which involve determining the body's reserve capabilities based on the responses of the cardiovascular system. For this purpose, more than 200 different tests have been proposed.

Non-specific functional tests

1. Tests with dosed physical activity: one-stage (20 sit-ups in 30 seconds, 2-minute run in place at a pace of 180 steps per minute, 3-minute run in place, 15-second run at a maximum pace, etc.), two-moment (a combination of 2 standard loads) and a combined three-moment Letunov test (20 squats, a 15-second run and a 3-minute run in place). In addition, this group includes bicycle ergometric loads, step test, etc.

2. Samples with a change in the external environment. This group includes samples with inhalation of mixtures containing different (increased or decreased compared to atmospheric air) percentage of 02 or CO2, breath holding, being in a pressure chamber, etc.; samples associated with exposure to different temperatures - cold and thermal.

3. Pharmacological (with the introduction of various substances) and vegetative-vascular (orthostatic, eye-cardiac, etc.) tests, etc.

In functional diagnostics, specific tests are also used that imitate activities characteristic of a particular sport (shadow boxing for a boxer, work in a rowing machine for a rower, etc.).

With all these tests, it is possible to study changes in the function indicators of various systems and organs and, using these changes, evaluate the body's response to a certain effect.

When assessing the functional state of the cardiovascular system, 4 types of reactions to the load are distinguished: normotonic, asthenic, hypertonic and dystonic. Identification of one or another type of reaction makes it possible to judge the regulatory disorders of the circulatory system, and therefore, indirectly, about performance (Fig. 2.7).

Rice. 2.7. Types of heart rate and blood pressure response to standard physical activity: L — normotonic; B - hypertonic; B - stepped; G - disgonic; D - hypotonic

It has been established that the most complete picture of the functional reserves of the body can be drawn up under conditions of loads, in which at least 2/3 of the muscle mass is involved. Such loads provide the ultimate intensification of the functions of all physiological systems and make it possible not only to reveal the underlying mechanisms for providing RF, but also to detect states bordering on the norm and hidden manifestations of insufficiency of functions. Such stress tests are becoming more widespread in clinical practice, labor physiology and sports.

WHO has developed the following requirements for testing with loads: the load must be quantifiable, accurately reproduced upon repeated use, involve at least 2/3 of the muscle mass and ensure maximum intensification of physiological systems; be characterized by simplicity and accessibility; completely exclude complex coordinated movements; provide the possibility of recording physiological parameters during the test.

Quantitative determination of RF is of great importance in the organization of physical education of the population of different age and sex groups, the development of motor modes for the treatment and rehabilitation of patients, determining the degree of disability, etc.

The functional state of the cardiovascular and respiratory systems determines the ability of the human body to adapt to changing environmental conditions. The impact of environmental factors, heredity, sports loads, as well as acute and chronic diseases affect the structure of organs and the course of physiological processes. The absence of pronounced clinical symptoms does not indicate complete health, therefore, functional tests of the respiratory system are used to assess the reserves of the human body, readiness for increased loads and for the purpose of early diagnosis of disorders.

Samples to assess the functional state of the respiratory system

Pathologies of the bronchopulmonary system most often develop against the background of infectious processes (pneumonia, bronchitis) and are accompanied by characteristic clinical signs:

• Cough with sputum (purulent or serous).
• Shortness of breath (depending on the phase of breathing, difficult inhalation or exhalation).
• Pain in the chest.

In medical practice, laboratory tests and instrumental methods are most often used to diagnose diseases, which assess morphological changes (radiography, computed tomography). The chronic course of diseases that reduce the patient's quality of life (bronchial asthma or obstructive pulmonary disease (COPD)) require monitoring of the process. The tactics of treatment is determined by the severity of the changes and the degree of decrease in function, which in the mild stages is not determined using x-ray methods.

In sports medicine and functional diagnostics, methods of tests and tests are widely used, which assess the state of the respiratory system at different levels (bronchial calibers) and determine the "reserve" of each person's capabilities.

A functional test (test) is a method that examines the response of an organ or system to a dosed load using standardized indicators. In the practice of pulmonologists, spirometry is most often used, which determines:

• Vital capacity of the lungs (VC).
• The rate of inhalation and exhalation.
• Forced expiratory volume.
• The speed of air flow through the bronchi of different calibers.

Another method - lung plethysmography is used to assess changes in the volume of the respiratory organs during a respiratory act.

Additional use of provocative tests (starting a pathological reaction with the help of pharmacological agents), studying the effectiveness of drugs are components of functional pulmonological diagnostics.

In sports medicine, tests are used to study the endurance, reactivity and dynamics of a person's fitness. For example, an improvement in the performance of the Stange and Genchi test indicates a positive trend in swimmers.

Indications and contraindications for functional respiratory tests

The introduction of functional tests into clinical practice obliges to form a contingent of patients for whom it is advisable to conduct a study.

• Long history of smoking (more than 10 years) with a high risk of developing diseases.
• Bronchial asthma (for clinical diagnosis and treatment selection).
• COPD
• Patients with chronic shortness of breath (to determine the cause and localization of the lesion).
• Differential diagnosis of pulmonary and heart failure (in combination with other methods).
• Athletes to assess the strength of the muscles of the chest, respiratory volume.
• Monitoring the effectiveness of treatment in pulmonary diseases.
• Preliminary assessment of possible complications before surgery.
• Examination of working capacity and military examination.

Despite the wide clinical use, the tests are accompanied by an increased load on the respiratory system and emotional stress.

Functional breath tests are not performed when:

• Severe condition of the patient due to somatic disease (liver, kidney failure, early postoperative period).
• Clinical variants of coronary heart disease (CHD): progressive angina pectoris, myocardial infarction (within 1 month), acute cerebrovascular accident (GNMK, stroke).
• Hypertension with a very high risk of cardiovascular disease, malignant hypertension, hypertensive crises.
• Gestosis (toxicosis) in pregnant women.
• Heart failure 2B and 3 stages.
• Pulmonary insufficiency, which does not allow breathing manipulations.

Important! The result of the study is affected by the weight, gender, age of a person and the presence of concomitant diseases, therefore, the analysis of spirometry data is carried out using special computer programs.

Do I need special preparation for the examination?

Functional breathing tests using a pneumotachometer or spirometer are performed in the morning. Patients are advised not to eat before the procedure, as a full stomach restricts diaphragmatic movement, leading to skewed results.

Patients who regularly take bronchodilators (Salbutamol, Seretide and others) are advised not to use drugs 12 hours before the study. The exception is patients with frequent exacerbations.

For the objectivity of the results, doctors advise not to smoke at least 2 hours before the study. Immediately before the study (20-30 minutes) - exclude all physical and emotional stress.

Types of functional respiratory tests

The methodology for conducting various tests differs due to the multidirectional research. Most tests are used to diagnose the latent (latent) stage of bronchospasm or pulmonary insufficiency.

Widely used functional tests are presented in the table.

The use of functional diagnostics in the clinical practice of therapists is justified by early diagnosis and control of the effectiveness of treatment of diseases. Sports medicine uses tests to assess a person's condition before a competition, to control the adequacy of the selected regimen and the body's response to stress. Dynamic research methods are more informative for physicians, since dysfunction is not always accompanied by structural changes.