Maitiro ekurapa nemuviri ekuwedzera kugona kwemapapu
Kugona mapapu zvakanaka kunoita basa guru mukuchengetedza simba, kurara zvakanaka, uye kugona kwemuviri kushanda pasina kuneta. Zvinosuwisa kuti vanhu vazhinji vanodzikira zvishoma nezvishoma mukushanda kwemapapu nekuda kwemararamiro ekugara pasi, kusvuta, kusvibiswa kwemhepo, kukwegura, uye mamwe mamiriro ehutano akadai seasthma, COPD (Chronic Obstructive Pulmonary Disease), kana hutachiona hwepashure pekufema. Apa ndipo panoshanda basa guru re physiotherapy yekufema. Kuburikidza nematekiniki ekurovedza muviri akanangana uye kupindira, physiotherapy inogona kubatsira kuvandudza kushanda zvakanaka kwekufema, kusimbisa tsandanyama dzekufema, kuvandudza maitiro ekufema, uye kuwedzera kushivirira kwekuita.
Chinyorwa chino chinokurukura nzira dzakasiyana-siyana dzekurapa mapapu dzinoshandiswa kuwedzera kugona kwemapapu, zvese kudzivirira, kupora, uye kuvandudza hutano hwemapapu.
1. Nzwisisa "kugona kwemapapu" uye zvinangwa zve physiotherapy
Zvichitaurwa zviri nyore, kugona kwemapapu kunoreva kugona kwemapapu kubata mweya uye kuchinjana okisijeni nekabhoni dhayokisaidhi zvinobudirira. Mukurapa, kugona uku kunoongororwa uchishandisa zvinhu zvakasiyana-siyana, zvakaita sehuwandu hwemhepo (kufema kwakajairika), kugona kwehupenyu (huwandu hwemhepo inogona kuburitswa mushure mekufemerwa kwakanyanya), uye kushanda kwekufema (semuenzaniso, FEV1 mu spirometry).
Kurapa nemuviri hakungotarisi chete pakuwedzera mapapu, asiwo pane:
- Inowedzera kukura kwemadziro echipfuva uye kusimba kwenyama
- Inoderedza basa rekufema kuitira kuti kufema kunzwike kuri nyore
- Inosimbisa tsandanyama dzinofema nedzinoburitsa mweya (diaphragm, intercostals, tsandanyama dzemudumbu)
- Inogadzirisa kucheneswa kwetsvina (manyoka) kuti nzira dzekufema dzive dzakajeka
- Wedzera kushivirira kwezviito kuburikidza nekurovedza muviri kwakarongeka
Saka, kuwedzera kwesimba remapapu kunoitika kuvarwere kunowanzoitika nekuda kwekusanganiswa kwekushanda zvakanaka kwekufema, kugwinya, uye kushanda zvakanaka kweokisijeni.
2. Maekisesaizi ekufema neDiaphragm
Kurovedza muviri uku ndiko kwakakosha pakurapa kufema nekuti kunodzidzisa kufema zvakanaka uchishandisa diaphragm, kwete tsandanyama dzepachipfuva chete. Kufema pachipfuva zvisina kudzika kunowanzoita kuti kufema kuwedzere uye kunoita kuti muviri unete nekukurumidza.
Maitiro ekuita:
1. Kurara: kurara nemusana kana kugara hafu, mapendekete akasununguka.
2. Isa ruoko rumwe pachipfuva chako uye ruoko rumwe padumbu rako.
3. Fema zvishoma nezvishoma nemumhino yako kusvika ruoko rwuri padumbu rwako rwasundidzirwa mudenga, uku chipfuva chako chikaramba chakamira.
4. Fema zvishoma nezvishoma (unogona kuita izvi nemiromo yakasungwa).
5. Dzokorora kwemaminitsi mashanu kusvika gumi, 1-3 pazuva.
Manfaat:
- Wedzera mhepo inofema mumapapu epasi
- Inoderedza kufema kushoma nekuda kwekufema zvishoma
- Inoderedza kushushikana kwemhasuru dzemutsipa nepafudzi
3. Kufema Nemiromo Yakapwanywa
Nzira iyi inofarirwa nevarwere vane COPD, asi inobatsirawo kune chero munhu anoshaya mweya panguva yekurovedza muviri. Kufema nemiromo yakavharirwa kunoita kuti nguva yekufema iwedzere, kunobatsira kudzivirira kuti nzira diki dzekufema dzisaputsike, uye kunoderedza kubatwa kwemhepo.
Maitiro ekuita:
1. Fema nemhino yako kwekaviri.
2. Bata miromo yako sekunge uri kudzima kenduru.
3. Fema zvishoma nezvishoma ka4 (nguva yakareba kupfuura kufemerwa).
4. Zviite kana wava kushaya mweya, kana sekurovedza muviri kwemaminitsi mashanu.
Manfaat:
- Inoderedza kufema kakawanda
- Zvinovandudza kudzora kushaya mweya
- Inobatsira kubvisa mweya kubva mumapapu zvinobudirira
4. Kurovedza Chifuva Kukura
Maekisesaizi aya anovavarira kuwedzera kufamba kwemadziro echipfuva, kuvandudza mhepo inofema, uye kudzivirira kuomarara kwembabvu netsandanyama dzekufema—kunyanya kuvanhu vanga vakarara pasi kwenguva yakareba, mushure mekuvhiyiwa, kana kuti vanga vakagara pasi.
Mienzaniso yezvidzidzo:
– Fema zvakadzika uchisimudza maoko ese mudenga kana kuvhura maoko ako padivi (uchivhura chipfuva chako).
– Bata kwemasekonzi maviri kusvika matatu, wobva waburitsa mweya zvishoma nezvishoma.
- Dzokorora ka5-10 pachikamu chimwe nechimwe, 2-3 pachikoro pazuva.
Manfaat:
- Inobatsira kuunganidzwa kwealveoli (ma air sacs)
– Inotsigira kudzivirira atelectasis (mapapu akadonha zvishoma)
- Kuvandudza chimiro chemuviri chinokanganisa maitiro ekufema
5. Maekisesaizi ekukosora nekukwenya zvinobudirira
Mune mamwe mamiriro ezvinhu (semuenzaniso, kugadzirwa kwemapundu akawandisa, bronchitis, kana mushure mehutachiona), dambudziko guru harisi mapapu chete, asiwo nzira dzekufema dzakavharirwa nekubuda kwemvura. Kurapa nemuviri kunodzidzisa nzira dzekubvisa mweya kuti upinde zvakanaka.
Kukosora kunoshanda:
– Fema zvakadzama, wobva wabata kwesekonzi 1-2, wobva wakosora zvine simba ka1-2.
Kukosora (Huff cough):
– Fema zvine mwero, wobva waburitsa mweya nekukurumidza uye nesimba wakashama muromo wako sekunge uri kuputira girazi (“ha, ha”).
– Kazhinji kacho, vanhu vane hushamwari kune varwere vanoneta kana kurwadziwa zviri nyore kupfuura kukosora zvakanyanya.
Manfaat:
- Inobatsira kubvisa madzihwa pasina kupedza simba rakawanda
- Inovhura nzvimbo dzisina mhepo yakakwana mumapapu
6. Kutenderera Kunoshanda Kwemaitiro Ekufema (ACBT)
ACBT inzira dzakasiyana-siyana dzinosanganisa kufema kwakasununguka, kuwedzera chipfuva, uye nzira dzekufuridzira. Inoshandiswa zvakanyanya kuvarwere vane sputum.
Zvikamu zveACBT:
1. Kudzora kufema: fema zvishoma nezvishoma, zorora kwemasekonzi 20-30.
2. Kukura kwechipfuva: kufema zvakadzika 3–5, bata kwemasekonzi 2–3.
3. Kukosora/kukosora: Kukosora kamwe chete kusvika kaviri kuti kubudise tsvina.
Kutenderera uku kunogona kudzokororwa kakawanda kusvika kufema kwava kurerukirwa.
7. Kudzidziswa kwetsandanyama dzekufema (IMT)
IMT inoshandisa mudziyo wekudzivirira (semuenzaniso, threshold IMT) kudzidzisa tsandanyama dzinofemera kuti dzive dzakasimba uye dzakasimba. Nzira iyi inowanzoshandiswa muvarwere vane COPD, vatambi, kana avo vane tsandanyama dzisina simba dzekufema.
Nheyo dzekurovedza muviri:
– Fema nepachishandiso chacho uine mutoro wakatarwa.
– Kazhinji maminetsi 15–30 pazuva, mazuva 5–7 pasvondo, zvichifambira mberi zvishoma nezvishoma zvichienderana neongororo yachiremba wezvekurapa muviri.
Manfaat:
- Inoderedza kunzwa kwekushaya mweya panguva yezviitiko
- Wedzera simba re diaphragm
- Kuvandudza mashandiro ekurovedza muviri kwe aerobic
8. Kufamba-famba, kurovedza muviri, uye kurovedza muviri nesimba
Vanhu vazhinji vanofunga kuti kuwedzera kugona kwemapapu kunokonzerwa nekurovedza muviri kufema. Zvisinei, kugwinya kwemoyo nekufema kunovandudza zvakanyanya kuburikidza nekurovedza muviri kwakayerwa, sezvo muviri uchiwedzera kugona kushandisa oxygen.
Mienzaniso yezviitwa zvinokurudzirwa:
- Kufamba nekukurumidza, kuchovha bhasikoro usingachinji, kushambira zvishoma (sezvingabvumirwa)
- Nguva yekutanga imaminitsi 10-20, zvishoma nezvishoma ichiwedzera kusvika kumaminitsi 30-45
- Kuwanda kwezviitiko 3–5 pasvondo
Kudzidzira simba (semuenzaniso, kugwinha makumbo zvishoma, kurovedza muviri musana nemapfudzi) kunobatsirawo kumira zvakanaka uye kufema zvakanaka, sezvo chiuno nemusana zvakagadzikana zvichiita kuti tsandanyama dzekufema dzishande zvakanaka.
9. Nzira dzekubvisa mvura mumuviri uye dzekuisa ganda panzvimbo yaro
Mune mamwe mamiriro ezvinhu, dzimwe nzvimbo dzemuviri dzinobatsira kubvisa tsvina uye kuvandudza mhepo inobuda. Semuenzaniso, kurara nerutivi kana kuti kutsamira kunogona kubatsira kuparadzira mweya zvakaenzana kunzvimbo dzemapapu. Zvisinei, nzira idzi dzinofanira kugadziriswa kuti dzienderane nemamiriro emurwere, kunyanya kana paine matambudziko emwoyo, reflux, kana matambudziko eropa.
10. Mazano ekuchengetedza hutano uye nguva yekuonana nachiremba
Maitiro ekurovedza muviri anofanirwa kuitwa zvishoma nezvishoma. Rega maekisesaizi kana uchinzwa dzungu rakakomba, kurwadziwa pachipfuva, kufema kushoma, miromo yebhuruu, kana kurova kwemoyo kusingadzoreki.
Zvakanaka kubvunza chiremba wemuviri kana chiremba kana:
- Kushaya mweya unodiwa kunowanzoitika kunyangwe paine zvinhu zvishoma
- Ane nhoroondo yeasthma/COPD, chirwere chemwoyo, kana mushure mekuvhiyiwa
– Kukosora nefivha inogara kwenguva inopfuura mavhiki maviri kusvika matatu
- Wakambonzwa kudzikira kwe oxygen saturation
Mhedziso
Maitiro ekurapa mapapu anosanganisira maekisesaizi ekufema anosanganisira diaphragmatic breathing, kufema nemuromo, maekisesaizi ekuwedzera chifuva, kubvisa secretion (kukosora zvakanaka, kufemera, ACBT), kudzidziswa kwemhasuru dzinofemera (IMT), uye maekisesaizi ekusimbisa tsandanyama ne aerobic nekufambira mberi kunoyerwa. Chinokosha pakubudirira chiri mukuenderana, nzira dzakarurama, uye kugadziriswa kwepurogiramu zvichienderana nemamiriro emunhu. Nekutungamirirwa nenyanzvi, physiotherapy yekufema inogona kubatsira kuvandudza kufema, kuwedzera mashandiro, uye kuvandudza hupenyu zvakanyanya.
