ФИЗИКАЛНА МЕДИЦИНА И КИНЕЗИТЕРАПИЈА КАЈ ПАЦИЕНТИ СО БЕЛОДРОБНИ ЗАБОЛУВАЊА
PHYSICAL MEDICINE AND KINESITHERAPY IN PATIENTS WITH LUNG DISEASES

Summary/Abstract: Anatomy of the lungs: The lungs are a passive structure - the inflow of air into them during inhalation is carried out by expanding the chest and reducing the pressure in the chest cavity under the action of the contraction of the intercostal muscles and the diaphragm. The trachea divides in the chest cavity into two main bronchi - left and right, each of which branches multiple times and thus forms the bronchial tree. The wall of the bronchioles is strengthened by cartilage. They end in air sacs called pulmonary alveoli. In these cavities - the terminal bronchioles and pulmonary alveoli, gas exchange between blood and air takes place. Bronchitis: Bronchitis is a disease in which inflammation develops in part of the airways of the lungs. Inflammation of the bronchial tree causes disruption of the flow of air through it and difficulty breathing. Incidence of Bronchitis: Bronchitis is one of the most common diseases in the world. According to various data, almost every person has suffered from some form of bronchitis at least once in their life, usually as part of the so-called common cold. Bronchitis Treatment: In the presence of fever, headache, fatigue, symptomatic treatment with analgesics and antipyretics is used. Antibiotics are indicated only in very serious cases or if complications are suspected. With concomitant bronchospasm, chronic and severe cases, the use of bronchodilators is appropriate, and anti-inflammatory agents - corticosteroids. Bronchiectasis: Bronchiectasis is a permanent widening of the bronchi, resulting from damage to the elastic and muscular elements that make up their wall. Symptoms of bronchiectasis: The most common symptom is a chronic cough, which is painful with the release of a lot of sputum. Diagnosis of bronchiectasis: The diagnosis is made on the basis of clinical and instrumental methods. After bronchoscopy and computed tomography, the disease is usually diagnosed with great certainty. Treatment can be conservative and surgical. It is extremely important to use secretolytics, bronchodilators, which reduce obstructive changes in the bronchi. Pneumonia: is an inflammatory disease of the lungs, in which the normal breathing process is disrupted. The cause of pneumonia is infections with various microorganisms - bacteria, viruses or fungi. The classification of pneumonia is very diverse. Pneumonia should always be considered a serious disease, although in the presence of powerful antibacterial agents, it is most often cured. Depending on the body's defenses, concomitant diseases and age, the severity of the course varies from almost asymptomatic forms to severe respiratory failure with a threat to the patient's life. Kinesitherapy for pneumonia is applied after the acute stage of the inflammatory process has ended (7-8 days). Patients are given exercises to improve peripheral blood flow and facilitate cardiac activity, Exercises to increase chest mobility, and Restoring the rhythm and frequency of breathing. Research methods: The research will be conducted at the PHI "Clinical Hospital - Shtip, in Banja Kežovica, in the departments of Physical Medicine and Kinesitherapy. The research will include 11 patients with diagnosed lung diseases (6 male patients and 5 female patients). These patients are treated with exercises to increase chest mobility with tilt and exercises for proper posture that normalize both phases of breathing, strengthen respiratory muscles, activate blood flow in the lungs, improve the drainage function of the bronchi, and prevent pleural adhesions. Dynamic breathing exercises for reducing breathing frequency, extending expiratory time, and training diaphragmatic breathing. In dynamic exercises, inhalation and exhalation are combined with exercises for the limbs and trunk. Results: Diaphragmatic exercises by pressing on the upper abdomen at the end of exhalation facilitate the contraction of the diaphragm, thereby achieving a physiological type of breathing. Discussion: Exercises for Bronchitis, to increase the mobility of the chest with a tilt and exercises for proper posture that normalize both phases of breathing, strengthen the respiratory muscles, activate blood flow in the lungs, improve the drainage function of the bronchi and prevent pleural adhesions. Conclusion: In patients with pneumonia, exercises to improve peripheral blood flow and facilitate cardiac activity, exercises to increase chest mobility, and exercises to restore the rhythm and frequency of breathing accelerate the healing process, improve pulmonary ventilation and the prophylaxis of possible complications.

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