The problem of assessing the state of individual health of a person and monitoring changes in its levels are becoming increasingly important, especially for people exposed to high psycho-emotional and physical stress, as well as for children. school age... The transition from a healthy state to a disease is considered to be a process of a gradual decrease in a person's ability to adapt to changes in the social and work environment, to the surrounding conditions of life. The state of an organism (its health or illness) is nothing more than the result of interaction with the environment, i.e., the result of adaptation or disadaptation to environmental conditions.

Achievement of a certain level of functioning of an organism or its certain systems is ensured by the activity of regulation and control mechanisms. The mobilization of reserves occurs as a result of a change in the level of activity of regulatory systems, and in particular an increase in the tone of the sympathetic part of the autonomic nervous system... With a constant deficit of functional reserves to achieve equilibrium with the environment, a state of functional tension arises, which is characterized by a shift in autonomic equilibrium towards the predominance of adrenergic mechanisms. In a state of functional stress, all the basic functions of the body do not go beyond the normal range, but the costs of functional reserves to maintain the normal level of functioning of systems and organs increase. Such conditions, in which the nonspecific component of the general adaptation syndrome manifests itself in the form of varying degrees of tension in the regulatory systems, are called prenosological. A significant increase in the degree of stress, leading to a decrease in functional resources, makes the biosystem unstable, sensitive to various influences and requires additional mobilization of reserves. This condition, associated with overstrain of regulatory mechanisms, is called unsatisfactory adaptation. In this state, specific changes on the part of individual organs and systems become more significant. Here it is quite permissible to talk about the development of the initial manifestations of premorbid conditions, when the changes indicate the type of probable pathology.

Thus, the manifestation of the disease as a result of the failure of adaptation is preceded by prenosological and premorbid states. It is these states that are studied in valeology and should be the object of control and self-control over the level of health. The term "prenosological conditions" was first proposed by R.M. Baevsky and V.P. Kaznacheev. The development of the doctrine of prenosological states is associated with space medicine, in which, starting from the first manned flights, medical control over the health of astronauts was focused not so much on the likely development of diseases as on the body's ability to adapt to new, unusual environmental conditions. Prediction of possible changes in the functional state in space flight was based on an assessment of the degree of tension in the body's regulatory systems. It was space medicine that gave impetus to the development of mass prenosological research in preventive medicine, promoted progress in the field of prenosological diagnostics; later, her methods became part of valeology.

Health science is an integral one, which is formed at the intersection of biology and ecology, medicine and psychology, cybernetics and pedagogy, and a number of other sciences. It follows from this that the science of health should be based on the science of the health of a person who lives in a real complex worldsaturated with stressful influences arising from changes in many factors of the surrounding biosocial environment, which takes away part of his health and leads to the so-called "third state". The concept of the third state in assessing human health is actually based on the laws of ancient medicine, set out more than a thousand years ago by the famous physician and philosopher Abu Ali Ibn Sina - Avicenna, who identified six states of human health: the body is healthy to the limit; the body is healthy, but not to the limit; the body is not healthy, but not sick; a body that easily perceives health; the body is sick, but not to the limit; the body is sick to the limit.

Of these conditions, only the last two are related to disease. Between the two extreme levels of health (according to Avicenna) - "a healthy body to the limit" - we distinguish five transitional states with varying degrees of tension in regulatory systems: with normal, moderate, pronounced, pronounced and overstrain. The transition from health to illness occurs through overstrain and failure of adaptation mechanisms. And the sooner it is possible to foresee such an outcome, the more likely it is to maintain health. Thus, the problem comes down to learning how to determine (measure) the degree of stress in the body's regulatory systems and, consequently, to manage health. At present, with the active formation of the science of health, prenosological diagnostics has become the main part of valeology, since it provides an assessment of the level of health in various functional states, develops systems for dynamic monitoring of the health of the adult population, children and adolescents of school age.

Modern understanding of cardiovascular system as an indicator of the adaptive reactions of a whole organism was developed in space medicine, where it first began practical use pulse diagnosis in her modern form, i.e. cybernetic (mathematical) analysis of heart rate. This methodological approach has become one of the most important principles of space cardiology, which consists in striving to obtain maximum information with a minimum of recording data. At present, with the help of electronic devices and computing facilities, it has become possible, based on the analysis of the heart rhythm, to obtain objective data on the state of the sympathetic and parasympathetic systems, their interaction, on higher levels of regulation in the subcortical centers and the cerebral cortex.

The recognition of functional states based on the data of the mathematical analysis of the heart rate requires special equipment (automated complex), certain experience and knowledge in the field of physiology and clinic. In order to make this methodology available to a wide range of specialists and possible for use at the pre-medical stage of control, a number of formulas and tables have been developed that allow calculating the adaptive potential of the circulatory system for a given set of indicators using multiple regression equations. A sufficiently high accuracy of recognizing the states of the body is provided by the method for determining the adaptive potential using special tables, according to a set of simple and accessible research methods: measuring the pulse rate, systolic and diastolic blood pressure, height, body weight (weight) and determining the age of the subject. The calculated value of the adaptive potential determines the degree of tension of regulatory mechanisms and the level of health.

Of great importance is the assessment of changes in the level of health based on the adaptive potential of the circulatory system, not only in individual individuals, but also at the level of entire collectives or groups of people who are exposed to similar conditions of life. This is possible by defining the so-called "health structure" of the collective, by which it is customary to understand the distribution (in percentage) of persons with varying degrees of adaptation to environmental conditions (with different values \u200b\u200bof the adaptive potential of the circulatory system). The structure of health is a very informative indicator that gives a versatile description of the surveyed group of people. It is the changes in the structure of health that should be considered as a sensitive indicator of the response of the collective (group of persons) to certain conditions of life, health-improving, sanitary and hygienic measures and other factors of the human environment.

For a number of years at the Department of Theoretical Foundations of Physical Culture of Stavropol state university in the scientific direction "Valeology and problems of assessing human health" teachers and students study the influence of various factors of the environment of life on the state of health of students educational institutions... Students of the Stavropol Territory of different ages, with a total number of 3150 people, were involved in research on the problem.

The studies revealed that with significant individual variability, the adaptive potential of the circulatory system has a versatile expressed information content.

During the study age changes the adaptive potential of the circulatory system of 2800 schoolchildren of 7 - 17 years old revealed a significant deterioration of its average values \u200b\u200bwith age. This age-related deterioration of the adaptive potential slowed down and even its temporary improvement was observed in groups with increased motor activity that did not exceed its optimal level. Cessation of exposure to the body of elevated to optimal levels physical activity again led to a deterioration in the adaptive potential of the circulatory system. With constant exposure of the body to dosed motor loads, the age-related deterioration in the level of health was much slower. Due to the large individual variability of the adaptive potential, changes in its level in each individual can be detected only in dynamic examinations.

These observations made it possible to conclude that the adaptive potential of the circulatory system as an integral criterion of the functional state of the whole organism can be used not only to assess the adaptation of the organism to the conditions of daily activity and predict its changes, but also as a reflection of aging processes in a developing organism and deterioration in the level of health. with age, the intensity of which depends on the student's motor activity.

Individual assessment of the adaptive potential of the circulatory system and the health structure of the class (team) can be used as a criterion for the optimality of students' physical activity. Insufficient physical activity both in school and out-of-school mode leads to a more rapid deterioration in the health of students and the structure of the health of classes during the school year. Moreover, a significant deterioration in the structure of health was observed by the end of the first half of the year. Students with high physical activity, as a rule, had a higher level of health, and its structure in these classes was distinguished by better indicators.

The study of the health levels of students and the health structure of classes (groups) with different physical development confirmed the position that physical development is one of the main criteria of health. Students with higher adaptive abilities and in classes with better health structure had higher physical development.

Level analysis adaptive capacity students confirmed the position that physical fitness is also one of the main criteria of health, since the levels of adaptation of students with good physical fitness in most cases were higher.

The deterioration of the health levels of students and the structure of the health of classes, and, consequently, of their working capacity, was observed in all cases when the operating modes of educational institutions had an exceeding standard duration of the school day and a shortened academic week (5 days) while maintaining the same weekly volume of hours as with six business days.

Particular attention in the research was paid to the prognostic assessment of the adaptive potential of the circulatory system in the optimization of physical activity at the physical culture lesson, in the training process in groups of children and youth sports schools with different sports orientation, in strengthening the health-improving orientation of both physical culture lessons and sports training. Attention is drawn to the fact that stable changes in the adaptive potential of the circulatory system under the influence of physical exertion are detected already at the early stages of their implementation. At the same time, changes in the adaptive potential quite clearly reflect both the developmental effect of loads and an increase in tension and overstrain of regulatory mechanisms during the development of overwork. The revealed improvements in the adaptive potential were accompanied in most cases by the improvement in the results of the fulfillment of the control standards of physical fitness. Deterioration in adaptation to stress was often accompanied by a decrease in results.

A stable and, in most cases, reliable correlation was revealed between the average group values \u200b\u200bof the adaptive potential of the circulatory system and the average results of the fulfillment of control standards, mainly reflecting one or another physical quality.

An increase in the value of the adaptive potential of the circulatory system made it possible to identify overfatigue in physical exercises at the early stages of its development. The revealed lack of significant improvement in the indicators of physical fitness of students during the academic year with a deterioration in the adaptive potential of the circulatory system allows us to believe that physical culture lessons conducted by traditionally established methods do not provide the formation of a cumulative effect in the development of physical activity in the body of a student in the development of physical activity at two physical education lessons a week a staged change in the adaptive potential and individual adjustment of physical activity in necessary cases (with an increase in the values \u200b\u200bof the adaptive potential of the circulatory system by at least 0.25 points) led to a noticeable reliable increase in students' physical qualities by the end of the school year. The use of a predictive assessment of changes in the adaptive potential of the circulatory system in staged examinations made it possible to ensure a stable health-improving effect of two physical education lessons per week and significantly reduce (up to 50% during the school year) school absenteeism due to illness in comparison with other classes.

The same step-by-step control made it possible to use unconventional methods conducting physical education lessons without fear of overfatigue of the body and overstrain of regulatory systems in students.

Studies have shown that the method of adaptive potential of the circulatory system, with its high information content, is quite accessible in the work of a teacher, trainer and even high school students themselves and can be used to control the impact of physical activity on the student's body in order to optimize them, as well as to assess and predict development of physical overtraining, improving the health-improving orientation of physical culture lessons and sports training.

Of great scientific interest are studies of the prognostic assessment of the functional capabilities of the body of athletes using the hardware-software complex "Varicard 1.2", which allows to identify the processes of fatigue and overwork under the influence of training loads at early stages.

A significant advantage of the methods of prenosological diagnostics used in the research is their wide versatile informativeness, ease of use in the management of the educational and training process.

The level of health is understood as a quantitative characteristic of the functional state of the body, its reserves and social capacity of a person. A high level of health will be characterized by the optimal functioning of the body systems with their maximum reserves and long-term social capacity. From the point of view of social medicine, there are three levels of health assessment:

• - the health of an individual (individual);
• - health of small social, ethnic groups (family or group health);
• - health of the entire population (population) living in a city, in a village, in a certain area.

To assess health at each of the three levels, different scales are used, but it should be emphasized that the most adequate criteria for each level are not yet fully justified and are sometimes interpreted differently, taking into account economic, reproductive, sexual, educational, medical and psychological criteria. When assessing the health of the population in sanitary statistics, typical medical and statistical indicators are used.

Medical and demographic indicators:

• a) indicators of the natural movement of the population - general and age-related mortality; average life expectancy; fertility, fertility; natural population growth;
• b) indicators of mechanical movement of the population - population migration (emigration, immigration, seasonal, intracity migration, etc.).
• 2. Indicators of incidence and prevalence of diseases (morbidity).
• 3. Indicators of disability and disability.
• 4. Indicators of physical development of the population.

Considering that the functional capabilities of the human body and its resistance to adverse factors external environment change throughout life, we can talk about the state of health as a dynamic process that also improves or worsens. In other words, we can talk about the weakening or strengthening of health depending on age, gender, professional activity, habitat (meaning the ecological and geographic position, the extreme nature of work, the mini- and macroenvironment of the individual, the social status of the family and the psychophysiological stability of the individual). A person, losing health, begins to seek salvation primarily in medicines. At the same time, he clearly underestimates the strength of the impact on the body and the effectiveness of factors such as physical activity, good nutrition, tempering, good sleep, massage, rejection of bad habits, etc. Meanwhile, these and other significant factors are integral components healthy way life. As they say, "a person dies not from a certain disease, but from his way of life." To assess the level of health of the population, timely diagnostics, as well as research using screening and monitoring, are required.

Diagnostics is the process of recognizing and evaluating the properties, characteristics and states of a subject or object, which consists in a purposeful study, interpretation of the results obtained and their generalization in the form of a conclusion (diagnosis).

Screening is a mass examination of population contingents in order to identify persons with a certain disease (certain diseases) for the prompt adoption of therapeutic and prophylactic measures.

Monitoring - constant tracking of any objects, phenomena or processes. In a general sense, it is a multipurpose information system, the main tasks of which are observation, assessment and forecasting of the states of an object (subject) in order to warn of emerging critical situations or states.

Health monitoring (monitoring, monitoring observation) - long-term monitoring of the state of a number of vital body functions by recording indicators of these functions.

Lifestyle, lifestyle, life motivations of each person ultimately determine his health and social well-being throughout his life. Timely diagnosis and assessment of the health level allows:

• - to identify weak links in the body for targeted impact;
• - make up individual program health-improving activities and evaluate the effectiveness;
• - predict the risk of life-threatening diseases;
• - to determine the biological age of a person.

The concept of health, developed in space and preventive medicine, considers the transition from health to disease, from norm to pathology as a process of a gradual decrease in the adaptive capabilities of the body, as a result of which various borderline states arise, which are called prenosological (R.M.Baevsky, V. P. Kaznacheev, 1978).

The norm is a zone of functional states, indicating the preservation of the morpho-functional status of the organism with the maintenance in these specific conditions at a high level of compensatory reactive-adaptive capabilities, working capacity and the ability to recreate.

Pre-nosological conditions are conditions in which the optimal adaptive capabilities of the body are provided by a higher than normal voltage of the regulatory systems, which leads to an increased expenditure of the body's functional reserves. A characteristic feature of prenosological conditions is the presence of an increased functional tension of adaptation mechanisms.

Premorbid conditions are conditions that are characterized by a decrease in the functional capabilities of the body. The state of failure of adaptation is characterized by a sharp decrease in the functional capabilities of the organism due to the violation of compensation mechanisms.

Adaptation is a set of adaptive reactions of a living organism to changing conditions of existence, developed in the course of long evolutionary development (phylogenesis) and capable of transforming, improving during individual development (ontogenesis).

It should be noted that a decrease in the body's adaptive capabilities is associated with a change in physiological functions. This is characterized by an increase in blood pressure, a decrease in cardiac activity. However, in prenosological conditions, the observed changes in physiological parameters, as a rule, do not go beyond the so-called clinical norm and therefore usually remain outside the field of vision of doctors during dispensary and preventive examinations of the population. As a result, only a breakdown in adaptation with the development of specific nosological forms of diseases becomes the basis for therapeutic measures. In the best case, with earlier detection of the initial signs of the disease, special measures of secondary prevention can be applied. In prenosological diagnostics, a scale of assessments of functional states associated with the transition from health to illness, called "Traffic Light", has been formed. The Traffic Light scale characterizes these classes of states in a popular, understandable form.

Green (satisfactory adaptation) means that everything is in order, you can move on without fear.

Yellow (prenosological and premorbid conditions) indicates the need for increased attention to your health: you need to stop and look around before moving on. Here we are talking about the need for improvement and prevention.

Red ( pathological conditions) shows that it is impossible to move on, it is necessary to take serious measures in relation to one's health, diagnostics and treatment of possible diseases are required.

The transition from health to illness occurs through overstrain and disruption of adaptation mechanisms, and the sooner such an outcome is foreseen, the more chances are to maintain health. The problem boils down to learning how to determine (measure) the degree of tension in the body's regulatory systems and thus manage health. According to many researchers, the diagnosis of human health should be based on theoretical general biological knowledge, including in the field of physical culture. In solving problems of diagnostics, forecasting, monitoring and assessment of health indicators, various computer models are now widely used.

Valeotechnology is the science of using new information technologies in solving the fundamental problems of the strategy of individual and public health. Valeotechnology allows you to integrate methods of field and laboratory methods of research, the functional state of the systems of the human body for the assessment, control and implementation of rehabilitation measures to improve health.

When assessing health, they use nosological diagnostics, dozonological diagnostics and health diagnostics based on direct indicators.

The advantage of prezonological diagnostics is that with its help, people who need health-improving measures or changes in environmental conditions are quickly and inexpensively identified.

However, the state of the adaptive potential, isolated during prenosological diagnostics, although to a certain extent characterizes health, is more likely the result of the interaction of the organism with the environment.

You can imagine a person with high level health, but caught in an extreme industrial or household situation. There will be a breakdown in adaptation, despite the significant reserves of functions.

The quantitative assessment of individual health remains one of the most pressing problems of modern medicine. To solve it, many different methods have been proposed, but only a few of them have received practical application.

The conceptual basis for all these methods is the theory of adaptation.

The view of health as a "successful adaptation" became widespread and formed the basis of most modern methods his assessment. This approach requires the use of stress tests.

The idea of \u200b\u200busing adaptability as an integral indicator of health emerged in the 70s. Health is understood as the ability of the body to adapt to environmental conditions, and disease arises as a result of a breakdown in adaptation.

In this case, the adaptive reactions of the body were supposed to be assessed mainly by the indicators of the circulatory system. Subsequently, it was proposed to measure the amount of health by the physiological reserves of the body, that is, by the maximum performance of systems while maintaining the qualitative limits of their functions in response to stress, most often in the form of physical activity.

Recently, there has been a clear trend towards an integrative assessment of health by including indicators of psychosocial adaptation in the calculation of indices. This refers to such a state of the organism and such a form of life activity, which provide an acceptable duration of life, its necessary quality and use the method of three scales: physical, mental and social satisfaction.

To date, various versions of automated programs for quantitative health assessment have been developed, which are widely used in preventive examinations of the population. However, most researchers admit that the diagnostic and prognostic significance of the proposed methods, as well as the informativeness of the indicators used in them, have not been sufficiently studied.

Assessment of the information content of the most common methods led to the conclusion that they mainly or almost exclusively reflect a decrease in adaptive capabilities only in connection with cardiovascular pathology. vascular system (CCC).

With regard to the pathology of other systems, the diagnostic algorithm of the methods does not provide their sufficient efficiency. Apparently, this is due to the fact that almost all the studied methods are based on the indicators of the cardiorespiratory system.

Undoubtedly, CVS plays a leading role in ensuring adequate adaptation of the organism to the environment. However, an assessment of health based on indicators of the functioning of any one body system can hardly be exhaustive.

The value of the integral health indicator strongly depends on the state of the CVS and is insensitive to changes in the functional state of other systems. A promising direction for improving integrative methods for quantitative health assessment is associated with an increase in their specificity and diagnostic efficiency.

It is quite obvious that the best quantitatively reflect the level of individual health indicators that characterize the mechanisms of self-organization of a living system - adaptation, homeostasis, reactivity, etc.

As indicators of health, it is preferable to use the key characteristics of the manifestation of health, since they reflect the result of the activity of the entire complex integral functional system of the body.

Pre-nosological diagnosis is based on the following theoretical principles. The transition from a state of health to a disease goes through a number of stages, at which the body tries to adapt to new conditions of existence for it by changing the level of functioning and tension of regulatory mechanisms.

The following types of adaptive reactions are distinguished: normal adaptive reactions, stress of adaptation mechanisms (short-term, or unstable, adaptation), overstrain of adaptation mechanisms and their breakdown ("sex").

As a fundamental link in the long-term adaptation of the organism to the environment, the activation of the formation of mitochondria due to a deficiency of macroergs and an increase in the capacity of the system of oxidative re-synthesis of ATP per unit of cell mass are used. Thus, the main adaptation mechanism that is available for control is the energy mechanism. It is the lack of energy that determines the further chain of regulatory, metabolic and structural changes.

Before the pathological process is formed, normal adaptive reactions give way to compensation mechanisms, which are, in fact, markers of pre-pathology, then the stage of reversible changes begins, and only after it does damage to structures occur.

The adaptation stage can be characterized by three parameters: the level of system functioning, the degree of tension of regulatory mechanisms and functional reserve. It is these approaches that are used to characterize prenosological states - stages of the adaptation process.

The most widely used method of mathematical

analysis of heart rhythm (R.M. Baevsky, 1979). Average duration cardiac cycle is inversely proportional to the heart rate and can be considered an indicator of the level of functioning. The very process of regulation is manifested in the "scatter functions", in particular, in the indicators of dispersions. "Scatter functions" can be studied by standard deviation (a) or variation range (DC). It is methodologically easier to determine HH than a. As a result of the mathematical analysis of the cardiac cycle, the stress index (TI) is calculated. After registering at least 100 ECG cardiocycles, the following indicators are determined:

Mode (Mo) - the most common duration of the R-R interval;

Mode amplitude (AMo) - the proportion (in percentage terms) of the mode in relation to all registered cardiointervals;

DH - scatter intervals R-R.

The voltage index is calculated by the formula:

J / JJ-J- --------

where: IN - stress index, conventional units; AMo - mode amplitude (%); Mo - fashion, s; DX - scatter of R-R intervals, s.

The physiological meaning of these parameters is that they, to a certain extent, reflect the shift of the central regulation circuit to the autonomous one along the nervous (AMo) and humoral (Mo) channels. Centralization of management, indicating the tension of adaptation mechanisms, leads to an increase in IU, decentralization - to a decrease. Thus, an increase in IU of more than 200 conv. units indicates the development of tension in regulatory mechanisms, and more than 500 conv. units - overvoltage condition.

Determination of ID is facilitated by using special computer programs.

The second method of prenosological diagnostics is quite simple and can be recommended for mass examinations. With this method, the so-called adaptive potential of the circulatory system is calculated. To obtain it, the following indicators are recorded: age, body weight, height, heart rate, arterial pressure.

The calculation is made according to the formula:

AP \u003d 0.011 CP + 0.014 ADs + 0.008 ADd + 0.014 V + 0.09 MT - (0.009 R + 0.27),

where AP is the adaptive potential; B - age, years, MT - body weight, kg; P - height, cm; ABP - systolic blood pressure, mm Hg; BPd - arterial pressure-50

diastolic laziness, mm Hg; HR - pulse rate in 1 min.

In the event that under conditions of mass examinations it is possible to record an ECG, the adaptive potential of the circulatory system is calculated by the formula:

AP-0.02 CP + 0.01 BP + 0.008 BPd + 0.006 V + 0.19- ECG- (0.001 R + 1.17).

The designations are the same. The degree of ECG changes is assessed on a four-point scale: normal ECG - 1 point; moderate changes - 2 points; physiologically significant changes - 3 points; clinically significant changes - 4 points.

The overall assessment of the adaptive potential of the circulatory system is assessed according to the following scale: Points State of AP

2.1 and below Satisfactory adaptation

3.21 - 4.30 Poor adaptation

4.31 and above Disruption of adaptation mechanisms

The advantage of this diagnostic approach lies in the fact that people are quickly and inexpensively identified, in relation to whom it is necessary to carry out health-improving measures or change environmental conditions. At the same time, the allocated states of the adaptive potential, although they characterize health to a certain extent, are more likely the result of the interaction of the organism with the environment. On the one hand, one can imagine an individual with a high level of health, but found himself in an extreme industrial or everyday situation, which led to a breakdown in adaptation, despite significant reserves of functions.

On the other hand, in a patient in remission of a chronic somatic disease (for example, chronic pneumonia), the stage of satisfactory adaptation will be determined, although his health level will be rather low.

The group of methods for diagnosing health by direct indicators is devoid of these shortcomings.