RU2581498C1 - Method for therapeutic exercises for patients with visceral adiposity - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, specifically to therapeutic exercises and therapy, and can be used for patients with visceral adiposity. Physical exercises are performed. Physical exercises are matched with a certain breathing algorithm. Inlet part includes first 2 minutes breath rhythm breathe in-out 3:1, 4:1, 5:1, 6:1, 7:1, 8:1 and 6 minutes combined developing and joint exercises. In main part - isotonic training extremity muscles and joints, back, chest, upper limb girdle, dynamic and static exercises for neck muscles accompanied by respiratory rhythm breathe in-out 1:3. At final part - first 6 minutes exercises self-tension of neck muscles, back, extremity and last 3 minutes-breath rhythm of breath-in-out pause-pause - 4:2:4:2, 4:2:5:2, 4:2:6:2, 4:2:7:2, 4:2:8:2. Mandatory condition of respiratory rhythm is that during exhalation there is tightening of stomach in direction of diaphragm.

EFFECT: method provides reliable reduction of level of visceral fat and prevention of cardiovascular and metabolic risk in patients with visceral obesity due to matching physical exercises with a certain breathing algorithm.

1 cl, 2 tbl, 2 ex

Description

The invention relates to medicine, namely to physiotherapy and therapy.

The problem of obesity is the focus of modern medical science and healthcare. Over the past few decades, the prevalence of obesity is growing rapidly in most countries of the world. According to statistics from the World Health Organization, more than 30% of the world's population is obese, by 2025, according to WHO, 50% of the world's population will be obese. In addition, this disease takes the fifth place in the world among mortality risks, defined as excess fat accumulation associated with chronic diseases and reducing life expectancy. By analogy with infectious diseases, we can talk about the pandemic of obesity (A.L. Vertkin, O.V. Nosov, A.S. Skotnikov, A.N. Diving. Obesity in general somatic practice // Attending physician 2009. - No. 11. - 2009; James WFT Epidemiology of obesity // Internat J. Obes. - 1992. - No. 16 (2 suppl). - P. 23-6). As a pandemic factor contributing to its development, it is, above all, inactive. An increase in the frequency of cases of obesity in recent years is directly related to the increased action of this particular factor (Shilov A.M., Chubarov M.V., Melnik M.V., Rybkina T.E. Arterial hypertension and metabolic syndrome X // Rus. Honey Zh., 2003. - T. 11., No. 21. - Konstantinov V.O., Sayfulina Y. R. Metabolic syndrome - a disease or a random set of risk factors // Arter. hypertension. 2007. - T. 13, No. 3. - S. 195-19).

Inadequate physical activity causes a violation of energy balance when energy consumption is lower than its cost, causing disruption of fat oxidation processes (Dedov I.I., Melnichenko G.A., Romantsova T.I. Pathogenetic aspects of obesity. - Obesity and metabolism. - 2004. - No. 1. - S. 3-9).

In addition, the development of obesity is caused by overeating and drinking alcohol, the discrepancy between the calorie content of the daily diet and the needs of the individual (Order of the Minister of Defense of the Russian Federation dated June 18, 2011 No. 800 “On the Approval of the Guidelines for Clinical Examination of the Armed Forces of the Russian Federation”).

Recent studies have shown that adipose tissue secretes a number of active molecules that affect metabolic processes, the formation of oxidative stress and disorders of the cardiovascular system (Unger RH Lipotoxic Diseases // Ann. Rev. Med., 2002 - 53: 319 - P. 36).

One of the adverse factors negative for the prognosis of life is the accumulation of fat in the visceral depots, since the disorders accompanying this type of obesity are interconnected like links in a “vicious circle”, when an adverse change in one can aggravate the other, and ultimately as a result, to the development of the metabolic syndrome (Butrova S.A., Dzgoeva F.Kh. Visceral obesity is a key link in the metabolic syndrome // Obesity and Metabolism. - 2004. - No. 1. - P. 10-13).

A decrease in visceral fat is the key to reducing the risk of developing cardiometabolic disorders. With an active lifestyle, there is an adequate production of adrenaline, norepinephrine, adrenocorticotropic hormone (ACTH), melanocytostimulating growth hormone, vasopressin, which are activators of hormone-sensitive lipase, accelerating the release of free fatty acids from adipose tissue and increasing their concentration in blood lipids three times, increasing Dedov I.I., Melnichenko G.A., Romantsova T.I. Pathogenetic aspects of obesity. - Obesity and metabolism. - 2004. - No. 1. - P. 3-9).

In this regard, in all developed countries of the world there is an active search for new highly effective methods of treating obesity. New methods of treatment for this disease created to date complement the previously developed strategy.

A known method of healing, correction of body mass and proportions "Aerobilding", including calculating the value of the reference indicators, such as body fat, muscle mass and the integral indicator of muscle strength, followed by determining the difference between the value of the reference and initial indicators and, based on this, compiling individual training regimen, which includes a combination of exercises from aerobics and bodybuilding systems, as well as a diet calculated by the composition of nutrients and calories, depending on t a required anabolic or catabolic orientation, and the training regimen is adjusted monthly after carrying out control measurements of indicators and when they reach values equal to the reference ones, they switch to the maintenance training regimen (patent RU 2144813 of 01.27.2000).

The main significant disadvantage of this method is the lack of correction of exercises from aerobics and bodybuilding systems during each training session, taking into account the anatomical and physiological characteristics and the psycho-emotional state of patients with abdominal obesity, which makes it impossible to use them to improve these patients.

The known Method of recovery from abdominal obesity (RU 2471469). The main objective of the invention is to ensure the improvement (reduction of the waist circumference) of patients with abdominal obesity using dosed physical activity, taking into account their corrected psycho-emotional state with reasonable correction of physical activity during each training session and reducing forms of physical activity.

The claimed invention is based on a combination of a set of breathing rhythm management techniques (a special rhythmic breathing algorithm) that can address the fat metabolism and exercises from kinesitherapy systems with psychological correction.

In the theoretical development of the proposed "Method of physiotherapy exercises for patients with visceral obesity" it was taken into account that: 1) the tonus of skeletal muscles during inspiration increases and decreases during exhalation (Sitel A.B. Manual therapy. - M., 1998. - P. 95 -97); 2) as a result of training the external respiration system, the ventilation equivalent of oxygen, the number of central and surface mitochondria in the sarcoplasm increase, the number and density of capillaries in the muscle increase, especially the slow (oxidative) type (Orlov PC Normal physiology: textbook for high schools. - M. , 2005. - S. 602-604; Human physiology: a textbook / Under the editorship of V.M. Smirnov. - M., 2001. - S. 570-573); 3) as a result of aerobic endurance training, the conversion of fast glycolytic fibers into oxidative-glycolytic fibers is possible (Fundamentals of Human Physiology. Textbook for universities, in 2 volumes, edited by B. Tkachenko. - St. Petersburg, 1994. - T. 1 . - S. 352-358).

The technical result of the proposed "Method of physiotherapy exercises for patients with visceral obesity" is that they use a special rhythmic breathing algorithm that can directionally affect fat metabolism: at the beginning of the water part of the physiotherapy exercises complex (the first 2 minutes), use the inhalation-expiration breathing rhythm 3 : 1, 4: 1, 5: 1, 6: 1, 7: 1, 8: 1, in the main part - the inhalation-exhalation rhythm 1: 3, in the final part (last 3 minutes) - the breathing rhythm inhale-pause - expiration-pause - 4: 2: 4: 2, 4: 2: 5: 2, 4: 2: 6: 2, 4: 2: 7: 2, 4: 2: 8: 2, a prerequisite for this rhythm is t That during exhalation is pulling the abdomen in the direction of the diaphragm, resulting in a lower percentage of visceral fat.

The proposed method consists in the fact that when performing the rhythmic breathing algorithm, the visceral fat index is taken into account.

In accordance with the purpose of the work, 53 patients with visceral obesity, who were rehabilitated for employees of the internal affairs bodies, performing tasks in special conditions of professional activity from 33 to 43 years, were examined at the base of the Ministry of Internal Affairs of the Ministry of Internal Affairs of Russia in the Ivanovo Region: group I - 26 people the use in the rehabilitation treatment of a complex of physiotherapy exercises (exercise therapy) No. 1 for obesity among employees of internal affairs bodies performing tasks in special conditions of professional activity (Table 1);

Group II - 27 people with the appointment of a therapeutic gymnastics complex No. 2, coordinated with a special rhythmic breathing algorithm for obesity among employees of internal affairs bodies performing tasks in special conditions of professional activity (Table 2).

All patients underwent studies using a Tanita fat mass analyzer using a bio-impedance test method (ΒΙΑ - “from foot to foot”). The amount of visceral fat in the body in patients was taken into account, which exceeded the range of the normal content of this indicator, more than 12% (the highest normal limit), of the total content of adipose tissue in the body.

As a result of the survey, it was proved that in the observation group, where the proposed “Method of physiotherapy exercises for patients with visceral obesity” was used, the decrease in the percentage of visceral fat by the end of rehabilitation was more pronounced, which amounted to 10.14 ± 0.28%. In the control group, the level of visceral fat after the course was 13.41 ± 0.36%. These indicators prove a significant decrease in visceral fat (p <0.01).

The use of coordinated respiratory gymnastics for patients with visceral obesity can ultimately prevent cardiovascular and metabolic risks in this category.

The effectiveness of using the “Method of physiotherapy exercises for patients with visceral obesity” lies in remodeling body composition by reducing the percentage of visceral fat.

Clinical example 1

Patient K., 41 years old, a policeman, was in the Hospital of the Ministry of Internal Affairs of Ivanovo from 03.03.2013 to 08.04.2013 for a course of rehabilitation treatment for employees of the internal affairs bodies performing tasks in special conditions of professional activity.

Upon admission to the clinic complained of weakness, poor sleep.

On examination: satisfactory condition, active position, increased nutrition. Height - 178 cm, weight - 103.0 kg, BMI - 32.5 kg / m ² , visceral fat - 15%. There is no disorder of consciousness. BH - 16 in 1 min. Vesicular breathing. Pulse - 67 in 1 min. HELL = 120/80 mm Hg Heart sounds are sonorous. The abdomen is soft, painless. Pasternatsky’s symptom is negative. Edema, no dysuria.

Clinical diagnosis: medical and psychological rehabilitation; obesity 2 tbsp.

Rehabilitation treatment was carried out using the rehabilitation gymnastics complexes No. 1 for obesity, presented in Table. one.

After the course of treatment, the following indicators were determined: growth - 178 cm, weight - 101.2 kg, BMI - 31.9 kg / m ² ; the level of visceral fat decreased to 13%, but is unreliable in relation to the initial data (p> 0.05).

Clinical example 2

Patient X., 43 years old, a policeman, was in the hospital of the Ministry of Internal Affairs of Russia in the city of Ivanov from 10/07/2013 to 10/21/2013 on course rehabilitation treatment for employees of the internal affairs bodies performing tasks in special conditions of professional activity.

Upon admission to the clinic complained of fatigue, weakness, anxious sleep.

On examination: satisfactory condition, active position, increased nutrition. Height - 174 cm, weight - 111.6 kg, BMI - 36.8 kg / m ² , visceral fat index - 18%. There is no disorder of consciousness. BH - 16 in 1 min. Vesicular breathing. Pulse - 67 in 1 min. HELL = 120/80 mm Hg Heart sounds are sonorous. The abdomen is soft, painless. Pasternatsky’s symptom is negative. Edema, no dysuria.

Clinical diagnosis: medical and psychological rehabilitation. Obesity 2 tbsp.

Restorative treatment was carried out using the "Method of physiotherapy exercises for patients with visceral obesity." Given the diagnosis, a therapeutic gymnastics complex No. 2 was prescribed, presented in Table. 2.

After the course of treatment, the patient did not show complaints. A repeated study of indicators was carried out: growth - 174 cm, weight - 105.2 kg, BMI - 34.8 kg / m ² , visceral fat level - 10%. A significant decrease in visceral fat was noted (p <0.01).

Thus, as a result of the survey, it was proved that employees of internal affairs bodies performing tasks in special conditions of professional activity, in whose rehabilitation complex the proposed “Method of physiotherapy exercises for patients with visceral obesity” was used, there was a significant decrease in visceral fat level.

Claims (1)

A method of physiotherapy exercises for patients with visceral obesity, including physical exercises, characterized in that the physical exercises are consistent with the following breathing algorithm: the introductory part includes the first 2 minutes of breathing in the rhythm inhalation-exhalation 3: 1, 4: 1, 5: 1, 6 : 1, 7: 1, 8: 1 and 6 minutes of general developmental and articular gymnastics; in the main part - isotonic training of muscles and joints of the extremities, muscles of the back, chest, upper shoulder girdle, dynamic and static exercises for the muscles of the neck, accompanied by breathing in the rhythm of inhalation-exhalation 1: 3; in the final part - the first 6 minutes of the exercise for self-extension of the muscles of the neck, back, limbs and the last 3 minutes - breathing in the rhythm of an inhalation-pause-exhale-pause - 4: 2: 4: 2, 4: 2: 5: 2, 4: 2: 6: 2, 4: 2: 7: 2, 4: 2: 8: 2, and a prerequisite for the rhythm of breathing is that during exhalation, the abdomen is pulled up in the direction of the diaphragm.