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8THE CONTENT OF PHYSICAL REHABILITATION PROGRAM FOR ELDERLY WOMEN WITH ARTERIAL HYPERTENSION AND OBESITY
Lee Eun Ok, postgraduate
O.V. Kozyreva, professor, Dr.Hab.
Russian State University of Physical Culture, Sport, Youth and Tourism (SCOLIPhC), Moscow
Lee Kwon Ho, professor, Dr.Med.
Joong Bu University. Geumsan, South Korea
Key words: physical rehabilitation, complex exercise, elderly women, obesity.
Introduction. Middle age is characterized by the pronounced decrease in motor activity, accompanied by the increase of body weight and exacerbation of a number of diseases [4]. Representatives of this age are characterized by the decrease in the rate of neural processes, weakness of memory, overall activity decay and decrease in physical strength, susceptibility to depressive moods, deterioration of general condition, which adversely affects their mood and emotional state [1, 2].
Given that the average life time for Korean women is 82 years [8], and for Russian about 74 years, it is obvious that maintaining the quality of life in this category becomes very important.
The purpose was to study the effects of two models of physical rehabilitation for elderly women.
Materials and methods. The study involved 12 women in Group 1 and 11 - in Group 2. The programs were designed for 6 months of classes twice a week. The duration of one class was 1 hour 30 minutes. Each program included a standard component set: stretching - general conditioning exercises (GCE) with full-range-of-motion at slow pace and succeeding self-stretching; aerobic exercises (fitness ball, stepper, aerobics without accessories); weightlifting exercises (lifting of own bodyweight and theraband exercises); GCE.
The difference in physical rehabilitation programs lays in the preferential usage of aerobic, weightlifting exercises or stretching. Exemplary program outlines are represented in Tables 1, 2.
Table 1. The content of Program №1 ofphysical rehabilitation with preferential usage of aerobic exercises.
Group 1
Orientation and type of exercise Original stance Content of routine
Shoulder girdle, Neck stretch
neck Arm stretch
Stretching, 15 min Pelvic girdle Sitting, standing Hip flexor stretch Calf stretch Ankle stretch
Body Spine stretch Abdominal stretch
Aerobic exercises with Fitness ball exercises Sitting on a ball Rolls in different directions hands on hips Jumping on a ball with variable arm moves
and without accessories, Stepper exercises Standing Forward-backward steps, with turns combined with variable arm moves
40 min Aerobics Standing, walking Rhythmic exercises: walking, running, jumping in place with arm moves
Break (10 min)
Standing Squatting
Exercises for different muscle groups or Knee- hand stand Arm-pumping
Weightlifting exercises, 15 min Lying flat on back Knees bent, feet flat on the floor, body bending
Resistance band (thera-band) exercises Lying flat on back Hip flexion
Standing Arm exercises
Lying Leg exercises
GCE, 10 min Affecting all muscle groups: Standing Dynamic breathing exercises and relaxation exercises
breathing exercises
Table 2. The content of Program №2 of physical rehabilitation with preferential usage of stretching exercises.
Group 2
Orientation and type of exercise Original stance Content of routine
Aerobic exercise, 35 min Fitness ball exercises Sitting on a ball Rolls in different directions hands on hips Jumping on a ball with variable arm moves
Stepper exercises Standing Forward-backward steps, with turns combined with variable arm moves
Aerobics Standing, walking Rhythmic exercises: walking, running, jumping in place with arm moves
Stretching, 40 min Shoulder girdle, neck Sitting, standing, lying Neck Stretch Arm stretch
Pelvic girdle Hip flexor stretch Calf stretch Ankle stretch
Body Spine stretch Abdominal stretch
Weightlifting exercises, 20 min Exercises for different muscle groups Standing Squats
Knee- hand stand Arm-pumping
Lying flat on back Knees bent, feet flat on the floor, body bending
Lying Hip flexion
flat on back
GCE, 10 min All muscle groups, breathing exercises Standing Dynamic breathing exercises and relaxation exercises
The implementation of the developed models of physical rehabilitation programs resulted in general increase of the studied indices. Evaluation was carried out using the Inbody device (model Olympia 3.3, by Ja Won Medical). Table 3 represents the dynamics of body composition indices before and after the implementation of the physical rehabilitation program in each group.
Table 3. Dynamics of body composition indices in elderly women at the beginning and at the
end of the physical rehabilitation course.
Indices At the beginning of the course At the end of the course Increment t p
Body mass, kg Group 1 59.92±9.92 60.27±9.07 +0.35 -0.574 <0.582
Group 2 57.89±17.71 57.5±18.6 -0.39 1.151 <0.194
Body fat percentage, kg Group 1 23.26±12.84 21.38±4.72 -1.88 1.368 <0.209
Group 2 20.85±14.65 20.92±14.58 +0.07 -0.164 <0.872
Bone and muscle mass, kg Group 1 38.1±4.9 38.68±4.98 +0.58 -1.534 <0.164
Group 2 37.57±9.53 37.13±11.27 -0.44 1.089 <0.291
Muscle mass, kg Group 1 34.73±4.33 35.48±4.68 +0.75 -1.481 <0.177
Group 2 34.29±8.51 33.87±10.23 -0.42 1.102 <0.286
More pronounced dynamics of body composition indices, specifically - reduction of body fat percentage and increase of bone and muscle mass, was registered in terms of realization of the program №1 of physical rehabilitation.
Table 4 represents the dynamics of blood pressure indices, which were evaluated using an automatic blood pressure monitor, for brachial artery, model FT-500R, by Ja Won Medical.
Table 4. Dynamics of blood pressure indices in elderly women at the beginning and at the end of the physical rehabilitation course.
Indices At the beginning of the course At the end of the course Increme nt t p
Systolic blood pressure, mm Hg Group 1 136.78±43.22 126±26 -10.78 1.59 >0.151
Group 2 132.33±41.67 123.89±24.89 -8.44 2.123 <0.049*
Diastolic blood pressure, mm Hg Group 1 80.56±20.56 70.33±18.33 -10.23 3.513 <0.008* *
Group 2 75.89±20.11 69.28±13.72 -6.61 3.649 <0.002* *
Here and in Table 5: * - p<0,05*, ** - p<0,01.
The implementation of each model resulted in a decrease of indices of systolic and diastolic blood pressure in both groups. However, as is seen from the Table, Group 1 displayed the best dynamics.
Over the last 10 years, noninvasive methods have become more popular, particularly using computerized devices for measurement of pulse-wave velocity (PWV). One of the modern devices used to study PWV is Pulse Wave Velocity 3.0 (KM tec., Korea), which works automatically. This noninvasive method is simple, accurate and is used in clinical studies for evaluation of individual risk of cardiovascular complications [3].
Table 6 represents the dynamics of PWV in terms of the implemented physical rehabilitation program.
Table 5. Dynamics of pulse-wave velocity index, ms
Indices, ms At the beginning of the course At the end of the course Increment t p
Left hand Group 1 205.78±22.82 210.69±23.69 +4.24 -3.355 >0.01**
Group 2 205.82±74.88 213.56±67.14 +7.74 -1.71 >0.105
Right Group 1 211.63±22.74 213.2±21.94 +1.57 -0.716 >0.495
hand Group 2 199.44±36.64 225.76±45.41 +26.32 -1.615 >0.125
Left Group 1 265.48±55.71 266.09±46.1 +0.61 -0.144 >0.889
leg Group 2 256.48±44.07 267.67±97.79 +11.19 -1.785 >0.092
Right Group 1 263.35±35.94 268.11±23.66 +4.76 -1.318 >0.224
leg Group 2 257.93±40.22 264.34±41.2 +6.41 -1.958 >0.067
The dynamics of PWV in terms of the study showed that the physical rehabilitation program determines the given index to a great extent if it is based on stretching exercises, which proves the data has been obtained earlier [5-7].
The questionnaire results result in the conclusion that the increase of motor activity in elderly women has a positive effect on the quality of their living during one of the longest stages of life.
When asked about subjective changes in their state of health after the experiment, 81.5% of women said that they had gained in health. 77.8% of them were satisfied with the results of the program. Same percentage of women were ready to continue recreational physical culture training, occasionally changing the program content in order to master new types of motor activity and diversity of their components.
Conclusions. The targeted expansion of the motor mode of women of senior age groups in view of existing diseases and individual preferences significantly improves the studied parameters.
Each program of physical rehabilitation provides a positive dynamics of most of the indicators, which makes it possible to use various in content of physical rehabilitation programs for classes with elderly women, the load in which corresponds to age standards and the nature of diseases.
References
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Corresponding author: [email protected]
