CHANGE OF EXTERNAL RESPIRATION FUNCTIONAL PARAMETERS OF OBESE MEN IN THE PROCESS OF PHYSICAL THERAPY AS A MARKER OF THE EFFECTIVENESS OF THE RESPIRATORY REHABILITATION ELEMENTS

Анотація

Objectives: to determine changes in the parameters of the respiratory system in men with obesity of the I-III degree under the influence of respiratory rehabilitation elements in a comprehensive program of physical therapy.

Methods. 116 men with alimentary-constitutional obesity of the I-III degree were examined. According to the results of the rehabilitation (therapeutic) alliance, they were divided into two groups. The comparison group consisted of individuals with a low level of alliance. The main group consisted of people with a high level of alliance. They underwent an annual program of correction with the use of measures to support the alliance, modify nutrition, increase physical activity, lymphatic drainage, psychocorrection, elements of respiratory therapy. The control group consisted of 31 men with normal body weight. The subjective condition, the intensity of dyspnea on the Borg scale, the degree of oxygenation of arterial blood (SpO₂), respiratory volumes using spirometry were studied.

Results. The annual implementation of a physical therapy program with elements of respiratory rehabilitation against the background of a high level of rehabilitation alliance (the implementation of prescribed interventions in the form of self-study, adherence to recommended diet, elimination of bad habits) has led to a significant improvement in the main groups compared to men. The low level of the rehabilitation alliance, which, although apparently informed about the consequences of obesity and weight loss methods, did not follow any recommendations.

In men of all main groups at re-examination were not identified complaints of shortness of breath at rest and its strengthening in a horizontal position, hypoxic sleep disorders. There were also less frequent complaints of a significant increase in shortness of breath during physical activity.

When assessing the intensity of shortness of breath on the Borg scale in men of the main group, it was not actually determined, and during physical activity reached only a mild and moderate level (with obesity II-III degree).

Improvement in the functioning of the respiratory system was manifested in the form of normalization of respiratory rate in all men of the main groups and parameters of saturation by the level of SpO₂.

Analysis of spirometric parameters revealed an improvement in their tidal volumes and normalization of the spirogram curves, which indicated the leveling of signs of respiratory failure.

According to all studied parameters, men of the main groups showed a statistically significantly better result compared to  men of the comparison groups (p <0.05).

Improvement of the respiratory system in obese patients can be explained both by primary changes in the bronchopulmonary system - increased respiratory volumes and reserves, improved blood oxygenation, and indirectly - by increasing the amplitude of diaphragm movements, reducing visceral fat and general training, which is confirmed by leveling  of mixed respiratory failure.

Conclusions. The use of elements of respiratory therapy in the program of complex physical therapy, aimed at reducing body weight, allows to normalize the functions of the respiratory system. Therefore, the elements of respiratory rehabilitation are pathogenetically appropriate to include in the schemes of restoring the health of obese men, especially in its high degrees or comorbidities.