Ефективність засобів фізичної терапії в корекції ознак дисфункції дихальної системи у жінок з абдомінальним ожирінням

Abstract

Respiratory disorders in obesity occur even in the absence of bronchopulmonary pathology, and in their presence, an excess of adipose tissue worsens the prognosis of the disease. Obese people have a high risk of obstructive sleep apnea syndrome, hypoventilation syndrome, bronchial hyperreactivity, pneumonia, pulmonary hypertension. The purpose of the study was to determine the effectiveness of using physical therapy in the correction of signs of respiratory system dysfunction in women with abdominal obesity. Material and methods. The study involved 172 women with abdominal obesity of I-III degrees, diagnosed by body mass index and the ratio of waist and hip circumferences. According to the results of the definition of the rehabilitation (therapeutic) alliance, they were divided into two groups. The comparison group consisted of women with a low level of alliance that refused to actively participate in the program of weight loss. The main group consisted of women with a high level of alliance; they underwent a one-year correction program using nutritional modification, increased physical activity, lymphatic drainage, psychocorrection, and elements of respiratory physical therapy. The control group consisted of 32 women with normal body weight. Subjective state, dyspnea intensity, pulsоoximetry and spirometry parameters were studied. Results and discussion. We revealed the respiratory system dysfunction in women with abdominal obesity: subjective signs of impaired respiratory function, a decrease in arterial blood oxygenation, and a decrease in spirometry volumes. Their content and severity were proportional to the severity of obesity. Using respiratory therapy elements in the program of complex physical therapy aimed at reducing body weight let us normalize the studied parameters of the respiratory system function in women of the main group. The low level of the rehabilitation alliance of women in the comparison group led to unsatisfactory implementation of the recommendations provided and was associated with a lack of rehabilitation effect. Improvement in the state of the bronchopulmonary system in women with abdominal obesity is justified both by primary changes in the respiratory system – an increase in spirometry volumes and reserves, improved blood oxygenation, and indirectly – by an increase in the range of motion of the diaphragm, a decrease in the amount of visceral fat and general fitness, which is confirmed by the leveling of signs of restrictive and mixed respiratory failure. Conclusion. It is advisable to include the elements of respiratory rehabilitation in the programs for restoring the health of women with abdominal obesity