Time course of cardiovascular risk changes in obese children during rehabilitation treatment using hydrokinesitherapy
Abstract
Objective: to evaluate the efficiency of the original rehabilitation procedure developed by the author for 12—13-year-old children (и=26) with grade 1-2 exogenous constitutional obesity, by using a complex of water physical exercises. The time course of changes in the determinants of nutritional status, cardiovascular system, and vascular endothelial function was studied. The implemented rehabilitation program could lose excess body weight (p=0,04) and reduce waist (p=0,035) and neck (p=0,027) circumferences, systemic vascular tone, and the number of children with brachial artery endothelial dysfunction (p=0,009). The clinical and functional findings indicate that there are hydrokinesitherapy-induced functional changes in vascular tone and their reversibility in obese children. This allows the developed rehabilitation complex to be recommended for the treatment of this category of children to prevent the development and progression of vascular disorders.
About the Authors
G. S. Maskova
Yaroslavl State Medical University; Children's Polyclinic Five, Yaroslavl
Russian Federation
Russian Federation
N. L. Chernaya
Yaroslavl State Medical University; Children's Polyclinic Five, Yaroslavl
Russian Federation
Russian Federation
A. I. Tanchuk
Yaroslavl State Medical University; Children's Polyclinic Five, Yaroslavl
Russian Federation
Russian Federation
L. A. Krapivina
Yaroslavl State Medical University; Children's Polyclinic Five, Yaroslavl
Russian Federation
Russian Federation
References
1. Садыкова Д.И. Артериальная гипертензия у детей: причины и диагностика. Практ мед 2010; 5:44: 36—41. (Sady-kova D.I. Arterial hypertension in children: causes and diagnosis. Prakt med 2010; 5: 44: 36-41.)
2. Александров A.A, Бубнова М.Г. Кисляк О.А. и др. Рекомендации по профилактике сердечно-сосудистых заболеваний в детском и подростковом возрасте Российского кардиологического общества. М 2012; 77. (Aleksandrov A.A., Bubnova M.G., Kisljak O.A. et al. Recommendations for prevention of cardiovascular disease in childhood and adolescence the Russian society of cardiology. Moscow 2012; 77.)
3. Аверьянов А.П., Болотова Н.В., Зотова С.А Ожирение в детском возрасте. Лечащий врач 2010; 2: 13—15. (Aver'janov A.P., Bolotova N.V., Zotova S.A. Obesity in childhood. Lechashhij vrach2010; 2: 13-15.)
4. Бувальцев В.И. Дисфункция эндотелия как новая концепция профилактики и лечения сердечно-сосудистых заболеваний. Международный мед журн 2001; 3: 14—19. (Buval'cev V.I. The endothelial dysfunction as a new concept for the prevention and the treatment of cardiovascular diseases. Mezhdunarodnyj med zhurn 2001; 3: 14—19.)
5. Benzuly K.H., Padgett R. C, Koul S. et al. Functional improvement precedes structural regression of atherosclerosis. Circulation 1994; 89: 1810-1818.
6. Azen S.P., Qian D., Mack W.J. et al. Effect of supplementary antioxidant vitamin intake on carotid arterial wall intima-media thickness in a controlled clinical trial of cholesterol lowering. Circulation 1996: 94: 2369-2372.
7. Homing В., Maier V., Drexler H. Physical training improves endothelial function in patients with chronic heart failure. Circulation 1996; 93: 210-214.
8. Watts K., Beye P., SiafarikasA. etal. Exercise training in obese children. J Pediatrics 2004; 144: 620-625.
9. Маскова T.C., Черная Н.Л., Белова Е.А. и др. Методика дозированной гидрокинезиотерапии при оздоровлении школьников с первичным ожирением. Вопросы школьной и университетской медицины и здоровья 2014; 3: 43-44. (Maskova G.S., Chernaja N.L., Belova E.A. et al. The technique dosage hydrokinesitherapy in the recovery of primary school children with obesity. Voprosy shkoFnoj i uni-versitetskoj meditsiny i zdorov'ya 2014; 3: 43—44.)
10. Федеральные клинические рекомендации (протоколы) по ведению детей с эндокринной патологией. Под ред. И.И. Дедова и В.А. Петерковой. М: Практика 2014; 163—183.(The Federal clinical guidelines for the management of children with endocrine disorders. I.I. Dedova, V.A. Peter-kova(eds). M: Praktika2014; 163-183.)
11. Национальные рекомендации по диагностике, лечению и профилактике артериальной гипертензии у детей и подростков (второй пересмотр). Кардиоваскулярная
12. терапия и профилактика 2009; 8: 4. (National guidelines for the diagnosis, treatment and prevention of arterial hypertension in children and adolescents (second revision). Kardio-vaskulyarnaya terapiya i profilaktika 2009; 8:4.)
13. CelermajerD.S., Sorensen K.E., Gooch V.M. et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992; 340: 1111-1115.
14. Булгакова Н.Ж. Оздоровительное, лечебное и адаптивное плавание. М: Академия 2008; 429. (Bulgakova N. Zh. The health, medical and adaptive swimming. Moscow: Aka-demija 2008; 429.)
15. Daniels S.R., Arnett D.K., Eckel R.H. et al. Overweight in Children and Adolescents Pathophysiology, Consequences, Prevention, and Treatment. Circulation 2005; 111: 1999-2012.
16. Кулешова Э.В. Частота сердечных сокращений как фактор риска у больных ишемической болезнью сердца (обзор литературы). Вестн аритмол 1999; 13: 75—83. (Kuleshova Je.V. Heart rate as a risk factor in patients with coronary heart disease (literature review). Vestn aritmol 1999; 13:75-83.)
17. Colin P., Ghaleh В., MonnetX. et al. Contributions of heart rate and contractility to myocardial oxygen balance during exercise. Amer J Physiol Heart Circ Physiol 2003; 284: 676-682.
18. Williams S.V., Fihn S.D., GibbonsRJ. Guidelines forthe management of patients with chronic stable angina: diagnosis and risk stratification. Ann Intern Med 2001; 135: 7: 530-547.
19. Sundstrom J., Neovius M., Tynelius P. et al. Association of blood pressure in late adolescence with subsequent mortality: cohort study of Swedish male conscripts. BMJ 2011; 342: d643.
20. Гнусаев С.Ф., Дианов О.А., Яковлев Б.Н. Эффективность использования метформина при нейроциркуляторной нестабильности у детей с ожирением. Ожирение и метаболизм 2005; 3: 43—45. (Gnusaev S.F., Dianov O.A., Jakov-lev B.N. The effectiveness of the use of Metformin in neuro instability in children with obesity. Ozhirenie i metabolizm 2005; 3:43-45.)
21. Маскова Г. С, Черная Н.Л., Нагорнова Э.Ю. и др. Функция эндотелия плечевой артерии у подростков с ожирением в зависимости от степени выраженности клинико-тро-фологических и метаболических нарушений. Кардиология 2014; 54: 2: 31-36. (Maskova G.S., Chernaja N.L., Nagornova E.Yu. et al. The state of the function of the en-dothelium brachial artery at teenagers with obesity depending on the degree of severity of the clinical, trophologhikal and metabolic disorders. Kardiologiya2014; 54: 2: 31—36.)
22. Custodis F., Baumhakel M., Schlimmer N. et al. Heart rate reduction by ivabradine reduces oxidative stress, improves endothelial function, and prevents atherosclerosis in apolipopro-tein E-deficient mice. Circulation 2008; 117: 2377-2387.
Review
For citations:
Maskova G.S., Chernaya N.L., Tanchuk A.I., Krapivina L.A. Time course of cardiovascular risk changes in obese children during rehabilitation treatment using hydrokinesitherapy. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2015;60(4):108-114. (In Russ.)
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