The Content of Physical Rehabilitation Program for Middle Aged Women with Arterial Hypertension and Obesity

The Content of Physical Rehabilitation Program for Middle Aged Women with Arterial Hypertension and Obesity

ˑ: 

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 of physical rehabilitation with preferential usage of aerobic exercises.

Group 1

Orientation and type of exercise

Original stance

Content of routine

Stretching,

 15 min

Shoulder girdle, neck

 

Sitting, standing

Neck stretch

Arm stretch

Pelvic girdle

Hip flexor stretch

Calf stretch

Ankle stretch

Body

Spine stretch

Abdominal stretch

Aerobic exercises with and without accessories,

40 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

Break (10 min)

Weightlifting exercises, 15 min

Exercises for different muscle groups

 

or

 

Resistance band (thera-band) exercises

Standing

Squatting

Knee-hand stand

Arm-pumping

Lying flat on back

Knees bent, feet flat on the floor, body bending

Lying flat on back

Hip flexion

Standing

Arm exercises

Lying

Leg exercises

GCE, 10 min

Affecting all muscle groups:  breathing exercises

Standing

Dynamic breathing exercises and  relaxation 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 flat on back

Hip flexion

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

Increment

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 hand

Group 1

211.63±22.74

213.2±21.94

+1.57

-0.716

>0.495

Group 2

199.44±36.64

225.76±45.41

+26.32

-1.615

>0.125

Left leg

Group 1

265.48±55.71

266.09±46.1

+0.61

-0.144

>0.889

Group 2

256.48±44.07

267.67±97.79

+11.19

-1.785

>0.092

Right leg

Group 1

263.35±35.94

268.11±23.66

+4.76

-1.318

>0.224

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

  1. Gavrilov, D.N. Organizational and pedagogical foundations of recreational physical culture with middle-aged and senior persons: Book of abstracts of inter-university theor.-pract. conf. "Humanitarian education: traditions and innovations" / D.N. Gavrilov, T.V. Kazankina, A.V. Malinin. – St. Petersburg, 2000. – P. 355-356. (In Russian)
  2. Kryazhev, V.D. Sport and health technologies of health protection and normalization of blood pressure in elderly persons / V.D. Kryazhev, F.A. Iordanskaya // Collected researches VNIIFK. – Moscow, 2002. – P. 191-198. (In Russian)
  3. Nedogoda, S.V. Vascular rigidity and pulse wave velocity: new risk factors of cardiovascular morbidity and target for pharmacotherapy / S.V. Nedogoda, T.A. Chalyabi // Bolezni serdtsa i sosudov. – 2006. – V. 1. – № 4. (In Russian)
  4. Tiunova, O.V. Methodical features of sports and recreation activities with elderly persons: method. recommendations / O.V. Tiunova // LFK i massazh. Sport. meditsina– 2007. – № 5. – P. 24-30. (In Russian)
  5. Lim Soon Gil. The effects of isokinetic training and stretching exercise for 12 weeks on physical fitness factors in elderly women / Soon Gil Lim, Jae Hyuk Cho // Institute of Sports Science Yongin University. Sports Science Studies. 2003, Vol. 13 No.2, P. 191-202.
  6. Park Jeong Bae. The effects of stretching and rhythm exercise program on the knee pain of osteoarthritis, blood lipid profile and brachial-ankle pulse wave velocity in elderly / Jeong Bae Park, Hea Joung Lee, Sun Tea Joung // The Journal of Korea Society for sports science. 2006. Vol.15 No 2, p. 451-460.
  7. Shin Ho Su. Effects of Combined Resistance Exercise on Pain and Vascular Compliance in Middle-Aged Women with Chronic Shoulder Disorder / Ho Su Shin, Kwang Sik Lee // The Journal of Korea Society for sports science. 2007. Vol. 16 No 1, p. 397-405.
  8. Yang Dae Seung. Difference of exercise types on elderly women’s body composition, blood pressure and vascular compliance / Dae Seung Yang, Joonp Young Park, Seung Suk Kim. // The Korea society of sports science. The Journal of Korea Society for sports science. 2011. Vol. 20, No 5, p. 1027-1036.

Corresponding author: y21c486@naver.com