PRINCIPLES OF PHYSICAL INACTIVITY CORRECTION IN PATIENTS WITH METABOLIC SYNDROME

Physical inactivity is considered to be the most notable feature of a modern society due to significant urbanization, mechanization and automation of labour-intensive processes as well as increased role of modern forms of communication and other blessings of civilization people are moving less and less these days. There are good reasons why physical inactivity is considered as a disease of civilization as well as one of the leading external factors of developing and progressing the manifestations of insulin resistance (IR), obesity and metabolic syndrome (MS). MS is now a relevant problem in many countries around the world as most disorders in this group of patients often result in macrovascular complications of type 2 diabetes mellitus. A significant prevalence of this syndrome among 25-35% of the adult population leads to a de-crease in both quality of life and life expectancy in people of working age. Therefore, the objective of our research was to study the effectiveness of step-by-step exercise program for patients with MS depending on the degree of obesity. Materials and methods. The study included 60 patients with MS. All the patients were divided into four groups according to their body mass index (BMI): Group I included 15 patients with MS and BMI of 25.0-29.9 kg/m2; Group II comprised 15 patients with the signs of MS and BMI of 30.0-34.9 kg/m2; Group III included 15 patients with MS and BMI of 35.0-39.9 kg/m2; Group IV comprised 15 patients with MS and BMI >40.0 kg/m2. The control group included 20 apparently healthy individuals of the same age and sex. There exercise programs for patients with excess weight/grade I-II obesity was developed: a 30-minute stationary cycling with a 5-minute exercise load followed by a 3-minute rest and the control of the increase in heart rate (HR) of no more than 75% from resting HR. The exercise program included 20 sessions. Patients with MS and grade III obesity underwent a macrocycle of exercise therapy: very slow controlled walking from 60 to 70 steps/min (from 2 to 3 km/h) for 45 minutes followed by a 3-minute rest in combination with breathing exercises and the control of the increase in HR of no more than 50% from resting HR. The duration of the recommended treatment course was 20 days. Results. All the patients completed the course of step-by-step exercise program. After treatment, a significant reduction in BMI by 5.0% was observed in patients with MS and excess weight. The identical results were achieved by patients of Group II. In patients with MS and grade II obesity, there was a tendency toward a decrease in BMI (- ∆ = 2.9%). The best results (-∆ = 6.8%) were obtained in patients of Group IV who were offered a cycle of exercise therapy, namely slow controlled walking in combination with breathing exercises. Conclusions. There high effectiveness and good tolerability of step-by-step exercise programs using an individualized approach to the management of patients depending on the degree of obesity has been proven as well as continuous monitoring of the intensity of physical activity calculating the maximum HR according to the patients' age. Thus, the proposed principle of drug-free correction prevents the progression of IR manifestations on the background of pharmacological therapy for patients with MS and should be recommended for patients with excessive weight or obesity.