DETERMINING THE EFFECTIVENESS OF A PHYSICAL THERAPY PROGRAM IMPLEMEN-TATION FOR PATIENTS WITH GRADE III OBESITY BASED ON THE METABOLIC PARAMETERS DYNAMICS

Objectives: to determine the dynamics of metabolism in obese patients under the influence of a physical therapy program. Methods. 74 people with degree III obesity were examined. In terms of rehabilitation compliance, they were divided into a comparison group (low level) and a main group (high level). The control group consisted of 63 people with normal body weight. Estimated anthro-pometric indicators (weight, body mass index, the ratio of waist and hips); parameters of hydrocarbon (fasting and after glucose loading of glucose) and lipid (concentration of cholesterol, triglycerides, high-density lipoproteins, leptin) metabolism; the visceral obesity index was calcu-lated. The examination was carried out before and after the introduction of a one-year physical therapy program, which included maintaining a high level of compliance, increasing physical activity, changing the diet, acupunc-ture, massage, and psycho-correction. Results. In all obese individuals, abdominal obesity, fasting hyperglycemia and impaired glucose tolerance, high levels of total cholesterol, triglycerides, leptin, low levels of low-density lipoproteins was deter-mined. The visceral obesity index exceeded those of individuals with normal body weight (p <0.05). Compli-ance with the principles of the developed program made it possible to achieve a statistically significant (p <0.05) improvement relative to the initial indicators of all the studied parameters of the persons of the main group. Patients of the comparison group showed an increase in body mass index, a tendency to worsen atherogenic dyslipidemia and glucose uptake, a high content of leptin. The problem of medical compliance, its features and methods of enhancement, receives a lot of attention. At the same time, it is extremely important to address the issues of rehabilitation compliance, because often pa-tients come to long-term health improvement programs, which gradually reduces the level of compliance. The very fact of obesity indicates, largely, that patients obvi-ously already received recommendations for weight loss but did not implement them for some reason. The level of consent to the implementation of known effective measures is the basis for making pro-gress in rehabilitation and explains the lack of outcome in some patients. Compliance with a high level of collaboration with a physical therapist to follow the recommendations developed for a long time is the key to reducing body weight, maintaining the result achieved, focusing on a long-term lifestyle change, rather than short-term weight loss. At the same time, diagnosis of low level of rehabilitation compliance allows saving resources of rehabilitation institutions and to identify contingent of patients, in the future, it will require highly specialized complex measures (medication, psychological, bariatric). Conclusions. The level of rehabilitation compli-ance and its maintenance at a sufficient level is a funda-mental point in adherence to obesity recommendations for lifestyle modification and physical activity within physical therapy programs. Decreased metabolic and dyslipidemia manifestations indicate the effectiveness of non-drug remedies for the correction of high body weight in obese patients as part of a physical therapy program. In order to achieve normal body weight and to fully normalize metabolic and dyslipidemia manifesta-tions, the duration of a degree III physical therapy pro-gram for patients with obesity should be longer than 1 year, followed by life-long balanced diet, which also requires specialist compliance.