Efficiency of a Variant of Physical Rehabilitation with Fitness Elements for Diabetes Mellitus Type I and Abdominal Obesity View PDF

Increased physical activity is an important addition to the medical treatment of many diseases [1,2]. When exercising, muscle mass increases [3-6], which increases the number of receptors on myocytes to insulin [7-9]. Also, regular exercise increases metabolic processes in the body [10-12]. This activates the body’s intake of glucose [13], fat metabolism [14], enhances protein metabolism [15]. With the metered exercise load, the psycho-emotional state of a person is significantly improved [16]. In view of the presence of these effects of muscular exercise, exercise is recommended as a non-drug treatment of diabetes mellitus [17-20].

Given that people with diabetes are on treatment in the hospital for no more than 2 weeks, then it is extremely difficult to provide proper physical rehabilitation during these periods, and it is impossible to reduce body weight [21,22]. Increase the entire process of rehabilitation of these patients can be through physical exercise [23,24].

In the gym, the physical load is selected individually for patients [25]. For patients with type I diabetes mellitus, exercise can be used to load all major muscle groups in a short time. This approach helps strengthen the muscle corset of patients, improve the quality of life, keep blood sugar level at the lower limit of the norm after physical exertion, contributing to weight loss [26]. This is due to the fact that fitness in diabetes mellitus makes it possible to increase the sensitivity of insulin receptors of the cell to insulin [27]. This leads to the fact that sugar after exercise in the body of the patient falls. Under these conditions, it is possible to reduce the doses of drugs used to lower the blood glucose level [28]. In some cases, training with diabetes can even reduce the dose of insulin used for injections [29].

The purpose of the study was to develop and test a variant of physical rehabilitation with fitness elements for healing in patients with type I diabetes and abdominal obesity.

The study was approved by the local ethics committee of the Russian State Social University on September 15, 2016 (protocol No. 9). The study was conducted on the basis of the Russian State Social University in Moscow.

Under observation, 75 persons of both sexes aged 30 to 35 years were taken, including 50 people diagnosed with type I diabetes and abdominal obesity of 1 and 2 degrees and 25 people clinically healthy. Of the surveyed, 2 controls and one experimental group were formed. Control group-1 includes 25 clinically healthy people engaged in fitness. Control group-2 included 25 people suffering from type I diabetes and abdominal obesity, which are practicing according to the generally accepted method. The experimental group included 25 people with type 1 diabetes and abdominal obesity, who received physical rehabilitation with fitness elements according to the author’s method, which included circular training.

The control group-1 was examined once. Assessment of the status of the control group-2 and the experimental group was carried out two times: at the end and after 2 months of rehabilitation.

The training program for the control group-1 included: a power program with free weights on the entire body; the number of lessons per week-3 times. All of them engaged in fitness for a long time under individual programs.

The training program for the control group-2 included: a power program with free weights on the entire body; the number of lessons per week-3 times. The scheme of their training is presented in Table 1.

This program uses basic, multi-joint exercises, which the practitioner can handle on his own. They are easy to carry out, carried out on simulators, which are difficult to get injured. This program provides rapid progression of loads and relatively rapid positive bodily changes.

The training program for the experimental group included circular training, the task of which was the withdrawal of the body to the anaerobic threshold, the intensification of fat burning processes and the activation of metabolism. It included a power program with free weights on the whole body with the number of lessons per week-3 times (Table 2).

All surveyed conducted a blood glucose measurement using a standard blood glucose meter; measurement of blood pressure and pulse with a semi-automatic tonometer; the body mass index was calculated. Also in all cases, an alarm was assessed on the Spielberger scale, consisting of forty questions. For each question there are 4 possible answers. After the survey, the sum of the points was calculated and the current level of anxiety was determined:

- Up to 30 points-low anxiety;

- 31-44 points-moderate anxiety;

- 45 or more points-high anxiety.

The data was statistically processed using the standard Microsoft Excel for Windows software package.

At the end and at the end of the observation, the control group-2 and the experimental group were examined, which revealed the dynamics of the indicators taken into account. The results obtained are presented in Table 3. This allowed us to compare the results ofmthe second survey between the experimental and the second control group, taking into account the parameters of the control group 1. It also helped determine the effect of the applied physical rehabilitation

Table 1. Training program for the control group-2.

4 × 10

Table 2. Training program for the experimental group.

Table 3. Dynamics of indicators of those surveyed during rehabilitation.

tools on the physiological and psychological indicators of the observed.

As a result of the study, it was revealed that in the experimental group, by the end of the observation, a more pronounced positive dynamics of the blood pressure level was achieved (systolic pressure up to 121.4 ± 0.53 mm Hg, diastolic pressure up to 81.0 ± 0.34). By the end of the observation in the experimental and control group-2, similar positive changes in the pulse values were noted. At the same time, in the control group-2, after physical rehabilitation, the level of this indicator exceeded that in the experimental group by 16.9%.

More pronounced positive changes in psychological indicators were noted at the end of the observation in the experimental group. So, according to the situation of anxiety, the indicator in the control group-2 exceeded that in the experimental group by 13.5%. The level of personal anxiety toward the end of the rehabilitation course also prevailed in the control group-2 by 17.1%, emphasizing the greater preference of the result in the experimental group.

As a result of physical rehabilitation, the blood glucose level in both groups of patients decreased. At the same time, it completely normalized only in the experimental group, completely eliminating the progression of complications of hyperglycemia in it.

Carrying out the metered, feasible and regular physical exertions provided in both groups of patients a decrease in initially increased body weight. At the same time, the experimental group achieved a more pronounced dynamics of this indicator. It provided a reduction in all patients of the body mass index. At the same time, the normalization of the body mass index was registered only in the experimental group, which indicated elimination of abdominal obesity and normalization of lipid metabolism.

Dose physical exercise in the complex treatment of type I diabetes mellitus and abdominal obesity is very important [30]. Against this background, there is an intensification of metabolic processes in connection with an increase in energy expenditure. This is due to the acceleration of the processes of protein, carbohydrate, fat and water mineral metabolism [31]. Favorable shifts in fat metabolism are very pronounced under the influence of long loads of moderate and moderate intensity. This is more pronounced than with short-term, but intense exercises [32,33]. Creation of conditions conducive to longterm energy consumption and preferential oxidation of fats with their release from the depot [34,35], provide exercises of applied and sports nature (walking, dosed walking, mechanotherapy, circular training etc.) [36,37]. In this regard, they are very useful in diabetes and obesity.

Active physical activity, regular physical training and sports play an important role in maintaining normal weight and blood sugar level [38,39]. The therapeutic effect of physical exercises in abdominal obesity in patients with diabetes mellitus is mainly due to the mechanism of trophic action [40]. It is thanks to this mechanism that active muscle activity improves metabolic processes in tissues and stimulates regeneration processes [41]. Due to this, physical exercises exert a general toning effect on the given contingent of patients and normalize the processes in their nervous and endocrine regulation of trophic processes, and also contribute to the restoration of normal motor-visceral reflexes, restoring impaired functions [42,43].

A more pronounced effect in the experimental group can be explained by the fact that when performing muscular work there is certain inertia in the change in the intensity and nature of the energy supply of the organism [44-46]. In particular, in the first five to seven minutes of work, the sources of energy supply for them are carbohydrates, which the working muscles extract and utilize from the blood flowing into them [47]. In the next ten to twelve minutes (ie, between the fifth and the twentieth minutes after the start of the work),the main energy reserves for the muscles are the carbohydrates formed during the breakdown of glycogen [48] first in the muscles themselves, and then in the others his depot. [49,50]. When work lasts longer than 20 minutes, energy sources become fats [51], which is an effective moment of physical rehabilitation [52]. Consequently, a sustained effect of reducing fat mass with the use of circular physical exercises can begin to be achieved only if they are carried out for a long time and at high traffic intensity. This explains the fact that the more “saturated” scheme of physical rehabilitation applied in the experimental group was able to give a more pronounced result in the observed patients, surpassing the traditional effect.

Active physical activity plays an important role in maintaining normal body weight and blood sugar levels. The therapeutic effect of physical exercises in abdominal obesity in patients with diabetes mellitus is mainly due to the mechanism of trophic action. Active muscular activity improves metabolic processes in tissues and stimulates regeneration processes. Due to this, physical exercises exert a general toning effect on this contingent of patients and normalize the processes of nervous and endocrine regulation in them, promote the restoration of normal motor-visceral reflexes. As a result of the study, it was revealed that in the experimental group receiving physical loads according to the author’s scheme, by the end of the observation, a more pronounced positive dynamics of the level of arterial pressure, pulse rate was achieved. This was accompanied by more pronounced positive changes in psychological indicators in the experimental group. As a result of physical rehabilitation, the blood glucose level in both groups of patients decreased. At the same time, he completely normalized only in the experimental group, excluding the progression of complications of hyperglycemia in her. Only in the experimental group was achieved the normalization of the body mass index, which indicated the elimination of the persons who made up abdominal obesity and the normalization of lipid metabolism against the background of optimization of carbohydrate metabolism.

1. Skoryatina IA, Medvedev IN, Zavalishina SY (2017) Disagregational control of vasoconstrictors on the basis of basic form elements of blood in persons with arterial hypertension and disclipidemia who have received complex treatment. Cardiovascular therapy and prevention 16: 8-14.
2. Zavalishina SY, Medvedev IN (2017) Comparison of opportunities from two therapeutical complexes for correction of vascular hemostasis in hypertensives with metabolic syndrome. Cardiovascular therapy and prevention 16: 15-21.
3. Medvedev IN, Skorjatina IA, Zavalishina SY (2016) Vascular control over blood cells aggregation in patients with arterial hypertension with dyslipidemia. Cardiovascular therapy and prevention 15: 4-9.
4. Medvedev IN (2016) Dynamics of violations of intravascular platelet activity in rats during the formation of metabolic syndrome using fructose models. Problems of nutrition 85: 42-46.
5. Medvedev IN, Zavalishina SY (2016) Platelet Activity in Patients with Third Degree Arterial Hypertension and Metabolic Syndrome. Kardiologiia 56: 48.
6. Zavalishina SY, Medvedev IN (2016) Features aggregation erythrocytes and platelets in old rats experiencing regular exercise on a treadmill. Adv Gerontol 29: 437-441.
7. Medvedev IN (2016) Platelet functional activity in clinically healthy elderly. Adv Gerontol 29: 633-638.
8. Medvdev IN, Skoryatina IA, Zavalishina SY (2016) Aggregation ability of the main blood cells in arterial hypertension and dyslipidemia patients on rosuvastatin and nondrug treatments. Cardiovascular therapy and prevention 15: 4-10.
9. Shmeleva SV, Yunusov FA, Morozov YUS, Seselkin AI, Zavalishina SYU (2018) Modern Approaches to Prevention and Correction of the Attorney Syndrome at Sportsmen. Prensa Med Argent 104 : 2
10. Morozova EV, Shmeleva SV, Rysakova OG, Bakulina ED, Zavalishina SY (2018) Psychological Rehabilitation of Disabled People Due to Diseases of the Musculoskeletal System and Connective Tissue. Prensa Med Argent 104 : 2
11. Zavalishina SY (2017) Physiological Dynamics of Spontaneous Erythrocytes’ Aggregation of Rats at Last Ontogenesis. Annual Research & Review in Biology 13: 1-7.
12. Zavalishina SY (2017) Restoration of Physiological Activity of Platelets in New-Born Calves with Iron Deficiency. Biomed Pharmacol J 10: 711-716.
13. Skoryatina IA, Zavalishina SY (2017) Impact of Experimental Development of Arterial Hypertension and Dyslipidemia on Intravascular Activity of Rats’ Platelets. Annual Research & Review in Biology 14: 1-9.
14. Alifirov AI, Mikhaylova IV, Makhov AS (2017) Sport-specific diet contribution to mental hygiene of chess player. Theory of Practice and Physical Culture 4: 17.
15. Mikhaylova IV, Makhov AS, Alifirov AI (2015) Chess as multi-component type of adaptive physical culture. Theory of Practice and Physical Culture 12: 56-58.
16. Mikhaylova IV, Alifirov AI (2017) Chess game application for people diagnosed with mental and intellectual disorders. Theory of Practice and Physical Culture 3: 14.
17. Safiulin EM, Makhov AS, Mikhaylova IV (2016) Chess groups for beginner players with musculoskeletal disorders: mastery and participation restraining factor analysis. Theory of Practice and Physical Culture 4: 33-35.
18. Makhov AS (2013). Management concepts of development of adaptive sport in russia. Theory of Practice and Physical Culture 7: 34-37.
19. Makhov AS, Stepanova ON (2013) The program of development control of adaptive sport “FINNIX” and results of its implementation. Theory and Practice of Physical Culture 8: 101–104.
20. Antonov AA, Makhov AS (2014). Factor Structure of Requirements of HearingImpaired People to Organization of Rink-Bandy (Mini Hockey) Classes. Theory of Practice and Physical Culture 5: 27-31.
21. Korneva MA, Makhov AS, Stepanova ON (2014) Features of motivation of disabled athletes with lesions of the musculoskeletal system to participate in the training process in the Russian press. Theory of Practice and Physical Culture 6: 37-43.
22. Makhov AS, Stepanova ON, Shmeleva SV, Petrova EA, Dubrovinskaya EI (2015) Planning and Organization of Sports Competitions for Disabled People: Russian Experience. Biosci Biotech Res Asia 12: 34-44.
23. Mikhaylova IV, Shmeleva SV, Makhov AS (2015) Adaptive chess educational technology for disabled children. Theory and Practice of Physical Culture 7: 12.
24. Mikhaylova IV, Shmeleva SV, Makhov AS (2015) Information communication teaching aids in long-term training of chess players. Theory and Practice of Physical Culture 5: 31.
25. Korneva MA, Makhov AS (2015) Methodology of the training process of novice disabled athletes with cerebral palsy in the Russian press. Theory and practice of physical culture 3: 47-49.
26. Bikbulatova AA (2014) Determining the thickness of materials in therapeutic and preventive heat-saving garments. Proceedings of higher education institutes. Textile industry technology 1: 119-123.
27. Bikbulatova AA, Andreeva EG, Medvedev IN (2017) Platelets’ Functional Peculiarities in Persons of the Second Mature Age with Spinal Column Osteochondrosis of the Second Degree. Annual Research & Review in Biology 21: 1-9.
28. Bikbulatova AA, Andreeva EG (2017) Dynamics of Platelet Activity in 5-6-Year Old Children with Scoliosis against the Background of Daily Medicinal-Prophylactic Clothes’ Wearing for Half a Year. Biomed Pharmacol J 10.
29. Bikbulatova AA (2017) Dynamics of Locomotor Apparatus’ Indices of Preschoolers with Scoliosis of I-II Degree against the Background of Medicinal Physical Training. Biomed Pharmacol J 10.
30. Mikhailova IV, Shmeleva SV, Makhov AS (2015) Application of ICT learning tools in long-term preparation of sportsmen-chess players. Theory and practice of physical culture 5: 70-73.
31. Mikhailova IV, Shmeleva SV, Makhov AS (2015) The Technology of adaptive chess learning disabled children. Theory and practice of physical culture 7: 38-41.
32. Kazakova TE, Makhov AS (2015) Basic problems of development of Paralympic boccia in Russia. Theory and practice of physical culture 8: 37-40.
33. Mikhailova IV, Makhov AS (2015) Creating federal innovative platform for dissemination of model and ideology of advanced development of university adaptive chess education. Theory and practice of physical culture 10: 56-59.
34. Mikhailova IV, Makhov AS, Alifirov AI (2015) Chess as a multifaceted form of adaptive physical culture. Theory and practice of physical culture 12: 56-59.
35. Makhov AS, Chepik VD, Karpov VY, Pushkin VN (2016) The System construction of the content of the discipline “Theory and methodology of chosen sports” in the direction “Physical culture” (undergraduate level). Theory and practice of physical culture 3: 23-25.
36. Glagoleva TI, Zavalishina SY (2017) Aggregation of Basic Regular Blood Elements in Calves during the Milk-feeding Phase. Annual Research & Review in Biology 17: 1-7.
37. Glagoleva TI, Zavalishina SY (2017) Physiological Peculiarities of Vessels’ Disaggregating Control over New-Born Calves’ Erythrocytes. Annual Research & Review in Biology 19: 1-9.
38. Makhov AS, Medvedev IN, Rysakova OG (2017) Functional features of hemostasis and physical fitness of skilled snowboarders with hearing impairment. Theory and practice of physical culture 12: 27.
39. Medvedev IN (2017) The Impact of Durable and Regular Training in Handto-handFighting Section on Aggregative Platelet Activity of Persons at the First Mature Age Annual Research & Review in Biology 15: 1-6.
40. Medvedev IN (2017) Microrheology of erythrocytes in arterial hypertension and dyslipidemia with a complex hypolipidemic treatment. Russian Journal of Cardiology 4: 13-17.
41. Kornev AV, Makhov AS, Makeeva VS, Rysakova OG (2016) Motivation of sports activities of students of special (correctional) schools. Theory and practice of physical culture 3: 35-37.
42. Stepanova ON, Makhov AS, Latushkina EN, Bernina JS (2016) Management activities coach: types, objects, performance criteria. Theory and practice of physical culture 3: 66-68.
43. Safiulin EM, Makhov AS, Mikhailova IV (2016) ?nalysis of the factors impeding the development of skill and number of players with lesions of the musculoskeletal system at the stage of initial sports training. Theory and practice of physical culture 4: 33-35.
44. Matveev AP, Makhov AS, Karpov VY, Kornev AV (2016) The concept of “Health saving technologies” in the context of modern school education. Theory and practice of physical culture 9: 59-61.
45. Petrova EA, Makhov AS, Savchenko DV, Kovalyova MA (2017) The peculiarities of psychological and emotional States Paralympic athletes. Theory and practice of physical culture 3: 48-50.
46. Makhov AS, Zubenko MB (2017) The Problems of organization of sports activities for children with down syndrome. Theory and practice of physical culture 4: 14-16.
47. Aliferov AI, Mikhailova IV, Makhov AS (2017) Sports nutrition as a component of mental health of the player. Theory and practice of physical culture 4: 96-98.
48. Chepik VD, Makhov AS, Nekrasova VM, Sidorov AS (2017) Qualimetry content of additional professional education of specialists in adaptive physical culture and sport. Theory and practice of physical culture 4: 38-40
49. Sizov ??, Zavalishina SJ (2015) Russian Criminal Legislation in Prevention of Sexually Transmitted Diseases in the Territory of the Russian Federation. Biol Med (Aligarh) 7: 5.
50. Skoryatina IA, Zavalishina SY (2017) A Study of the Early Disturbances in Vascular Hemostasis in Experimentally Induced Metabolic Syndrome. Annual Research & Review in Biology 15: 1-9.
51. Skoryatina IA, Zavalishina SY, Makurina ON, Mal GS, Gamolina OV (2017) Some aspects of Treatment of Patients having Dislipidemia on the Background of Hypertension. Prensa Med Argent 103: 3.
52. Makhov AS, Medvedev IN (2018) Motor rehabilitation of children with cerebral palsy. Theory and practice of physical culture 6: 8.