Rehabilitation of patients with sarcopenic obesity within the framework of the Active Longevity project

BACKGROUND. The Russian government has set itself an ambitious goal – to significantly increase both the duration and quality of life of citizens, paying special attention to the older generation. The promotion and comprehensive support of active longevity is becoming a key area of government policy. The essence of this strategy is to maximize the involvement of older people in work and social life, which, in turn, has a positive effect on their physical and psychological condition. Voronezhstat data for 2024 indicate that pensioners make up an impressive 42 % of the population of the Voronezh Region. This figure clearly demonstrates the scale of the task facing the regional authorities to ensure a decent life and social adaptation of the older generation.

OBJECTIVE. To determine the effectiveness of a recovery program for 65-year-old women with sarcopenic obesity.

MATERIALS AND METHODS. The study involved 60 people selected according to certain criteria. The studied patients were classified according to the presence or absence of sarcopenic obesity. To analyze the effectiveness of rehabilitation intervention, two groups were formed: experimental and control. For 6 months, the participants of the experimental group, in addition to traditional treatment, underwent a rehabilitation program developed at the N. N. Burdenko State Medical University. The program included physical exercises, dosed according to the condition and functional capabilities of the patients, as well as a high-protein diet (1.0 g/kg/day). The Sports Complex (SC) of the N. N. Burdenko VSMU, as part of the program for the rehabilitation of the elderly, offers a course of 10 thematic classes organized in a scientifically based manner for this category of patients. Classes lasting 60 minutes are held 2 times a week for 6 months in a certain sequence. On the first day, a group is formed and an introductory lecture is held. Participants are explained the principles of the program, rules of conduct, individual wishes are taken into account. A medical examination is conducted by a doctor to identify health problems. The day ends with an introductory complex of therapeutic gymnastics and an introduction to the psychologist. The second session starts with therapeutic gymnastics and continues in the phytobar with a discussion of physiological changes in old age with basic recommendations. The third day includes therapeutic gymnastics in the gym and a talk on the prevention of aging of the musculoskeletal system, as well as an introductory chiropractic procedure. The fourth day includes a session in the swimming pool and discussion of the basics of proper nutrition and modern diets, principles of healthy lifestyle. The fifth session - discussion of techniques and performance of breathing exercises and inhalations. The sixth day - exercise machines, discussion about skin care and anti-cellulite massage, doctor's examination. The seventh session - dosed walking and a talk about its role in longevity. Eighth session - Nordic walking and a talk about its principles, pros and cons, a session with a psychologist. The program is completed by a walk in nature (ninth day) and a relaxation complex of therapeutic gymnastics (tenth day).

RESULTS. In the experimental group of patients suffering from sarcopenic obesity, statistically significant changes in anthropometry and quality of life were found after the rehabilitation course. There was a significant decrease in weight (from 90.1 kg to 84.2 kg; p < 0.001) and body mass index (BMI) (from 32.8 kg/m² to 30.9 kg/m²; p < 0.001). At the same time, after rehabilitation measures, there was a noticeable increase in absolute (from 14.8 kg to 16.2 kg; p < 0.001) and relative (from 16% to 22%; p < 0.001) muscle mass, as well as the MMI/BMI ratio (from 0.459 to 0.583; p < 0.001). The assessment of quality of life revealed a significant decrease in the overall score, which indicates an improvement in various aspects of life in these patients. Statistically significant changes in anthropometric indicators and quality of life assessment were also recorded in patients of the experimental group without sarcopenic obesity. There was a marked decrease in body weight (from 80.0 kg to 74.9 kg; p = 0.001) and BMI (from 28.2 kg/m² to 25.3 kg/m²; p < 0.001

 CONCLUSION. Regular physical activity, especially of an aerobic nature, stimulates the mechanisms of muscle tissue repair. In addition to building muscle mass, they have a positive effect on the functioning of the heart and blood vessels of the brain, which is especially important for overweight people.