Issue №6-21, 2022

https://doi.org/10.38025/2078-1962-2022-21-6-99-109

The Use of Terrain Cure in the Treatment and Rehabilitation of Patients with Cardiovascular Diseases: a Review

View article (Download PDF file)



Download XML file

1 ORCIDTatiana A Knyazeva, 1 ORCIDTatiana I. Nikiforova, 2 ORCIDAndrey A. Lobanov

1 National Medical Research Center of Rehabilitation and Balneology, Moscow, Russian Federation
2 I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia, Center for Bioelementology and Human Ecology, Moscow, Russian Federation


ABSTRACT

INTRODUCTION. The review is devoted to the study of one of the modern complex methods of treatment and rehabilitation of patients with cardiovascular diseases – terrain cure which includes elements of therapeutic physical training, climatotherapy and provides for dosed physical activity in the form of hiking in rough terrain, climbing in mountainous areas on specific, marked routes under the supervision of a doctor. It is a method of exercise therapy that improves endurance, cardiovascular, respiratory and nervous system function, metabolism, as well as the muscles of the limbs and trunk.

AIM. To highlight the mechanisms of the complex action of terrain cure, combining elements of climatotherapy and metered physical activity for the most optimal use in patients with pathology of the cardiovascular system, including those with excess body weight.

MATERIAL AND METHODS. The analysis of publications in the electronic databases PubMed and the Russian Scientific Citation Index by keywords: terrain cure , metered physical activity, climatotherapy, rehabilitation, cardiovascular diseases. The date of the last search is August 9, 2022.

CONCLUSION. The world and domestic scientific and practical experience of the use of terrain cure testifies to its high efficiency and an increase in the adaptive and compensatory potential of the patient's body, the safety of using this method in both preventive and therapeutic and rehabilitation programs, due to the main mechanisms of its rehabilitative action. Taking into account its wide availability, cost-effectiveness and additional therapeutic effects when in contact with the terrain, it seems advisable to expand the introduction of the terrain cure and use it for preventive purposes not only in sanatorium–resort conditions, but also in the urban environment – parks and other recreation areas of citizens.


KEYWORDS: terrain cure, physical activity, climatotherapy, cardiovascular diseases

For citation: Knyazeva T.A., Nikiforova T.I., Lobanov A.A. The Use of Terrain Cure in the Treatment and Rehabilitation of Patients with Cardiovascular Diseases: a Review. Bulletin of Rehabilitation Medicine. 2022; 21 (6): 99-109. https://doi.org/10.38025/2078-1962-2022-21-6-99-109



References:

  1. World Health Organization. Non-communicable diseases: key facts. 2021. https://www.who.int/news-room/fact-sheets/detail/noncommunicablediseases. Available at: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases (accessed 21.10. 2021).
  2. Adam Timmis, Panos Vardas, Nick Townsend, Aleksandra Torbica, Hugo Katus, Delphine De Smedt, Chris P. Gale, Aldo P. Maggioni, Steffen E. Petersen, Radu Huculeci, Dzianis Kazakiewicz, Victor de Benito Rubio, Barbara Ignatiuk, Zahra Raisi-Estabragh, Agnieszka Pawlak, Efstratios Karagiannidis, Roderick Treskes, Dan Gaita, John F. Beltrame, Alex McConnachie, Isabel Bardinet, Ian Graham, Marcus Flather, Perry Elliott, Elias A. Mossialos, Franz Weidinger, Stephan Achenbach, Atlas Writing Group, European Society of Cardiology: cardiovascular disease statistics 2021. European Heart Journal. 2022: 8(43): 716-799. https://doi.org/10.1093/eurheartj/ehab892
  3. Go A.S., Mozaffarian D., Roger V. L., Benjamin E. J., Berry D. D., Blaha M. J. et al. Executive Summary: Heart Disease and Stroke Statistics—2014 Update: report of the American Heart Association. Circulation. 2014: 129(3): 399-410. https://doi.org/10.1161/01.cir.0000442015.53336.12
  4. Kyu H.H., Bachman V.F., Alexander LT. et al. Physical activity and risk of breast cancer, colon cancer, diabetes, coronary heart disease and isch- emic stroke: a systematic review and dose-response meta-analysis for the 2013 Global Burden of Disease study. The BMJ. 2016; (354): i3857. https://doi.org/10.1136/bmj.i3857
  5. Ekelund U., Tarpaulin J., Steen-Johannes J. et al. Dose-response relationships between accelerometry-measured physical activity and sedentary life- style time and all-cause mortality: a systematic review and a consistent meta-analysis. The BMJ. 2019; (366): l4570. https://doi.org/10.1136/bmj.l4570
  6. Ming Zhao, Srinivas P. Veranki, Kostan G. Magnussen, Bo Xi. Recommended physical activity and all causes and causes of mortality among adults in the USA: prospective cohort study. The BMJ. 2020: (370): m2031. https://doi.org/10.1136/bmj.m2031
  7. Kinoshita M., Yokote K., Arai H. et al. Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2017. Journal of Atherosclerosis and Thrombosis. 2018; 25(9): 846-984. https://doi.org/10.5551/jat.GL2017
  8. Hansen D., Dendale P., Koninks K., Vanhees L., Piepoli M.F., Niebauer J., Cornelissen V., Pedretti R., Hertz E., Ruiz G.R., Corra Y., Schmid J.P., Greco E., Davos Ch., Edelmann F., Abreu A., Rauch B., Ambrosetti M., Braga S.S., Barna O. et al. The European Association of Preventive Cardiology tool for prescribing exercises in daily practice and rehabilitation training (EXPERT): A digital training and decision support system for optimizing the appointment of exercises in cardiovascular diseases. Concept, definitions and methodology of construction. European Heart Journal to Cardiology. 2017; 24(10): 1017-1031. https://doi.org/10.1177/2047487317702042
  9. Bilo G., Villafuerte F.S., Faini A., Anza-Ramirez S., Revera M., Giuliano A., Caravita S., Gregorini F., Lombardi S., Salvioni E. et al. Outpatient blood pressure in untreated and treated patients with hypertension at high altitude: A study of the cardiovascular system at high altitude-Andes study. Journal of Hypertension. 2015 ; (65): 1266-1272.
  10. Kanayama H., Kusaka Y., Hirai T., Inoue H., Agis and Y., Shuk A. Climatotherapy in Japan: a pilot study. International Journal of Biometeorology. 2017; 61(12): 2141-2143. https://doi.org/10.1007/s00484-017-1418-x
  11. Wang L., Ai D., Zhang N. Dosing and prescribing exercise is a Safe Game: Dangers and Recipes. Advances in Experimental Medicine and Biology. 2017; (1000): 357-387. https://doi.org/10.1007/978-981-10-4304-8_19
  12. Lobanov A.A., Bobrovnitsky I.P., Uyanaeva A.I., Yakovlev M.Yu., Andronov S.V., Grishechkina I.A., Nikitin M.V., Fesyun. A.D. Climatotherapy. In the book The Scientific and Practical Guide for Doctors «Sanatorium and Spa Treatment». Moscow. LLC «Renovation». 2022; (1): 83-114 (In Russ.).
  13. Bokeria L.A., Aronov D.M. Coronary bypass surgery in patients with coronary heart disease: rehabilitation and secondary prevention. Russian clinical guidelines. Moscow. 2016. (In Russ.).
  14. Knyazeva T.A., Nikiforova T.Y., Eremushkin M.A., Styazhkina E.M., Shchukina I.M. Improving the efficiency of cardiorehabilitation the inclusion of methods of metabolic adaptation of ischemic myocardium. Bulletin of Rehabilitation Medicine. 2019; 3(91): 34-39 (In Russ.).
  15. Sakib Z.A., Dai J., Minhas R., Mahmoud S., Karim M., Sang H., Wang Yu. Physical Activity is a Medicine for Non-Communicable Diseases: A Survey Study Regarding the Perception of Physical Activity Impact on Health Wellbeing. Risk Management and Healthcare Policy. 2020; (13): 2949-2962. https://doi.org/10.2147/RMHP.S280339
  16. Nasi M., Patrizi G., Pizzi S., Landolfo M., Boriani G., Dei Cas A., Cicero A.F., Fogacci F., Rapezzi S., Sisca G., Capucci A., Vitolo M., Galie N., Borgi S., Berrettini U., Piepoli M., Mattioli A.V. The role of physical activity in individuals with cardiovascular risk factors: an opinion paper from Italian Society of Cardiology-Emilia Romagna-Marche and SIC-Sport. Journal of Cardiovascular Medicine. 2019; 20(10): 631-639. https://doi.org/10.2459/JCM.0000000000000855
  17. Vella K.A., Taylor K., Drummer D. High-intensity interval and moderate-intensity continuous training elicit similar enjoyment and adherence levels in overweight and obese adults. European Journal of Sport Science. 2017; 17(9): 1203-1211. https://doi.org/10.1080/17461391.2017.1359679
  18. Barashkov G.N., Sergeev V.N., Karamnova N.S. Terrencures and physical training by walking: rehabilitation – preventive aspects. Profilakticheskaya Meditsina. 2021: 24(5):87-93 (In Russ.).
  19. Schobersberger W., Leichtfried V., Mueck-Weyman M., Humpeler E. Austrian Moderate Altitude Studies (AMAS): benefits of exposure to moderate altitudes (1,500–2,500 m). Sleep and Breathing. 2010; (14): 201-207. https://doi.org/10.1007/s11325-009-0286-y
  20. Faulhaber M., Flatz M., Gatterer H., Shobersberger W., Burtscher M. Prevalence of Cardiovascular Diseases Among Alpine Skiers and Hikers in the Austrian Alps. High Altitude Medicine & Biology. 2007; (8): 245-252. https://doi.org/10.1089/ham.2007.1005
  21. Faulhaber M., Gatterer H., Bertscher M. Preexisting Cardiovascular Diseases Among High-Altitude Mountaineers in the Alps. Journal of Travel Medi- cine. 2011; (18): 355-357. https://doi.org/10.1111/j.1708-8305.2011.00536.x
  22. Bercher M. Risk of cardiovascular events during mountain activities. Advances in Experimental Medicine and Biology. 2007; (618): 1-11.
  23. Stoltzfus K.B., Naylor D., Cattermole T., Ankeny A., Mount R., Chang R., Gibson C.A. Blood Pressure Changes While Hiking at Moderate Altitudes: A Pro- spective Cohort Study. International Journal of Environmental Research and Public Health. 2020; 17(21): 7978. https://doi.org/10.3390/ijerph17217978
  24. Parati G., Agostoni P., Basnyat B., Bilo G., Brugger H., Coca A., Festi L., Giardini G., Lironcurti A., Luks A.M. et al. Clinical recommendations for high altitude exposure of individuals with pre-existing cardiovascular conditions: A joint statement by the European Society of Cardiology, the Council on Hypertension of the European Society of Cardiology, the European Society of Hypertension, the International Society of Mountain Medicine, the Italian Society of Hypertension and the Italian Society of Mountain Medicine. European Heart Journal. 2018; 39(17): 1546-1554. https://doi.org/10.1093/eurheartj/ehx720
  25. Festa A., D'Agostino R., Howard G., Mykkänen L., Tracy R.P., Haffner S.M. Chronic Subclinical Inflammation as Part of the Insulin Resistance Syndrome. The Insulin Resistance Atherosclerosis Study (IRAS). Circulation. 2000; (102): 42-47.
  26. Schlaich M., Straznicky N., Lambert E., Lambert G. Metabolic syndrome: a sympathetic disease? The Lancet Diabetes & Endocrinology. 2015; (3): 148-157.
  27. Carnagarin R., Mathews V., Zaldivia M.T.K., Peter K. and Schleich M.P. The bidirectional interaction between the sympathetic nervous system and immune mechanisms in the pathogenesis of hypertension. British Journal of Pharmacology. 2019; 176(12): 1839-1852. https://doi.org/10.1111/bph.14481
  28. Li G., Liu J.Y., Zhang H.X., Li Q., Zhang S.W. Exercise training attenuates sympathetic activation and oxidative stress in diet-induced obesity. Physiological Research. 2015; (64): 355-367.
  29. Peichenen-Alkho M.K., Mankhem K., Katsman P., Kibarskis A., Antikainen R.L., Erkkola R.U. et al. Central sympatholytic therapy has anti-inflammatory properties in postmenopausal women with hypertension. Journal of Hypertension. 2008; (26): 2445-2449.
  30. Chazova I., Almazov V.A., Shlyakhto E. Moxonidine improves glycaemic control in mildly hypertensive, overweight patients: a comparison with metformin. Diabetes, Obesity and Metabolism. 2006; 8(4): 456-465.
  31. Panchapakesan U., Pegg K., Gross S., Komala M.G., Mudaliar X., Forbes J., Pollock C., Mather A. Effects of SGLT2 inhibition in human kidney proximal tubular cells--renoprotection in diabetic nephropathy? PLoS One. 2013; 8(2): e54442.
  32. Matthews V.B., Elliot R.H., Rudnicka C., Hricova J., Herat L., Schlaich M.P. Role of the sympathetic nervous system in regulation of the sodium glucose cotransporter 2. Journal of Hypertension. 2017; 35(10): 2059-2068.
  33. Arita Y., Kihara S., Ouchi N., Takahashi M., Maeda K., Miyagawa J. et al. Paradoxical Decrease of an Adipose-Specific Protein, Adiponectin, in Obesity. Biochemical and Biophysical Research Communications. 1999; 257(1): 79-83. https://doi.org/10.1006/bbrc.1999.0255
  34. Qiao L., Zou C., van der Westhuizen D.R., Shao J. Adiponectin Reduces Plasma Triglyceride by Increasing VLDL Triglyceride Catabolism. Diabetes. 2008; 57(7): 1824-33. https://doi.org/10.2337/db07-0435
  35. Matsuura F., Oku H., Koseki M., Sandoval J.C., Yuasa-Kawase M., Tsubakio-Yamamoto K. et al. Adiponectin accelerates reverse cholesterol transport by increasing high density lipoprotein assembly in the liver. Biochemical and Biophysical Research Communications. 2007; 358(4): 1091-1095. https://doi.org/10.1016/j.bbrc.2007.05.040
  36. Oku H., Matsuura F., Koseki M., Sandoval J.C., Yuasa-Kawase M., Tsubakio-Yamamoto K. et al. Adiponectin deficiency suppresses ABCA1 expression and ApoA-I synthesis in the liver. FEBS Letters. 2007; 581(26): 5029-5033. https://doi.org/10.1016/j.febslet.2007.09.038 37.
  37. Ryo M., Nakamura T., Kihara S., Kumada M., Shibazaki S., Takahashi M. et al. Adiponectin as a biomarker of metabolic syndrome. Circulation Journal. 2004; 68(11): 975-81. https://doi.org/10.1253/circj.68.975
  38. Mattu H.S., Randeva H.S. Role of adipokines in cardiovascular disease. Journal of Endocrinology. 2013; 216(1): T17-36. https://doi.org/10.1530/JOE-12-0232
  39. Schindlert T.H., Cardenas J., Pryor J.O., Fact A.D., Kreissl M.C., Zhang X.L. et al. Relationship Between Increasing Body Weight, Insulin Resistance, Inflammation, Adipocytokine Leptin, and Coronary Circulatory Function. Journal of the American College of Cardiology. 2006; (47): 1188-95. https://doi.org/10.1016/j.jacc.2005.10.062
  40. Gruzdeva O., Uchasova E., Belik E., Dyleva Y., Shurygina E., Barbarash O. Lipid, adipokine and ghrelin levels in myocardial infarction patients with insulin resistance. BMC Cardiovascular Disorders. 2014; 14(7). https://doi.org/10.1186/1471-2261-14-7
  41. Vissers D., Hens W., Taeymans J., Baeyens J.P., Poortmans J., Van Gaal L. The effect of exercise on visceral adipose tissue in overweight adults: a systematic review and meta-analysis. PloS One. 2013; 8(2): e56415.
  42. Pattyn N., Cornelissen V.A., Eshghi S.R.T., Vanhees L. The effect of exercise on the cardiovascular risk factors constituting the metabolic syndrome: a meta-analysis of controlled trials. Sports Medicine. 2013; 43(2): 121-33. https://doi.org/10.1007/s40279-012-0003-z
  43. Gruzdeva O., Uchasova E., Belik E., Dyleva Yu., Shurygina E., Barbarash O. Lipid, adipokine and ghrelin levels in myocardial infarction patients with insulin resistance. BMC Cardiovascular Disorders. 2014; (14): 7. https://doi.org/10.1186/1471-2261-14-7
  44. Golbidi S., Laher I. Exercise Induced Adipokine Changes and the Metabolic Syndrome. Journal of Diabetes Research. 2014; (2014): 726861. https://doi.org/10.1155/2014/726861
  45. Pattin N., Kornelissen V.A., Eshgi S.R., Vanhis L. The Effect of Exercise on the Cardiovascular Risk Factors Constituting the Metabolic Syndrome. Sports Medicine. 2013; (43): 121-33. https://doi.org/10.1007/s40279-012-0003-z
  46. Pescatello L.S., Blanchard B.E., Van Hist J.L., Marech K.M., Gordisch-Dressman H., Thompson P.D. The Metabolic Syndrome and the immediate antihypertensive effects of aerobic exercise: a randomized control design. BMC Cardiovascular Disorders. 2008; (8): 12. https://doi.org/10.1186/1471-2261-8-12
  47. Boyer S.J., Blum F D. Weight loss and changes in body composition at high altitude. Journal of Applied Physiology. 1984; (57): 1580-5.
  48. Wu T-Y., Ding Q., Liu J.L., Yu M.T., Jia J.H., Chai Z.C. et al. Who Should Not Go High: Chronic Disease and Work at Altitude During Construction of the Qinghai-Tibet Railroad. High Altitude Medicine & Biology. 2007; 8(2): 88-107. https://doi.org/10.1089/ham.2007.1015
  49. Ri-Li G., Chase P.J., Witkowski S., Wyrick B.L., Stone J.A., Levine B.D., Babb G.T. Obesity: Associations with Acute Mountain Sickness. Annals of Internal Medicine. 2003; (139): 253-7. https://doi.org/10.7326/0003-4819-139-4-200308190-00007
  50. Zheqing Cai, Weibo Luo, Huiwang Zhan, Gregg L. Semenza. Hypoxia-inducible factor 1 is required for remote ischemic preconditioning of the heart. PNAS. 2013; (110): 17462-7. https://doi.org/10.1073/pnas.1317158110 51.
  51. Netzer N.C., Chytra R., Küpper T. Low intense physical exercise in normobaric hypoxia leads to more weight loss in obese people than low intense physical exercise in normobaric sham hypoxia. Sleep and Breathing. 2008; (12): 129-34. https://doi.org/10.1007/s11325-007-0149-3
  52. Workman C., Basset F.A. Post-metabolic response to passive normobaric hypoxic exposure in sedendary overweight males: a pilot study. Nutrition & Metabolism. 2012; (9): 103. https://doi.org/10.1186/1743-7075-9-103
  53. Anne-Christin Stöwhas, Tsogyal D. Latshang, Christian M. Lo Cascio, Sina Lautwein, Katrin Stadelmann, Noemi Tesler, Lisa Ayers, Kaspar Berneis, Philipp A. Gerber, Reto Huber, Peter Achermann, Konrad E. Bloch, Malcolm Kohler. Effects of Acute Exposure to Moderate Altitude on Vascular Function, Metabolism and Systemic Inflammation. PLoS One. 2013; (8): e70081. https://doi.org/10.1371/journal.pone.0070081
  54. Kiave Yune Howangyin, Jean-Sébastien Silvestre. Diabetes Mellitus and Ischemic Diseases Molecular Mechanisms of Vascular Repair Dysfunction. Arteriosclerosis, Thrombosis, and Vascular Biology. 2014; (34): 1126-35. https://doi.org/10.1161/ATVBAHA.114.303090
  55. Martin Burtscher. Effects of Living at Higher Altitudes on Mortality: A Narrative Review. Aging and Disease. 2014; (5): 274-80. https://doi.org/10.14336/AD.2014.0500274
  56. Wolfgang Schobersberger, Peter Schmid, Monika Lechleitner, Serge P. von Duvillard, Helmut Hörtnagl, Hanns-Christian Gunga, Anton Klingler, Dietmar Fries, Karl Kirsch, Reinhard Spiesberger, Rochus Pokan, Peter Hofmann, Fritz Hoppichler, Gebhard Riedmann, Holger Baumgartner, Egon Humpeler. Austrian Moderate Altitude Study 2000 (AMAS 2000). The effects of moderate altitude (1,700 m) on cardiovascular and metabolic variables in patients with metabolic syndrome. European Journal of Applied Physiology. 2003; 88(6): 506-14. https://doi.org/10.1007/s00421-002-0736-8
  57. Greie S., Humpeler E., Gunga H.C., Koralewski E., Klingler A., Mittermayr M., Fries D., Lechleitner M., Hoertnagl H., Hoffmann G., Strauss-Blasche G., Schobersberger W. Improvement of metabolic syndrome markers through altitude specific hiking vacations. Journal of Endocrinological Investigation. 2006; 29:497-504. https://doi.org/10.1007/BF03344138
  58. Johannes Mair, Angelika Hammerer-Lercher, Markus Mittermayr, Anton Klingler, Egon Humpelere, Otmar Pachinger, Wolfgang Schobersberger. 3-week hiking holidays at moderate altitude do not impair cardiac function in individuals with metabolic syndrome. International Journal of Cardiology. 2008; (123): 186-8. https://doi.org/10.1016/j.ijcard.2006.11.127 59.
  59. Tobias Dünnwald, Hannes Gatterer, Martin Faulhaber, Marjan Arvandi, Wolfgang Schobersberger. Body Composition and Body Weight Changes at Different Altitude Levels: A Systematic Review and Meta-Analysis. Frontiers in Physiology. 2019; (10): 430. https://doi.org/10.3389/fphys.2019.00430
  60. Chacaroun S., Borowik A., Vega-Escamilla Y. Gonzalez I., Doutreleau S., Wuyam B., Belaidi E., Tamisier R., Pepin J-L., Flore P., Verges S. Hypoxic Exercise Training to Improve Exercise Capacity in Obese Individuals. Medicine & Science in Sports & Exercise. 2020; 52(8): 1641-1649. https://doi.org/10.1249/mss.0000000000002322



Creative Commons License
The content is available under the Creative Commons Attribution 4.0 License.

©

Эта статья открытого доступа по лицензии CC BY 4.0. Издательство: ФГБУ «НМИЦ РК» Минздрава России.
This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.

Aссоциация НАЭСКЛ