Issue №4-22, 2023

Effectiveness of Complex Medical Rehabilitation of Patients with Postthrombophlebitic Syndrome of Lower Extremities and Obesity: a Randomized Clinical Study

¹ Tatiana V. Konchugova, ¹ Anantoliy D. Fesyun, ¹ Tatyana V. Apkhanova, ¹ Detelina B. Kulchitskaya, ¹ Valeriia A. Vasilieva, ¹ Olga V. Yurova,¹ Valentina A. Morunova

¹National Medical Research Center for Rehabilitation and Balneology, Moscow, Russian Federation

ABSTRACT

INTRODUCTION. The relevance of the development of comprehensive rehabilitation programmes for patients with postthrombophlebitic syndrome (PTPS) is due to the high frequency of disability and a significant reduction in their quality of life. Since obesity and excessive body weight are proven risk factors for the development and progression of chronic vein diseases, weight reduction is one of the important tasks of rehabilitation measures in patients with PTPS and concomitant obesity.
AIM. Comparative study of the influence of complex methods of medical rehabilitation, including various methods of laser blood irradiation (supravascular and intravenous), pulse magnetotherapy and dry carbon baths, on the dynamics of indicators of composite body composition according to bioimpedance measurements in patients with postthrombophlebitic syndrome of the lower extremities and obesity.
MATERIALS AND METHODS. A randomized prospective study was conducted on the basis of the Department of Medical Rehabilitation of Patients with Somatic Diseases of National Medical Research Center of Rehabilitation and Balneology of the Ministry of Health of Russia. The study included 40 patients with PTS of the lower extremities and accompanying obesity, the average age of which was 58.3 [51.5; 68.0] year), randomized to two groups. The patients of the 1st group received Intravenous laser blood irradiation (ILIB) (“Lazmik”, Russia), impulse magnetotherapy and dry carbon baths, as well as therapeutic gymnastics in the hall. The patients of the 2nd group received a complex that included supravascular laser irradiation of blood (“Azor-2K”, Russia), pulse magnetic therapy, and dry carbon baths, as well as therapeutic gymnastics in the gym. Anthropometric measurements (body mass, malleolar volume) were used for the evaluation of anti-edema and lipolytic effects after a comprehensive course of medical rehabilitation, as well as bioimpedance measurement of body composition (“MEDASS”, Russia).
RESULTS. In patients with PTS of the lower extremities and obesity, after carrying out a course of medical rehabilitation using preformed physical factors, including various methods of laser irradiation of the blood (supravascular and intravenous), a significant decrease in body weight indicators was observed (p < 0.001), a decrease in BMI (p < 0.001), total and extracellular fluid (p < 0.001) without significant differences between groups. A significant decrease in the index of fat mass (kg) (p = 0.007) was found in patients of the main group.
DISCUSSION. Maintaining a healthy body weight as well as combating obesity are first-line secondary prevention measures recommended for all patients with PTS of the lower extremities. For the control of the dynamics of the composite composition of the body, an effective and sensitive method is the method of bioimpedance measurement, which allows to estimate the reduction of extracellular fluid (anti-flow effect) and fat mass of the body (lipolytic effect).
CONCLUSION. The method of bioimpedance measurement, used for the evaluation of the composite composition of the body, showed high sensitivity and allowed to establish the greater effectiveness of the developed complex, which includes ILIB with a wavelength of low-intensity laser radiation (NILI) of 635 nm in reducing fat mass.

KEYWORDS: chronic venous diseases, postthrombophlebitic syndrome, obesity, bioimpedance measurement, body composition

Acknowledgments: The study had no sponsorship.

Conflict of interest:: The authors declare no apparent or potential conflicts of interest related to the publication of this article.

For citation: Konchugova T.V., Fesyun A.D., Apkhanova T.V., Kulchitskaya D.B., Vasileva V.A., Yurova O.V., Morunova V.A.
Effectiveness of Complex Medical Rehabilitation of Patients with Postthrombophlebitic Syndrome of Lower Extremities and Obesity: a Randomized Clinical Study. Bulletin of Rehabilitation Medicine. 2023; 22(4):71-79. https://doi.org/10.38025/2078-1962-2023-22-4-71-79 (In Russ.). 

For correspondence:  Valeriia A. Vasileva, Е-mail: VasilevaVA@nmicrk.ru

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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.