Pre-illness in geriatrics: rehabilitation issues

ВACKGROUND: Changes in the body, such as sarcopenia and sarcopenic obesity, are common in people with chronic heart failure, which complicates the course of the disease and worsens the prognosis.

АIM: Evaluation of the effectiveness of the proposed rehabilitation method, which includes a hypocaloric but protein-rich diet, individually selected physical activity and breathing exercises for patients with pre-disease-pre-stage CHF.

MATERIALS AND METHODS: The study involved 80 patients over 50 years of age, treated in the endocrinology department of the State Healthcare Institution of the Voronezh Regional Clinical Hospital No. 1, the observation lasted 6 months. The SARC-F questionnaire was used for the primary diagnosis of sarcopenia. The Katz index, clinical frailty scale (CFS), grip strength (HGS), SPPB test battery and 6-minute walking distance (6MWD) were also assessed. Patients were divided into 4 groups: the main group (with and without sarcopenic obesity) and the control group (with and without sarcopenic obesity).

RESULTS: In the first group of patients, after rehabilitation, there was a significant decrease in weight (from 89.7 kg to 82.9 kg; p <0.001) and BMI (33.3 kg/m² to 31.1 kg/m²; p <0.001), accompanied by an increase in absolute (from 15.3 kg to 16.7 kg; p <0.001) and relative muscle mass (from 17% to 21.5%; p <0.001), as well as an improvement in the BMI/BMI ratio (from 0.461 to 0.572; p <0.001). Improvement in quality of life was noted. In the second group, a decrease in weight (from 79.9 kg to 75.0 kg; p=0.001) and BMI (from 27.4 kg/m² to 26.3 kg/m²; p <0.001) was also recorded.

CONCLUSION: The rehabilitation program proved to be successful both for patients with and without sarcopenic obesity, in terms of improving the muscular component of body composition and quality of life, and preventing the development of the nosology of chronic heart failure.