Purpose: to make physical rehabilitation program for patients with chronic gastritis type B, promotes normalization of gastric secretory function and prolong the period of remission. Objectives of the study was to assess the dynamics of gastric secretory function and functional status of the autonomic nervous system in patients with the chronic gastritis type B . Material: the study involved 37 women with a diagnosis of the chronic gastritis type B, increased acid gastric function. Results: it was established the positive influence of corrective exercises for the lower thoracic and lumbar spine, regulated breathing exercises based on the tone of the autonomic nervous system in combination with massage and diet therapy on the state of gastric secretory function. Conclusions : it is recommended to carry out therapeutic physical culture in the form of morning hygienic gymnastics, therapeutic exercises, self-study

G. S. Urdina

I. V. Pelikh

S. A. Kalmykov

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 30    STUDY OF THE EFFICIENCY USE OF PHYSICAL REHABILITATION IN PATIENTS WITH CHRONIC GASTRITIS Kalmykov S.A., Urdina G.S., Pelikh I.V. Kharkov State Academy of Physical Culture  Annotation. Purpose: to make physical rehabilitation program for patients with chronic gastritis type B, promotes normalization of gastric secretory function and prolong the period of remission. Objectives of the study was to assess the dynamics of gastric secretory function and functional status of the autonomic nervous system in patients with the chronic gastritis type B. Material: the study involved 37 women with a diagnosis of the chronic gastritis type B, increased acid gastric function. Results: it was established the positive influence of corrective exercises for the lower thoracic  and  lumbar  spine,  regulated  breathing  exercises  based  on  the  tone  of  the  autonomic  nervous  system  in combination with massage and diet therapy on the state of gastric secretory function. Conclusions: it is recommended to carry out therapeutic physical culture in the form of morning hygienic gymnastics, therapeutic exercises, self-study. Keywords: physical rehabilitation, chronic gastritis, gastric secretory function.  Introduction1 Chronic gastritis (CG) is a chronic pluricausal inflammation-dystrophic disease of stomach’s mucosa with disordering of cells’ regeneration and progressing atrophy of stomach epithelium. CG is of the following kinds: A- auto-immune  CG,  B  –  bacterial,  C  –  chemically  conditioned  and  special  (rear)  forms  of  CG  (eosinophilic, granulomatous, lymphocyte, radiation and caused by some infections)  [8, 13, 14, 20].  Analysis of rehabilitations of CG patients permitted to determine that  in rehabilitation treatments’ system important  place  is  taken  by  therapeutic  physical  culture,  massage,  diet  therapy.  They  permit  to  weaken  disease, strengthen immunity and organism’s responsiveness [7, 15, 18, 19]. With chronic gastritis therapeutic physical culture methodic (TPC) of I.I. Parkhotic (2003), S.N. Popova (2005, 2008), V.A. Yepifanova (2006) et al. 1, 5, 9, 11, 16, 17 are used. At rehabilitation stages the following TPC form are applied: morning hygienic exercises, Terrainkur, walking, dozed run, outdoor games (volleyball, badminton, tennis), swimming,, rowing, skiing. However, existing programs of physical rehabilitation do not consider significant influence of vegetative innervations on secretory function of stomach. Normalization of stomach’s secretory function happens just after application of TPC means and is not durable. In literature there is no information about combined application of massage and physical exercises with this disease. Thus, all listed above conditions demand in working out and evaluation of effectiveness of new rehabilitation program, which would facilitate normalization of stomach’s secretory function and achievement of steady remission of B-type chronic gastritis.  The work has been fulfilled by direction of priority according to Law of Ukraine “On Directions of priority in development  of  science  and  engineering”,  number  3.5.  “Sciences  about  life,  new  technologies  of  prophylaxis  and treatment of the most frequent diseases” in frames of topic of protity 3.5.29. “Creation of standards and technologies of healthy life style’s implementation, technologies of increasing of food’s safety and quality”.  Purpose, tasks of the work, material and methods  The purpose of the research is to create program of physical rehabilitation for patients with chronic B-type gastritis, which would facilitate normalization of stomach’s secretory function and prolongation of remission period.  The tasks of the research were evaluation of dynamic of stomach secretory function’s indicators, functional status of vegetative nervous system of patients with chronic B-type gastritis.  The methods of the research: our researches were conducted from September 2013 to March 2014 in Kharkov municipal students’ hospital. Clinic examination of 37 women with chronic B-type gastritis and increased acid forming stomach’s function was the base of our research. They were divided in two groups: main group (MG – 19 patients) and control one (CG – 18 patients). Mean age of main group patients was 38.9±0.8 years old and in control group  – 39.4±0.6 years old. By quantity of patients, age and presence of diagnosed pathology main and control groups were homogeneous.  For evaluation of rehabilitation measures’ effectiveness we used results of tests of stomach's secretory function with the help of ph-metering with acid gastro-meter AGM-05K Gastroscan-5; also we used indicators of vegetative nervous system’s functional condition, measured with the help of ortho- and clinostatic tests 6, 10, 12. The received data were processed by mathematical statistic’s methods with the help of certified software STATISTICA-6,0.  Results of the research  Primary examination  was conducted before physical rehabilitation course. Patients of both groups showed disorders of stomach’s secretory function in form of hyper-acidity in combination with continuous acid forming (see table 1).                                                      © Kalmykov S.A., Urdina G.S., Pelikh I.V., 2014 doi: 10.5281/zenodo.10125  31 Table 1 Indicators of stomach secretion during primary examination (Мm) Indicators  Secretion  Norm Groups t  р MG, n=19  CG, n=18 Condition  of  acid formation in stomach On  an  empty stomach  1.6-2.0  1.28±0.06  1.23±0.05  0.57  0.05 stimulated  1.2-2.0  1.07±0.03  1.07±0.04  0.08  0.05  With ortho and clinostatic tests we found increased activity of parasympathetic section of VNS (57.9% of MG patients and 55.6% of CG patients. For prolongation of remission period of chronic B-type gastritis and normalization of stomach’s secretory function we worked out and applied in main group complex program of physical rehabilitation. Including therapeutic physical culture, massage and diet therapy. TPC was carried out in forms of morning hygienic exercises, therapeutic gymnastic,  independent  trainings.  The  basis  of  therapeutic  gymnastic  complexes  were  general  physical  exercises, exercises  for  correction  of  backbone  (mainly  lower  thoracic  sand  lumbar  spines)  and  dozed  breathing  exercises, considering  VNS  tonus,  executed  in  relaxed  state  and  in  walk.  At  poly-clinical  stage  in  main  group  we  applied therapeutic massage by methodic of P.B. Yefimenko (2013) 2. At poly-clinical stage in control group we applied TPC by methodic of O.I. Parkhotik (2003) and therapeutic massage by methodic of L.A. Kunichev (1985)  4, 9. Diet therapy  was  recommended  to  both  groups’  patients  –  table  No.16  by  M.I.  Pevzner  with  four  meals  a  day  3. Considering remission period of main disease, both groups’ patients were not cured with medicine 13, 15. After 4  months of physical rehabilitation certain changes  took place in general condition of both groups’ patients. During repeated examination we found improvement of stomach’s secretory function of both groups. Patients (see  table  2).  Patients  of  main  group  showed  normalization  of  acid  forming  on  empty  stomach  and  stimulated: accordingly 1.65±0.04 and 1.46±0.04 (р0.05). In control group improvement of acid forming function also took place, but stimulated secretion did not reached normal values. Besides, with repeated examination in MG normal acidity was diagnosed in 13 patients (68.4%), in CG – in 6 patients (33,3%); in MG stimulated acidity was found in 18 patients (94.7%), in CG – in 9 patients (50.0%).  Table 2 Indicators of stomach secretion during primary and repeated examinations in main and control groups  (Мm) Indicators  Secretion  Norm Periods of examination t  р  Primary  examination Repeated examination Main group  (n=19) Condition of acid formation in stomach On  an  empty stomach 1.6-2.0  1.28±0.06  1.65±0.04  5.53  0.05 stimulated  1.2-2.0  1.07±0.04  1.46±0.04  10.9  0.05 Control group (n=18) Condition of acid formation in stomach On  an  empty stomach 1.6-2.0  1.23±0.05  1.45±0.04  3.35  0.05 stimulated  1.2-2.0  1.07±0.04  1.16±0.03  6.59  0.05  When  comparing  repeated  indicators  of  acid  forming  on  empty  stomach  and  stimulated  one  we  found statistically significant improvement of main group’s indicators in comparison with control group that witnesses about more substantial influence of the offered physical rehabilitation program on  stomach’s secretory  function of  main group’s patient (see table 3).      32    Table 3 Comparative characteristic of stomach secretion’s indicators of main and control groups’ patients during repeated examination  (Мm) Condition of acid formation in stomach Groups t  р MG, n=19  CG, n=18 On and empty stomach  1.65±0.04  1.45±0.04  3.62  0.05 Stimulated  1.46±0.04  1.16±0.03  5.37  0.05  Application of physical rehabilitation means resulted in changes of functioning of vegetative nervous system’s sympathetic and parasympathetic sections. For example, balance of both VNS sections was registered in 73.7% of main group’s patients and in 22.2% of control group’s patients. Parasympathetic thonium took place in 10.5% of MG patients and  in  61.1%  of  CG  patients  (see  fig.1).  Thus,  application  of  dozed  breathing,  considering  activity  of  VNS parasympathetic an sympathetic sections facilitated progressing of  aethonium  of main group’s patients that, in its turn, facilitated normalization of stomach’s secretory function Condition of acid formation in stomach 8, 13.  D  F Fig.1. Activity of VNS sections of both groups’ patients in repeated examination (%): І –primary examination; ІІ –repeated examination;  А –sympathetic thonium, В – parasympathetic thonium; С – aethonium;  D –main group; F – control group   Conclusions:  For normalization of stomach’s secretory function in case of chronic B-type gastritis it is recommended to include in complexes of therapeutic gymnastic and independent trainings correcting physical exercises for backbone (mainly low thoracic and lumbar spines), dozed exercised, considering tonus of VNS in combination with therapeutic massage and diet therapy.  020406080І ІІ26,315,857,910,5 15,873,7 33 The prospects of further researches imply grounding, development and evaluation of effectiveness of physical rehabilitation program for patients with chronic A-type gastritis.  References: 1.  Epifanov V.A. Lechebnaia fizicheskaia kul'tura [Therapeutic physical culture], Moscow, GEOTAR-MED, 2006, pp. 249-262. 2.  Iefimenko  P.B.  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Study of the efficiency use of physical rehabilitation in patients with chronic gastritis

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