ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 48 of 67
УЖМБС 2020, 5(3): 359–365
Physical Therapy and Ergotherapy

Opportunities and Limitations of Physical Therapy in Teenagers with Arterial Hypertension

Ivanko O. G., Mikhalyuk E. L., Lyakhova I. N., Pidkova V. Ya., Puzik S. G., Tovma A. V., Levchenko L. I.

In modern conditions arterial hypertension occurs in 15% of teenagers aged 16-17 years, and according to some reports the number of such patients may be even 22%. It can be argued that the incidence of arterial hypertension in the contingent of young people is promoted by high psychoemotional and informational loads, poor nutrition with the consumption of excess sodium chloride, low physical activity, smoking and a hereditary predisposition. The purpose of the work was to improve the means of physical therapy in teenagers aged 16-17 with primary arterial hypertension, first detected during a routine examination, taking into account the individual characteristics of the course of the disease and its long-term prognosis. Material and methods. We conducted the study of blood pressure of more than 1700 first year students with the help of medical workers from the departments of pediatric and therapeutic profile of Zaporizhzhya State Medical University for 10 years. All these students were subsequently divided in clinical observation groups. At the screening stage, all teenagers had office blood pressure measured using the N. S. Korotkov method. Daily blood pressure and ECG monitoring, laboratory tests of urine and blood, echocardiography, sonography of the kidneys, adrenal, thyroid and ophthalmoscopy were also performed. The body mass index and physical performance were determined using the PWC170 bicycle ergometric submaximal test. Seven month long physical therapy program included exercises on a stationary bike 2 times a week for 50 minutes. Results and its discussion. The study results showed that with the highly probable development of adverse events in the near future, namely, chronic arterial hypertension and the development of left ventricular hypertrophy, it is appropriate to prescribe physical therapy in combination with medication, for example, with drugs like angiotensin II blockers (enalapril) or calcium channel blockers (amlodipine), which are compatible with physical activity and even with sports. Conclusion. The use of health-saving technologies, taking into account their capabilities and limitations, creates new prospects for providing medical care to adolescents with arterial hypertension, provided that the physical therapy program is carried out directly in the educational institution.

Keywords: teenagers, arterial hypertension, physical therapy

Full text: PDF (Ukr) 219K

  1. Flynn JT, Kaelber DC, Baker-Smith CM. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics. 2017 Sep; 140 (3): 1904-2017.
  2. Pakhomya NS, Uryasyev OM, Shakhanov AB. Rol polimorfizmov nekotorykh genov v realizatsii arterialnoy gipertenzii [The role of polymorphisms of certain genes in the implementation of arterial hypertension]. Zemsky Doctor. 2014; 3-4(24): 21-4. [Russian]
  3. Marushko YuV. Pervichnaya arterialnaya gipertenziya u detej i podrostkov: diagnostika i terapiya [Primary arterial hypertension in children and adolescents: diagnosis and therapy]. Medical Nature. 2017; 2(22): 31-3. [Russian]
  4. Maidannyk VH, Moskalenko VF, Koreniev MM. Pervynna arterialna hipertenziia u ditei i pidlitkiv [Primary arterial hypertension in children and adolescents]. Kyiv; 2006. 389 s. [Ukrainian]
  5. Woroniecki RP, Kahnauth A, Panesar LE, Supe-Markovina K. Left Ventricular Hypertrophy in Pediatric Hypertension: A Mini Review. Front Pediatr. 2017 Oct; 5(101): 1-7.
  6. Maggio AB, Aggoun Y, Martin XE, Marchand LM, Beghetti M, Farpour-Lambert NJ. Long-term follow-up of cardiovascular risk factors after exercise training in obese children. Int J Pediatr Obes. 2011 Jun; 6(22): e603-10.
  7. Bianchini JA, da Silva DF, Nardo CC, Carolino ID, Hernandes F, Nardo NJr. Multidisciplinary therapy reduces risk factors for metabolic syndrome in obese adolescents. Eur J Pediatr. 2013 Feb; 172(2): 215-21.
  8. Knowles G, Pallan M , Thomas GN, Ekelund U, Cheng KK, Barrett T. Physical Activity and Blood Pressure in Primary School Children. A Longitudinal Study. Hypertension. 2013 Jan; 61(1): 70-5.
  9. Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A. Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013 Jul; 31(7): 1281-357.
  10. Marushko YuV. Novi rekomendatsii shchodo diahnostyky i likuvannia arterialnoi hipertenzii u ditei: perevahy i perspektyvy [New guidelines for the diagnosis and treatment of hypertension in children: benefits and perspectives]. Dytiachyi likar. 2018; 3-4(60-61): 5-17. [Ukrainian]
  11. Maidannyk VH, Khaitovych MV, Hliebova LP. Diahnostyka ta likuvannia arterialnoi hipertenzii u ditei i pidlitkiv: Metodychni rekomendatsii [Diagnosis and treatment of hypertension in children and adolescents: Guidelines]. Mizhnarodnyi zhurnal pediatrii, akusherstva i hinekolohii. 2014; 6(1): 109-22. [Ukrainian]
  12. Lurbe E, Cifkova R, Cruickshank JK, Dillon MJ. European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertens. 2016 Sep; 34(10): 1887-920.
  13. Korenev NM, Bogmat LF, Nosova EM. Arterialnaya gipertenziya podrostkovogo vozrasta: rasprostranennost, mehanizmy formirovaniya, podhody k lecheniyu i dr [Adolescent arterial hypertension: prevalence, formation mechanisms, treatment approaches, etc.]. Ukr kardiol zhurn. 2010; 1: 57-64. [Russian]
  14. Porter TR, Mulvagh SL, Abdelmoneim SS. Clinical Applications of Ultrasonic Enhancing Agents in Echocardiography: 2018 American Society of Echocardiography Guidelines Update. J Am Soc Echocardiogr. 2018 Mar; 31(3): 241-74.
  15. Muharlyamov FM. Mehanizmy fizicheskoj reabilitacii pri arterialnoj gipertenzii [The mechanisms of physical rehabilitation for arterial hypertension]. Serdce. 2008; 6(44): 346-8. [Russian]
  16. Ivanko OH, Mykhaliuk YeL, Pidkova VIa, Nedelska YeV. Fizychna reabilitatsiia pidlitkiv 16-17 rokiv iz arterialnoiu hipertenziieiu z vykorystanniam velotrenazheru v umovakh navchalnoho zakladu: Metodychni rekomendatsii [Physical rehabilitation of adolescents 16-17 years of age with hypertension using an exercise bike in an educational setting: Guidelines]. Dytiachyi likar. 2015; 3-4(40-41): 9-22. [Ukrainian]
  17. Mykhaliuk YeL, Malakhova SM, Levchenko LI. Vprovadzhennia suchasnykh monitoriv pulsu v ozdorovchi trenuvannia studentiv z pervynnoiu arterialnoiu hipertenziieiu [Implementation of modern pulse monitors in wellness training of students with primary hypertension]. Visnyk Chernihivskoho natsionalnoho pedahohichnoho universytetu im TH Shevchenka. 2013; 112(1): 223-5. [Ukrainian]
  18. Ivanko OG, Mihalyuk EL, Nedelskaya EV. Metodicheskoe obosnovanie programmy fizicheskoj reabilitacii arterialnoj gipertenzii u studentov pervyh kursov medicinskogo universiteta [Methodological substantiation of the program of physical rehabilitation of arterial hypertension in first-year students of medical university]. Zaporozh med zhurn. 2013; 1: 67-9. [Russian]
  19. Patent 90071 Ukraine, МПК A61B 5/00 (2006.01). Sposib provedennia likarsko-pedahohichnykh sposterezhen [Method of conducting medical-pedagogical observations] / Mykhaliuk YeL, Ivanko OH, Malakhova SM. (UA); zayavnik i vlasnik patentu Zaporizkyi derzhavnyi medychnyi universytet (UA). № u201314616, zayavl 13.12.13; opubl 12.05.14. [Ukrainian]
  20. Smolenskij AV, Miroshnikov AB. Novye podhody k fizicheskoj reabilitacii bolnyh arterialnoj gipertoniej s ispolzovaniem trenazhernyh ustrojstv [New approaches to physical rehabilitation of patients with arterial hypertension using training devices]. Sportivna medicina. 2014; 1: 13-7. [Russian]
  21. Muharlyamov FYu, Ivanova ES. Novye podhody k ispolzovaniyu metodov fizicheskoj reabilitacii u bolnyh arterialnoj gipertenziej [New approaches to the use of physical rehabilitation methods in patients with arterial hypertension]. Fizioterapevt. 2014; 2: 58-61. [Russian]
  22. Miroshnikov AB. Fizicheskaya reabilitaciya bolnyh gipertonicheskoj boleznyu (obzor literatury) [Physical rehabilitation of patients with hypertension (literature review)]. Terapevt. 2014; 5: 76-81. [Russian]
  23. Golovunina IS. Popov SN, Muharlyamov FYu. Sovremennye tehnologii i obosnovanie formirovaniya programm fizicheskoj reabilitacii s ispolzovaniem ciklicheskih i silovyh trenazherov u bolnyh gipertonicheskoj boleznyu [Modern technologies and the rationale for the formation of physical rehabilitation programs using cyclic and power simulators in patients with hypertension]. Lechebnaya fizkultura i sportivnaya medicina. 2012; 1: 27-33. [Russian]