DYNAMICS OF ANTHROPOMETRIC AND PHYSICAL MARKERS OF SARCOPENIC OBESITY IN ELDERLY PERSONS WITH OSTEOARTHRITIS OF THE HIP IN THE PROCESS OF PHYSICAL THERAPY
Authors: Kravets A. S. 
Published: October 2024

Purpose: to determine the effect of a physical therapy program on anthropometric and physical indicators of elderly people with osteoarthritis of the hip, which occurs against the background of sarcopenic obesity.
Material. 68 elderly people with osteoarthritis of the hip and sarcopenic obesity and 36 of their healthy peers (control group) were examined. Representatives of the comparison group (33 persons) corrected the signs of osteoarthritis according to the clinical guideline "Osteoarthrosis". Representatives of the main group (35 persons) were engaged in a physical therapy program for six months. Its goal was: reduction of pain and discomfort in the hip; improvement of the amplitude of movements in the hip, joints of the lower limbs, spine; optimization of general mobility and motor stereotype; decrease of body weight; facilitating activities of daily living; improvement of geriatric status. The physical therapy was implemented in rehabilitation center and in the form of telerehabilitation. It included kinesitherapy, Proprioceptive Neuromuscular Facilitation of the lower limbs and lower back; massage, kinesiological taping of the hip, thigh and lower back muscles; a course of shock wave therapy of the hip, nutritional correction, education of patients and their family members. The effectiveness of the program was evaluated by the dynamics of anthropometry (mass, body mass index, waist and hip circumferences and their ratio), body composition (fat content, muscle tissue, visceral fat), sarcopenia markers (hand dynamometry, Short Physical Performance Battery).
Results. Application of the physical therapy program led to a decrease in body weight in patients of the main group: in men by 5.4 kg, in women by 4.51 kg, p<0.05. Corresponding changes occurred in body mass index, and the women of the main group reached the level of overweight. The dynamics of the abdominal nature of obesity also changed: the decrease in waist circumference in men was 8.3 cm, in women - 5.9 cm, which had a favorable effect on the ratio of waist and hip circumferences. A decrease in the severity of the signs of sarcopenia in main group persons was confirmed by the results of a statistically significant increase in the content of muscle tissue both in men (from 22.17±1.30% to 28.12±1.09%) and in women (from 19, 01±1.20% to 23.44±1.15%). The content of visceral fat in the subjects of the main group decreased by almost 25%. The content of adipose tissue in the whole body decreased in men from 42.29±1.73% to 34.50±1.22%, in women – from 46.53±1.19% to 40.57±1.57%. The increase in hand dynamometry results in women was from 13.48±1.14 kg to 17.22±0.56 kg, in men - from 19.80±1.07 kg to 26.15±1.01 kg.
The complex nature of the physical therapy program contributed to the improvement of performance of all Short Physical Performance Battery subtests in the main group, and the improvement of its total score was 35.5% (from 6.49±0.53 points to 10.07±0.44 points, p<0, 05).
Patients of the comparison group, who underwent rehabilitation according to the standard program for the correction of osteoarthritis, did not show improvement in the studied indicators of anthropometry and markers of sarcopenia (p>0.05).
Conclusions. Elderly patients with osteoarthritis of the hip and sarcopenic obesity require the development of physical therapy programs taking into account and correcting the specifics of each condition, which will increase the overall effectiveness of rehabilitation measures.