Effects of peripheral and different inspiratory muscle training methods in coronary artery disease patients with metabolic syndrome: A randomized-controlled trial.

Background OBJECTIVE: To investigate the effects of peripheral muscle training (PMT) and different inspiratory muscle training (IMT) methods on respiratory functions, exercise capacity, and biochemistry parameters in coronary artery disease patients with metabolic syndrome. METHODS: This prospective, single-blind, randomized-controlled study included 60 patients of stable coronary artery disease with metabolic syndrome (New York Heart Association [NYHA] Class I-II, left ventricular ejection fraction >40%). Patients were randomly divided into three groups: neuromuscular electrical stimulation (NMES) plus PMT group (NMES + PMT group, n = 20), IMT plus PMT group (IMT + PMT group, n = 20) and PMT group (PMT group, n = 20). Treatment continued for six weeks for all groups. The NMES was applied to rectus abdominis, IMT was applied with 30% of maximal inspiratory pressures, and PMT was applied at home. Spirometry, maximal inspiratory and expiratory pressure, dyspnea scores, exercise stress test, and biochemistry parameters were measured before and after training. RESULTS: There were significant improvements in spirometric tests, respiratory muscle strength, dyspnea scores, exercise capacity, fasting blood glucose, and antistreptolysin O after treatment in all groups (p < 0.05). Significant improvements in C-reactive protein and erythrocyte sedimentation rate were observed in NMES + PMT and IMT + PMT groups (p < 0.05). Among the groups, there was a significant difference in maximal inspiratory pressure (p = 0.02) and erythrocyte sedimentation rate (p = 0.037) in favor of NMES + PMT group (p < 0.05). CONCLUSION: Our study results showed significant improvements in respiratory functions, exercise capacity, and biochemistry markers in all groups. Different IMT methods can be used in cardiopulmonary rehabilitation to improve exercise intolerance in coronary artery disease patients with metabolic syndrome. CLINICAL TRIAL REGISTRATION NUMBER: NCT03523026.

Evaluation of the Role of Balneotherapy in Rehabilitation Medicine.

Balneotherapy is a treatment with healing waters, which includes bathing and physiotherapy in thermal water, therapeutic drinks, medical massage, and water jet massage. It is based on the buoyancy, physical properties, temperature, and chemical effects of mineral water. Throughout European and Japanese medical institutions, balneology and hot spring therapy is very much a part of routine medical treatment. The mechanism of balneotherapy is not yet completely understood. Balneotherapeutic procedures are mainly performed for the prevention, treatment, and rehabilitation of musculoskeletal diseases, but they have also proven useful for various other indications such as for the treatment or rehabilitation of dermatological diseases, immuno-inflammatory diseases, chronic pain syndromes, chronic cardiac diseases, and metabolic syndromes or neurological diseases as well as in the rehabilitation of patients with psychiatric conditions. Balneotherapy works well in the case of muscle tension, as it is relieving and relaxing, and it may be associated with improvement of various diseases. However, further investigations are necessary to determine the effectiveness, safety, standard procedures, and potential side effects of balneotherapy.

Yoga for metabolic syndrome: A systematic review and meta-analysis.

Background Metabolic syndrome is the most important risk factor for developing cardiovascular disease and type 2 diabetes. The aim of this review was to systematically assess and perform a meta-analysis of the effects of yoga on the parameters of metabolic syndrome. Methods MEDLINE/PubMed, Scopus, the Cochrane Central Register of Controlled Trials and IndMED were searched and screened from their inception through to 8 March 2016 for randomised controlled trials on yoga for patients with metabolic syndrome. Risk of bias was assessed using the Cochrane risk of bias tool. Results Seven trials with a total of 794 participants were included. No effects of yoga on resolution of metabolic syndrome, diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol and fasting plasma glucose were found, but yoga was superior to usual care for waist circumference (standardised mean difference (SMD) = -0.35; 95% confidence interval (CI) = -0.57 to -0.13; p < 0.01) and systolic blood pressure (SMD = -0.29; 95% CI = -0.51 to -0.07; p = 0.01). However, these effects were not robust against selection bias. No intervention-related adverse events were reported. Conclusion Based on the results of this meta-analysis, no recommendation can be made for or against yoga in order to influence the parameters of metabolic syndrome. Despite methodological drawbacks, and until further research is undertaken, yoga can be preliminarily considered as a safe and effective intervention for reducing waist circumference and systolic blood pressure in individuals with metabolic syndrome who are not adhering to conventional forms of exercise.

[The efficacy of the combined rehabilitative treatment of the patients presenting with obesity, metabolic syndrome, and diseases of the hepatobiliary system].

A total of 80 patients presenting with exogenous constitutional obesity, metabolic syndrome, and diseases of the hepatobiliary system (including chronic non-calculous cholecystitis and fatty hepatosis) were enrolled to participate in the present study. The basal treatment consisted of the adequate reducing diet, remedial gymnastics, massage, reflexo-acupuncture, the application of galvanic muds, and controlled intake of chofitol. It was supplemented with magnetic laser irradiation of selected abdominal regions, and electrical stimulation of femoral, dorsal, and abdominal muscles. It was shown that the combination of the above procedures and physical factors significantly improves the overall outcome of the treatment. The patients suffering intestinal dysbacteriosis were prescribed the intake of probiotic Nor Narine together with Jermuk mineral water; they were found to benefit from such treatment due to normalization of intestinal biocenosis and improvement of their general condition. The clinical and paraclinical data obtained in this study give evidence of the therapeutic efficacy of certain physical factors and especially their combination used for the medical rehabilitation of the patients presenting with constitutional obesity, metabolic syndrome, and digestive disorders. Moreover, the well-apparent positive results were documented from the combined treatment with magnetic laser radiation and therapeutic muds.

[The combined rehabilitative treatment of the children with obesity and metabolic syndrome].

The present study included a total of 66 children at the age from 11 to 16 years with obesity and metabolic syndrome. The latter condition in the childhood and adolescence is characterized by the pronounced disturbances of basal metabolism, vasoactive systems, psychoemotional status, and regulatory hormonal functions that determine the choice of rehabilitative modalities. The combined treatment of such disturbances is considered to be an efficacious method for the rehabilitation of these patients. It is recommended that cortexin be prescribed to the children presenting with obesity and metabolic syndrome because this medication promotes correction of the hormonal and metabolic status and improves the brain cognitive function.

[Evidence-based acute and long-lasting effects of climatotherapy in moderate altitudes and on the seaside]. / Klimatherapie im Hochgebirge und im Meeresklima. Evidente Akut- und Langzeiteffekte ­ein qualitativer Review.

Evidence has been provided for acute and long-lasting effects of climatotherapeutic rehabilitation of atopic diseases (neurodermatitis, asthma bronchiale) in moderate altitudes. However, to sustain the climatotherapeutical evidence of psoriasis and non-allergic asthma treatment, controlled studies are required, especially for long-lasting benefits. For other indications of climatotherapy in moderate altitudes (heart and circulatory diseases, osteoporosis, metabolic syndrome) the results demonstrate an acute effect. At North Sea and Baltic Sea, the climatotherapeutic effects remain uncertain, especially for the well-known indications such as psoriasis, atopic dermatitis and bronchial asthma. There is evidence for the acute beneficial effects at Canary Islands and long-lasting remissions of Dead Sea climatotherapy and thalassotherapy.

[Rehabilitative treatment of metabolic syndrome in a sanatorium].

This study included 386 patients with metabolic syndrome admitted for the treatment to a health spa facility. Diagnosis was established using the specially developed program of combined clinical examination, functional tests, and laboratory analyses. A specific feature of the present spa and resort treatment was the extensive application of carefully selected non-medicinal therapeutic modalities in combination with pharmaceutical preparations. The study has demonstrated that the use of the active treatment program produced beneficial effect in the majority of the patients.