DYNAMICS OF PHYSICAL FUNCTIONING PARAMETERS IN THE ELDERLY ADULTS WITH FRAILTY AND INSULIN RESISTANCE UNDER THE INFLUENCE OF THE PHYSICAL THERAPY PROGRAM

Abstract

Aim: to determine the effectiveness of physical therapy program according to the parameters of physical functioning in older adults with frailty syndrome and insulin resistance.

Material and methods. Ninety six older adults were examined. The control group consisted of individuals without signs of insulin resistance and frailty syndrome. The main group 1 (MG 1) consisted of persons with insulin resistance and frailty syndrome who did not want to cooperate with a physical therapist and / or actively improve their health on their own (low level of therapeutic alliance). They were provided with recommendations according to the WHO CINDI program (modification of nutrition, expansion of household and training physical activity). The main group 2 (МG2) included patients who agreed to take active steps to improve their own health under the supervision of a physical therapist (high level of therapeutic alliance). A program of physical therapy with the using of kinesіоtherapy, massage, nutritional correction, education of the patients and their families, elements of cognitive training and occupational therapy for 1 year was developed for them. The dynamics of the condition was evaluated by the results of wrist dynamometry, Timed Up and Go test, a 6-minute test, Functional Mobility Assessmetn in Eldery Patients, Bartel index.

Results. Older adults with frailty and insulin resistance demonstrated a statistically significant deterioration in physical function compared to peers (coordination, balance, strength, flexibility, endurance, agility skills according to the results of tests), which increases the risk of adverse health effects, loss of autonomy and death. The use of physical therapy in МG1 led to a statistically significant improvement in the parameters of physical functioning, reducing the intensity of signs of frailty and the fall-risk, reducing the degree of dependence in domestic functioning, indicating the biopsychosocial effect of the program. The low level of therapeutic alliance of МG2 individuals led to unsatisfactory implementation or non-implementation of the provided recommendations and was associated with a lack of improvement in their physical status and a high fall-risk.

Conclusion. It is advisable to include physical therapy means in the rehabilitation programs for elderly patients with comorbid pathology – frailty and metabolic syndrome.