E.Yu. D'yakova, associate professor, Dr.Med.
A.N. Zakharova     
National research Tomsk state university, Tomsk

Key words: remedial gymnastics, body fitness shape indices, adaptation.

Introduction. Nowadays National research Tomsk state university is a leading classical research university, one of the largest in Siberia and the Far East. The university contains in its structure 23 faculties and educational establishments where 19 thousand students are being trained [6].

According to the medical examination of 1st year students of Tomsk state university (TSU) for 2012, only 27 % of them were recognized healthy and attributed to the main medical group. At the same time, 24% were included to the preliminary group, where the loads are a little reduced in comparison with the main group. The percentage of students with minor health deviations is rather high, and they are recommended to attend classes in a special medical group (30%). 19% have abnormalities of various body systems, classes of remedial gymnastics (RG) are recommended for such students [3].

The conditions of student life (big mental stress, long stay in a sitting position in a classroom or at the computer, irregular meals, etc.) are the reason of various pathologies among students, increase the risk of deterioration of body fitness shape. The climatic conditions of the Tomsk region, which differ in significant diurnal and annual variations in temperature and atmospheric pressure, a longer winter period are essential too. Under such conditions the body’s adaptive systems are constantly at the level of potential breakdown.

Every year about 400 students enter the 1st course of TSU, who need special corrective exercises with strictly graduated loads and advanced medical supervision. Special groups of remedial gymnastics were organized for these students since 2010. However, for obvious reasons, it is impossible to evaluate the increment in the indices of physical qualities in these subjects using the standard pedagogical testing. The standard pulse rate calculation during training sessions and blood pressure control do not give a complete picture of the body fitness shape. The lack of evaluation criteria of physical state of the ones training in the groups of remedial gymnastics makes it difficult to correct the programs of classes.

In this regard, the purpose of the study was to allocate the model criteria of the body fitness shape of students training in the groups of remedial gymnastics.

Materials and methods. The examined subjects attributed by the physician to remedial gymnastics classes, were freshmen of TSU with diseases of various body systems. The study involved 50 persons (9 males and 41 females) aged 17-19 years.

Cardiorhythmography (CRG) and the study of the respiratory function (RF) were carried out using the apparatus of functional diagnostics "Valenta" (produced by "Neo Company", Russia, St.Petersburg). Contact coordination measurement and dynamometry was held on the apparatus of psychophysiological testing HC-Psychotest (produced by "NEUO-SOFT", Ivanovo town, Russia) to identify coordination and power indicators. In addition, the examination included calculation of the physical condition index using the R.M. Baevsky’s method and orthostatic, clinostatic tests with registration of heart rate, the Stange’s test, the Genche’s test, characterizing the state of the respiratory system, Aschner’s test of the balance of the autonomic nervous system.

Students were subject to the initial examination at the beginning of the academic year (in October 2012), before starting classes of remedial gymnastics. All the indices were re-measured in April 2013. During the year students attended 75 minute remedial gymnastics classes twice a week. The groups were mixed in respect to gender and diseases.

The data obtained were statistically processed using the software Statistica 6.1. The nonparametric Wilcoxon test was applied since the distribution of the features in the selected combination was abnormal and the samples were pairwise connected.

Results and discussion. Most of the freshmen attributed by the physician to remedial gymnastics classes in 2012 had diseases of the musculoskeletal system (MSS) - 32.6%, and a significant percentage of students had more than two pathologies (32.6%). There was a high percentage of cardiovascular diseases (CVS) and neuropathies. In addition, there was a small percentage of students (0.3 %) with different rare diseases, among which: thecitis, exostotic disease, ordinary joint dislocation, various forms of infantile cerebral palsy, etc. [3].

Functional tests at the beginning and at the end of the academic year did not promote the conclusion on the changes in the body fitness shape of the involved, since there were no significant differences between them.

However, the use of hardware research methods gave a fuller picture of the functional changes in students of the groups of remedial gymnastics.

In the CRG at the beginning and at the end of the academic year significant differences were identified in the following statistical indices of heart rate variability (HRV): mathematical expectation, maximum value of RR, minimum value of RR, mode, SV2/BV, (SV1+SV2)/BV, standard deviation, pRR50, BV power (norm), MV power (norm).

The mathematical expectation (M) shows the final result of all regulatory effects on heart and blood circulation system in general, it is equivalent to the mean HR [5]. An increase of this index was fixed in the examined students at the end of the experiment.

The most frequent value of RR, indicating the dominant level of functioning of the sinoatrial node is called mode (Mo). At sympathicotonia the mode is lower, at vagotonia - bigger [5]. Proceeding from the data in Table 1 above, there is an increase in the examined Mo in the subjects, indicating the enhancement of activity of the parasympathetic regulation.

The indices of SV2/BV (centralization indices), (SV1+SV2)/ BV (vagosympathetic interaction index) show the ratio of the tones of sympathetic and parasympathetic autonomous nervous systems. In case of increase of these indices one can state the stronger influence of sympathetic, and in case of decrease - parasympathetic autonomous nervous system (ANS) [2]. Table 1 shows the significant decrease of these indices testifying to the stronger influence of the parasympathetic ANS.

Changes in the standard deviation (SD) can be due to autonomous and central contour of regulation (both with sympathetic and parasympathetic effects on heart rate). The decrease of the SD is associated with the intensified sympathetic regulation, which suppresses the activity of the autonomous contour. A sharp decrease of SD is caused by the significant tension of regulatory systems when senior control levels join the regulatory process, leading to almost full suppression of the autonomous contour [1]. The growth of this index at the end of the year was detected in the analysis of the obtained data. The rise of the SD usually indicates the intensification of autonomic regulation.

pRR50 shows the activity of the parasympathetic autonomic regulation. This index is calculated by the time series of differences of the values of serial pairs of cardiointervals and does not contain slow wave components of СР. It is a reflection of breathing-related sinus arrhythmia [1]. A significant increase of this parameter was registered in the cardiorhythmography of students, indicating the activation of the part of parasympathetic regulation.

When considering the parameters of power of fast and slow waves the increase of the FV power index (normalized units) and a reduction in power of SV 2 (normalized units) can be observed, which conditions the conclusion on the intensification of the preemptive effect of parasympathetic ANS.

Thus, in general, there is an increase in the influence of parasympathetic ANS, which means an increase of adaptabilities of the given contingent of trainees.

Table 1. Сardiorhythmographic indices of students with diseases of various body systems, Хср.±m

The examination of students included study of the respiratory function (RF). The parameters of the state of students’ RF are given in Tab. 2.

The statistical processing of the obtained results has shown significant changes in the following indices: VCinsp, RVinsp, RVexp, RC, FVC, FEV1, PF, MEF25, MEF50, ARF25-75, Tfor.exp., PF/MEF50, FEV1/RC, RMV.

VCinsp (inspiratory vital capacity): a considerable decrease of this index was marked at the repeated examination of students.

RVinsp (inspiratory reserve volume): an increase of this parameter is marked in the examined subjects.

RVexp (expiratory reserve volume) – maximum expiratory volume after quiet expiration [6]. The decrease of RVexp was detected in students at the end of the year.

Respiratory capacity (RC) shows the inspiratory volume per one inspiration at quiet breathing, RC indices change subject to tension and ventilation level [6]. In addition, a remarkable deterioration of this index was found at the end of the experiment.

FVC is the maximum air volume, exhaled after maximum expiration when breathing at maximum strength and velocity. Forced expiration provokes airway constriction, decelerating it [6]. At the beginning of the year the mean value of this index was 4,55±0,4 l, while at the end of the year the index changes to 2,18±0,19 l, testifying to the extremely significant decrease.

Forced expiratory volume per 1 s (FEV1) – maximum expiratory volume per 1 expiration after a deep breath, i.e. the part of FVC, exhales per 1st s. First of all, FEV1 shows the state of big airways [4]. Having analyzed the data of the FEV1 index (at the beginning of the year – 1,52±0,14 l, at the end – 0,96±0,07 l), it can be concluded that a deterioration of the state of big airways is observed among students engaged in the group of remedial gymnastics.

PF (peak flow) shows the volume from the beginning of expiration to the peak speed [4]. In this index a regress (3,85±0,26 l/s) was fixed at the end of the experiment compared with the initial examination (1,59±0,12 l/s).

MEF25 (maximum expiratory flow 25% FVC) indicates the state of large bronchi. MEF50 (maximum expiratory flow 50% FVC) (mainly – mid-bronchi). Proceeding from the analysis of the data adduced in Table 3 on the given parameter, a deterioration of the state of large and mid-bronchi is observed in students by the end of the experiment due to marked sharp decrease of the indices. It is also proved by the data of the ARF25-75 index – average expiratory flow at the part of from 25 to 75% of the volume of FVC, which characterizes the mid-bronchi area [4].

PF/ MEF50 and FEV1/PF are speed indices of airway. The decrease of PF/MEF50 at the simultaneous increase of FEV1/PF indicated the decrease of the lumen of large and mid-bronchi.

Tfor.exp. is determined by the time spent for a forced expiration. The decrease of this index indicates the decrease of the respiratory function.

RMV (respiratory minute volume) – the volume of gas inhaled or exhaled per 1 minute. Respiratory capacity (RC) – the volume of air going through the lungs when performing a test of RMV per one inspiration-expiration [4]. Tab. 3 contains the values of the data of indices, and after analyzing them the deterioration of the pulmonary ventilation can stated in the subjects due to a sharp decrease of RMV and RC observed at the end of the experiment.

Reduction of these indices of the respiratory function of students with dysfunctions of various body systems can be related with the fact that the re-examination was conducted in spring, when there is a seasonal decline in immunity and as a consequence – the increase of the threshold of acute respiratory viral infections incidence. The individuals with decreased adaptabilities have a significantly high risk of upper respiratory infections, especially when staying indoors at public gatherings for a long time. Sustained upper respiratory diseases cause a decrease in the studied indices, which can be observed in this case.

Table 2. Indices of the respiratory function of students with diseases of various body systems, Хср.±m           

A study of coordination abilities and dynamometry were conducted using the apparatus of psychophysiological testing HC-Psychotest.

According to the study of coordinating function significant changes in the number of touches and the total time of touches were observed. In this case the re-examination revealed the improved coordination function, as the number and total time of touches significantly reduced. The improvement of coordination abilities is due to constant use of graduated physical loads, since complex effects on the body, including on the vestibular apparatus, are observed when they are used.

The dynamometric indices were slightly reduced. The maximal strength of right hand decreased: it was 26,89 ± 1,33 and 25,94 ± 1,21 at the beginning and at the end of the experiment respectively. In addition, a significant decrease of the maximum force was revealed at the beginning of the study - for the right hand, the value of the maximum effort at the end - for the left and right hands, endurance coefficient for left and right hands.

The reduction of these indices can be explained by the fact that the fatigue due to great mental and physical loads during the academic year increases in students at the end of the semester, what surveyed students complained verbally of, it negatively affects the dynamometric indices.

Conclusion. Proceeding from the study, the indices of functional tests, such as orthostatic, clinostatic, Stange, Genchi and Ashner probes, do not have significant differences at the beginning and at the end of the academic year. These probes cannot estimate changes in the body physical state of the ones engaged in the groups of remedial gymnastics.

However, the conduct of hardware researches conditioned a number of conclusions:

1. In respect to the functional state of the cardiovascular system of the students engaged in remedial gymnastics group, the most significant are mathematical expectation, maximum RR, minimum RR, mode, SV2/FV, (SV1 + SV2) / FV, SD, pRR50, FV power (norm), SV power (norm).

2. In respect to respiratory system – IVC, RVinsp, RVexp, RC, FVC, FEV1, PF, MEF 25, MEF50, ARF25-75, Tfor.exp., PF / MEF50, FEV1/ PF, RMV.

3. In respect to the coordination function - the number of touches and total time of touches.

4. In respect to musculoskeletal system - the maximum muscular strength, effort regulation, the value of maximum force at the beginning of the study, the amount of the maximum effort - at the end, as well as endurance coefficient.

The analysis of the allocated criteria indicates to deterioration of the respiratory function in the ones involved in remedial gymnastics. It must be associated with the spring season when the repeat examination was carried out, which is characterized by increased acute respiratory diseases. Moreover, the studies revealed diminution of muscle strength of the involved that can be due to general tiredness in the end of the academic year or insufficient strength loads during classes. Herewith, coordinating abilities improved and there was marked a positive dynamics of intensification of the influence of the parasympathetic nervous system, indicating to the increase of students’ body adaptabilities.

 References

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  Author’s contacts: adyakova@yandex.ru