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УДК: 612.063/612.064 DOI:10.33920/med-14-2210-07

Терренкур как высокоэффективный метод лечения и реабилитации пациентов с заболеваниями сердечно-сосудистой системы

Князева Татьяна Александровна д-р мед. наук, главный научный сотрудник, ФГБУ «НМИЦ РК» Минздрава России, профессор, Россия, 129090, г. Москва, Протопоповский пер., д. 6, кв. 48, 8 985 955 0410, e-mail: tatjanaknyazewa@yandex.ru, http://orcid.org.0000-0002-3759-5779
Никифорова Татьяна Ивановна канд. мед. наук, старший научный сотрудник, ФГБУ «НМИЦ РК» Минздрава России, Россия, 125413, Москва, ул. Флотская, д. 27, кв. 150, 8 906 731 8200, e-mail: nikiforova.tania@yandex.ru, http://orcid.org.0000-0003-4574-9908
Максим Юрьевич Яковлев д-р мед. наук, руководитель научно-исследовательского управления, ФГБУ «НМИЦ РК» Минздрава России, Россия, Московская область, Октябрьский пр-т, д. 5, к. 1, кв. 63, 8 915 106 1754, e-mail: masdat@mail.ru, http://orcid.org.0000-0002-5260-8304

Настоящий обзор посвящен современному и высокоэффективному комплексному методу лечения и реабилитации пациентов с сердечно-сосудистыми заболеваниями — терренкуру, который, по определению А.Д. Фесюна (2022), представляет собой сочетание климатотерапии и физических упражнений на открытом воздухе в природной среде, значительно повышающее эффективность каждого из отдельно взятых методов. Физическая активность важна для предотвращения и ограничения заболеваемости и смертности от хронических заболеваний и тем самым снижения расходов на здравоохранение и экономику. Терренкур представляет собой дозированные физические нагрузки в виде пеших прогулок по пересеченной местности, восхождений в гористой местности по определённым размеченным маршрутам под наблюдением врача. Дозированные физические нагрузки по расстоянию, времени и углу наклона, пешие восхождения — метод лечения и реабилитации сердечно-сосудистых заболеваний, способствующий улучшению выносливости и функционированию сердечно-сосудистой, дыхательной и нервной систем, обмена веществ, а также мышц конечностей и туловища. Мировой и отечественный научно-практический опыт свидетельствует о его высокой эффективности и повышении адаптационно-компенсаторного потенциала организма пациентов в результате применения терренкура, безопасности его использования в лечебных и реабилитационных программах. Широкая доступность, низкая экономичность и дополнительные терапевтические эффекты при контакте с местностью представляются целесообразными для расширения использования терренкура для санаторно-курортного лечения и реабилитации кардиологических пациентов.

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Всемирная организация здравоохранения (ВОЗ) свидетельствует о том, что хронические неинфекционные заболевания (НИЗ) ежегодно убивают 41 млн человек, или 71% всех смертей в мире. 85% преждевременных смертей приходится на страны с низким и средним уровнем дохода [1]. Более 15 млн человек ежегодно умирают от НИЗ в возрасте от 30 до 69 лет, причиной большинства смертей из которых (17,9 млн в год) приходятся на сердечно-сосудистые заболевания (ССЗ). К ним относят инфаркт миокарда (сердечные приступы), цереброваскулярные заболевания (инсульт), атеросклероз и гипертонию (повышенное кровяное давление).

Основной целью в борьбе с НИЗ, имеющей отношение к глобальному здоровью от ССЗ, которая должна быть достигнута к 2025–2029 гг., является борьба с недостаточной физической активностью (НФА) [2]. Согласно систематическому обзору, проведенному Kyu CHCH. et al. (2016) [3], и многим исследованиям, растет число доказательств защитного эффекта физической активности в предотвращении сердечно-сосудистых заболеваний, сахарного диабета 2 типа и рака [3, 4], а также в снижении смертности от всех причин [5]. Физическая активность, предотвращая и ограничивая развитие заболеваемости и смертности, положительно влияя на факторы риска ССЗ и других хронических заболеваний, тем самым снижает расходы на здравоохранение и экономику [5, 6]. В комплексной и междисциплинарной кардиореабилитации физические упражнения, по данным Wang L.et al. (2017) [7], имеют чрезвычайно важное значение.

В современной лечебно-профилактической медицине используется большое количество методов лечебной физкультуры, и терренкур — один из них. Терренкур — ходьба по гористой местности, комплексное понятие, в основу которого положена научно обоснованная методика лечебной ходьбы, усиленная дополнительными терапевтическими эффектами воздействия местности, такими как климат, ландшафт, аэрофитовоздействие. Терапевтический эффект от использования терренкура многокомпонентен и включает благоприятное влияние на нервно-психическую и эмоциональную сферу, улучшение показателей резервно-адаптационных функций организма, в частности увеличения выносливости к физическим нагрузкам, улучшения функций сердечно-сосудистой системы и органов дыхания, коррекции профиля метаболических показателей [8].

Для Цитирования:
Князева Татьяна Александровна, Никифорова Татьяна Ивановна, Максим Юрьевич Яковлев, Терренкур как высокоэффективный метод лечения и реабилитации пациентов с заболеваниями сердечно-сосудистой системы. Физиотерапевт. 2022;5.
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