actabiomedicaActa Biomedica ScientificaActa Biomedica Scientifica2541-94202587-9596Scientific Centre for Family Health and Human Reproduction Problems10.29413/ABS.2021-6.6-1.10actabiomedica-3114Research ArticleОФТАЛЬМОЛОГИЯOPHTHALMOLOGYО лечебно-профилактических возможностях физических нагрузок при первичной открытоугольной глаукомеTherapeutic and preventive eff ect of physical exercises in primary open-angle glaucomahttps://orcid.org/0000-0001-9002-0969КозинаЕ. В.KozinaE. V.

 доктор медицинских наук, заведующая кафедрой офтальмологии имени профессора М.А. Дмитриева с курсом ПО

660022, г. Красноярск, ул. Партизана Железняка, 1, Россия

 Dr. Sc. (Med), Head of the Department of Ophthalmology named after Professor M.A. Dmitriev with Postgraduate Education Course

Partizana Zheleznyaka str. 1, Krasnoyarsk 660022, Russian Federation

el.kozina@yandex.ruhttps://orcid.org/0000-0002-6577-4870КохИ. А.KokhI. A.

 ассистент кафедры офтальмологии имени профессора М.А. Дмитриева с курсом ПО

660022, г. Красноярск, ул. Партизана Железняка, 1, Россия

 Teaching Assistant at the Department of Ophthalmology named after Professor M.A. Dmitriev with Postgraduate Education Course 

Partizana Zheleznyaka str. 1, Krasnoyarsk 660022, Russian Federation

imrika@mail.ruhttps://orcid.org/0000-0003-0540-6889ТороповА. В.ToropovA. V.

 ассистент кафедры офтальмологии имени профессора М.А. Дмитриева с курсом ПО 

660022, г. Красноярск, ул. Партизана Железняка, 1, Россия

 Teaching Assistant at the Department of Ophthalmology named after Professor M.A. Dmitriev with Postgraduate Education Course 

Partizana Zheleznyaka str. 1, Krasnoyarsk 660022, Russian Federation

artemiy.toropov@ya.ruhttps://orcid.org/0000-0003-3756-3475КадомцеваЕ. М.KadomtsevaE. M.

 кандидат педагогических наук, заведующая кафедрой физической культуры

660022, г. Красноярск, ул. Партизана Железняка, 1, Россия

 Cand. Sc. (Ped.), Head of the Department of Physical Education and Sports 

Partizana Zheleznyaka str. 1, Krasnoyarsk 660022, Russian Federation

katerina.dvorkina@mail.ruhttps://orcid.org/0000-0002-9412-1529МожейкоЕ. Ю.MozheykoE. Yu.

 доктор медицинских наук, заведующая кафедрой физической и реабилитационной медицины с курсом ПО

660022, г. Красноярск, ул. Партизана Железняка, 1, Россия

 Dr. Sc. (Med.), Head of the Department of Physical and Rehabilitation Medicine with Postgraduate Education Course 

Partizana Zheleznyaka str. 1, Krasnoyarsk 660022, Russian Federation

el_mozhejko@mail.ruФГБОУ ВО «Красноярский государственный медицинский университет им. проф. В.Ф. Войно-Ясенецкого» Минздрава РоссииProfessor V.F. Voino-Yasenetsky Krasnoyarsk State Medical Universit20212812202166-18295Copyright © Козина Е.В., Кох И.А., Торопов А.В., Кадомцева Е.М., Можейко Е.Ю., 20212021Козина Е.В., Кох И.А., Торопов А.В., Кадомцева Е.М., Можейко Е.Ю.Kozina E.V., Kokh I.A., Toropov A.V., Kadomtseva E.M., Mozheyko E.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.actabiomedica.ru/jour/article/view/3114

В обзоре дана оценка физическим упражнениям как дополнительному нефармакологическому средству борьбы с прогрессированием первичной открытоугольной глаукомы. Офтальмогипотензивный эффект зависит от типа упражнений, их продолжительности и интенсивности. Предпочтительны аэробные нагрузки умеренной интенсивности. Среди динамических упражнений наибольшим гипотензивным эффектом обладают занятия бегом. Изометрические тренировки с отягощениями верхней части тела обеспечивают более длительное понижение офтальмотонуса. Снижение внутриглазного давления (ВГД) у больных глаукомой в несколько раз более выражено в сравнении со здоровыми людьми и происходит вне зависимости от характера проводимой местной медикаментозной гипотензивной терапии. После прекращения занятий ВГД возвращается к прежнему уровню в среднем в течение месяца. Повышение глазного перфузионного давления, ассоциированное с физической активностью, диктует целесообразность занятий физическими упражнениями для больных глаукомой псевдонормального давления. Сочетание гипотензивного, «сосудистого», нейропротекторного эффектов физической активности с высоким уровнем физической подготовки не исключает снижения риска развития и прогрессирования первичной открытоугольной глаукомы. Сохраняет актуальность выработка показаний к использованию физических нагрузок больными глаукомой продвинутых стадий, в том числе перенесшими гипотензивные операции. Индивидуального выбора требуют вид, интенсивность, дозированность и режим выполнения рекомендуемых физических упражнений.

The review assesses physical exercises as an additional non-pharmacological mean of combating the progression of primary open-angle glaucoma. The ophthalmic hypotensive effect is determined by the type of exercise, its duration and intensity. Moderate aerobic activity is preferred. Among dynamic exercises, jogging has the greatest hypotensive effect. Upper body isometric resistance training provides a more lasting decrease in ophthalmotonus. The decrease in intraocular pressure (IOP) in patients with glaucoma is several times more pronounced in comparison with healthy people and occurs regardless of the nature of the local drug antihypertensive therapy. After the termination of classes IOP returns to the previous level on average within a month. An increase in ocular perfusion pressure associated with physical activity dictates the appropriateness of physical exercise for patients with pseudo-normal pressure glaucoma. The combination of hypotensive, vascular, neuroprotective effects of physical activity with a high level of physical fi tness does not exclude a decrease in the risk of development and progression of primary open-angle glaucoma. The development of indications for the use of physical activity by patients with advanced glaucoma, including those who have undergone hypotensive surgery, remains relevant. The type, intensity, dosage and mode of performing the recommended physical exercises require an individual choice.

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The authors declare that there are no conflicts of interest present.