О лечебно-профилактических возможностях физических нагрузок при первичной открытоугольной глаукоме

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.

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