HiOTMVaHUmUIYfflTrtllHD - 8 0 6/2019
THIfC TRANG HINH THAI, CHUfC N A N G VA NANG LlfC THE CHAT CUA NGIfifl CAO TUiil B| CAO HUYET AP 0 0 1
TAI THANH PHO V I N H - T i N H NGHE AN
N g o T h j N h u ' T h o ' *
^ r Tom tat: .^-^^^^^^^^^^
^ Vao thdi \(.y tu6i gia, qua trinh Ido hda diln ra, co nang sinh 1;^ suy giam, b^nh t$t gia tang, phd bien la b$nh cao huyet ap (CHA), b#nh vg dudng hd hip, tilu dudng [31, [5]. Bk cd co sd thyc tiin cho vipcxay dyng chuang trinh tap luyen yoga cho ngudi cao tuoi (NCT) bi CHA dp 1, de tai da tien hanh khao sat mpt s6tidu chi v§ hinh thai, chtic n^ng va nang lyc the chat cua 108 NCTbj CHA dp 1 tai TP. Vinh ~ Tinh Nghe An. Kit qua khao sat phan anh quy luat lao hda dang dien ra da lam giam sOt chiic- nang sinh ly va nang lyc t h i chit, qua do cho thay sy can thiet cua viec xay dyng cac chuang trinh t^p luyen phu hgp nham duy tri vd tdng cudng sifc khde, ho trg dieu trj benh CHA.
TCP khoa: Thyc tr^ng, hinh thai, chuc nang, nang lyc t h i chit, ngudi cao tuoi, cao huyet dp dp 1.
Current situation of form, function and physical ability of the elderly with high blood pressure level 1 in Vinh City - Nghe An Province
Summary:
in the old age, the aging process takes place, the physiological function declines, the disease increases, the most common is hypertension high blood pressure (HBP), respiratory diseases, diabetes [3], [5]. In order to have a practical basis for the development of a yoga exercise program for the elderly with HBP level 1, the thesis has examined a number of criteria on form, function and physical ability of 108 elderly people who suffer HBP level 1 in Vinh city ~ Nghe An province. The survey result reflects the ongoing aging rule that has reduced the physiological function and physical ability, thereby showing the need for developing appropriate exercise programs to maintain and promote health, support the treatment for HBP.
Keywords: Reality situation, form, ftjnction, physical ability, the elderly, hypertension high blood
pressure level 1. ^ A A T U ^ N flE trong viec lua chon phuang phap va xay dung
Ddc diim Idn nhdt d NCT la qua trinh lao hda ki hoach tap luyen phii hgp vdi dac diim siic dan din su suy giam ve chirc nang ciia cac he khoe NCT.
ea quan trong ca the. Mgi bieu hien ciia lao hda PHuONG PHAP NGHIEN CIIU
diu lien quan din siic khde cua NCT va dugc Trong qua trinh nghien ciiu chiing tdi da su phan dnh qua nhung biin ddi ve hinh thai, chiic dung cae phuang phap sau: Phuang phap dgc ndng, ndng lyc thi chdt... Ddi vdi NCT bj CHA va phan tich tai lieu, phuang phap phdng vdn, do 1 khdng chi cd nhiing dac diim chung vi sy phuang phap nhan trdc, phuang phap kiim tra suy giam siic khde theo qui luat lao hda, ma siic su pham, va kiem tra y hpc, toan hgc thdng ke.
khde cdn chju sy chi phdi cua benh ly benh Di danh gia nang lyc thi chdt cua NCT CHA - benh cd ty le tii vong cao trong nhdm chiing tdi sir dung bp test kiim tra Senior Fibiess benh tim mach tren toan cdu [2],[6]. Viec danh Test (SFT) ciia Rikli va Jones (2001) da va dang gia thyc trang mgt sd tieu chi hinh thai, chiic dugc iing dung rgng rai tai My, cac nude chau ndng, nang lyc thi chdt... la co sd danh gia tinh Au va nhiiu cdng trinh nghien ciiu tai Viet Nam.
trang siic khde NCT, bd sung ca sd khoa hgc SFT co y nghia cao trong viec danh gia cac nang
*ThS, Trudng Oai hpc Vinh; Email: [email protected]
BAI BAO KHOA HOC
lyc the chat thdng qua cac td chat the lyc ca ban va phu hgp vdi dac diem ciia NCT do dugc thiet ki dua tren sy hdi hda ve nang luc the chdt cua ca thi trong mdi quan he vdi kha nang dap iing sinh ly tuang iing vdi cac boat dpng the chat hangngdy[l], [4].
Cac test dugc lua ehpn su dyng trong bp test SFT: Test 1: Ngdi ghi-diing len 30 gidy (sd Idn):
danh gid siic manh chi dudi. Test 2: Ngdi gbS nang ta tay (2,27 kg d nii vd 3,63 kg d nam) 30 giay (so lan): Danh gia siic manh chi tren. Test 3: Ngdi ghi-cui vuan tay (em): Danh gia do linh boat, mim deo cua cot sdng va day chdng kheo chan. Ghi cao 17 inch (43,18 cm). Test 4: Ngdi ghi-diing day-di 8 budc (gidy): Danh gid siic manh toe dp, sy nhanh nhen vd thdng bang khi di chuyin; 8 budc ^ 2,44m. Test 5: Nang gdi tai chd 2 phut (sd Idn): Ddnh gid siic ben ua khi va kha nang thang bang trong hoat dpng.
BMI dupfc tinh theo cdng thiic: BMI = can nang/ (chieu eao)^; sd do vdng bung duge do qua eo va % md, % ca dugc do bang may quet chi sd CO the Tanita ciia Nhdt Ban.
Mdu nghien ciiu: 108 NCT, trong do bao gdm cd nam, nu. Do tieu chuan danh gid cua hau het cac tieu chi khdng cd sy phan biet gidi tinh
Bang 1. Thyc trang mpt so tieu t^i Thanh pho Vinh -
(ngoai tru sd do vdng bung) nen ket qud sau sir ly duoc trinh bay bdy chung cho NCT.
KET QUA NGHIEN CUfUVA BAN LUAN 1. Thyc trang hinh thai 6' NCT bj CHA do 1 tai Thanh phd Vinh - tinh Nghe An
Cdc tiSu chi hmh thdi ciia NCT b j CHA dp 1 dupfc khao sat bao gdm: Chi sd khdi co the (BMI), sd do vdng byng, % md vd % eo cua ea the. Ket qua khdo sat duge trinh bay t^i bang 1.
Kit qua khdo sdt tai bdng 1 cho thay, NCT bj CHA do 1 tai Thanh phd Vinh cd BMI trung binh kha cao 23,79 kg/m^, d ngudng thS trang tiin beo phi theo thang danh gia ciia ngudi Chdu A. Sd do vdng bung trung binh 90,34 cm phan dnh tinh trang beo bung vugt qua miie khuyen cao cua WHO (nam <90 cm, nu < 80 cm). Ve cau tnie cdc thanh phdn ca the: Chi sd % md va
% CO tmng binh eiia NCT bj CHA do 1 tai Thanh phd Vinh Idn luat Id 34,99% va 56,35%.
Chi sd % ma ndm trong miic nguy hiem theo khuyin cao cua WHO (nam >30, nir >40), chi sd % CO d miic trung binh. Nhu vdy su thiia cdn cbu yeu la do thira md gay nen.
Thyc trang nay phan anh the hinh phd bien cua NCT bi CHA do 1 tai Thanh phd Vinh la thira cdn, ty le % md cao va cd so do vdng bung chi hinh thai v NCT bj CHA do 1
tinh Nghe An (n=108) TT
1 2 3 4
Ti^u chi khao sat BMI
So do vong bung
%m&
%ca
1.1.
2.1
Thira can/ beo phi (BMI)
Beo bung (so do vong bung)
K^t qua khao sat
X
23.79 90.34 34.99 56.35
3 1.92 8.33 4.04 5.21
Cy 8.08 9.23 11.55 9.24 Ket qua phan loai Loai
Thap gay Binh thuong Tien beo phi Beo phi dp 1 Beo phi do 2 Beo phi do 3 Nam > 90 cm
Nil > 80 cm
Ulj
2 34 49 22 I 0 34 35
%
1.85 31.48 45.37 20.37 0.93
0 31.48 32.41
DAO TAO VA HUAN LUYBil THE THAO - SO 6/2019
T h i dMC d y a n g sinh la lo^i hinh tap luyen
Idn hon gidi han binh thudng. Trong khi dd, giam can ddi vdi ngudi thira can, han che sd do vdng bung khdng vugt ngudng khuyen cao la mgt trong nhung vdn de dugc khuyen nghj trong hudng dan dieu tri CHA cua Bd Y te vd WHO;
giam can theo hudng giam % rad, duy tri hoac tang % ca la xu hudng giam can lanh manh dang dugc khuyen nghj [5], [6].
2. Thyc trang mot so chirc nang o" NCT b|
CHA do 1 tai Thanh pho Vinh - tinh Nghe An Hoat ddng cua he tim mach, ho hap va than kinh tdm ly vira phan anh tinh trang siic khde NCT vua phan miic dp benh ly CHA. De danh gia tinh trang siic khde NCT bi CHA dp 1 tai TP.
Vinh - tinh Nghe An thdng qua hoat dpng chiic nang, de tdi khao sat cac tieu chi: Tan sd tim, HATT, HATTr, tdn so thd, dung tich sdng (VC), khd nang chit y, tri nhd ngan han. Ket qua phan anh dugc trinh bay tai bang 2.
Ket qua d bang 2 cho thay:
v i chiic nang tim mach: Tan so tim trung hmh cua NCT bj CHA do 1 tai TP. Vinh la 79,37
± 3,31 Idn/ phiit, cao han nhiiu so vdi chi sd tan sd tim trung binh d ngudi trudng thanh (khoang 70 Idn/ phiit) nhung phu hgp vdi quy luat khach quan vi dac diim liia tudi va benh ly cua ddi tugng. Tuy nhien, tdn sd tim cao se khiin tim phai boat dgng thudng xuyen, ca tim nhanh chdng met mdi, thdi gian bdi phuc cua tim ngan, se gay nhirng ap lyc cho hoat dgng cua he tuan
phu hop VOI nguai cao tuoi bj cao huyet dp hoan va luc co bdp cua mau. Van de can dat ra la sir dung cac bdi tap phu hgp nham tang siic CO bdp ciia tim, tang hieu qua hoat dpng eua he tim mach, giam tan sd tim, se giup cai thien siic khde tim mach cho ddi tugng nghien ciiu.
Gia trj HATT va HATTr trung binh cua NCT bi CHA dp 1 tai TP Vinh Idn luat la 151,23 ± 8,77 mmHg va 89,48 ± 4,6 mmHg, diu d miic cao ddi vdi ngudng huyet dp theo thang phan loai CHA cua WHO. Viec can thiep bang thay ddi loi sdng, van ddng de dn djnh va ha huyet ap se gop phan tang cudng sue khoe va nang cao chat luong sdng cho NCT.
Tim mach va hd hap la hai he ca quan cd mdi lien he mat thiet vdi nhau trong boat dpng. Vdi nhirng bien ddi lien quan tdi lao hda, NCT thudng bi hut hai, hai thd ngan va nong, he hd hap phai tang tan sd ho hap mdi dap irng dugc nhu cau oxy ciia ca the, dung tich sdng giam.
Ket qua nay ciing dugc phan anh qua sd lieu cita bang 2 vdi tan sd thd trung binh la 23,57 ± 3,04 Idn/ phut; VC trung binh la 2,43 ± 0,23 lit. Tuy nhien, nhieu cdng trinh nghien cim da chiing minh, tan sd thd va VC la nhiing chi sd cd tbi dugc cai thien neu can thiep bang nhiing bdi tap thd va bai tap van dpng hpp ly.
CHA se anh hudng tdi chiic nang than kinh tam ly, dac biet gay giam kha nang chii y va anh hudng tdi tri nhd ngan han cua benh nhan. Sd lieu bang 3 cho thay thyc trang kha nang chii y
BAI BAD KHOA HOC
Bang 2. Tiiirc trang m^t so tieu chi chu'c nang o- NCT bj CHA dp 1 tai Thanh pho Vinh - tinh Ngh$ An (n=108)
TT 1 2 3 4 5 6 7
Chi ti§u Idiao sat Tan so tim (nhip/ phut) HATT (mmHg) HATTr (mmHg) Tan so tho (nhip/ phut) VC (lit)
Kha nang ehu y (so ehu so xep dugc) Tri nho ngiin han (so ehu so nho dugc)
6.1
7.1
Kha nang ehu y (so chii so xep dugc)
Tri nha ngan han (so chij so nhd dugc)
Kit qua khao sat
"x 79.37 151.23
89.48 23.57 2.43
9.2 3,09
S 3.31 8.77 4.6 3.04 0.23 2.14 0.8
Cv 4.16 5.8 5.14 12.88 9.32 23.24 25.98 Ket qua phan lo^i Loai
Gioi Kha Trung binh
Kem Gioi Kha Trung binh
Kem
m.
0 0 5 103
0 4 6 98
%
0 0 4.63 95.37
0 3.7 5.56 90.74 trung binh ciia ddi tugng khao sat la 9,20 ± 2,14 quan, trong dd cd he van ddng (eo bap, xuong, (ehu sd), thugc ngudng xep loai kem; tri nhd khd) nen ddn din su giam siit kha nang van ddng ngan han la 3,08 ± 0,80 (chii sd) ciing d miic d NCT dugc phdn dnh qua cac td chdt vdn dpng xep loai kem. Sy suy giam chiic nang than kinh
tam ly se dugc cai thien neu cd nhung tac ddng phii hgp nham tang lim thdng tuan hodn mau len nao va ren luyen kha nang tap trung.
3. Thyc trang nang lyc the lyc a NCT bj
nhu sire nhanh, siic manh, mem deo, kheo leo.
Nang luc the chat dugc ddnh gia qua cdc tieu chi dac trung cho cac nang lyc van ddng thdng qua ket qud lap cdc test dugc the hien d bang 3.
Kit qud d bang 3 cho thdy: So lieu thong ke CHA do 1 tai Thanh pho Vinh - tinh Nghe An tuang ddi tan man da phan anh mOt ddc diem
Do su lao hda diln ra d ddng thdi cdc he ca ndng lye thi chdt cua NCT, ngoai trii siie bin Bang 3. Thyc trang nang lyc t h i lyc a NCT bj CHA do 1
t?i Thanh pho Vinh - tinh Nghd An (n=108)
TT
I 2 3 4 5
Chi tieu danh gia Ngdi ghi-diing len 30 giay (lin) Ng6i ghi nang ta tay 30 giay (lln) Ngoi ghe-cui vuon tay (cm) Nang goi tai cho 2 phiit (lln) Ng6i ghe-diing day-di 8 buoc (giay)
Ket qui Idem tra
X
12.31 12.93 -3.06 74.76 8.81
8 1.43 1.99 2.02 6.66 2.42
Cv 11.57 15.39 -65.75 8.9 27.53
DAO TAO VA KUAN UrYBUTW THAO - 5 0 6 / 2 0 1 9
Ngoai viec tham gia t^p luyen TDTT, de co sijc khoe tot, ngu'o'i cao tuoi can co cupc song vui ve, thoai mdi
(nang gdi tai chd 2 phut vdi Cv la 8,9). Kit qua cho thdy tinh b-^ng the luc cua mdu nghien ciiu khdng ddng deu. Chiing tdi cho rdng, sd di cd dieu nay la do so lieu thdng ke tdng hgp d cd nam vd nii, trong do, cd su khde biet vi khd ndng thyc biSn cac dpng tac m6m deo, siie manh va sire nhanh d nam va nii NCT la khdc nhau, ban the dp tudi ciia mau cd su phdn bd rpng (60 - 74 tudi). Ket qua eiing cho thdy su can thiit phai dp dung gidi phdp tang eudng tap luyen de nang cao ddng deu sire khde the chat eho NCT tgi Thdnh pho Vinh.
KETLUAN
Thyc trang hmh thai, chiie nang va nang lyc the chdt ciia NCT bi CHA dp 1 tgi Thanh phd Vinh:
- Ve hinh thai: BMI trung binh d ngudng tien beo phi; ty le beo byng cao, sd do vdng bung vuyt ngudng khuyen cdo. Ty le % md trong miic nguy hiem vd % ea d miic trung bmh, thira can la do thira md.
- Ve chirc ndng: Chiic nang tim mach, hd hap va than kinh tdm ly d NCT deu cd dau bipu suy gidm, dac bi?t kha ndng tap trung, tri nhd ngdn ban deu d mirc kem.
- Ve nang lyc the chat: Cdc ndng luc the ehdt nhu siie nhanh, siic manh, sice ben vd mem deo thdp va khdng ddng deu d nam va nii.
Thyc trang nay dat ra yeu cau can nghien ciiu xdy dung ehuong trinh tap luyen phii hpp nham
duy tri va tang eudng sue khde, phdng va hd trg diiu trj benh CHA cho NCT bj CHA do 1 tai Thdnh phd Vinh.
TAI LIEU THAM KHAO
1. Chris de Laet Oscar H., Anna Peeters, Jacqueline Jonker, Johan Mackenbach, Wilma Nusseder (2005), "Effect of physical activity on life expectancy with cardiovascular disease".
Arch Intern Med, U. p. 2355-2360.
2. M. H. & Cihlar Nguyen, V. (2013),
"Differences in physical fitness and subjectively rated health between Vietnamese and German older adults", Journal of Cross-Cultural Gerontology. 28(2), tr. 181-194.
3. Pham Khue (2000), Benh hpc ngudi gia, Nxb Ha Npi, Ha Ndi.
4. Rikh R. and C.J. Jones (2001), Senior Fitness Tests Manual, Champaign, IL. Human Kinetics.
5. Vien tim mach Viet Nam (2012), Chuang trinh Qudc gia phdng chdng benh tdng huyet ap.
6. World Health Organization and International Society of Hypertension (2003), "WHO/ISH statement on management of hypertension".
Journal of Hypertension 21, tr. 1983-1992, (Bai nop ngay 10/12/2019, Phdn bl^n ngay
18/10/2019, duyet in ngay 26/12/2019)
