assessment of influence of the program of physical rehabilitation on results of the six-minute test of walking at children with recurrent bronchitis

It is specified by results of the last statistical researches of the structure of incidence of children that the first place is won by diseases of the respiratory system among which respiratory diseases prevail [6]. Nonspecific inflammations of respiratory tracts, which are followed by frequent repeated episodes, are widespread among children and practically are not prevented, and episodes of diseases are badly treated, as predetermines the relevance of problem [3]. Besides, the role of treatment consists not only in diagnostics and therapy, but also in prevention of these diseases [7].


introduction
It is specified by results of the last statistical researches of the structure of incidence of children that the first place is won by diseases of the respiratory system among which respiratory diseases prevail [6].Nonspecific inflammations of respiratory tracts, which are followed by frequent repeated episodes, are widespread among children and practically are not prevented, and episodes of diseases are badly treated, as predetermines the relevance of problem [3].Besides, the role of treatment consists not only in diagnostics and therapy, but also in prevention of these diseases [7].

communication of the research with scientific programs, plans, subjects
The work is performed according to the scientific subject "The latest technologies in physical rehabilitation, assessment of quality of life of different groups of the population at diseases of internals and systems of organism and musculoskeletal system".Number of the state registration is 0111U001870.

the purpose of the research:
to estimate efficiency of the program of physical rehabilitation of children this is carried out in the conditions of sanatorium with recurrent bronchitis.

Material and Methods of the research
Materials of the work were received during the research on the basis of the sanatorium "Malyatko" (Uzhhorod).The contingent of investigated -109 children of younger school age, who are ill with recurrent bronchitis, from them 53 (48,6%) are boys and 56 (51,4%) are girls, aged from 7 up to 9 years, which arrived for performing sanatorium treatment.The middle age made 8,6±0,62 (Х±S) years.
At implementation of the six-minute test of walking (6-MTW) which is rather widely used also among children [5,9,10], distance length indicators in the first and second attempt (D 1 , D 2 ) were registered for calculation of index of adaptation (IAd=D 2 /D 1 ); heart rate (HR), systolic and diastolic arterial pressure (SAP and DAP); time of renewal of HR to initial heart rate in the first and second attempt (t 1 , t 2 ) for calculation of index of adaptation of renewal of rhythm (ІАt=t 2 /t 1 ).Besides, the Borg scale in the modified look was applied to the assessment of feeling of physical efforts and fatigue [4,8].
Children were distributed on two groups for definition of reliable differences in the state of health according to indicator of index Tiffeneau (IT), namely by the absence (norm, conditional norm of 61 children) or the existence of moderate changes (48 children).In turn each of these groups at passing of the sanatorium therapy were divided into the main and control for the research of features of dynamics of indicators throughout the sanatorium therapy with use of the developed program of rehabilitation.So, children with the moderate decrease in IT got to MG1 (n=23) and CG1 (n=25), and without the essential changes to MG2 (n=32) and CG2 (n=29).The MG1 and CG1 groups did not differ among themselves (р>0,05), MG2 and CG2 also satisfied this condition.
Let's note that children without changes of IT had the best results on indicators of D 2 , ІAd and point by the Borg scale at the time of arrival.

results of the research and their discussion
The sanatorium stage of rehabilitation is important for the maximum renewal of health and use of rehabilitation potential among children [2].The developed program of physical rehabilitation was introduced in the process of the sanatorium therapy of children of the main groups and went to the main tasks in pediatrics, namely on the improvement of somatic health and quality of life [1], and also included at itself the sparing and sparing-training motive modes and consisted of basic and variable components; was based on the complex of the indicators, which were received in the course of the stating experiment and, in particular, differed from standard in methodical creation and content of remedial gymnastics classes and hydro-kinesiatherapy.
The carried-out analysis of dynamics of indicators which were defined when carrying out 6-MTW, found the existence of changes of number of indicators throughout the sanatorium therapy, which was defined by the comparison of values before and after between the main and control groups, and reliable differences, between results of certain indicators of the main and control groups that was not observed at the time of arrival to the sanatorium.The reliable differences are established (р<0,001) when comparing lengths of the passable distance in six minutes in the first attempt (D 1 ) before and after as children (n=109) took part in rehabilitation programs which passed in conditions of sanatorium, confirm the statistical growth of this indicator and positive influence of the carried-out therapies on functional condition of the cardiorespiratory system and physical fitness of patients.The indicator D 1 grew more significantly at the same time in the main groups (tab.1).So, indicator D 1 of MG1 at children authentically differed from CG1 (р<0,01), and in MG2 from CG2 (р<0,01).The value of indicator D 1 in MG1 after passing of rehabilitation course grew by 47,4 m (12,1%) to 438,70±12,36 m; the gain was a little smaller in CG1and made 32,4 m (8,3%) to 422,20±15,21 The similar tendency was observed % in groups of children who had no considerable changes of IT at the time of arrival.So, the increase is noted in D 1 in the MG2 group by 47,5 m (12,1%) to 438,75±14,14 m, and in the CG2 group on 32,42 m (8,2%) to 424,66±14,07 m.The reliable differences between the MG1 group (with the available moderate changes of IT) and the group of children of MG2 (without considerable changes in values of index Tiffeneau) are not revealed at the time of extract (р>0,05).Such dynamics of indicator of D 1 indicates big efficiency of the developed program concerning the improvement of condition of the cardiorespiratory system and the general endurance.
Considering the lack of reliable differences at inspections both at the time of receipt, and after the passable rehabilitation course, between MG1 and CG2 (р>0,05), CG1 and CG2 (р>0,05) by the results of D 1 , the fact that the received points by the Borg scale when comparing the main groups among themselves and control do not differ attracts attention after passing of physical rehabilitation (р>0,05).Thus, the carriedout treatment promoted the improvement of subjective tolerance of loading at children with the available decrease in IT, as the best point but the Borg scale at children without the essential changes of IT was established authentically (р<0,01) at the time of the first inspection.And it is possible to tell that the developed program in this aspect was more effective considering the reliable decrease in the point of the mentioned above in MG1 and the difference between MG1 and CG1 (р<0,01) by the values D 1 .Also statistical differences were established (р<0,001) when comparing lengths of the passable distance in the second attempt 6-MTW (D 2 ) before and after the rehabilitants (n=109) executed rehabilitation programs in the conditions of the sanatorium which confirms the statistical general growth of this indicator and the positive influence of both programs on possibilities of the cardiorespiratory system.The indicator D 2 grew more significantly at the same time among children of the main groups that is noted in the table.
In particular, D 2 indicator at children of MG1 authentically differed from CG1 (р<0,01), and in MG2 from CG2 (р<0,01).The value of indicator of D 2 after passing of the rehabilitation course grew by 58,26 m (14,5%) to 459,35±14,48 m among children of MG1; the gain was a little smaller and made 33 m (8,4%) to 428,20±16,00% CG1.The similar dynamics was observed among groups of children who had no considerable changes of IT at the time of receipt.So, the increase in D 2 is noted by 64,53 m (15,8%) to 473,44±9,87 m in the MG2 group, and in the CG2 group on 33,8 m (8,2%) to 444,66±17,62 m.The given dynamics of indicator D 2 indicates the smaller efficiency of the standard program concerning the improvement of condition of the cardiorespiratory system and the general endurance.Besides, found existence of the reliable difference between the MG1 group (with the available moderate changes of IT) and the group of children of MG2 (without considerable changes in values of index Tiffeneau) at the time of extract (р<0,01), and also similar differences in between control groups that indicates the lack of equalizing of groups of children (for IT) by the results of D 2 and after the sanatorium therapy.
The presented results demonstrate that the gradual increase in physical activity of children with recurrent bronchitis can and promote in the future improvement of results of length of distance as children after passing of the course of recovery treatment didn't reach the standard values, which are given in literature for healthy children, though they got closer to them.

SlobozhanSkyi herald of Science and Sport
program of rehabilitation.Also the reliable differences were found during the statistical analysis when comparing results of MG1 from CG1 (р<0,01), MG2 from CG2 (р<0,01) at the time of the repeated inspection.These differences also in addition prove advantages of the developed program of physical rehabilitation.
Children with the available moderate changes of IT didn't achieve results of children without considerable changes of index Tiffeneau and at the time of extract from the sanatorium to what the existence of statistical differences between MG1 and MG2 (р<0,01), CG1 and CG2 testifies (р<0,05).
The reliable changes of values of indicator of HR before 6-MTW are not revealed after passing of the sanatorium therapy with application of means of physical rehabilitation both in the general selection, and among groups of children (р>0,05).So, the average value of indicator of HR before 6-MTW made 86,90±3,73 bpm -1 at the time of extract at the examined children (n=109).
The analysis of heart rate after 6-MTW found the reliable difference between values before and after passing of the sanatorium therapy with application of means of physical rehabilitation in the general selection of children (р<0,05), though the reduction made 1,2 bpm -1 to 114,13±7,12 bpm -1 that demonstrates the presence of this small reduction of heart rate at the vast majority of children.
The value of indicator of HR Δ , what displays the change of heart rate at the time of the termination 6-MTW in comparison with condition of rest, authentically changed on the termination of the rehabilitation course only in MG2 on 2,5 bpm -1 also made 25,69±5,35 bpm -1 (р<0,01).In other groups indicator HR Δ didn't experience the reliable changes in comparison with results at the time of receipt (р>0,05).Let's note also that the values received at the time of extract had no statistical differences between MG1 and CG1, MG2 and CG2 (р>0,05).

conclusions
Considering the stated, it is possible to draw conclusion that the main studied indicators of the test 6-MTW experienced positive changes in the main and control groups of children with recurrent bronchitis at extract from the sanatorium, however more positive dynamics was noted among children who passed the sanatorium therapy with inclusion of the developed program of physical rehabilitation.In particular, authentically the best changes took place in indicators of the passable distance in both attempts, index of adaptation, index of adaptation of renewal of rhythm which testifies to efficiency of the introduced program of physical rehabilitation.
prospects of the subsequent researches consist in the research of influence of the conducted course of physical rehabilitation on the respiratory system, posture and quality of life of children.

Conflict of interests.
The author declares that there is no conflict of interests.
Financing sources.This article didn't get the financial support from the state, public or commercial organization.

average indicators of the six-minute test of walking at children with recurrent bronchitis after the sanatorium therapy indicators of the test of the forced vital capacity of lungs
arterial pressure before 6-XTX changed in the general selection (р<0,01) and in all groups of children (р<0,05).The result lowered from 107,34 6,46 mm Hg to 106,44 6,54 mm Hg in the general selection of children, also had insignificant quantitative character in groups that it is impossible to connect fully by the carriedout programs of rehabilitation.Besides we will note what the reliable differences between MG1 and CG1, MG2 and CG2 groups are not established also at the time of extract from the sanatorium (р>0,05).The following changes are established between children without the initially registered considerable changes of IT: the reliable reduction of ІAt from 1,10±0,05 s.u. to 0,94±0,06 s.u.(р<0,01) is noted in MG2, and in CG2 from 1,09±0,04 s.u. to 0,99±0,06 s.u.(р<0,01).Considering the reliable differences, which are established between MG1 and CG1 (р<0,05), MG2 and CG2 (р<0,01), it should be noted that the improvement of values of ІAt was more essential in the main groups.
This work is licensed under a Creative Commons 4.0 International (CC BY 4.0) the change