IMPROVEMENT OF THE PHYSICAL DEVELOPMENT OF CHILDREN AND ADOLESCENTS WITH REFRACTION ANOMALIES

Cherednichenko N.L., Tarutta E.P., Korenyak G.V., Karpov S.M., Shakhray S.M.

State Budgetary Educational Institution of Higher Professional Education "Stavropol State Medical University"

Federal State Budgetary Institution "Helmholtz Moscow Research Institute of Eye Diseases" of the Ministry of Health of the Russian Federation, Moscow

Federal State Budgetary Educational Institution of Higher Education "Lomonosov Moscow State University"

 

At present, great importance is given to the physical development of children. However, health deterioration of the child population is associated, first of all, with physical inactivity, problems of nutrition and environment, and with great visual loads. Disorders of the musculoskeletal system are at the first place by morbidity, and at the second place there are disorders of the visual analyzer. Refractive disorders, or refractive errors are the most common type of visual disorders, their incidence is 70% in the population [1]. Depending on the severity of disorders and the time of its occurrence refractive disorders can be accompanied by dysadaptation symptoms, and lead to the development of complications such as strabismus, amblyopia, high progressive myopia [3,5,6].

In recent years, much attention is paid to the role of general somatic pathology in the origin and development of refractive errors. In 96% of children with refractive errors various somatic diseases are observed. Among them the most frequent are prenatal and natal lesions of the central nervous system, the instability of the cervical spine, the early osteochondrosis, cervical spine subluxations. This pathology indicates the weakness of ligamentous and muscular apparatus of the cervical spine, which promotes the formation of intervertebral blocks with vertebral-basilar circulatory failure and disturbance of regional circulation. Various signs of connective tissue dysplasia, dystonia are often detected in children with myopia.

 

Objective: To carry out a comparative clinical analysis of the influence of badminton training on physical development of children and adolescents with refractive errors.

 

Material and Methods: We examined 58 children and adolescents (116 eyes), going in for badminton within six months. The children were divided into three groups according to refraction: group 1 – the children with myopia, 20 persons; 2nd group – children with hyperopia, 22 persons; 3rd control group – children with emmetropia, 16 persons. Each group is divided into subgroups by age: 1st subgroup consisted of 35 children aged from 7 to 10 (mean age 8,9 ± 1,24 years old), 2nd subgroup – 23 children aged 11 to 14 (mean age 11,4 ± 2,45 years old). Of them, 28 were boys (56 eyes), girls – 30 (60 eyes).

The children underwent ophthalmologic examination including visometry, refractometry, skiascopy without cycloplegia, determination of reserves of accommodation by Dashevsky, and ophthalmoscopy. Measurement of blood pressure (BP) was performed with a professional tonometer LD-90, the vital capacity (VC) was measured with a dry spirometer SP, the percentage of oxyhemoglobin in arterial blood (SpO2) – using a pulse oximeter OP-31A.

Kerdo Vegetation Index (KVI) was calculated according to the data of the diastolic blood pressure and the heart rate. The calculation is made using the formula: KVI = (1-DBP / HR) × 100, where DBP – diastolic blood pressure, HR – heart rate. With the shift of vegetative tone towards sympathicotonia the diastolic pressure decreases, the heart rate increases. At parasympaticotonia the diastolic pressure increases, the heart rate decreases. Thus, KVI is an integer positive or negative number. At functional equilibrium (eutonia) DBP / HR = 1, KVI = 0, if DBP / HR <1, KVI is positive, if DBP / HR> 1, KVI is negative [4.10].

Statistical processing of the data was performed with a personal computer IBM PC using Microsoft Excel 2000, and statistical software package Statistica for Windows 5,5 and Biostat.

 

Results and discussion: The studies of cardio-respiratory parameters are presented in Tables 1 and 2.

 

Table 1. Dynamics of cardio-respiratory parameters in boys engaged in badminton for six months.

 

Age group

Quantity  n=

28

HR

SpO2

VC

BP

KVI

before

after

before

after

before

after

before

after

before

after

7-10 years old

19

93,5 ±0,93

85,8 ±2,29

87,2 ±0,91

94,0 ±0,85

1,8±0,06

1,95±0,09

97/63

±1,8

97/62

±1,7

0,75

0,72

±0,03

11-14 ëåò

9

91,3 ±0,41

82,3 ±1,06

92,0 ±0,8

96,7 ±0,54

1,95±0,09

2,42±0,04

105/65±2,3

103/63±1,8

0,71

±0,01

0,77

±0,02

Mean value

 

92,4 ±1,1

84,1

±1,7

89,6 ±2,4

95,3  ±1,35

1,87     ±0,08

2,2 ±0,23

101/64 ±0,8

100/63 ±0,7

0,73  ±0,02

0,75      ±0,02

 

 

Table 2. Dynamics of cardio-respiratory parameters in girls engaged in badminton for six months.

Age group

Quantity n=

30

HR

SpO2

VC

BP

KVI

before

after

before

after

before

after

before

after

before

after

7-10 years old

16

99,3 ±1,3

83,6 ±1,5

91,0 ±1,4

93,2 ±1,2

1,73±0,04

1,95±0,06

98/64

±1,6

99/63

±1,5

0,64

0,78

±0,03

11-14 years old

14

90,3 ±1,3

86,0 ±1,5

89,3 ±0,9

95,0 ±0,9

1,97±0,09

2,3±

0,04

107/74±1,5

104/67±1,5

0,78

±0,03

0,81

±0,03

Mean value

 

94,8 ±1,3

84,8

±1,5

90,2 ±0,8

94,1  ±0,9

1,85     ±0,06

2,13

±0,05

102/67 ±1,5

101/65 ±1,5

0,71

±0,02

0,80      ±0,03

 

As shown in Tables 1 and 2, the positive dynamics of cardio-respiratory parameters is observed in children playing badminton: heart rate and blood pressure return to normal, vital capacity increases by 0.33 liters for boys and by 0.28 liters for girls. The level of arterial oxygen saturation (oxygen saturation - SpO2) in boys rose by 5.7%, in girls – by 3.9%. Since SpO2 (saturation) indicators are correlated with the partial pressure of oxygen in the blood, which normally is 80-100 mm Hg. and corresponds to 95% -100% SpO2 [2], it is possible to infer the insufficient oxygenation of the arterial blood. This explains the low adaptation of the child's body to physical activity and a tendency to hypoxia development.

According to KVI indices, sympathicotonia dominated in boys in 100%, the girls have sympathicotonia in 73.5%, parasympaticotonia (vagotonia) – in 17.7%, and eutonia – in 8.8%.

It is known that the autonomic nervous system (ANS) plays an important role in the adaptation of the organism, participates in the mechanism of accommodation, in the development of connective tissue [3,7,9]. According to I.A. Viktorova and co-authors, sympathicotonia predominance is characteristic of dysplastic syndrome, while in healthy children eutonia and vagotonia are more common [4,6]. And vegetative balance – the relationship of its sympathetic and parasympathetic parts – matters, it is equal to one at rest. At exertion, ANS sympathetic activity should increase by 1.5 - 2 times. The obtained data in Tables 1 and 2 show KVI values increase in boys on an average by 0.02, and by 0.1 for girls.

Since the effect of parasympathetic ANS is revealed only in 17.7% of the surveyed girls and eutonia – in 8.8%, then we can speak about disorders of the connective tissue supporting properties. Therefore, disturbance of the state of the musculoskeletal system indicates low physical development of most of the children surveyed.

In addition, in accordance with the visometry findings and accommodation reserves (AR) research in children with commensurate refraction visual acuity did not change in the course of badminton training and remained equal to one. Reserves for accommodation increased in 75% of children in the control group, while 25% remained unchanged. The data are presented in Table 3.

 

Table 3. Dynamics of visual acuity and reserves of accommodation of children with emmetropia.

 

Age group

Quantity n=16

Visual acuity

AR

before

after

before

after

7-10 years old boys

8

1,0

1,0

-4,0±0,76

-6,0±0,61

7-10 years old girls

8

1,0

1,0

-1,0±0,34

-1,67±0,57

Mean value

 

1,0

1,0

-2,5±0,54

-3,8±0,66

 

Visual acuity in boys, after six months of badminton training, increased on an average by of 3 % in all age groups. AR increased 1.5 times in both age groups, indicating the development of the accommodative ability of the ciliary muscle (Table 4).

 

Table 4. Dynamics of visual acuity and accommodation reserve in boys.

 

Age group

Quantity n=20

Visual acuity

AR

before

after

before

after

7-10 years old

11

0,66±0,09

0,69±0,09

-2,8±0,54

-4,44±0,61

11-14 years old

9

0,61±0,08

0,65±0,08

-3,87±1,34

-5,25±1,12

Mean value

 

0,64±0,02

0,67±0,02

-3,34±0,5

-4,85±0,4

 

Table 5. Changes of refraction in boys involved in badminton training for six months

 

Age group

Quantity n=10

Myopia

Quantity n=10

Hypermetropy

before

after

before

after

7-10 years old

5

-2,3±0,44

 

-1,6±0,32

6

+3,17±0,82

+2,83±0,78

11-14 years old

5

-1,21±0,51

 

-0,96±0,15

4

+1,0±0,01

+1,0±0,01

Mean value

 

-1,67±0,24

-1,46±0,24

 

+2,63±0,65

+2,38±0,61

 

Table 5 shows that the refraction in children has changed. Myopia decreased by 0.21, hyperopia – by 0.25 in boys after six months of badminton sessions.

 

Table 6. Dynamics of visual acuity and accommodation reserve in girls.

 

Age group

Quantity n=30

Visual acuity

AR

before

after

before

after

7-10 years old

16

0,9±0,03

0,93±0,03

-2,2±0,39

-3,2±0,63

11-14 years old

14

0,76±0,05

0,83±0,05

-1,57±0,35

-2,43±0,38

Mean value

 

0,83±0,07

0,88±0,05

-1,89±0,32

-2,82±0,39

 

Table 6 shows that the visual acuity in girls has increased on an average by 5%, and AR increased 0.93 times.

 

Table 7. Changes in refraction of girls engaged in badminton training for six months.

 

Age group

Quantity n=10

Myopia

Quantity

n=12

Hypermetropy

before

after

before

after

7-10 years old

4

-1,0±0,12

 

-0,75±0,06

4

+1,0±0,01

 

+1,0±0,01

11-14 years old

6

-1,63±0,26

-1,34±0,23

 

8

+2,06±0,32

 

+1,87±0,31

Mean value

 

-1,36±0,19

 

-1,09±0,15

 

 

+1,71±0,23

+1,58±0,22

 

Table 7 shows that the visual acuity increases irrespective of refraction both in girls and in boys. After six months of badminton training, myopia decreased by 0.27, hyperopia – by 0.13, indicating the positive influence of badminton training on refraction.

 

Conclusions: Based on the results of clinical studies of children playing badminton, a beneficial effect of sport on the physical development of the body is observed; working ability of the body increases, cardio-respiratory indices improve, acuity and accommodation reserves increase, gradient of myopia progression reduces that improves the physical health of children and raises the functional capacity of the accommodation apparatus.

 

 

 

 

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