Влияние тренировок в воде на состояние сердечно-сосудистой системы у пациентов с сахарным диабетом 2 типа: систематический обзор и метаанализ

Цель    Провести систематический обзор и мета-анализ данных исследований, изучавших влияние тренировок в воде (ВТ) на здоровье сердечно-сосудистой системы у пациентов с сахарным диабетом 2 типа (СД2).
Материал и методы    Поиск публикаций по исследованиям, изучавшим тренировки в воде у пациентов с СД2 проводился в базах данных PubMed, Cochrane, EMBASE, Web of Science и Ovid за период до 25 мая 2021 г. Основными анализируемыми параметрами были тест 6-минутной ходьбы (Т6МХ) и максимальное потребление кислорода (VO2max). Вторичными конечными точками были частота сердечных сокращений (ЧСС), систолическое (САД) и диастолическое (ДАД) артериальное давление в покое.
Результаты    Было отобрано 12 исследований, включивших 320 участников. Среди них в трех исследованиях ВТ сравнивались с упражнениями в зале, шесть исследований сравнивали ВТ с контролем без вмешательства и три исследования сравнивали результат до/после ВТ без контрольной группы. Мета-анализ показал, что по сравнению с исходным уровнем после тренировок в воде (исследования до/после) VO2max увеличился (взвешенная разница средних (ВРС)=0,71, 95% ДИ 0,47; 0,94), в то время как ЧСС покоя, САД покоя и ДАД покоя снижались (ВРС=-5,88, 95% ДИ -6,88;-4,88; ВРС=-5,76, 95% ДИ 7,75;-3,78; ВРС=-2,48, 95% ДИ -3,83;-1,13). При сравнении ВТ с группой контроля, дистанция Т6МХ и VO2max увеличились (ВРС=127,00, 95% 95%ДИ 49,26; 204,74; ВРС=2,02, 95% ДИ 1,66; 2,38, соответственно) и ЧСС покоя снизились (ВРС=-4,20, 95% ДИ -6,36; -2,03, ВТ по сравнению с контролем). Достоверных различий по указанным выше показателям между ВТ и тренировками в зале не выявлено.
Выводы    ВТ как и тренировки на суше увеличивают VO2max и снижают ЧСС покоя, САД и ДАД покоя. Динамика этих показателей говорит о положительном влиянии ВТ на состояние сердечно-сосудистой системы у пациентов с СД2. Однако необходимы дополнительные данные, чтобы подтвердить влияние ВТ на результаты Т6МХ у пациентов с СД2.

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