The object of the study is physical therapy of the elderly with respiratory and sarcopenic manifestations of post-COVID syndrome.The purpose of the study is theoretical justification, creation and verification of the effectiveness of a comprehensive physical therapy program for the elderly with post-COVID syndrome, aimed at improving the functional capabilities of patients and facilitating the performance of activities of daily living by correcting the signs of respiratory and sarcopenic consequences of the coronavirus disease.Research methods. Analysis and generalization of special and scientific and methodological literature. To characterize the changes associated with the general clinical signs of post-COVID syndrome, patient complaints were determined, the assessment was carried out using the Post-COVID-19 Functional Status scale. The parameters of respiratory consequences were analyzed using the modified Medical Research Council, respiratory rate, determination of the degree of blood oxygenation, spirometry indicators. Malnutrition indicators were characterized using the Mini Nutritional assessment, Simplified Nutrition Assessment Questionnaire. The anthropometric method was used to determine body mass index, shoulder and lower leg circumferences. Sarcopenia was characterized by Short Physical Performance Battery, handgrip dynamometry; Edmonton Frail Scale. Physical geriatric status was assessed by the 6-minute walk test, Senior Fitness Test, Functional Gait Assessment, Activities Balance Confidence (ABC) Scale. Fear of falling risk was assessed by the Fall efficacy scale. Limitations in activities of daily living were determined by the Barthel Activities of daily living Index. The degree of psychoemotional depression was determined by the Geriatric Depression Scale. Astheno-vegetative syndrome was described by the indicators of the test with isometric load, calculation of the Kerdo index, analysis of heart rate variability monitoring, Fatigue Assessment Scale. Methods of mathematical statistics (parametric and nonparametric criteria for testing statistical hypotheses) were used to analyze the results obtained. Theoretical and practical significance. It consists in creating a scientifically based comprehensive physical therapy program for the elderly with post-COVID syndrome, which contributed to reducing the severity of its respiratory and sarcopenic manifestations associated with respiratory dysfunction, muscle weakness, balance disorders, risk of falls, and depression by improving respiratory reserves, reducing signs of muscle weakness, malnutrition, improving static and dynamic balance, and reducing manifestations of depression and astheno-vegetative syndrome; determining the criteria for selection, sequence, dosage and parameters of use of physical therapy tools. The scientific novelty lies in the substantiation of scientific and theoretical foundations for the creation of a comprehensive physical therapy program for the elderly with respiratory and sarcopenic manifestations of post-COVID syndrome. For the first time, based on the analysis of the dynamics of respiratory and sarcopenic manifestations of post-COVID syndrome, a comprehensive physical therapy program in the long-term rehabilitation period for the elderly has been scientifically substantiated and tested, the defining features of which are the performance of therapeutic exercises of various orientations, the Otago exercise program, post-isometric relaxation, telerehabilitation, and patient education; for the first time, a comprehensive physical therapy program has been built from the standpoint of correcting sarcopenia in elderly patients not only as a non-respiratory manifestation of post-COVID syndrome, but also as a geriatric syndrome that occurs against the background of others (physical, mental, social) - malnutrition, senile asthenia, risk of falling, depression.
