Physical rehabilitation of the patients during the early postoperative period after coronary artery bypass surgery


Cite item

Full Text

Abstract

The purpose of the study. To estimate efficacy and safety of controlled cardio workouts on a treadmill in the early postoperative period for patients, who underwent coronary artery bypass surgery (CABS). Materials and methods. In the study there were109 patients having coronary artery disease and preserved systolic function of the left ventricle, who underwent coronary artery bypass surgery. The first group consisted of 59 patients who underwent not only standard cardiac rehabilitation activities in the early postoperative period, but also controlled cardio workouts on a treadmill. The second (control) group consisted of 50 patients with standard activities of physical rehabilitation. Cardio workouts with intensity of 3-6 MET were carried out on a running track before discharge of a patient from hospital, starting on the third-fourth day after surgery. At the same time thorough monitoring of blood pressure (BP), heart rate (HR), ECG were performed. At the end of the stationary phase of physical rehabilitation the patients in both groups filled the questionnaire «SF-36 Health Status Survey». The results. Initially, according to clinical and demographic and perioperative characteristics the compared groups did not differ authentically. At the end of the program of physical rehabilitation for the average value of the total post-operative bed day in the first (8,14 ± 0,99) and the second group (9,22 ± 1,64) statistically significant differences were obtained (р<0,0001), which are in favor of the studied population. According to the results of the questionnaire «SF-36» in the group of patients who underwent cardio workouts, the average indexes of physical, role functioning, mental health were significantly different from the results in the control group (accordingly р = 0,0038, р < 0,0001, р = 0,033). Conclusion. Carrying out ofcontrolled cardio workouts on a treadmill with a low intensity level at a stationary stage of rehabilitation of patients after CABS did not increase the risk of cardio - vascular events, did not cause attacks of stenocardia, significant changes in ECG and blood pressure, wound sequel, that is why we can consider that introduction of this method is safe.

About the authors

V. V Bazylev

Federal state budgetary institution «Federal Centre for Cardiovascular Surgery» of the Ministry of Health of the Russian Federation

Penza, Russia, 440071

N. V Gal’tseva

Federal state budgetary institution «Federal Centre for Cardiovascular Surgery» of the Ministry of Health of the Russian Federation

Email: galceva_nadezhda@mail.ru
зав. отделением физической реабилитации и ЛФК, врач-кардиолог, ФГБУ ФЦССХ Минздрава России Penza, Russia, 440071

References

  1. Boden W.E., O’Rourke Courage R.A., Teo K.K. et al. Trial Research Group. Optimal medical therapy with or without PCI for stable coronary disease. N. Engl. J. Med. 2007; 356: (15): 1503-16.
  2. Hambrecht R., Walther C. et al. Percutaneous coronary angioplasty compared with exercise training in patients with stable coronary artery disease: a randomized trial. Circulation. 2004; 109: (11): 1371-8.
  3. Katritsis D.G., Ioannidis J.P. Percutaneous coronary intervention versus conservative therapy in nonacute coronary artery disease: a meta-analysis. Circulation.2005; 111: (22): 2906-12.
  4. Panagopoulou E., Montgomery A. Quality of life after coronary artery bypass grafting: evaluating the influence of preoperative physical and psychosocial functioning. J. Psychosom. Res. 2006; 60: 639-44.
  5. Bradshaw P.J., Jamrozik K.D. Asymptomatic long-term survivors of coronary artery bypass surgery enjoy a quality of life equal to the general population. Am. Heart. J. 2006; 151: 537-44.
  6. Marwick T.H., Zuchowsk C. Functional status and quality of life in patients with heart failure undergoing coronary bypass surgery after assessment of myocardial viability. J. Am. Coll. Cardiol. 1999; 33: 750-8.
  7. Hammill B.G., Curtis L.H., Schulman K.A. et al. Relationship between cardiac rehabilitation and long-term risks of death and myocardial infarction among elderly medicare beneficiaries. Circulation. 2010; 121: 63-70.
  8. Myers J., Prakash M., Froelicher V. et al. Exercise capacity and mortality among men referred for exercise testing. N. Engl. J. Med. 2002; 346: 793-801.
  9. Jolliffe J.A., Rees K., Taylor R.S. et al. Exercise-based rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2011; (7): CD001800.
  10. Taylor R.S., Brown A., Ebrahim S. et al. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and metaanalysis of randomized controlled trials. Am. J. Med. 2004; 116: 682-92.
  11. AHA / ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 Update A Guideline from the American Heart Association and American College of Cardiology Foundation Endorsed by the World Heart Federation and the Preventive Cardiovascular Nurses Association. J. Am. Coll. Cardiol. 2011; 58 (23): 2432-46.
  12. Niebaujer Dzh. Cardiorehabilitation. [Kardioreabilitatsiya]: Transl. from Engl. Moscow: Logosfera; 2012: 116-8.
  13. ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J. Am. Coll. Cardiol. 2011; 58 (24): e123-210.
  14. Аронов Д.М., Бубнова М.Г. Комплексная программа медицинской реабилитации после чрескожного коронарного вмешательства при остром инфаркте миокарда у больных с ишемической болезнью сердца и артериальной гипертонией: эффективность, безопасность и результаты отдаленного наблюдения. Кардиосоматика. 2015; (1): 6-12.
  15. Тавровская Т.В. Велоэргометрия: Практическое пособие для врачей. СПб.; 2007: 4-9.
  16. Ware J.E., Snow K.K., Kosinski M., Gandek B. SF-36 Health Survey. Manual and Interpretation Guide. Boston: The Health Institute, New England Medical Center; 1993.
  17. Jolliffe J.A., Rees K., Taylor R.S. et al. Exercise-based rehabilitation for coronary heart disease. Cochrane Database Syst. Rev. 2011; (7): CD001800.
  18. Maines T.Y., Lavie C.J., Milani R.V. et al. Effects of cardiac rehabilitation and exercise programs on exercise capacity, coronary risk factors, behavior, and quality of life in patients with coronary artery disease. South. Med. J. 1997; 90: 43-9.
  19. Adachi H., Itoh H., Sakurai S. et al. Short-term physical training improves ventilatory response to exercise after coronary arterial bypass surgery. Jpn Circ. J. 2001; 65: 419-23.
  20. Chuang T.Y., Sung W.H., Lin C.Y. Application of a virtual realityenhanced exercise protocol in patients after coronary bypass. Arch. Phys. Med. Rehabil. 2005; 86: 1929-32.
  21. Moholdt T.T., Amundsen B.H., Rustad L.A., et al. Aerobic interval training versus continuous moderate exercise after coronary artery bypass surgery: a randomized study of cardiovascular effects and quality of life. Am. Heart J. 2009; 158: 1031-7.
  22. Onishi T., Shimada K., Sunayama S. et al. Effects of cardiac rehabilitation in patients with metabolic syndrome after coronary artery bypass grafting. J. Cardiol. 2009; 53: 381-7.
  23. Chicco A.J. Exercise training in prevention and rehabilitation: which training mode is best? Minerva Cardioangiol. 2008; 56 (5): 557-70.
  24. Naughton J. Exercise training for patients with coronary artery disease. Cardiac rehabilitation revisited. Sports Med. 1992; 14: 304-19.
  25. Hadian M., Attarbashi B. The effects of phase II cardiac rehabilitation on quality of life scales in post coronary artery bypass grafts patients. Modern Rehabil. 2007; 1: 3.
  26. Firouzabadi M.G., Sherafat A., Vafaeenasab M. Effect of physical activity on the life quality of coronary artery bypass graft patients. J. Med. Life. 2014; 7 (2): 260-3.

Copyright (c) 2016 Eco-Vector


 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies