Physical rehabilitation of patients with shoulder joint dysfunction after coronary artery bypass surgery

Background. Use of a complex of special exercises with a low-load long-term regime of tissue stretching in exercise therapy (ET) after a coronary artery bypass surgery is an effective method that enables not only to reduce and even eliminate completely pain sensations, but also to start the recovery process in the joint.

Aim: to evaluate the effectiveness of the low-load long-term regime of tissue stretching using special exercises in exercise therapy in patients with adhesive capsulitis of the shoulder joint that developed after coronary artery bypass surgery.

Methods. The study included 97 patients with coronary heart disease, who underwent coronary artery bypass surgery. At the inpatient rehabilitation stage 2, the patients were randomized into two comparable groups, namely the main group which received in addition to the standard rehabilitation program the therapy classes exercises aimed at relaxing, sparing stretching the shoulder girdle muscles and increase in the amplitude of movements in the shoulder joint, and the comparison group which was engaged in the traditional program. The patients’ condition was evaluated 12 and 26 days after the coronary artery bypass surgery. All patients underwent a comprehensive examination.

Results. When assessing the changes in time of exercise load tolerance, evaluated by the six-minute walk test, in patients of both compared groups, this indicator increased significantly in comparison with the initial level, however, in patients who practiced special exercises within ET, the increase was more pronounced. In addition, in patients who performed special exercises within ET, exercise tolerance was significantly higher before discharge at the stage II of rehabilitation in comparison with patients who applied traditional ET methods. When analyzing the changes in time of the severity of the range of motion limitation in the shoulder joint and the respiratory excursion index, their significant increase was noted only in the group with special exercises. In the group with traditional ET methods, these indicators have not been changed. After a month, these indicators in patients with traditional methods of exposure were significantly lower than in the group with special exercises.