Konsolinės žaidimų – eksžaidimų taikymas širdies reabilitacijoje: pilotinė studija

Kamil Szcześniak, Iwona Sarna, Anna Mierzyńska, Rafał Dąbrowski, Edyta Smolis-Bąk

 

Kamil Szcześniak, Iwona Sarna, Anna Mierzyńska, Rafał Dąbrowski, Edyta Smolis-Bąk– The application of console games – exergames in cardiac rehabilitation: a pilot study. Fizjoterapia Polska 2023; 23(4); 182-191

DOI: https://doi.org/10.56984/8ZG20AR1N

Santrauka
Įvadas. Per daug žmonių vengia reguliaraus fizinio aktyvumo, todėl įgyvendinamos įvairios strategijos, skirtos padidinti jų motyvaciją. Per pastaruosius metus populiarėja žaisti konsoliniais žaidimais, t.y. eksžaidimais, sportuojant.
Medžiaga ir metodai. Tyrimas apėmė pacientus, kurie buvo nukreipti į ankstyvą po ligoninės stacionarinį reabilitaciją. Visi subjektai dalyvavo ištvermės treniruotėse ant dviračio ergometruose ir fizinėse treniruotėse (dinaminėse, tempimo, koordinacijos, balanso) su pasipriešinimo treniravimo elementais 5 kartus per savaitę. Tyrimo grupėje reabilitacijos programa buvo papildyta treniruotėmis su ActivLife įranga. Treniruotės vyko kasdien, 5 kartus per savaitę. Jos apėmė treniruočių programą, kuri susideda iš 7 pratimų, skirtų vystyti judesio gebėjimus: koordinaciją, jėgą ir balansą, o tai atliekama veiklomis, panašiomis į tradicinius pratimus – kėliniai, šoninė lenkimas, viršutinių galūnių trimatės judesio ir kūno lenkimas sagitaliniame plane. Treniruotės truko nuo 15 iki 20 minučių.
Rezultatai. Po reabilitacijos pastebimas reikšmingas pakankamumo pagerėjimas abiejose grupėse šiuose testuose: 6MWT [m] – tyrimo grupė: 369 vs 426, p <0,05, kontrolinė grupė: 341 vs 434, p <0,001; apatinių galūnių raumenų jėgos testas [kartai per 30 s]: tyrimo grupė: 11,4 vs 13,6, p <0,001, kontrolinė grupė: 9,9 vs 13,1, p <0,001, ir Up&Go testas [s]: tyrimo grupė 7,8 vs 6,7, p <0,01, kontrolinė grupė 8,4 vs 7,3, p <0,01.
Išvados. Širdies ligoniams interaktyvūs konsoliniai žaidimai yra vertinami kaip patraukli, saugi ir naudinga fizinio aktyvumo forma. Treniruotės naudojant ActivLife įrangą pasirodė tokios pat veiksmingos kaip ir tradicinės treniruotės.
Raktažodžiai:
eksžaidimai, širdies reabilitacija, kardiologija, fizioterapija, mankšta
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Early physical rehabilitation in left ventricular assist device recipients

Katarzyna Gubała, Mariusz Stachowiak, Joanna Foik-Potęga, Karina Drżał, Agnieszka Biełka, Miłosz Cimcioch, Agnieszka Gaponik, Piotr Przybyłowski, Michał O. Zembala


Katarzyna Gubała, Mariusz Stachowiak, Joanna Foik-Potęga, Karina Drżał, Agnieszka Biełka, Miłosz Cimcioch, Agnieszka Gaponik, Piotr Przybyłowski, Michał O. Zembala – Early physical rehabilitation in left ventricular assist device recipients. Fizjoterapia Polska 2022; 22(3); 122-129

Abstract
Background. Left ventricular assist devices represent a significant advance in therapy of patients with end-stage heart failure. Early rehabilitation of patients implanted with left ventricular assist device is crucial and should be implemented as soon as possible. The aim of this study was to evaluate outcomes and establish algorithm for early cardiac rehabilitation in patients with end-stage heart failure implanted with continuous-flow left ventricular assist devices (CF-LVAD).
Methods. The study was designed as prospective, single center, observational study and included 68 patients who underwent early stage physiotherapy after CF-LVAD implantation in our institution in years 2017-2020. Therapeutic sessions took place in Intensive Care Unit and in Cardiac Surgery Unit. An algorithm of physiotherapeutic sessions included early mobilizations and transfers , breathing and circulatory exercises and finally training on a bicycle ergometer.
Results. The mean total hospitalization time of the studied group was 34.5 days. A significant statistical correlation between age and the result obtained in bicycle training was noted (p = 0.0007) as well as for the relationship between age and gaining independence (p = 0.03) and between time of first upstanding and total hospital stay (p = 0.001). We found no statistically significant correlations between BMI and the result obtained in the cycling training (p = 0.64).
Conclusions. In CF-LVAD recipients starting physical therapy as soon as possible is safe, effective and contributes to significant shortening of total hospital stay. Younger patients achieve better results in bicycle training and 6 minutes walking test.

Key words:
cardiac rehabilitation, continuous – flow left ventricular assist device, heart failure, mechanical circulatory support

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Rehabilitation of a patient following dynamic cardiomyoplasty

Grzegorz Mańko, Dominika Batycka, Rafał Stabrawa

Grzegorz Mańko, Dominika Batycka, Rafał Stabrawa – Rehabilitation of a patient following dynamic cardiomyoplasty. Fizjoterapia Polska 2001; 1(2); 167-172

Abstract
Background. The authors presents an evaluation of a rehabilitation program for a young patient who underwent dynamic cardiomyoplasty due to chronic cardiac insufficiency. Since this was one of the first cases in Poland in which this surgical method was used, it was necessary to develop a therapeutic program from the ground up, especially tailored to the specific nature of this operation and the patient’s needs, based on experience acquired in the Cardiovascular Surgery and Transplant Clinic at the Jagiellonian University’s Collegium Medicum, where the patient underwent intensive rehabilitation after cardiosurgery. The exercises were conducted in two stages: preoperative and post-operative (to 12 weeks after surgery). Method. The effectiveness of the therapy program was evaluated on the basis of basic parameters of upper limb function. Muscle strength, muscle folds, chest cavity circumference upon inhalation and exhalation, and strength of peak respiratory flow were measured. Results. As a result of pre-operative preparation the patient’s general condition was shown to have improved prior to surgery, which enabled him to better tolerate the cardiosurgical operation. An analysis of the results also indicates that as a result of the rehabilitation program implemented after surgery the general condition and functional status of the patient improved. Conclusions. The authorial program of rehabilitation applied in this case proved to be effective, both in terms of the patient’s pre-operative preparation and post-operative improvement. The targeted combination of isometric, exertion, relaxing, and stretching exercises, and their systematic application by the patient in the largest range of motion, exerted a positive impact on the quality of skeletal muscle, as evidenced by increased muscle mass, strength, and elasticity. The properly exercised and stimulated dorsus latissimus muscle proved to be suitable and fulfilled its role in the process of supporting the weakened heart; thanks to the pre-operative rehabilitation this muscle proved to be suitable for use in dynamic cardiomyoplasty, which in this case constituted an alternative to a heart transplant. Essential improvement was also noted in the patient’s self-evaluation of this health status.

Key words:
cardiological rehabilitation, cardiac surgery

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Psychiatric rehabilitation of a patient after myocardial infarct

Bożena Grochmal-Bach

Bożena Grochmal-Bach – Psychiatric rehabilitation of a patient after myocardial infarct. Fizjoterapia Polska 2001; 1(2); 161-166

Abstract
Background. The purpose of this article is to describe the psychiatric rehabilitation of patient RK, who in the course of cardiological rehabilitation subsequent to a myocardial infarct experienced psychopathological symptoms provoked by the crisis situation resulting from his heart attack. A specially developed program of psychiatric rehabilitation was implemented, using goal management techniques. Research methods. The instruments used to evaluate the effects of rehabilitation included clinical interviews oriented towards psychopathological symptoms, an abbreviated version of the Beck Depression inventory, the Claparede Memory Test, the Wechsler Memory Scale – Revised (Polish version), and an authorial Clinical Self-Evaluating Test of Cognitive, Emotional, Vegetative, and Neurobehavioral Disturbances, which includes measurements of anxiety, mood, sleep disturbances, psychomotor arousal, self-esteem, and fatigue. Results. When retested after 6 months of rehabilitation the patient proved to have higher level self-esteem, while symptoms of anxiety, depression, restlessness, and aggression had diminished. Despite the very small doses of antidepressive, antianxiety, and sedative drugs, the patient’s condition improved due various other of the therapy program. Conclusion. The patient described in this article was characterized prior to his heart attack by superficial politeness severing to conceal anxiety and the resultant aggression, which was directly related to the development of cardiomyopathy. The interdisciplinary treatment program involved an entire team, including especially cooperation between the psychiatrist and the physiotherapist. It was directed especially towards improving the patient’s ability to relax and cope with stress constructively, which made it possible to improve the patient’s physical condition in daily functioning, reduce physical and mental tension, ameliorate emotional disturbances, and rebuild disturbed cognitive functions, improvement was obtained not only in the patient’s overall condition, but also in his of life.

Key words:
cardiological rehabilitation, psychoterapy, psychotonic training

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Usefulness of three-stage walking test for evaluation of physical capacity on the basis of correlation with exercise treadmill test results in patients after CABG surgery

Edyta Smolis-Bąk, Barbara Kazimierska, Rafał Dąbrowski, Ilona Kowalik, Hanna Szwed

Edyta Smolis-Bąk, Barbara Kazimierska, Rafał Dąbrowski, Ilona Kowalik, Hanna Szwed – Usefulness of three-stage walking test for evaluation of physical capacity on the basis of correlation with exercise treadmill test results in patients after CABG surgery. Fizjoterapia Polska 2008; 8(1); 43-50

Abstract
Background. Reducing the duration of hospital stay of coronary surgery patients makes it necessary to develop reliable methods for the evaluation of their physical capacity. The aims of this study were as follows: 1. to assess the physical capacity of CABG patients. 2. to correlate the results of the treadmill test and the three-stage walking test. Material and methods. The study group consisted of 71 men aged 35-74 years qualified to undergo CABG with EF&gt;40% and with no arrhythmias or cardias conduction defects. All patients received comprehensive rehabilitation care. The following tests were performed before (examination 1) and 3 months after CABG (examination 2): modified 3-stage walking test according to Bassey and treadmill exercise test to the Bruce protocol. Parameters evaluated comprised energy expenditure (E, kJ/ml), maximum workload (METs), oxygen consumption (VO2, ml/min/kg), and oxygen pulse (HRO2, ml/systole). Results. Significant improvements across all parameters examined were observed three months after CABG. Treadmill exercise test results were significantly better than the results of the walking test (p&lt;0.001). There were correlations for oxygen pulse (r=0.63) and energy expenditure (r=0.51) between the treadmill test and self-paced walking test results at 3 months after CABG. Conclusions. The three-stage walking test may be useful in the evaluation of physical capacity. It may supplement clinical evaluation in post-CABG patients.
Key words:
cardiac rehabilitation, walking test, exercise test, VO2, CABG
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The use of the 6-minute walk test for the assessment of exercise tolerance of post-CABG patients in early hospital rehabilitation

Eugeniusz Bolach, Bartosz Bolach, Karolina Kozaruk

Eugeniusz Bolach, Bartosz Bolach, Karolina Kozaruk – The use of the 6-minute walk test for the assessment of exercise tolerance of post-CABG patients in early hospital rehabilitation. Fizjoterapia Polska 2009; 9(1); 75-83

Abstract
Background. The assessment of exercise tolerance in CABG patients has been the subject of research. However, the testing methods used, such as treadmill or cycle ergometer testing, require specialised equipment, the use of safety measures to protect the patient, and the assistance of qualified medical staff. The aim of this paper was to analyse the 6-minute walk test as used to assess exercise tolerance of CABG patients. A sun/ey was also developed and implemented to assess the impact of somatic cha-racteristics, co-existing medical conditions and coronary heart disease risk factors on exercise tolerance in these patients. Materiał and methods. The study involved 31 men with a history of coronary heart disease or myocardial infarction. The age rangę was 45-58 years, with a mean age of 51.5 years, mean body weight of 83.3 kg and mean height of 172.7 cm. Results. The results indicated considerable statistical significance between these characteristics. Conclusions. The walk test affords the possibility of assessing exercise tolerance in these patients, while also allowing phy-siotherapists to use the 6-minute walk test as a tool for assigning post-revascularisation patients to suitable rehabilitation pro-grammes. It should also be stated that the test is a simple and inexpensive supplement of clinical evaluation in such patients.
Key words:
coronary artery bypass grafting, corridor walk test, cardiological rehabilitation
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Does duration ofintubation influence ventilation parameters following CABG?

Edyta Smolis-Bąk, Barbara Kazimierska, Tomasz Kaszczyński, Ryszard Smolis, Rafał Dąbrowski, Ilona Kowalik, Dariusz Białoszewski, Anna Cabak, Hanna Szwed

Edyta Smolis-Bąk, Barbara Kazimierska, Tomasz Kaszczyński, Ryszard Smolis, Rafał Dąbrowski, Ilona Kowalik, Dariusz Białoszewski, Anna Cabak, Hanna Szwed – Does duration ofintubation influence ventilation parameters following CABG? Fizjoterapia Polska 2010; 10(1); 78-83

Abstract
Background. Contemporary cardiac surgery is increasingly relying on less invasive techniques to minimise hospital stay. We asses-sed the influence ofartificial ventilation time in CABG patients on ventilation parameters.Materiał and methods. The study enrolled 92 men aged 35-75 years following CABG undergoing rehabilitation. Patients were divi-ded into two groups based on duration of intubation: Group I included patients with artificial ventilation time (AVT) &lt;17 hours and Group II those with AVT &gt; 17h The correlation between AVT and respiratory capacity was assessed by spirometry before CABG, on fifth po-stoperative day, and at three months post-CABG.Results. The parameters decreased significantly in both groups on 5th post-operative day, except ERV (ns) in Group II. At 90 days post-surgery, all parameters had increased significantly compared to the 5th post-operative day readings in both groups, but FEV1 had not reached the preoperative level in either group. FVC EX was higher than pre-CABG value in Group I (ns) but not in Group II (p&lt;0.05). VC failed to reach preoperative levels in both groups (Gr I ns, Gr II p&lt;0.005).Conclusions. Most spirometric parameters tended to behave in the same manner irrespective of the duration ofAVT. Shorter AVThad a significant effect only on VC and FVC EX at 90 days after the surgery. The decrease in respiratory capacity was apparently related to the sternotomy associated with cardiac surgery.
Key words:
CABG, spirometry, cardiac rehabilitation
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Postępowanie fizjoterapeutyczne u pacjenta po pierwszej w Polsce implantacji sztucznego serca – SynCardia Total Artificial Heart (TAH)

Katarzyna Gubała, Agnieszka Gaponik, Mariusz Stachowiak, Joanna Foik-Potęga, Izabela Copik, Jacek Waszak, Małgorzata Jasińska, Remigiusz Antończyk, Michał Zembala

K. Gubała, A. Gaponik, M. Stachowiak, J. Foik-Potęga, I. Copik, J. Waszak, M. Jasińska, R. Antończyk, M. Zembala – Physiotherapeutic treatment in a patient after the first implantation of an artificial heart in Poland – SynCardia Total Artificial Heart (TAH). Fizjoterapia Polska 2020; 20(3); 54-66

Streszczenie
Wstęp. Złotym standardem w leczeniu skrajnej niewydolności serca jest transplantacja serca. Jednak ze względu na niewystarczającą ilość dawców dostęp do tej metody jest ograniczony. Wobec tego implantacja urządzeń mechanicznego wspomagania krążenia staje się coraz bardziej rozpowszechniona. Jedynym z nich jest całkowicie sztuczne serce – SynCardia Total Artificial Heart (TAH), dedykowane dla pacjentów z niewydolnością lewej, jak i prawej komory serca. Ze względu na inwazyjność zabiegu wszczepienia TAH konieczne jest natychmiastowe wdrożenie rehabilitacji celem jak najszybszej mobilizacji pacjenta oraz uzyskania przez niego samodzielności.
Cel. Określenie korzyści i bezpieczeństwa postępowania fizjoterapeutycznego przeprowadzonego u pacjenta po implantacji pierwszego w Polsce całkowicie sztucznego serca.
Podstawowe założenia. Postępowanie fizjoterapeutyczne prowadzone było zgodnie ze standardami rehabilitacji kardiologicznej, jednak ze szczególnym zwróceniem uwagi na indywidualizację całego procesu w oparciu o aktualny stan kliniczny pacjenta.
Wnioski. Przeprowadzone postępowanie fizjoterapeutyczne było korzystnym i niezbędnym elementem skoordynowanego leczenia pacjenta po implantacji TAH, pozwalającym na zredukowanie powikłań pooperacyjnych oraz uzyskanie samodzielności przez pacjenta.
Słowa kluczowe:
niewydolność serca, mechaniczne wspomaganie krążenia, sztuczne serce, rehabilitacja kardiologiczna
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The loss of body weight during cyclo-ergometer training in cardiac patients

Witold Pawełczyk, Iwona Kulik-Parobczy, Tomasz Sirek, Jacek Łuniewski, Katarzyna Bogacz, Jan Szczegielniak

W. Pawełczyk, I. Kulik-Parobczy, T. Sirek, J. Łuniewski, K. Bogacz, J. Szczegielniak – Spadek masy ciała u chorych kardiologicznych po treningu na cykloergometrze rowerowym. FP 2013; 13(3); 22-27

Abstract

Introduction. The problem of weight loss associated with the loss of wafer in athletes has been the subject of numerous studies. Until now, the average values of weight loss due to sweating at rest and while participating in some sports were calculated. However, no comprehensive studies have not been conducted info water loss in patients undergoing intensive physical exertion, including in patients after myocardial infarction, in the course of intensive rehabilitation.
Aim. the aim of this study was to assess weight loss in patients after myocardial infarction during intensive rehabilitation including training on cycle ergometer.
Material and methods. A total of 47 randomly selected patients (72 women, 35 men) treated in Rehabilitation Department of MSW Hospital in Glucholazy participated in the research. Before and after exercise, measurements were taken with the use of body mass weight Tanita SC 330S in all patients. In addition, for all patients at the end of rehabilitation program, 10-point questionnaire was used to examine fluid intake during the day, during and after physical exercises.
Results. There was a statistically significant difference (p <0.05) between body weight values before and after exercise. Based on the questionnaire, it was found that a large number of patients did not fake additional supplementary fluids, unless they experienced the feeling of thirst; the information about the quantity and type of fluid they should take was not given to patients during rehabilitation
Conclusions. The study showed a significant decrease in body weight after training conducted in patients undergoing cardiac rehabilitation. Lack of adequate hydration for patients in the course of their rehabilitation was found.
Complex cardiac rehabilitation program should take into account the need to maintain proper water balance.

Key words:
cardiac rehabilitation, water loss

Analysis of intramural cardiac rehabilitation services

Karol Wojciechowski, Marek Kiljański, Krzysztof Mirecki,
Jan Szczegielniak

K. Wojciechowski, M. Kiljański, K. Mirecki, J. Szczegielniak – Analysis of intramural cardiac rehabilitation services. FP 2015; 15(2); 100-108

Abstract

The aim of this paper was to make an attempt at characterizing a profile of patients referred for intramural systemic rehabilitation therapies. The analysis covered also an assessment of effectiveness of the rehabilitation applied to the patients.
The research material were data reported by five departments of intramural cardiac rehabilitation which had signed contracts with the Lodz Voivodeship Department of the National Health Fund. All the services had been performed in 2013.
The research showed that the largest group of patients subjected to intramural cardiac rehabilitation in the area of Lodz voivodeship in 2013 were the patients aged 56-75 (68,02% of all the researched).
The research analysis showed that the most commonly reported diagnosis was “unspecified heart failure” (58,04% of the whole of the research material).
The analysis of the modes of discharge from rehabilitation units showed that the mode of “completion of therapeutic or diagnostics process” accounted for 76,75% of all the researched patients.
It was noted that the vast majority of the patients subjected to cardiac rehabilitation were men (67,17% of the whole).

Key words:
cardiac rehabilitation, main diagnoses, discharge mode

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