The impact of cardiac rehabilitation on haemodynamic parameters, respiratory function and cardiovascular disease risk factors in heart failure patients

Dominika Zielińska, Jerzy Bellwon, Andrzej Rynkiewicz, Małgorzata Kusiak-Kaczmarek, Stanisław Bakuła

Dominika Zielińska, Jerzy Bellwon, Andrzej Rynkiewicz, Małgorzata Kusiak-Kaczmarek, Stanisław Bakuła – The impact of cardiac rehabilitation on haemodynamic parameters, respiratory function and cardiovascular disease risk factors in heart failure patients. Fizjoterapia Polska 2008; 8(2); 139-152

Abstract
Background. Recent scientific data are revealing an epidemic of heart failure. The aim of the study was to evaluate the effect of exercise on left ventricular function and spirometry results and assess the usefulness of cardiac rehabilitation for modification of cardiovascular risk factors. Material and methods. 61 patients with NTHA class II-III heart failure (54 men, 7 women) aged 60±10 years, LVEF≤ 40%; 51 due to coronary artery disease and 10 due to non-ischaemic dilatedcardiomyopathy. 43 patients (REHAB group) underwent 3 week ambulatory exercise program. 18 subjects refused to participate (NREHAB group) and were instructed about the influence of exercise and lifestyle modification on prognosis in heart failure. REHAB patients continued the exercise program for 9 weeks at home. Spirometry, echocardiography and lipid profile determination were performed on entry and on completion of the program. Results. Testing systolic blood pressure in REHAB decreased from 117,2±14,2 mmHg on entry to 106,4±14,8 mmHg at the end of rehabilitation (p<0,05). LVEF increased significantly in the REHAB group from 32,7±8,3% do 35±8,4%. The lipid profile improved, with TC decreasing from 218,8±39,7 do 189,4 ±18,4 mmol/l, TG decreasing from 150,2 ± 76,8mmol/l to 117,4 ± 52,8mmol/l). VC ex and in increased significantly. In the NREHAB group, these parameters did not change significantly. Conclusions. Cardiac rehabilitation appears to improve left ventricular systolic function as assessed with the ejection fraction, and some parameters of pulmonary function. It faciliates the correction of some cardiovascular risk factors in patients witch chronic heart failure.
Key words:
heart failure, physical exercise, spirometry
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Usability of sEMG analysis for the evaluation of the muscles stimulation sequence in the lumbosciatic area in patients suffering from pain in lumbar spine

Karolina Kleist-Lamk, Rita Hansdorfer-Korzon, Stanisław Bakuła, Elżbieta Rajkowska-Labon

K. Kleist-Lamk, R. Hansdorfer-Korzon, S. Bakuła, E. Rajkowska-Labon – Usability of sEMG analysis for the evaluation of the muscles stimulation sequence in the lumbosciatic area in patients suffering from pain in lumbar spine. FP 2014; 14(3); 56-64

Abstract

Aim of the study: 1.  Evaluation of the relationship between the change in the stimulation sequence of muscles in the lumbosciatic area and the occurrence of functional pain in the L section of the vertebral column, as compared to the Janda’s model.
2. Analysis of the differences in the superficial electromyography (sEMG) record of a correct and disturbed pattern of muscle recruitment during the prone hip extension test in two sub-groups of patients: suffering from pain (sub-group A) and without pain (sub-group B).
3. Evaluation of the suitability of the sEMG measurement for making diagnoses in patients with pains in the lumbar section of the vertebral column.
The material and method: For the research, 61 persons were qualified, aged 20-35 years, with the average age 25 years (+/- 6). The tested group was divided into two sub-groups. 33 persons were qualified to sub-group A, and to sub-group B (reference group) 28 persons were qualified. Among the participants, a questionnaire was spread, prepared for the needs of the survey, to be filled in. For testing the sequence of stimulations, the measurements were used which had been obtained from the sEMG record during the Prone Hip Extension (PHE )Test.
Results: The results obtained during the examination of the muscles recruitment pattern in PHE test showed a changed sequence of muscles activation in the Patients from sub-group A vs. these from sub-group B. The results of chi-square test (χ²) confirmed the statistically significant dependence: the persons with pain symptoms in the lumbar spine statistically less frequently showed the correct sequence of muscles engagement:  χ²=5.05,  p=0.041, R= – 0.59 (strong negative dependence).
Conclusions: Changes in the pattern of muscles recruitment during the hip joint extension lead to overloads in the lumbosciatic area, consequently causing pain in the lumbar section. Superficial electromyography, because of the possibility of obtaining the quantitative outcome, is a useful method of evaluating muscles performance.

Key words:
The Janda test, Prone Hip Extension Test, PHE, sEMG, LBP, pain in the lower part of back

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