Tag: cardiological rehabilitation

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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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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