Tag: rehabilitacja kardiologiczna

The Impact of Thoracic Physiotherapy Procedures on Rehabilitation Outcomes in Patients after Coronary Artery Bypass Grafting

Katarzyna Bogacz, Anna Szczegielniak, Jacek Łuniewski, Bartosz Pańczyszak, Aleksandra Kucińska, Hanna Piekarska, Igor Świerkowski, Jan Szczegielniak

Katarzyna Bogacz et al. – The Impact of Thoracic Physiotherapy Procedures on Rehabilitation Outcomes in Patients after Coronary Artery Bypass Grafting –  Fizjoterapia Polska 2025; 25(5); 26-36

DOI: https://doi.org/10.56984/8ZGA4318Q2M

Abstract
Introduction. Coronary artery bypass grafting performed via median sternotomy frequently leads to postural disturbances, reduced thoracic mobility, and diaphragmatic dysfunction, which may adversely affect pulmonary ventilatory function and exercise tolerance. Supplementing standard cardiac rehabilitation with physiotherapeutic interventions targeted at the thorax and diaphragm may enhance the effectiveness of functional recovery in patients after CABG.
Aim of the Study. The aim of the study was to evaluate the effect of thoracic physiotherapy procedures on body posture, pulmonary ventilatory function, and exercise tolerance in patients after coronary artery bypass grafting.
Material and Methods. The study included 80 patients (28 women and 52 men) after OPCAB surgery, qualified for phase II cardiac rehabilitation. The patients were randomly assigned to an experimental group (I) and a control group (II). Both groups followed a 3-week standard cardiac rehabilitation program, while the experimental group additionally received exercises aimed at improving posture, thoracic mobility, and manual therapy techniques targeting the diaphragm. Before and after physiotherapy, body posture, breathing pattern, spirometric parameters, and exercise tolerance in the 6-minute walk test were assessed. Repeated-measures ANOVA was used for statistical analysis.
Results. After physiotherapy, both groups demonstrated a significant improvement in pulmonary ventilatory function and exercise tolerance (p < 0.05). The experimental group showed a significantly greater magnitude of changes in body posture, diaphragmatic function, spirometric parameters, and MET values in the 6-minute walk test compared with the control group.
Conclusions. Physiotherapeutic interventions targeted at the thorax and diaphragm constitute a valuable adjunct to standard cardiac rehabilitation in patients after coronary artery bypass grafting, contributing to improved respiratory function and exercise tolerance.
Key words
coronary artery bypass grafting, cardiac rehabilitation, respiratory physiotherapy, diaphragm, exercise tolerance, 6MWT
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Effects of bicycle ergometer training on functional capacity in phase I among heart valve surgery patients – a randomized controlled trial

Deepa, Senthil kumar T, Yogeshwari R, Sridevi S, Venkatesh N

 

Deepa, Senthil kumar T, Yogeshwari R, Sridevi S, Venkatesh N – Effects of bicycle ergometer training on functional capacity in phase I among heart valve surgery patients – a randomized controlled trial –  Fizjoterapia Polska 2025; 25(3); 89-94

DOI: https://doi.org/10.56984/8ZG7D1979F3

Abstract
Background. Valvular diseases and their surgical repair or replacement are increasing globally among cardiovascular conditions. Phase I post-surgery patients often experience pain, fatigue, reduced appetite, fear, and sleep disturbances, impairing physical activity. Bicycle ergometer training, conducted in a seated position, provides an effective alternative for immediate post-operative rehabilitation.
Aim. To compare the efficacy of a bicycle ergometer-based exercise program to a routine exercise protocol on functional capacity in phase I cardiac rehabilitation.
Methodology. Twenty-three patients aged 30 to 60 years, who underwent valve surgery with resting oxygen saturation greater than 90% and    low-risk profiles (left ventricular ejection fraction greater than 50%), were randomized into control (n = 12) and study (n = 11) groups. The control group received routine care, while the study group received routine care plus cycle ergometer training for 20 minutes, twice a day, starting from the third post-operative day until discharge. Both groups underwent the Six-Minute Walk Test before and after the intervention. Physiological responses such as heart rate (HR), blood pressure (BP), and oxygen saturation (SpO2) were monitored during training.
Results. Baseline characteristics were similar in both groups. There was an increase in the six-minute walk distance after training in both groups, and the mean difference was significant in the study group (365.5 ± 46.3) compared to the control group (266.7 ± 40.1) with p ≤ 0.05. In the study group, there was a significant reduction in resting HR (p = 0.048), peak HR (p = 0.010), and rate of perceived exertion (p = 0.04).
Conclusion. Bicycle ergometer training significantly improved functional capacity compared to routine care. It is feasible and beneficial for phase I cardiac rehabilitation in valve replacement surgery patients.
Key words
cardiac rehabilitation, valve replacement, bicycle ergometer, six-minute walk test, functional capacity
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The application of console games – exergames in cardiac rehabilitation: a pilot study

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

Abstract
Introduction. Too many people avoid regular physical activity, and therefore various strategies are taken to increase their motivation. In recent years, exercising with the use of console games, i.e. exergames, has gained popularity.
Material & Methods. The study included patients referred for an early post-hospital inpatient rehabilitation. All subjects participated in endurance training on cycle ergometers and in fitness exercises (dynamic, stretching, coordination, balance) with elements of resistance training 5 times per week. In the test group, the rehabilitation program was complemented with training with ActivLife equipment. Training sessions took place every day, 5 times a week. They involved training program consisting of 7 exercises that develop motor abilities: coordination, strength and balance in the form of activities similar to traditional exercises – squats, lateral flexion, three-plane movements of the upper limbs and torso deflections in sagittal plane. Trainings lasted from 15 to 20 minutes.
Results. After rehabilitation significant improvement of exertion tolerance was observed in patients in both groups in the following tests: 6MWT [m] – test group: 369 vs 426, p < 0.05, control group: 341 vs 434, p < 0.001; test of strength of the muscles in the lower limbs [number of repetitions/30s] were: test group: 11.4 vs 13.6, p < 0.001, control group: 9.9 vs 13.1, p < 0.001 and in the Up&Go Test [s]: test group 7.8 vs 6.7, p < 0.01, control group 8.4 vs 7.3, p < 0.01.
Conclusions. Interactive console games are evaluated by cardiac patients as an attractive, safe, and useful method of exercising. Training with the use of the ActivLife equipment has proved to be as effective as traditional exercises.
Key words:
exergames, cardiac rehabilitation, cardiology, physiotherapy, exercise
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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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hysiotherapeutic treatment in a patient after the first implantation of an artificial heart in Poland – 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

Abstract
Introduction. The gold standard in the treatment of extreme heart failure is heart transplantation. However, due to the insufficient number of donors, access to this method is limited. Therefore, the implantation of mechanical circulatory support devices is becoming more and more common. One of them is a completely artificial heart – SynCardia Total Artificial Heart (TAH), dedicated to patients with left and right ventricular failure. Due to the invasiveness of the TAH implantation procedure, it is necessary to immediately implement rehabilitation in order to mobilize the patient as soon as possible so that the patient gains independence.
Objective. To determine the benefits and safety of physiotherapeutic treatment carried out in a patient after implantation of the first completely artificial heart in Poland.
Basic assumptions. Physiotherapeutic treatment was carried out in accordance with the standards of cardiac rehabilitation, but with particular attention to the individualisation of the entire process based on the patient’s current clinical condition.
Conclusions. The performed physiotherapeutic treatment was a beneficial and necessary element of the coordinated treatment of the patient after TAH implantation, allowing for the reduction of postoperative complications and for the patient to regain independence.
Key words:
heart failure, mechanical circulatory support, artificial heart, cardiac rehabilitation

kardiologiczna

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