Type 2 diabetes mellitus and rehabilitation after myocardial infarction

Paulina Głowacka, Katarzyna Mizia-Stec, Zbigniew Gąsior

Paulina Głowacka, Katarzyna Mizia-Stec, Zbigniew Gąsior – Type 2 diabetes mellitus and rehabilitation after myocardial infarction. Fizjoterapia Polska 2010; 10(4); 289-297

Abstract
This paper assesses the impact of type 2 diabetes mellitus (T2DM) on the effects of early post-discharge (Phase II) cardiac rehabilitation in post-myocardial infarction patients. The study involved 47 post-MI patients, of whom 21 had T2DM (Group I) and 26 did not have diabetes (Group II). Clinical symptoms and exercise test results according to the modified Bruce protocol were analysed at baseline and after 3 weeks of rehabilitation. HR and BP responses to exercise were evaluated along with metabolic expense and exercise duration. Both groups had a similar frequency of significant co-morbidities: arterial hypertension (76% in Group I and 73% in Group II) and lipid disorders (67% vs. 76%). Obesity was only found in Group II (36%). Both groups included patients after STEMI (75% in Group I vs. 69% in Group II) with no post-MI complications. The rehabilitation resulted in a significant improvement of exercise tolerance, which rose by 15% in METs, 20% in Watts, with test duration increasing by 13% in Group I, compared to 17%, 28%, and 16%, respectively, in Group II. Early post-discharge cardiac rehabilitation had a beneficial effect on exercise tolerance. In post-MI patients, type 2 diabetes diminishes the beneficial effects of rehabilitation.
Key words:
Diabetes Mellitus, Myocardial Infarction, phase II of cardiac rehabilitation
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Physiotherapy in patients after myocardial infarction

Włodzisław Kuliński, Sylwia Pająk

W. Kuliński, S. Pająk – Physiotherapy in patients after myocardial infarction. Fizjoterapia Polska 2019; 19(4); 6-22

Abstract
Background. Myocardial infarction is a serious social and health problem of modern society. Cardiac rehabilitation is a very important part of management in this group of patients.
Aim. To assess the efficacy of rehabilitation and its effects on cardiovascular and respiratory performance in patients after myocardial infarction.
Materials and methods. The study assessed a group of 30 patients who participated in 3-week day-care cardiac rehabilitation at the District Health Care Institution in Starachowice.
The effectiveness of rehabilitation was analysed using an original study card, divided into two parts (history taking and physical examination). The first part included personal and medical history and a scale for subjective assessment of exertion during daily activities, similar to the Borg scale. The other part included daily blood pressure and pulse measurements taken before and 5 minutes after cycle ergometer training. Dependent variables were verified before rehabilitation and after 15 days of rehabilitation.
Results. After rehabilitation, patients showed permanent cardiovascular adaptation to more intense exercise, reflected by reduced systolic and diastolic blood pressure values and a lower heart rate.
Conclusions. 1. Cardiac rehabilitation helped improve physical performance in patients after myocardial infarction. 2. Systolic pressure was reduced as early as after the first training and permanent cardiovascular adaptation to more intense exercise was seen in study patients, which was reflected by normal blood pressure and pulse values. 3. Rehabilitation had a positive influence on patient functioning in everyday life.

Key words:
myocardial infarction, physiotherapy

 

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Ocena ryzyka upadków wybranymi parametrami skali Berg u chorych po ostrych zespołach wieńcowych i po koronarografii

Grzegorz Biliński, M. Wójtowicz, Małgorzta Fuchs, Jacek Soboń, Henryk Racheniuk, Jan Szczegielniak

G. Biliński, M. Wójtowicz, M. Fuchs, J. Soboń, H. Racheniuk, J. Szczegielniak – Ocena ryzyka upadków wybranymi parametrami skali Berg u chorych po ostrych zespołach wieńcowych i po koronarografii. FP 2013; 13(4); 19-23

Streszczenie
Proces leczenia oraz wybrane badania diagnostyczne wykonywane w warunkach szpitalnych u chorych kardiologicznych często wymagają unieruchomienia. Procedury stosowane w leczeniu mogą u tych chorych mieć wpływ na zmianę kontroli posturalnej po unieruchomieniu i dotyczyć zaburzeń na poziomie aktywności dnia codziennego, uniemożliwiających albo utrudniających utrzymanie pionowej postawy ciała.
Celem przeprowadzonych badań była ocena stabilności postawy ciała u chorych po ostrych zespołach wieńcowych i po koronarografii.
Zbadano 70 chorych, w tym 35 po przebytym ostrym zespole wieńcowym leczonym interwencyjnie na oddziale kardiologicznym Wojewódzkiego Centrum Medycznego w Opolu. Podczas wykonywania poszczególnych prób badani chorzy utrzymywali równowagę ciała w wybranej pozycji przez określony czas.
Badania przeprowadzono za pomocą zmodyfikowanej skali Berg.

Słowa kluczowe:
zawał mięśnia sercowego, koronarografia, skala Berg, równowaga, upadki

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