A program of motor rehabilitation for patients in the early phase after cardiac surgery

Jan Talar, Grzegorz Mańko, Dominika Batycka

Jan Talar, Grzegorz Mańko, Dominika Batycka – A program of motor rehabilitation for patients in the early phase after cardiac surgery. Fizjoterapia Polska 2001; 1(2); 105-110

Background. This article describes a program of rehabilitation for patients recovering from cardiac surgery (including coronary by-passes, surgical repair of valve defects, and heart transplants) currently in use at the Cardiovascular Surgery and Transplantation Clinic at the Jagiellonian University’s Collegium Medicum in Cracow. Physiotherapeutic procedures implemented preand post-operatively are presented, with particular emphasis on respiratory and motor rehabilitation and an educational program intended to improve the patient’s sense of cognitive control. Material and methods. The effectiveness of this program was evaluated in a natural clinical experiment involving 42 patients who underwent rehabilitation after cardiac surgery. The patients were divided into two groups, matched by age and sex: a control group (K), consisting of 21 patients treated prior to the implementation of the new physiotherapy program, using traditional respiratory exercises, and an experimental group (E), also including 21 patients, who received the new program. The results were obtained from clinical observation, and from the evaluation of the patients’ scores on the Self-Evaluating Clinical Scale of cognitive, emotional, vegetative, and neurobehavioral disturbances and the Self-Evaluating Quality of Life Scale, as pertains to the patient’s health image, pain management, and the feeling of security. The patients were tested twice: once before rehabilitation (before the cardiosurgical operation), and again 7 days into the program. Results. The results obtained by these patients clearly indicated that the program here proposed is more effective than traditional programs in terms of patient satisfaction with the course of rehabilitation, increased motivation to exercise, and faster attainment of independence by the patient. The authors discuss the possible significance if brain hypoxia in the etiology of the cognitive and emotional deficits displayed by virtually all the patients. Conclusion. The rehabilitation program for patients recovering from cardiac surgery should be implemented even prior to surgery. It should include respiratory therapy and physiotherapy, with elements or patient education. The program described in this article supports improvement in the physical and psychological status of the patients in the early phase post-surgery, which leads to a better quality of life.

Key words:
cardias surgery, motor rehabilitation, respiratory exercises

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