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