Krzysztof Jodzio, Denise A. Drumm

Krzysztof Jodzio, Denise A. Drumm – Cognitive disorders subsequent to ischemic heart disease from the physiotherapeutic perspective. Fizjoterapia Polska 2001; 1(2); 117-122

Abstract
Background. The contemporary model of rehabilitation for persons with ischemic heart disease (CHNS) emphasizes the necessity to coordinate the therapeutic interventions of various specialists who come into contact with the patient. One of the essential elements of such coordination, vital to the successful cooperation of the physiotherapeutic and physiotherapeutic teams, is the proper evaluation of the impact of chronic circulatory insufficiency on disturbances of cognitive process in persons with CHNS, which was the object the present study. Material and method. The research involved two groups of patients with CHNS and a control group of healthy persons (30 persons in each group, matched for sex, age educational status). Group I consisted of patients qualified for bypass surgery, while Group II included persons referred for conservative treatment exclusively. The instruments used to evaluate disturbances of cognitive functions included Benton’s Visual Memory Test, the Logical Memory subtest form Choynowski’s Memory Scale, the Bourdon-Wiersma Attention Test, Raven’s Matrix Test (standard version), and the Tapping Test from the Halstead-Reitan Battery. Results. Persons with CHNS were found to have significant deterioration of visual memory, problem-solving skills, and psychomotor speed, in comparison to healthy persons. Moreover, cognitive disturbances were found to be less severe in patients qualified for surgery than in those qualified for conservative treatment. The patients qualified for bypass surgery made fewer mistakes in the test of attention than those treated conservatively. The results are discussed in the context of the involvement of psychological factors in the treatment and rehabilitation of ischemic heart disease. Conclusions. Persons with CHNS exhibit relatively selective disturbances of cognitive functions, including visual memory, reasoning by analogy, and hand fine motor proficiency. The presence of numerous and/or pronounced cognitive disturbances suggesting brain dysfunction is a contraindication for open heart surgery. Testing cognitive functions and psychomotor efficiency in persons with CHNS broadens the scope of traditional psychological assessment for purposes of rehabilitation, which has traditionally focused on the emotional and characteristic of patients.

Key words:
ischemic heart disease, cognitive disturbances, coronary artery bypass graft (CABG)