Tag: Grzegorz Mańko

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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Sport training as an alternative form of rehabilitation for heart transplant patients

Dominika Batycka, Grzegorz Mańko, Michał Stachnik

Dominika Batycka, Grzegorz Mańko, Michał Stachnik – Sport training as an alternative form of rehabilitation for heart transplant patients. Fizjoterapia Polska 2001; 1(2); 111-116

Abstract
Background. The goal of this study was to evaluate „sports training” as an alternative to the traditional forms of cardiac rehabilitation for patients in advanced recovery from heart transplant surgery. Sports training is a good, diversified form of therapy, and at the same time plays an additional role in social integration and relief of psychological stress. Material and method. The effectiveness of “sports training” was evaluated in a natural clinical experiment involving 34 patients undergoing rehabilitation in the Cardiovascular Surgery and Transplantation Clinic at the Jagiellonian University’s Collegium Medicum in Cracow. The patients were divided into a control group (K), including 17 patients (15 men and 2 women) who underwent rehabilitation before the implementation of “sports training”, using the traditional form of rehabilitation, and an experimental group (E), also including 17 patients matched by age and sex, who received “sports training”. Results. An analysis of the results obtained demonstrated no statistically significant difference between the outcome under traditional rehabilitation and in “sports training”, including respiratory parameters. Nothing in the results pointed to increased risks associated with sports training. Conclusion. Sports’ training is a good alternative to traditional forms of exercises for patients who are well advanced in recovery from heart transplant surgery.

Key words:
Heart Transplant, sport training, rehabilitation

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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

Abstract
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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Long-term respirotherapy, dishabituation from the respirator, and the rehabilitation process in a patient with marfan syndrome subsequent to surgery on an aortal aneurysm

Dominika Batycka, Grzegorz Mańko, Michał Stachnik, Donata Kołacz

Dominika Batycka, Grzegorz Mańko, Michał Stachnik, Donata Kołacz – Long-term respirotherapy, dishabituation from the respirator, and the rehabilitation process in a patient with marfan syndrome subsequent to surgery on an aortal aneurysm. Fizjoterapia Polska 2001; 1(3); 292-296

Abstract

The purpose of this article is to present the case of a patient with the Marfan syndrome who underwent surgery to repair an aortal aneurysm and his early rehabilitation, with particular emphasis on respiratory therapy. A 32-year-old patient with the Marfan syndrome was admitten to the Cardiovascular Surgery and Transplantology Clinic at the Jagiellonian University’s Collegium Medicum in Cracow, Poland, with suspected delamination of an aneurysm in the ascending aorta. Computer tomography revealed supravalvular dilatation of the ascending aorta along a 5-6 cm segment. Emergency surgery was performed using the Bental de Bono Composite Graft St. Jude Medical 25A method and ingrafting a venous bypass to the RCA. After surgery the patient was “suppressed” for 7 days in a drug-induced coma (low arterial blood pressure must be maintained initially in a patient with a surgically implanted prosthesis to prevent damage to the graft site). On the 8th day an attempt was made to extubate the patient. After ca. 14 hours of spontaneous respirator the patient was reintubed due to respiratory and circulatory insufficiency. On the 13th day when it proved impossible to terminate mechanical ventilation of the patient, a tracheotomy was performed. On the 19th day a successful effort was made to disconnect the patient from the respirator. At present the patient is breathing independently and is undergoing rehabilitation in the Department of Surgery. The article describes the program of early rehabilitation for this patient. The significance of the case for physiotherapy practice will be discussed.

Key words:
mechanical ventilation, Rehabilitation, Marfan Syndrome
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