Influence of an early rehabilitation program with aerobic activity on the postoperative period in patients with coronary artery bypass grafting

Lyapina, I. N.; Argunova, Yu.A.; Помешкина, С. А.; Барбараш, О. Л.

doi:10.17116/profmed20212401186

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…Однако структура программы реабилитации, сроки ее начала зависят от самой патологии сердца и сосудов. В основу реабилитации пациентов после хирургической коррекции приобретенных пороков сердца (ППС) легли стандарты реабилитации больных, перенесших КШ [6][7][8][9][10][11][12].…”

Section: материал и методыunclassified

“…В работах зарубежных и российских авторов убедительно показана эффективность и безопасность ранних аэробных физических нагрузок для пациентов, перенесших КШ [7][8][9]11]. Однако современные рекомендации по реабилитации пациентов с КШ не могут быть в полной мере применены к группе пациентов после хирургической коррекции ППС.…”

Section: материал и методыunclassified

“…частоты сердечных сокращений (ЧСС) при СВЭМ, воспринимаемое напряжение по шкале Борга, не >13 баллов по 20-балльной шкале. Данная интенсивность нагрузки была выбрана в соответствии с рекомендациями по физическим тренировкам пациентам с хронической сердечной недостаточностью [20], и на основании рекомендаций по реабилитации пациентов после операции КШ [6], собственного опыта ранней реабилитации пациентов после планового КШ, проведенного в условиях искусственного кровообращения [8,9].…”

Section: кардиоваскулярная терапия и профилактика 2023;22unclassified

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Effect of early postoperative rehabilitation with aerobic exercise on functional status and cardiac remodeling in patients after heart valve surgery

Lyapina

Shaleva

Teplova

et al. 2023

Cardiovasc Ther Prev

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Aim. To develop a program for early physical rehabilitation of inpatients after heart valve surgery and to evaluate its effectiveness and safety.Material and methods. The study included 80 patients with valvular heart disease (VHD) after elective on pump valve surgery. Patients in the control group (n=47) underwent standard cardiac rehabilitation after surgery; patients of the main group (n=33) additionally, starting from the 8th day after the intervention, had 14-day treadmill training with the program selection, taking into account the results of cycle ergometry spirometry (CES). A week after the operation and at the end of the training course (median, 24 days after the operation), cardiac remodeling and functional status was assessed according to echocardiography and CE, respectively.Results. For 7 days after surgery, patients of both groups were comparable. During physical training in the main group, there were no lifethreatening cardiac arrhythmias, episodes of ischemia, desaturation, as well as intracardiac hemodynamics deterioration. With a 14-day training, CES showed a significant increase in exercise tolerance (ET) in the main group from a median of 50 to 75 W (p=0,002), peak oxygen uptake (VO2peak) from 11,7 to 13,4 ml/kg/min (p=0,001). For 24 days after surgery in the control group, there was a trend towards improvement in ET and VO2peak, but without significant changes (p=0,09/p=0,08).Conclusion. Early inhospital rehabilitation, including physical training of moderate intensity with an individual treadmill speed and incline angle, starting from day 8 after surgery, showed effectiveness and safety in the form of an increase in ET and VO2peak, while not worsening hemodynamic parameters.

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Section: материал и методыunclassified

Section: кардиоваскулярная терапия и профилактика 2023;22unclassified

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Effect of early postoperative rehabilitation with aerobic exercise on functional status and cardiac remodeling in patients after heart valve surgery

Lyapina

Shaleva

Teplova

et al. 2023

Cardiovasc Ther Prev

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Dynamics of anxiety, depression, and quality of life after early physical rehabilitation of patients who underwent surgical correction of acquired mitral valve defect: clinical prospective randomized study

et al. 2023

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BACKGROUND: The activation of the patient from the day after an acquired mitral valve (MV) defect with standard cardiorehabilitation surgery and further physical training at an early uncomplicated inpatient stage of the postoperative period appears promising to improve not only the functional status but also the quality of life (QL). AIM: Our aim was to examine the effect of early physical rehabilitation on the dynamics of anxiety, depression, and QL in patients after surgical correction of the MV defect. MATERIALS AND METHODS: The study included 80 patients (median age 60.8 [47.5; 69.0] years) who underwent surgical correction of an acquired MV defect. Starting from the 7th day after the surgery, patients were assessed for functional status, and the intensity of the training load was selected, and this was done again on the 24th day after the surgery. Moreover, the QL parameters on the SF-36 scale and levels of anxiety and depression on the Hospital Anxiety and Depression Scale (HADS) were evaluated. The control group (n=47) underwent a standard cardiac rehabilitation program from 1st day after surgery. In the main group (n=33), based on the results of the cardiopulmonary exercise testing, physical training on a treadmill was initiated for 14 days, from the 8th day after the surgery, in addition to a personalized training program. RESULTS: In addition to improving the functional state, early physical training improved the dynamics of QL indicators in the main group. After 14 days of treadmill training, the physical health component increased from a median of 35.1 to 64.4 (p=0.03), and the mental health component from a median of 49.1 to 82.1 (p=0.03). In addition, after the early physical rehabilitation program in the main group, the number of people without anxiety and depression, according to the HADS scale, significantly increased from 9% to 27.3% (p=0.04), whereas the dynamics of the QL, anxiety, and depression levels in the control group were not significant. CONCLUSION: Early physical rehabilitation, including moderate-intensity workouts with an individual calculation of the speed / angle of the treadmill, starting from 8 days after surgical correction of the acquired MV defect demonstrated efficacy in improving the QL and reducing anxiety and depression levels 24 days after surgery.

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Early Physical Rehabilitation in Frail Patients Undergoing Coronary Artery Bypass Surgery

Argunova

Помешкина

Барбараш

2022

Bulletin of Rehabilitation Medicine

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To date, there are insufficient data on the concept of exploring rehabilitation potential in older patients with frailty syndrome, while developing strategies to improve outcomes after cardiac surgery and reducing the number of postoperative complications remains a relevant topic. Aim. To assess safety and feasibility of early physical rehabilitation in frail patients undergoing coronary artery bypass grafting (CABG). Material and methods. The study included 49 patients with stable coronary artery disease (CAD) admitted for elective CABG with cardiopulmonary bypass (CPB). Patients were randomized into two groups according to the approach to physical rehabilitation: in the early rehabilitation group (n=22), treadmill workouts were conducted starting from the 7th postoperative day and continued at the second stage of inpatient rehabilitation. Patients in the control group (n=27) had no treadmill training. In the inpatient rehabilitation setting, the incidence and the type of complications were assessed; on the 6th day and 21-23 days after CABG, the results of the cardiopulmonary exercise testing (CPET) were analyzed. Results and discussion. The groups were similar in baseline intraoperative characteristics. Postoperative complications occurred in 18% of patients in the early rehabilitation group and in 48% of patients in the control group (p=0.037). In the group of patients with early rehabilitation, the rate of postoperative complications decreased by 4 times compared to the control group (OR – 0.24; 95% CI – 0.06-0.896). Peak oxygen consumption (p=0.03) and exercise tolerance (p=0.03) were significantly higher in the group of patients with the early rehabilitation according to CPET conducted three weeks after the surgery. At the present stage, it seems optimal to shift the start of physical rehabilitation in postoperative period to the earlier dates. Minimizing the patient’s immobilization period helps to optimize the course of the postoperative period. Conclusion. Early rehabilitation in the postoperative period of CABG in patients with frailty is associated with lower incidence of postoperative complications and improvements in physical capacity of patients by the end of the hospital stay

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Influence of an early rehabilitation program with aerobic activity on the postoperative period in patients with coronary artery bypass grafting

Cited by 3 publications

References 11 publications

Effect of early postoperative rehabilitation with aerobic exercise on functional status and cardiac remodeling in patients after heart valve surgery

Effect of early postoperative rehabilitation with aerobic exercise on functional status and cardiac remodeling in patients after heart valve surgery

Dynamics of anxiety, depression, and quality of life after early physical rehabilitation of patients who underwent surgical correction of acquired mitral valve defect: clinical prospective randomized study

Early Physical Rehabilitation in Frail Patients Undergoing Coronary Artery Bypass Surgery

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