Currently, there are no standards for medical rehabilitation of patients after surgical interventions on the heart. The treatment protocols of this category of patients proposed for practical use do not contain multiplicity, specific deadlines for monitoring the effectiveness of ongoing activities, predictors by which to assess the quality and effectiveness of each individual case.
Objective. To conduct a comparative analysis of the effectiveness of aerobic interval intensive physical training and constant moderate intensity training in cardiac rehabilitation of adult patients after open heart surgery.
Material and methods. The study included patients on the 16th day after open heart surgeries (under conditions of cardiopulmonary bypass) in the NRC them. A.N. Bakuleva for the period from 2015–2018. The study included (n=105) patients who underwent heart surgery, of which 2 groups of patients were formed: the study (main) group (n=60), in which rehabilitation measures were carried out and the control group, (n=45) in which rehabilitation measures were not carried out. Separately, groups of patients were compared according to rehabilitation programs: one carried out constant aerobic training of moderate and medium intensity, and others, aerobic interval high-intensity physical training. The waltz group was also analyzed in comparison with the control group. (Figure 1 – study design). The course of aerobic physical training was 2 weeks. All patients received drug therapy, including ACE inhibitors, β-blockers, diuretics, cardiac glycosides, antiplatelet agents, anticoagulants, antiarrhythmic drugs, if necessary. Other methods and approaches to treatment were identical, and corresponded to accepted Russian and International standards for the management of patients with relevant diseases.
Results. Carried out an objective assessment of the influence of physical training with different characteristics of patients who underwent surgical intervention in the heart in the conditions of artificial circulation. Analysis of body mass index revealed a significant decrease in the patients of the main group (26.9±2.5 and 28.3±2,1, p=0.0032 vs 28.9±2.0 and 29.3±1.7, p=0.4), with an increase in the number of patients in 1 and 2 classes (respectively, p=0.0032, p=0.0095), as well as the positive dynamics of BP in both groups in SBP (main p=0.0000 vs control p=0.0015) and DBP (main p=0.0000 vs control p=0.0003). The total power of the loads carried by patients in the main group significantly increased (p=0.0000 vs p=0.033).
Conclusion: Aerobic intervals of high-intensity physical exercises in the framework of cardioreactivation programs in patients after open heart surgery, as well as constant aerobic training of moderate frequency.
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- Boсkeria Leo Antonovich, Dr. Med. Sc., Professor, Academician of RAS and RAMS, Director, orcid.org/0000-0002-6180-2619;
- Kakuchaya Tea Tamazovna, Dr. Med. Sc, Chief of Department, orcid.org/0000-0001-9383-2073;
- Dzhitava Tamara Georgievna, Cand. Med. Sc., Cardiologist, orcid.org/0000-0002-6141-2231;
- Pachuashvili Nona Vazhaevna, Cand. Med. Sc., Cardiologist, orcid.org/0000-0002-0076-775X;
- Kuular Arzhana Makarovna, Cand. Med. Sc., Cardiologist, orcid.org/0000-0002-2133-9674