EARLY PHYSICAL REHABILITATION IN ADULT PATIENTS AT THE STATIONARY PHASE AFTER OPEN-HEART SURGERY
Objective - to formulate the basic recommendations of using aerobic training programme for patients at the inpatient stage who underwent surgical intervention in the heart in the conditions of artificial circu-lation. Material and methods. The study included patients on 12-16 day after the open heart surgery in the conditions of artificial blood circulation. Rehabilitation activities were conducted in the early recovery period (up to 30 days) after surgical intervention in the Department of Cardiac Rehabilitation and Restorative Medicine. Criteria for inclusion of patients in the study: compensation or lack of heart failure, heart rate at rest ≤80 beats per minute, blood pressure ≥ 90/50 mm Hg and ≤ 140/90 at rest, while performing strenuous exercise less than 50 watts ≤ 11 points on the Borg scale (shortness of breath, fatigue). The study included 90 patients, of which 2 groups of patients were formed: the studied group (main group) ( n = 60) and control group ( n = 30). In addition to the main (studied) group, a group ( n = 15) was formed for the rehabilitation by the method of dance program (waltzing). General clinical parameters were evaluated, standard cardiological examination, spirometry and ergospirometry were carried out, main indicators of tolerance to strenuous exercise were evaluated (VO2peak, METs and Borg scale). The basis for the assessment of effectiveness was the indicators of body mass index, the end diastolic diameter, left ventricular ejection fraction, and glycosylated Hb, level of NT pro-BNP. 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 (29.6 ± 2.5 and 28.3 ± 2.1, p = 0.0032; vs 28.9 ± 2.0 and 29.3 ± 1.7, p = 0.4153), with an increase in the number of patients in I and II classes (respectively, p = 0.0032, p = 0.0095), as well as the positive dynamics of blood pressure (BP) in both groups in systolic BP (main p = 0.0000 vs control p = 0.0015) and diastolic BP (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. The obtained results allow us to determine the principles for the preparation of physical rehabilitation programmes for patients who underwent cardiac surgery in the conditions of artificial circulation, as well as to formulate the main recommendations of the using of various aerobic training programs.