Gender-related dynamics of exercise tolerance in patients with acute coronary syndrome undergoing the outpatient phase of rehabilitation

Dovgalyuk, Yuri V.; Chistyakova, Yulia V.; Vorobyova, Tatyana V.; Mishina, Irina E.

doi:10.36425/rehab26343

Cited by 3 publications

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“…Клиническая значимость ТШХ высока: он может служить инструментом оценки функционального статуса (активности) больного; результаты ТШХ могут иметь прогностическое значение и рассматриваться предикторами летальности; данные ТШХ в динамике используются в кардиореабилитации для оценки результатов проведенной терапии [3][4][5][6].…”

Section: обоснованиеunclassified

Methods of Evaluation of Tolerance yo Physical Activity Based on Six-Minute Walking Test During Outpatient Rehabilitation of Patients with Ischemic Heart Disease

Mikhailovskaya

Валентиновна²,

Мишина

et al. 2021

Physical and rehabilitation medicine, medical rehabilitation

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Background.Even though the six-minute walking test is a simple and widely available tool for the evaluation of the functional capacity of cardiac patients, its interpretation is associated with some difficulties and contradictions.Aims:To evaluate the dynamics of tolerance to physical activity during outpatient rehabilitation of patients with ischemic heart disease using predicted values of distance in the six-minute walking test.Materials and methods.97 patients (70 men and 27 women, average age 59.6 [50; 60] years) after acute coronary syndrome and after myocardial revascularization were included. The six-minute walking test was performed at the beginning of the 3-weeks stage of cardiac rehabilitation and before the patients discharge. The results of the test were reported as an absolute value, a change in absolute value, and the percentage of predicted values, estimated with the reference equation by Enright and colleagues.Results.The absolute value of distance in the six-minute walking test was increased significantly from 418 [385; 465] m to 485 [440; 525] m (p0.001). The number of patients with a distance less than 300 m was decreased significantly (12 patients, 12% vs 2 patients, 2%,p0.001). In most patients, the absolute increase in distance was 30 m and more (81 people, 84%). After comparing the perceived data with the calculated predicted values, it was revealed that the distance raised from 79 [71; 82]% to 92 [88; 96]% of the predicted values. And 56 patients (58%) had a distance equal to 90% or more from its predicted value.Conclusions.During the third stage of cardiac rehabilitation the significant increase of the absolute value of the six-minute walking test, the growth of the percentage of predicted values, and the decrease of patients with a distance less than 300 m were found. All these estimation methods may be used to demonstrate and prove favourable changes of tolerance to physical activity in patients with ischemic heart disease.

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Section: обоснованиеunclassified

Methods of Evaluation of Tolerance yo Physical Activity Based on Six-Minute Walking Test During Outpatient Rehabilitation of Patients with Ischemic Heart Disease

Mikhailovskaya

Валентиновна²,

Мишина

et al. 2021

Physical and rehabilitation medicine, medical rehabilitation

Self Cite

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Physical Training effectiveness and Tolerance in Patients after Myocardial Infraction, Depending on the Initial Physical activity Tolerance

Chistyakova

Мишина

Dovgalyuk

et al. 2021

Bulletin of Rehabilitation Medicine

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Aim. To investigate exercise tolerance in patients undergoing acute coronary syndrome with outcome in myocardial infarction, dependingon physical activity tolerance. Material and methods. We studied 80 patients aged from 40 to 75 years old who were admitted from primary vascular centers for athree-week rehabilitation course to the department of medical rehabilitation for patients with somatic diseases of the clinic of the IvanovoState Medical University of the Ministry of Health of Russia, of which 61 were men (76,3%) and 19 women (23,7%). In accordancewith the aim of the study, a 6-minute walk test was performed in all patients before and after the completion of the rehabilitationcourse. Based on the test results, physical exercise tolerance was assessed and the functional class (FC) of coronary heart disease (CHD) was determined. The patients with I class coronary heart disease (CHD) in the number of 20 patients (25%) made up the 1st group, 21patients (26,3%) with II class – the 2nd group, 21 patients (26,3%) with III class – the 3rd group, and 18 patients (22,5%) with IV class– the 4th group. Results. Every third patient who was admitted to a 3-week cardiac rehabilitation course had short-term adverse reactionson loading during physical training on simulators. Most cases of inadequate reactions were noted in patients with III and IV IHDclass III (according to the 6-minute walk test) having, according to the International Classification of Functioning, Disability and Health(ICF), moderate and pronounced reduction of exercise tolerance function. Patients often had tachycardic and hypertensive reactionsin the porcess of prysical training on stimulators and some patients (more often those with the pronounced decrease in exercise tolerancefunction) had hypotensive reaction which is the most unfavorable type of response to the load. In the vast majority of patientswith I and II CHF with no impairment or mild decrease in exercise tolerance according to ICF, an adequate response of hemodynamicparameters to exercise was determined. Adverse reactions were observed only in every fifth-seventh patient and were manifested onlyin the form of tachycardic and hypertensive reactions to exercise. The study analyzed the effectiveness of rehabilitation measures inthe groups of patients with different levels of tolerance to physical activity. It was found out that all the patients with myocardial infarction,regardless of the initial level, had increased exercise tolerance after cardiac rehabilitation. Conclusion. The 6-minute walk test is insufficiently informative for patients with markedly reduced tolerance to physical activity. The«gold standard» of qualitative and quantitative assessment of reactions and interaction between cardiovascular and respiratory systems,as well as metabolic response of the body during physical activity for these patients is the spiroergometric study.

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Information Support as a Way to Improve Lifestyle Modification Adherence

Tarasevich

Kobzar

Strokova

2021

Bulletin of Rehabilitation Medicine

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The treatment compliance of cardiovascular and metabolic patients is one of the topical issues of modern medicine. Nowadays thereare not many effective interventions, which could increase adherence of patients to administered treatment. Aim. To determine the effectiveness of the program for correcting the eating behavior and physical activity of participants against thebackground of long-term informational support by the doctor, based on the analysis of the clinical and laboratory data dynamics, dailyreports of participants on the performed physical, control stress lactate tests and on the quality of life assessment. Material and methods. An open-label prospective study involved volunteers with a high body mass index (BMI), irrational diets,chronic self-imposed sleep deprivation and hypodynamia. Relevant blood chemistry values and microbiota were measured at thebeginning and at the end of the study; fasting glycemia, eating behavior and physical exercises were monitored on a daily basis. For 6months, the information support and comprehensive rehabilitation aimed at the lifestyle modification were provided. Results. At the end of the program, a reliable positive dynamics of body weight was recorded in 18 volunteers from 20% or more, ineight people – a decrease in body weight amounted to 20% of the laboratory indicators. When comparing studied laboratory indicatorsof 0-6 months, a statistically significant reduction in such indicators was obtained as a serum glucose concentration (median 5.8 VS4.4 mmol / l, p <0.01), homocysteine (median 8,9 VS 7, 7 μmol / l, p <0,01), atherogenic index (median 2.5 VS 2.4, p <0.05), with increasein vitamin D3 concentration (median 21,5 VS 54.9 ng / ml, p <0.01) in patients, compared to the indicators before complex rehabilitation.A statistically significant (p <0.01) improvement in well-being was recorded on all scales of the SF-36 quality of life questionnaire,which remained in dynamics a year after the program is completed. Conclusion. Permanent training, discrete screening and episodic treatment, implemented in programs of information support forlifestyle modification, can be considered as an effective method of involving an individual in the process of personalized health preservationand improvement and, ultimately, the population as a whole.

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Gender-related dynamics of exercise tolerance in patients with acute coronary syndrome undergoing the outpatient phase of rehabilitation

Cited by 3 publications

References 5 publications

Methods of Evaluation of Tolerance yo Physical Activity Based on Six-Minute Walking Test During Outpatient Rehabilitation of Patients with Ischemic Heart Disease

Methods of Evaluation of Tolerance yo Physical Activity Based on Six-Minute Walking Test During Outpatient Rehabilitation of Patients with Ischemic Heart Disease

Physical Training effectiveness and Tolerance in Patients after Myocardial Infraction, Depending on the Initial Physical activity Tolerance

Information Support as a Way to Improve Lifestyle Modification Adherence

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