Concept of choosing of physical rehabilitation programs for patients with coronary artery disease

Aim. To determine the feasibility of complex approach for the determination of individual tolerance to physical activity based on functional and biochemical markers, in order to choose an effective program of physical rehabilitation for patients with non-ST elevation acute coronary syndrome (NSTEACS...

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Main Authors: N. P. Lyamina, E. S. Karpova
Format: Article
Language:Russian
Published: «SILICEA-POLIGRAF» LLC 2019-04-01
Series:Кардиоваскулярная терапия и профилактика
Subjects:
Online Access:https://cardiovascular.elpub.ru/jour/article/view/786
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author N. P. Lyamina
E. S. Karpova
author_facet N. P. Lyamina
E. S. Karpova
author_sort N. P. Lyamina
collection DOAJ
description Aim. To determine the feasibility of complex approach for the determination of individual tolerance to physical activity based on functional and biochemical markers, in order to choose an effective program of physical rehabilitation for patients with non-ST elevation acute coronary syndrome (NSTEACS) after percutaneous coronary intervention (PCI).Material and methods. A prospective study included 80 patients with NSTEACS who underwent coronary revascularization. One month after the acute coronary event and conducting PCI, patients were invited to participate in cardiac rehabilitation programs, including with the inclusion of exercise program. In order to select a program of physical rehabilitation, a general clinical examination, an assessment of the risk of cardiovascular complications in NSTEACS, and an individual tolerance to physical activity were carried out. Individual tolerance to physical activity was assessed by the results of a loading test and biochemical markers characterizing metabolic processes during aerobic exercise. A loading test was performed on the Marquette-Hellige 2000 treadmill (Bruse protocol). According to the results of the exercise test and biochemical markers, patients were recommended to controlled walking or prescribed a short course of exercises with an intensity of 60% of the threshold power.Results. At the end of the short cycle of the exercise program, a significant increase of the minute oxygen consumption (MOC) was observed in 72,5%. In 15,5% of the remaining patients the increase of MOC was insignificant, and in 12% MOC remained at the initial level. The analysis of biochemical markers in the dynamics of these patients showed consistently elevated values. The level of urea and creatinine increased by 16,7% compared with baseline afterload parameters. The level of creatine phosphokinase decreased by 16-24% of the afterload data. Myoglobin level was 106,2+8,4 pig/i vs baseline 90,2±6,2 gg/l. In addition, the total duration of exercise programs in these patients was less than stated.Conclusion. Thus, focusing on the initial level of the MOC in determining of load is not always possible to obtain the expected increase in physical performance. In this case, the assessment of biochemical blood changes allows to determine signs of overstrain under the influence of physical exertion, which makes it possible to correct the level of load.
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spelling doaj.art-b4939099605e48a1bdd595aa2e7645372023-03-13T07:23:27Zrus«SILICEA-POLIGRAF» LLCКардиоваскулярная терапия и профилактика1728-88002619-01252019-04-01182131910.15829/1728-8800-2019-2-13-191902Concept of choosing of physical rehabilitation programs for patients with coronary artery diseaseN. P. Lyamina0E. S. Karpova1Научно-исследовательский институт кардиологии, ФГБОУ ВО “Саратовский государственный медицинский университет имени В. И. Разумовского” Министерства здравоохранения Российской Федерации; ГАУЗ “Московский научно-практический центр медицинской реабилитации, восстановительной и спортивной медицины” ДЗМНаучно-исследовательский институт кардиологии, ФГБОУ ВО “Саратовский государственный медицинский университет имени В. И. Разумовского” Министерства здравоохранения Российской ФедерацииAim. To determine the feasibility of complex approach for the determination of individual tolerance to physical activity based on functional and biochemical markers, in order to choose an effective program of physical rehabilitation for patients with non-ST elevation acute coronary syndrome (NSTEACS) after percutaneous coronary intervention (PCI).Material and methods. A prospective study included 80 patients with NSTEACS who underwent coronary revascularization. One month after the acute coronary event and conducting PCI, patients were invited to participate in cardiac rehabilitation programs, including with the inclusion of exercise program. In order to select a program of physical rehabilitation, a general clinical examination, an assessment of the risk of cardiovascular complications in NSTEACS, and an individual tolerance to physical activity were carried out. Individual tolerance to physical activity was assessed by the results of a loading test and biochemical markers characterizing metabolic processes during aerobic exercise. A loading test was performed on the Marquette-Hellige 2000 treadmill (Bruse protocol). According to the results of the exercise test and biochemical markers, patients were recommended to controlled walking or prescribed a short course of exercises with an intensity of 60% of the threshold power.Results. At the end of the short cycle of the exercise program, a significant increase of the minute oxygen consumption (MOC) was observed in 72,5%. In 15,5% of the remaining patients the increase of MOC was insignificant, and in 12% MOC remained at the initial level. The analysis of biochemical markers in the dynamics of these patients showed consistently elevated values. The level of urea and creatinine increased by 16,7% compared with baseline afterload parameters. The level of creatine phosphokinase decreased by 16-24% of the afterload data. Myoglobin level was 106,2+8,4 pig/i vs baseline 90,2±6,2 gg/l. In addition, the total duration of exercise programs in these patients was less than stated.Conclusion. Thus, focusing on the initial level of the MOC in determining of load is not always possible to obtain the expected increase in physical performance. In this case, the assessment of biochemical blood changes allows to determine signs of overstrain under the influence of physical exertion, which makes it possible to correct the level of load.https://cardiovascular.elpub.ru/jour/article/view/786физические нагрузкитолерантность к физическим нагрузкамбиохимические маркеры
spellingShingle N. P. Lyamina
E. S. Karpova
Concept of choosing of physical rehabilitation programs for patients with coronary artery disease
Кардиоваскулярная терапия и профилактика
физические нагрузки
толерантность к физическим нагрузкам
биохимические маркеры
title Concept of choosing of physical rehabilitation programs for patients with coronary artery disease
title_full Concept of choosing of physical rehabilitation programs for patients with coronary artery disease
title_fullStr Concept of choosing of physical rehabilitation programs for patients with coronary artery disease
title_full_unstemmed Concept of choosing of physical rehabilitation programs for patients with coronary artery disease
title_short Concept of choosing of physical rehabilitation programs for patients with coronary artery disease
title_sort concept of choosing of physical rehabilitation programs for patients with coronary artery disease
topic физические нагрузки
толерантность к физическим нагрузкам
биохимические маркеры
url https://cardiovascular.elpub.ru/jour/article/view/786
work_keys_str_mv AT nplyamina conceptofchoosingofphysicalrehabilitationprogramsforpatientswithcoronaryarterydisease
AT eskarpova conceptofchoosingofphysicalrehabilitationprogramsforpatientswithcoronaryarterydisease