Statementtype in complex rehabilitation and secondary prevention of cardiovascular disorders in patients with coronary heart disease

Abstract

The single-center randomized comparative study on revealing the clinical efficacy of the complex method of rehabilitation and secondary prevention of cardiovascular disorders in patients with ischemic heart disease with the inclusion of physical training with the use of stabilometric complex with biofeedback (stabilo-training), general iodine-bromine baths and infrared laser therapy in patients with ischemic heart disease in the remote period after surgical revascularization of myocardium. Observation was made in 60 patients with ischemic heart disease, in remote, not earlier than one year, terms after surgical revascularization of myocardium. Patients were divided into 2 groups by simple randomization method. Group 1, the main group consisted of 30 patients who received a complex rehabilitation method with the inclusion of stabilizing training, general iodine-bromine baths and infrared laser therapy; group 2, the comparison included 30 patients who received a rehabilitation course with the inclusion of general iodine-bromine baths and infrared laser therapy only. Cardiovascular disorders (CVD) were evaluated using electrocardiography (ECG) in standard leads, echocardiography (ECG), daily ECG monitoring with assessment of cardiac rhythm variability, veloergometry (VEM), stabilometry and a 6-point rating scale and psychological testing with the help of HAM and Spielberg tests. The study results were processed using the Statistica 8 for Windows application package. Preliminary calculation of sample power showed a sufficient number of patients in groups of 30 people. Calculation of statistical reliability of the results was performed by the Student-Fisher criterion. The differences between the two mean values were considered reliable at p<0.05. Under the influence of the complex with inclusion of statokinesoterapy in patients with IHD of the main group in comparison with the comparison group, more expressed antianginal and antiarrhythmic effects, increase of tolerance of physical activity, physical efficiency were noted. Positive ECG dynamics, increased cardiac output fraction, improved mood and sleep were noted. Positive dynamics of SSN in 85% of patients of the main group and in 65% of the comparison group was accompanied by increased stability in the vertical posture, decreased walking precariousness, improved coordination and equilibrium, decreased indices of the pressure center deviation (CD) in frontal and sagittal directions. The average rate of displacement of CD and the total area of the statokinesiogram decreased only in the main group of patients, in the comparison group the stated indices of stabilometry remained without dynamics. The total dynamics index of symptom severity decreased by 11±0.03 points in the main group of patients and by 6.7±0.01 points in the comparison group. The revealed positive clinical effects in patients with IHD in the distant period after surgical revascularization of myocardium, a complex method with inclusion of stabilokinesotherapy, allows to recommend this method of sensomotor physical training in complex rehabilitation programs with the purpose of SSN correction, prevention of development of acute coronary syndrome and heart insufficiency.