New Assessment of Overall Tolerance in the Rehabilitation of Patients in the Early Recovery Period of Ischemic Stroke

Abstract

Enhanced external counterpulsation (EECP) has taken a worthy place among other methods in the complex treatment and rehabilitation of patients with cardiovascular pathology. Its use in outpatient and sanatorium-clinical practice significantly expands the prospect of treatment and improvement of prognosis in a wide range of patients with multifocal atherosclerosis. Aim. To study the effect of the EECP method in the complex medical rehabilitation of stable forms of coronary heart disease (CHD) in patients permanently residing in the resort city of Sochi. Material and methods. The study included 60 patients with CHD (FC II – 23, FC III – 29, FC IV – 8) living in the resort city of Sochi. Patients were randomized into intervention and control groups, in which there were no significant differences between clinical and anthropometric parameters. All of them received basic drug therapy, a complex of climatotherapeutic non-drug effects and attended the Coronary Club, a public health school for patients with СHD. Additional outpatient courses of EECP were conducted in the form of 35 one-hour sessions daily, 5 days a week, a full course for 7 weeks for each patient of the intervention group on basis. Initially and after the end of the rehabilitation course, the patients of both groups underwent electrocardiography (ECG), bifunctional daily ECG and blood pressure monitoring, Doppler echocardiography, ultrasound duplex scanning of brachycephalic vessels and lower limb vessels, exercise test on cycle ergometer, six-minute walking test, as well as physical activity level determination using IPAQ questionnaire and psychodiagnostic testing. Results and discussion. When comparing the data, patients in the intervention group showed a significant reduction in angina attacks and nitroglycerine use, stabilization of central haemodynamic parameters, increased exercise tolerance and improved subjective “quality of life” indicators. Conclusion. The data obtained confirm the experience accumulated in the world medical practice of the effective clinical impact of the EECP method in the treatment of patients with chronic coronary syndromes in outpatient treatment, including in conditions of humid subtropical climate. Therefore, its inclusion in the programs of complex sanatorium-resort rehabilitation of patients with stable forms of CHD is justified and promising.