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Medical Rehabilitation - quarterly journal
Volume 13 year 2009, Issue number 2
The influence on physical fitness as well as on elements of the psychic state of mind and the quality of life of rehabilitation extension by an ambulatory form for patients previously subjected to stationary rehabilitation following interventionally treated acute coronary syndrome
Wpływ wydłużenia o formę ambulatoryjną wczesnej stacjonarnej rehabilitacji pacjentów po leczonym interwencyjnie ostrym zespole wieńcowym na wydolność fizyczną oraz elementy stanu psychicznego ijakości życia
Izabela Przywarska 1,2, Ewa Deskur-Śmielecka 1, Sławomira Borowicz-Bieńkowska1,2, Małgorzata Wilk 1,2,3, Aleksandra Brychcy 2, Piotr Dylewicz 1,2
1 The Cardiological Rehabilitation Department of the Academy of Physical Education in Poznań, Poland
2 The Cardiological Rehabilitation Unit of the Provincial Hospital in Poznań, Poland
3 College of Education and Therapy in Poznań, Poland
Cardiological rehabilitation, acute coronary syndrome, exertion tolerance, quality of life, psychic state
Objectives: The evaluation of the direct and remote effects of stationary rehabilitation following interventionally treated acute coronary syndrome and its extension by a three-month period of supervised training in ambulatory conditions within the scope of physical fitness, psychic state and quality of life.
Materials and methods: The research was conducted on a group of 44 patients (32 men and 12 women) aged 56.9±9, 62 years old for a period of 2-3 weeks following interventional treatment of acute coronary syndrome. All the patients had participated in stationary rehabilitation with 14 expressing a willingness to participate in a futher three-month period of ambulatory rehabilitation. All patients prior to the commencement of rehabilitation had threadmill exertion tests, fear was evaluated by means of the SOPER questionnaire, basic mood and psychic tension as well as the feeling of health were assessed by means of the VAS scale of the EuroQol 5D questionnaire. The set of tests was repeated after the completion of the stationary phase, and after time periods of 3 months and a year.
Results: Patients subjected to the extended ambulatory phase 3-month period of rehabilitation displayed a greater increase in exercise tolerance when compared with the group that had merely undergone the 3-week stationary rehabilitation. Patients with extended rehabilitation gradually improved their evaluation of their state of health and after a year maintained it at the level it had been after the completion of the stationary rehabilitation. In patients who did not express a willingness to continue an organised form of exercise in ambulatory conditions the noticeable improvement in health following the end of rehabilitaiton was not lasting in nature. After a year, regardless of the programme of rehabilitation selected, there was noted an improvement in the psychic state, expressed in an increased positive mood although the level of fear did not change to a significant degree.
Conclusions:1. Extended rehabilitation, combining stationary and ambulatory forms, following on from intervention treatment of ACS gives a better longterm effect in the area of improving physical fitness and self evaluation of one’s state of health than is the case after three-week stationary rehabilitation. 2. The extending of the period of rehabilitation has no influence on the obtainment of post-rehabilitation changes on the level of mood and fear.