Araştırma Makalesi
Miyokard infarktüsü geçirmiş hastalarda hastanede kardiyak rehabilitasyon ve ev egzersiz programının etkileri
Öz
Amaç: Miyokard infarktüsü (MI) geçiren
hastalarda, egzersiz temelli rehabilitasyon, tedavinin önemli bir parçasıdır.
Çalışmamızın amacı, MI geçiren hastalarda, hastanede yapılan kardiyak
rehabilitasyon ile ev egzersiz programının kardiyak parametreler üzerindeki
etkisini karşılaştırmaktı.
Yöntem: Çalışmaya 1 ay öncesinde MI geçiren stabil 35 hasta alındı. Hastalar
rastgele iki gruba randomize edildi: aerobik egzersiz eğitimi grubu (I), ev
egzersiz grubu (II). Grup I, hastanede 6 haftalık aerobik egzersiz programına
katıldı. Grup II için evde aşamalı fiziksel aktivite programı öngörüldü.
Bulgular: Grup I’de, ejeksiyon fraksiyonu (EF), altı dakika
yürüme testi (6-DYT), kol ergometresi testi, VO2max ve anaerobik zaman (AT)
değerlerinde artış olduğu bulundu. Aynı zamanda grup II’deki 6-DYT, kol
ergometresi testi ve AT değerlerinde de anlamlı artışlar vardı. Kol ergometresi
testi değerlerindeki değişim oranı, hastane grubunda daha yüksekti.
Sonuçlar: Hastanede yapılan egzersiz programına katılamayacak
düşük veya orta riskli hastalar için, evde yapılan egzersiz programları, iyi
bir alternatif olabilir.
Anahtar Kelimeler
Kardiyak rehabilitasyon miyokard infarktüsü ev egzersiz programı hastanede egzersiz programı
Kaynakça
- 1. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR. White HD Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction. Third universal definition of myocardial infarction. Circulation 2012; 16; 126 (16): 2020-2035.
- 2. Uysal H. Kardiyak Rehabilitasyonda Hasta Eğitimi. Türkiye Klinikleri J Cardiol-Special Topics 2012; 5(2): 26-32.
- 3. Gürses N. Akut Miyokard İnfarktüsü Sonrası Rehabilitasyon. Türkiye Klinikleri J Cardiol 2002; 15(5): 357-363.
- 4. Wenger NK. Current status of cardiac rehabilitation. J Am Coll Cardiol 2008; 51: 1619-1631.
- 5. Metkus TS Jr, Baughman KL, Thompson PD. Exercise Prescription and Primary Prevention of Cardiovascular Disease Circulation 2010; 121: 2601-2604.
- 6. Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ, Thompson PD, Williams MA, Lauer MS. American Heart Association; Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention); Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity); American association of Cardiovascular and Pulmonary Rehabilitation. Cardiac Rehabilitation and Secondary Prevention of Coronary Heart Disease An American Heart Association Scientific Statement From the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in Collaboration With the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation 2005; 111(3): 369-376.
- 7. Karapolat H, Durmaz B. Kardiyak Rehabilitasyonda Egzersiz. Anatolian J Cardiol 2008; 8: 51-57.
- 8. Garrow JS, Webster J. Quetelet's index (W/H2) as a measure of fatness. Int J Obes. 1985;9(2):147-53).
- 9. Balke B. A simple field test for the assessment of physical fitness. REP 63-6. Rep Civ Aeromed Res Inst US 1963: 1-8.
- 10. Fiorina C, Vizzardi E, Lorusso R, Maggio M, De Cicco G, Nodari S, Faggiano P, Dei Cas L. The 6-min walking test early after cardiac surgery. Reference values and the effects of rehabilitation programme. Eur J Cardiothorac Surg. 2007 Nov;32(5):724-9.
- 11. Jolliffe JA, Rees K, Taylor RS, Thompson D, Oldridge N, Ebrahim S. Exercise-based rehabilitation for coronary heart disease (Cochrane Review): Cochrane Database Syst Rev. 2001; 1: CD001800.
- 12. Kellermann JJ. Long-term Comprehensive Cardiac Care: the perspectives and tasks of cardiac rehabilitation. Eur Heart J 1993; 14(11): 1441-1444.
- 13. Giannuzzi P, Temporelli PL, Tavazzi L, Corrá U, Gattone M, Imparato A, Giordano A, Schweiger C, Sala L, Malinverni C. EAMI-Exercise Training in Anterior Myocardial Infarction: an ongoing multicenter randomized study: Preliminary results on left ventricular function and remodeling. Chest 1992; 101(5 Suppl): 315-321.
- 14. Aros F, Armentia J, Castillo C, Cardo JC, Loma-Osoria AN. Evaluation of home physical training soon after acute myocardial infarction. Rev Esp Cardiol 1993; 46(9): 544-551.
- 15. Kim C, Kim DY, Lee DW. The impact of early regular cardiac rehabilitation program on myocardial function after acute myocardial infarction. Ann Rehabil Med 2011; 35: 535-540.
- 16. Giallauria F, Acampa W, Ricci F, Vitelli A, Torella G, Lucci R, Del Prete G, Zampella E, Assante R, Rengo G, et al. Exercise training early after acute myocardial infarction reduces stress-induced hypoperfusion and improves left ventricular function. Eur J Nucl Med Mol Imaging. 2013; 40(3): 315-324.
- 17. Palevo G, Keteyian SJ, Kang M, Caputo JL. Resistance Exercise Training Improves Heart Function and Physical Fitness in Stable Patients With Heart Failure. Cardiopulm Rehabil Prev 2009; 29: 294-298.
- 18. Giannuzzi P, Temporelli PL, Corrà U, Tavazzi L; ELVD-CHF Study Group. Antiremodeling effect of long-term exercise training in patients with stable chronic heart failure: results of the Exercise in Left Ventricular Dysfunction and Chronic Heart Failure (ELVD-CHF) Trial. Circulation. 2003; 108(5): 554-559.
- 19. Taylor RS, Brown A, Ebrahim S, Jolliffe J, Noorani H, Rees K, Skidmore B, Stone JA, Thompson DR, Oldridge N. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med 2004; 116(10): 682-692.
- 20. Lee HY, Kim JH, Kim BO, Byun YS, Cho S, Goh CW, Ahn H, Rhee KJ, Kim C. Regular exercise training reduces coronary restenosis after percutaneous coronary intervention in patients with acute myocardial infarction. Int J Cardiol 2013; 167(6): 2617-2622.
- 21. Kim C, Youn JE, Choi HE. The effect of a self exercise program in cardiac rehabilitation for patients with coronary artery disease. Ann Rehabil Med 2011; 35(3): 381-387.
- 22. Dubach P, Myers J, Dziekan G, Goebbels U, Reinhart W, Vogt P, Ratti R, Muller P, Miettunen R, Buser P. Effect of exercise training on myocardial remodeling in patients with reduced left ventricular function after myocardial infarction: application of magnetic resonance imaging. Circulation 1997; 95(8): 2060-2067.
- 23. Kargarfard M, Rouzbehani R, Basati F. Effects of exercise rehabilitation on blood pressure of patients after myocardial infarction. Int J Prev Med 2010; 1(2): 124-130.
- 24. Golabchi A, Basati F, Kargarfard M, Sadeghi M. Can cardiac rehabilitation programs improve functional capacity and left ventricular diastolic function in patients with mechanical reperfusion after ST elevation myocardial infarction?: A double-blind clinical trial. ARYA Atheroscler 2012; 8(3): 125-129.
- 25. Aamot IL, Moholdt T, Amundsen BH, Solberg HS, Mørkved S, Støylen A. Onset of exercise training 14 days after uncomplicated myocardial infarction: a randomized controlled trial. Eur J Cardiovasc Prev Rehabil 2010; 17(4): 387-392.
- 26. Jolly K, Taylor RS, Lip GY, Stevens A. Home-based cardiac rehabilitation compared with centre-based rehabilitation and usual care: A systematic review and meta-analysis. Int J Cardiol 2006; 111(3): 343-351.
- 27. Daskapan A, Arikan H, Caglar N Tunali N, Ataman S. Comparison of supervised exercise training and home-based exercise training in chronic heart failure. Saudi Med J 2005; 26(5): 842-847
- 28. Anderson L, Thompson DR, Oldridge N, Zwisler AD, Rees K, Martin N, Taylor RS. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2016 Jan 5;(1):CD001800
Effects of hospital-based cardiac rehabilitation and home-based exercise program in patients with previous myocardial infarction
Öz
Background: Exercise-based rehabilitation
is an important part of treatment patients following myocardial infarction.
Method: We studied 35
post–myocardial infarction patients having a 1-month myocardial infarction
history with a stable disease. The patients were randomly assigned to 2 groups
as follows: aerobic exercise training group (I), home-based exercise group
(II). The group I participated in the aerobic exercise program at the hospital
for 6 weeks. Group II was prescribed a home-based gradual physical activity
program.
Results: It was found
that there were significant increases in the values of ejection fraction (EF), the
six-minutes-walk test (6-MWT), arm ergometer test, VO2max, anaerobic time
in group I. It was also found that there were significant increases in the
values of 6-MWT, arm ergometer
test, and anaerobic time in group II. The ratio of change in arm ergometer test
values was higher in the hospital group.
Conclusions: Home-based exercise
programs can be a good alternative for patients with low or moderate risk who
can't attend hospital-based exercise programs.
Anahtar Kelimeler
Cardiac rehabilitation myocardial infarction home-based exercise program hospital-based exercise program
Kaynakça
- 1. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR. White HD Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction. Third universal definition of myocardial infarction. Circulation 2012; 16; 126 (16): 2020-2035.
- 2. Uysal H. Kardiyak Rehabilitasyonda Hasta Eğitimi. Türkiye Klinikleri J Cardiol-Special Topics 2012; 5(2): 26-32.
- 3. Gürses N. Akut Miyokard İnfarktüsü Sonrası Rehabilitasyon. Türkiye Klinikleri J Cardiol 2002; 15(5): 357-363.
- 4. Wenger NK. Current status of cardiac rehabilitation. J Am Coll Cardiol 2008; 51: 1619-1631.
- 5. Metkus TS Jr, Baughman KL, Thompson PD. Exercise Prescription and Primary Prevention of Cardiovascular Disease Circulation 2010; 121: 2601-2604.
- 6. Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ, Thompson PD, Williams MA, Lauer MS. American Heart Association; Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention); Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity); American association of Cardiovascular and Pulmonary Rehabilitation. Cardiac Rehabilitation and Secondary Prevention of Coronary Heart Disease An American Heart Association Scientific Statement From the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in Collaboration With the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation 2005; 111(3): 369-376.
- 7. Karapolat H, Durmaz B. Kardiyak Rehabilitasyonda Egzersiz. Anatolian J Cardiol 2008; 8: 51-57.
- 8. Garrow JS, Webster J. Quetelet's index (W/H2) as a measure of fatness. Int J Obes. 1985;9(2):147-53).
- 9. Balke B. A simple field test for the assessment of physical fitness. REP 63-6. Rep Civ Aeromed Res Inst US 1963: 1-8.
- 10. Fiorina C, Vizzardi E, Lorusso R, Maggio M, De Cicco G, Nodari S, Faggiano P, Dei Cas L. The 6-min walking test early after cardiac surgery. Reference values and the effects of rehabilitation programme. Eur J Cardiothorac Surg. 2007 Nov;32(5):724-9.
- 11. Jolliffe JA, Rees K, Taylor RS, Thompson D, Oldridge N, Ebrahim S. Exercise-based rehabilitation for coronary heart disease (Cochrane Review): Cochrane Database Syst Rev. 2001; 1: CD001800.
- 12. Kellermann JJ. Long-term Comprehensive Cardiac Care: the perspectives and tasks of cardiac rehabilitation. Eur Heart J 1993; 14(11): 1441-1444.
- 13. Giannuzzi P, Temporelli PL, Tavazzi L, Corrá U, Gattone M, Imparato A, Giordano A, Schweiger C, Sala L, Malinverni C. EAMI-Exercise Training in Anterior Myocardial Infarction: an ongoing multicenter randomized study: Preliminary results on left ventricular function and remodeling. Chest 1992; 101(5 Suppl): 315-321.
- 14. Aros F, Armentia J, Castillo C, Cardo JC, Loma-Osoria AN. Evaluation of home physical training soon after acute myocardial infarction. Rev Esp Cardiol 1993; 46(9): 544-551.
- 15. Kim C, Kim DY, Lee DW. The impact of early regular cardiac rehabilitation program on myocardial function after acute myocardial infarction. Ann Rehabil Med 2011; 35: 535-540.
- 16. Giallauria F, Acampa W, Ricci F, Vitelli A, Torella G, Lucci R, Del Prete G, Zampella E, Assante R, Rengo G, et al. Exercise training early after acute myocardial infarction reduces stress-induced hypoperfusion and improves left ventricular function. Eur J Nucl Med Mol Imaging. 2013; 40(3): 315-324.
- 17. Palevo G, Keteyian SJ, Kang M, Caputo JL. Resistance Exercise Training Improves Heart Function and Physical Fitness in Stable Patients With Heart Failure. Cardiopulm Rehabil Prev 2009; 29: 294-298.
- 18. Giannuzzi P, Temporelli PL, Corrà U, Tavazzi L; ELVD-CHF Study Group. Antiremodeling effect of long-term exercise training in patients with stable chronic heart failure: results of the Exercise in Left Ventricular Dysfunction and Chronic Heart Failure (ELVD-CHF) Trial. Circulation. 2003; 108(5): 554-559.
- 19. Taylor RS, Brown A, Ebrahim S, Jolliffe J, Noorani H, Rees K, Skidmore B, Stone JA, Thompson DR, Oldridge N. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med 2004; 116(10): 682-692.
- 20. Lee HY, Kim JH, Kim BO, Byun YS, Cho S, Goh CW, Ahn H, Rhee KJ, Kim C. Regular exercise training reduces coronary restenosis after percutaneous coronary intervention in patients with acute myocardial infarction. Int J Cardiol 2013; 167(6): 2617-2622.
- 21. Kim C, Youn JE, Choi HE. The effect of a self exercise program in cardiac rehabilitation for patients with coronary artery disease. Ann Rehabil Med 2011; 35(3): 381-387.
- 22. Dubach P, Myers J, Dziekan G, Goebbels U, Reinhart W, Vogt P, Ratti R, Muller P, Miettunen R, Buser P. Effect of exercise training on myocardial remodeling in patients with reduced left ventricular function after myocardial infarction: application of magnetic resonance imaging. Circulation 1997; 95(8): 2060-2067.
- 23. Kargarfard M, Rouzbehani R, Basati F. Effects of exercise rehabilitation on blood pressure of patients after myocardial infarction. Int J Prev Med 2010; 1(2): 124-130.
- 24. Golabchi A, Basati F, Kargarfard M, Sadeghi M. Can cardiac rehabilitation programs improve functional capacity and left ventricular diastolic function in patients with mechanical reperfusion after ST elevation myocardial infarction?: A double-blind clinical trial. ARYA Atheroscler 2012; 8(3): 125-129.
- 25. Aamot IL, Moholdt T, Amundsen BH, Solberg HS, Mørkved S, Støylen A. Onset of exercise training 14 days after uncomplicated myocardial infarction: a randomized controlled trial. Eur J Cardiovasc Prev Rehabil 2010; 17(4): 387-392.
- 26. Jolly K, Taylor RS, Lip GY, Stevens A. Home-based cardiac rehabilitation compared with centre-based rehabilitation and usual care: A systematic review and meta-analysis. Int J Cardiol 2006; 111(3): 343-351.
- 27. Daskapan A, Arikan H, Caglar N Tunali N, Ataman S. Comparison of supervised exercise training and home-based exercise training in chronic heart failure. Saudi Med J 2005; 26(5): 842-847
- 28. Anderson L, Thompson DR, Oldridge N, Zwisler AD, Rees K, Martin N, Taylor RS. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2016 Jan 5;(1):CD001800
Toplam 28 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Medical Science Research Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 20 Mart 2018 |
| Kabul Tarihi | 1 Şubat 2018 |
| Yayımlandığı Sayı | Yıl 2018Cilt: 40 Sayı: 1 |