Эффективность программы ранней реабилитации с применением дистанционных технологий на амбулаторном этапе у пациентов после хирургической коррекции приобретенных клапанных пороков сердца

Abstract

Aim: to investigate the clinical safety and efficacy of a combined rehabilitation consisting of early rehabilitation with physical training in the hospital and remote rehabilitation using a mobile application in the outpatient setting after surgery for acquired valvular heart disease (VHD) using bypass Patients and Methods: the study involved 68 patients who underwent surgery for VHD, with 34 patients in the study group and 34 patients in the control group, based on their rehabilitation approach The study group consisted of two subgroups based on the type of rehabilitation. The subgroup that underwent complex rehabilitation (n=16) participated in treadmill training for 2 weeks in the inpatient setting at least 8 days after surgery, followed by remote rehabilitation in the outpatient setting using a mobile application. The subgroup that underwent remote rehabilitation (n=18) did not undergo early inpatient treadmill training. The control group only received standard cardiac rehabilitation methods Results: there were no significant differences in the rate or type of complications during the early postoperative period A more significant improvement in functional status was reported in the subgroup that underwent complex rehabilitation 24 days after surgery, compared to patients who did not receive early physical training as part of their rehabilitation program. The subgroup undergoing complex rehabilitation showed a significantly greater improvement in exercise tolerance (p=0.03) and peak oxygen uptake (p=0.04) 24 days after surgery. These indices continued to increase (p=0.04; p=0.03) by month 4 of the follow-up compared to postoperative day 7. These changes were more significant in the complex rehabilitation group than in the remote rehabilitation group. Patients who underwent complex rehabilitation showed better adherence to using the mobile application for remote rehabilitation than patients who underwent remote rehabilitation (50% vs. 38.8%; p=0.04). Conclusion: the rehabilitation program for patients after surgery for VHD, which includes early moderate-intensity physical treadmill training followed by outpatient distance rehabilitation using a mobile application, is safe and effective This is demonstrated by a significant improvement in functional status Additionally, early initiation of physical training is associated with better adherence to further use of distance rehabilitation technologies KEYWORDS: valvular heart disease, heart surgery, postoperative cardiac rehabilitation, early rehabilitation, remote rehabilitation FOR CITATION: Lyapina I.N., Argunova Yu.A., Dren E.V.', Chereneva L.A., Barbarash O.L. Effectiveness of early rehabilitation program with remote technologies in the outpatient setting after surgery for acquired valvular heart disease. Russian Medical Inquiry. 2024;8(1):16–25 (in Russ.). DOI: 10.32364/2587-6821-2024-8-1-3.