Оптимизация реабилитации больных коронарной болезнью сердца при укороченных сроках санаторного лечения

Abstract

Aim: to study the effect of a two-week course of sanatorium treatment using both iodine-bromine baths (IBB) and physical training (PT) on physical performance of coronary heart disease (CHD) patients with stable angina when using their different combinations. Design: the randomized, controlled, prospective study. Materials and methods. The study included 126 CHD patients, divided into 3 groups. 42 patients (Group 1) were prescribed IBB and PT on a bicycle ergometer; with PT performed 1,5–2 hours before taking IBB (Complex No. 1). 43 individuals (Group 2) were prescribed IBB and PT, with the latter performed 1,5–2 hours after taking IBB (Complex No. 2). 41 patients (Group 3, control) received IBB and therapeutic exercises (TE) Complex No. 3). Physical factors in the groups of CHD patients were prescribed every other day, with the treatment duration being 2 weeks (14 days). The evaluation of the results in CHD patients was carried out using 24-hour Holter ECG monitoring, spiro- and bicycle ergometry. Results. A spiro- and bicycle ergometry showed that the rehabilitation courses for CHD patients with the Complex No. 1 gives a more pronounced training effect and an increase in coronary reserve than the Complex No. 2 or when prescribing IBB and TE. The decrease in myocardial ischemia while 24-hour Holter ECG monitoring in CHD patients was also the largest after the Complex No. 1 rehabilitation. The training effect of the Complex, i.e. when PT was prescribed before taking IBB, led to both a greater increase in the coronary reserve and a decrease in myocardial ischemia in CHD patients, compared with either prescribing PT after taking IBB or when using IBB and TE. Conclusion. Thus, the rehabilitation effectiveness for CHD patients with a shortened time of using iodine-bromine baths and physical training up to fourteen days depends on their combinations. The best result was obtained when prescribing PT before taking IBB. Keywords: coronary heart disease, balneotherapy, physical training, physical performance cardiac arrhythmia, myocardial ischemia.