Cardiovascular problems and functional evaluation in rehabilitation of hemiplegic patients

Abstract

Arteriosclerotic or hypertensive heart disease was found in 56 per cent and rheumatic heart disease in 10 per cent of 195 non-traumatic hemiplegic patients admitted to a chronic disease hospital for rehabilitation. Significant heart disease with functional classifications of grades II and III was found in 30 per cent. Atrial fibrillation was present in 12 per cent. In arteriosclerotic-hypertensive patients recent myocardial infarction was an occasional etiological factor but atrial fibrillation was not. In rheumatic patients embolie complications occurred with all grades and types of valvular disease but most frequently with mitral stenosis. Metabolic responses determined in 50 hemiplegic patients during exercise revealed significantly greater increases in arterial blood lactate and lactate-pyruvate ratios in hemiplegic cardiac patients compared to non-cardiac patients. These observations were interpreted to indicate increased anaerobic metabolism in hemiplegic cardiac patients which might lead to congestive failure. The lack of correlation between the metabolic responses to exercise and the functional capacity estimated from history stressed the importance of an objective method of functional evaluation.