Abstract
Aim.To study psychophysiological parameters in the patients undergoing coronary artery bypass grafting (CABG) who optionally underwent a short course of physical prehabilitation (PPR).Materials and Methods.We carried out a prospective randomised study which included 97 male patients (45 to 70 years) with coronary artery disease who underwent elected CABG; 47 of them additionally underwent a 5-7-day course of aerobic physical training before the surgery. Both patient groups were comparable with respect to the baseline clinicopathological features. Neuropsychological examination and electroencephalography was performed before the surgery and at 7th-10th day after CABG. Development of postoperative cognitive dysfunction (POCD) was considered as the study endpoint.Results.POCD developed in 58% patients with PPR and in 78.7% patients without PPR (p = 0.037); therefore, the risk of developing POCD in those who underwent PPR was lower (OR=0,39, р=0,045). Further, patients with PPR showed an increase in integral attention value relative to the preoperative state (p = 0.04) while those without PPR demonstrated a decrease in this cognitive parameter (p = 0.03). Integral attention value and general cognitive status remained higher in patients with PPR than in those without (p = 0.048 and p = 0.048, respectively) at 7th-10th day after CABG. The theta1 rhythm power increase was higher in patients without PPR at 7th-10th day after CABG (p = 0.01).Conclusion.The patients with a short preoperative course of PPR had better indicators of electrical cortical activity and higher integral cognitive value in the early postoperative period after CABG than those without training. Short course of PPR before CABG can increase the resistance of the brain to the intraoperative injury and may reduce the severity of the cognitive impairment after cardiac surgery. Indicators of brain electrical activity can be informative to evaluate the efficiency of cardiac rehabilitation
Highlights
The patients with a short preoperative course of physical prehabilitation (PPR) had better indicators of electrical cortical activity and higher integral cognitive value in the early postoperative period after coronary artery bypass grafting (CABG) than those without training
postoperative cognitive dysfunction (POCD) developed in 58% patients with PPR and in 78.7% patients without PPR (p = 0.037); the risk of developing POCD in those who underwent PPR was lower (OR=0,39, р=0,045)
Patients with PPR showed an increase in integral attention value relative to the preoperative state (p = 0.04) while those without PPR demonstrated a decrease in this cognitive parameter (p = 0.03)
Summary
ТРУБНИКОВА О.А.*, ТАРАСОВА И.В., МОСЬКИН Е.Г., КУПРИЯНОВА Д.С., СЫРОВА И.Д., АРГУНОВА Ю.А., БАРБАРАШ О.Л. Изучение особенностей психофизиологических показателей у пациентов, перенесших коронарное шунтирование (КШ), в зависимости от применения короткого курса физической преабилитации (ФП). Интегральный показатель внимания возрастал на 7−10-е сутки после операции по сравнению с исходными значениями у пациентов с ФП (p=0,04), тогда как у пациентов без тренировок − снижался (p=0,03). Также на 7−10-е сутки после КШ у пациентов с ФП интегральный показатель внимания и общий показатель когнитивного статуса был выше, чем пациентов без преабилитации (p=0,048 и p=0,048 соответственно). У пациентов, не прошедших курс преабилитации, на 7−10е сутки после КШ, степень увеличения мощности биопотенциалов тета ритма была выше, чем у пациентов с ФП (p=0,01). Прошедшие предоперационный курс ФП, имели лучшие показатели электрической корковой активности и интегральные характеристики когнитивного статуса в раннем послеоперационном периоде КШ по сравнению с пациентами без тренировок. Особенности психофизиологических показателей у пациентов, перенесших коронарное шунтирование, в зависимости от применения короткого курса физической преабилитации.
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