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EN
Introduction: The effort test is the most popular type of a test used for the verification of a heart disease. The main target of rehabilitation is to achieve the improvement of exercise tolerance. Material and methods: The examination group included 60 patients aged 34-76 (average 60±8,87) qualified for II period of rehabilitation. The effort test on a movable track has been carried out before and after the rehabilitation, according to the modified Bruce’s protocol. The following parameters were tested: a heart rate rest and maximum, blood pressure rest and maximum, test duration, costs of energy effort (METs), a reason for test interruption, subjective sense of tiredness, a number of breaths per minute and a maximum intake of oxygen (VO2max). For the A model, 14 patients have been qualified, B-31, C-15, D-0. In that case, the training on a cycloergometer was of a continuous type, while for the patients qualified for the B and C models, was of an interval type. Results and conclusions: The biggest part of work was done during the final 21st training. The increase in exercise tolerance was proven, due to the obtained results.
EN
Introduction: The aging process, characterized by physiological changes which compromise various organs and systems, is not the only factor leading to a decline in physical efficiency - biologically unjustified reductions in physical activities are also observed in the elderly. Various psychological, sociological and other factors may determine elderly individuals’ susceptibility to limitations in their everyday physical activities. Diagnostics of the circulation system in terms of physical efficiency and tolerance of effort are therefore more difficult in the elderly than for young individuals. Objectives: To assess the orthostatic reaction of the circulation system in elderly individuals by means of the Crampton test and to obseive changes in the coefficient values after 4 months of intensive physical activity. Material and method: Forty-four students of the University of the Third Age in Warsaw participated in the study. Their average age was 64.2 years, weight 66.5 kg and height 158.5 cm. Their heart rate and blood pressure were re-corded after 10 minutes in recumbent position and 2 minutes after taking standing positions. Results: High values in the Crampton test indicate good and very good orthostatic efficiency of the circulation system. However, these results were not found to correlate with effort ability. We conclude that the Crampton test is of low diagnostic value in the tolerance of effort prediction in the elderly.
PL
Wstęp: Ocena tolerancji wysiłku odgrywa ważną rolę w kwalifikacji do leczenia i rehabilitacji. Cel: Celem niniejszej pracy była ocena tolerancji wysiłku u chorych przed i po operacji przepukliny pachwinowej metodą Lichtensteina. Materiał i metody: Do badania włączono mężczyzn operowanych z powodu przepukliny pachwinowej metodą Lichtensteina, których podzielono na grupę badaną (n = 50) i kontrolną (n = 50). Chorzy z grupy badanej spełniali kryterium współistnienia chorób układu krążenia i układu oddechowego. Dzień przed operacją i w 2. dobie po operacji pacjenci zostali poddani testowi 6-minutowego marszu (ang. 6 Minute Walk Test; 6MWT) oraz subiektywnie ocenili poziom zmęczenia według skali Borga (przed, bezpośrednio po i 10 minut po teście). Analizowano dystans 6MWT, poziom zmęczenia wg skali Borga. W 2. dobie po operacji 66% chorych z grupy badanej i 58% z grupy kontrolnej nie ukończyło testu. Pacjenci z grupy badanej przed operacją (500,07 ± 40,38 m) i w 2. dobie po operacji (243,46 ± 18,18 m) osiągali krótsze dystanse w porównaniu do grupy kontrolnej (565,93 ± 20,41 m; 249,47 ± 26,66 m), p < 0,001 i p = 0,481. Potwierdzono istotną statystycznie silnie ujemną korelację pomiędzy dystansem 6MWT przed operacją a wiekiem badanych. Pacjenci, którzy nie rozwinęli powikłań, osiągali w dniu przyjęcia istotnie dłuższe dystanse (dla grupy badanej p = 0,003, dla kontrolnej p = 0,004). Dla 6MWT przed operacją oraz 2 dni po operacji chorzy z grupy badanej wykazali istotnie wyższy poziom zmęczenia w porównaniu do grupy kontrolnej po teście (przed operacją: p = 0,001, po operacji: p = 0,001). Pacjenci z grupy badanej częściej przerywali 6MWT i gorzej tolerowali wysiłek w porównaniu do grupy kontrolnej. 6MWT jest przydatnym narzędziem do określenia wydolności fizycznej i tolerancji wysiłku.
EN
Objectives: The evaluation of the direct and remote effects of stationary rehabilitation following interventionally treated acute coronary syndrome and its extension by a three-month period of supervised training in ambulatory conditions within the scope of physical capacity psychic state and quality of life.Materials and methods: The research was conducted in a group of 44 patients (32 men and 12 women) aged 56.9±9, 62 years old for a period of 2-3 weeks following interventional treatment of acute coronary syndrome. All the patients had participated in stationary rehabilitation, 14 of whom expressed a willingness to participate in a futher three-month period of ambulatory rehabilitation. All patients prior to the commencement of rehabilitation had threadmill exertion tests. Fear was evaluated by means of the SOPER questionnaire. Basic mood and psychic tension as well as the feeling of health were assessed by means of the VAS scale of the Euro-Qol 5D questionnaire. The set of tests was repeated after the completion of the stationary phase, and after time periods of 3 months and a year.Results: Patients subjected to the extended 3-month ambulatory phase of rehabilitation displayed a greater increase in exercise tolerance when compared with the group that had merely undergone the 3-week stationary rehabilitation. Patients with extended rehabilitation gradually improved their evaluation of their state of health and after a year maintained it at the level it had been after the completion of the stationary rehabilitation. In patients who did not express a willingness to continue an organised form of exercise in ambulatory conditions the noticeable improvement in health following the end of rehabilitation was not long lasting. After a year, regardless of the programme of rehabilitation selected, an improvement in the psychic state was noted, which was expressed in an increased positive mood although the level of fear did not change to a significant degree.Conclusions: 1. Extended rehabilitation, combining stationary and ambulatory forms, after interventional treatment of ACS gives a better long-term effect in the area of improving exercise capacity and patient self-evaluation of state of health than is in the case after three-week stationary rehabilitation. 2. The extending of the period of rehabilitation has no influence on attaining the postrehabilitation changes on the level of mood and fear.
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