Kirurgiliselt ravitud südame isheemiatõvega haigete aeroobne kehaline treening taastusravi varases etapis kodustes ja ambulatoorsetes tingimustes
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1. Varane individuaalselt doseeritud aeroobne kehaline treening suurendab oluliselt kirurgiliselt ravitud südame isheemiatõvega patsientide kardiorespiratoorset reservi ja funktsionaalset töövõimet. 2. Kolmekuulise aeroobse treeningu tulemusena kehamassiindeks kodutreeningrühmal ega ambulatoorsel treeningrühmal statistiliselt oluliselt ei muutunud. 3. Kodustes tingimustes teostatud aeroobne treening peale südamelihase revaskulariseerimist on sobiv alternatiiv ambulatoorsetes tingimustes juhendatud taastusravile.The aim of the study was to evaluate the efficacy of the aerobic exercise in home based and amulatory supervised conditions during three month early rehabilitation of patients with ischaemic heart disease after surgical revascularization. In this clinical trial 87 patients, mean age 61,3±8,6 and body mass index (BMI) 27,5, participated (NYHA functional class I-III). In home based aerobic exercise group (HBG) participated 17 patients (age 60,8±7,5, BMI 26,7±3,2) and in ambulatory supervised exercise group (ASG) participated 70 patients (age 61,4±8,7, BMI 27,7±3,9). All the patients where surgically revascularizated 2-6 weeks before recruitment to early rehabilitation. The patients underwent breath-by-breath bicycle cardiopulmonary testing before and after the 12-week aerobic exercise program, while the functional indices of cardiorespiratory system (VO2max, Wmax, VO2maxAnTh, HRmax) and BMI were measured. Patients at HBG and ASG started with 50-60 minute aerobic exercise sessions three times a week, overall length of 12 weeks. The exercise session consisted of three parts according to the classical scheme: warm-up period of 10-15 minutes, aerobic exercise of 30 minutes and cool-down of 10-15 minutes. HBG performed walking sessions and ASG group ride stationary bicycle at the intensity level forming 80-90 % of AnTh energy expenditure or 60-75% of maximal energy expenditure, if AnTh was not achieved. Control and maintenance of the intensity level was continuously monitored by patients and physiotherapist with sport-testers. In conclusion, the present study is the first one to investigate the efficacy of the aerobic exercise in very early stage of rehabilitation in Estnonia. 46 Aerobic exercise of patients with ischaemic heart disease after surgical revascularization in early rehabilitation at home and ambulatory settings The following was concluded: 1. Aerobic exercise in early period after surgical revascularization of the myocardium improved significantly basic indices of exercise capacity and cardiorespiratory reserve. 2. During three month aerobic exercise the body mass index din not change in home based group nor the ambulatory supervised group. 3. Home based aerobic exercise is properate alternative for ambulatory supervised aerobic exercise in patients with ischaemic heart disease after surgical revascularization in early rehabilitation.