Yıl: 2005 Cilt: 5 Sayı: 2 Sayfa Aralığı: 116 - 121 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Koroner baypas geçiren olgularda faz II kardiyak rehabilitasyon programının etkileri

Öz:
Amaç: Koroner arter cerrahisi geçiren 52 hastaya uygulanan Faz II kardiyak rehabilitasyonun etkilerini araştırmaktır. Yöntemler: Faz II kardiyak rehabilitasyona alınan hastalara bu program öncesinde ve sonunda; dereceli yürüme testleri, kalp-akciğer kapasite testleri, lipid profili yapıldı. Programa uygun olarak 12 hafta boyunca haftada 3 kez 20 dakika süreli seanslar şeklinde, 12 kanal elektrokardiyografi kontrolünde koşu bandında egzersiz antrenmanları yapıldı. Hastalara düşük veya orta yoğunluklu egzersiz programı verildi. Rehabilitasyon süresince Cleveland Clinic Chronotropic Assessment egzersiz protokolu uygulandı. Bulgular: Koroner baypas operasyonu geçirmiş 52 hastaya uygulanan Faz II kardiyak rehabilitasyon sonunda hastaların efor kapasitesi, oksijen tüketimi, anaerobik eşik, kalp debisi ortalama değerlerinde anlamlı artma (p£0.001), HDL-kolesterol ortalama değerinde anlamlı artma (p£0.05) ve beden kitle indeksi (BKİ), total-kolesterol, LDL-kolesterol, trigliserid ortalama rakamlarında anlamlı azalma (p£0,001) tespit edildi. Sonuç: Koroner arter cerrahisi geçiren hastalarda Faz II kardiyak rehabilitasyon, yaşam kalitesi ve ikincil korunma açısından çok yararlı bir programdır.
Anahtar Kelime: Rehabilitasyon Koroner arter köprüleme Kalp debisi Oksijen tüketimi Yaşam kalitesi

Konular: Anestezi Rehabilitasyon Kalp ve Kalp Damar Sistemi

The effects of phase II cardiac rehabilitation programme on patients undergone coronary bypass surgery

Öz:
Objective: To investigate the effects of phase II cardiac rehabilitation in 52 patients undergone coronary artery bypass surgery.Methods: Gradual walking tests, cardio-pulmonary capacity tests and lipid profile were administered to patients selected for phase II cardiac rehabilitation before and after the programme. Training was started on 12-channel electrocardiogram controlled running bands 3 times a week for 20 min periods for 12 weeks fitting the programme. Low or intermediate level exercise programme was applied to patients. Cleveland Clinic Chronotropic Assessment exercise protocol was used during rehabilitation.Results: As a result of phase II cardiac rehabilitation administered to 52 patients undergone coronary bypass operation, exercise capacity, oxygen consumption, anaerobic threshold, cardiac output mean values (p£0.001) and mean HDL cholesterol level (p£0.05) were found to increase, whereas body mass index, total cholesterol, LDL cholesterol and triglyceride mean levels reduced (p£0.001) significantly. Conclusion: In patients who have undergone coronary bypass surgery, phase II cardiac rehabilitation is a very useful programme in improvement of life quality and secondary prevention.
Anahtar Kelime: Cardiac Output Oxygen Consumption Quality of Life Rehabilitation Coronary Artery Bypass

Konular: Anestezi Rehabilitasyon Kalp ve Kalp Damar Sistemi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. West R. Cardiac nehabilitation. Eur Heart J 1999; 20: 1843-5.
  • 2. Chugh SK. Cardiac rehabilitation. Eur Heart J 2000; 21: 10.
  • 3. Gibbons LW, Clark SM. Exercise in the reduction of cardiovascular events. Lessons from epidemiologic trials. Cardiol Clin 2001; 19: 347-55.
  • 4. O’Connor GT, Buring JE, Yusuf S, et al. An overview of randomized tirals of rehabilitation with exercise after myocardial infarction. Circulation 1989; 80: 234-42.
  • 5. Oldridge NB, Guyatt GH, Fischer ME, et al. Cardiac rehabilitation after myocardial infarction: combined experience of randomized clinical tirals. JAMA 1988; 260: 945-51.
  • 6. Wenger NK, Froelicher ES, Smith LK. Cardiac Rehabilitation: Clinical Practice Guideline No. 17. Rockville, Md: US Dept of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, National Heart, Lung, and Blood Institute. AHCPR; 1995. Publication No. 96-0672.
  • 7. Haskell WL, Alderman EL, Fair JM, et al. Effects of intensive multiple risk factor reduction on coronary atherosclerosis and clinical cardiac events in men and women with coronary artery disease. The Stanford Coronary Risk Intervention Project (SCRIP). Circulation 1994; 89: 975-83.
  • 8. Rechnitzer PA, Cunningham DA, Andrew GM, et al. Relation of exercise to the recurrence rate of myocardial infarction in men: Ontario Exercise-Heart Collaborative Study. Am J Cardiol 1983; 51: 65-9.
  • 9. Goble AJ, Hare DL, Macdonald PS, et al. Effect of early programmes of high and low intensity exercise on physical performance after transmural acute myocardial infarction. Br Heart J 1991; 65:126-30.
  • 10. Williams MA, Fleg JL, Ades PA, et al. Secondary prevention of coronary heart disease in the elderly (with emphasis on patients ≥ 75 years of age). An American Heart Association Scientific Statement from the council on clinical cardiology subcommittee on exercise cardiac rehabilitation, and prevention. Circulation 2002; 105: 1735-42.
  • 11. Williams MA: Exercise testing and training in the elderly cardiac patient. Human Kinetics. 3rd ed. New York: Champaign; 1994.
  • 12. Lavie CJ, Milani RV. Effects of cardiac rehabilitation programs on exercise capacity, coronary risk factors, behavioral characteristics, and quality of life in a large elderly cohort. Am J Cardiol 1995; 76: 177-9.
  • 13. Williams MA, Maresh CM, Esterbrooks DJ, et al. Early exercise training in patients older than age 65 years compared with that in younger patients after acute myocardial infarction or coronary artery baypas grafting. Am J Cardiol 1985; 55: 263-6.
  • 14. Lavie CJ, Milani RV, Littman AB. Benefits of cardiac rehabilitation and exercise training in secondary coronary prevention in the elderly. J Am Coll Cardiol 1993; 22: 678-83.
  • 15. Williams MA. Exercise testing in cardiac rehabilitation: exerise prescription and beyond. In: Balady GJ, editor. Exercise in Secondary Prevention and Cardiac Rehabilitation. Cardiology Clinics. Philadelphia: W.B. Saunders Company; 2001. p.415-31.
  • 16. Ades PA, Waldmann ML, Polk DM, et al. Referral patterns and exercise response in the rehabilitation of female coronary patients aged ≥62 years. Am J Cardiol 1992; 69: 1422-5.
  • 17. Ades PA, Waldmann ML, McCann WJ, et al. Predictors of cardiac rehabilitation participation in older coronary patients. Arch Intern Med 1992; 152: 1033-5.
  • 18. Wannamethee SG, Shaper AG, Walker M. Physical activity and mortalitiy in older men with diagnosed heart disease. Circulation 2000; 102: 1358-63.
  • 19. Hakim AA, Petrovith H, Burchfiel CM, et al. Effects of walking on mortality among nonsmoking retired men. N Engl J Med 1998; 338: 94-9.
  • 20. Fried LP, Kronmal RA, Newman AB, et al. Risk factors for 5-year mortality in older adults. JAMA 1998; 279: 585-92.
  • 21. Parmley WW. Position report on cardiac rehabilitation: Recom- mendations of the American College of Cardiology. J Am Coll Cardiol 1986; 7: 451-3.
  • 22. Balady GJ, Fletcher BJ, Froelicher ES, et al. Cardiac rehabilitation programs: a statement for healthcare professionals from the Anerican Heart Association. Circulation 1994; 90: 1602-9.
  • 23. NIH Consensus Development Panel on Physical Activity and Cardiovascular Health. Physical activity and cardiovascular health. JAMA 1996; 276: 241-9.
  • 24. Whaley MH, Kaminsky LA. Epidemiology of physical activity, physical fitness, and selected chronic diseases. In: Williams MA, editor. ACSM’s resource manual for guidelines for exercise testing and prescription. Philadelphia: Lippincott Williams&Wilkins; 2001. p.29-31.
  • 25. Murphy JG, Gau GT. Cardiac rehabilitation. In: Murphy JG, editor. Mayo Clinic Cardiology Review. 2nd ed. Philadelphia: Lippincott Williams&Wilkins; 2000. p.241-5.
  • 26. Ades PA. Cardiac rehabilitation and secondary prevention of coronary heart disease. N Engl J Med 2001; 345: 892-902.
  • 27. Gürses NH, Durusoy F, Özker R. Miyokard infarktüsü sonrası egzersiz programı uygulanan hastalarla sedanter kalanlar arasında kar- şılaştırılmalı bir çalışma. Fizyoterapi Rehabilitasyon 1978; 2: 67-89.
  • 28. Gürses NH, Durusoy F. Egzersizde kardiyovasküler sistemde meydana gelen değişikliklerle normal kiflilerde ve koroner kalp hastaları nda egzersiz eğitiminin bu sisteme etkileri. Fizyoterapi Rehabilitasyon 1979; 3: 20-7.
  • 29. Gürses NH, Durusoy F. Miyokard infarktüsünde rehabilitasyon. Fizyoterapi Rehabilitasyon 1980; 3: 67-77.
  • 30. Akdur H, Gürses N, Ziyaettin M, ve ark. Miyokard infarktüslü hastalarda risk faktörü dağılımı: Ev programlarının değişebilir faktörlere olan etkisi. T Klin Kardiyoloji 1997; 10: 53-9.
  • 31. Demir R, Gurses H, Özyılmaz S, et al. The effect of exercise training on cardiopulmonary parameters after percutaneous transluminal coronary angioplasty. Proceedings of the 17th Asia-Pacific Congress on the Diseases of the Chest; 2003 Aug 29-Sept 1; İstanbul, Turkey; p.141.
  • 32. Özyılmaz S, Gürses H, Demir R, Muammar K, Gurmen T. The effect of exercise training on cardiopulmonary parameters after coronary artery bypass surgery. Proceedings of the 17th Asia-Pacific Congress on the Diseases of the Chest; 2003 Aug 29-Sept 1; İstanbul, Turkey; p. 95.
  • 33. Poirier P, Despres JP. Exercise in weight management of obesity. Cardiol Clin 2001; 19: 459-70.
  • 34. Chipkin SR, Klugh SA, Chasan-Taber L. Exercise and diabetes. Cardiol Clin 2001; 19: 489-505.
  • 35. Hillegass EA. Cardiac tests and procedures. In: Hillegass EA, Sadowsky HS, editors. Essentials of Cardiopulmonary Physical Therapy. Philadelphia: W.B. Saunders Company; 1994. p.327-354
  • 36. Hillegass EA. The well individual. In: Hillegass EA, Sadowsky HS, editors. Essentials of Cardiopulmonary Physical Therapy. Philadelphia: W.B. Saunders Company; 1994. p.703-42.
  • 37. Çelikoğlu S, Türkoğlu Ç, Çalış Ö, ve ark. Kalb debisinin asetilen inhalasyonu ile tek nefeste noninvaziv olarak ölçümünün Fick metodu ile karşılaştırılması. T Klin Kardiyoloji 1996; 9: 192-6.
  • 38. Elkayam U, Wilson A, Morrison J, et al. Non-invasive measurement of cardiac output by a single breath constant expiratory technigue. Thorax 1984; 390: 107-13.
  • 39. Ramage J, Coleman E, Maclntyre N. Rest and exercise cardiac output and diffusing capacity assessed by a single slow exhalation of methane, acetylene and carbon monoxide. Chest 1987; 92: 44-50.
  • 40. Zenger M, Brenner M, Haruna M, Mahon D, Wilson AF. Measurement of cardiac output by automated single breath technique and comparison with thermodilution and Fick methods in patients with cardiac disease. Am J Cardiol 1993; 71: 105-9.
  • 41. Lauer MS. Exercise electrocardiogram testing and prognosis. Novel markers and predictive instruments. Cardiol Clin 2001; 19: 401-14.
  • 42. Kelemen MH, Stewart KJ, Gillian RE, et al. Circuit weight training in cardiac patients. J Am Coll Cardiol 1986; 7: 38-43.
  • 43. Franklin BA, Bonzheim K, Gordon S, et al. Resistance training in cardiac rehabilitation program: A six-month follow-up. Arch Phys Med Rehabil 1990; 71: 148-54.
  • 44. Kelemen MH. Resistive training safety and assessment guidelines for cardiac and coronary prone patients. Med Sci Sports Exerc 1989; 21: 675-9.
  • 45. Wilke NA, Sheldahl LM, Levandoski SG, et al. Transfer effect of upper extremity training to weight carrying in men with ischemic heart disease. J Cardiopulm Rehabil 1991; 11: 365-70.
  • 46. Kennedy MD, Haykowsky M, Daub B, et al. Effects of a comprehensive cardiac rehabilitation program on quality of life and exercise tolerance in women: a retrospective analysis. Curr Control Trials Cardiovasc Med 2003; 4: 1. Avalaible from: URL: http://cvm.controlled-trials.com/content/4/1/1
  • 47. Gysan DB, Heinzler R, Schmidt K. Primary results and long-term outcome of an ambulatory, cardiac rehabilitation model (phase II) after myocardial infarct, dilatation treatment and heart operation. Z Kardiol 1997; 86: 691-702.
  • 48. Van Camp SP, Peterson RA. Cardiovascular complications of outpatient cardiac rehabilitation programs. JAMA 1986; 256: 1160-3.
  • 49. Franklin BA, Bonzheim K, Gordon S, Timmis GC. Safety of medically supervised outpatient cardiac rehabilitation exercise therapy: a 16- year follow-up. Chest 1998; 114: 902-6.
  • 50. Kushi LH, Fee RM, Folsom AR, et al. Physical activity and mortality in postmenopausal women. JAMA 1997; 277: 1287-92.
APA ÇİFTÇİ Ç, SÜSLEYİCİ DUMAN B, ÇAĞATAY P, DEMİROĞLU C, AYTEKİN V (2005). Koroner baypas geçiren olgularda faz II kardiyak rehabilitasyon programının etkileri. , 116 - 121.
Chicago ÇİFTÇİ Çavlan,SÜSLEYİCİ DUMAN BELGİN,ÇAĞATAY Pembe,DEMİROĞLU Cemşid,AYTEKİN Vedat Koroner baypas geçiren olgularda faz II kardiyak rehabilitasyon programının etkileri. (2005): 116 - 121.
MLA ÇİFTÇİ Çavlan,SÜSLEYİCİ DUMAN BELGİN,ÇAĞATAY Pembe,DEMİROĞLU Cemşid,AYTEKİN Vedat Koroner baypas geçiren olgularda faz II kardiyak rehabilitasyon programının etkileri. , 2005, ss.116 - 121.
AMA ÇİFTÇİ Ç,SÜSLEYİCİ DUMAN B,ÇAĞATAY P,DEMİROĞLU C,AYTEKİN V Koroner baypas geçiren olgularda faz II kardiyak rehabilitasyon programının etkileri. . 2005; 116 - 121.
Vancouver ÇİFTÇİ Ç,SÜSLEYİCİ DUMAN B,ÇAĞATAY P,DEMİROĞLU C,AYTEKİN V Koroner baypas geçiren olgularda faz II kardiyak rehabilitasyon programının etkileri. . 2005; 116 - 121.
IEEE ÇİFTÇİ Ç,SÜSLEYİCİ DUMAN B,ÇAĞATAY P,DEMİROĞLU C,AYTEKİN V "Koroner baypas geçiren olgularda faz II kardiyak rehabilitasyon programının etkileri." , ss.116 - 121, 2005.
ISNAD ÇİFTÇİ, Çavlan vd. "Koroner baypas geçiren olgularda faz II kardiyak rehabilitasyon programının etkileri". (2005), 116-121.
APA ÇİFTÇİ Ç, SÜSLEYİCİ DUMAN B, ÇAĞATAY P, DEMİROĞLU C, AYTEKİN V (2005). Koroner baypas geçiren olgularda faz II kardiyak rehabilitasyon programının etkileri. Anadolu Kardiyoloji Dergisi, 5(2), 116 - 121.
Chicago ÇİFTÇİ Çavlan,SÜSLEYİCİ DUMAN BELGİN,ÇAĞATAY Pembe,DEMİROĞLU Cemşid,AYTEKİN Vedat Koroner baypas geçiren olgularda faz II kardiyak rehabilitasyon programının etkileri. Anadolu Kardiyoloji Dergisi 5, no.2 (2005): 116 - 121.
MLA ÇİFTÇİ Çavlan,SÜSLEYİCİ DUMAN BELGİN,ÇAĞATAY Pembe,DEMİROĞLU Cemşid,AYTEKİN Vedat Koroner baypas geçiren olgularda faz II kardiyak rehabilitasyon programının etkileri. Anadolu Kardiyoloji Dergisi, vol.5, no.2, 2005, ss.116 - 121.
AMA ÇİFTÇİ Ç,SÜSLEYİCİ DUMAN B,ÇAĞATAY P,DEMİROĞLU C,AYTEKİN V Koroner baypas geçiren olgularda faz II kardiyak rehabilitasyon programının etkileri. Anadolu Kardiyoloji Dergisi. 2005; 5(2): 116 - 121.
Vancouver ÇİFTÇİ Ç,SÜSLEYİCİ DUMAN B,ÇAĞATAY P,DEMİROĞLU C,AYTEKİN V Koroner baypas geçiren olgularda faz II kardiyak rehabilitasyon programının etkileri. Anadolu Kardiyoloji Dergisi. 2005; 5(2): 116 - 121.
IEEE ÇİFTÇİ Ç,SÜSLEYİCİ DUMAN B,ÇAĞATAY P,DEMİROĞLU C,AYTEKİN V "Koroner baypas geçiren olgularda faz II kardiyak rehabilitasyon programının etkileri." Anadolu Kardiyoloji Dergisi, 5, ss.116 - 121, 2005.
ISNAD ÇİFTÇİ, Çavlan vd. "Koroner baypas geçiren olgularda faz II kardiyak rehabilitasyon programının etkileri". Anadolu Kardiyoloji Dergisi 5/2 (2005), 116-121.