Early physical rehabilitation after elective percutaneous coronary interventions during incomplete revascularization: Exercise regimen calculation by ergospirometry

Abstract

Aim. To evaluate the efficiency and safety of outpatient physical exercises (PE), calculated using ergospirometry (ESM) in patients in the early periods after elective percutaneous coronary interventions (PCI) during incomplete coronary bed revascularization. Subjects and methods. Three hundred and eighty-three patients were screened. The trial enrolled the patients after elective PCI in its early periods (3 to 14 days) who had signed an informed consent document to participate in the investigation and who could perform themselves PE at home or visit the medical center. Patients with angioplasty complications (myocardial infarction, severe hematomas, major bleeding, etc.) who had standard contraindications to exercise testing and PE were excluded. The patients included in the trial (n = 50) were divided into 2 groups: 1) 21 patients who had undergone incomplete revascularization; 2) 29 patients who had complete revascularization. The authors estimated exercise endurance by ergospirometry before the investigation, 8 weeks after a course of exercises, and following 6 months and assessed quality of life (QL) using the SF-36 questionnaire. A physical rehabilitation program was elaborated for all the patients according to exercise test results. During the trial, all the patients were allocated to groups of home and clinic exercises using exercise bikes. Medical control of the patients who were exercising at home was made by their telephone conversation, control visits to the medical center at least once monthly, and their concurrently keeping an exercise diary in which each training (duration, intensity), health status, and blood pressure were recorded. The patients could consult their physician at any time if required. Results. In the incomplete and complete revascularization groups, VO2 max increased by 6 and 15%, respectively. Following 6 months, no additional increment in VO2 max was seen in the study groups. According to SF-36 data, QL improved in patients in both groups after 8 weeks and remained at the same level after 6 months. Conclusion. An early time course of exercises only in combination with regular medical control has a positive impact on exercise tolerance and QL and preserves its efficiency for at least 6 months regardless of the degree of revascularization.

Keywords

• cardiac rehabilitation
• percutaneous coronary interventions
• physical exercises