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№4' 2018

THERAPY

THE EFFICIENCY OF PHYSICAL REHABILITATION IN PATIENTS WITH CARDIOPULMONAL PATHOLOGY

M. M. KOCHUIEVA, L. A. RUBAN, H. A. TYMСHENKO, A. V. ROHOZHYN, V. H. PSAROVA, H. I. KOCHUIEV

Kharkiv Medical Academy of Postgraduate Education

Kharkiv State Academy of Physical Culture

Sumy State University, Ukraine

Great importance in enhancing the effectiveness of the treatment of patients with COPD accounts for the introduction to the program of rehabilitation therapy techniques, psychological training, patient education about the disease and the specific situation for the development of partnership in the fight against the disease. An important component of the treatment of patients with COPD should be physical rehabilitation. An integrated approach to the treatment of these patients can improve tolerance to physical and mental stress, improve quality of life, restore the social and professional status, improve clinical and laboratory efficacy of treatment and eventually slow down the progression of the disease. The aim of the study was to investigate the influence of physical rehabilitation program on respiratory function (ERF) and cardiac hemodynamics in patients with COPD combined with hypertension. The study involved 46 patients with severity II of airflow limitation COPD (all male) in remission stage with step II hypertension (stage 2) which established for at least five years ago and with clinical signs of congestive heart failure (CHF). The patients were divided into 2 groups. The first group included 25 men who, against the background of basic drug therapy, underwent a course of physical rehabilitation (GR1). The second group included patients who received standard basic drug therapy without a set of physical rehabilitation methods (21 people, GR2). To confirm the diagnosis a spirometric study was performed, the forced expiratory volume in the first second (FEV1), the forced lung capacity (FVC) was measured and the ratio of these indicators (FEV1/FVC) was determined. Spirographic studies were carried out using the computer system "SPIROLAB". All patients underwent one− and two−dimensional echocardiography in a pulsed mode with a phased sensor (2−4 MHz), spectral and tissue doppler−echocardiography from standard accesses on the "ULTIMA PRO 30" device. Basic drug therapy included taking a combination of Tiotropium at a dose of 5 mg per day with Olodaterol at a daily dose of 5 mg, Candesartan at a dose of 16 mg, Amlodipine at a dose of 5−10 mg. The main component of the comprehensive physical rehabilitation program was therapeutic gymnastics, which included standard exercises in combination with breathing exercises with elements of shallow breathing, muscle relaxation, auto−training and metered walking. The results showed that the treatment of patients with COPD in conjunction with the hypertension with the use of physical rehabilitation contributed significantly larger positive changes ERF parameters and reduction in blood pressure levels than in patients receiving only medical therapy.

Key words: chronic obstructive pulmonary disease, hypertension, physical rehabilitation.

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