تأثیر یک دوره‌ی بازتوانی قلبی بر شاخص‌های پرشدگی دیاستولی و ظرفیت عملکردی در بیماران مبتلا به سکته‌ی قلبی

نوع مقاله : Original Article(s)

نویسندگان

1 دانشیار، گروه فیژیولوژی ورزش، دانشکده ی تربیت بدنی و علوم ورزشی، دانشگاه اصفهان، اصفهان، ایران

2 کارشناس ارشد، گروه تربیت بدنی و علوم ورزشی، دانشکده‌ی تربیت بدنی و علوم ورزشی، دانشگاه اصفهان، اصفهان، ایران

3 دانشیار، گروه قلب و عروق، مرکز تحقیقات بازتوانی قلبی، پژوهشکده‌ی قلب و عروق اصفهان، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.

4 متخصص پزشکی اجتماعی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

5 دستیار، گروه قلب و عروق، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: امروزه برنامه‌ی بازتوانی قلبی به عنوان بخشی از روند درمانی بیماران قلبی شناخته می‌شوند. با این همه تأثیر این برنامه‌ها‌ بر شاخص‌ها‌ی عملکرد دیاستولی و سیستولی هنوز متناقض است. هدف از تحقیق حاضر بررسی تأثیر 8 هفته بازتوانی قلبی بر عملکرد دیاستولی و ظرفیت عملکرد بیماران پس از ابتلای به سکته‌ی قلبی بود.. روش‌ها: بدین منظور تعداد 29 نفر بیمار مبتلا به سکته‌ی قلبی (15 نفر گروه مداخله و 14 نفر گروه شاهد) در تحقیق حاضر شرکت کردند. گروه مداخله به مدت 8 هفته هر هفته 3 جلسه و هر جلسه 1 ساعت با شدت 65 تا 85 درصد حداکثر ضربان قلب در برنامه‌ی بازتوانی شرکت کردند و گروه شاهد تحت مراقبت‌های معمول بیماران قلبی عروقی قرار گرفتند. قبل از شروع برنامه‌ی بازتوانی و بعد از آن از بیماران برای ارزیابی شاخص‌ها‌ی عملکرد دیاستولی اکوکاردیوگراف پالس ویو داپلر گرفته شد و ظرفیت عملکرد بیماران با استفاده از آزمون ورزش بر اساس پروتکل نوتن مشخص شد. داده‌ها با استفاده از آزمون ANCOVA و Paired-t در سطح آلفای 5 درصد تجزیه و تحلیل شد. یافته‌ها: نتایج نشان داد برنامه‌ی بازتوانی به مدت 8 هفته تغییر معنی‌داری در شاخص‌ها‌ی عملکرد دیاستولی ایجاد نمی‌کند، اما ظرفیت عملکرد، ضربان استراحت و حداکثر ضربان قلب در گروه مداخله در مقایسه با گروه شاهد بطور معنی‌داری بهبود یافت. نتیجه‌گیری: این گونه به نظر می‌رسد که برنامه‌ی بازتوانی قلبی به مدت 8 هفته، هر هفته 3 جلسه باعث بهبود ظرفیت عملکرد در بیماران قلبی می‌شود اما بر شاخص‌ها‌ی عملکرد دیاستولی تأثیر ندارد. بهبود در ظرفیت عملکرد شاید ناشی از سازگاری‌ها‌ی محیطی در نتیجه‌ی فعالیت ورزشی باشد. .

کلیدواژه‌ها

عنوان مقاله [English]

Effects of a Cardiac Rehabilitation Program on Diastolic Filling Properties and Functional Capacity in Patients with Myocardial Infarction

نویسندگان [English]

  • Mehdi Kargarfard 1
  • Fatemeh Basati 2
  • Masoumeh Sadeghi 3
  • Reza Rouzbehani 4
  • Allahyar Golabchi 5
1 Associate Professor, Department of Exercise Physiology, School of Physical education and Sport Sciences, The University of Isfahan, Isfahan, Iran.
2 Department of Physical Education and Sport Sciences, School of Physical education and Sport Sciences, The University of Isfahan, Isfahan, Iran
3 Associate Professor, Department of Cardiology, Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
4 Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
5 Resident, Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
چکیده [English]

Background: Cardiac rehabilitation and secondary prevention is an integral part of the treatment of patient with cardiovascular disease to date, however the effect of this programs on systolic and diastolic function is controversial. The aim of this study was to evaluate the effect of 8 weeks cardiac rehabilitation program on diastolic function and functional capacity in patients with myocardial infarction. Methods: twenty-nine post myocardial patient enrolled in this study, which was completed in cardiac rehabilitation group (15 men) and control group (14 men). Echocardiographic measures of diastolic filling and functional capacity by symptom limited exercise test based on naughton protocol on treadmill were performed at baseline and after 8 weeks of training. Data were analyzed using repeated analysis of covariance (ANCOVA) in P < 0.05 level. Finding: After 8 weeks cardiac rehabilitation program, diastolic filling indicators did not change significantly (E velocity, A velocity, E/A ratio and deceleration time). But functional capacity increase significantly in cardiac rehabilitation group. But, functional capacity, resting HR and maximal HR improved significantly in the training group compared to the control group. Conclusion: This study revealed that Cardiac rehabilitation program for 8 weeks significantly improves functional capacity in post myocardial patients but diastolic function did not change significantly. It seems likely that the improvement in functional capacity largely pertain to non cardiac effects.

کلیدواژه‌ها [English]

  • Cardiac Rehabilitation
  • Diastolic filling
  • Functional capacity
  • Myocardial Infarction

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مجله دانشکده پزشکی اصفهان
دوره 29، شماره 131 - شماره پیاپی 131
فروردین و اردیبهشت 1390
صفحه 243-252

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  • تاریخ دریافت: 24 اردیبهشت 1390
  • تاریخ بازنگری: 06 اردیبهشت 1403
  • تاریخ پذیرش: 17 فروردین 1401

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