Keywords
myocardial infarction
personalised medicine
cardioprotective factors
physical activity
training intensity
How to Cite
Abstract
In press
Background. Cardiovascular diseases are the leading cause of death worldwide. The effectiveness of outpatient multidisciplinary cardiac rehabilitation in Ukraine requires evidence-based justification.
Aim. To evaluate the effectiveness of a multidisciplinary outpatient cardiac rehabilitation model for patients with cardiovascular disease based on physical performance, hemodynamic status, body mass index, psycho-emotional state, and treatment adherence compared with standard outpatient follow-up.
Materials and Materials. A multidisciplinary outpatient cardiac rehabilitation model was developed. A total of 120 patients were examined and randomized equally into a multidisciplinary group and a control group. The multidisciplinary group received a structured cardiac rehabilitation programme. The control group remained under standard outpatient follow-up. The following methods for controlling exercise intensity were used: heart rate reserve, percentage of peak heart rate, exercise intensity in metabolic equivalents, and subjective assessment of exertion using the Borg scale. Statistical analysis was performed using Student’s t-test for group comparisons; data are presented as M ± SD. Calculations were carried out using Statistica 8.0 (Statsoft, USA). The study was conducted as a private initiative of the authors, without grant support or state registration of the research topic.
Research Ethics. The study was conducted in accordance with the principles of the World Medical Association’s Declaration of Helsinki (1964–2024) and Order No.690 of the Ministry of Health of Ukraine of September 23, 2009. The study protocol was approved by the Bioethics Committee of the Uzhhorod National University. All patients provided written informed consent to participate in the study.
Results. After 12 weeks, the multidisciplinary group achieved a statistically significant greater increase in MET compared with the control group: from [4.3±0.6] relative units (RU) to [6.1±0.8] RU, compared with [4.2±0.7] RU to [5.0±0.9] r.u. (p<0.001); a reduction in systolic blood pressure: from [142±12] mmHg to [130±10] mmHg versus from [143±11] mmHg to [136±11] mmHg (p=0.002); reduction in anxiety on the HADS-A scale: from [10.2±3.1] points to [6.5±2.4] points versus from [9.8±2.9] points to [8.7±2.8] points (p<0.001) and in depression on the HADS-D scale: from [8.7±2.7] points to [5.2±2.0] points versus from [8.4±2.8] points to [7.6±2.4] points (p<0.001). Adherence to treatment increased to 89% in the multidisciplinary group compared with 75% in the control group (p<0.001).
Conclusions. The results showed that cardiac rehabilitation with multidisciplinary support and full support of the multimodal clinical model is an effective means of managing patients' health at the outpatient observation point.
Keywords: physiotherapy and rehabilitation, myocardial infarction, personalised medicine, cardioprotective factors, physical activity, training intensity.
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