Disabled persons, who have undergone lower limb amputation (LLA) due to obliterating atherosclerosis, are a special group among patients with coronary heart disease (CHD). In the developed countries, 25—35% of patients was performed high LLA in the first year of critical ischemia, ant the number of interventions is steadily increasing. The development of personalized medical rehabilitation programs (MR) for such patients is relevant.

OBJECTIVE

To scientifically substantiate the therapeutic effects of MR in patients with CHD and LLA.

MATERIAL AND METHODS

The research design was a prospective cohort comparative study of MR therapeutic effects. The research subject was a change of physical activity tolerance (PAT) in patients during the implementation of recommended MR programs. The study object was 102 patients aged from 45 to 74 years. All patients were distributed by the random numbers method. The examined sample of patients was divided into two clusters. The first cluster consisted of 52 patients with CHD and LLA: study group included 1 — 26 patients, who were performed MR (kinesitherapy, manual mechanokinesitherapy, breathing exercises) and comparison group consisted of 1 — 26 patients, who were performed the preparation to prosthetics). The second cluster included 50 patients with CHD (study group consisted of 2 — 25 patients, who were performed MR and pharmacotherapy, and comparison group consisted of 2 — 25 patients, who were performed only pharmacotherapy). Clinical, instrumental and laboratory methods of examination were used in the research, as well as indicators of psychophysiological status and life quality, subjected to adequate statistical analysis.

RESULTS

Dosed physical activities improve clinical and psychophysical statuses, as well as life quality of patients with CHD and LLA, increase contractility and optimize diastolic myocardial function, raise PAT, improve central and intracardial hemodynamics levels, neurohumoral regulation and lipid metabolism. The efficacy of personalized MR programs for patients with CHD and LLA is 88%, and standardized programs is 76%. The determinants of MR efficacy are base PAT values, as well as indicators of myocardial contraction and diastolic function.

CONCLUSION

The MR in patients with CHD and LLA forms obvious cardiotonic, vegetative correcting and lipid lowering healing effects.