Wnuk Bartosz R, Durmała Jacek, Ziaja Krzysztof, Kotyla Przemysław, Woźniewski Marek, Błaszczak Edward
Department of Rehabilitation, School of Health Sciences in Katowice, Medical University of Silesia, Poland.
Department of General and Vascular Surgery, Medical Faculty in Katowice, Medical University of Silesia, Poland.
Adv Clin Exp Med. 2016 Nov-Dec;25(6):1241-1371. doi: 10.17219/acem/62239.
Major surgical procedures as well as general anesthesia contribute to muscle weakness and posture instability and may result in increased postoperative complications and functional disorders resulting from an elective operation.
We aim to state the significance of backward walking as a form of interval march training with patients after abdominal aortic aneurysm surgery.
Sixty-five patients were randomly divided into three subgroups and three various models of physiotherapy were applied. The participants were males, aged 65-75 years, with stable cardiologic status, absence of neurological disorders, and non-symptomatic aneurysm - non-ruptured, no pain complaints and no motor system impairments. The control group had only routine physiotherapy, since therapeutic groups I and II also had walking exercises, forward in group II and backward in group I. Both experimental groups were applied interval training. The patient data analyzed was as follows: hospitalization period-days; 6-min walking test-distance (m), training heart rate (1/min), mean speed (km/h), MET; spirometry test-FVC(L), FEV1(L), FEV1/FVC and PEF(L/s).
The hospital stay period in all groups did not vary significantly. Statistical analysis showed that patients with backward walking had a statistically significantly lower reduction of walking distance in the corridor test when compared to the control group (p < 0.05). After the operation, a significant reduction of mean speed in the control group was noted in comparison with both the forward and backward walking groups (p < 0.05). No significant differences were noted between the experimental groups in average walking speed as well as in heart rate in all observed groups.
Physical training applied to patients after major abdominal aortic aneurysm surgery influences sustaining the level of exercise tolerance to a small extent. Both backward and forward walking seem to be alternative methods when compared to classic post-surgery physiotherapy.
大型外科手术以及全身麻醉会导致肌肉无力和姿势不稳，并可能导致择期手术后并发症增加和功能障碍。
我们旨在阐述倒走作为腹主动脉瘤手术后患者间歇行军训练形式的意义。
65例患者随机分为三个亚组，并采用三种不同的物理治疗模式。参与者均为男性，年龄在65 - 75岁之间，心脏状况稳定，无神经系统疾病，无症状性动脉瘤——未破裂，无疼痛主诉且无运动系统损伤。对照组仅进行常规物理治疗，治疗组I和II还进行步行锻炼，治疗组II向前走，治疗组I向后走。两个实验组均进行间歇训练。分析的患者数据如下：住院天数；6分钟步行试验距离（米）、训练心率（次/分钟）、平均速度（千米/小时）、代谢当量；肺功能测试——用力肺活量（升）、第1秒用力呼气量（升）、第1秒用力呼气量/用力肺活量以及呼气峰值流速（升/秒）。
所有组的住院时间差异无统计学意义。统计分析表明，与对照组相比，倒走患者在走廊试验中的步行距离减少具有统计学显著差异（p < 0.05）。术后，与向前走和向后走组相比，对照组的平均速度显著降低（p < 0.05）。在所有观察组中，实验组之间的平均步行速度和心率均未发现显著差异。
对腹主动脉瘤大手术后患者进行体育训练在一定程度上影响运动耐力水平的维持。与传统的术后物理治疗相比，向前走和向后走似乎都是替代方法。
