Method of physical rehabilitation of patients after myocardial infarction in the elderly sanatorium rehabilitation

摘要

method of physical rehabilitation of patients after myocardial infarction (them) in old age u0441u0430u043du0430u0442u043eu0440u043du043eu043c stage of rehabilitation, including u043eu0431u0449u0435u043au043bu0438u043du0438u0447u0435u0441u043au043eu0435 and u0438u043du0441u0442u0440 u0443u043cu0435u043du0442u0430u043bu044cu043du043eu0435 examination: ecg u043fu043eu043au043eu00a0, u0432u0435u043bu043eu044du0440u0433u043eu043cu0435u0442u0440u0438u0447u0435u0441u043au0443u044e sample, echo, daily u043cu043eu043du0438u0442u043eu0440u0438u0440u043eu0432u0430u043du0438u0435 on ekg and hell on u0445u043eu043bu0442u0435u0440u0443, medicines therapy and physical tran u0438u0440u043eu0432u043au0438 using physical therapy, u0437u0430u043du00a0u0442u0438u0439 on the treadmill.u043eu0442u043bu0438u0447u0430u044eu0449u0438u0439u0441u00a0 dosed walk, so that u043eu043fu0440u0435u0434u0435u043bu00a0u044eu0442 tolerance to physical activity by u043fu0440u043eu0432u0435u0434u0435u043du0438u00a0 6 minute walk test and u0432u0435u043bu043eu044du0440u0433u043eu043cu0435u0442u0440u0438u0447u0435u0441u043au043eu0439 samples of u043fu0440u0435u0434u0435u043bu00a0u044eu0442 step motor activity (sda) for the classification of d.m.u0430u0440u043eu043du043eu0432u0430 and functional class u0442u00a0u0436u0435u0441u0442u0438 u0441u043eu0441u0442u043eu00a0u043du0438u00a0 patients from 1 to 4, with at iii level activity set 1 class u0442u00a0u0436u0435u0441u0442u0438 in the period from the start of 14 to 18 days from the u0441u0443u0442u0441u0442u0432u0438u0438 attacks of angina or 1 - 2 fc, the lack of u043au0440u043eu0432u043eu043eu0431u0440u0430u0449u0435u043du0438u00a0 (nc) 0 - 1, no arrhythmia third gradation and higher u043bu0430u0443u043du0443, the absence of an aneurysm, with the fra u043au0446u0438u0438 release of more than 40% on the echo.class 2 u0442u00a0u0436u0435u0441u0442u0438 in the period from the beginning of their 18 - 20 days, the presence of angina 1 - 2 fc, nc 1 - 2a, the absence of an arrhythmia third gradation and higher u043bu0430u0443u043du0443, absence of aneurysms, u0443u0441u0442u0430u043du0430u0432u043b u0438u0432u0430u044eu0442 3 class in the period from the beginning of u0442u00a0u0436u0435u0441u0442u0438 20 - 23 u0434u043du00a0, the presence of angina 2 - 3 fc, nc 1 - 2a set 4 class in the period from the start u0442u00a0u0436u0435u0441u0442u0438 23 - 30 days, the u0441u0442u0435u043du043eu043au0430u0440u0434 and 3 - 4 fc, nc 2 - 3the arrhythmia third gradation and higher u043bu0430u0443u043du0443, an aneurysm, with the fraction of pv less than 40%, iv level 1 class in the period of u0442u00a0u0436u0435u0441u0442u0438 activity set e of them 24 - 28 days, the absence of attacks of angina or the existence of angina 1 fc, nc 0 - 1, the absence of an arrhythmia, the absence of an aneurysm, with the pv more than 40%, make the t 2 class u0442u00a0u0436u0435u0441u0442u0438 in period from the start of 28 - 30 daysthe availability of angina 1 - 2 fc, nc 0 - 1, the absence of an arrhythmia, the absence of an aneurysm, establish 3 class u0442u00a0u0436u0435u0441u0442u0438 in period from the beginning of their 30 - 33 u0434u043du00a0, the presence of angina 2 - 3 fc, nc 1 - 2a set 4 class in the period from the beginning of his 33 - 40 days, the presence of angina 3 - 4 fc, nc 2 - 3, the presence of arrhythmia 3 scales and higher u043bu0430u0443u043du0443, an aneurysm, with the pv less than 4 0 per centin the v stage activity set 1 class u0442u00a0u0436u0435u0441u0442u0438 with time from the start of 30 to 34 days, the absence of attacks of angina or the existence of angina 1 fc, nc 0 - 1, u043eu0442u0441u0443u0442u0441u0442u0432u0438 and arrhythmia, the absence of an aneurysm, with the pv more than 40%, have 2 class u0442u00a0u0436u0435u0441u0442u0438 in the period from the start of 34 - 36 days, the presence of angina 1 - 2 fc, nc 1 - 2a, the absence of an arrhythmia. u0442u0441u0443u0442u0441u0442u0432u0438u0438 aneurysms.set 3 class in the period from the start u0442u00a0u0436u0435u0441u0442u0438 36 to 39 days, the presence of angina 2 - 3 fc, nc 1 - 2a set 4 class in the period from the beginning of their 39 - 43 days, the u0441u0442u0435u043du043eu043au0430 u0440u0434u0438u0438 3-4 fc, nc 2 - 3, the presence of arrhythmia 3 scales and higher u043bu0430u0443u043du0443, an aneurysm, with the pv less than 40%, the vi level activity set 1 class u0442u00a0u0436u0435u0441u0442u0438 in term of ant ala '36 - 40 daysthe absence of attacks of angina or the existence of angina 1 fc, nc 0 - 1, the absence of an arrhythmia, the absence of an aneurysm, with the pv more than 40%, set in a class 2 u0442u00a0u0436u0435u0441u0442u0438 sr as from the beginning of their 40 - 46 days, the presence of angina 1 - 2 of the pc 1, 2a, 3 class are u0442u00a0u0436u0435u0441u0442u0438 in period from the start of 46 - 49 days, the presence of angina 2 - 3 fc, nc 1, 2a, u0443u0441u0442u0430u043du0430u0432u043bu0438u0432 u0430u044eu0442 4 class in the period from the beginning of the 49 - 54 u0434u043du00a0,the availability of angina 3 - 4 fc, nc 2 - 3, the presence of arrhythmia 3 scales and higher u043bu0430u0443u043du0443, an aneurysm, with the pv less than 40%; choose the appropriate set of u0437u0430u043du00a0u0442u0438u0439 curative s u0438u0437u043au0443u043bu044cu0442u0443u0440u043eu0439 (medicine) on sda and u043fu0440u043eu0432u043eu0434u00a0u0442 u0437u0430u043du00a0u0442u0438u00a0 medicine in 2 h after breakfast during the entire phase of rehabilitation, on the basis of a functional class u0442u00a0u0436u0435 ste u043fu0440u043eu0432u043eu0434u00a0u0442 u0437u0430u043du00a0u0442u0438u00a0 with increasing load of 25% of any class.u0434u043eu0437u0438u0440u043eu0432u0430u043du043du0443u044e walking with 0.5 km. 70 steps of mines up to 2 km in the time 100 - 110 steps of mines in 2 hours after dinner, daily walks in the 2 - 3 admission duration of 2 to 2.5 hours a day on the u0440u0430u0441u0441u0442u043eu00a0u043du0438u0435 from 2 to 10 km, about 1 hour before lunch u043fu0440u043eu0432u043eu0434u00a0u0442 u0432u0435u043bu043eu0442u0440u0435u043du0438u0440u043eu0432u043au0438 intensity of 40% of the threshold pressure of 10 min, the course of 10 to 14 training, all u0437u0430u043du00a0u0442u0438u00a0 ol u043eu0432u043eu0434u00a0u0442 controlled hemodynamics.