The influence of extending early stationary rehabilitation by ambulatory form in patients treated interventionally after ACS on the exercise capacity on the components of psychic state of mind and quality of life

Objectives: The evaluation of the direct and remote effects of stationary rehabilitation following interventionally treated acute coronary syndrome and its extension by a three-month period of supervised training in ambulatory conditions within the scope of physical capacity psychic state and quality of life.Materials and methods: The research was conducted in a group of 44 patients (32 men and 12 women) aged 56.9±9, 62 years old for a period of 2-3 weeks following interventional treatment of acute coronary syndrome. All the patients had participated in stationary rehabilitation, 14 of whom expressed a willingness to participate in a futher three-month period of ambulatory rehabilitation. All patients prior to the commencement of rehabilitation had threadmill exertion tests. Fear was evaluated by means of the SOPER questionnaire. Basic mood and psychic tension as well as the feeling of health were assessed by means of the VAS scale of the Euro-Qol 5D questionnaire. The set of tests was repeated after the completion of the stationary phase, and after time periods of 3 months and a year.Results: Patients subjected to the extended 3-month ambulatory phase of rehabilitation displayed a greater increase in exercise tolerance when compared with the group that had merely undergone the 3-week stationary rehabilitation. Patients with extended rehabilitation gradually improved their evaluation of their state of health and after a year maintained it at the level it had been after the completion of the stationary rehabilitation. In patients who did not express a willingness to continue an organised form of exercise in ambulatory conditions the noticeable improvement in health following the end of rehabilitation was not long lasting. After a year, regardless of the programme of rehabilitation selected, an improvement in the psychic state was noted, which was expressed in an increased positive mood although the level of fear did not change to a significant degree.Conclusions: 1. Extended rehabilitation, combining stationary and ambulatory forms, after interventional treatment of ACS gives a better long-term effect in the area of improving exercise capacity and patient self-evaluation of state of health than is in the case after three-week stationary rehabilitation. 2. The extending of the period of rehabilitation has no influence on attaining the postrehabilitation changes on the level of mood and fear.