Vpliv pandemije COVID-19 na funkcionalno sposobnost srčno-žilnih bolnikov : magistrsko delo

Granov, Žan (author), Jug, Borut (mentor), Pori, Primož (comentor)

Telesna vadba je ključni dejavnik dolgotrajne oskrbe večine srčno žilnih bolezni. V Sloveni-ji se bolnikom s koronarno boleznijo in srčnim popuščanjem priporoča ambulantna rehabili-tacija, kasneje pa vključitev v programe vseživljenjske rehabilitacije v okviru koronarnih klubov in društev. Koronarni klub Ljubljana vrsto let izvaja program prilagojene telesne vadbe za srčne bolnike; leta 2019 je uvedel tudi ocenjevanje funkcionalne sposobnosti s 6-minutnim testom hoje (6MTH). Leta 2020 so koronarni klubi in društva morali prekiniti svoje aktivnosti zaradi epidemije koronavirusne bolezni 19 (covid-19), Koronarni klub Ljubljana pa je poskusno uvedel program telerehabilitacije. Cilj naše raziskave je bil oceniti vpliv 1) epidemije covid-19, 2) izbranih značilnosti bolni-kov (starost, spol, telesna masa ter diagnoza srčne bolezni) ter 3) vključenosti bolnikov v program telerehabilitacije na A) prehojeno razdaljo pri 6MTH in B) sekundarne opazovane dogodke (krvne maščobe). Vključili smo 126 bolnikov (mediana starost 74 let, 68 % žensk), ki so leta 2019 opravili 6MTH ter pri njih leta 2021 ponovili 6MTH, odvzeli kri za določitev krvnih maščob in aplicirali vprašalnike DASS, IPAQ in SF-36. V času epidemije je prehojena razdalja pri 6MTH upadla (s 510 +/- 92 metrov na 488 +/- 101 metrov, p<0,001); zvečala se je telesna masa, upadel je HDL-holesterol. 6MTH je bolj upadel pri ženskah ter z naraščajočo starostjo in telesno maso. Upad je bil večji pri bolnikih z diagnozo srčnega popuščanja. Povezanosti med vključenostjo v telerehabilitacijski pro-gram in 6MTH nismo potrdili. Prav tako nismo potrdili povezanosti med samoporočanimi kazalniki psihološkega zdravja in tedenske telesne dejavnosti, medtem ko je bila povezanost med 6MTH in samoporočano kakovostjo življenja statistično značilna. Naši rezultati potrjujejo, da je aerobna funkcijska sposobnost med epidemijo covid-19 pri članih koronarnega kluba Ljubljana upadla. Upad je bil povezan s spolom, starostjo, telesno maso ter samoporočano kakovostjo življenja. Izsledki name raziskave potrjujejo pomen rednega spremljanja funkcionalne sposobnosti članov koronarnih klubov in društev, saj le tako lahko pravočasno naslovimo dejavnike, ki vplivajo na morebitni upad funkcionalne sposobnosti.

• Language: Slovenian
• Keywords: funkcionalna sposobnost, šestminutni test hoje, pandemija covid-19, srčno-žilne bolezni, koronarni klubi in društva
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: FŠ - Faculty of Sport
• Year: 2023
• PID: 20.500.12556/RUL-144679
• COBISS.SI-ID: 148587779
• Publication date in RUL: 08.03.2023

Secondary language

• Language: English
• Title: Impact of the covid-19 pandemic on functional capacity in cardiovascular patients

Abstract

Exercise training is a pivotal component of long-term management of cardiovascular diseases. In Slovenia, outpatient rehabilitation is recommended for patients with coronary artery disease and heart failure, followed by long-life rehabilitation in coronary clubs and associa-tions. The Ljubljana Coronary Club has provided exercise training for cardiac patients for several years; in 2019, appraisal of functional capacity with 6-minute walk tests (6MWT) was introduced. In 2020, however, coronary clubs and associations had to shut down on-site activities because of the coronavirus 19 (covid-19) pandemic; in response, the Ljubljana Coronary Club introduced a tele rehabilitation programme. We aimed to assess the effect of 1) the covid-19 pandemic, 2) selected patients’ characteris-tics (age, sex, body mass and cardiac diagnosis) and 3) adherence to the telerehabilitation programme on A) 6MWT and B) secondary endpoints (body mass and blood lipid levels). We included 126 patients (median age 74, 68% women) who had performed a 6MWT in 2019 and repeated the 6MTW in 2021. In addition, we determined blood lipid levels and patients responded to the DASS, IPAQ and SF-36 questionnaires. During the pandemic, the 6MWT distance decreased (from 510 +/- 92 m to 488 +/- 101 m, p<0.001); body mass increased, and HDL levels decreased. 6MWT distance decrease was associated with female sex, increasing age and increasing body mass. The decrease was associated with a heart failure diagnosis. Telerehabilitation adherence, self-reported psychological health and self-reported physical activity over the preceding week were not associated with 6MWT. Self-reported quality of life, on the other hand, was statistically significantly associated with 6MWT distance. Our results confirm a decrease in aerobic functional capacity in members of the Coronary Club Ljubljana during the pandemic. The decrease was associated with sex, age, body mass, and self-reported quality of life. Our findings underscore the importance of regular assess-ments of functional capacity in members of coronary clubs and associations, as factors driving a decrease in functional capacity should be promptly addressed.

• Keywords: Functional capacity, 6-minute walk test, covid-19 pandemic, cardiovascular disease, coronary clubs and associations