SHORT TERM EFFECTS OF CARDIOPULMONARY REHABILITATION AND NEUROMUSCULAR ELECTRICAL STIMULATION ON FUNCTIONAL CAPACITY, MYOCARDIAL TISSUE DOPPLER AFTER CORONARY ARTERY BYPASS GRAFT SURGERY

Abstract

Purpose: Exercise capacity is associated with diastolic function. The aim of our study is to investigate the short-term effects of cardiopulmonary rehabilitation and NMES on functional capacity and myocardial tissue doppler (MTD) after coronary artery surgery. Methods: Forty patients with coronary artery bypass graft were randomly divided into two groups: CPR+NMES and CPR. Functional capacity were analyzed through 2 minutes walk test (2MWT) and sit to stand test (SST), left ventricular (LV) diastolic functions were analyzed with MTD and thoracic expansion was analyzed with chest wall measurement on the 2nd and 7th postoperative days. Results: Statistically significant difference was identified between the groups in 2MWT distance (CPR+NMES, Zt*p=0.000*), SST (CPR, Zt*p=0.000*), E’ (CPR+NMES, Zt*p=0.002*), E (CPR+NMES, Zt*p=0.025*), E/E’ (CPR+NMES, Zt*p=0.007*), A (CPR, Zt*p=0.006*) (p<0.05). Statistically significant difference has been observed in group comparisons in E’ (CPR+NMES, G*p=0.000*) ve E/E’(CPR+NMES, G*p=0.007* postoperative 2nd day; G*p=0.019* postoperative 7th day) (p<0.05). The temporal changes of 2MWT distance, heart rate, blood pressures, respiratory frequency, saturation and Borg dyspnea-fatigue measurements did not show a statistically significant difference between groups (p>0.05), except for E'(Zg*p=0.000*), E/E' (Zg*p=0.003*) parameters (p<0.05). Conclusion: It was seen that NMES, which we applied in addition to early cardiopulmonary rehabilitation, made a positive contribution to LV filling pressure and LV filling rate in the CPR+NMES group. Additionally, in the intergroup comparisons of the CPR+NMES group, it was observed that there was a statistically significant increase in the 2 MWT distance on the postoperative 7th day compared to the postoperative 2nd day.