Cardiorehabilitation organization in Russia. The results of the pilot project "Development of the system of rehabilitation of patients with cardiovascular diseases in medical institutions of the Russian Federation"

• Published in: CardioSomatika Vol. 7; no. 3-4; pp. 72 - 81
• Main Authors: Bubnova, M. G, Aronov, D. M, Boytsov, S. A, Ivanova, G. E, Andreev, A. G, Barbarash, O. L, Belova, V. V, Belov, V. N, Borisov, B. V, Ivanov, E. V, Karamova, I. M, Karpukhin, A. V, Krasnitskiy, V. B, Kylbanova, E. S, Lebedev, P. A, Lisnyak, E. A, Lyamina, N. P, Mizurova, T. N, Misyura, O. F, Mishina, I. E, Mishchenko, O. V, Nikulina, S. Yu, Ostroushko, N. I, Pomeshkina, S. A, Sidorov, A. S, Sprikut, A. A, Sukhinina, I. S, Tkacheva, A. G, Ustyugov, S. A, Chumakova, G. A
• Format: Journal Article
• Language: English
• Published: Concilium Medicum 15.12.2016
• Subjects: acute myocardial infarction; cardiac rehabilitation; organization; physical training; rehabilitation stages
• ISSN: 2221-7185; 2658-5707
• DOI: 10.26442/CS45219

Goal. The pilot project to organize or conduct performance improvement of existing structural units in specific hospitals (LU) Russia to provide rehabilitative care for patients with cardiovascular diseases in three stages under the current "Procedure for the provision of medical care for patients in medical rehabilitation", to introduce in practice these units tested scientifically sound approaches, forms and methods of cardio-rehabilitation, and try to create some patients routing algorithm. Material and methods. The pilot project includes 17 of the medical institutions of 13 regions of Russian Federation. Single special cards that allow to evaluate the appropriate order on the medical rehabilitation provided rehabilitation assistance to cardiac patients, a multidisciplinary team involved in the provision of rehabilitation assistance, staffing and equipping MI To analyze the effectiveness of organizational models in cardiorehabilitation MI have been developed. Special cards consisted of three sections, each of which allows you to evaluate the effectiveness of each of the three stages cardiorehabilitation: Stage I - unit intensive care unit (BRIT), and a specialized cardiology department; Stage II - stationary cardiorehabilitation department; Stage III - patient department cardiorehabilitation. The article presents the results of a three-year analysis from January 2013 to December 2015. Results. The pilot project was organized with the cardiorehabilitational help stage I in 10 DR, II stage - a 10-LU and Phase III - 7 DR. By 2015, almost all of Latvia to provide assistance in cardiorehabilitational area, multidisciplinary teams consisting of a cardiologist, cardiologist, rehabilitator, medical physical culture (physical therapy) specialist, physical therapy instructor-methodologist, psychotherapist, clinical psychologist, physiotherapist were formed. They were provided and equipped with facilities to practice physical therapy, room for educational schools. Home rehabilitation process BRIT has reduced the patient's stay in the bed of 0.7 days (2013 to 2015) and for 1 day in the cardiology department. On average, 67% of patients with acute myocardial infarction (AMI) were translated into Phase II cardiorehabilitaяtion in which they have become actively involved in the physical rehabilitation program, which is based on a classic exercise therapy, dosage walking in the room, physical training on simulators. Each MI educational schools were organized for patients actively pursued discussions with the relatives. Special complexity of the project has caused the organization phase III cardiorehabilitation. The project is currently ongoing. Conclusion. The analysis of the organization of a three-stage kardioreabilitatsionnoy care system with AMI patients considering the use of staffing, equipment and methodology, according to the current normative law, showed a significant increase in recreational activities created by multidisciplinary teams in all three stages of cardio-rehabilitation, increasing the number of used rehabilitation methods and improve the quality of their performance, as well as demonstrated safety of the proposed principles of physical rehabilitation, according to Russian clinical guidelines "Acute myocardial infarction with ST-segment elevation ECG: rehabilitation and secondary prevention", in the framework of the proposed organizational models cardiorehabilitation.