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Curs ReabilitareAMG2bis
Curs ReabilitareAMG2bis
Curs ReabilitareAMG2bis
PD PD
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Indicatiile RC
• Cardiopatia ischemica (angina pectorala
stabila, post-IMA, post by-pass aorto-
coronarian, post-PTCA)
• Valvulopatii operate/neoperate
• Insuficienta cardiaca
• Transplant cord-pulmon
• Alte categorii (aritmii, dispozitive implantabile,
cardiomiopatii etc.)
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Contraindicatiile RC
• Absolute
- Angina pectorala instabila
- Insuficienta cardiaca decompensata
- Aritmii necontrolate
- HTP severa
- Stenoza aortica severa si simptomatica
- Miocardita acuta, endocardita, pericardita
- HTA necontrolata (> 180/110 mm Hg)
- Disectie de aorta
- Sindrom Marfan
- Retinopatie DZ proliferativa
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PD PD
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Abordarea pacientului cu BCV inaintea
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RC
• Examenul fizic
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Teste paraclinice
• Rx torace
• Ecg repaus
• Monitorizare Holter
• ABPM
• Testarea de efort – standard, test de mers 6
min, cardiorespirator
• Angiografia coronariana
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TESTELE DE EFORT
• Teste “de laborator”, cu grad
înalt de complexitate
• Testul de efort
cardiorespirator
• Suplimentar: gazometrie,
pulsoximetrie, analiza gazelor
expirate
10/30/2016 7
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TESTELE DE EFORT
Walking is for almost everyone! • testele ”de teren” sau testele
de mers (testul de mers de
12- 6 - 2 minute)
• simplu i reproductibil, nu
necesita dotare exceptionala
• reprezint alternativa
pragmatic
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CONTRAINDICATIILE 6MWT
ABSOLUTE
• Angina pectorala instabila sau infarct miocardic acut in ultima luna
• Stenoza aortica stransa
• Tulburari locomotorii severe care impiedica deplasarea
• Tulburari neuropsihice severe
• Deficite neurosenzoriale (surditate, scadere severa a acuitatii
vizuale)
RELATIVE
• Frecventa cardiaca de repaus > 120/min
• Tensiunea arteriala 180/ 100 mm Hg
• Boli musculoscheletale
musculoscheletale,, osteoarticulare
osteoarticulare,, neuromusculare care
limiteaza ambulatia
• Sincopa de efort (pacienti cu HTP)
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PD PD
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PREGATIREA PACIENTULUI
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• instruirea pacientului
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SCALA BORG
10/30/2016 15
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Valori normale
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Interpretare
• Modificarea distantei parcurse la 6MWT –
utilizata pt a evalua eficienta unui program
de reabilitare sau pt a descrie istoria naturala
de modificare a capacitatii de efort la un
anumit pacient
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Interpretare
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VA MULTUMESC !