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clinmed/2003020002v1 (February 13, 2003)
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A special rehabilitation physical training exercise program for high-risk unconscious surgical patients.
Yuzefa Ts. Sobol, Constantin V. Sobol, and Boris L. Makeev
Objectives: This study evaluates short- and long-term effects of a special therapeutic physical exercises (TPE) applied immediately after the operations. Design: The TPE were designed for high-risk surgical patients without consciousness and/or with severe postoperative complications. 165 patients without consciousness after the operations were divided into three groups: control group (n = 17) to whom no TPE were applied; group 1 (n = 80) who performed the TPE by about 50%; group 2 (n = 68) who performed the TPE completely. Outcome Parameters: Short-term effects were the in-hospital mortality rate, regain of consciousness, and complications after surgical interventions. Long-term effects were the number of reemployed patients and the time of repeated operations. Setting: The TPE program was tested for 24 years (1966-1990) at the Surgical Department, Military Medical Academy, St.-Petersburg, Russia. Results: The in-hospital mortality rate was 100% in control group, 36% in group 1, and 0% in group 2; regain of consciousness was 38+12 hr in control group and 4.1+1.5 hr in group 2 after the operations. Postoperative complications were the least in group 2. Period of hospitalization was 5 times shorter in patients of group 2 as compared with group 1. The periods between repeated operations were longer in patients of group 2 in comparison to group 1, and the number of reemployed patients of group 2 was 7 times higher. Conclusions: TPE for high-risk surgical patients, has significant short- and long-term benefits. TPE is proposed to be integrated into a basic medical therapy rehabilitation process.