ECG telemonitoring of Cardiac Risks in Medical Rehabilitation of Stroke Patients: Controlled Study in Parallel Groups

• Published in: Vestnik vosstanovitelʹnoj mediciny (Online) Vol. 22; no. 2; pp. 52 - 65
• Main Authors: Pogonchenkova, Irena V., Kostenko, Elena V., Petrova, Liudmila V., Neprintseva, Natalia V.
• Format: Journal Article
• Language: English
• Published: 22-08-2023
• ISSN: 2078-1962; 2713-2625
• DOI: 10.38025/2078-1962-2023-22-2-52-65

INTRODUCTION. Safety and the personal dosing of physical activity are the main aspects of medical rehabilitation in stroke patients. AIM. To study the possibilities of assessment and correction of cardiac risks by ECG telemonitoring during complex medical rehabilitation of patients in early and late recovery period of ischemic cerebral stroke (IS). MATERIALS AND METHODS. The study included 60 patients in the early and 60 patients in the late recovery period of IS aged 45 to 75 years. During each procedure of complex medical rehabilitation with multimodal impact on impaired motor functions, the ECG parameters of patients were monitored using a portable telecardiocomplex (ECG Dongle cardioflash). Real-time ECG analysis allowed individual correction of the rehabilitation load. RESULTS AND DISCUSSION. ECG changes were analyzed in subgroups of patients taking into account the pathogenetic subtype of IS according to TOAST. The high comorbidity of patients with IS according to the cardiac profile was confirmed (arterial hypertension 64.1 %, dislipidemia 68.3 %, obesity 41.6 %, ischemic heart disease 15 %). There were clinically significant ECG changes: ventricular extrasystole in RVP in 11.7 % of cases, PVP in 8.3 %; atrial fibrillation in RVP in 16.7 %, in PVP in 10 % of patients, conduction abnormalities in 15 % and 11.7 % cases, respectively. Most ECG abnormalities were clinically asymptomatic. Most of the patients had marked abnormalities of cardiac activity regulation, also clinically asymptomatic. Individual correction of the motor rehabilitation program in patients with clinically significant ECG changes allowed to fully complete the medical rehabilitation course in patients with IS. CONCLUSION. The use of remote TMT in assessing cardiac safety in patients after IS provides a personalized approach and allows for a reliable assessment of cardiac risks, including in comorbid patients, which expands the prospects and possibilities of their rehabilitation.