Role and Features of Physical Therapy in Myocardial Infarction at the Stages of Rehabilitation

In Ukraine, about 1.2–1.5 million people suffer from coronary heart disease, about 100,000 people suffer from myocardial infarction. Medical and interventional treatments play an important role in the treatment of this chronic disease. Many researchers have found that physical exercise is safe and brings benefits, especially in terms of functional capacity, quality of life and survival. The rehabilitation program for patients with myocardial infarction is a set of sequential stages of rehabilitation in a cardiac hospital, in the rehabilitation department of a local cardiac sanatorium and in polyclinics at the patient's place of residence. Cardiac rehabilitation is a complex process that involves improvement through endurance training, medical education on proper nutrition and lifestyle changes. Analyzing the existing literature, in our country there was a system of cardiac rehabilitation, which included 3 stages - inpatient, outpatient and sanatorium. The following stages of rehabilitation of patients who have suffered a myocardial infarction are distinguished. The inpatient stage, the main purpose of which is to restore the patient's ability to self-service, prevent deterioration of the cardiovascular system, skeletal muscles and other organs and systems due to hypodynamia. This stage includes the psychological preparation of the patient for further expansion of physical activity. The sanatorium stage of rehabilitation is carried out by the patient on the basis of sanatorium-resort institutions (specialized cardiological sanatoriums). Here, patients perform the recovery phase program. The sanatorium stage, like the inpatient stage, has several levels, starting from the moment of admission to the sanatorium and ending with the end of the period of temporary disability. The stage of maintenance rehabilitation is carried out under the supervision of a district therapist with periodic consultations of a cardiologist, this stage can be carried out both before and after the sanatorium stage of rehabilitation. In different countries, their own systems of rehabilitation of patients have been created. For some of them, accelerated, for others - slowed down rates of restoration of motor activity of patients are characteristic. However, the first direction prevails. Thus, different variants of three indicators (degree of myocardial damage, nature of complications and severity of coronary insufficiency) form the class of severity of the patient's condition, which determines the tactics of physical rehabilitation. Conclusions. 1. Existing cardiac rehabilitation programs and physical therapy methods in the recovery of individuals after myocardial infarction require generalization, improvement, approval and inclusion in protocols. The development of rehabilitation programs for patients after acute coronary syndrome should include a phased approach, comprehensiveness, multidisciplinary approach and an individual approach. Cardiac rehabilitation programs at different rehabilitation stages can be proposed when conducting physical therapy in patients with myocardial infarction. The rehabilitation process should be assessed using the method of current and staged control, which ensures adequate expansion of the regimen and intensification of the load of each specific patient.