Introduction of alternative rehabilitation method for the patients with cardiovascular diseases in conditions of the COVID-19 pandemic
Authors: Nesterak R V , Vakaliuk I P , Yakymchyk N V , Drapchak I , Savchuk N V , Sovtus V I , Grygoryshyn R S , Bardashevska S M 
Published: October 2021

Abstract

COVID-19 pandemic caused structure reorganization in rehabilitation. Nowadays telerehabilitation is the best method due to close-out and readjustment of clinics. There is a need to search and develop alternative rehabilitation models in the conditions of COVID-19 pandemic.

Aim
Developing and introducing an alternative rehabilitation model for the patients after acute coronary syndrome in the conditions of COVID-19 pandemic.

Methods
An alternative rehabilitation model was developed for the patients after acute coronary syndrome in the condition of COVID-19 pandemic. 70 patients after the acute coronary syndrome who were hospitalized into the cardiology center went thought our rehabilitation model.
The 1st stage of the rehabilitation is conducted during in-patient treatment. Before the discharge from the hospital, the patient gets evaluated his/her clinical state, physical activity level, evaluation of his/her psychological state, risk stratification with noting in a developed by us patient's individual self-check diary. The individual diary includes: ID data, pharmaceutical treatment, recommendations on physical activity with a possibility to note daily data on angina and dyspnea attacks, their number, need in medications, heart rate, blood pressure, distance walked during a day, evaluation in points according to the Borg scale, HADS and SAQ questionnaires.
The 2nd stage is conducted using telerehabilitation methods: phone call, group training on the ZOOM platform, and individual consulting. At this stage we used the components of rehabilitation:
– group training in breathing exercises and using relaxation techniques, are conducted 2 times/week during 3 months after discharge, then 1 time/week up to 6th month or on patient's request individually
– group training using an author's method of psychological rehabilitation while optimizing internal health picture, is conducted 2 times/week during 3 months after discharge, then 1 time/week up to 6th month or on patient's request individually
Control of the patient's state and indices (according to data from the patient's individual diary) is conducted after 1, 6 months, and a year.

Results
We established that our alternative rehabilitation method contributed to the improvement of clinical and functional capabilities of the patients, decrease of depression and anxiety, improved quality of life, attitude towards the disease and health.

Conclusion
The COVID-19 pandemic changed our life and health care for the patients. But a time-lag in conducting and using rehabilitation in patients with cardiovascular diseases causes complications and progression of the disease. Using alternative rehabilitation methods will grant providing timely and complex medical care, improving clinical, physical, and psychological indices that will contribute to increased adherence to rehabilitation and treatment in conditions of the COVID-19 pandemic.

Funding Acknowledgement
Type of funding sources: None. Alternative rehabilitation modelThe patients' state dynamics