Rehabilitation of patients with comorbid pathology: age specifics

INTRODUCTION. A personalized approach to the rehabilitation of patients with coronary heart disease (CHD) and concomitant musculoskeletal disorders (MSDs) is becoming increasingly relevant, especially for older patients. The number of patients with comorbidities is significantly related to age. Older people tend to experience slowly progressive pathological conditions, they gradually develop several diseases, particularly chronic ones, and their ability to compensate and adapt is reduced.

OBJECTIVE: To analyze modern methods of cardiac rehabilitation for this group of patients.

MATERIALS AND METHODS: Three types of analysis (quantitative, qualitative and structural) were used to conduct the scientometric analysis of a personalized approach in the rehabilitation of patients with CHD and concomitant MSDs.

RESULTS: The findings from the indicate that conventional cardiac rehabilitation programs often fail to produce satisfactory results for patients with concomitant conditions. Alternative modalities, such as aquatic exercise, Nordic walking, and personalized resistance training, have been shown to be highly effective and safe. A multidisciplinary approach and tailored exercise prescription are crucial components for successful rehabilitation, particularly in older individuals with age-related concomitant conditions.

DISCUSSION: The findings of a comprehensive scientometric analysis, which includes quantitative, qualitative, and structural analysis, support the significance of a personalized approach to rehabilitation for patients with coronary heart disease (CHD) and comorbid musculoskeletal disorders (MSDs). However, a limitation of the review is the absence of randomized controlled trials that evaluate the effectiveness of personalized rehabilitation programs based on scientometric analysis for patients with CHD and MSDs. Most studies included in the review had small sample sizes and short follow-up periods.

CONCLUSION: Further research is required to explore new rehabilitation options, develop and validate tools for assessing the functional status of comorbid patients, and compare the efficacy of various individualized rehabilitation techniques, taking into consideration the age-related changes and specific characteristics of older individuals (the interaction of several factors such as age, somatic diseases, polypragmasia, social maladaptation).

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