Personalized Rehabilitation of Patients with Age-Associated Cardiovascular and Musculoskeletal Disorders

BACKGROUND. The increasing prevalence of chronic diseases with age makes the management of elderly patients a major challenge in modern medicine. In patients with coronary heart disease (CHD), concomitant musculoskeletal disorders (MSD) are common, reducing exercise tolerance and limiting the effectiveness of standard cardiac rehabilitation programs. This highlights the importance of personalized rehabilitation approaches. Promising methods include Nordic walking (NW) and Arm Crank Ergometry (ACE), which can be adapted for patients with impaired lower-limb function.

OBJECTIVE is to evaluate the dynamics of exercise tolerance and functional mobility in patients with CHD and MSDs during standard and personalized rehabilitation programs involving NW and ACE.

MATERIALS AND METHODS. A prospective single-center study was conducted involving 84 patients with CHD and osteoarthritis of the knee and/or hip joints. The mean age of the patients was (66.3 ± 10.4) years. Participants were randomized into three groups: Group 1 (n = 30, NW), Group 2 (n = 24, ACE), and a control group (n = 30, standard rehabilitation). Each program lasted 2 weeks with 3 sessions per week (30 minutes each). Effectiveness was evaluated using the 6-Minute Walk Test (6MWT), ACE Test, and 10-Meter Walk Test (10MWT). Statistical analysis employed the Wilcoxon signed-rank test and Kruskal – Wallis H-test, followed by post-hoc analysis where appropriate; significance level p < 0.05.

RESULTS. All groups demonstrated significant improvement in all functional tests (p < 0.001). The improvement rates in 6MWT and ACE test were higher in personalized groups compared to  the control group (p < 0.05). No statistically significant difference was found between NW and ACE programs. For the 10MWT, significance was not achieved (H = 5.4; p = 0.067).

DISCUSSION. The findings confirm the effectiveness of personalized rehabilitation programs utilizing NW and ACE. All groups showed significant enhancement in exercise tolerance (p < 0.001), with greater progress in personalized programs (p < 0.05). The most pronounced improvement was observed in the ACE group, though the difference between NW and ACE was not statistically significant (p = 1.0). For the 10MWT, intergroup differences did not reach statistical significance (p = 0.067), which may be attributable to the test’s limited sensitivity to short-term aerobic interventions (NW and ACE).

CONCLUSION. Personalized rehabilitation programs incorporating NW and ACE improve exercise tolerance in patients with CHD and MSDs, demonstrating superiority over standard approaches. Both methods showed comparable efficacy, supporting their integration into clinical rehabilitation practice.

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