Three projects were carried out dealing with results of diagnstics in rehabilitation. These researches were targetted on Holter-electrocardiography, sonography and echocardiography in rehabilitation patients.

Project 1:

Concomitant device diagnostics in a rehabilitation unit - sonographic procedures and long-term-ECG

In this project, the results of several non-invasive examinations (different ultrasonic techniques and Holter-ECG) should be analyzed which were carried out on 585 rehabilitation patients (from a total of 1670 patients) showing clinical symptoms. The targetted use of dagnostics especially under the favourable conditions associated with residential rehabilitation could produce various important diagnoses of otherwise unknown diseases. By this, the usefulness of residential rehabilitations could be significyntly increased, and important early diagnoses of several deseases could be made, leading to significant diminutions of expenses in Public Health and long-term maintenance of fitness for work as well as for special occupations.

Project 2:

Importance of ultrasonic examinations for early diagnoses and prevention – results and efficiency on 3200 rehabilitation patients

In 1103 cases taken from a total of 3200 rehabilitation patients, a sonographic screening of abdomen, thyroid and heart was carried out. In a significant proportion new and otherwise unknown diagnoses resulted from these examinations. Thus, sonographic methods can make an important contribution to early diagnoses and disease prevention. Because of this, combinings of sonographic diagnostics with established cancer prevention and health checkups should be considered.

Project 3:

Sonomorphological findings on cardiological rehabilitation patients in the early postacute phase of cardiac diseases – differences in functional treatment results in correlation to the strategy of primary therapy.

It should be ascertained, which echocardiographic constellations on rehabilitation patients with heart diseases exist, depending on the kind of diseases and treatments. Furthermore, the priority of different optional primary treatments on the basis of echokardiographically determinable functional results should be discussed.

Rehabilitation patients with myocardial infarction, prosthetic valves or aortocoronary bypass grafts were examined by B- and M-mode-echocardiography, colour doppler echocardiography and planimetric quantifications of the left ventricle. Differences of functional parameters at the different patient populations were set in relationship to the kind of diseases and treatments and tested on statistical significance.

Patients with infarction of the anterior left ventricular wall had more pronounced ventricular malfunctions than those with infarction of the posterior left ventricular wall. PTCA, Stent and aortocoronary bypass grafts were correlated with lower ventricular malfunctions than conservative treatment strategies in cases of myocardial infarction. Patients with severe coronary heart disease did not differ from patients with myocardial infarctions of the anterior ventricular wall, regarding to the ventricular function. Patients with myocardial infarctions or severe coronary heart diseases were correlated with more severe left ventricular dilatations than patients with prosthetic valves.

Thus, in cases of acute myocardial infarction invasive or surgical coronary treatments should be prefered, if possible. In cases of anterior myocardial infarctions or severe coronary heart diseases rehabilitation resources are more reduced than in cases of posterior myocardial infarctions or prosthetic valves.

Planimetry of the left ventricle according to Simpson, using sonographic contrast enhancers (Optison)
a: Two-chamber view, systolic, b: Two-chamber view, diastolic
c: four-chamber view, systolic, d: four-chamber view, diastolic
 

Publications:

Piper, J.: Concomitant device diagnostics in a rehabilitation unit
Part 1: Sonographic procedures (in German)
Phys Rehab Kur Med 3, 144-147, Thieme, 1993

Piper, J.: Concomitant device diagnostics in a rehabilitation unit
Part 2: Long-term ECG (in German)
Phys Rehab Kur Med 3 (1993), 178-180, Thieme, 1993

Piper, J.: Importance of ultrasonic examinations for early diagnoses and prevention – results and efficiency on 3200 rehabilitation patients (in German)
Praev.-Rehab 6 / 2, 56-59, Dustri, 1994

Piper, J., Berner, S., Wichmann, A., Pera, F.:
Sonomorphological findings on cardiological rehabilitation patients in the early postacute phase of cardiac diseases – differences in functional treatment results in correlation to the strategy of primary therapy (in German)
Herz-Kreisl. 32 / 9, 272-279, Pflaum, 2000

Copyright: Joerg Piper, Bad Bertrich, Germany, 2007

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