The Clinical Management of Deconditioned Patient

The current study was designed to investigate the clinical management of deconditioned patients. In the current study, we investigate the clinical manifestations of deconditioned patients. A subacute functional deficiency was determined when getting up from a supine position and developing tachycardia with an increase in heart rate by ۳۰ or more per minute for ۱۰ minutes. This study included ۱۷۲ elderly patients aged ۶۵ to ۷۴ years. The average age of the patients was ۶۹.۲+۲.۲ years. There were ۱۰۲ men and ۷۰ women in the study. These patients were registered at the dispensary with the therapists of outpatient clinics after an infectious disease. Within ۶ months after the treatment, a comprehensive geriatric assessment of patients was performed. All patients were divided into four groups depending on the indicators of motor activity, which in the framework of this study was the criterion of the adaptive function of the body and viability. Patients with normal motor activity indicators did not have the decondition and were designated as a control group. Patients with the decondition did not have normal indicators of motor activity. The obtained results were processed statistically. According to the results of our study, it was noted that the assessment of the six months after the treatment showed heterogeneity of patients from a functional point of view with a homogeneous somatic structure. Six months after the treatment, out of ۱۷۲ people, ۴۵ people (۲۶.۲%) had normal motor activity indicators (۳۹-۴۰ points); according to the questionnaire "Assessment of motor activity in the elderly", the average score was ۳۹.۶+۰.۲; ۴۲ people (۲۴.۴%) had mild motor activity disorders (۳۴-۳۸ points), the average score was ۳۶.۱+۰.۴; moderate disorders (۲۱-۳۳ points) were registered in ۴۷ people (۲۷.۳%), the average score was ۲۷.۹+۲.۱; significant motor activity disorders (۰-۲۰ points) occurred in ۳۸ people (۲۲.۱%), the average score was ۱۳.۲+۱.۴. The fall syndrome was characteristic of those patients with the decondition who demonstrated moderate and significant motor activity disorders ۶ months after the treatment. In particular, in people with significant motor activity disorders, there was a decrease in muscle strength in the lower extremities by ۴۸.۳+۳.۲% and in the upper extremities – by ۲۷.۱+۳.۱% (P<۰.۰۵). As a result of the presence of the decondition, an unfavorable cascade of geriatric syndromes is formed in the form of an increase in the level of situational anxiety from ۲۱.۹-۲۴.۸ to ۵۸.۴-۷۵.۳ points on the Spielberger-Hanin scale, a deterioration in morale with an increase in the severity of depression from ۵.۸-۶.۰ to ۱۱.۰-۱۴.۹ points, a decrease in the quality of sleep on the ten-point visual analog scale from ۸.۳-۸.۴ to ۵.۲-۵.۷ points on the Beck scale, an increase in the proportion of patients at risk of developing malnutrition syndrome from ۴.۸-۶.۷% to ۴۶.۸-۶۸.۴%, the development of the fall syndrome, which, in turn,, it is a predictor of the development of dinapenia in the form of a decrease in the strength of the upper extremities by ۲۲.۷-۲۷.۱%, a decrease in the strength of the lower extremities by ۲۹.۶-۴۹.۶%, with a faster rate of decrease in the strength of the lower extremities compared to the upper extremities by ۱.۸ times, which, accordingly, reduces the rehabilitation potential. Clinical manifestations of the decondition in elderly patients were such geriatric syndromes as anxiety, depression, cognitive decline, sleep disorders, hypomobility, dinapenia, risk of developing malnutrition syndrome and falls syndrome.

کلیدواژه ها:

older age ، geriatric patient ، Physical activity