Case Report: The Rehabilitation of a Patient with Acute Transverse Myelitis after COVID-19 Vaccination.

We report the case of a 55-year-old man with multi-symptomatic transverse myelitis after vaccination against coronavirus disease 2019 (COVID-19). The patient was diagnosed based on the course of the disease and the results of imaging and laboratory tests. We excluded other most probable causes of the disease. The quick start of diagnosis allowed for early treatment with intravenous steroids and then plasmapheresis and the implementation of modern rehabilitation methods using biofeedback platforms, among others, and an exoskeleton. The patient returned to work, but the rehabilitation process continues to this day due to persistent symptoms that impair the patient's quality of life.

Influence of a hybrid form of cardiac rehabilitation on exercise tolerance in coronary artery disease patients with and without diabetes.

BACKGROUND: The effectiveness of stationary and ambulatory cardiac rehabilitation of patients with coronary artery disease (CAD) and diabetes has been proven by some authors, but data concerning the effects of hybrid forms of cardiac rehabilitation (HCR) in this population are lacking. A home-based telerehabilitation is a promising form of secondary prevention of cardiovascular diseases in this group of patients. AIM: The objective of the study was to compare the effects of HCR in CAD patients with and without diabetes mellitus (DM). The secondary endpoint was the assessment of CAD risk factors like low exercise capacity and obesity, in both groups of patients. METHODS: This was a retrospective study, which comprised 125 patients with CAD aged 57.31 ± 5.61 years referred for HCR. They were assigned to Group D (with diabetes; n = 37) or Group C (without diabetes; n = 88). HCR was carried out as a comprehensive procedure that included all core components of cardiac rehabilitation according to guidelines. Before and after HCR all patients underwent a symptom-limited exercise test performed according to the Bruce protocol on a treadmill. RESULTS: Before HCR the maximal workload was higher in Group C than in Group D (8.13 ± 2.82 METs vs. 6.77 ± 1.88 METs; p = 0.023), but after HCR the difference was not significant. In both groups an increase in the maximal workload after HCR was observed (Group D: before HCR 6.81 ± 1.91 METs, after HCR 8.30 ± 2.04 METs; p < 0.001; Group C: before HCR 8.31 ± 2.71 METs, after HCR 9.13 ± 2.87 METs; p = 0.001). Resting heart rate, double product, and heart rate recovery 1 (HRR1) declined in both groups. No significant differences in changes in exercise test parameters between both groups' parameters were found. CONCLUSIONS: HCR was effective in patients with DM. The adherence was high. Patients with DM had higher rates of obesity and significantly lower exercise tolerance than patients without DM. Patients from both groups gained similar benefit from HCR in terms of physical capacity, resting heart rate, and heart rate recovery.

Effects of outpatient followed by home-based telemonitored cardiac rehabilitation in patients with coronary artery disease.

BACKGROUND: Cardiac rehabilitation (CR) has been shown to reduce the cardiovascular mortality of patients with coronary artery disease (CAD) and help people to return to professional work. Unfortunately, limited accessibility and low participation levels present persistent challenges in almost all countries where CR is available. Applying telerehabilitation provides an opportunity to improve the implementation of and adherence to CR, and it seems that the hybrid form of training may be the optimal approach due to its cost-effectiveness and feasibility for patients referred by a social insurance institution. AIM: To present the clinical characteristics and evaluate the effects of hybrid: outpatient followed by home-based cardiac telerehabilitation in patients with CAD in terms of exercise tolerance, safety, and adherence to the programme. METHODS: A total of 125 patients (112 men, 13 women) with CAD, aged 58.3 ± 4.5 years, underwent a five-week training programme (TP) consisting of 19-22 exercise training sessions. The first stage of TP was performed in the ambulatory form of CR in hospital; then, patients continued to be telemonitored TP at home (hybrid model of cardiac rehabilitation - HCR). Before and after completing CR, all patients underwent a symptom-limited treadmill exercise stress test. Adherence was reported by the number of dropouts from the TP. RESULTS: The number of days of absence in the HCR programme was 1.50 ± 4.07 days. There were significant improvements (p < 0.05) in some measured variables after HCR in the exercise test: max. workload: 7.86 ± 2.59 METs vs. 8.88 ± 2.67 METs; heart rate (HR) at rest: 77.59 ± 12.53 bpm vs. 73.01 ± 11.57 bpm; systolic blood pressure at rest: 136.69 ± 17.19 mm Hg vs. 130.92 ± 18.95 mm Hg; double product at rest: 10623.33 ± 2262.97 vs. 9567.50 ± 2116.81; HRR1: 97.46 ± 18.27 bpm vs. 91.07 ± 19.19 bpm; and, NYHA class: 1.18 ± 0.48 vs. 1.12 ± 0.35. CONCLUSIONS: In patients with documented CAD, HCR is feasible and safe, and adherence is good. Most patients were on social rehabilitation benefit, had a smoking history, and suffered from hypertension, obesity, or were overweight. A hybrid model of CR improved exercise tolerance.