Piotr Dylewicz

University School of Physical Education, Posen, Greater Poland Voivodeship, Poland

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Publications (23)38.11 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: The aim of this study was to determine whether short-term cardiac rehabilitation (CR), including dietary counseling, had an impact on changing eating habits in patients after acute coronary syndrome (ACS), treated with primary percutaneous coronary intervention (PCI). Methods: The controlled, prospective, nonrandomized study was performed on 44 patients, early following ACS/PCI, who underwent 2- to 3-week inpatient CR with dietary counseling and compared to 18 patients who did not participate in CR. An analysis of the daily diet composition was performed at baseline, at 3 months post-ACS, and at 1 year post-ACS. Results: In the CR group, comparing baseline with 3 months post-ACS, daily calorie intake was significantly reduced from a mean ± SD of 2260 ± 525 kcal to 2037 ± 514 kcal (P < .05), and daily cholesterol intake from 509 ± 237 to 394 ± 199 mg (P < .05). The daily energy intake of saturated fatty acids was also significantly reduced from 13.6% at baseline to 12.2 ± 4.5% at 3 months and further reduced at 1 year post-ACS to 10.2 ± 4.3% (P < .05). Although both groups exhibited increased body mass index, the increase was significantly greater in the nonrehabilitation group than in the CR group at 1 year post-ACS (2.61 ± 2.23 vs 0.86 ± 1.67 kg/m, respectively, P < .001). Conclusions: The analysis suggests that a short-term CR program following ACS, which includes educational meetings on dietary prevention of atherosclerosis, may result in some favorable and lasting modifications of eating habits of post-ACS patients.
    Journal of cardiopulmonary rehabilitation and prevention 05/2013; 33(4). DOI:10.1097/HCR.0b013e318293b47b · 1.58 Impact Factor
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    ABSTRACT: Rehabilitation based on physical exercise should focus notonly on improving the current level of physical fitness, but also on increasing patients’ awareness and forming a habit of physical activity as a form of secondary cardiovascular disease prevention. The aim of this article is to review the most current publications on this subject and point to the importance of walking training in successful cardiac rehabilitation, even for cardiac surgery patients. The authors of this article postulate the necessity of propagating simple forms of physical activity, such as walking training, as an important factor in reducing the incidence and recurrence of cardiovascular diseases as well as the resulting mortality rate.
    Polish journal of cardio-thoracic surgery 12/2012; 9(4):481-485. DOI:10.5114/kitp.2012.32690 · 0.21 Impact Factor
  • Piotr Dylewicz ·

    Kardiologia polska 01/2012; 70(6):598. · 0.54 Impact Factor
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    ABSTRACT: The aim of this study was to assess the 1-yr follow-up effects of inpatient rehabilitation and its prolongation with an ambulatory training program on blood pressure and metabolic risk factors in patients after an acute coronary syndrome. A controlled (n = 20) prospective study was undertaken. The study group consisted of 54 consecutive patients participating in a 3-wk inpatient rehabilitation. Of these, 14 chose to continue the training for 3 mos (CR_In+Amb group) and 40 declined (CR_In group). Body mass index increased in the CR_In and control groups. The magnitude of change was greater in controls (2.2 ± 2.14 vs. 0.7 ± 1.70 kg/m; P < 0.05). Waist circumference increased only in the control group, and at 12 mos, it was higher than in the CR_In and CR_In+Amb groups (P < 0.05). Mean systolic and diastolic blood pressure increased in the CR_In (from 121/76 to 130/82 mm Hg; P < 0.01) and control (from 122/74 to 139/87 mm Hg; P < 0.01) groups. At 12 mos, blood pressure in the CR_In group was lower than in the control group but higher than in the CR_In+Amb group (119/77 mm Hg; P < 0.05). Total cholesterol, low-density lipoprotein cholesterol level, and triglyceride level at 12 mos were higher in the control group than in the CR_In and CR_In+Amb groups (P < 0.05). C-reactive protein decreased in the CR_In and CR_In+Amb groups (P < 0.01). Inpatient rehabilitation was associated with beneficial effects on blood lipids and C-reactive protein in coronary patients and attenuated the rise in blood pressure and adiposity indices observed in nonparticipants. Prolongation of rehabilitation with an ambulatory program improved blood pressure control.
    American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 07/2011; 90(7):589-98. DOI:10.1097/PHM.0b013e3182063bec · 2.20 Impact Factor

  • Kardiologia polska 01/2011; 69(10):1104-6. · 0.54 Impact Factor
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    Piotr Kocur · Ewa Deskur-Smielecka · Malgorzata Wilk · Piotr Dylewicz ·
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    ABSTRACT: To investigate the effects of Nordic Walking training supplemental to a standard, early rehabilitation programme on exercise capacity and physical fitness in men after an acute coronary syndrome. A controlled trial. Cardiac rehabilitation service of a provincial hospital. Eighty men 2-3 weeks after an acute coronary syndrome, with good exercise tolerance. Three-week, inpatient cardiac rehabilitation programme (control group) supplemented with Nordic Walking (Nordic Walking group), or with traditional walking training (walking training group). Exercise capacity was assessed as peak energy cost (in metabolic equivalents) in symptom-limited treadmill exercise test, and physical fitness with the Fullerton Functional Fitness Test. Exercise capacity after the rehabilitation programme was higher in the Nordic Walking group than in the control group (10.8 +/- 1.8 versus 9.2 +/- 2.2 metabolic equivalents, P =0.025). The improvement in exercise capacity in the Nordic Walking group was higher than in the control group (1.8 +/- 1.5 versus 0.7 +/- 1.4 metabolic equivalents, P =0.002). In contrast to the control group, the results of all components of the Fullerton test improved in the Nordic Walking and walking training groups. After the programme, lower body endurance, and dynamic balance were significantly better in the Nordic Walking group in comparison with the walking training and control groups, and upper body endurance was significantly better in the Nordic Walking and walking training groups than in the control group. Nordic Walking may improve exercise capacity, lower body endurance and coordination of movements in patients with good exercise tolerance participating in early, short-term rehabilitation after an acute coronary syndrome.
    Clinical Rehabilitation 09/2009; 23(11):995-1004. DOI:10.1177/0269215509337464 · 2.24 Impact Factor
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    ABSTRACT: The value of cardiac rehabilitation in patients with coronary artery disease has been well established. The main problem is a low attendance of patients qualified for rehabilitation. To assess differences between subjects attending outpatient cardiac rehabilitation (OutCR) after completing an early inpatient programme (InCR), and patients refusing participation in OutCR; to investigate factors determining patients' decisions. Seventy-two patients (mean age 57 +/- 9.4 years; 53 men) 2-3 weeks after an acute coronary syndrome (ACS) treated with primary PCI were enrolled. On admission to the cardiac rehabilitation ward, the following parameters were assessed: quality of life (EuroQol-5D questionnaire), psychological status (Beck's, SOPER and STAI questionnaires), marital status, education, economic status, employment, place of living, smoking status, and comorbidities (a questionnaire prepared by the authors). Additionally, patients' opinions on outpatient and inpatient cardiac rehabilitation were noted. The inpatient programme lasted 2-3 weeks. At discharge, the assessment was repeated, and patients were proposed to enrol in a 12-week outpatient programme. In the case of refusal, patients were asked to give the reason. Two men failed to complete the inpatient program. Of the remaining 70 subjects, 16 attended and completed the outpatient programme. In the group participating in OutCR, there were fewer patients with depression before InCR (12 vs. 39% in the group without OutCR, p = 0.0484). Subjects in the OutCR group had a higher score for mood after InCR (7.7 +/- 1.25 vs. 6.7 +/- 1.69, p = 0.0365), lower score for emotional stress before and after InCR (before InCR: 4.4 +/- 1.09 vs. 5.3 +/- 1.34, p = 0.0188; after InCR: 3.8 +/- 1.51 vs. 4.8 +/- 1.4, p = 0.0262), and lower score for anxiety before InCR (3.1 +/- 1.75 vs. 4.4 +/- 2.12, p = 0.0426). Patients in the two groups differed with regard to employment (p = 0.0256) and smoking status (p = 0.0517). In both groups, most patients (ł 80%) preferred inpatient rehabilitation. Continuous medical care, lack of commuting problems, and convenience were the most frequently given advantages of inpatient rehabilitation, while commuting problems and conflict with job were the most frequently perceived barriers to outpatient rehabilitation. Only a small proportion of patients after an ACS decides to participate in outpatient rehabilitation after completing a short-term inpatient programme. Psychological status, employment and smoking status are among the factors that differentiate OutCR attenders and non-attenders. Continuous medical care, lack of commuting problems, and convenience were the most frequently given advantages of inpatient rehabilitation, while commuting problems and conflict with job were the most frequently perceived barriers to outpatient rehabilitation.
    Kardiologia polska 07/2009; 67(6):632-8. · 0.54 Impact Factor
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    ABSTRACT: Aim: to compare estimated energy expenditure by means of three simple methods during various forms of training used in cardiac rehabilitation. Material and methods: the examined group consisted of 40 men involved in early cardiac rehabilitation following acute coronary syndrome. The rehabilitation program consisted of 12-13 sessions comprising Nordic Walking (NW), calisthenics (Cal), and cycle ergometer training (Erg). In each subject, energy expenditure was measured four times using a heart rate monitor with inbuilt function for calculating energy expenditure (CRS), an accelerometer, and heart rate calculated from mean exercise heart rate value based on the data from the treadmill exercise test. Results: for all types of training, the energy expenditure value assessed with an accelerometer was lower than calculated based on data from the treadmill exercise test. For Cal and Erg, it was also lower than estimated with the heart rate monitor. The assessment of energy expenditure with the heart rate monitor and calculated based on the data from the exercise test differed exclusively in the case of ergometer training. For all methods of assessment, the energy expenditure was highest during NW. Conclusions: the use of the heart rate monitor enables reliable comparison of energy expenditure during various forms of physical activity. The accelerometer may be useful in assessment of energy expenditure only during simple activities with high linear acceleration.
    Fizjoterapia 01/2009; 17(2). DOI:10.2478/v10109-010-0001-3
  • Ewa Deskur-Smielecka · Andrzej Jóźwiak · Piotr Dylewicz ·

    Kardiologia polska 07/2008; 66(6):684-7. · 0.54 Impact Factor
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    ABSTRACT: Education on behavioural risk factors and lifestyle modification is one of the core components of comprehensive cardiac rehabilitation. To assess the level of knowledge of cardiovascular risk factors and recommended lifestyle changes in patients rehabilitated after an acute coronary syndrome (ACS). The study group consisted of 31 consecutive patients (22 males, 56.6+/-10.9 years) participating in short-term, early, comprehensive cardiac rehabilitation. On admission, at discharge and 3 months after discharge patients' knowledge was assessed with a questionnaire worked out by the authors. On admission, patients had poor knowledge of cardiovascular risk factors and recommended lifestyle modifications, especially concerning diabetes, hypertension, and diet. After completing the rehabilitation programme, significantly higher percentage of patients gave correct answers to questions concerning diabetes and cholesterol-rich diet as cardiovascular risk factors, and substitution of vegetable fat for animal fat as a lifestyle modification, and significantly higher proportion of patients gave the correct value for elevated systolic blood pressure. Patients after ACS have poor knowledge of cardiovascular risk factors and recommended lifestyle modifications. The level of knowledge improves after short-term, stationary cardiac rehabilitation; however, the degree of this improvement is not completely satisfactory.
    Kardiologia polska 03/2008; 66(2):230-2. · 0.54 Impact Factor

  • European Journal of Cardiovascular Prevention and Rehabilitation 05/2006; 13(Supplement 1). DOI:10.1097/00149831-200605001-00341 · 3.69 Impact Factor

  • European Journal of Cardiovascular Prevention and Rehabilitation 05/2006; 13(Supplement 1). DOI:10.1097/00149831-200605001-00343 · 3.69 Impact Factor
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    ABSTRACT: A low level of physical activity and decreased exercise capacity are independent risk factors for cardiovascular and all-cause mortality. The assessment of the level of physical activity and its improvement following preventive procedures is methodologically difficult. In population studies, subjective methods, such as questionnaires, activity records and other somewhat imperfect measures (accelerometers, pedometers, and pulse monitors), are used. Direct and especially indirect assessment of physical capacity with exercise tests has become increasingly more accessible and cheap. Both methods have been proved to have high prognostic value. Assessment of physical capacity enables objectification of information on the level and effects of a subjects physical activity acquired via a questionnaire. Taking into account the above-mentioned issues, the role of the assessment of exercise capacity and its improvement is not adequately appreciated. Routine evaluation of exercise capacity has not been included in the current statements on epidemiology and prevention, even in those with an increased Framingham or SCORE risk index in whom low exercise tolerance has been proved to have an unfavorable influence on prognosis. The importance of an increase in the level of physical activity resulting in an improvement in exercise capacity in different population groups should be verified in the near future, but in our opinion there is indirect but strong evidence that actions to improve exercise capacity should become the main goals in the prevention of cardiovascular and all-cause mortality, such as cessation of cigarette smoking, body weight reduction, correction of lipid and carbohydrate metabolism disturbances, and a decrease in blood pressure.
    Journal of Public Health 10/2005; 13(6):313-317. DOI:10.1007/s10389-005-0127-9 · 2.06 Impact Factor
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    ABSTRACT: Summary Introduction: Heart failure (HF) is one of the most important complications of a myo-cardial infarction. Its prevalence is very high, and the prognosis is unfavorable. It has been proved only recently that appropriate physical training may slow down the progres-sion of chronic heart failure. Study aim: The aim of the study was to evaluate the results of a short-term rehabilitation of patients after myocardial infarction complicated with heart failure by means of the six-minute walk test (6MWT). Material and Methods: The study population consisted of 30 patients (15 women and 15 men) referred to a short-term rehabilitation program (12 training sessions). The effects of the rehabilitation program were assessed on the basis of the following parameters recorded during the 6MWT: the covered distance, post-exercise pulse and systolic blood pressure, and rate-pressure product. The 6MWTs were performed in a rehabilitation hospital on admission and before discharge. Results and Conclusions: The distance covered during consecutive tests increased sig-nificantly both in women and men. The post-exercise pulse, systolic blood pressure and rate-pressure product during the end 6MWT were significantly higher in men and lower in women in comparison with appropriate values recorded during the baseline test. This finding may indicate that dissimilar mechanisms are involved in the adaptation to exer-cise in both genders.
    Advances in Rehabilitation 01/2005;
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    ABSTRACT: It has been shown that short-term exercise training improves insulin resistance parameters in patients with ischaemic heart disease. The effects of such a rehabilitation programme in patients with hypertension have not been well established. To assess whether short-term endurance training after coronary artery bypass grafting (CABG) may improve metabolic parameters and reduce blood pressure in patients with hypertension. The study group consisted of 30 male patients (15 with hypertension and 15 normotensive) aged 55+/-2.1 years who underwent CABG 1 to 6 months before the initiation of a 3-week endurance training. Glucose, insulin and C-peptide blood levels as well as binding and degradation of 125I-insulin by erythrocyte receptors were assessed before and after the training programme. The effects of training on blood pressure values were also evaluated. A significant improvement (p<0.01) in the insulin resistance parameters, i.e. binding and degradation of labelled insulin was noted only in patients with hypertension. This was accompanied by a significant (p<0.05) increase in the HDL-cholesterol level. In the subgroup with hypertension, both the exercise systolic and diastolic pressures decreased significantly (p<0.05 and p<0.01, respectively), and similar changes were noted in the resting systolic and diastolic blood pressures values (p<0.05). Rehabilitation after CABG based on the endurance training was especially effective in patients with hypertension in whom beneficial changes in some metabolic risk factors of ischaemic heart disease as well as the reduction in the blood pressure values were observed.
    Kardiologia polska 06/2004; 60(5):431-40; discussion 440. · 0.54 Impact Factor
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    ABSTRACT: We have investigated the effect of endurance training on cell metabolism and exercise tolerance in patients with ischemic heart disease. Study population consisted of 24 survivors of myocardial infarction. Patients were assigned to the training group (n=18, mean age 48.2 years) or to the control group (n=6, mean age 42.6 years). Directly before (ExTest I) and after completing a 3-week endurance training program (ExTest II) patients performed bicycle ergometry with computer analysis of ventilatory expired gas (CardioO2, Medical Graphics Corporation). The exercise intensity increased gradually until ventilatory threshold was reached. ExTest II was finished at the same workload level as ExTest I. ECG was recorded and blood pressure was assessed during each ergometry. Prior to and 3 minutes after finishing each test, capillary blood samples were taken for measurements of acid-base equilibrium parameters and lactate concentrations and venous blood samples were collected for assessment of oxypurines and uric acid levels (HPLC method). The training consisted of five 40-min sessions of continuos working on a bicycle ergometer weekly. The workload was 25 W lower than the load at which ventilatory threshold had been reached by the patient. Subjects in the control group did not participate in endurance training. During exercise tests performed after the rehabilitation program, heart rate and rate-pressure product at particular workload were lower than on admission. Similarly, the increases in lactate concentrations and changes in base excess were reduced during ExTest II. The oxypurines pool was reduced after the training, which reflects improvement in cell metabolism. No influence of training on uric acid concentrations was observed.
    Biology of Sport 01/2003; 20(3). · 0.79 Impact Factor
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    ABSTRACT: Our study was aimed at determining whether beneficial modification of carbohydrate metabolism can be obtained after a short-term training program and whether it is associated with an increase in binding and degradation of (125)I-insulin by erythrocyte receptors that suggests a decrease in insulin resistance. The study was conducted in a group of 20 patients aged 56 +/- 1.9 years (mean +/- SEM), within 1 to 6 months after coronary bypass surgery. All patients completed 15 training sessions based on 30 min of cycling with a constant load. Before and after a 3-week training program, glucose, insulin, and C-peptide blood levels, as well as binding and degradation of (125)I-insulin by erythrocyte receptors, were determined. A statistically significant decrease was found in the blood glucose level, from 111.2 +/- 4.2 to 97.8 +/- 3.5 mg/dL (p < 0.01); this decrease was not accompanied by significant insulin concentration changes. There was also a significant increase in insulin binding, from 0.535 +/- 0.059 to 0.668 +/- 0.042 pg (125)I/10(11) RBCs (p < 0.01), and degradation from 7.64 +/- 0.54 to 9.49 +/- 0.58 pg (125)I/10(11) RBCs (p < 0.05). The results indicated that even short-term endurance training in patients rehabilitated after coronary bypass surgery induced favorable modification of glucose metabolism, presumably caused by a decrease in insulin resistance.
    Chest 02/2000; 117(1):47-51. DOI:10.1378/chest.117.1.47 · 7.48 Impact Factor
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    ABSTRACT: This study was directed toward establishing whether and to what extent, short-term endurance training influences the insulin blood level, and the binding and degradation of 125I-insulin by erythrocyte receptors in patients undergoing rehabilitation after myocardial infarction. The study was conducted in a group of 60 patients who had had myocardial infarction within the past 1.5 to 3 months and who did not have arterial hypertension and diabetes mellitus. All the patients took a symptom-limited cardiopulmonary exercise test. Before and after the test, venous blood was collected to determine lactic acid and insulin blood levels as well as the binding and degradation of 125I-insulin. The study group was randomized into two subgroups. One subgroup entered into a 3-week in-patient rehabilitation course. The control group was discharged from the hospital and was given no recommendations for physical exercise. The same investigation was repeated 3 weeks later. In the patients (50%) with hyperinsulinemia (insulin resistance index, > 10 microIU/mL), which was detected during the first investigation, insulin blood level decreased from 23.9 +/- 4.4 to 15.0 +/- 1.9 microIU/mL (P < 0.05) after rehabilitation, whereas insulin binding increased from 0.67 +/- 0.05 to 0.85 +/- 0.08 pg 125I/10(11) erythrocytes (P < 0.05). In the control group, which included normal subjects and those with hyperinsulinemia, the results obtained during the first and second investigations showed no statistically significant changes when compared. The results suggest that a 3-week endurance training period during rehabilitation after myocardial infarction reduces insulin resistance in patients with hyperinsulinemia.
    Journal of Cardiopulmonary Rehabilitation 03/1999; 19(2):98-105. DOI:10.1097/00008483-199903000-00003
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    ABSTRACT: We have investigated the influence of physical training on exercise-induced changes in free radical activity in patients after myocardial infarction. Seventeen patients admitted to the cardiac rehabilitation center performed a bicycle ergometry before and after a 3-week endurance training program. The oxygen consumption and carbon dioxide production were measured and the ECG and the systemic blood pressure were monitored during the tests. Blood samples for acid-base equilibrium, lactic acid levels and hydrogen peroxide concentrations were collected directly before and after each exercise test. Exercise-induced increases in systolic blood pressure, heart rate and rate-pressure product as well as lactic acid concentrations were significantly less marked during the bicycle ergometry performed after the rehabilitation program. During the initial exercise test hydrogen peroxide levels increased significantly from 7.15+/-0.74 micromol/l before to 9.09+/-1.04 micromol/l 3 min after the test (P=0.0229). In contrast, no significant changes in hydrogen peroxide concentrations were observed during the exercise test performed after the training (6.31+/-1.05 micromol/l before the test, 5.85+/-1.08 micromol/l after the test, P=0.201). These observations suggest that physical training may have a beneficial influence on free radicals' generation in patients after myocardial infarction.
    International Journal of Cardiology 01/1999; 67(3):219-24. DOI:10.1016/S0167-5273(98)00231-9 · 4.04 Impact Factor
  • A Nowak · L Szcześniak · T Rychlewski · P Dylewicz · I Przywarska ·
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    ABSTRACT: Glucosamine has a major influence on the impairment of some metabolic mechanisms in the human body. As shown in vitro experiments, it takes part in inducing mechanisms of insulin resistance. Therefore, the purpose of our study was to evaluate glucosamine levels in the serum of patients who suffered myocardial infarction (MI) and who either had or didn't have diagnosed type II diabetes in relation to healthy people. The levels of glucosamine, immunoreactive insulin, C-peptide, glucose and lipid indexes were measured in venous blood in investigated patients. In patients with MI without diabetes the highest concentrations of glucosamine, insulin and C-peptide were noted as compared to the results obtained from other groups of patients. In patients with diabetes, on the other hand, the highest glucose levels were noted as compared to the results of other patients. There were no statistically differences of lipid indexes between two groups of patients following MI. A negative correlation between glucosamine levels and glucose concentrations in patients without diabetes may suggest that glucose does not directly determine glucosamine levels. The returning of insulin levels to normal in patients with hyperinsulinemia (antidiabetic drugs) may play a role in the lowering of glucosamine induced peripheral insulin resistance.
    Polskie archiwum medycyny wewnȩtrznej 12/1998; 100(5):419-25. · 2.12 Impact Factor