Piotr Dylewicz

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

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Publications (42)

  • Article · Jan 2016
  • Dorota Sobczak · Piotr Dylewicz
    [Show abstract] [Hide abstract] ABSTRACT: Walking is regarded as one of the most common and utilitarian activities of everyday life. Rehabilitation programs developed on the basis of this form of activity often constitute the primary method of rehabilitating patients after coronary artery bypass grafting. This paper provides a review of literature concerning various forms of walking training, discussing their impact on the parameters of exercise capacity and verifying the training methods with regard to the current guidelines. Attention is drawn to the diversity of the exercise protocols applied during the early and late stages of rehabilitation and pre-rehabilitation programs including: Treadmill walking, walking down the corridor, treadmill walking enriched with virtual reality, and walking as an element of training sessions consisting of many different forms of activities. Exercise protocols were also analyzed in terms of their safety, especially in the case of high-intensity interval training. Despite the variety of the available rehabilitation programs, the training methodology requires constant improvement, particularly in terms of load dosage and the supervision of training sessions.
    Article · Dec 2015 · Polish journal of cardio-thoracic surgery
  • [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.
    Article · May 2013 · Journal of cardiopulmonary rehabilitation and prevention
  • [Show abstract] [Hide abstract] 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.
    Article · Dec 2012 · Polish journal of cardio-thoracic surgery
  • Piotr Dylewicz
    Article · Jan 2012 · Kardiologia polska
  • Article · Oct 2011 · Kardiologia polska
  • [Show abstract] [Hide abstract] 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.
    Article · Jul 2011 · American journal of physical medicine & rehabilitation / Association of Academic Physiatrists
  • Piotr Dylewicz · M. Krzywicka-Michałowska
    [Show abstract] [Hide abstract] ABSTRACT: The positive results of rehabilitation and secondary prevention of patients after cardiac surgery are well documented. This is confirmed by the statements of the relevant scientific and political societies such as the European Heart Health Charter. In this paper we have tried to comment on the position of the Section of Cardiac Rehabilitation of the European Association for the Prevention and Cardiac Rehabilitation, which was published last year. The authors of the mentioned paper point out that preventive efforts are currently focused primarily on interventional cardiology and drug-medication therapy, both of which give short-term effects. Lifestyle modification, the necessary rehabilitation process and health education for each patient individually are necessary to obtain a long term and permanent improvement in health. This is obviously the main challenge of current medicine and it needs international efforts. Physical activity and diagnostic tests to obtain the individual training programme are considered as the main core components for the rehabilitation of cardiac patients. This is the first time that such a wide range of health issues and different programmes for patients after cardiac surgery, especially after heart transplantation, was noted. The criteria for stationary rehabilitation have been re-defined. In our opinion some questions need further discussion between wide medical associations experienced in those issues.
    Article · Jun 2011 · Polish journal of cardio-thoracic surgery
  • [Show abstract] [Hide abstract] ABSTRACT: Introduction: The preservation of functional performance and the independence of elderly people is a challenge for rehabilitation today. Aim of the study: We aimed to investigate the effects of a 6-week, low-intensity rehabilitation program on functional fitness, assessed with a simple obstacle test, in elderly subjects. Material and Method: A retrospective analysis of data of 208 patients (mean age 73 ±5.5 yrs; 45 men) participating in a 6-week, ambulatory rehabilitation program for the older adults. The program included calisthenics, occupational and physical therapy, and massage. An obstacle test (OT) consisting of 4 stations (1. opening a door, 2. sitting and standing up from an armchair, 3. slalom, 4. crossing 3 obstacles of increasing height) was performed on admission and at discharge. The results are shown as total time (in seconds) and summarized score (0-3 points for each station). Results: The OT time strongly correlated to the score for the quality of the action (r = -0.84 at baseline and r = -0.81 at the end, p < 0.05). The mean OT time in the entire group improved by 5.5 ±9.68 s (from 45.3 ±2.09 to 39.8 ±23.05 s, p < 0,0001). The median OT score increased from 9 to 11; p < 0.0001. The OT time and the score improved significantly (p < 0.01) in subgroups of patients differing with sex, age (< 75 vs ≥ 75 yrs), comorbidities (ischemic heart disease, hypertension, heart failure, stroke) and in the subjects with the lowest baseline fitness level (baseline OT time > upper quartile). The improvement in OT time and the score in patients with the lowest fitness level was greater (p < 0.0001) than in the subjects with the highest fitness level (baseline OT time < lower quartile). Conclusion: A six-week, low-intensity rehabilitation training program improves functional fitness of elderly subjects, independently on their age, sex and comorbidities. The biggest benefits were observed in patients with the lowest level of fitness.
    Article · Jan 2010 · Rehabilitacja Medyczna
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    [Show abstract] [Hide abstract] 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.
    Full-text Article · Sep 2009 · Clinical Rehabilitation
  • [Show abstract] [Hide abstract] 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.
    Article · Jul 2009 · Kardiologia polska
  • [Show abstract] [Hide abstract] 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.
    Article · Jan 2009 · Fizjoterapia
  • [Show abstract] [Hide abstract] ABSTRACT: Objectives: The evaluation of the direct and remote effects of stationary rehabilitation following interventionally treated acute coronary syndrome and its extension by a three-month period of supervised training in ambulatory conditions within the scope of physical fitness, psychic state and quality of life. Materials and methods: The research was conducted on a group of 44 patients (32 men and 12 women) aged 56.9±9, 62 years old for a period of 2-3 weeks following interventional treatment of acute coronary syndrome. All the patients had participated in stationary rehabilitation with 14 expressing a willingness to participate in a futher three-month period of ambulatory rehabilitation. All patients prior to the commencement of rehabilitation had threadmill exertion tests, fear was evaluated by means of the SOPER questionnaire, basic mood and psychic tension as well as the feeling of health were assessed by means of the VAS scale of the EuroQol 5D questionnaire. The set of tests was repeated after the completion of the stationary phase, and after time periods of 3 months and a year. Results: Patients subjected to the extended ambulatory phase 3-month period of rehabilitation displayed a greater increase in exercise tolerance when compared with the group that had merely undergone the 3-week stationary rehabilitation. Patients with extended rehabilitation gradually improved their evaluation of their state of health and after a year maintained it at the level it had been after the completion of the stationary rehabilitation. In patients who did not express a willingness to continue an organised form of exercise in ambulatory conditions the noticeable improvement in health following the end of rehabilitaiton was not lasting in nature. After a year, regardless of the programme of rehabilitation selected, there was noted an improvement in the psychic state, expressed in an increased positive mood although the level of fear did not change to a significant degree. Conclusions: 1. Extended rehabilitation, combining stationary and ambulatory forms, following on from intervention treatment of ACS gives a better longterm effect in the area of improving physical fitness and self evaluation of one's state of health than is the case after three-week stationary rehabilitation. 2. The extending of the period of rehabilitation has no influence on the obtainment of post-rehabilitation changes on the level of mood and fear.
    Article · Jan 2009
  • E. Deskur-Smielecka · M. Maleszka · M. Wilk · [...] · P. Dylewicz
    Article · Sep 2008 · European Heart Journal
  • S. Borowicz-Bienkowska · M. Wilk · E. Deskur-Smielecka · [...] · P. Dylewicz
    Article · Sep 2008 · European Heart Journal
  • Article · Jul 2008 · Kardiologia polska
  • Article · Jun 2008 · Polish journal of cardio-thoracic surgery
  • [Show abstract] [Hide abstract] 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.
    Article · Mar 2008 · Kardiologia polska
  • [Show abstract] [Hide abstract] ABSTRACT: Physical training is one of the key elements in a health-oriented change of lifestyle in diabetes. A regular aerobic training (AT) in diabetes is recommended both by European and American scientific associations in order to control glycaemia and one’s body mass better as well as to reduce considerably the cardio-vascular risk. A number of studies have pointed to a likewise beneficial influence of resistance training (RT), yet they have been carried out on a small number of subjects and the criteria of assessment applied were not homogenous. The aim of the present paper is to carry out a meta-analysis of studies available assessing the influence of resistance training on the glycaemic and lipid control. Two independent authors have searched through medical databases: Medline and Cochrane Central Register of Controlled Trials (CENTRAL), as well as the database of the “Diabetes Care” journal. The search criteria have been narrowed down to studies involving randomization (RCT), which evaluated the influence of resistance training lasting for a minimum of ten weeks on the level of lipids and the concentration of glycosylated hemoglobin (HbA1c). Problematic cases were assessed by a third author. The total of five studies have been included in the meta-analysis (4 RT vs. the continuation of treatment without training and 1 RT vs. AT). All the abovementioned studies are RCT in which the follow up was at least 80%. The studies under analysis assumed the reduction of drug intervention to an absolute minimum. The studies were carried out on 193 patients. The analysed group subject to resistance training comprised 99 patients (the average age of the tested group was 61.2 yrs). The mean study length was 17.7 weeks (10–24 weeks), the number of training sessions per week varying from 2 to 3 (2.82 on average). The meta-analysis of the above-said studies showed a positive influence of resistance training on the lipid profile (the lowering of the LDL level by 0.286 mmol/l, the lowering of the total cholesterol level by 0.362 mmol/l, the lowering of the triglyceride level by 0.478 mmol/l, the rise of the HDL level by 0.060 mmol/l) and the reduction of HbA1c by 0.858%. The meta-analysis confirms the legitimacy of implementing resistance training in the treatment and rehabilitation of patients with diabetes, consisting in the correction of metabolic disorders. The assessment of the influence of training under discussion on other parameters applied in the evaluation of the effectiveness of physical training in rehabilitation and secondary prevention requires further research.
    Article · Jan 2008
  • Article · Jan 2008