الفهرس 
Long term effect of physical therapy program in refractory anginal patients
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Abstract
Background and purpose: The evolution of medical therapy, and revascularization procedures have significantly reduced the morbidity and mortality in patients presenting with stable coronary artery disease (CAD). Despite all these treatment innovations, 5{u2013}10% of patients with stable CAD remain symptomatic despite optimal therapy referred to as {u2018}refractory angina pectoris (RA){u2019}. Patients with RA are severely restricted in performing daily activities by debilitating angina complaints that adversely affect well-being, causing functional disability; sleep deprivation, depression, severely impairing quality of life (QoL). Additional treatment modalities for refractory angina are therefore needed. Aim of the study: to investigate the effect of exercise training program in addition to Transcutaneous Electrical Nerve Stimulation (TENS) on endothelial function, QoL and physical work capacity (PWC) in patients with RA. Materials and methods: forty male patients, suffering from chronic RA secondary to ischemic heart disease was selected and referred by the cardiologist from the outpatient clinic of National Heart Institute. Their ages ranged from 45 to 65 years. They were randomly assigned into two groups equal in number; group (A) who participated in a conventional TENS application program in addition to a conditioning program for eight weeks consisting of calisthenics exercises three times a week for 30 minutes, followed by an exercise training program composed of aerobic training and strengthening exercise three times/week for 12 weeks, and group (B) who were subjected to conventional TENS for thirty minutes, four days per week for five months. Assessment was performed before treatment program (pre), after eight weeks (post I), after termination of the program (post II), and after another four weeks for both groups of patients (post III). The following measures were obtained: brachial artery flow-mediated dilation (FMD) for assessment of endothelial function,The Seattle Angina Questionnaire (SAQ) for QoL assessment and the 6-minute walk test (6MWT) was used for PWC assessment.Results: the statistical analysis revealed that at the end of the study, the FMD improved significantly in group (A) with no significant difference in group (B) which favoring group (A)WC, and QoL in selected patients with RA