FYSIOTERAPEUTEN 6/22 45 dype tverrfriksjoner av interkostal muskulatur på tvers av vevets fibre, kraftig og dypt i korte intervaller. Pasientene responderer erfaringsvis raskt på behandling (to til tre behandlinger á 5-7 minutter). Avslutning Denne fagartikkelen er basert på forfatternes lange kliniske erfaring med hjerterehabilitering, internasjonale retningslinjer og et skjønnsmessig litteraturvalg. Hjerterehabilitering som inkluderer trening, har den sterkeste anbefalingen i internasjonale retningslinjer og burde på lik linje med medikamentell behandling være implementert i det helhetlige pasientforløpet. Det foreligger betydelig dokumentasjon på at hjerterehabilitering er effektivt for å redusere morbiditet, reinnleggelser i sykehus og mortalitet. Fysioterapeuten spiller en viktig rolle i det tverrfaglige teamet og er oftest den som har mest kontakt med pasientene over tid. Til tross for at hjerterehabilitering oftest foregår i grupper i Norge er det av stor betydning at fysioterapeuter tilpasser treningen individuelt, evner å samarbeide tverrfaglig og fortløpende oppdaterer seg på ny kunnskap på feltet. Trening er behandling, men hjerterehabilitering er mer enn trening, og «one size does not fit all». Referanser 1. Govatsmark RES, K.K. H, Berge VB, Sneeggen S, Bønaa KH. Norsk hjerteinfarktregister, årsrapport 2020. https://www.kvalitetsregistre.no/sites/default/ files/2021-06/Norsk%20hjerteinfarktregister%20%C3%85rsrapport%202020. pdf; 2021. 2. Peersen K, Munkhaugen J, Olsen SJ, Otterstad JE, Sverre E. Post-myocardial infarction rehabilitation and secondary prevention in hospitals. Tidsskr Nor Laegeforen. 2021;141(16).http://dx.doi.org/10.4045/tidsskr.21.0349 3. Ambrosetti M, Abreu A, Corra U, Davos CH, Hansen D, Frederix I, et al. Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. 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Circulation. 2017;135(9):839-49.http://dx.doi.org/10.1161/ CIRCULATIONAHA.116.022924 29. Hollings M, Mavros Y, Freeston J, Fiatarone Singh M. The effect of progressive resistance training on aerobic fitness and strength in adults with coronary heart disease: A systematic review andmeta-analysis of randomised controlled trials. Eur J Prev Cardiol. 2017;24(12):1242-59.http://dx.doi. org/10.1177/2047487317713329 Trening er behandling, men hjerterehabilitering er mer enn trening, og «one size does not fit all».
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