Bulletin of Rehabilitation MedicineBulletin of Rehabilitation MedicineВестник восстановительной медицины2078-19622713-2625National Medical Research Center for Rehabilitation and Balneology68063110.38025/2078-1962-2026-25-3-57-66ArticlesСтатьиResearch ArticleEffect of Acu-TENS on autonomic cardiac regulation after open heart surgery: a randomized controlled studyВлияние Acu-TENS на вегетативную регуляцию сердца после операции на открытом сердце: рандомизированное контролируемое исследованиеhttps://orcid.org/0009-0004-9741-0280El-MesallamyHaidy M.Эль-МесалламиХайди М.
Egypt

Assistant Lecturer, Cardiopulmonary and Internal Department, Faculty of Physical Therapy

haidyssmustufa@cu.edu.eghttps://orcid.org/0009-0008-1284-3036HelmyZeinab M.ХелмиЗейнаб М.
Egypt

Professor, Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy

haidyssmustufa@cu.edu.eghttps://orcid.org/0009-0008-1083-0477GadoAyman S.ГадоАйман С.
Egypt

Professor, Cardiothoracic Surgery Department, Faculty of Medicine

haidyssmustufa@cu.edu.eghttps://orcid.org/0000-0003-0307-4745FelayaEl-Sayed E. E.ФелаяЭль-Сайед Э. Э.
Egypt

Assistant Professor, Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy

haidyssmustufa@cu.edu.egCairo UniversityКаирский университет2306202625357662605202520042026Copyright ©; 2026, El-Mesallamy H.M., Helmy Z.M., Gado A.S., Felaya E.E.Copyright ©; 2026, Эль-Месаллами Х.М., Хелми З.М., Гадо А.С., Фелая Э.Э.2026El-Mesallamy H.M., Helmy Z.M., Gado A.S., Felaya E.E.Эль-Месаллами Х.М., Хелми З.М., Гадо А.С., Фелая Э.Э.https://creativecommons.org/licenses/by-nc-sa/4.0https://journals.eco-vector.com/2078-1962/article/view/680631

INTRODUCTION. Cardiac autonomic nervous system (ANS) dysfunction is a common and clinically significant complication in patients undergoing open heart surgery (OHS). In traditional Chinese medicine, the pericardium meridian is considered essential in regulating cardiovascular function. Stimulation of specific acupoints along this meridian may modulate cardiovascular responses and reduce the physiological stress associated with surgery.

AIM. To evaluate the effects of acupuncture transcutaneous electrical nerve stimulation (Acu-TENS) on heart rate variability (HRV) indices and functional capacity in patients after OHS.

MATERIALS AND METHODS. Forty patients (aged 40–65 years) of both sexes who underwent OHS were enrolled in a randomized controlled trial. Participants were randomly assigned to two groups (n = 20 each). Group A received Acu-TENS in addition to the standard postoperative medical and physiotherapy program. Group B received only the conventional medical and physiotherapy regimen. Dependent variables assessed pre- and post-intervention included heart rate (HR), RR interval, standard deviation of normal-to-normal interbeat intervals (SDNN), HRV index, low-frequency to high-frequency (LF/HF) ratio, Borg scale ratings, 6-minute walk test (6MWT) distance, and percentage of predicted walking distance.

RESULTS. Both groups showed improvements, but Group A had significantly greater changes. Group A showed reduced HR (p = 0.001) and LF/HF ratio (p = 0.032), and increased HRV index (p = 0.045), RR interval (p = 0.010), SDNN (p = 0.002), 6MWT distance (p = 0.025) and percentage of predicted percent (p = 0.034). No significant difference in Borg scale scores was observed (p = 0.321).

DISCUSSION. Both grouped showed statistically significant improvement across all dependent variable measured post rehabilitation program, autonomic regulation following following acupuncture at the PC6 acupoint is thought to be mediated through cardiac cholinergic pathways, resulting in suppression of sympathetic activity and reduction of elevated heart rate.

CONCLUSION. Postoperative Acu-TENS enhanced autonomic recovery, improved HRV indices, augmented hemodynamics, and increased functional capacity in patients after OHS supporting its consideration as an adjunct to standard physical therapy rehabilitation post-open-heart surgery protocols.

ВВЕДЕНИЕ. Дисфункция вегетативной нервной системы сердца является распространенным и клинически значимым осложнением у пациентов, проходящих операцию на открытом сердце (ООС). В традиционной китайской медицине перикардный меридиан считается необходимым для регулирования сердечно-сосудистых функций. Стимуляция определенных акупунктурных точек вдоль этого меридиана может модулировать сердечно-сосудистые реакции и снизить физиологический стресс, связанный с операцией.

ЦЕЛЬ. Оценить влияние акупунктуры транскутанной (чрескожной) электрической стимуляции нервов (Acu-TENS) на индексы вариабельности сердечного ритма (ВСР) и функциональную способность у пациентов после ООС.

МАТЕРИАЛЫ И МЕТОДЫ. Сорок пациентов (в возрасте от 40 до 65 лет) обоих полов, прошедших ОГС, были включены в рандомизированное контролируемое исследование. Участников случайным образом распределили на две группы (n = 20 в каждой группе). Группа A получила Acu-TENS в дополнение к стандартной послеоперационной медицинской и физиотерапевтической программе. Группа B получала только традиционную медицинскую и физиотерапию. Зависимые переменные, оцениваемые до вмешательства и после него, включали частоту сердечных сокращений (ЧСС), интервал RR, стандартное отклонение интервалов между интервалами между ритмами от нормы к норме (SDNN), индекс ВСР, соотношение низких и высоких частот (LF/HF), оценку шкалы Борга, дистанцию 6-минутного теста ходьбы (6MWT) и процент прогнозируемого расстояния ходьбы.

РЕЗУЛЬТАТЫ И ОБСУЖДЕНИЕ. В обеих группах наблюдалось улучшение, но в группе А изменения были значительно больше. В группе А отмечалось снижение ЧСС (p = 0,001) и соотношения LF/HF (p = 0,032), а также увеличение индекса ВСР (p = 0,045), интервала RR (p = 0,010), SDNN (p = 0,002), дистанции в тесте 6MWT (p = 0,025) и процента от прогнозируемого значения (p = 0,034). Значимых различий в показателях шкалы Борга не наблюдалось (p = 0,321).

ЗАКЛЮЧЕНИЕ. Послеоперационная акупунктурная (чрескожная)электростимуляция (Acu-TENS) улучшила восстановление вегетативной нервной системы и функциональные возможности у пациентов после синдрома обструктивного апноэ сна.

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