Ades P A, Pashkow F J, Fletcher G, Pina I L, Zohman L R, Nestor J R
Division of Cardiology, Fletcher-Allen Health Care, University of Vermont College of Medicine, VT, USA.
Am Heart J. 2000 Mar;139(3):543-8. doi: 10.1016/s0002-8703(00)90100-5.
The goal of this study was to compare the effectiveness of home-based, transtelephonically monitored cardiac rehabilitation with standard, on-site, supervised cardiac rehabilitation.
Participation in cardiac rehabilitation has been demonstrated to increase exercise capacity, decrease cardiovascular symptoms, improve psychosocial status, and decrease total and cardiovascular mortality rates in patients with coronary heart disease. Because of multiple factors, national overall participation is only at 15% of eligible patients.
Effects of a 3-month home-based, transtelephonically monitored rehabilitation program (n = 83 patients) with simultaneous voice and electrocardiographic transmission to a centrally located nurse coordinator were compared with effects of a standard on-site rehabilitation program (n = 50 patients). The study design was a multicenter, controlled trial. Primary outcome variables were peak aerobic capacity and quality of life, as measured by the Health Status Questionnaire.
Patients in the home-based monitoring program increased peak aerobic capacity to a similar degree as patients who exercised on site (18% vs 23%). Quality of life domains of physical functioning, social functioning, physical role limitations, emotional role limitations, bodily pain, and energy/fatigue improved similarly in both groups. There were no circulatory arrests or other major exercise-related medical events in either group. A total of 3100 hours of home exercise were transtelephonically monitored.
Patients with coronary heart disease can effectively participate in home-based, monitored cardiac rehabilitation, with exercise and quality of life improvements comparable to those demonstrated at on-site programs.
本研究旨在比较家庭式、通过电话远程监测的心脏康复与标准的、现场监督的心脏康复的效果。
参与心脏康复已被证明可提高冠心病患者的运动能力、减轻心血管症状、改善心理社会状况并降低总死亡率和心血管死亡率。由于多种因素，全国总体参与率仅为 eligible 患者的 15%。
将一项为期 3 个月的家庭式、通过电话远程监测的康复计划（n = 83 例患者）的效果与标准现场康复计划（n = 50 例患者）的效果进行比较，该康复计划同时向位于中心位置的护士协调员传输语音和心电图。研究设计为多中心对照试验。主要结局变量为峰值有氧能力和生活质量，通过健康状况问卷进行测量。
家庭式监测计划中的患者峰值有氧能力提高程度与现场锻炼的患者相似（18% 对 23%）。两组在身体功能、社会功能、身体角色限制、情感角色限制、身体疼痛和精力/疲劳等生活质量领域的改善情况相似。两组均未发生循环骤停或其他与运动相关的重大医疗事件。通过电话远程监测了总共 3100 小时的家庭锻炼。
冠心病患者可以有效地参与家庭式、受监测的心脏康复，其运动和生活质量的改善与现场康复计划相当。
