Mital A, Shrey D E, Govindaraju M, Broderick T M, Colon-Brown K, Gustin B W
Ergonomics and Engineering Controls Research Laboratory, University of Cincinnati, OH 45221-0116, USA.
Disabil Rehabil. 2000;22(13-14):604-20. doi: 10.1080/09638280050138287.
Conventional phase II cardiac rehabilitation (CR) programmes have not resulted in an improvement in returning coronary heart disease (CHD) patients to work in over 35 years. This 4 year field-initiated research, sponsored by the National Institute on Disability and Rehabilitation Research, compares conventional CR programmes with a low-intensity CR programme that simulates elements of work (job-simulated CR programme) in terms of return to work (RTW) and physiological conditioning. The effect of training on physical capabilities of patients participating in the job-simulated CR programme was also of equal interest.
Thirty patients (15 bypass and 15 angioplasty; 15 males and 15 females) participated in a conventional CR programme (control group). The job-simulated CR programme included 15 male and 2 female bypass and angioplasty patients (experimental group). Patients in the control group underwent regular aerobic exercise training (treadmill and bicycle). Experimental group patients participated in a series of low-intensity exercises such as progressive time exercises, flexibility exercises, and dexterity exercises.
All patients participating in the low-intensity job-simulated CR programme returned to the same job they held at the onset of myocardial infarction (MI). In contrast, only 60% of the control group patients returned to work; at least one-third of these did not go back to the same job they held at the onset of M1. Patients in both groups achieved the same level of physiological conditioning. The physical functional capabilities of the experimental group patients improved significantly throughout training.
The results of this field-study lead to the conclusion that a low-intensity phase II cardiac rehabilitation programme that simulates elements of work may be far superior to conventional endurance exercise-based cardiac rehabilitation programmes in terms of returning patients to work. Such a programme also strengthens patients, improving their physical capabilities, without compromising their physiological conditioning.
在超过35年的时间里，传统的II期心脏康复（CR）项目并未使冠心病（CHD）患者恢复工作的情况得到改善。这项由美国国家残疾与康复研究所资助、为期4年的实地研究，比较了传统CR项目与模拟工作要素的低强度CR项目（工作模拟CR项目）在恢复工作（RTW）和生理调节方面的情况。训练对参与工作模拟CR项目患者身体能力的影响同样受到关注。
30名患者（15名搭桥手术患者和15名血管成形术患者；15名男性和15名女性）参与了传统CR项目（对照组）。工作模拟CR项目包括15名男性和2名女性搭桥手术及血管成形术患者（实验组）。对照组患者进行常规有氧运动训练（跑步机和自行车）。实验组患者参与一系列低强度运动，如渐进性定时运动、柔韧性运动和灵巧性运动。
所有参与低强度工作模拟CR项目的患者都回到了心肌梗死（MI）发作时所从事的相同工作。相比之下，对照组中只有60%的患者恢复工作；其中至少三分之一的患者没有回到MI发作时所从事的相同工作。两组患者在生理调节方面达到了相同水平。实验组患者的身体功能能力在整个训练过程中显著提高。
这项实地研究的结果得出结论，在使患者恢复工作方面，模拟工作要素的低强度II期心脏康复项目可能远优于传统的基于耐力运动的心脏康复项目。这样的项目还能增强患者体质，提高他们的身体能力，同时不影响其生理调节。
