Ernst E, Quittan M
Universitätsklinik für Physikalische Medizin, Wien.
Acta Med Austriaca. 1991;18(4):93-100.
Today rehabilitation after myocardial-infarction is a routine measure in most countries, yet its effectiveness is still under discussion. Rehabilitation aims at ameliorating the quality of life and at preventing a cardiovascular reevent, in other words at prolonging life. The latter "hard" endpoints is best amenable to quantification. Only recent meta-analyses of pooled data were able to show that rehabilitation in fact does prolong life. The relative importance of physical exercise in mostly complex rehabilitation programs is even less clear. This analyses implies a benefit, yet the exact proof is still missing. If rehabilitation could be shown to improve quality of life, its application would, of course, be justified even if it did fail to prolong life. Important open questions relate to the optimizing of rehabilitation: duration, frequency, intensity as well as age and sex of responders. Answering these will be a challenge for tomorrow's rehabilitation medicine.
如今，心肌梗死后的康复治疗在大多数国家已是一项常规措施，但其有效性仍在讨论之中。康复治疗旨在改善生活质量并预防心血管疾病再次发作，换言之，就是延长寿命。后者这种“硬性”终点最适合进行量化。直到最近对汇总数据进行的荟萃分析才能够表明，康复治疗实际上确实能延长寿命。在大多复杂的康复计划中，体育锻炼的相对重要性甚至更不明确。这一分析暗示了其益处，但确切的证据仍然缺失。如果康复治疗能被证明可改善生活质量，那么即使它未能延长寿命，其应用也当然是合理的。重要的悬而未决的问题涉及康复治疗的优化：持续时间、频率、强度以及康复治疗有效者的年龄和性别。回答这些问题将是未来康复医学面临的一项挑战。
