Budnick Karen, Campbell Jennifer, Esau Lauren, Lyons Jessica, Rogers Nikki, Haennel R G
Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta.
Can J Cardiovasc Nurs. 2009;19(4):13-25.
Current cardiac rehabilitation (CR) evidence was systematically evaluated to identify program components that may yield improvements in physiological and psychosocial outcomes in women.
A search was conducted in the electronic databases: MEDLINE, Embase, CINAHL, Scopus, Sport Discus and Cochrane Library. Search terms included women, heart disease, exercise therapy, and cardiac rehabilitation. A systematic elimination process was used with specific inclusion/exclusion criteria. Included articles were independently evaluated by four reviewers for level of evidence and internal validity. Specific recommendations were made based on trends in the literature and strength of supporting evidence.
Thirty-seven articles were included with a combined sample of 3,807 subjects. Ten studies included an analysis of physiological effects of exercise. Aerobic, resistance, and combined exercise interventions all yield physiological benefits. CR yielded favourable health-related quality of life outcomes and women benefited from psychosocial support in both formal and informal environments.
The following recommendations are based on the review: 1) For patients with good cardiac function, community/home-based programs are as effective as supervised programs (Level II, B); 2) resistance training should be included as an adjunct to aerobic training (Level I, A); 3) programs need to address the specific educational needs of women (Level I, A) and a stronger emphasis needs to be placed on social support (Level II, B).
系统评估当前心脏康复（CR）的证据，以确定可能改善女性生理和心理社会结局的项目组成部分。
在电子数据库进行检索：MEDLINE、Embase、CINAHL、Scopus、Sport Discus和Cochrane图书馆。检索词包括女性、心脏病、运动疗法和心脏康复。采用系统排除过程，依据特定的纳入/排除标准。纳入的文章由四位评审员独立评估证据水平和内部效度。根据文献趋势和支持证据的力度提出具体建议。
纳入37篇文章，样本总量为3807名受试者。十项研究分析了运动的生理效应。有氧运动、抗阻运动和联合运动干预均产生生理益处。心脏康复产生了良好的健康相关生活质量结局，女性在正式和非正式环境中均从心理社会支持中获益。
基于该综述提出以下建议：1）对于心功能良好的患者，社区/家庭为基础的项目与有监督的项目效果相同（证据水平II，B级）；2）抗阻训练应作为有氧运动的辅助（证据水平I，A级）；3）项目需要满足女性的特定教育需求（证据水平I，A级），并且需要更加强调社会支持（证据水平II，B级）。
