Department of Internal Medicine, Division of Cardiovascular Diseases, Cardiovascular Health Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
J Cardiopulm Rehabil Prev. 2010 Jul-Aug;30(4):235-9. doi: 10.1097/HCR.0b013e3181e17387.
To determine the prevalence of musculoskeletal, neurological, and balance problems in patients enrolled in early outpatient (phase II) cardiac rehabilitation.
Data were assessed retrospectively for 284 consecutive patients who attended the phase II Mayo Clinic Cardiac Rehabilitation program from April 2005 to August 2006. All participants completed a questionnaire that identified the presence of musculoskeletal pain, history of falls, joint replacements, osteoporosis, neurological disorders, and difficulties in performing activities of daily living. Balance assessment was evaluated using the single leg stance and the tandem gait tests.
Of the total study population (mean age, 62.1 +/- 12.3 years), 25% reported musculoskeletal pain. A significantly higher prevalence of pain was noted in women than men (37% vs 20%, P = .004) and in those > 65 years than those < or = 65 years (35% vs 17%, P = .001). Back (29%), knee (17%), and hip (8%) pain were the most common symptoms, in order of decreasing frequency. Pain was worse with any activity in 32% of participants while 16% of participants had worsening at night. An abnormality in balance was present in 58% of the study participants and was significantly more common in women (71%) and those > 65 years (83%). Falls or gait instability or both were reported by 11% of participants.
Musculoskeletal and balance limitations are common in persons enrolled in early outpatient cardiac rehabilitation, particularly in women and patients > 65 years. Cardiac rehabilitation programs should screen patients for musculoskeletal limitations and incorporate adaptations for treatment strategies of such patients.
确定参加早期门诊(二期)心脏康复的患者中肌肉骨骼、神经和平衡问题的患病率。
回顾性评估了 2005 年 4 月至 2006 年 8 月期间参加梅奥诊所心脏康复计划的 284 名连续患者的数据。所有参与者都完成了一份问卷,该问卷确定了肌肉骨骼疼痛、跌倒史、关节置换、骨质疏松症、神经障碍以及日常生活活动能力困难的存在情况。平衡评估使用单腿站立和串联步态测试进行评估。
在总研究人群(平均年龄 62.1 ± 12.3 岁)中,25%报告有肌肉骨骼疼痛。女性的疼痛患病率明显高于男性(37%比 20%,P =.004),且年龄大于 65 岁的患者高于年龄等于或小于 65 岁的患者(35%比 17%,P =.001)。背痛(29%)、膝痛(17%)和髋痛(8%)是最常见的症状,按频率递减顺序排列。32%的参与者在任何活动时疼痛加重,而 16%的参与者在夜间疼痛加重。研究参与者中有 58%存在平衡异常,且女性(71%)和年龄大于 65 岁的患者(83%)更为常见。11%的参与者报告有跌倒或步态不稳或两者兼有。
肌肉骨骼和平衡受限在参加早期门诊心脏康复的患者中很常见,尤其是女性和年龄大于 65 岁的患者。心脏康复计划应筛查患者的肌肉骨骼受限情况,并将适应治疗策略纳入此类患者的治疗中。