Centre for Evidence-Based Physiotherapy and Department of Epidemiology, Maastricht University, Maastricht, the Netherlands,
Neth Heart J. 2013 Oct;21(10):429-38. doi: 10.1007/s12471-013-0467-y.
To improve the quality of exercise-based cardiac rehabilitation (CR) in patients with coronary heart disease (CHD) the CR guideline from the Dutch Royal Society for Physiotherapists (KNGF) has been updated. This guideline can be considered an addition to the 2011 Dutch Multidisciplinary CR guideline, as it includes several novel topics.
A systematic literature search was performed to formulate conclusions on the efficacy of exercise-based interventions during all CR phases in patients with CHD. Evidence was graded (1-4) according the Dutch evidence-based guideline development (EBRO) criteria. In case of insufficient scientific evidence, recommendations were based on expert opinion. This guideline comprised a structured approach including assessment, treatment and evaluation.
Recommendations for exercise-based CR were formulated covering the following topics: preoperative physiotherapy, mobilisation during the clinical phase, aerobic exercise, strength training, and relaxation therapy during the outpatient rehabilitation phase, and adoption and monitoring of a physically active lifestyle after outpatient rehabilitation.
There is strong evidence for the effectiveness of exercise-based CR during all phases of CR. The implementation of this guideline in clinical practice needs further evaluation as well as the maintenance of an active lifestyle after supervised rehabilitation.
为提高冠心病患者运动为基础的心脏康复（CR）的质量，荷兰物理治疗师皇家学会（KNGF）更新了 CR 指南。该指南可被视为对 2011 年荷兰多学科 CR 指南的补充，因为它包含了几个新的主题。
系统地进行了文献检索，以制定关于冠心病患者在 CR 所有阶段进行基于运动的干预的疗效的结论。根据荷兰循证指南制定（EBRO）标准对证据进行分级（1-4）。在科学证据不足的情况下，建议基于专家意见。本指南包括一个结构化的方法，包括评估、治疗和评估。
制定了针对基于运动的 CR 的建议，涵盖以下主题：术前物理治疗、临床阶段的动员、有氧运动、力量训练以及门诊康复阶段的松弛疗法，以及在门诊康复后采用和监测积极的生活方式。
有强有力的证据表明 CR 所有阶段的基于运动的 CR 是有效的。在临床实践中实施本指南以及在监督康复后保持积极的生活方式需要进一步评估。
