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通过对冠状动脉疾病患者进行体育活动远程监测来提高基于医院的心脏康复的中期临床效益。

Increasing the medium-term clinical benefits of hospital-based cardiac rehabilitation by physical activity telemonitoring in coronary artery disease patients.

作者信息

Frederix Ines, Van Driessche Niels, Hansen Dominique, Berger Jan, Bonne Kim, Alders Toon, Dendale Paul

机构信息

Catholic University of Leuven, Leuven, Belgium

University of Hasselt, Hasselt, Belgium.

出版信息

Eur J Prev Cardiol. 2015 Feb;22(2):150-8. doi: 10.1177/2047487313514018. Epub 2013 Nov 18.

DOI:10.1177/2047487313514018
PMID:24249840
Abstract

BACKGROUND

The purpose of this study was to evaluate the effect of a physical activity telemonitoring program on daily physical activity level, oxygen uptake capacity (VO(2peak)), and cardiovascular risk profile in coronary artery disease (CAD) patients who completed phase II cardiac rehabilitation (CR).

METHODS

Eighty CAD patients who completed phase II CR were randomly assigned to an additional telemonitoring intervention or standard CR. The patients in the intervention group (n = 40) wore a motion sensor continuously for 18 weeks. Each week these patients received a step count goal, with the aim to gradually increase the patients' physical activity level. In the control group (n = 40), the patients wore an unreadable motion sensor for seven days for measurement purposes only (at start of follow-up, and after six and 18 weeks). At start of follow-up and after 18 weeks blood lipid profile, glycemic control, waist circumference and body mass index was assessed. VO(2peak) was assessed at start of follow-up, and after six and 18 weeks. Re-hospitalisation rate was followed during this timeframe.

RESULTS

In the intervention group, VO(2peak) increased significantly during follow-up (P = 0.001), in the control group it did not (P = 0.273). A significant correlation was found between daily aerobic step count and improvement in VO(2peak) (P = 0.030, r = 0.47). Kaplan-Meier curve analysis showed a trend towards fewer re-hospitalisations for patients in the telemonitoring group (P = 0.09).

CONCLUSIONS

The study showed that, to maintain exercise tolerance and lower re-hospitalisation rate after hospital-based CR in CAD patients, a physical activity telemonitoring program might be an effective intervention.

摘要

背景

本研究旨在评估身体活动远程监测计划对完成二期心脏康复(CR)的冠状动脉疾病(CAD)患者的日常身体活动水平、摄氧量(峰值摄氧量)及心血管风险状况的影响。

方法

80例完成二期CR的CAD患者被随机分配至额外的远程监测干预组或标准CR组。干预组(n = 40)的患者连续18周佩戴运动传感器。每周这些患者会收到一个步数目标,目的是逐步提高患者的身体活动水平。对照组(n = 40)的患者仅在随访开始时、6周和18周后佩戴无法读取数据的运动传感器7天用于测量。在随访开始时和18周后评估血脂谱、血糖控制、腰围和体重指数。在随访开始时、6周和18周后评估峰值摄氧量。在此时间段内跟踪再住院率。

结果

在干预组中,随访期间峰值摄氧量显著增加(P = 0.001),而对照组未增加(P = 0.273)。发现每日有氧步数与峰值摄氧量的改善之间存在显著相关性(P = 0.030,r = 0.47)。Kaplan-Meier曲线分析显示,远程监测组患者的再住院次数有减少的趋势(P = 0.09)。

结论

该研究表明,对于CAD患者在院内心脏康复后维持运动耐量和降低再住院率,身体活动远程监测计划可能是一种有效的干预措施。

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