Gaede-Illig C, Limbourg T, Jannowitz C, Völler H
Professur für Rehabilitationswissenschaften, Universität Potsdam.
Institut für Herzinfarktforschung, Ludwigshafen.
Rehabilitation (Stuttg). 2014 Oct;53(5):341-5. doi: 10.1055/s-0034-1370983. Epub 2014 Oct 15.
Objective Patients who suffered from an acute coronary syndrome (ACS) boast a low exercise capacity (EC). To enhance EC is a core component of cardiac rehabilitation (CR). The aim of the study was to investigate predictors of exercise capacity to optimize the rehabilitation process in untrained subgroups.
47 286 patients (mean age 64±11.62, 74.5% male) were enclosed in the TROL registry. All patients underwent a bicycle stress test at admission and discharge. The dependent variable for the univariate analysis and multivariate logistic regression was the increase of EC during CR, with a cutoff of 15 Watts (pre/post design). Furthermore comorbidities and physical activity before the index event were analyzed.
Exercise capacity enhancement differs between active and inactive patients significantly (21.84 Watt vs. 16.35 Watt; p<0.001). While a male gender (OR 1.62 [95% CI: 1.51-1.74]) and physical activity before rehabilitation (OR 1.85 [95% CI: 1.75-1.97]) were positive, comorbidities and age (OR 0.82 [95% CI: 0.74-0.90]) were negative predictors.
In cardiac rehabilitation settings special exercise training programs for elderly and comorbid patients are needed, to enhance their exercise capacity sufficiently.
目的 患有急性冠状动脉综合征（ACS）的患者运动能力较低。提高运动能力是心脏康复（CR）的核心组成部分。本研究旨在调查运动能力的预测因素，以优化未受过训练亚组的康复过程。
47286例患者（平均年龄64±11.62岁，男性占74.5%）纳入TROL登记研究。所有患者在入院时和出院时均接受了自行车运动负荷试验。单因素分析和多因素逻辑回归的因变量是心脏康复期间运动能力的增加，临界值为15瓦（前后设计）。此外，还分析了合并症和指数事件前的体力活动情况。
活跃患者和不活跃患者的运动能力增强情况存在显著差异（21.84瓦对16.35瓦；p<0.001）。男性（比值比1.62 [95%可信区间：1.51 - 1.74]）和康复前的体力活动（比值比1.85 [95%可信区间：1.75 - 1.97]）为正向预测因素，而合并症和年龄（比值比0.82 [95%可信区间：0.74 - 0.90]）为负向预测因素。
在心脏康复环境中，需要为老年和合并症患者制定特殊的运动训练计划，以充分提高他们的运动能力。
