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基于运动的心脏康复可增加心肌梗死后患者的日常身体活动:两项随机对照试验的亚组分析。

Exercise-based cardiac rehabilitation increases daily physical activity of patients following myocardial infarction: subanalysis of two randomised controlled trials.

作者信息

Ribeiro F, Oliveira N L, Silva G, Campos L, Miranda F, Teixeira M, Alves A J, Oliveira J

机构信息

School of Health Sciences and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal.

Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal.

出版信息

Physiotherapy. 2017 Mar;103(1):59-65. doi: 10.1016/j.physio.2015.12.002. Epub 2015 Dec 25.

Abstract

OBJECTIVE

To assess the effects of an exercise-based cardiac rehabilitation programme on daily physical activity levels of patients following myocardial infarction.

DESIGN

Subanalysis of two randomised, prospective controlled trials.

SETTING

Outpatient clinic of a secondary hospital.

PARTICIPANTS

Fifty consecutive patients randomised to the exercise group {n=25; 23 males; mean age 54 [standard deviation (SD) 9] years} or the control group [n=25; 20 males; mean age 58 (SD 9) years].

INTERVENTIONS

The exercise group participated in an 8-week aerobic exercise programme plus usual medical care and follow-up. The control group received usual medical care and follow-up.

MAIN OUTCOME MEASURES

The primary outcome measure was change in time spent undertaking moderate-to-vigorous physical activity per day, assessed by accelerometer over 7 consecutive days. Secondary outcome measures were cardiorespiratory fitness, body mass, and resting blood pressure and heart rate.

RESULTS

Moderate-to-vigorous physical activity levels increased significantly in the exercise group [43.2 (SD 36.3) to 53.5 (SD 31.9) minutes/day, P=0.030], and remained unchanged in the control group [40.8 (SD 26.2) to 36.8 (SD 26.5) minutes/day, P=0.241] from baseline to the end of the programme. Cardiorespiratory fitness increased significantly in the exercise group (mean difference 2.8; 95% of the difference 1.3 to 4.4ml/kg/minute, P=0.001) after the 8-week programme.

CONCLUSIONS

In patients under optimal medication following myocardial infarction, participation in an 8-week exercise-based cardiac rehabilitation programme was found to improve physical activity levels consistent with health-related benefits. Future studies are needed to determine whether the increase in physical activity is maintained in the long term.

摘要

目的

评估基于运动的心脏康复计划对心肌梗死后患者日常身体活动水平的影响。

设计

两项随机、前瞻性对照试验的亚分析。

地点

二级医院门诊。

参与者

连续50例患者被随机分为运动组(n = 25;23名男性;平均年龄54 [标准差(SD)9]岁)或对照组(n = 25;20名男性;平均年龄58(SD 9)岁)。

干预措施

运动组参加为期8周的有氧运动计划,外加常规医疗护理和随访。对照组接受常规医疗护理和随访。

主要结局指标

主要结局指标是每天进行中度至剧烈身体活动所花费时间的变化,通过加速度计连续7天进行评估。次要结局指标是心肺适能、体重、静息血压和心率。

结果

从基线到计划结束,运动组中度至剧烈身体活动水平显著增加[从43.2(SD 36.3)分钟/天增至53.5(SD 31.9)分钟/天,P = 0.030],而对照组保持不变[从40.8(SD 26.2)分钟/天降至36.8(SD 26.5)分钟/天,P = 0.241]。8周计划后,运动组的心肺适能显著增加(平均差异2.8;差异的95%为1.3至4.4ml/kg/分钟,P = 0.001)。

结论

在心肌梗死后接受最佳药物治疗的患者中,发现参与为期8周的基于运动的心脏康复计划可改善身体活动水平,并带来与健康相关的益处。未来需要开展研究以确定身体活动的增加能否长期维持。

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