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[冠状动脉旁路移植术后患者的家庭运动训练效果及治疗依从性]

[Efficacy of Home-Based Exercise Training and Adherence to Therapy in Patients After Coronary Artery Bypass Grafting].

作者信息

Pomeshkina S A, Loktionova E B, Arkhipova N V, Barbarash O L

机构信息

Research Institute for Complex Problems of Cardiovascular Diseases, Kemerovo, Russia.

出版信息

Kardiologiia. 2017 Jan(1):23-29.

Abstract

AIM

to assess efficacy of home-based exercise training (HBET) at outpatient stage of cardiac rehabilitation and its impact on adherence to treatment in patients after coronary artery bypass grafting (CABG).

MATERIAL AND METHODS

In 1 month after CABG 112 male patients (after completion of rehabilitation program in the sanatorium) were distributed to 3 groups with comparable demographic, clinical, and functional parameters: group 1 - patients fulfilling supervised cycling training program (SCTP), group 2 - patients subjected to home-based exercise training (HBET) with defined walking sessions (WS), and the control group of usual care without exercise training. Patients were examined 1, 4 months and 1 year after CABG.

RESULTS

Three months SCTP was most efficient relative to improvement of exercise tolerance (ET), modification of cardiovascular risk factors (smoking, obesity, dyslipidemia), and of adherence to medical therapy. Lowest ET and worst adherence to medical and non-medical therapies were found in the group of usual care without exercise training. The intermediate position was occupied by patients subjected to HBET and WS. Effects of 3 months of HBET diminished by 1 year of follow-up.

CONCLUSION

HBET of moderate intensity appeared to be safe, easily workable and affordable training program for patients after CABG. However, it was less effective, compared with SCTP. Moreover, effects of this rehabilitation program were transitory.

摘要

目的

评估居家运动训练(HBET)在心脏康复门诊阶段的疗效及其对冠状动脉旁路移植术(CABG)后患者治疗依从性的影响。

材料与方法

在CABG术后1个月,112例男性患者(在疗养院完成康复计划后)被分为3组,各组患者的人口统计学、临床和功能参数具有可比性:第1组为完成监督下自行车训练计划(SCTP)的患者;第2组为接受规定步行训练(WS)的居家运动训练(HBET)患者;对照组为未进行运动训练的常规护理患者。在CABG术后1个月、4个月和1年对患者进行检查。

结果

相对于运动耐量(ET)的改善、心血管危险因素(吸烟、肥胖、血脂异常)的改善以及药物治疗依从性,3个月的SCTP最为有效。在未进行运动训练的常规护理组中,ET最低,药物和非药物治疗的依从性最差。接受HBET和WS的患者处于中间位置。随访1年时,3个月HBET的效果有所减弱。

结论

中等强度的HBET似乎是CABG术后患者安全、易于实施且经济实惠的训练方案。然而,与SCTP相比,其效果较差。此外,该康复方案的效果是暂时的。

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