Morisawa Tomoyuki, Ueno Katsuhiro, Fukuda Yuko, Kanazawa Naoto, Kawaguchi Hiroshi, Zaiki Rikito, Fuzisaki Hiroaki, Yoshioka Haruka, Sasaki Maki, Iwata Kentaro, Koyama Tadaaki, Kitai Takeshi, Furukawa Yutaka, Takahashi Tetsuya
Department of Physical Therapy, Hyogo University Health Sciences, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo, 650-8530, Japan.
Department of Rehabilitation, Nishi-Kinen Port-Island Rehabilitation Hospital, Kobe, Japan.
Heart Vessels. 2017 Oct;32(10):1220-1226. doi: 10.1007/s00380-017-0983-6. Epub 2017 Apr 27.
This study is to evaluate the impact of cooperation between acute care hospital and rehabilitation hospital on physical function, exercise tolerance, activities of daily living (ADL), health-related quality of life (HR-QOL), and psychological function in heart disease patients undergoing cardiac rehabilitation. Among patients undergoing concurrent medical treatment and cardiac rehabilitation starting early in acute care hospitalization, we selected 30 patients who required continued cardiac rehabilitation in rehabilitation hospitals as subjects. At the time of admission and discharge from the rehabilitation hospital, we measured and compared physical function [grip strength, knee extension strength, and the short physical performance battery (SPPB)], ADL ability using the Functional Independence Measure (FIM), exercise tolerance [six-minute walking distance (6MD)], and psychological functions such as the MOS 36-Item Short-Form Health Survey (SF-36). The average age of the subjects was 76.8 years and 60% were women. In 70% of cases, musculoskeletal causes were the reasons for continued cardiac rehabilitation in a rehabilitation hospital. In evaluations before and after hospitalization, significant improvements were observed in knee extension strength and the results of the SPPB (p < 0.01), FIM, and 6MD (p < 0.01). In SF-36, significant improvements were observed in physical function, role functioning, vitality, and emotional functioning (p < 0.05, p < 0.01). With intensive cardiac rehabilitation in rehabilitation hospitals, physical function, ADL, exercise tolerance, and HR-QOL improved significantly. As the severity and prevalence of heart disease are expected to increase in association with multiple disabilities and aging, the importance of cooperation between acute care hospitals and rehabilitation hospitals will increase; therefore, cardiac rehabilitation should be the basis for such cooperation.
本研究旨在评估急症医院与康复医院之间的合作对接受心脏康复的心脏病患者的身体功能、运动耐量、日常生活活动能力（ADL）、健康相关生活质量（HR-QOL）和心理功能的影响。在急症住院早期同时接受药物治疗和心脏康复的患者中，我们选取了30名需要在康复医院继续进行心脏康复的患者作为研究对象。在康复医院入院时和出院时，我们测量并比较了身体功能[握力、膝关节伸展力量和简短体能状况量表（SPPB）]、使用功能独立性测量量表（FIM）评估的ADL能力、运动耐量[6分钟步行距离（6MD）]以及心理功能，如MOS 36项简短健康调查量表（SF-36）。研究对象的平均年龄为76.8岁，60%为女性。70%的病例中，肌肉骨骼问题是在康复医院继续进行心脏康复的原因。在住院前后的评估中，膝关节伸展力量、SPPB结果（p<0.01）、FIM和6MD（p<0.01）均有显著改善。在SF-36量表中，身体功能、角色功能、活力和情感功能方面有显著改善（p<0.05，p<0.01）。通过康复医院的强化心脏康复，身体功能、ADL、运动耐量和HR-QOL均有显著改善。随着心脏病的严重程度和患病率预计会随着多重残疾和老龄化而增加，急症医院与康复医院之间合作的重要性将会提高；因此，心脏康复应成为这种合作的基础。
