School of Health and Exercise Sciences (Mrs Gabelhouse and Drs Eves, Reid, and Caperchione), Centre for Heart, Lung and Vascular Health (Drs Eves and Caperchione), and Institute for Healthy Living and Chronic Disease Prevention (Dr Caperchione), University of British Columbia, Kelowna, Canada; and School of Kinesiology and Health Science, York University, and Toronto Rehabilitation Institute, University Health Network, Toronto, Canada (Dr Grace).
J Cardiopulm Rehabil Prev. 2018 Jul;38(4):231-238. doi: 10.1097/HCR.0000000000000253.
Due to the suboptimal uptake of cardiac rehabilitation (CR), alternative models have been proposed. This study compared the effectiveness of a traditional supervised program in a medical setting versus a hybrid CR model, where patients transition to unsupervised programming.
This was a prospective, 2-arm, nonrandomized study. Health-related quality of life (HRQoL), functional capacity, physical activity, diet, smoking, blood pressure, lipids, blood glucose, anthropometrics, and depressive symptoms were assessed before and after the 8-week program models. Program adherence and completion were also recorded. Both models offered outpatient supervised exercise sessions, group health education classes, and a resource manual. The hybrid model involved a blend of supervised and unsupervised, independent home-based exercise, and followup phone calls.
One hundred twenty-five cardiac patients consented to the study, of whom 72 (57.6%) and 53 chose the traditional and hybrid programs, respectively. One hundred ten (traditional: n = 62, 86.1%; hybrid: n = 48, 92.3%; P > .05) participants completed their program. Significant improvements were observed for both models over time in HRQoL (P < .001), physical activity (P < .001), and diet (P < .001). Significant reductions in smoking (P = .043), systolic blood pressure (P < .001), total cholesterol (P < .001), low-density lipoprotein (P < .001), waist circumference (P < .001), and depressive symptoms (P < .001) were also observed. There were no significant differences pre- and postprograms between models for any outcome.
Hybrid CR was not significantly different from the traditional model in terms of HRQoL, functional capacity, heart health behaviors, and risk factors, with no differences in completion rates.
由于心脏康复（CR）的接受度不理想，因此提出了替代模式。本研究比较了在医疗环境中进行传统监督计划与混合 CR 模式（患者过渡到非监督编程）的效果。
这是一项前瞻性、2 臂、非随机研究。在 8 周的方案模型前后评估了健康相关生活质量（HRQoL）、功能能力、体力活动、饮食、吸烟、血压、血脂、血糖、人体测量学和抑郁症状。还记录了方案的依从性和完成情况。两种模式都提供门诊监督运动课程、团体健康教育课程和资源手册。混合模式涉及监督和非监督、独立家庭锻炼以及后续电话随访的混合。
125 名心脏患者同意参加该研究，其中 72 名（57.6%）和 53 名分别选择了传统和混合方案。110 名（传统组：n = 62，86.1%；混合组：n = 48，92.3%；P >.05）参与者完成了他们的方案。两种模式在 HRQoL（P <.001）、体力活动（P <.001）和饮食（P <.001）方面均随时间显著改善。吸烟（P =.043）、收缩压（P <.001）、总胆固醇（P <.001）、低密度脂蛋白（P <.001）、腰围（P <.001）和抑郁症状（P <.001）显著降低。两种方案在任何结果上均无显著差异。
混合 CR 在 HRQoL、功能能力、心脏健康行为和危险因素方面与传统模式无显著差异，完成率无差异。
