Capri Cardiac Rehabilitation, Rotterdam, The Netherlands; Erasmus University Medical Centre, Department of Rehabilitation Medicine, Rotterdam, The Netherlands.
Capri Cardiac Rehabilitation, Rotterdam, The Netherlands.
Int J Cardiol. 2018 Mar 15;255:221-228. doi: 10.1016/j.ijcard.2017.12.015.
Standard cardiac rehabilitation (CR) is insufficient to help patients achieve an active lifestyle. The effects of two advanced and extended behavioral CR interventions on physical activity (PA) and sedentary behavior (SB) were assessed.
In total, 731 patients with ACS were randomized to 1) 3months of standard CR (CR-only); 2) 3months of standard CR with three pedometer-based, face-to-face PA group counseling sessions followed by 9months of aftercare with three general lifestyle, face-to-face group counseling sessions (CR+F); or 3) 3months of standard CR, followed by 9months of aftercare with five to six general lifestyle, telephonic counseling sessions (CR+T). An accelerometer recorded PA and SB at randomization, 3months, 12months, and 18months.
The CR+F group did not improve their moderate-to-vigorous intensity PA (MVPA) or SB time compared to CR-only (between-group difference=0.24% MVPA, P=0.349; and 0.39% SB, P=0.529). However, step count (between-group difference=513 steps/day, P=0.021) and time in prolonged MVPA (OR=2.14, P=0.054) improved at 3months as compared to CR-only. The improvement in prolonged MVPA was maintained at 18months (OR=1.91, P=0.033). The CR+T group did not improve PA or SB compared to CR-only.
Adding three pedometer-based, face-to-face group PA counseling sessions to standard CR increased daily step count and time in prolonged MVPA. The latter persisted at 18months. A telephonic after-care program did not improve PA or SB. Although after-care should be optimized to improve long-term adherence, face-to-face group counseling with objective PA feedback should be added to standard CR.
标准的心脏康复（CR）不足以帮助患者实现积极的生活方式。评估了两种先进且扩展的行为 CR 干预措施对体力活动（PA）和久坐行为（SB）的影响。
共有 731 名 ACS 患者被随机分为 1）3 个月的标准 CR（仅 CR）；2）3 个月的标准 CR，外加三次基于计步器的面对面 PA 小组咨询，然后是 9 个月的后续护理，外加三次一般生活方式的面对面小组咨询（CR+F）；或 3）3 个月的标准 CR，随后是 9 个月的后续护理，通过五到六次一般生活方式的电话咨询（CR+T）。在随机分组、3 个月、12 个月和 18 个月时，使用加速度计记录 PA 和 SB。
与仅 CR 相比，CR+F 组并没有改善其中等至剧烈强度 PA（MVPA）或 SB 时间（组间差异=0.24%MVPA，P=0.349；和 0.39%SB，P=0.529）。然而，与仅 CR 相比，在 3 个月时，步数（组间差异=513 步/天，P=0.021）和长时间 MVPA（OR=2.14，P=0.054）都有所改善。长时间 MVPA 的改善在 18 个月时得到维持（OR=1.91，P=0.033）。与仅 CR 相比，CR+T 组并没有改善 PA 或 SB。
在标准 CR 中增加三次基于计步器的面对面小组 PA 咨询，可增加日常步数和长时间 MVPA 的时间。后者在 18 个月时仍然存在。电话随访方案并没有改善 PA 或 SB。尽管应该优化随访以提高长期依从性，但应在标准 CR 中增加基于面对面小组的客观 PA 反馈。
