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远程监测运动为基础的心脏康复可提高身体能力和健康相关的生活质量。

Telemonitored exercise-based cardiac rehabilitation improves physical capacity and health-related quality of life.

机构信息

Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Denmark.

Department of Clinical Medicine, Aarhus University, Denmark.

出版信息

J Telemed Telecare. 2020 Jan-Feb;26(1-2):36-44. doi: 10.1177/1357633X18792808. Epub 2018 Aug 22.

Abstract

INTRODUCTION

Cardiac rehabilitation improves physical capacity, health-related quality of life, and reduces morbidity and mortality among cardiac patients. Telemonitored exercise-based cardiac rehabilitation may innovate existing programmes and increase participation rates.

OBJECTIVE

The purpose of this study was to investigate if telemonitored exercise-based cardiac rehabilitation improves physical capacity, muscle endurance, muscle power, muscle strength and health-related quality of life in cardiac patients.

METHODS

A follow-up study on moderate risk patients with ischaemic heart and heart valve disease referred to a 12-week telemonitored exercise-based cardiac rehabilitation intervention at Aarhus University Hospital (Denmark). Participants were encouraged to exercise 60 min three times weekly with moderate/high intensity for 20 min per session. Intensity and duration of training sessions were visualised on a smartphone and uploaded to a website. Participants received individual feedback from physiotherapists on their training efforts by telephone/email. Outcome measures were changes in physical capacity (peak oxygen uptake), muscle endurance, power, and strength, and health-related quality of life between baseline end of telemonitored exercise-based cardiac rehabilitation intervention, and at six and 12 months after end of telemonitored exercise-based cardiac rehabilitation.

RESULTS

Thirty-four participants completed telemonitored exercise-based cardiac rehabilitation. We identified a significant increase in peak oxygen uptake of 10%, in muscle endurance of 17%, in muscle power of 7%, and in muscle strength of 10% after the telemonitored exercise-based cardiac rehabilitation programme. Health-related quality of life was significantly improved by 19% in the physical and 17% in the mental component scores. We found no significant improvement in peak oxygen uptake between baseline and 12 months follow-up, but a significant improvement in muscle endurance (0.3 watts/kg, 95% confidence interval; 0.2-0.4), muscle power (0.4 watts/kg; 0.2-0.5), muscle strength (0.5 N/m/kg; 0.1-0.9), physical health-related quality of life (five points; 2-8) and mental health-related quality of life (six points; 3-9).

DISCUSSION

This study demonstrated that the self-elected type of physical exercise in cardiac rehabilitation with telemonitoring improved all outcome measures both on the short and long-term, except for peak oxygen uptake at 12 months follow-up.

摘要

简介

心脏康复可以提高身体能力、健康相关生活质量,并降低心脏病患者的发病率和死亡率。基于远程监测的运动心脏康复可能会创新现有的项目,并提高参与率。

目的

本研究旨在探讨基于远程监测的运动心脏康复是否能提高心脏病患者的身体能力、肌肉耐力、肌肉力量、肌肉爆发力和健康相关生活质量。

方法

一项在丹麦奥胡斯大学医院进行的后续研究,针对患有缺血性心脏病和心脏瓣膜病的中度风险患者,接受为期 12 周的基于远程监测的运动心脏康复干预。参与者被鼓励每周进行 3 次 60 分钟的运动,每次运动强度为中等/高强度,持续 20 分钟。智能手机上会显示训练强度和持续时间,并将其上传到网站上。参与者通过电话/电子邮件收到物理治疗师对其训练效果的个人反馈。在基线、远程监测的运动心脏康复干预结束时、远程监测的运动心脏康复结束后 6 个月和 12 个月,测量身体能力(峰值耗氧量)、肌肉耐力、力量和健康相关生活质量的变化。

结果

34 名参与者完成了基于远程监测的运动心脏康复。我们发现,在远程监测的运动心脏康复计划后,峰值耗氧量增加了 10%,肌肉耐力增加了 17%,肌肉力量增加了 10%,肌肉爆发力增加了 7%。健康相关生活质量的生理和心理分量表分别显著提高了 19%和 17%。我们发现,在基线和 12 个月随访之间,峰值耗氧量没有显著改善,但肌肉耐力(0.3 瓦/公斤,95%置信区间:0.2-0.4)、肌肉力量(0.4 瓦/公斤;0.2-0.5)、身体健康相关生活质量(5 分;2-8)和心理健康相关生活质量(6 分;3-9)均有显著改善。

讨论

本研究表明,远程监测的心脏康复中自我选择的运动类型在短期和长期内都改善了所有的结果指标,除了 12 个月随访时的峰值耗氧量。

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