Greenland P, Chu J S
University of Rochester School of Medicine and Dentistry, New York.
Ann Intern Med. 1988 Oct 15;109(8):650-63. doi: 10.7326/0003-4819-109-8-650.
During the 1970s, emphasis increased in clinical practice on early ambulation and exercise-based rehabilitation after myocardial infarction and other cardiac illnesses or procedures. This shift was based on the belief that exercise and improved conditioning would improve prognosis. We examine the evidence supporting this assertion. Most of the reports on cardiac rehabilitation are about patients who have coronary artery disease and a history of myocardial infarction. The review, therefore, is focused primarily on the patient who has had a myocardial infarction. Effects of cardiac rehabilitation, emphasizing exercise treatment and conditioning, are reviewed with regard to patient outcomes, including changes in functional (work) capacity, psychosocial functioning and health-related knowledge, risk factor modification, morbidity and mortality, and cardiac function. The safety of cardiac exercise programs is reviewed, and the use of telemetry monitoring is considered. We also discuss the role of cardiac rehabilitation in categories of patients other than those with myocardial infarction and the application of newer approaches to rehabilitation such as programs based in the patient's home.
20世纪70年代，临床实践中对心肌梗死及其他心脏疾病或手术后早期下床活动和基于运动的康复的重视程度有所增加。这一转变基于这样一种信念，即运动和改善身体状况会改善预后。我们审视支持这一论断的证据。大多数关于心脏康复的报告是关于患有冠状动脉疾病且有心肌梗死病史的患者。因此，本综述主要聚焦于曾发生过心肌梗死的患者。从患者的各项预后指标方面，包括功能（工作）能力、心理社会功能和健康相关知识的变化、危险因素的改善、发病率和死亡率以及心脏功能等方面，对强调运动治疗和身体状况改善的心脏康复效果进行综述。对心脏运动项目的安全性进行综述，并考虑使用遥测监测。我们还讨论了心脏康复在除心肌梗死患者以外的其他患者类别中的作用，以及诸如基于患者家庭的项目等新的康复方法的应用。
