心力衰竭近期住院患者运动训练和身体活动依从性的预测因素：简要报告。

Predictors of Exercise Training and Physical Activity Adherence in People Recently Hospitalized With Heart Failure: A BRIEF REPORT.

机构信息

Heart Support Service (Ms Adsett) and Departments of Physiotherapy (Ms Adsett) and Internal Medicine and Aged Care (Dr Mudge), Royal Brisbane and Women's Hospital, Brisbane, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Australia (Ms Adsett and Dr Morris); Menzies Health Institute, Queensland, Australia (Ms Adsett and Dr Morris); Metro North Hospital and Health Service, The Prince Charles Hospital, Allied Health Research Collaborative, Queensland, Australia (Dr Morris); and University of Queensland Faculty of Medicine, Brisbane, Queensland, Australia (Dr Mudge).

出版信息

J Cardiopulm Rehabil Prev. 2019 May;39(3):E12-E16. doi: 10.1097/HCR.0000000000000407.

DOI:10.1097/HCR.0000000000000407

PMID:31022007

Abstract

PURPOSE

For individuals with heart failure (HF), frequent attendance at exercise training programs and meeting physical activity (PA) guidelines are significantly associated with improvements in 6-min walk distance. Despite the evidence, adherence to exercise interventions remains poor. The aim of this study was to identify predictors of these 2 variables in patients recently hospitalized with HF.

METHODS

In this substudy of the Exercise Joins Education: Combined Therapy to Improve Outcomes in Newly-discharged Heart Failure (EJECTION-HF) trial, all participants were enrolled in a HF disease management program, including weekly review of a home exercise program for 12 wk. Intervention group participants additionally undertook twice weekly supervised exercise training. Primary outcomes were frequent exercise training program attendance (≥12 sessions) and attainment of PA guidelines (150 min/wk of moderate intensity exercise) at 12 wk. Participant and clinical characteristics were analyzed using a logistic regression model to identify significant predictors of each outcome.

RESULTS

A total of 278 participants provided PA data and 140 contributed attendance data. New diagnosis of HF was a significant predictor of frequent program attendance (OR = 2.3; 95% CI, 1.1-4.7; P = .03). Predictors of meeting PA guidelines at follow-up included new HF diagnosis (OR = 2.4; 95% CI, 1.2-4.8, P = .013), and being physically active at baseline (OR = 2.7; 95% CI, 1.3-5.6; P = .007). Gender, symptom severity, multimorbidity, and disability were not significantly associated with either outcome in multivariate analysis.

CONCLUSION

To improve adherence, specific strategies may be required for patients with decompensated HF and those physically inactive at time of referral.

摘要

目的

对于心力衰竭（HF）患者，频繁参加运动训练计划和达到身体活动（PA）指南与 6 分钟步行距离的改善显著相关。尽管有证据表明，运动干预的依从性仍然很差。本研究的目的是确定最近因 HF 住院的患者中这两个变量的预测因素。

方法

在心力衰竭（EJECTION-HF）试验的运动结合教育：联合治疗改善新出院心力衰竭患者结局（Exercise Joins Education: Combined Therapy to Improve Outcomes in Newly-discharged Heart Failure，EJECTION-HF）的这项子研究中，所有参与者都参加了 HF 疾病管理计划，包括在 12 周内每周审查一次家庭运动计划。干预组参与者另外每周进行两次监督运动训练。主要结局是在 12 周时频繁参加运动训练计划（≥12 次）和达到 PA 指南（每周 150 分钟中等强度运动）。使用逻辑回归模型分析参与者和临床特征，以确定每个结局的显著预测因素。

结果

共有 278 名参与者提供了 PA 数据，140 名参与者提供了出勤数据。HF 的新诊断是频繁参加计划的显著预测因素（OR=2.3；95%CI，1.1-4.7；P=0.03）。在随访时达到 PA 指南的预测因素包括 HF 的新诊断（OR=2.4；95%CI，1.2-4.8，P=0.013），以及基线时的体力活动（OR=2.7；95%CI，1.3-5.6；P=0.007）。在多变量分析中，性别、症状严重程度、多病共存和残疾与这两个结局均无显著相关性。