实施外周动脉疾病监督运动疗法的经验
Experience Implementing Supervised Exercise Therapy for Peripheral Artery Disease.
作者信息
Salisbury Dereck L, Whipple Mary O, Burt Marsha, Brown Rebecca, Mays Ryan J, Bakken Mark, Treat-Jacobson Diane
机构信息
University of Minnesota, School of Nursing, Minneapolis, MN.
Fairview Health System, Minneapolis, MN.
出版信息
J Clin Exerc Physiol. 2019 Mar;8(1):1-12. doi: 10.31189/2165-6193-8.1.1.
BACKGROUND
Supervised exercise therapy (SET) is a cornerstone of treatment for improving walking distance for individuals with symptomatic peripheral artery disease and claudication. High quality randomized controlled trials have documented the efficacy of SET as a claudication treatment and led to the recent Centers for Medicare and Medicaid decision to cover supervised exercise therapy (SET). However, to date, the translation of highly controlled, laboratory based SET programs in real world cardiopulmonary rehabilitation settings has been unexplored.
METHODS
In this article, we describe our experience integrating SET into existing cardiopulmonary rehabilitation programs, focusing on patient evaluation, exercise prescription, outcome assessments, strategies to maximize program adherence, and transitioning to home and community-based exercise training.
RESULTS
Our team has over 3 years experience successfully implementing SET in cardiac rehabilitation settings. The experiences communicated within can serve as a model for rehabilitation therapists to follow as they begin to incorporate SET in their rehabilitation programs.
CONCLUSIONS
CMS reimbursement has the potential to change clinical practice and utilization of SET for patients with symptomatic peripheral artery disease. The experience we have gained through implementation of SET programs across the M Health and Fairview Health Systems and in other Minnesota communities, including specific elements in our programs and the lessons learned from our clinical experience, can inform and help to guide development of new programs.
BRIEF ABSTRACT
The recent Centers for Medicare and Medicaid decision to cover supervised exercise therapy (SET) for beneficiaries with peripheral artery disease (PAD) has the potential to transform practice. In this article, we describe our experience integrating SET into existing cardiopulmonary rehabilitation programs, which could serve as a model for new programs.
背景
监督运动疗法（SET）是改善有症状外周动脉疾病和间歇性跛行患者步行距离的治疗基石。高质量随机对照试验已证明SET作为间歇性跛行治疗方法的有效性，并促使医疗保险和医疗补助服务中心最近决定涵盖监督运动疗法（SET）。然而，迄今为止，高度受控的基于实验室的SET项目在现实世界心肺康复环境中的转化尚未得到探索。
方法
在本文中，我们描述了将SET纳入现有心肺康复项目的经验，重点关注患者评估、运动处方、结果评估、提高项目依从性的策略以及向家庭和社区运动训练的过渡。
结果
我们的团队在心脏康复环境中成功实施SET已有3年多的经验。文中交流的经验可作为康复治疗师在开始将SET纳入其康复项目时遵循的范例。
结论
医疗保险和医疗补助服务中心的报销政策有可能改变有症状外周动脉疾病患者SET的临床实践和应用。我们通过在M健康和美景医疗系统以及明尼苏达州其他社区实施SET项目所获得的经验，包括我们项目中的具体内容以及从临床经验中学到的经验教训，可为新项目的开发提供参考并帮助指导其发展。
简短摘要
医疗保险和医疗补助服务中心最近决定为外周动脉疾病（PAD）受益人提供监督运动疗法（SET），这有可能改变临床实践。在本文中，我们描述了将SET纳入现有心肺康复项目的经验，可为新项目提供范例。
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