远程康复居家高强度间歇训练对冠心病患者的影响。

Effect of home-based high-intensity interval training using telerehabilitation among coronary heart disease patients.

作者信息

Dosbaba Filip, Hartman Martin, Hnatiak Jakub, Batalik Ladislav, Ludka Ondrej

机构信息

Department of Rehabilitation, University Hospital Brno.

Faculty of Medicine, Masaryk University, Brno, Czech Republic.

出版信息

Medicine (Baltimore). 2020 Nov 20;99(47):e23126. doi: 10.1097/MD.0000000000023126.

Abstract

INTRODUCTION

Cardiovascular diseases are the world's most common causes of morbidity and mortality in the population, including Central Europe. Cardiac rehabilitation (CR) is an effective preventive approach that includes several core components. Physical training is identified as an integral and essential part of CR. Training can positively influence several cardiovascular risk factors in people diagnosed with coronary heart disease and prevent them from clinical events. Our study aims to research the method of high-intensity interval training (HIIT) in a home environment using telerehabilitation. We assume that the HIIT form of telerehabilitation, using a heart rate monitor as a tool for backing up training data, can improve cardiorespiratory fitness and lead to higher peak oxygen uptake than the traditional moderate-intensity continuous training (MICT).

METHODS

This study is designed as a monocentral randomized controlled trial at University Hospital Brno in the Czech Republic. After the coronary heart event, the suitable patients will be randomized (1:1 ratio) and separated into 2 groups: the experimental HIIT group and the control MICT group. Both groups undergo a 12-week telerehabilitation with a 1-year follow-up period. Study participants will be telemonitored during physical training in their home environment via a heart rate monitor and a web platform. Once a week, the patients will give their feedback and motivation by a telephone call.The primary outcome observed will be the effect of intervention expressed by changes in cardiorespiratory fitness. Secondary outcomes will be the health-related quality of life, anxiety, training adherence, body composition, safety, and satisfaction.

DISCUSSION

The HIIT is widely researched predominantly in a center-based supervised form. Our study differs from others by the use of telemedicine and smart technologies in home-based settings. Previous home-based cardiac telerehabilitation studies have focused primarily on MICT, which has demonstrated feasibility, and results have shown similar improvements as center-based CR. There is a presumption that HIIT may be superior to MICT. However, it can be complicated to self-dose the method in the home environment. Investigators expect that HIIT research will provide insight into the possibilities of telemedicine feasibility, effect, and limitations of coronary heart disease patients' use at low to moderate cardiovascular risk.

摘要

引言

心血管疾病是全球(包括中欧)人群发病和死亡的最常见原因。心脏康复(CR)是一种有效的预防方法,包括几个核心组成部分。体育锻炼被视为心脏康复不可或缺的重要部分。锻炼可以对被诊断患有冠心病的人的多种心血管危险因素产生积极影响,并预防临床事件的发生。我们的研究旨在探讨在家庭环境中使用远程康复进行高强度间歇训练(HIIT)的方法。我们假设,使用心率监测器作为备份训练数据工具的远程康复HIIT形式,与传统的中等强度持续训练(MICT)相比,能够提高心肺适能,并带来更高的峰值摄氧量。

方法

本研究设计为捷克布尔诺大学医院的单中心随机对照试验。在冠心病事件发生后,符合条件的患者将被随机分组(1:1比例),分为两组:实验性HIIT组和对照MICT组。两组均接受为期12周的远程康复,并进行1年的随访。研究参与者在家庭环境中进行体育锻炼时,将通过心率监测器和网络平台进行远程监测。患者每周通过电话提供一次反馈和动力。观察的主要结果将是通过心肺适能变化来表示的干预效果。次要结果将包括与健康相关的生活质量、焦虑、训练依从性、身体成分、安全性和满意度。

讨论

HIIT主要在基于中心的监督形式下得到广泛研究。我们的研究与其他研究的不同之处在于在家庭环境中使用了远程医疗和智能技术。以往基于家庭的心脏远程康复研究主要集中在MICT上,MICT已证明具有可行性,结果显示与基于中心的心脏康复有类似的改善。有一种推测认为HIIT可能优于MICT。然而,在家庭环境中自行确定该方法的剂量可能会很复杂。研究人员期望HIIT研究能够深入了解远程医疗在冠心病低至中度心血管风险患者中的可行性、效果和局限性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2236/7676562/27da5897470a/medi-99-e23126-g001.jpg

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