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不要停止行走:COVID-19 大流行期间外周动脉疾病患者的家庭康复计划。

Don't stop walking: the in-home rehabilitation program for peripheral artery disease patients during the COVID-19 pandemic.

机构信息

Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy.

Rehabilitation Medicine Unit, University Hospital of Ferrara, Ferrara, Italy.

出版信息

Intern Emerg Med. 2021 Aug;16(5):1307-1315. doi: 10.1007/s11739-020-02598-4. Epub 2021 Jan 7.

Abstract

We studied the outcomes of peripheral artery disease (PAD) patients enrolled in a structured in-home walking program right before the lockdown due to the SARS-CoV-2 epidemic emergency, to determine whether this intervention ensured the maintenance of mobility even in the case of movement restrictions.We selectively studied 83 patients (age 72 ± 11, males n = 65) enrolled in the program within 9-month before the lockdown. The usual intervention was based on two daily 8-min sessions of slow intermittent in-home walking prescribed in circa-monthly hospital visits. During the lockdown, the program was updated by phone. Six-minute (6MWD) and pain-free walking distance (PFWD) were measured pre- and post-lockdown as well as body weight (BW), blood pressure (BP), and ankle-brachial index (ABI). Sixty-six patients were measured 117 ± 23 days after their previous visit. A safe, pain-free execution of the prescribed sessions was reported (median distance: 74 km). Overall, the 6MWD was stable, while PFWD improved (p < 0.001). The improvement was not related to age/gender, comorbidities, type of home but to the time of enrollment before lockdown. The new-entry subjects (≤ 3 months; n = 35) obtained significant improvements post-lockdown for 6MWD and PFWD, while those previously enrolled (> 3 months; n = 31) were stable. Decreased BW with stable BP and ABI values were also recorded, with better outcomes for new-entry subjects. In PAD patients, a structured walking program performed inside home and purposely guided by phone was adhered to by patients and favored mobility and risk factor control during the COVID-19 pandemic, regardless of walking ability, type of home and external conditions.

摘要

我们研究了在 SARS-CoV-2 疫情紧急情况下,因封锁而提前参加结构化家庭步行计划的外周动脉疾病(PAD)患者的结局,以确定这种干预措施是否能确保即使在行动受限的情况下也能保持活动能力。

我们选择性地研究了 83 名(年龄 72 ± 11,男性 n = 65)在封锁前 9 个月内参加该计划的患者。通常的干预措施基于在大约每月一次的医院就诊中规定的每日两次 8 分钟的缓慢间歇性家庭步行。在封锁期间,通过电话更新计划。在封锁前后测量 6 分钟(6MWD)和无痛步行距离(PFWD)以及体重(BW)、血压(BP)和踝肱指数(ABI)。66 名患者在他们上次就诊后 117 ± 23 天进行了测量。报告称安全、无痛地执行了规定的疗程(中位数距离:74 公里)。总体而言,6MWD 保持稳定,而 PFWD 有所改善(p < 0.001)。这种改善与年龄/性别、合并症、家庭类型无关,而是与封锁前的登记时间有关。新登记的患者(≤ 3 个月;n = 35)在封锁后 6MWD 和 PFWD 均有显著改善,而之前登记的患者(> 3 个月;n = 31)则保持稳定。还记录了 BW 的下降,同时 BP 和 ABI 值保持稳定,新登记的患者有更好的结果。在 PAD 患者中,结构化的家庭步行计划由电话专门指导,患者能够坚持执行,这有利于在 COVID-19 大流行期间保持活动能力和控制风险因素,无论步行能力、家庭类型和外部条件如何。

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