Vidal-Almela Sol, Czajkowski Brenna, Prince Stephanie A, Chirico Daniele, Way Kimberley L, Pipe Andrew L, Reed Jennifer L
Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada.
School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Canada.
Eur J Prev Cardiol. 2021 Jul 10;28(7):761-778. doi: 10.1177/2047487320907748.
Cardiovascular disease remains a leading cause of death in women. Despite the well-known benefits of cardiac rehabilitation, it remains underutilized, especially among women. Physical activity programs in the community, however, attract a large female population, suggesting that they overcome barriers to physical activity encountered by women. The characteristics of interventions that extend beyond the traditional cardiac rehabilitation model and promote physical activity merit examination.
This narrative review aimed to: (a) summarize women's barriers to attend cardiac rehabilitation; (b) examine the characteristics of community- and home-based physical activity or lifestyle coaching interventions; and (c) discuss which barriers may be addressed by these alternative programs.
Studies were included if they: (a) were published within the past 10 years; (b) included ≥70% women with a mean age ≥45 years; (c) implemented a community- or home-based physical activity intervention or a lifestyle education/behavioral coaching program; and (d) aimed to improve physical activity levels or physical function.
Most interventions reported high (≥70%) participation rates and significant increases in physical activity levels at follow-up; some improved physical function and/or cardiovascular disease risk factors. Community- and home-based interventions address women's cardiac rehabilitation barriers by: implementing appealing modes of physical activity (e.g. dancing, group-walking, technology-based balance exercises); adapting the program to meet participants' needs; offering flexible options regarding timing and setting (e.g. closer to home, the workplace or faith-based institutions); and promoting social interactions.
Cardiac rehabilitation can be enhanced by understanding the specific needs of women; novel elements such as program offerings, convenient settings and opportunities for socialization should be considered when designing cardiac rehabilitation programs.
心血管疾病仍然是女性死亡的主要原因。尽管心脏康复有诸多益处，但仍未得到充分利用，尤其是在女性中。然而，社区中的体育活动项目吸引了大量女性群体，这表明这些项目克服了女性在体育活动中遇到的障碍。超越传统心脏康复模式并促进体育活动的干预措施的特点值得研究。
本叙述性综述旨在：（a）总结女性参加心脏康复的障碍；（b）研究基于社区和家庭的体育活动或生活方式指导干预措施的特点；（c）讨论这些替代项目可以解决哪些障碍。
纳入的研究需满足以下条件：（a）在过去10年内发表；（b）女性比例≥70%，平均年龄≥45岁；（c）实施基于社区或家庭的体育活动干预或生活方式教育/行为指导项目；（d）旨在提高体育活动水平或身体功能。
大多数干预措施报告的参与率较高（≥70%），随访时体育活动水平显著提高；一些措施改善了身体功能和/或心血管疾病风险因素。基于社区和家庭的干预措施通过以下方式解决女性心脏康复的障碍：采用有吸引力的体育活动方式（如跳舞、集体散步、基于技术的平衡练习）；使项目适应参与者的需求；在时间和地点方面提供灵活选择（如离家更近、工作场所或宗教机构附近）；促进社交互动。
了解女性的具体需求可以加强心脏康复；在设计心脏康复项目时，应考虑项目内容、便利的环境和社交机会等新元素。
