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远程心脏康复后对冠心病患者的长期运动效果:一项随机研究的 1 年随访结果。

Long-term exercise effects after cardiac telerehabilitation in patients with coronary artery disease: 1-year follow-up results of the randomized study.

机构信息

Department of Rehabilitation, University Hospital of Brno, Brno, Czech Republic -

Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic -

出版信息

Eur J Phys Rehabil Med. 2021 Oct;57(5):807-814. doi: 10.23736/S1973-9087.21.06653-3. Epub 2021 Feb 23.

Abstract

BACKGROUND

Home-based cardiac telerehabilitation (HBCT) is a feasible and effective alternative to traditional center-based cardiac rehabilitation (CBCR). Currently, there are only limited studies focusing on a long-term effect of HBCT, which means it is essential to do more research in this study field.

AIM

This study aimed at investigating a 1-year effect of a randomized controlled study using Cardiac Rehabilitation through the Global Position System (CR-GPS) compared to outpatient cardiac rehabilitation. Study focused on cardiorespiratory fitness (CRF) and health-related quality of life (HRQL) in patients with coronary heart disease (CAD).

DESIGN

A long-term follow-up of a randomized study.

SETTING

Patients were enrolled, and the intervention was performed in an outpatient or home-based model. The results were obtained and evaluated in a hospital.

POPULATION

Patients who participated in the CR-GPS study were diagnosed with CAD with low to moderate cardiovascular risk.

METHODS

Patients enrolled in the study were eligible participants who had previously completed a 12-week HBCT program using a wrist heart rate (HR) monitor or attended a traditional CBCR. Primary outcome was the change in CRF expressed in peak oxygen uptake (pVO2), and the secondary outcomes were self-reported HRQL, objectively measured anthropometric characteristics, and mortality and hospitalization rates.

RESULTS

Forty-four patients (76%) completed the long-term follow-up. The average peak of pVO2 was higher after 1-year follow-up in the telerehabilitation group (HBCT 25.5 mL/kg/min compared to the active control group CBCR 23.6 mL/kg/min P=0.047). No statistically significant difference between the two groups was found after long-term follow-up for the parameter HRQL. For both groups, there was a significant improvement in the range of perceptions of general health. There was no death case and no difference in hospitalization rate between the groups.

CONCLUSIONS

This study supports the HBCT model. It has been demonstrated that it induces satisfactory long-term effects in pVO2, exercise performance, and perceived general health in CAD patients with low to moderate cardiovascular risk.

CLINICAL REHABILITATION IMPACT

Cardiovascular telerehabilitation using wrist HR monitors is a feasible and effective rehabilitation method that can help patients eliminate barriers that prevent them from using CBCR programs. Especially in the current global situation with the COVID-19 pandemic, this topic is becoming increasingly important.

摘要

背景

家庭心脏远程康复(HBCT)是传统中心心脏康复(CBCR)的一种可行且有效的替代方法。目前,仅有有限的研究关注 HBCT 的长期效果,因此在该研究领域进行更多研究至关重要。

目的

本研究旨在通过全球定位系统(GPS)心脏康复(CR-GPS)与门诊心脏康复比较,调查一项随机对照研究的 1 年效果。该研究主要关注冠心病(CAD)患者的心肺适应能力(CRF)和健康相关生活质量(HRQL)。

设计

一项随机研究的长期随访。

设置

在门诊或家庭模型中招募患者,并进行干预。在医院获得并评估结果。

人群

参加 CR-GPS 研究的患者被诊断为 CAD,且心血管风险低至中度。

方法

符合条件的研究参与者为先前完成了 12 周使用腕式心率(HR)监测器的 HBCT 计划或参加了传统 CBCR 的患者。主要结局是用峰值摄氧量(pVO2)表示的 CRF 变化,次要结局是自我报告的 HRQL、客观测量的人体测量特征以及死亡率和住院率。

结果

44 名患者(76%)完成了长期随访。远程康复组(HBCT 25.5 mL/kg/min)在 1 年随访时的平均 pVO2峰值高于主动对照组(CBCR 23.6 mL/kg/min,P=0.047)。长期随访后,两组之间在 HRQL 方面没有统计学上的显著差异。对于两组,一般健康感知范围都有显著改善。两组均无死亡病例,且住院率无差异。

结论

本研究支持 HBCT 模式。它已经证明,在低至中度心血管风险的 CAD 患者中,它可以在 pVO2、运动表现和感知一般健康方面产生令人满意的长期效果。

临床康复影响

使用腕式 HR 监测器的心血管远程康复是一种可行且有效的康复方法,可以帮助患者消除使用 CBCR 计划的障碍。特别是在当前 COVID-19 大流行的全球形势下,这个话题变得越来越重要。

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