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中风康复中的心肺运动测试:物理治疗师和中风患者所感知到的益处及临床效用

Cardiopulmonary Exercise Testing in Stroke Rehabilitation: Benefits and Clinical Utility Perceived by Physiotherapists and Individuals with Stroke.

作者信息

Sharpe Allison, Boyes Valerie, Lee Calvin, Murtha Christopher, Mah Justin, Yoshida Karen, Marzolini Susan, Inness Elizabeth L

机构信息

Department of Physical Therapy, University of Toronto.

Cardiovascular Prevention and Rehabilitation Program.

出版信息

Physiother Can. 2021 Spring;73(2):110-117. doi: 10.3138/ptc-2019-0070.

Abstract

The purpose of this study was to understand the perceived benefits and clinical utility of cardiopulmonary exercise testing (CPET) from the perspectives of physiotherapists and patients and to explore the factors that influence adopting CPET in a stroke rehabilitation setting. A qualitative descriptive study was conducted. Physiotherapists ( = 6) participated in a focus group to discuss the use of CPET in practice. Patients ( = 8) who had completed CPET during stroke rehabilitation participated in a semi-structured interview to explore their experiences. Thematic analysis was performed. CPET increased the physiotherapists' confidence in prescribing exercise, especially for medically complex patients. Ongoing medical management early post-stroke was a barrier to referral. Physiotherapists expressed decreased confidence in interpreting test results. Consultation with local experts facilitated the use of CPET. Patients described how CPET increased their confidence to participate in exercise. They desired more information before and after CPET to better understand the purpose and results and their relation to their rehabilitation goals. Both physiotherapists and patients described the benefit of having CPET available to support them as they participated in exercise in a stroke rehabilitation setting. Physiotherapists would benefit from having educational tools to support their interpretation and application of test results, and patients would benefit from improved communication and education to support their understanding of the relevance of CPET to their rehabilitation goals. Future research should explore these findings in other stroke rehabilitation settings.

摘要

本研究的目的是从物理治疗师和患者的角度了解心肺运动试验(CPET)的感知益处和临床实用性,并探讨在中风康复环境中影响采用CPET的因素。进行了一项定性描述性研究。物理治疗师(n = 6)参加了一个焦点小组,讨论CPET在实践中的应用。在中风康复期间完成CPET的患者(n = 8)参加了半结构化访谈,以探讨他们的经历。进行了主题分析。CPET增强了物理治疗师开具运动处方的信心,特别是对于病情复杂的患者。中风后早期持续的医疗管理是转诊的障碍。物理治疗师对解读测试结果的信心下降。与当地专家的咨询促进了CPET的使用。患者描述了CPET如何增强他们参与运动的信心。他们希望在CPET前后获得更多信息,以更好地理解目的和结果以及它们与康复目标的关系。物理治疗师和患者都描述了在中风康复环境中进行CPET以支持他们参与运动的益处。物理治疗师将受益于拥有教育工具来支持他们对测试结果的解读和应用,而患者将受益于改善沟通和教育以支持他们理解CPET与康复目标的相关性。未来的研究应在其他中风康复环境中探索这些发现。

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