在 COVID-19 大流行期间接受心脏康复的患者，步行能力预后不良，日常生活活动改善有限。
Poor walking ability outcome and activities of daily living improvement in patients undergoing cardiac rehabilitation during COVID-19 pandemic.
机构信息
Department of Rehabilitation Medicine, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan -
Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan -
出版信息
Eur J Phys Rehabil Med. 2022 Aug;58(4):606-611. doi: 10.23736/S1973-9087.21.07054-4. Epub 2021 Dec 6.
BACKGROUND
The COVID-19 pandemic has had wide-ranging impacts across international healthcare systems and direct impacts on rehabilitation professionals. Few outcome data for cardiac patients undergoing rehabilitation programs during the COVID-19 pandemic are available.
AIM
We conducted a study to compare the effect of modified rehabilitation therapies mainly performed in wards versus conventional therapies mainly performed in rehabilitation units in which exercise on a treadmill and cardiopulmonary exercise testing were available.
DESIGN
Observational study.
SETTING
University hospital.
POPULATION
Fifty-five consecutive inpatients admitted to a university hospital and underwent a cardiac rehabilitation program from August 2019 to June 2020.
METHODS
The patients were divided into two groups: those admitted during the COVID-19 outbreak (Group A, N.=28) and those admitted before the COVID-19 outbreak (Group B, N.=27). The evaluation included age, sex, duration of the rehabilitation intervention program, days before initiation of the rehabilitation program, functional status, and Functional Independence Measure (FIM) Score.
RESULTS
A higher proportion of patients in Group A than B underwent a cardiac rehabilitation program provided in wards (88.5% vs. 48.8%, respectively). Group A showed a significantly lower 6-minute walking distance and walking speed than Group B at discharge (P=0.031 and 0.014, respectively). Group A showed a significantly shorter exercise time using an ergometer than Group B (P=0.028).
CONCLUSIONS
The difference in the cardiac rehabilitation location during the COVID-19 pandemic may affect the rehabilitation contents and lead to less improvement in physical function.
CLINICAL REHABILITATION IMPACT
A cardiac rehabilitation program was performed mainly in wards instead of in rehabilitation units during the COVID-19 pandemic. Walking abilities were adversely affected by the modified cardiac rehabilitation program.
背景
COVID-19 大流行对国际医疗体系产生了广泛影响，并直接影响了康复专业人员。在 COVID-19 大流行期间，接受康复计划的心脏病患者的预后数据很少。
目的
我们进行了一项研究，比较了主要在病房进行的改良康复治疗与主要在康复单元进行的常规治疗的效果，后者可提供跑步机运动和心肺运动测试。
设计
观察性研究。
地点
大学医院。
人群
55 名连续住院患者，于 2019 年 8 月至 2020 年 6 月在一所大学医院接受心脏康复计划。
方法
将患者分为两组：COVID-19 爆发期间入院的患者（A 组，n=28）和 COVID-19 爆发前入院的患者（B 组，n=27）。评估包括年龄、性别、康复干预方案的持续时间、开始康复方案前的天数、功能状态和功能独立性测量（FIM）评分。
结果
A 组比 B 组有更高比例的患者在病房接受心脏康复计划（分别为 88.5%和 48.8%）。A 组出院时的 6 分钟步行距离和步行速度明显低于 B 组（分别为 P=0.031 和 0.014）。A 组使用测功计的运动时间明显短于 B 组（P=0.028）。
结论
COVID-19 大流行期间心脏康复地点的差异可能会影响康复内容，并导致身体功能的改善减少。
临床康复影响
在 COVID-19 大流行期间，心脏康复计划主要在病房进行，而不是在康复单元进行。改良的心脏康复计划对步行能力产生了不利影响。
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