Borland Maria, Bergfeldt Lennart, Cider Åsa, Rosenkvist Agneta, Jakobsson Marika, Olsson Kristin, Lundwall Adam, Andersson Lars, Nordeman Lena
Närhälsan Sörhaga Rehabilitation Center, Alingsås, Sweden.
Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Borås Västra Götaland, Sweden.
Eur Rev Aging Phys Act. 2022 Apr 29;19(1):14. doi: 10.1186/s11556-022-00293-1.
Atrial fibrillation negatively impacts physical fitness and health-related quality of life. We recently showed that 3 months of physiotherapist-led exercise-based cardiac rehabilitation improves physical fitness and muscle function in elderly patients with permanent atrial fibrillation and concomitant diseases. Little is, however, known about the consequences for physical fitness, physical activity level, and health-related quality of life after ending the rehabilitation period.
Prospective 3 months follow-up study of 38 patients out of 40 eligible (10 women) who, as part of a randomized controlled trial, had completed a 3 months physiotherapist-led cardiac rehabilitation resulting in improved physical fitness,. In the current study, the participants were instructed to refrain from exercise for 3 months after completion of the rehabilitation period. Primary outcome measure was physical fitness measured as highest achieved workload using an exercise tolerance test. Secondary outcome measures were muscle function (muscle endurance tests), physical activity level (questionnaire and accelerometer), and health-related quality of life, (Short Form-36), as in the preceding intervention study. We used the Wilcoxon Signed Rank test to analyse differences between the end of rehabilitation and at follow-up. The effect size was determined using Cohen's d .
Exercise capacity and exercise time significantly decresead between end of rehabilitation and at follow-up (p < .0001 for both). A significant reduction in shoulder flexion repetitions (p = .006) was observed as well as reduced health-related quality of life in the Short Form-36 dimensions Physical Function (p = .042), Mental Health (p = .030), and Mental Component Score (p = .035). There were, however, no changes regarding objective and subjective physical activity measurements.
In older patients with permanent atrial fibrillation, previously achieved improvements from physiotherapist-led exercise-based cardiac rehabilitation in physical fitness and muscle function were lost, and health-related quality of life was impaired after ending the rehabilitation period. A strategy for conserving improvements after a rehabilitation period is essential.
心房颤动对身体健康和与健康相关的生活质量有负面影响。我们最近发现，由物理治疗师主导的为期3个月的运动心脏康复可改善患有永久性心房颤动及合并疾病的老年患者的身体健康和肌肉功能。然而，对于康复期结束后身体健康、身体活动水平和与健康相关的生活质量的影响知之甚少。
对40名符合条件的患者中的38名（10名女性）进行前瞻性3个月随访研究，这些患者作为随机对照试验的一部分，完成了由物理治疗师主导的为期3个月的心脏康复，从而改善了身体健康状况。在本研究中，参与者被要求在康复期结束后3个月内停止运动。主要结局指标是通过运动耐量测试以达到的最高工作量来衡量的身体健康状况。次要结局指标包括肌肉功能（肌肉耐力测试）、身体活动水平（问卷和加速度计）以及与健康相关的生活质量（简短健康调查问卷36项简表），与之前的干预研究相同。我们使用Wilcoxon符号秩检验来分析康复结束时和随访时的差异。效应大小使用Cohen's d来确定。
康复结束时和随访时，运动能力和运动时间均显著下降（两者p均<0.0001）。观察到肩部屈曲重复次数显著减少（p = 0.006），并且在简短健康调查问卷36项简表的身体功能（p = 0.042）、心理健康（p = 0.030）和心理综合评分（p = 0.035）维度中，与健康相关的生活质量也有所下降。然而，客观和主观身体活动测量方面没有变化。
在患有永久性心房颤动的老年患者中，由物理治疗师主导的运动心脏康复先前在身体健康和肌肉功能方面取得的改善在康复期结束后丧失，且与健康相关的生活质量受到损害。制定康复期后保持改善效果的策略至关重要。
