Borg Sabina, Öberg Birgitta, Nilsson Lennart, Alfredsson Joakim, Söderlund Anne, Bäck Maria
Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, 581 83, Linköping, Sweden.
Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
BMC Sports Sci Med Rehabil. 2023 Mar 24;15(1):42. doi: 10.1186/s13102-023-00647-x.
Interventions promoting adherence to exercise-based cardiac rehabilitation (exCR) are important to achieve positive physical and psychological outcomes, but knowledge of the added value of behavioral medicine interventions for these measures is limited. The aim of the study was to investigate the added value of a behavioral medicine intervention in physical therapy (BMIP) in routine exCR on psychological outcomes and health-related quality of life (HRQoL) versus routine exCR alone (RC).
A total of 170 patients with coronary artery disease (136 men), mean age 62.3 ± 7.9 years, were randomized at a Swedish university hospital to a BMIP plus routine exCR or to RC for four months. The outcome assessments included HRQoL (SF-36, EQ-5D), anxiety and depression (HADS), patient enablement and self-efficacy and was performed at baseline, four and 12 months. Between-group differences were tested with an independent samples t-test and, for comparisons within groups, a paired t-test was used. An intention-to-treat and a per-protocol analysis were performed.
No significant differences in outcomes between the groups were shown between baseline and four months or between four and 12 months. Both groups improved in most SF-36 domains, EQ-VAS and HADS anxiety at the four-month follow-up and sufficient enablement remained at the 12-months follow-up.
A BMIP added to routine exCR care had no significant effect on psychological outcomes and HRQoL compared with RC, but significant improvements in several measures were shown in both groups at the four-month follow-up. Since recruited participants showed a better psychological profile than the general coronary artery disease population, further studies on BMIP in exCR, tailored to meet individual needs in broader patient groups, are needed. Trial registration number NCT02895451, 09/09/2016, retrospectively registered.
促进坚持运动心脏康复（exCR）的干预措施对于实现积极的身体和心理结果很重要，但行为医学干预对这些指标的附加价值的了解有限。本研究的目的是调查在常规exCR中，物理治疗中的行为医学干预（BMIP）相对于单独的常规exCR（RC）对心理结果和健康相关生活质量（HRQoL）的附加价值。
在瑞典一家大学医院，共有170例冠心病患者（136例男性），平均年龄62.3±7.9岁，被随机分为接受BMIP加常规exCR或RC治疗四个月。结局评估包括HRQoL（SF-36、EQ-5D）、焦虑和抑郁（HADS）、患者赋能和自我效能感，并在基线、4个月和12个月时进行。组间差异用独立样本t检验进行检验，组内比较用配对t检验。进行了意向性分析和符合方案分析。
在基线和4个月之间或4个月和12个月之间，两组之间的结局没有显著差异。在4个月随访时，两组在大多数SF-36领域、EQ-VAS和HADS焦虑方面均有改善，在12个月随访时仍保持足够的赋能。
与RC相比，在常规exCR护理中添加BMIP对心理结果和HRQoL没有显著影响，但在4个月随访时两组在多项指标上均有显著改善。由于招募的参与者的心理状况优于一般冠心病患者群体，因此需要针对更广泛患者群体的个体需求，进一步研究exCR中的BMIP。试验注册号NCT02895451，2016年9月9日，回顾性注册。
