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心脏手术患者术前和术后身体康复的可行性——一项纵向队列研究。

Feasibility of preoperative and postoperative physical rehabilitation for cardiac surgery patients - a longitudinal cohort study.

作者信息

Dijkstra Sandra, Hartog Johanneke, Fleer Joke, van der Harst Pim, van der Woude Lucas H V, Mariani Massimo A

机构信息

Department of Cardio-Thoracic Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.

Department of Health Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.

出版信息

BMC Sports Sci Med Rehabil. 2023 Dec 19;15(1):173. doi: 10.1186/s13102-023-00786-1.

Abstract

BACKGROUND

This study aimed to determine the feasibility of a preoperative and postoperative (in- and outpatient) physical rehabilitation program, the Heart-ROCQ-pilot program.

METHODS

This cohort study included patients undergoing cardiac surgery (including coronary artery bypass graft surgery, valve surgery, aortic surgery, or combinations of these surgeries) and participated in the Heart-ROCQ-pilot program. Feasibility involved compliance and characteristics of bicycle and strength training sessions in the three rehabilitation phases.

RESULTS

Of the eligible patients, 56% (n = 74) participated in the program (41% of exclusions were due to various health reasons). On average across the rehabilitation phases, the compliance rates of bicycle and strength training were 88% and 83%, respectively. Workload to heart rate (W/HR) ratio and total absolute volume load for bicycle and strength training, respectively, improved in each rehabilitation phase (P < 0.05). The W/HR-ratio was higher during the last postoperative session compared to the first preoperative session (0.48 to 0.63 W/beat, P < 0.001) and similar to the last preoperative session (0.65 to 0.64 W/beat, P < 0.497). During less than 1% of the bicycle sessions, patients reported discomfort scores of 5 to 6 (scale 0-10, with higher scores indicating a higher level).

CONCLUSIONS

The Heart-ROCQ-pilot program was feasible for patients awaiting cardiac surgery. Patients were very compliant and were able to safely increase the training load before surgery and regained this improvement within eight weeks after surgery.

摘要

背景

本研究旨在确定术前和术后(门诊和住院)心脏康复计划——Heart-ROCQ试点计划的可行性。

方法

这项队列研究纳入了接受心脏手术(包括冠状动脉搭桥手术、瓣膜手术、主动脉手术或这些手术的联合)并参与Heart-ROCQ试点计划的患者。可行性涉及三个康复阶段中自行车训练和力量训练课程的依从性及特点。

结果

在符合条件的患者中,56%(n = 74)参与了该计划(41%的排除是由于各种健康原因)。在整个康复阶段,自行车训练和力量训练的平均依从率分别为88%和83%。自行车训练和力量训练的工作负荷与心率(W/HR)比值及总绝对容量负荷在每个康复阶段均有所改善(P < 0.05)。与术前第一次训练相比,术后最后一次训练时的W/HR比值更高(从0.48 W/次心跳增至0.63 W/次心跳,P < 0.001),且与术前最后一次训练相似(从0.65 W/次心跳降至0.64 W/次心跳,P < 0.497)。在不到1%的自行车训练课程中,患者报告的不适评分为5至6分(0 - 10分制,分数越高表示不适程度越高)。

结论

Heart-ROCQ试点计划对等待心脏手术的患者是可行的。患者依从性很高,能够在手术前安全地增加训练负荷,并在术后八周内恢复到术前水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da2a/10731823/e8c4ba6b150b/13102_2023_786_Fig1_HTML.jpg

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