Lee Jong-Young, Joo Kee-Chan, Brubaker Peter H, Yoon Dae-Sik, Choi Kyung-Su
Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Wellness Academy, Seoul, Republic of Korea.
Pulse (Basel). 2024 Apr 24;12(1):40-48. doi: 10.1159/000538517. eCollection 2024 Jan-Dec.
Despite its efficacy, conventional center-based cardiac rehabilitation has several limitations which have led to the emergence of home-based programs and intensive cardiac rehabilitation as alternative methods for overcoming these limitations. Alternative methods for primary prevention have been recommended for similar reasons. Lifestyle modification is considered key to success in both primary and secondary prevention. Therefore, this primary prevention study aimed to investigate the efficiency of intensive lifestyle education and home-based programs involving unstructured exercise in urban forests to prevent coronary artery disease (CAD). The availability of urban forests as preventive exercise environments was also examined.
Patients with risk factors for CAD participated in primary prevention using either FBEG (forest-based exercise group (FBEG, = 11) or CBEG (center-based exercise group (CBEG, = 17) for 12 weeks. The FBEG was provided with intensive residential lifestyle education and followed a home program that included performing exercise in an urban forest. The CBEG followed a conventional supervised exercise program at a fitness facility. Changes in body composition, cardiometabolic variables, and functional capacity were tested using a 2-way repeated ANOVA measurement. An independent -test was used to examine the differences in weekly energy expenditure between the two groups.
Significant within-group differences were identified in body composition, cardiometabolic variables, and the 10-yr probability of CAD in both groups. However, the functional capacity, weekly energy expenditure, and attendance rate showed between-group differences, with superiority in the FBEG.
Intensive lifestyle education and subsequent home-based programs with unstructured exercise in the forest were as effective as a conventional center-based program, with superiority in terms of the change of some variables. Intensive education on experiencing and habituating a healthy lifestyle seemed to play an important role in improving motivation.
尽管传统的基于中心的心脏康复具有疗效，但它有几个局限性，这导致了家庭康复计划和强化心脏康复的出现，作为克服这些局限性的替代方法。出于类似原因，也推荐了一级预防的替代方法。生活方式的改变被认为是一级和二级预防成功的关键。因此，这项一级预防研究旨在调查强化生活方式教育和涉及在城市森林中进行非结构化锻炼的家庭康复计划预防冠状动脉疾病（CAD）的效果。还研究了城市森林作为预防性锻炼环境的可用性。
有CAD危险因素的患者参加了为期12周的一级预防，分为森林锻炼组（FBEG，n = 11）或中心锻炼组（CBEG，n = 17）。FBEG接受了强化的居家生活方式教育，并遵循一项家庭计划，其中包括在城市森林中进行锻炼。CBEG在健身设施中遵循传统的有监督的锻炼计划。使用双向重复方差分析测量来测试身体成分、心脏代谢变量和功能能力的变化。使用独立t检验来检查两组之间每周能量消耗的差异。
两组在身体成分、心脏代谢变量和CAD的10年发病概率方面均存在显著的组内差异。然而，功能能力、每周能量消耗和出勤率显示出组间差异，FBEG更具优势。
强化生活方式教育以及随后在森林中进行非结构化锻炼的家庭康复计划与传统的基于中心的计划一样有效，在某些变量的变化方面更具优势。对体验和养成健康生活方式的强化教育似乎在提高积极性方面发挥了重要作用。
