Department of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland.
University Rehabilitation Centre, Wroclaw Medical University, 50-367 Wroclaw, Poland.
Physiotherapy. 2024 Dec;125:101412. doi: 10.1016/j.physio.2024.07.003. Epub 2024 Jul 8.
To systematically review the effectiveness of psychologically-enhanced cardiac rehabilitation (CR) in improving psychological and functional outcomes in patients with cardiovascular disease.
A systematic search was performed in PubMed, Scopus, Cochrane Library, Embase, and Web of Science, up to January 31, 2024.
Two reviewers independently identified randomized clinical trials that evaluated the effectiveness of psychologically-enhanced CR in improving psychological and functional outcomes in patients with cardiovascular disease. The search yielded 1848 results. Finally, data from 14 studies (1531 participants) were included in the review.
Information regarding cardiac rehabilitation phase, duration of the intervention, group characteristics, measured outcomes, and the conclusions drawn by the authors was extracted. The Revised Cochrane risk-of-bias tool for Randomized Trials was used to evaluate the methodological quality.
Pooled results indicate that psychologically-enhanced CR is more effective than specific cardiac training alone in maintaining lower resting blood pressure, with a mean difference of -3.09 (95% CI: -5.18 to -1.00). Furthermore, psychologically-enhanced CR shows superiority in improving patients' quality of life compared to specific cardiac training alone, with a standardized mean difference of 0.15 (95% CI: 0.01 to 0.31). Analyses of depression and anxiety level, exercise tolerance, and blood lipid profile did not show significant differences between the two treatment conditions.
Psychologically-enhanced CR shows a positive effect on reducing resting blood pressure and improving the quality of life. However, the supportive methods were of limited effectiveness in addressing the psychological aspects of health.
PROSPERO CRD42022304063. CONTRIBUTION OF THE PAPER.
系统评价心理强化型心脏康复对改善心血管疾病患者心理和功能结局的有效性。
系统检索了 PubMed、Scopus、Cochrane 图书馆、Embase 和 Web of Science，检索时间截至 2024 年 1 月 31 日。
两位评审员独立确定了评估心理强化型心脏康复对改善心血管疾病患者心理和功能结局有效性的随机临床试验。检索结果为 1848 项。最终，有 14 项研究（1531 名参与者）的数据纳入了综述。
提取了心脏康复阶段、干预持续时间、组间特征、测量结果以及作者得出的结论等信息。采用修订后的 Cochrane 随机试验偏倚风险工具评估了方法学质量。
汇总结果表明，与单纯特定心脏训练相比，心理强化型心脏康复更能有效维持较低的静息血压，平均差值为-3.09（95%置信区间：-5.18 至-1.00）。此外，与单纯特定心脏训练相比，心理强化型心脏康复在改善患者生活质量方面具有优越性，标准化均数差值为 0.15（95%置信区间：0.01 至 0.31）。对抑郁和焦虑水平、运动耐量以及血脂谱的分析显示，两种治疗条件之间没有显著差异。
心理强化型心脏康复对降低静息血压和改善生活质量有积极影响。然而，支持性方法在解决健康的心理方面效果有限。
PROSPERO CRD42022304063。本文的贡献。
