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老年心力衰竭患者心血管物理治疗中可行评估与干预的真实世界证据——来自日本心血管物理治疗学会J-Proof HF的见解

Real-World Evidence of Feasible Assessment and Intervention in Cardiovascular Physical Therapy for Older Patients With Heart Failure - Insight From the J-Proof HF of the Japanese Society of Cardiovascular Physical Therapy.

作者信息

Kono Yuji, Sakurada Koji, Iida Yuki, Iwata Kentato, Kato Michitaka, Kamiya Kentaro, Saitoh Masakazu, Taya Masanobu, Funami Yoshinari, Morisawa Tomoyuki, Takahashi Tetsuya

机构信息

Committee of the J-Proof HF Registry, Japanese Society of Cardiovascular Physical Therapy Tokyo Japan.

出版信息

Circ Rep. 2024 Sep 21;6(10):441-447. doi: 10.1253/circrep.CR-24-0058. eCollection 2024 Oct 10.

Abstract

BACKGROUND

This study aimed to clarify the feasibility of cardiovascular physical therapy assessment and intervention in older patients with heart failure (HF) in Japan.

METHODS AND RESULTS

We performed a secondary analysis of data from a nationwide multicenter registry (the J-Proof HF), and enrolled consecutive HF patients aged ≥65 years who were prescribed cardiovascular physical therapy during hospitalization from December 2020 to March 2022. Of the 9,650 enrolled patients (median age 83.0 years; 49.8% male), the availability rate of comorbidities and assessments was >95%. In the activities of daily living (ADL) assessment, the Barthel Index (BI) and Functional Independence Measure were 97.6% and 60.4%, respectively. The results of the physical therapy assessment indicated completion rates of ≥80%, with lower rates of <60% for gait speed and short-performance physical battery in the group with a BI of <85 points. In physiotherapy intervention, gait training and muscle strength training were performed by >80% of patients, whereas aerobic exercise and resistance training were performed by 35.4% and 2.6% patients, respectively.

CONCLUSIONS

Our results in this study indicated that medical findings, such as comorbidities, echocardiography, and laboratory findings, were considered a feasible assessment that could be confirmed at all hospitals. Gait training, ADL training, and muscle strength training are much more common than exercise training in older patients with HF.

摘要

背景

本研究旨在阐明在日本老年心力衰竭(HF)患者中进行心血管物理治疗评估和干预的可行性。

方法与结果

我们对来自全国多中心登记处(J-Proof HF)的数据进行了二次分析,纳入了2020年12月至2022年3月住院期间接受心血管物理治疗的连续≥65岁的HF患者。在9650名纳入患者中(中位年龄83.0岁;49.8%为男性),合并症和评估的可获得率>95%。在日常生活活动(ADL)评估中,Barthel指数(BI)和功能独立性测量分别为97.6%和60.4%。物理治疗评估结果显示完成率≥80%,BI<85分的组中步态速度和简短体能测试的完成率<60%。在物理治疗干预中,>80%的患者进行了步态训练和肌力训练,而分别有35.4%和2.6%的患者进行了有氧运动和抗阻训练。

结论

我们在本研究中的结果表明,合并症、超声心动图和实验室检查结果等医学检查结果是一种可行的评估,在所有医院均可得到确认。在老年HF患者中,步态训练、ADL训练和肌力训练比运动训练更为常见。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/732a/11464020/70db093cb752/circrep-6-441-g001.jpg

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