Fletcher B J, Thiel J, Fletcher G F
Am J Cardiol. 1986 Apr 1;57(10):751-6. doi: 10.1016/0002-9149(86)90607-7.
To evaluate phase II intensive monitored cardiac rehabilitation using a 6-level, 6-session protocol, 31 patients were placed in a progressive 6-level exercise protocol with careful supervision and assessment of heart rate, rhythm, blood pressure and perceived exertion. Duration after the cardiac event ranged from 12 days to 8 years (median 10 months). Each exercise prescription was based on exercise testing with oxygen consumption determinations. Exercise activities were individually prescribed according to percentages of maximal MET level achieved on the exercise test. Each exercise session incorporated calisthenics, treadmill exercise, and bicycle and arm ergometry with progressively greater workloads on the various stations. All patients completed the 6 levels within 6 sessions of approximately 1 hour each, and achieved their designated 50 to 75% target heart rate with perceived exertion level 13 or less. There were no critical cardiac events, i.e., high-grade ventricular arrhythmias or myocardial infarction. All completed the 6-level protocol and progressed to a nonmonitored exercise program with no difficulty. The results of this short-term method of telemetry-monitored rehabilitation suggest benefits of proper exercise instruction, successful achievement of the 50 to 75% exercise target heart rate, detection of minor new arrhythmias and alterations of blood pressure response, adequate use of the perceived exertion scale, and a safe and effective transition to subsequent exercise programs.
为了评估采用六级、六节方案的II期强化监测心脏康复效果，31例患者被纳入一个循序渐进的六级运动方案，同时对心率、心律、血压和自觉用力程度进行仔细监测和评估。心脏事件后的时间间隔为12天至8年（中位数为10个月）。每个运动处方均基于耗氧量测定的运动测试。根据运动测试中达到的最大代谢当量水平百分比，为患者个体化制定运动活动。每个运动节段都包括健身操、跑步机运动、自行车和手臂测力计运动，各运动站的负荷逐渐增加。所有患者均在6节、每节约1小时的时间内完成了6个级别，且自觉用力程度为13或更低时达到了指定的50%至75%的目标心率。未发生严重心脏事件，即高级别室性心律失常或心肌梗死。所有患者均顺利完成六级方案，并顺利过渡到非监测运动计划。这种短期遥测监测康复方法的结果表明，适当的运动指导、成功达到50%至75%的运动目标心率、检测到轻微的新心律失常和血压反应变化、充分使用自觉用力量表以及安全有效地过渡到后续运动计划均有益处。
