Choi Sang-Suk, Son Yoon-Jin, Kim Sung-Jung, Yoo Myungjae, Roh Sumin, Yoon Mi-Jeong, Hwang Youmi
Department of Cardiology, St. Vincent's Hospital, The Catholic University of Korea, Seoul 16247, Republic of Korea.
Catholic Research Institute for Intractable Cardiovascular Disease (CRID), College of Medicine, The Catholic University of Korea, Seoul 06649, Republic of Korea.
J Clin Med. 2024 Nov 21;13(23):7014. doi: 10.3390/jcm13237014.
: Cardiac implantable electronic devices (CIEDs) can prevent ventricular arrhythmia-related sudden cardiac death but cause paradoxical discomfort that impairs daily living and quality of life. No management guidelines exist for reducing pain, improving motion around the CIED implantation site, or preventing shoulder contractures. We evaluated the impact of continuous successive shoulder rehabilitation programs for CIED patients on reducing shoulder pain, improving shoulder range of motion, and patient satisfaction in daily living. : In this prospective observational study, patients who had received CIED implantation underwent shoulder rehabilitation therapy with education during hospitalization from the day post-CIED implantation. After in-hospital rehabilitation, patients chose to undergo successive shoulder rehabilitation from their home and after 4 weeks in the outpatient clinic (rehabilitation group, n = 68) or not (non-rehabilitation group, n = 33). Pain and shoulder function was assessed using the Visual Analog Scale (VAS) and Disability of the Arm, Shoulder, and Hand (DASH) scores, respectively, the day following CIED implantation and at 1-3 months postoperatively. Patient satisfaction was evaluated using the 36-item Short Form Survey (SF-36). Outcomes were compared between groups. : VAS pain scores significantly decreased, while DASH scores substantially improved in the rehabilitation group compared to the non-rehabilitation group. Although the SF-36 subdomains were similar between groups, the rehabilitation group showed a better health-related quality of life trend. No complications were observed following post-CIED rehabilitation. : Shoulder rehabilitation therapy with successive education after CIED implantation significantly improved pain and shoulder function. Definitive guidelines and long-term outcomes should be investigated further.
心脏植入式电子设备（CIEDs）可预防与室性心律失常相关的心脏性猝死，但会引起反常不适，影响日常生活和生活质量。目前尚无关于减轻疼痛、改善CIED植入部位周围活动或预防肩部挛缩的管理指南。我们评估了针对CIED患者的持续连续肩部康复计划对减轻肩部疼痛、改善肩部活动范围以及患者日常生活满意度的影响。
在这项前瞻性观察研究中，接受CIED植入的患者在CIED植入后当天住院期间接受肩部康复治疗并接受相关教育。住院康复后，患者选择在家中接受连续肩部康复治疗，并在门诊治疗4周后（康复组，n = 68），或者不接受（非康复组，n = 33）。分别在CIED植入后当天以及术后1 - 3个月，使用视觉模拟量表（VAS）和手臂、肩部和手部功能障碍（DASH）评分评估疼痛和肩部功能。使用36项简短问卷调查（SF - 36）评估患者满意度。对两组结果进行比较。
与非康复组相比，康复组的VAS疼痛评分显著降低，而DASH评分显著改善。尽管两组之间的SF - 36子领域相似，但康复组显示出与健康相关的生活质量有更好的趋势。CIED康复后未观察到并发症。
CIED植入后进行连续教育的肩部康复治疗可显著改善疼痛和肩部功能。应进一步研究明确的指南和长期结果。
