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临床之星专栏:老年心力衰竭患者的康复治疗

Clin-STAR Corner: Rehabilitation for Older Adults With Heart Failure.

作者信息

Wingood Mariana, Vincenzo Jennifer L, Goyal Parag, Brach Jennifer S

机构信息

Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.

Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.

出版信息

J Am Geriatr Soc. 2025 Jun;73(6):1697-1703. doi: 10.1111/jgs.19346. Epub 2025 Jan 26.

Abstract

Heart failure is a major contributor to morbidity, mortality, and healthcare costs, especially among older adults. Despite a large body of evidence supporting the benefits of cardiac rehabilitation, less than 30% of eligible Medicare beneficiaries participate in cardiac rehabilitation. Thus, it is essential to examine alternatives, such as physical rehabilitation, a rehabilitation approach that focuses on physical activity and function. We systematically identified and summarized four key articles published between 2022 and 2024 that highlight innovations in rehabilitation with the potential of increasing utilization. These articles emphasize three areas of opportunity: (1) home-based telerehabilitation; (2) research focused on underrepresented and underserved populations; and (3) economic evaluations. Additional research on alternative modes of cardiac or physical rehabilitation, strategies to address heart failure-related health inequities, and implementation studies incorporating cost-effectiveness are needed to support increased utilization of cardiac and physical rehabilitation.

摘要

心力衰竭是导致发病、死亡和医疗费用增加的主要因素,在老年人中尤为如此。尽管有大量证据支持心脏康复的益处,但符合条件的医疗保险受益人中只有不到30%参与心脏康复。因此,研究替代方案至关重要,比如身体康复,这是一种专注于身体活动和功能的康复方法。我们系统地识别并总结了2022年至2024年间发表的四篇关键文章,这些文章突出了康复方面的创新,具有提高利用率的潜力。这些文章强调了三个机会领域:(1)基于家庭的远程康复;(2)针对代表性不足和服务欠缺人群的研究;(3)经济评估。需要对心脏或身体康复的替代模式、解决与心力衰竭相关的健康不平等问题的策略以及纳入成本效益的实施研究进行更多研究,以支持增加心脏和身体康复的利用率。

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本文引用的文献

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Role of exercise therapy and cardiac rehabilitation in heart failure.运动疗法和心脏康复在心力衰竭中的作用。
Prog Cardiovasc Dis. 2024 Jan-Feb;82:26-33. doi: 10.1016/j.pcad.2024.01.002. Epub 2024 Jan 9.
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Tracking Cardiac Rehabilitation Utilization in Medicare Beneficiaries: 2017 UPDATE.追踪 Medicare 受益人心血管康复利用情况:2017 年更新。
J Cardiopulm Rehabil Prev. 2022 Jul 1;42(4):235-245. doi: 10.1097/HCR.0000000000000675. Epub 2022 Feb 8.

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