Fujita Y, Hasegawa T, Niitani H
Jpn Circ J. 1983 Jun;47(6):696-702. doi: 10.1253/jcj.47.696.
The relative benefits of 4- and 8-week rehabilitation programs were compared in inpatients with myocardial infarction. In the 8-week program, complete bed rest was instituted for the initial 3 days, followed by walking around the bed from the 14th day; exercise was gradually increased to target levels such as walking for distances of 500m per time up to a total of 2 to 3 km and climbing up and down several sets of 20 stairs daily. In the 4-week program, complete bed rest was provided for the initial 3 days, and exercise was more rapidly increased for 4 weeks to reach the same exercise level as that of the 8-week program. The duration of hospitalization, and the clinical progress, prognosis and the ability to return to work after discharge of the patients were compared in each program. The percentage of patients who were hospitalized for 40 days or less increased from 0% in the 8-week program to 15.9% in the 4-week program, while the percentage of patients who were hospitalized from 41 to 60 days increased from 13.3 to 37.0%. Shortening of the program did not cause significant differences in the incidence of serious complications such as heart failure, arrhythmia and infarction. The 2-year mortality was 15.9% in the 8-week program and 7.9% in the 4-week program. The state of work after discharge was comparable in both programs. Exercise tolerance, measured by bicycle ergometer, tended to improve remarkably 6 months after infarction. Based on the above results, the 4-week program is considered to be more practical than the 8-week program.
对心肌梗死住院患者比较了4周和8周康复计划的相对益处。在8周的计划中，最初3天完全卧床休息，从第14天开始床边走动；运动逐渐增加到目标水平，如每次步行500米，总计2至3公里，每天上下爬几组共20级楼梯。在4周的计划中，最初3天同样完全卧床休息，4周内运动增加得更快，以达到与8周计划相同的运动水平。比较了每个计划中患者的住院时间、临床进展、预后以及出院后恢复工作的能力。住院40天及以内的患者比例从8周计划中的0%增至4周计划中的15.9%，而住院41至60天的患者比例从13.3%增至37.0%。缩短康复计划并未导致心力衰竭、心律失常和梗死等严重并发症发生率出现显著差异。8周计划的2年死亡率为15.9%，4周计划为7.9%。两个计划出院后的工作状态相当。通过自行车测力计测量的运动耐量在梗死后6个月有显著改善的趋势。基于上述结果，4周计划被认为比8周计划更实用。
