Initial efficacy of a cardiac rehabilitation transition program: Cardiac TRUST

The purpose of this pilot study was to test the initial efficacy, feasibility, and safety of a specially designed postacute care transitional rehabilitation intervention for cardiac patients. Cardiac Transitional Rehabilitation Using Self-Management Techniques (Cardiac TRUST) is a family-focused intervention that includes progressive low-intensity walking and education in self-management skills to facilitate recovery following a cardiac event. Using a randomized two-group design, exercise self-efficacy, steps walked, and participation in an outpatient cardiac rehabilitation (CR) program were compared in a sample of 38 older adults (17 Cardiac TRUST, 21 usual care). At discharge from postacute care, the intervention group trended toward higher levels of self-efficacy for exercise outcomes than the usual care group. During the 6 weeks following discharge, the intervention group had greater attendance in outpatient CR and a trend toward more steps walked during the first week. The feasibility of the intervention was better for the home health care participants than for those in the skilled nursing facility. The provision of CR during postacute care has the potential to bridge the gap in transitional services from hospitalization to outpatient CR for these patients at high risk for future cardiac events. Further evidence of the efficacy of Cardiac TRUST is warranted.     

心理干预结合运动训练对冠脉搭桥患者术后恢复及心功能的影响

目的:观察心理干预联合运动训练对冠状动脉搭桥(CABG)患者术后恢复及心功能的影响。方法:52例拟行CABG的住院患者随机分为康复组(n=27)和对照组(n=25)。康复组给予心理干预治疗和强度渐增的运动。主要观察指标为:焦虑自评量表(SAS)、抑郁自评量表(SDS)、6min步行试验(6MWT)、肿瘤坏死因子α(TNFα)、左室射血分数(LVEF)、术后插管时间、重症护理时间与术后住院时间。结果:与对照组比较,康复组患者术后SAS与SDS评分下降显著(P<0.01);康复组患者6min步行距离(6MWD)明显加长(P<0.005);康复组TNF-α浓度明显降低(P<0.01);康复组患者术后呼吸机辅助通气时间及重症监护时间较对照组缩短(P<0.05);与术前比较,康复组LVEF明显改善(P<0.005);将康复组患者的上述观察指标进行相关性分析,结果显示SAS、SDS评分的下降分别与6MWD的加长(rSAS=0.46,P<0.01;rSDS=0.48,P<0.01)成明显正相关。结论:心理干预联合运动训练可以改善CABG术后患者的焦虑及抑郁程度,提高运动能力,促进心脏功能的恢复。     

Long-term risk factor control after a cardiac rehabilitation programme.

This study examined the hypothesis that Phase II cardiac rehabilitation participants (CRP) had better long-term risk factor control, self-rated perception of health and return to work rates than non-participants (NP) between 18 and 36 months post myocardial infarction (MI). It was a comparative study in a 550 bed hospital. Approximately half of both groups did not achieve a total cholesterol (TC) of 5.5 mmol/L or less. Compared with NP, CRP were significantly more likely to have a TC < = 6.5 mmol/L (7% vs. 28%) (p = 0.006). NP with TC > 6.5 mmol/L were significantly less likely to be on treatment (p = 0.002). CRP were more likely to regularly exercise than NP (79% vs. 61%) (p = 0.038). The success rate for blood pressure targets, return to work rates and self-rated perception of health were similar in both groups. In conclusion, CRP had better long-term control of some risk factors than NP. The study provides comparative longer-term patient outcomes after an Australian cardiac rehabilitation (CR) programme and forms the basis for further outcome measurement.     

A pilot randomized controlled trial to evaluate the benefit of the cardiac rehabilitation paradigm for the non-acute ischaemic stroke population

OBJECTIVE: To evaluate risk factor reduction and health-related quality of life following a 10-week cardiac rehabilitation programme in non-acute ischaemic stroke subjects. DESIGN: Single-blinded randomized control trial.SETTING: Outpatient rehabilitation.SUBJECTS: Forty-eight community-dwelling ischaemic stroke patients (38 independently mobile, 9 requiring assistance, 1 non-ambulatory) were randomly assigned to intervention or control groups by concealed allocation.INTERVENTION: The trial consisted of a 10-week schedule with measures taken at weeks 1 and 10. Both groups continued usual care (excluding aerobic exercise); intervention subjects attended 16 cycle ergometry sessions of aerobic-training intensity and two stress-management classes.MAIN OUTCOME MEASURES: Cardiac risk score (CRS); VO(2) (mL O(2)/kg per minute) and Borg Rate of Perceived Exertion (RPE) assessed during a standardized ergometry test; Hospital Anxiety and Depression Scale (HADS); Frenchay Activity Index; Fasting Lipid Profiles and Resting Blood Pressure.RESULTS: Group comparison with independent t-tests showed significantly greater improvement at follow-up by intervention subjects than controls in VO(2) (intervention 10.6 +/-1.6 to 12.0 +/- 2.2, control 11.1 +/-1.8 to 11.1 +/-1.9 t=4.734, P<0.001) and CRS (intervention 13.4 +/-10.1 to 12.4 +/-10.5, control 9.4 +/-6.7 to 15.0 +/-6.1 t=-2.537, P<0.05). RPE rating decreased in intervention subjects (13.4 +/-12.2 to 12.4 +/-2.0) and increased in controls (13.8 +/-1.8 to 14.4 +/-1.6); Mann-Whitney U (U = 173.5, P<0.05). Within-group comparison showed significant decrease in the HADS depression subscale in the intervention group alone (5.1 +/-3.4 to 3.0 +/-2.8) (Wilcoxon signed ranks test Z=-3.278, P<0.001).CONCLUSION: Preliminary findings suggest non-acute ischaemic stroke patients can improve their cardiovascular fitness and reduce their CRS with a cardiac rehabilitation programme. The intervention was associated with improvement in self-reported depression.     

糖尿病患者的康复治疗与评定

目的:观察综合康复治疗对社区2型糖尿病患者的疗效,探讨适合我国国情的社区糖尿病康复治疗模式。方法:对本市社区的2型糖尿病患者进行1年的综合康复治疗随访观察。结果:1年康复治疗后糖尿病患者的空腹血糖较1年前有显著降低,平均降低1.75mmol/L;三酰甘油和胆固醇水平降低明显,高密度胆固醇(HDL-ch)虽有所升高,但差别不显著;体重指数(BMI)、腰臀比(WHR)和血压康复治疗后都有显著下降。糖尿病患者每人每季度平均医疗费用较康复治疗前减少331元,费用下降幅度达41.2%。结论:在社区开展糖尿病患者的康复治疗可有效控制糖尿病患者血糖水平,降低糖尿病危险因素水平,增强患者的体质,这对预防糖尿病并发症的发生起到重要作用。     

综合干预疗法对择期经皮冠状动脉介入治疗患者术后康复的影响

目的探讨综合干预疗法对择期经皮冠状动脉介入治疗(PCI)患者术后康复的影响。方法选择择期PCI术患者100例,随机分为实验组与对照组各50例,实验组给予综合干预措施,包括健康教育、心理护理、全身放松疗法、康复锻炼等;对照组按护理常规护理。随访1年后进行效果评价,评定指标包括运动耐量评定、心绞痛控制情况、心脏事件发生率,将2组数据进行比较。结果实验组运动耐量较对照组高(P<0.01),心绞痛控制较对照组好(P<0.05),心脏事件发生率较对照组低(P<0.01)。结论综合干预疗法能明显提高患者运动耐量,有效控制心绞痛,降低心脏事件发生率,促进患者康复。     

系统心肺康复训练对冠心病病人运动耐力和生活质量的影响

[目的]探讨系统心肺康复训练对冠心病(CHD)病人运动耐力和生活质量的影响。[方法]按随机数字法将100例康复期CHD病人分为对照组和实验组各50例。对照组按照CHD治疗指南进行常规药物治疗及常规干预,而实验组在对照组基础上进行系统心肺康复训练。于干预前及干预后检测两组病人心功能各项指标,采用6min步行距离测试(6MWD)评价运动耐力,并采用健康调查量表(SF-36)评价病人生活质量。[结果]实验组病人干预后心功能各项指标及6MWD结果较干预前均有明显改善,且优于对照组,差异有统计学意义(P0.05);实验组干预后SF-36量表中各维度评分均高于对照组(P0.05)。[结论]系统心脏康复训练能明显改善康复期CHD病人心功能,提高病人的运动耐力,改善病人的生活质量。     

Improvement of worklife participation through vocationally oriented cardiac rehabilitation? Findings of a randomized control group study

PURPOSE: Although acute medical care of cardiac patients has clearly improved, vocational integration and vocational outlook of patients after MI and/or cardiac surgery did not improve substantially over the last few decades. This study is intended to evaluate a programme aimed at enhancing the return to work of cardiac rehabilitands. The programme is applied in addition to the usual rehabilitation programme and includes job-related interventions by the Social and Psychological Services as well as standardized application of the functional capacity evaluation (FCE). METHODS: This prospective randomized controlled trial is intended to evaluate the effects of the intervention programme on return to work. 150 patients who received the job-related programme (the intervention group) were compared to 150 patients who received the usual rehabilitation interventions (the control group). The study includes cardiac patients insured under the workers' pension insurance scheme and not older than age 56. Before coming to the clinic they had been unable to work, and problems with their returning to work were anticipated. Exclusion criteria were heart surgery less than three months ago, a cardiac capacity below 75 Watt, and reduced left-ventricular function. Follow-up data collection was performed 12 months after rehabilitation using a mail questionnaire. RESULTS: At the beginning of the rehabilitation programme, comparison of the groups showed no significant differences in biological, psychological and social variables. At 12-months follow-up, the data of 212 participants (70.6% of the participants) were available. Up to this time, 79.1% of the patients from the intervention group had returned to work, whereas in the control group only 62.9% had returned to work (chi(2) test, p<0.05). CONCLUSION: The results of the 12-months follow-up underline the positive effects of a job-oriented rehabilitation programme for patients' return to work.     

居家康复锻炼对乳腺癌患者术后淋巴水肿治疗的作用

目的探讨居家康复锻炼对乳腺癌患者术后淋巴水肿的治疗效果。 方法选取2019年10月至2021年4月期间在中南大学湘雅医学院附属海口医院肿瘤化疗科治疗的乳腺癌术后淋巴水肿患者80例,采用随机分组将患者平均分为2组,对照组保持通常的自我护理,锻炼组在对照组的基础上给予患者居家康复训练指导,并通过检测患者淋巴水肿手臂周径大小、患肢间体积差异、肩部关节运动范围、手臂肌肉力量、生活质量等方面评估康复锻炼对淋巴水肿治疗的作用。 结果2组患者在经过为期至少6周的干预康复后,与对照组相比,锻炼组的淋巴水肿手臂周径大小有所下降（P＜0.05）,手臂体积也随之变小（P＜0.05）;锻炼组的肩关节运动范围恢复情况相比对照组显著提高（P＜0.05）。此外,在锻炼组中患者的手臂屈曲肌、外展肌、外旋肌、内旋肌和水平内收肌的肌力水平都显著增强（P＜0.05）;最后通过乳腺癌患者生命质量测定量表（FACT-B表）对患者生活质量进行评估之后发现,锻炼组患者各方面的生活质量都有所改善。 结论康复锻炼对于乳腺癌患者术后淋巴水肿的治疗是安全有效的,在一定程度上,有益于淋巴水肿的康复和预后,这为居家康复锻炼治疗乳腺癌术后淋巴水肿治疗提供了参考依据。     

Circuit-Based Rehabilitation Improves Gait Endurance but Not Usual Walking Activity in Chronic Stroke: A Randomized Controlled Trial

Mudge S, Barber PA, Stott NS. Circuit-based rehabilitation improves gait endurance but not usual walking activity in chronic stroke: a randomized controlled trial.

Objective

To determine whether circuit-based rehabilitation would increase the amount and rate that individuals with stroke walk in their usual environments.

Design

Single-blind randomized controlled trial.

Setting

Rehabilitation clinic.

Participants

Sixty participants with a residual gait deficit at least 6 months after stroke originally enrolled in the study. Two withdrew in the initial phase, leaving 58 participants (median age, 71.5y; range, 39.0–89.0y) who were randomized to the 2 intervention groups.

Interventions

The exercise group had 12 sessions of clinic-based rehabilitation delivered in a circuit class designed to improve walking. The control group received a comparable duration of group social and educational classes.

Main Outcome Measures

Usual walking performance was assessed using the StepWatch Activity Monitor. Clinical tests were gait speed (timed 10-meter walk) and endurance (six-minute walk test [6MWT]), confidence (Activities-Based Confidence Scale), self-reported mobility (Rivermead Mobility Index [RMI]), and self-reported physical activity (Physical Activity and Disability Scale).

Results

Intention-to-treat analysis revealed that the exercise group showed a significantly greater distance for the 6MWT than the control group immediately after the intervention (P=.030) but that this effect was not retained 3 months later. There were no changes in the StepWatch measures of usual walking performance for either group. The exercise and control groups had significantly different gait speed (P=.038) and scores on the RMI (P=.025) at the 3-month follow-up. These differences represented a greater decline in the control group compared with the exercise group for both outcome measures.

Conclusions

Circuit-based rehabilitation leads to improvements in gait endurance but does not change the amount or rate of walking performance in usual environments. Clinical gains made by the exercise group were lost 3 months later. Future studies should consider whether rehabilitation needs to occur in usual environments to improve walking performance.     

心脏康复护理对冠心病PCI术后患者运动耐力及生活质量的影响

目的观察心脏康复护理在冠心病经皮冠状动脉介入(PCI)术后患者中的应用效果。方法将我院120例接受PCI术治疗的冠心病患者随机分为对照组(n=60,常规护理)和观察组(n=60,常规护理+心脏康复护理)。比较两组的干预效果。结果护理后,两组的无氧阈、峰值氧耗量、METs、最大运动功率、LVEF、CI及生理机能、躯体疼痛、社会功能、精神健康、精力评分均升高,LAVImax及Gensini评分均降低,且观察组优于对照组(P<0.05)。结论给予冠心病PCI术后患者心脏康复护理,有助于增强患者的运动耐力,改善其心脏功能及冠脉扩张能力,提升生活质量。     

Cardiac rehabilitation vs. home exercise after coronary artery bypass graft surgery: a comparison of heart rate recovery

OBJECTIVE: The autonomic dysfunction is known to adversely affect clinical outcome in patients with cardiovascular disease, and exercise training has been shown to modify the sympathovagal control of heart rate. The purposes of this study were to investigate the effect of cardiac rehabilitation on heart rate recovery in patients who received coronary artery bypass grafting (CABG) and compare the effect with that of a home-based exercise program. DESIGN: Fifty-four male patients having undergone CABG were randomly assigned to a cardiac rehabilitation exercise program (n = 18), a home-based exercise program (n = 18), and a control group (n = 18) for 12 wks to evaluate the differences in heart rate recovery among groups. RESULTS: Patients in the cardiac rehabilitation group had significant increases in heart rate recovery (19.1 +/- 6.2 vs. 14.0 +/- 5.4 beats/min, P = 0.022) compared with those in the control group. There were no significant differences in heart rate recovery between cardiac rehabilitation and home-based exercise groups (16.2 +/- 4.8 beats/min) or between home-based exercise and control groups. All three groups had significantly improved heart rate recovery compared with their baseline data (P < 0.001, < 0.001, and 0.007). CONCLUSION: Our results point out that a cardiac rehabilitation exercise program has a positive effect on heart rate recovery in patients having undergone CABG and is consistent with the autonomic improvement. Although the home-based exercise group did not reveal statistical significances over those in the control group, it had comparable efficacy to that demonstrated in the cardiac rehabilitation group.     

居家老年冠心病伴衰弱患者心肺运动康复效果评价

目的:观察心肺运动康复对居家老年冠心病伴衰弱患者心肺功能和生活质量的影响.方法:便利选取郑州市航海东路社区卫生服务中心的98例患者为研究对象,按照居住地分成两组,干预组与对照组各49例患者.对照组接受心肺康复健康教育,干预组接受心肺康复健康教育+心肺运动康复.比较干预前后两组患者衰弱得分、心肺功能和生活质量变化情况.结...     

吸气肌训练对经皮冠状动脉介入治疗术后患者的影响研究

目的探讨吸气肌训练对急性心肌梗死行经皮冠状动脉介入治疗术后患者心肺功能和运动能力的影响。方法将99例接受经皮冠状动脉介入治疗术的患者随机分为试验组(50例)和对照组(49例),试验组在7 d心脏康复运动程序的基础上增加吸气肌训练,对照组按照7 d心脏康复运动程序进行康复训练。采用最大吸气压和5次坐立试验在患者术后、干预后7 d、出院后4周时进行效果评价,采用6 min步行试验和心肺运动试验指标评价出院后4周时心肺功能改善程度。结果相比对照组,试验组在干预7 d、出院后4周时最大吸气压增加,5次坐立试验时间减少,重复测量方差分析结果显示,最大吸气压和5次坐立试验时间效应、组间效应、交互效应的比较,差异均具有统计学意义(P<0.05);出院后4周,试验组与对照组6 min步行试验、峰值耗氧量、氧摄取效率斜率的比较,差异具有统计学意义(P<0.05)。结论急性心肌梗死经皮冠状动脉介入治疗术后患者在常规心脏康复的同时,增加吸气肌训练可以提升患者的心肺功能。     

泽泻醇提取物对高血糖小鼠血液生化指标及胰岛素的影响

目的探讨泽泻醇提取物 (rhizoma alismatic extract,RAE)对正常动物及糖尿病动物的血糖、血脂、胰淀粉酶及胰岛素的影响 , 为泽泻用于治疗糖尿病及康复措施的介入提供理论依据. 方法选择雄性昆明种小鼠 29只,按随机抽签法分为 4组生理盐水组、格列齐特组、 RAE 10 g/kg组、 RAE 20 g/kg组.给小鼠尾静脉注射四氧嘧啶 90 mg/kg, 造成高血糖动物模型. 用自动生化分析仪测定血糖、血脂和胰淀粉酶. 放免法测定血清胰岛素.光镜下观察胰腺和胰岛的组织学变化. 结果RAE一次灌胃 20 g/kg,可使正常小鼠血糖明显降低 [对照组 (7.6± 1.1) mmol/L; RAE 20.0 g/kg组( 5.6± 1.5) mmol/L,(t=2.329,P< 0.01)]. 重复治疗 7 d, RAE 10,20 g/kg使四氧嘧啶小鼠血糖降低 [对照组 ,RAE 10 g/kg组, RAE 20 g/kg组血糖值分别为( 21.9± 2.8), (15.7± 5.7),( 9.3± 3.9) mmol/L( t=2.329,P< 0.05,t=3.118,P< 0.01) ].光镜下观察 四氧嘧啶小鼠胰岛数量减少 ,形态也明显缩小,而用 RAE 治疗动物的胰岛组织学未见明显变化. RAE 20 g/kg还使正常小鼠 [对照组, RAE 20 g/kg组的胰岛素水平分别为 (16.4± 4.0),(24.6± 8.1) μ U/L]及四氧嘧啶小鼠的胰岛素水平 [对照组, RAE 20 g/kg组的胰岛素水平分别为 (13.5± 4.3),(20.1± 9.1)μ U/L]增加. 结论RAE具有明显的降血糖和降血脂作用,并能保护胰岛组织免受损伤; RAE降低血糖作用与促进胰岛素的释放有关.     

异丙酚对血管紧张素Ⅱ诱导大鼠心肌成纤维细胞增殖的抑制作用及机制

目的探讨不同剂量异丙酚对血管紧张素Ⅱ(angiotensinⅡ, AngⅡ)诱导大鼠心肌成纤维细胞增殖的抑制作用和机制。方法 100只出生1~3 d的Wistar大鼠进行心肌成纤维细胞的分离与培养后,将细胞分为对照组(细胞培养基中加入1 mL含体积分数1%小牛血清的DMEM培养基)、AngⅡ组(细胞培养基中加入1 mL 1.0×10-7 mol/L AngⅡ),AngⅡ+异丙酚0.5 mmol/L组(细胞培养基中加入1 mL 1.0×10-7 mol/L AngⅡ+0.5 mmol/L异丙酚)、AngⅡ+异丙酚1.0 mmol/L组(细胞培养基中加入1 mL 1.0×10-7 mol/L AngⅡ+1.0 mmol/L异丙酚)、AngⅡ+异丙酚1.5 mmol/L组(细胞培养基中加入1 mL 1.0×10-7 mol/L AngⅡ+1.5 mmol/L异丙酚)。采用MTT法检测各组细胞生长抑制率,采用PCR法检测各组细胞α-SMA mRNA相对表达量,采用Western blot法检测各组细胞总蛋白含量。结果培养48 h,AngⅡ组细胞生长抑制率[(14.23±1.17)%]低于对照组[(23.32±2.15)%]、AngⅡ+异丙酚0.5 mmol/L组[(24.19±1.36)%]、AngⅡ+异丙酚1.0 mmol/L组[(29.25±2.30)%]及AngⅡ+异丙酚1.5 mmol/L组[(31.37±2.19)%](P<0.05),AngⅡ+异丙酚1.5 mmol/L组、AngⅡ+异丙酚1.0 mmol/L组、AngⅡ+异丙酚0.5 mmol/L组细胞生长抑制率依次降低(P<0.05);AngⅡ组心肌成纤维细胞α-SMA mRNA相对表达量(2.05±0.23)、总蛋白含量(225.06±18.66)均高于对照组(0.98±0.12、150.65±11.23)、AngⅡ+异丙酚0.5 mmol/L组(1.78±0.25、197.54±11.56)、AngⅡ+异丙酚1.0 mmol/L组(1.50±0.11、182.51±10.14)和AngⅡ+异丙酚1.5 mmol/L组(1.12±0.05、168.26±11.05)(P<0.05),AngⅡ+异丙酚0.5 mmol/L组、AngⅡ+异丙酚1.0 mmol/L组、AngⅡ+异丙酚1.5 mmol/L组及对照组心肌成纤维细胞α-SMA mRNA相对表达量及总蛋白含量依次降低(P<0.05)。结论异丙酚具有抑制AngⅡ诱导的大鼠心肌成纤维细胞增殖的作用,且随剂量增加,抗心肌成纤维的作用逐渐增强。     

The effect of cardiac rehabilitation on recovery of heart rate over one minute after exercise in patients with coronary artery bypass graft surgery

OBJECTIVE: To evaluate the effects of cardiac rehabilitation on the recovery of heart rate over 1 min after peak exercise of patients who received coronary artery bypass graft (CABG) surgery. DESIGN: Thirty subjects who received CABG surgery were randomly assigned to enter or not enter a cardiac rehabilitation exercise programme (cardiac rehabilitation n = 15; control group n = 15). SETTING: Outpatient cardiac rehabilitation centre in a national medical hospital. INTERVENTIONS: Patients assigned to the cardiac rehabilitation group received 36 sessions of the exercise programme, three times a week, with the intensity designed to achieve an individual 60-85% peak heart rate in cardiopulmonary exercise test. Patients assigned to the control group did not get further advice about a specific exercise programme. MAIN OUTCOME MEASURES: Resting heart rate and recovery of heart rate over 1 min after a peak exercise test at discharge and three months later were collected. The heart rates were analysed with computer-recorded electrocardiogram. RESULTS: At follow-up, the 15 patients in the cardiac rehabilitation group had a significantly lower resting heart rate (77.46+/-9.49 versus 92.31+/-10.18 bpm; p<0.001) and a significantly higher recovery of heart rate over 1 min (16.38+/-6.32 versus 11.38+4.81 bpm; p = 0.03) compared with the control group. There were also significant reductions in resting heart rates (cardiac rehabilitation p < 0.001; control p = 0.05) and improvements in recovery on heart rate over 1 min (cardiac rehabilitation p < 0.001; control p = 0.001) compared with baseline measurements in both the cardiac rehabilitation and control groups. CONCLUSION: Cardiac rehabilitation had a positive effect on the improvement of recovery on heart rate over 1 min in patients with coronary artery disease who received CABG surgery.     

信息-动机-行为模型在冠心病患者经皮冠状动脉介入术后心脏康复中的应用研究

目的 探讨信息-动机-行为(information-motivation-behavioral,IMB)模型在冠状动脉粥样硬化心脏病(冠心病)患者经皮冠状动脉介入治疗(percutaneous coronary intervention, PCI)术后心脏康复中的应用效果。方法 选取2021年1月-12月在心血管内科行PCI术的120例冠心病患者。按照随机数字表法将其分为对照组和研究组,各60例。对照组给予心脏康复健康教育,研究组在对照组基础上应用IMB模型进行个体化教育,比较2组干预3个月后的心脏康复信息需求和依从性。结果 干预3个月后,研究组心脏基础知识、营养知识、药物知识、心理压力、紧急与安全、风险因素评分及心脏康复依从性各条目评分均高于对照组(P＜0.05)。结论 应用IMB模型进行个体化教育,能改善冠心病PCI术后患者的心脏康复信息需求和依从性。     

三球式呼吸训练器主导的呼吸康复锻炼在放射性肺损伤患者中的疗效

目的:探讨三球式呼吸训练器为主导的呼吸康复锻炼对放射性肺损伤患者肺功能、不良情绪及生活质量的影响。方法:选取行胸部放射治疗的患者80例,随机分为观察组和对照组各40例。行三球式呼吸训练器为主导的呼吸康复锻炼的患者作为观察组,行常规呼吸康复锻炼的患者作为对照组,收集患者干预前后相关资料并统计分析。结果:与治疗前相比,干预30d和90d后,观察组组内呼吸频率、Hamilton焦虑量表(HAMA)评分随时间显著下降(均P<0.05),血氧饱和度、第1秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)、生理健康(PCS)及心理健康(MCS)评分随时间显著升高(均P<0.05),对照组除血氧饱和度治疗后较治疗前显著升高(P<0.05)外,其他指数组内比较无统计学差异。干预30d及90d后,观察组患者呼吸频率、HAMA评分、Hamilton抑郁量表(HAMD)评分、放射性肺炎程度均显著低于对照组(均P<0.05);血氧饱和度、FEV1/FVC、PCS及MCS评分均显著高于对照组(均P<0.05)。结论:三球式呼吸训练器主导的呼吸康复锻炼可以改善肿瘤患者的肺功能...     

The effects of exercise training on fatigue and dyspnea in heart failure

BACKGROUND: Physiological benefits of exercise training for heart failure (HF) patients have been demonstrated, however little is known about the effects of training on the symptoms of fatigue and dyspnea. AIM: The purpose of this study was to examine HF symptoms of fatigue and dyspnea in response to a 24-week exercise training intervention. METHODS: This pilot study was a randomized, two-group repeated measures design. Fifteen subjects in the intervention group completed a combination of aerobic and resistance training three times per week in a standard cardiac rehabilitation setting. The control group consisted of 6 subjects who were instructed not to begin any formal exercise program during the 24-week intervention. RESULTS: Subjects (19 males and 2 females) had a mean age of 66.2+/-10.2 years and mean ejection fraction (EF) of 28.4+/-7.4%. Non-parametric Friedman Analysis of Variance by Ranks showed the exercise group significantly decreased sensory fatigue (Piper Fatigue Scale) over time (chi(2)=6.49, p=.04) while the control group did not change (chi(2)=0.93, p=.63). Dyspnea showed a non-significant decrease over time for the exercise group (chi(2)=4.16, p=.13) while the control group showed a decrease from baseline to 12 weeks but an increase to above baseline values by week 24 (chi(2)=0.18, p=.91). CONCLUSION: These results provide support for the beneficial effects of exercise training on symptoms of fatigue and dyspnea in HF patients. Larger studies to evaluate symptom response to exercise are needed.