Cardiac Rehabilitation

心脏康复
  • 文章类型: Journal Article
    运动恐惧症表示患者对身体活动或运动的过度和非理性的担忧,源于对疼痛损伤或再损伤的敏感性。心脏康复在心血管疾病患者的二级预防范围中起着关键作用,运动构成了这个方案的基石。然而,运动恐惧症的出现带来了巨大的挑战,降低患者对心脏康复方案的依从性,尤其是那些患有慢性心力衰竭的人。为了支持该队列中基于运动的康复计划,必须彻底理解诱发运动恐惧症的多方面因素。这篇综述试图描述慢性心力衰竭患者的运动恐惧症触发因素的流行证据和患病率。同时为未来的探索确定研究空白。
    采用范围审查方法,我们的调查收集了来自不同学术数据库的数据,包括Embase,PubMed,Scopus,CINAHL,WebofScience,Medline,Sinomed,CNKI,王凡,和VIP。
    经过全面评估,最终纳入9项符合纳入标准的研究。
    我们的研究结果强调了慢性心力衰竭患者运动恐惧症的明显患病率,主要受社会人口因素影响,心理和认知因素,疾病和治疗因素,以及生活方式和行为。有了这些见解,未来的干预措施可以量身定做,以减轻运动恐惧症的水平,在慢性心力衰竭患者中加强参与以运动为中心的心脏康复工作。
    UNASSIGNED: Kinesiophobia denotes an excessive and irrational apprehension towards physical activity or exercise among patients, stemming from a perception of susceptibility to painful injury or re-injury. Cardiac rehabilitation stands pivotal in the secondary prevention spectrum for individuals with cardiovascular ailments, with exercise constituting a cornerstone of this regimen. However, the emergence of kinesiophobia poses a formidable challenge, diminishing patient adherence to cardiac rehabilitation protocols, particularly among those grappling with chronic heart failure. To bolster exercise-based rehabilitation initiatives in this cohort, a thorough comprehension of the multifaceted factors precipitating kinesiophobia is imperative. This review endeavors to delineate prevailing evidence and prevalence concerning kinesiophobia triggers in chronic heart failure patients, while pinpointing research lacunae for future exploration.
    UNASSIGNED: Employing a scoping review methodology, our investigation culled data from diverse scholarly databases, including Embase, PubMed, Scopus, CINAHL, Web of Science, Medline, Sinomed, CNKI, Wangfan, and VIP.
    UNASSIGNED: After thorough evaluation, 9 studies that met the inclusion criteria were ultimately incorporated.
    UNASSIGNED: Our findings underscore a notable prevalence of kinesiophobia in chronic heart failure patients, predominantly influenced by socio-demographic factors, psychological and cognitive factors, disease and treatment factors, as well as lifestyle and behavior. Armed with these insights, future interventions can be tailored to mitigate kinesiophobia levels, fostering enhanced engagement in exercise-centric cardiac rehabilitation endeavors among patients grappling with chronic heart failure.
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  • 文章类型: Journal Article
    本研究旨在定量评估压力,与冠状病毒病-19(COVID-19)相关的焦虑和强迫性思维,并对COVID-19大流行期间接受心脏康复(CR)的急性心肌梗死(AMI)患者的认知进行了定性评估。
    我们在2个中心的CR患者中使用了混合方法设计,这些中心在COVID-19大流行期间提供了不间断的服务。冠状病毒焦虑量表(CAS),对COVID-19量表(OCS)的痴迷,COVID-19应力量表(CSS),医院焦虑和抑郁量表(HADS),和面对面访谈(先验问题和调查相结合)用于评估患者在大流行期间对COVID-19和医疗保健服务的体验和看法。
    总共,109名患者(平均年龄59±10,20%女性)被纳入定量部分,其中30名我们进行了面对面访谈。大约四分之一的患者达到了焦虑和抑郁的HADS阈值,而CAS和OCS结果显示,与冠状病毒相关的思维障碍(3%)和焦虑(2%)的可能性极低。CSS表明,最普遍的担忧与COVID-19疫苗的安全性(60%)和对被感染的恐惧(60%)有关。在采访中,患者认为CR和医疗保健提供者是安全的,值得信赖,并有足够的支持来避免或管理COVID-19相关的健康风险。
    总的来说,患者报告AMI比COVID-19大流行对生活的影响更大.与COVID-19相关的压力和焦虑相对较低,并且主要与传染病的一般观点有关。就原发疾病和COVID-19而言,CR被认为是安全可信的。
    这项混合方法研究包括109名急性心肌梗死患者,他们在COVID-19期间接受了心脏康复治疗,重点关注他们在大流行期间对COVID-19和医疗服务的体验和看法。-报告急性心肌梗死的患者比COVID-19大流行对生活的影响更大。-与COVID-19相关的担忧主要与传染病的一般观点有关(疫苗安全性,害怕被感染),而在COVID-19期间,心脏康复被认为是安全和值得信赖的环境。
    UNASSIGNED: This study aimed to quantitatively assess stress, anxiety and obsessive thinking related to coronavirus disease-19 (COVID-19) and qualitatively appraise perceptions in patients after acute myocardial infarction (AMI) undergoing cardiac rehabilitation (CR) during the COVID-19 pandemic.
    UNASSIGNED: We used mixed-methods design in patients referred for CR in 2 centres which delivered uninterrupted service during COVID-19 pandemic. Coronavirus Anxiety Scale (CAS), Obsession with COVID-19 Scale (OCS), COVID-19 Stress Scale (CSS), Hospital Anxiety and Depression Scale (HADS), and in-person interviews (combination of a priori questions and probing) were used to evaluate patient experience and perceptions with COVID-19 and the healthcare services during pandemic.
    UNASSIGNED: In total, 109 patients (mean age 59 ± 10, 20% women) were included in quantitative part and in 30 of them we conducted the in-person interviews. About a quarter of patients met HADS threshold for anxiety and depression while CAS and OCS results demonstrated extremely low possibility of coronavirus related dysfunctional thinking (3%) and anxiety (2%). The CSS indicated the most prevalent concerns were related to COVID-19 vaccines safety (60%) and fear of getting infected (60%). During interviews, patients perceived the CR as well as health care providers as safe, trustworthy and with enough support to avoid or manage COVID-19 related health risks.
    UNASSIGNED: Overall, patients reported AMI affected their lives more than the COVID-19 pandemic. The COVID-19 related stress and anxiety were relatively low and mostly related to general views of infectious disease. CR was perceived safe and trustworthy in terms of primary disease and COVID-19.
    UNASSIGNED: This mixed-method study included 109 patients with acute myocardial infarction who underwent cardiac rehabilitation during the COVID-19 and focused on their experience and perceptions with COVID-19 and the healthcare services during pandemic.-Patients reported acute myocardial infarction affected their lives more than the COVID-19 pandemic.-The COVID-19 related concerns were mostly related to general views of infectious disease (vaccine safety, fear of getting infected) whilst cardiac rehabilitation was perceived safe and trustworthy environment during COVID-19.
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  • 文章类型: Journal Article
    近年来,通过提高中国公众的认识,中国在心脏康复领域取得了重大进展,学者,医院,和政府关于心脏康复/心血管疾病二级预防的实质性好处。心脏康复包括心血管疾病的综合干预策略,整合多个学科,比如心脏病学,运动医学,康复医学,营养学,心理学,行为医学,和预防医学。规范化、系统化的心脏康复治疗可以帮助心血管疾病患者恢复身心健康,降低心血管疾病复发和死亡的风险。本文概述了历史发展,现有的临床实践模式,以及心脏康复的最新临床研究结果,重点介绍了目前我国心脏康复的临床模式和临床研究成果。它旨在为国际同行提供一个系统的视角来了解和理解中国的心脏康复,以及推进这一领域的客观分析和未来前景。
    In recent years, significant progress has been made in China in the field of cardiac rehabilitation by raising awareness among the Chinese public, scholars, hospitals, and government regarding the substantial benefits of cardiac rehabilitation/secondary prevention of cardiovascular diseases. Cardiac rehabilitation encompasses a comprehensive intervention strategy for cardiovascular diseases, integrating multiple disciplines, such as cardiology, sports medicine, rehabilitation medicine, nutriology, psychology, behavioral medicine, and preventive medicine. Standardized and systematic cardiac rehabilitation therapy can help patients with cardiovascular diseases restore their physical and mental health and reduce the risk of recurrences and deaths from cardiovascular diseases. This article provides an overview of the historical development, existing clinical practice modes, and the latest clinical research findings on cardiac rehabilitation, focusing on the current clinical modes and clinical research results of cardiac rehabilitation in China. It aims to offer a systematic perspective for international peers to know and understand cardiac rehabilitation in China, along with an objective analysis and future prospects for advancing this field.
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  • 文章类型: Journal Article
    目的:评估Ekblom-Bak周期测力计测试在接受心脏康复治疗的心血管疾病患者中的有效性。
    方法:将来自Ekblom-Bak测试的估计峰值耗氧量与来自跑步机心肺运动测试的直接测量峰值耗氧量进行比较。患者先完成心肺运动试验,休息24小时后进行Ekblom-Bak测试。皮尔逊相关系数(r)用于建立估计和测量的峰值耗氧量之间的相关性,和具有一致性限制的Bland-Altman地块用于确定2个测试之间的偏差。
    结果:26例患者被纳入最终分析。Ekblom-Bak检验显著高估了峰值耗氧量。估计和测量的峰值耗氧量之间的一致性为:偏差=4.3mL/kg/min(一致性极限:-4.0-12.6mL/kg/min)。
    结论:Ekblom-Bak测试高估了峰值耗氧量,以至于无法准确评估心血管疾病患者的心肺适应性。因此,心肺运动测试仍然是首选测试。
    OBJECTIVE: To assess the validity of the Ekblom-Bak cycle ergometer test in patients with cardiovascular disease admitted to cardiac rehabilitation.
    METHODS: Estimated peak oxygen consumption from the Ekblom-Bak test was compared with directly measured peak oxygen consumption from a treadmill cardiopulmonary exercise test. Patients completed the cardiopulmonary exercise test first, followed by the Ekblom-Bak test after 24 h rest. Pearson\'s correlation coefficient (r) was used to establish the correlation between estimated and measured peak oxygen consumption, and Bland-Altman plots with limits of agreement were used to determine the bias between the 2 tests.
    RESULTS: Twenty-six patients were included in the final analysis. The Ekblom-Bak test significantly overestimated peak oxygen consumption. Agreement between estimated and measured peak oxygen consumption was: bias = 4.3 mL/kg/min (limits of agreement: -4.0-12.6 mL/kg/min).
    CONCLUSIONS: The Ekblom-Bak test overestimated peak oxygen consumption to such an extent that it cannot accurately assess cardiorespiratory fitness in patients with cardiovascular disease. Thus, the cardiopulmonary exercise test remains the test of choice.
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  • 文章类型: Journal Article
    目的:这项研究评估了特征,管理,和吞咽困难康复的结果在一个超老年社会的心血管疾病患者,强调社区医院设置综合管理策略的必要性。它旨在揭示将吞咽困难康复与心脏护理结合在患者管理中的益处的宝贵见解。
    方法:我们对2019年1月至2021年12月新泻医院收治的年龄≥65岁的CVD患者进行了回顾性研究。我们专注于需要吞咽困难康复的患者,并评估这些干预措施对康复的影响。
    结果:该研究包括732名参与者,平均年龄为86.0±7.8岁,其中41.9%为男性。大约55.1%需要吞咽困难康复。吞咽困难康复显着改善了接受康复的患者的口服热量摄入和BMI,这些改善与不需要吞咽困难康复的患者相当。出院时观察到患者的ADL显着增强。需要吞咽困难康复的患者的住院时间也更长,并且更有可能出院到护理机构。
    结论:吞咽困难常见于老年CVD患者,和吞咽困难康复积极影响营养状况的维持,并帮助患者在出院时实现ADL独立性。这项研究强调了将吞咽困难康复纳入心血管疾病老年患者普通心脏康复计划以改善其生活质量的重要性。
    OBJECTIVE: This study assessed the characteristics, management, and outcomes of dysphagia rehabilitation in older patients with CVD in a super-aged society, highlighting the need for comprehensive management strategies in community hospital settings. It aimed to uncover valuable insights into the benefits of integrating dysphagia rehabilitation with cardiac care in patient management.
    METHODS: We conducted a retrospective review of patients with CVD aged ≥ 65 years who were admitted to Niigata Minami Hospital between January 2019 and December 2021. We focused on patients requiring dysphagia rehabilitation and assessing the effects of these interventions on recovery.
    RESULTS: The study included 732 participants with an average age of 86.0 ± 7.8 years, of whom 41.9% were male. Approximately 55.1% required dysphagia rehabilitation. Dysphagia rehabilitation significantly improved oral caloric intake and BMI in patients who underwent rehabilitation, and these improvements were comparable to those in patients who did not require dysphagia rehabilitation. Significant enhancement in the ADL of patients was observed at discharge. Patients who required dysphagia rehabilitation also had longer hospital stays and were more likely to be discharged to nursing facilities.
    CONCLUSIONS: Dysphagia is common in older patients with CVD, and dysphagia rehabilitation positively affects the maintenance of nutritional status and helps patients achieve ADL independence at discharge. This study highlights the importance of integrating dysphagia rehabilitation into ordinary cardiac rehabilitation programs for older patients with CVD to improve their QOL.
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  • 文章类型: Journal Article
    心脏康复是心血管疾病管理的核心组成部分。东方走廊医学工程-心脏康复是在线心脏康复运动的数字健康平台。我们进行了一项混合方法试点试验,以评估东部走廊医学工程-心脏康复。
    该研究试图检查客观测量的结果与参与者对参与心脏康复锻炼计划所获得的益处和改善的看法之间的差异。
    17名参与者(14名男性,3名女性;69.5±7.3岁)参加,并被分配到2组中的1组;在线运动组(n=8),或当面锻炼(n=9)组。由于COVID-19大流行,采取了务实的小组分配方法。在基线时评估客观结果,并在干预期后重复评估。主要结果是6分钟步行测试距离。除了临床结果测量,我们对参与者进行了定性访谈。
    只有5名参与者在6分钟步行测试距离方面表现出临床意义的改善,遵循为期8周的锻炼计划。定性访谈中出现的主要主题是心脏康复锻炼计划的重要收益。尽管缺乏可测量的物理变化,参与者自我定义了他们所重视的一系列益处,并直接归因于参与心脏康复锻炼计划.
    这项研究的结果可能为进一步研究基于社区的心脏康复运动提供了一个有用的起点,并且还强调了采用混合方法方法的好处,该方法既考虑了测量的客观结果,也考虑了从参与者那里获得的主观报告。
    UNASSIGNED: Cardiac rehabilitation is a core component of cardiovascular disease management. Eastern Corridor Medical Engineering-Cardiac Rehabilitation is a digital health platform for online cardiac rehabilitation exercise. We conducted a mixed methods pilot trial to evaluate Eastern Corridor Medical Engineering-Cardiac Rehabilitation.
    UNASSIGNED: The study sought to examine the difference between objectively measured outcomes and participant perceptions of benefits and improvements gained from participation in a cardiac rehabilitation exercise program.
    UNASSIGNED: Seventeen participants (14 male, 3 female; 69.5 ± 7.3 years of age) took part and were allocated to 1 of 2 groups; an online exercise group (n = 8), or an in-person exercise (n = 9) group. Due to the COVID-19 pandemic, a pragmatic approach to group allocation was adopted. Objective outcomes were assessed at baseline and repeated following the intervention period, with the primary outcome being 6-minute walk test distance. In addition to clinical outcome measurements, we undertook qualitative interviews with participants.
    UNASSIGNED: Only 5 participants demonstrated a clinically meaningful improvement in 6-minute walk test distance, following the 8-week exercise program. The main theme emerging from the qualitative interviews was the valued benefits of the cardiac rehabilitation exercise program. Despite the lack of measurable physical change, participants self-defined a range of benefits they valued and attributed directly to participation in the cardiac rehabilitation exercise program.
    UNASSIGNED: The findings from this study may offer a useful starting point for further study of community-based cardiac rehabilitation exercise and also highlight the benefit of adopting a mixed methods approach that considers both the objective outcomes measured as well as the subjective reports obtained from participants.
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  • 文章类型: Journal Article
    意大利心血管康复与预防协会(ITACARE-P)和意大利医院内科医师协会联合会(FADOI)发布了联合立场文件,以指导从内科(IM)病房出院的心血管患者转诊到心脏康复(CR)设施。该文件为适当性(即合格诊断)和优先标准提供了理由和操作建议,以克服CR计划的潜在需求和有效供应之间的不匹配。如果由于后勤障碍而无法转诊,该文件建议采用CR的最佳替代方案来减少残疾,预后较好,和生活质量的提高。联合立场文件还旨在促进将IM视为CR的潜在利益相关者。
    The Italian Association for Cardiovascular Rehabilitation and Prevention (ITACARE-P) and the Italian Federation of Associations of Hospital Doctors on Internal Medicine (FADOI) released a joint position paper to guide referrals of cardiovascular patients discharged from Internal Medicine (IM) wards to Cardiac Rehabilitation (CR) facilities. The document provides rationale and operative recommendations for appropriateness (i.e. qualifying diagnoses) and priority criteria to overcome the mismatch between potential demand and effective supply of CR programmes. In case of no-referral due to logistic barriers, the document recommends the adoption of best alternatives to CR for disability reduction, better prognosis, and improvement of quality of life. The joint position paper is also aimed to promote the consideration of IM as a potential stakeholder of CR.
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  • 文章类型: Journal Article
    女性从心脏康复(CR)中获得的益处与男性相似或更大。然而,他们参与的可能性较小。需要对心血管疾病采取综合和对性别问题有敏感认识的方法,以提高对患有不同心血管问题的妇女一生的护理质量和经验。意大利心血管康复和预防联盟(ITACARE-P)致力于制定针对性别的CR方法,以更有效地满足男女的需求。
    Women receive similar or greater benefits than men from Cardiac Rehabilitation (CR). However, they are less likely to participate. An integrated and gender-sensitive approach to cardiovascular disease is required to enhance the quality and experience of care for women with different cardiovascular issues throughout their lives. The Italian Alliance for Cardiovascular Rehabilitation and Prevention (ITACARE-P) is committed to developing a gender-specific approach to CR that will more effectively meet the needs of both women and men.
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  • 文章类型: Journal Article
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