Aerobic Exercise Effects on Quality of Life and Psychological Distress After an Implantable Cardioverter Defibrillator
Aerobic Exercise Effects on Quality of Life and Psychological Distress After an Implantable Cardioverter Defibrillator
复制标题
DOI：
10.1097/hcr.0000000000000444
复制
发表时间：
2020-03-01
影响因子：
3.8
通讯作者：
Glenny, Robb W.
中科院分区：
文献类型：
--
作者：
Dougherty, Cynthia M.;Burr, Robert L.;Glenny, Robb W.
目的：本研究的目的是评估ICD试验后运动抗心律失常效果的生活质量（QOL）、心理功能和自我效能结局。方法：在ICD试验后运动的抗心律失常作用中，160名患者（124名男性和36名女性）使用植入式心律转复除颤器进行初级（43%）或二级（57%）预防，随机分为运动（EX, n = 84）或常规护理（UC, n = 76）。试验包括8周的5天/周的1小时/天的家庭步行，随后16周的150分钟/周的维持性家庭步行。依从性通过运动记录、门诊HR记录和电话来确定。在基线、8周和24周对QOL进行评估：患者关注点评估和简表-36；焦虑：状态-特质焦虑量表；抑郁症：医师健康问卷-抑郁症；自我效能：行走量表的自我效能。结果：参与者平均年龄55 +/- 12岁，射血分数= 40.6 +/- 15.7%。8周时，EX显著降低抑郁严重程度（EX: 1.33 +/- 0.64; UC: 1.51 +/- 0.86, P = 0.05），改善自我效能（EX: 7.65 +/- 1.97; UC: 6.85 +/- 2.40, P = 0.05）。24周时无显著影响。与不坚持锻炼的人相比，坚持锻炼的人在第8周和第24周的生活质量、心理和自我效能方面都有显著改善。没有与运动相关的植入式心律转复除颤器电击。结论：EX对8周抑郁和自我效能感有显著影响，对生活质量无影响。坚持锻炼者在结果上比不坚持锻炼者或接受UC的锻炼者有显著的改善。
Purpose:The purpose of this study was to evaluate quality of life (QOL), psychological function, and self-efficacy outcomes in the Anti-Arrhythmic Effects of Exercise After an ICD Trial.Methods:In the Anti-Arrhythmic Effects of Exercise After an ICD Trial, 160 patients (124 men and 36 women) who had an implantable cardioverter defibrillator for primary (43%) or secondary (57%) prevention were randomized to exercise (EX, n = 84) or usual care (UC, n = 76). The EX consisted of 8 wk of home walking 1 hr/d 5 d/wk, followed by 16 wk of maintenance home walking for 150 min/wk. Adherence was determined from exercise logs, ambulatory HR recordings, and phone calls. Assessments were conducted at baseline, 8, and 24 wk for QOL: Patient Concerns Assessment and Short Form-36; anxiety: State Trait Anxiety Inventory; depression: Physician Health Questionnaire-Depression; and self-efficacy: Self-Efficacy for Walking Scale.Results:Participants averaged 55 +/- 12 yr of age with ejection fraction = 40.6 +/- 15.7%. The EX significantly decreased depression severity (EX: 1.33 +/- 0.64; UC: 1.51 +/- 0.86, P = .05) and improved self-efficacy (EX: 7.65 +/- 1.97; UC: 6.85 +/- 2.40, P = .05) at 8 wk. There were no significant effects at 24 wk. Adherent exercisers had significant improvements in QOL, psychological, and self-efficacy outcomes at 8 and 24 wk compared with those who were nonadherent. There were no implantable cardioverter defibrillator shocks associated with exercise.Conclusions:The EX conferred significant effects on depression and self-efficacy at 8 wk, without effects on QOL. Adherent exercisers experienced significant improvements in outcomes over those who were nonadherent or received UC.