Program participation, exercise adherence, cardiovascular outcomes, and program cost of traditional versus modified cardiac rehabilitation
Program participation, exercise adherence, cardiovascular outcomes, and program cost of traditional versus modified cardiac rehabilitation
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DOI：
10.1016/s0002-9149(00)00822-5
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发表时间：
2000-07-01
影响因子：
2.8
通讯作者：
VanderLaan, RL
中科院分区：
文献类型：
--
作者：
Carlson, JJ;Johnson, JA;VanderLaan, RL
心脏康复的传统方案（TP）的常见问题包括次优的计划参与，独立运动的便利性差，使用昂贵的连续心电图（ECG）监测，以及缺乏保险报销。为了解决这些问题，降低成本的修改协议（MP），以促进独立行使。将80例低至中度风险心脏病患者随机分为TP组（n = 42）或MP组（n = 38），并在6个月内对项目参与、运动依从性、心血管结局和项目成本进行比较。在第1个月期间，患者遵循相同的方案，包括每周3次ECG监测的运动，并鼓励达到每周大于或等于5次30分钟的运动。在第5周，TP继续使用基于机构的方案，包括每周3次运动，持续6个月，并在最初3个月使用ECG监测。MP在第5周停止ECG监测，并逐渐停用场外运动方案，并辅以教育支持会议和电话随访。与TP患者相比，MP患者在6个月内的非现场运动率更高（p = 0.05），在最后3个月内的总运动（现场+非现场）率更高（p = 0.03）。此外，MP患者不太可能脱落（p = 0.05）。两种方案均促进了最大摄氧量的可比改善（p
Common concerns with the traditional protocol (TP) for cardiac rehabilitation include suboptimal program participation, poor facilitation of independent exercise, the use of costly continuous electrocardiographic (ECG) monitoring, and lack of insurance reimbursement. To address these concerns, a reduced cost-modified protocol (MP) was developed to promote independent exercise. Eighty low- to moderate-risk cardiac patients were randomized to a TP (n = 42) or a MP (n = 38) and were compared over 6 months on program participation, exercise adherence, cardiovascular outcomes, and program costs. During month 1, patients followed identical regimens, including 3 ECG-monitored exercise sessions/ week, with encouragement to achieve greater than or equal to 5 thirty-minute sessions/week. In week 5, the TP continued with a facility-based regimen including 3 exercise sessions/week for 6 months and used ECG monitoring the initial 3 months, The MP discontinued ECG monitoring in week 5 and were gradually weaned to an off-site exercise regimen that was complemented with educational support meetings and telephone follow-up. Compared with TP patients, MP patients had higher rates of off-site exercise over 6 months (p = 0.05), and total exercise (on site + off site) during the final 3 months (p = 0.03). Also, MP patients were less likely to drop out (p = 0.05). Both protocols promoted comparable improvements in maximal oxygen uptake (p