The cardiac model of rehabilitation for reducing cardiovascular risk factors post transient ischaemic attack and stroke: a randomized controlled trial
The cardiac model of rehabilitation for reducing cardiovascular risk factors post transient ischaemic attack and stroke: a randomized controlled trial
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DOI：
10.1177/0269215513502211
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发表时间：
2014-04-01
影响因子：
3
通讯作者：
Conway, Joy
中科院分区：
文献类型：
--
作者：
Kirk, Hayden;Kersten, Paula;Conway, Joy
目的：评价国民健康服务标准心脏康复方案对降低轻度卒中和短暂性缺血性发作后患者危险因素的可行性和有效性。设计：单盲随机对照试验。设置：心脏康复课程。主题:24例。干预：所有参与者均接受标准治疗。此外，干预组进行了为期八周的心脏康复计划，包括每周锻炼和教育课程。结局指标：心血管疾病风险评分；脂质;静息血压；c反应蛋白（用高灵敏度测定法测定）和纤维蛋白原水平；血糖;肥胖;身体活动水平；主观健康状况（SF-36）；医院焦虑抑郁量表。结果：组间比较独立t检验显示，干预组受试者心血管疾病危险评分较标准治疗有显著提高（干预25.7 +/- 22.8 ~ 23.15 +/- 18.3，对照组25.03 +/- 15.4 ~ 27.12 +/- 16.1,t = -1.81, P < 0.05）。也有显著的改善活动水平(干预组的干预9.41 + / - 7.7到8.08 + / - 5.7,控制14.50 + / - 5.5到9.83 + / - 6.6,t = -2.00, P < 0.05)和SF-36域的物理功能(干预70 + / - 24.6到75.4 + / - 11.1,控制90.00 + / - 12.4到83.16 + / - 17.3,t = -2.72, P < 0.05)和心理健康干预84 + / - 40到92 + / - 40,控制88.00 + / - 60到84 + / - 44,z = -2.06, P < 0.05)。结论：标准的心脏康复方案是降低轻度脑卒中和短暂性缺血发作后患者未来心血管事件风险的一种可行有效的手段。
Objective:To evaluate the feasibility and effectiveness of a standard National Health Service cardiac rehabilitation programme on risk factor reduction for patients after a minor stroke and transient ischaemic attack.Design:Single-blind randomized controlled trial.Setting:Cardiac rehabilitation classes.Subjects:Twenty-four patients.Intervention:All participants received standard care. In addition, the intervention group undertook an eight-week cardiac rehabilitation programme consisting of weekly exercise and education classes.Outcome measures:Cardiovascular disease risk score; lipid profiles; resting blood pressure; C-reactive protein (measured with a high sensitive assay) and fibrinogen levels; blood glucose; obesity; physical activity levels; subjective health status (SF-36); Hospital Anxiety and Depression Scale.Results:Group comparison with independent t-tests showed a significantly greater improvement in the cardiovascular disease risk score for participants in the intervention group compared to standard care (intervention 25.7 +/- 22.8 to 23.15 +/- 18.3, control 25.03 +/- 15.4 to 27.12 +/- 16.1, t = -1.81, P < 0.05). There were also significant improvements for the intervention group in activity levels (intervention 9.41 +/- 7.7 to 8.08 +/- 5.7, control 14.50 +/- 5.5 to 9.83 +/- 6.6, t = -2.00, P < 0.05) and the SF-36 domains of physical functioning (intervention 70 +/- 24.6 to 75.4 +/- 11.1, control 90.00 +/- 12.4 to 83.16 +/- 17.3, t = -2.72, P < 0.05) and mental health (intervention 84 +/- 40 to 92 +/- 40, control 88.00 +/- 60 to 84 +/- 44, z = -2.06, P < 0.05).Conclusion:The results suggest that standard cardiac rehabilitation programmes are a feasible and effective means of reducing the risk of future cardiovascular events for patients after minor stroke and transient ischaemic attack.