A controlled trial of hospital versus home-based exercise in cardiac patients
A controlled trial of hospital versus home-based exercise in cardiac patients
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DOI：
10.1097/00005768-200210000-00003
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发表时间：
2002-10-01
期刊：
影响因子：
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通讯作者：
McKelvie, R
中科院分区：
文献类型：
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作者：
Arthur, HM;Smith, KM;McKelvie, R
背景：大量从心脏康复的运动训练部分受益的患者由于通道问题而没有得到服务。以家庭为基础的运动训练可能是在机构环境中训练的一个潜在有用的替代方案。目的：本研究的目的是检查6个月的以医院为基础的运动训练与6个月的监测、以家庭为基础的运动训练在冠状动脉旁路移植术（CABG）术后患者的身体、生活质量和社会支持结果方面的益处。方法：在CABG术后35-49 d进行“直接到家”（Home; N = 120）和“直接到医院”（Hosp; N = 122）运动训练的随机对照试验。主要终点是峰值运动能力，在症状受限周期运动测试中通过峰值耗氧量(V)除以dotO(2)来测量。次要结局是健康相关的生活质量（由SF-36测量）和社会支持（由ISEL测量）。测量分别在基线和运动训练3个月和6个月后进行。结果：研究组在基线时具有相似的人口统计学和健康概况。运动训练6个月后，两组的峰值(V)over dotO(2)均有显著改善；36%为Hosp组(1222.1 +/- 269.0 mL(.)min(-1) ~ 1497.2 +/- 594.3 mL(.)min(-1)；P < 0.0001)和31% Home组(1260.3 +/- 306.5 mL(.)min（-1）至1433.4 +/- 589.7 mL(.)min(-1)；P < 0.05)。家庭组在3个月（36.2 +/- 4.5 vs 34.0 +/- 6.7; P < 0.0001）和6个月（36.0 +/- 4.9 vs 34.6 +/- 6.4; P = 0.05）时报告的总社会支持高于寄宿组。与Hosp患者相比，Home组在6个月的健康相关生活质量（身体）方面表现出更大的改善（51.2 +/- 6.4 vs 48.6 +/- 7.1; P = 0.004）。结论：这项研究表明，低风险的CABG手术患者可以通过监控的、基于家庭的锻炼计划比基于机构的计划更好地服务。
Background: Large numbers of patients who stand to benefit from the exercise training component of cardiac rehabilitation are not being served due to access issues. Home-based exercise training may be a potentially useful alternative to training in institutional environments. Purpose: The purpose of this study was to examine the benefit of 6 months of hospital-based exercise training versus 6 months of monitored, home-based exercise training with respect to physical, quality of life, and social support outcomes in patients after coronary artery bypass graft (CABG) surgery. Methods: Randomized controlled trial of "direct-to-home" (Home; N = 120) versus "direct-to-hospital" (Hosp; N = 122) exercise training, 35-49 d post CABG surgery. The primary outcome was peak exercise capacity, measured by peak oxygen consumption ((V)over dotO(2)) on a symptom-limited cycle ergometer exercise test. Secondary outcomes were health-related quality of life (measured by the SF-36) and social support (measured by the ISEL). Measurements were taken at baseline and after 3 and 6 months of exercise training. Results: The study groups had similar demographic and health profiles at baseline. Peak (V)over dotO(2) improved significantly in both groups after 6 months of exercise training; 36% in the Hosp group (1222.1 +/- 269.0 mL(.)min(-1) to 1497.2 +/- 594.3 mL(.)min(-1); P < 0.0001) and 31% in the Home group (1260.3 +/- 306.5 mL(.)min(-1) to 1433.4 +/- 589.7 mL(.)min(-1); P < 0.05). The Home group reported greater total social support than the Hosp group at 3 (36.2 +/- 4.5 vs 34.0 +/- 6.7; P < 0.0001) and 6 months (36.0 +/- 4.9 vs 34.6 +/- 6.4; P = 0.05). The Home group demonstrated a greater improvement in health-related quality of life (physical) by 6 months in comparison to the Hosp patients (51.2 +/- 6.4 vs 48.6 +/- 7.1; P = 0.004). Conclusion: This study suggests that low-risk CABG surgery patients may be served as well or better with a monitored, home-based exercise program than with an institution-based program.