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病毒性心肌炎患者運動訓練成效-病例研究

The Effect of Exercise Training for a Patient with Acute Viral Myocarditis-A Case Study

摘要


背景與目的:病毒性心肌炎不只常發生在心臟移植患者,一般人也可能會發生。除了臨床表徵有個人差異外,患者的預後也呈現很大的差異,從完全康復到猝死都曾被報導過。還有些患者,復原後可能會繼續演變成擴張性心肌病變(dilated cardiac myopathy),文獻追蹤尚未發現有關於此類患者復原後運動能力的探討,本個案報告探討運動治療對一位病毒性心肌炎患者的治療成效。方法:本文個案是一位41歲婦女,先前健康狀況良好,二月時出現類似感冒的症状,後來發生呼吸困難與全身虛弱而送院治療,經過後續處理與病理檢查確定診斷為急性病毒性心肌炎,並有左腳垂足現象。住院期間接受物理治療包括有氧訓練;功能生訓練;姿勢矯正與節省體力之衛教;神經肌肉電刺激。出院後經門診繼續接受心肺功能運動訓練,一週三次,為期約四個月,同時執行居家運動。結果:六分鐘行走測試有明顯改善,行走距離增加了246公尺,心電圖中心律不整現象降低,心室過早收縮次數也顯著減少,腳踏車運動測試結果顯示最大攝氧量從464毫升/分鐘進步到1030毫升/分鐘,相當於5.4 METs的運動程度,日常生活功能也從依賴他人到重回工作職場。結論:由此個案,我們發現經過合宜的運動訓練,的確可以改善此類患者的運動能力與生活功能,甚至是生活品質滿意度。

並列摘要


Purposes: In this case study, we described a 41-year-old female patient with acute onset of viral myocarditis. Methods: Physical therapy program started one month post admission when her medical condition was stable. It included aerobic exercise, functional training, posture correction, and electric stimulation. Results: After physical therapy, she showed improvement in exercise capacity and daily function. Her maximal VO2 increased from 464ml/min to 1030 ml/min and maximal METs from 2.3 METs to 5.4 METs. She was able to return to work seven months after the onset. Conclusion: Exercise training has improved the exercise capacity and quality of life of this patient.

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