心臟衰竭病人居家運動復健之成效—系統性文獻回顧與統合分析

背景：隨著全球平均餘命延長，藉由復健運動計畫改善心臟衰竭族群之日常生活功能與生活品質，是醫療團隊照護的目標，然而迄今少有研究探討居家復健運動對心臟衰竭病人於心肺耐力、紐約心臟協會心臟功能分級（New York Heart Association functional class，NYHAFc）、左心室功能、六分鐘行走距離、生活品質成效等範疇的整體成效。目的：探討居家復健運動對心臟衰竭病人心肺耐力、NYHAFc、左心室功能、六分鐘行走距離及生活品質之效益。方法：採系統性文獻回顧與統合分析，搜尋Cochrane Central Register of Controlled Trials（CENTRAL）、PubMed、EMBASE、Web of Science（WOS）、CINAHL、Medline（EBSCO）、華藝線上圖書館、台灣碩博士論文知識加值系統等資料庫於2021年1月前發表的文章。以考科藍風險偏差工具2.0版（Cochrane risk of bias tool version 2.0，Cochrane RoB 2.0），評估隨機臨床試驗性研究之品質，並以RevMan 5.3軟體進行分析。結果：最後納入6篇文獻進行評析，共包含450名心臟衰竭病人。結果顯示居家復健運動能顯著改善心肺耐力，增加六分鐘行走距離；然而對NYHAFc與左心室功能無顯著成效，生活品質亦無顯著改善。結論／實務應用：居家復健運動可病人改善心肺耐力與六分鐘行走距離，但對於生活品質無顯著成效。

關鍵字

心臟衰竭；居家復健運動；生活品質；系統性文獻回顧；統合分析

並列摘要

Background: With the prolonged global life expectancy, improving the physical function status and quality of life of heart failure patients through rehabilitation exercise is the goal of medical professionals. Exercise rehabilitation helps patients enhance their functional status and quality of life. However, only a few studies investigate the effect of home-based exercise rehabilitation on cardiorespiratory capacity, NYHA Fc, left ventricular function, six-minute walking distance, and quality of life. Purpose: To investigate the effect of home-based exercise on cardiorespiratory capacity, NYHA Fc, left ventricular function, six-minute walking distance, and quality of life in patients with heart failure. Methods: A systematic review and meta-analysis were performed by searching the databases of the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science (WOS), CINAHL, Medline (EBSCO), Airiti Library, and National digital library of theses and dissertations in Taiwan from their inception to January 2021. Each included a randomized controlled trial assessed using version 2 of the Cochrane risk-of-bias tool. In addition, data were analyzed using the Cochrane Collaboration's RevMan 5.3. Results: A total of six articles were recruited for appraisal, including 450 patients with heart failure. The results showed that home-based exercise significantly improves cardiorespiratory endurance and increases the six-minute walking distance; however, there was no significant effect on NYHA Fc and left ventricular function. In addition, there was no significant improvement in quality of life. Conclusions/Implications for Practice: Home rehabilitation exercise can improve cardiorespiratory endurance and six-minute walking distance. Nevertheless, it has no significant effect on the quality of life.

並列關鍵字

heart failure ； home-based exercise ； quality of life ； systematic review ； meta-analysis

參考文獻

鄧秀琴、施淑玲、李作英（2018）．心臟復健於臨床護理之應用．源遠護理，12（1），11-16。https://doi.org/10.6530/YYN/2018.5.2

Chen, Y. W., Wang, C. Y., Lai, Y. H., Liao, Y. C., Wen, Y. K., Chang, S. T., Huang, J. L., & Wu, T. J. (2018). Home-based cardiac rehabilitation improves quality of life, aerobic capacity, and readmission rates in patients with chronic heart failure. Medicine, 97(4), e9629. https://doi.org/10.1097/MD.0000000000009629

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