第三期居家運動療法對急性心肌梗塞患者運動耐受力暨冠狀動脈危險因子之影響

The Effects of Home-Based Exercise Therapy on Exercise Capacity and Coronary Risk Factors in Patients with Acute Myocardial Infarction

李志偉(Chih-Wei Lee) ； 吳英黛(Ying-Tai Wu) ； 吳育儒(Yu-Zu Wu) ； 張芙美(Fwu-Mei Chang)

《物理治療》 27卷2期 (2002/04) Pp. 90-99

摘要

Background and Purpose: To investigate the effects of a minimally supervised, home-based phase Ⅲ cardiac exercise program (phase Ⅲ) with monthly telephone interview and/or home visits on exercise capacity and coronary risk factors in patients after acute myocardial infarction (AMI). Methods: Patients who participated in an 8-week supervised, hospital-based phase Ⅱ and 6-month home-based phase Ⅲ exercise program with monthly telephone interview and/or home visits were defined as the exercise group (n=20), while those who did not exercise according to the questionnaire about exercise habit were included in the non-exercise group (n=17). There were no differences between groups in any of the initial conditions. The training intensity of the exercise group was 60-79% maximal heart rate derived from symptom-limited maximal exercise test. Subjects in the exercise group underwent exercise tests at pre- and post- phase Ⅱ and five and eight months after discharge. Coronary risk factors were evaluated for both groups pre- and post- phase Ⅱ and eight months after discharge. ANOVA and Mann-Whitney U tests were used for intra- and inter-group comparisons of exercise tolerance (metabolic equivalents, METs) and lipid data. Results: The exercise group showed a significant increase in exercise tolerance (6.28±1.40 METs vs 9.69±1.70 METs, p＜0.001) after phase Ⅱ exercise training and was able to maintain it at the follow-up of 8 months after discharge. Both groups had significantly fewer persons who kept on smoking during follow-up. High density lipoprotein cholesterol (HDL-C) increased significantly from the initial value of 36.3±9.1 mg/dl to 43.0±8.1 mg/ dl (F=27.647, p=0.006) at the last follow-up in the exercise group, while no significant differences were noted in the non-exercise group; however, no between-group differences were noted. Conclusions: Home-based phase Ⅲ exercise therapy was able to maintain the therapeutic effect of smoking cessation and exercise capacity enhancement from a phase Ⅱ program. HDL-C in exercise group was even higher after the home-based phase Ⅲ exercise therapy.

關鍵字

急性心肌梗塞 ； 居家式運動療法 ； 運動耐受力 ； 冠狀動脈危險因子

並列摘要

Background and Purpose: To investigate the effects of a minimally supervised, home-based phase Ⅲ cardiac exercise program (phase Ⅲ) with monthly telephone interview and/or home visits on exercise capacity and coronary risk factors in patients after acute myocardial infarction (AMI). Methods: Patients who participated in an 8-week supervised, hospital-based phase Ⅱ and 6-month home-based phase Ⅲ exercise program with monthly telephone interview and/or home visits were defined as the exercise group (n=20), while those who did not exercise according to the questionnaire about exercise habit were included in the non-exercise group (n=17). There were no differences between groups in any of the initial conditions. The training intensity of the exercise group was 60-79% maximal heart rate derived from symptom-limited maximal exercise test. Subjects in the exercise group underwent exercise tests at pre- and post- phase Ⅱ and five and eight months after discharge. Coronary risk factors were evaluated for both groups pre- and post- phase Ⅱ and eight months after discharge. ANOVA and Mann-Whitney U tests were used for intra- and inter-group comparisons of exercise tolerance (metabolic equivalents, METs) and lipid data. Results: The exercise group showed a significant increase in exercise tolerance (6.28±1.40 METs vs 9.69±1.70 METs, p＜0.001) after phase Ⅱ exercise training and was able to maintain it at the follow-up of 8 months after discharge. Both groups had significantly fewer persons who kept on smoking during follow-up. High density lipoprotein cholesterol (HDL-C) increased significantly from the initial value of 36.3±9.1 mg/dl to 43.0±8.1 mg/ dl (F=27.647, p=0.006) at the last follow-up in the exercise group, while no significant differences were noted in the non-exercise group; however, no between-group differences were noted. Conclusions: Home-based phase Ⅲ exercise therapy was able to maintain the therapeutic effect of smoking cessation and exercise capacity enhancement from a phase Ⅱ program. HDL-C in exercise group was even higher after the home-based phase Ⅲ exercise therapy.

並列關鍵字

Acute myocardial infarction ； Home-based exercise therapy ； Exercise capacity ； Coronary risk factors