Improving Respiratory Muscle Strength and Overall Function in Patients With Cardiovascular Disease Through Rehabilitation Hospitals.

IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiology Research Pub Date : 2024-02-01 Epub Date: 2024-02-28 DOI:10.14740/cr1616
Tomohiro Matsuo, Tomoyuki Morisawa, Takuro Ohtsubo, Katsuhiro Ueno, Shuichi Kozawa
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Abstract

Background: The prevalence of respiratory sarcopenia and its effect on respiratory muscle strength (RMS) in patients with cardiovascular disease (CVD), who are transferred to a convalescent rehabilitation hospital after acute care and require continuous cardiac rehabilitation (CR), is currently unclear. This study aimed to assess changes in RMS, physical function, and activities of daily living (ADL) before and after CR performed in a rehabilitation hospital.

Methods: Of 50 consecutive patients transferred to a rehabilitation hospital for ongoing CR, 30 fulfilled the inclusion criteria. Maximal inspiratory and expiratory pressures (MIP and MEP, respectively) were measured at transfer, and patients with decreased RMS were diagnosed with respiratory sarcopenia. RMS, physical function, exercise tolerance, ADL ability, and health-related quality of life (HR-QoL) were measured and compared at transfer and discharge.

Results: The prevalence of respiratory sarcopenia at the time of transfer to the rehabilitation hospital was 93.3%. RMS assessments at transfer and discharge demonstrated significant improvements in %MIP (from 46.3±26.1% to 63.6±33.7%) and %MEP (from 44.8±17.3% to 56.6±21.8%). Short physical performance battery, gait speed, handgrip strength, and knee extension muscle strength significantly improved, along with significant prolongation of 6-min walking distance as a measure of exercise tolerance. ADL assessment using the functional independence measure revealed significant improvement, as did HR-QoL assessed according to the five-dimension, five-level, EuroQoL instrument, following CR.

Conclusions: Although respiratory sarcopenia was highly prevalent among patients with CVD who required transfer to a rehabilitation hospital after acute care, continuous CR significantly improved RMS, ADL, physical function, and exercise tolerance. These findings support the continued expansion of CR, particularly in dedicated rehabilitation hospitals.

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通过康复医院改善心血管疾病患者的呼吸肌力量和整体功能。
背景:心血管疾病(CVD)患者在接受急性护理后转入康复医院并需要持续进行心脏康复(CR),目前尚不清楚这些患者中呼吸肌疏松症的发生率及其对呼吸肌强度(RMS)的影响。本研究旨在评估在康复医院进行心脏康复治疗前后RMS、身体功能和日常生活活动(ADL)的变化:在连续转入康复医院进行 CR 的 50 名患者中,有 30 人符合纳入标准。转院时测量了最大吸气压力和呼气压力(分别为 MIP 和 MEP),RMS 下降的患者被诊断为呼吸肌疏松症。在转院和出院时对 RMS、身体功能、运动耐量、ADL 能力和健康相关生活质量(HR-QoL)进行测量和比较:结果:转入康复医院时,呼吸道肌肉疏松症的发病率为 93.3%。转院和出院时的RMS评估显示,MIP%(从46.3±26.1%增至63.6±33.7%)和MEP%(从44.8±17.3%增至56.6±21.8%)均有显著改善。短程体能测试、步态速度、手握力和膝关节伸展肌力均有明显改善,作为运动耐量测量指标的6分钟步行距离也有显著延长。使用功能独立性测量法进行的ADL评估显示,CR治疗后,患者的ADL和根据五维、五级、EuroQoL工具评估的HR-QoL均有明显改善:虽然在急性期后需要转入康复医院的心血管疾病患者中,呼吸性肌少症的发病率很高,但持续的 CR 能明显改善 RMS、ADL、身体功能和运动耐量。这些研究结果支持继续扩大 CR 的应用范围,尤其是在专门的康复医院。
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来源期刊
Cardiology Research
Cardiology Research CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.50
自引率
0.00%
发文量
42
期刊介绍: Cardiology Research is an open access, peer-reviewed, international journal. All submissions relating to basic research and clinical practice of cardiology and cardiovascular medicine are in this journal''s scope. This journal focuses on publishing original research and observations in all cardiovascular medicine aspects. Manuscript types include original article, review, case report, short communication, book review, letter to the editor.
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