Influence of early rehabilitative exercise in patients with myocardial infarction
- VernacularTitle:早期康复运动对心肌梗死患者的影响
- Author:
Yumei ZHANG
;
Haixin SUN
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2006;10(24):164-166
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: In treatment of traditional acute myocardial infarction,patients were required to lie on the bed resting for 1-4 weeks. Recently research showed that early rehabilitation exercise in myocardial infarction patients could ameliorate the reservation of cardio function, increase exercise tolerance, augment myocardial hemoperfusion, decrease myocardial ischemia and reduce the anxious and depressive emotion.OBJECTIVE: To observe the influence of early rehabilitation movement on activity of daily living, duration of hospital stay, mean hospitalized cost,incidence rate of arrhythmia and recurrence rate of myocardial infarction in two years.DESIGN: Non-randomized concurrent control analysis.SETTING: Beijing Tiantan Hospital.PARTICIPANTS: Totally 80 patients with acute myocardial infarction,who were hospitalized at Department of Circulation, Beijing Tiantan Hospital from August 2002 to October 2003, were enrolled. They were all at most 70 years old with stable pathogenetic condition. Left ventricular ejection fraction (LVEF) was over 35%. They were not combined with severe hypertension, severe pulmonary disease, nerve and disease of locomotor system.METHODS: The selected cases based on patients' will were assigned into two groups (n=40), ①early rehabilitation group: They were treated with routine drugs, absolute bed rest for 24 hours. At day 2 the head stock was rose about 30°to do passive exercise of extremity joint. At days 3-5, the patients sat on the bed, 3 times per day. At days 6-7,the patients stood at bedside, 3 times per day. At days 8-9, the patients moved joints of extremities at bedside and walked slowly in room. At days 10-14, the patients exercised walking. If there were angina pectoris attacks, serious cardiac arrhythmias or dyspneic respiration, etc., the movement should be suspended or the exercise intensity came back to that in the former stage. ②Absolute bed rest group: The patients were absolute bed rest, and only treated with routine drug without any rehabilitation training.MAIN OUTCOME MEASURES: Barthel index (full mark was 100 points, and ＜ 60 points represented unable self-care) was used to assess activity of daily living of patients. Mean duration of hospital stay, mean hospitalized cost, incidence rate of arrhythmia and recurrence rate of my ocardial infarction in two years were compared between the two groups.RESULTS: A total of 80 patients that conducted the therapy and follow up were involved in the result analysis. ①Mean duration of hospital stay and mean hospitalized cost in the early rehabilitation group were less than those in the absolute bed rest group (17.1 days vs 24.5 days; 9 021.23 yuan vs 12 383.45 yuan; P ＜ 0.05). ②Barthel index: There was insignificant difference before treatment between the two groups. It was significantly higher in the early rehabilitation group than that in the absolute bed rest group before discharge (81.43±13.57,70.68±11.48,P ＜ 0.05). ③Six and seven patients had the onset of arrhythmia in the early rehabilitation group and the absolute bed rest group, respectively. ④Follow-up observation was performed for two years. The recurrence rate of myocardial infarction in the early rehabilitation group (5% ,2/40) was obviously lower than that in the absolute bed rest group (22 %,9/40).CONCLUSION: The early rehabilitation training is of benefit to elevate activity of daily living of myocardial infarction patients, reduce mean duration of hospital stay and mean hospitalized cost and decrease recurrence rate.
