心血管物理治疗中的ASSOBRAFIR临床实践指南:心力衰竭门诊康复计划中的基于运动的干预措施
Marlus Karsten1, Giulliano Gardenghi2, Alessandra Choqueta Toledo Arruda3
1Programa de Pós-Graduação em Fisioterapia, Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brasil; Grupo de Pesquisa em Saúde Cardiovascular e Exercício, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brasil.
Brazilian journal of physical therapy
|August 26, 2025
概括
这项研究为心力衰竭患者提供了运动训练 (ET) 建议. 主要发现包括高强度间歇训练和中等强度连续训练的等价性,以及中等强度抵抗训练和高强度鼓动肌肉训练的优越性.
科学领域:
- 心血管康复
- 运动生理学
- 心脏衰竭的治疗方法
背景情况:
- 运动是心力衰竭 (HF) 康复的重要组成部分.
- 由于HF治疗的进步, 标准化炼方案至关重要.
- 物理治疗师在巴西提供这些干预的关键作用.
研究的目的:
- 建立基于证据的建议,用于对HF患者进行门诊心血管康复.
- 用保存和减少的左心室喷射分数来覆盖HF.
- 帮助临床医生优化康复策略.
主要方法:
- 遵守国际指南网络 (GIN) 和AGREE-II的方法严格原则.
- 使用GRADE方法评估证据的确定性 (CoE) 并提出建议.
- 进行自2009年以来发表的随机临床试验的元分析.
主要成果:
- 高强度间歇训练和中等强度持续训练显示同样的结果 (有条件的建议,低Coe).
- 中等强度的抵抗训练优于低强度的训练 (有条件的建议,非常低的CoE).
- 高强度的灵感肌肉训练 (IMT) 比低强度的IMT更有效 (有条件的建议,非常低的CE).
- 神经肌肉电刺激 (NMES) 比安慰剂更有效 (有条件的建议,低Coe),但不优于单独的有氧训练 (有条件的建议,低Coe).
结论:
- 这些建议为HF门诊心血管康复中以运动为基础的干预提供了必要的指导.
- 这些发现支持有效的实践模式的结构化实施.
- 优化运动方案可以提高患者心力衰竭管理的结果.
相关概念视频
01:30Heart Failure VII: Nursing Interventions
139
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
139
01:22Heart Failure VI: Adjunct Therapies
27
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
27
01:29Cardiomyopathy V: Interprofessional Care
33
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
33
01:27Peripheral Artery Disease III: Interprofessional Care
29
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
29
01:29Cardiomyopathy VI: Nursing Management
35
Assessment: Nursing management of patients with cardiomyopathy begins with a thorough assessment of the patient's history, including a family history of cardiomyopathy or sudden cardiac death, personal history of heart disease, hypertension, diabetes, and any alcohol consumption or drug use.During the physical examination, assess vital signs, look for signs of heart failure (such as edema, jugular venous distention, and cyanosis), auscultate for abnormal heart sounds (like murmurs and gallops),...
35
01:30Heart Failure V: Medical Management
23
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
23