心脏康复中吸烟和不吸烟者运动训练的预后差异演示文稿.pptVIP

Outcome of exercise training in Cardiac Rehabilitation of Smoker and Non-smoker心脏康復中吸烟和不吸烟者運動訓练的預后差异 李常威醫生 Leonard S.W. Li Division of Rehabilitation Medicine University Department of Medicine, Tung Wah Hospital and The University of Hong Kong Components of CRP 心脏康復的成份 Exercise training 運動訓練 Physical counseling 活動講解 Weight management 控制体重 Lipid management 脂肪控訓 Psychosocial management 心理社會處理 Diabetes management 糖尿控制 HT management 血庄治理 Nutritional counseling 营養講解 Smoking cessation 介烟 Prediction of outcome after cardiac rehabilitation預测在心脏康復的结果 Am. J. Cardiology 2001 Prediction of Long- Term Prognosis in 12,126 Men Referred for Cardiac Rehabilitation Kavanagh T et al, Circulation. 2002; 106:666-671 Exercise capacity, as determined by direct measurement of VO2peak exerts a major long-term influence on prognosis in men After MI, CABG or IHD can play a valuable role in risk stratification and counseling Aerobic Exercise Training in Cardiac Rehabilitation心脏康復的帶氧運動 Improvement in exercise capacity by an average of 15-25% 增加運動量百份之十五至二十五 Patients who have the poorest functional capacity get the largest benefit 功能性量度低的有最大效益 Exercise Training in Smokers吸烟者的運動訓練 Pulmonary rehabilitation for COPD 慢性支气管炎在胸肺康復 The emphasis is on the re-conditioning rather than aerobic exercise capacity training 主要在復元，而不是運動量增加 運動的重要性Importance of Exercise for COPD 肺部功能減弱 Reduced Lung Function 普通性運動便出現氣喘現象 SOB on moderate exercise 運動量隨之而減少 Reduced exercise capacity 體能下降 Reduced exercise endurance 運動量越來越少 Amount of exercise progressively reduced 輕微運動便引致氣喘現象 SOB on mild exertion 體能衰弱 Generalised body weakness 最後在日常生活動作中出現氣喘現象 SOB on routine activities RCTs:Exercise in Heart Failure運動訓練在心脏衰竭的研究 Author Patients S/U Method Intensity Frequency Duration Response Sullivan I/II/III 2/8/6 S C/W 75% 60 min, 3-5/week 16-24 w 23% Coats II/III 10/7 U C 70% 20 min, 5/week 8 w 18% Meyer