最新心脏康复中吸烟和不吸烟者运动训练的预后差异PPT课件.ppt

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1、心脏康复中吸烟和不吸烟者心脏康复中吸烟和不吸烟者运动训练的预后差异运动训练的预后差异Components of CRP 心心脏脏康復的成康復的成份份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Exercise Training

2、in Cardiac Rehabilitation:Practical Considerations 運動訓練的實踐考慮運動訓練的實踐考慮uUpper limbs Vs Lower Limbs exercise 上肢：下肢訓练uCo-ordination&balance 平衡uStress 压力uMedications 药物uStress test 心脏運動評估uSmoking 吸烟uSleeping time 睡眠時閒uUse of RPE 辛苦情度評估辛苦程度辛苦程度Smokers and Non-smokers in Cardiac Rehabilitation吸烟和不吸烟者在心脏康復心

3、脏康復uSmoking risk factor for IHD 吸烟是冠心病的危险因素之一uNot uncommon to see smokers to enter cardiac rehabilitation program 參加心脏康復病人是吸烟者很常見uUsed to have no or minimal respiratory symptoms 很少呼吸道的病癥uAny difference after exercise training?兩者在運動訓練有否分别？Phases of Cardiac Rehabilitation心心脏脏康復期康復期Phase IVIn-patient p

4、rogram住院Out-patient supervised program 門診Community-based program 社区Life-long program長期Phase IPhase IIPhase III8 weeks3 monthsForever1 2 weeksPhase II 第二期第二期Intense exercise after medical clearance 密什式運動Group exercise 1:5Exercise 運動Aerobic exercise帶氧Flexibility exercise 鬆弛+Resistance exercise阻力Aims:目

5、的 Exercise capacity 增加運動量Exercise habit 習慣Exercise ProtocolExercise Prescription 運動處方運動處方F frequency次數次數3X per week 每星期三次 I intensity 强烈度强烈度*50 80%HRR 心跳T time 時閒時閒30 minutes 分钟T type 种类种类Aerobic exercise 帶氧EHR 運動心跳運動心跳RHR静止+(MHR最快 RHR)x*%Or other alternatives 别的RPE 10-15Dynamic 動態Rhythmic 節奏Isotoni

6、c 等力Interval 分隔Cumulative 積聚Supervised Home exercise 家中運動Progression 進度MONITOR 監察監察Resistance Exercise for Cardiac Patients阻力性運動AHA Exercise Standards 20011 set;10-15 reps8-10 exercise2-3 days/wkAACVPR Guidelines 20041 set;12-15 reps8-10 exercise2-3 days/wkACM Guidelines 20061 set;12-15 reps8-10 exe

7、rcise2-3 days/wkConventional:0.5 2.0 kgdumbbells,pulley weights,spring pulleys,weight machine哑铃，舉重器械哑铃，舉重器械Smokers and Non-smokers in Cardiac Rehabilitation吸烟和不吸烟者在心脏康復心脏康復uTo look into any difference between the training outcome 訓練后是否不同结果uTo analysis smokers and non-smokers in terms of exercise cap

8、acity 用運動量作分析uPatients entered cardiac rehabilitation at Tung Wah Hospital in last 10 years.在十年内在东華医院参加心脏康復者Smokers and Non-smokers in Cardiac Rehabilitation吸烟和不吸烟者在心脏康復心脏康復Female女Male男Total總數Smoker吸烟26263289Non-smoker不吸烟201388589Total總數227651878P 0.001Smokers and Non-smokers in Cardiac Rehabilitati

9、on吸烟和不吸烟者在心脏康復心脏康復Smoker吸烟Non-smoker不吸烟P-value%Predicted FVC 102.7+50.896.6+24.0 0.333%Predicted FEV189+24.992+25.50.445Age65+1663+170.69Smokers and Non-smokers in Cardiac Rehabilitation吸烟和不吸烟者在心脏康復心脏康復Smoker吸烟Non-smoker不吸烟P-valuePre-exercise(MET)前5.52+3.025.18+2.990.364Post-exercise(MET)后6.86+3.236

10、.48+3.100.087Change(MET)改变1.35+1.961.29+1.750.675Conclusion 總结uNo difference between non-smoker and respiratory asymptomatic smoker in exercise capacity after training 兩组在運動量訓练没有分別uTraining methods seem to be tolerated well by both groups 訓练方法在兩组中都能夠接受uDespite being chronic smokers,the impairment of lung function seems to minimal when compared with the non-smoker group 雖然是長期吸烟，肺功能没有太大影響1st Asian Oceania Conference of Physical and Rehabilitation Medicine16-19 May 2008,Nanjing CThank you结束语结束语谢谢大家聆听！谢谢大家聆听！23