Exercise In Retired Cadres Of PLA With Cardiovascular Diseases During The Transitional Period From Hospital To Home

[Objectives] To make and test the effect of exercise protocol led by nurses on functional ability and QOL in retired cadres of PLA with cardiovascular disease during the transitional period from hospital to home.[Methods] ①Systematic literature reviewes were performed in the databases PubMed, EMBASE, SCI, Cochrane and four Chinese databases to find base-evidence for making and implementing the exercise protocol. ②Health promotion theories were analyzed to direct making and implementing the exercise protocol. ③A cross-sectional and convenience sampling study was performed to investigate the state of physical activity in retired cadres of PLA with cardiovascular diseases, and to analyze its influential factors. Data were collected through self-design questionnaire, the Chinese version of physical activity and self-efficacy scale in chronic disease management, and Beck self-rating depression scale. ④Based on the preliminary work, the exercise protocol was made.14-type joint exercises were improved 25-type joint exercises which were recorded in’Chinese physical fitness method’.⑤A randomized, controlled, and single-blinded study was performed to test the effect of exercise protocol.Seventy-seven advanced ages (≥75 years, mean 80.68 years of age) were included. The outcome measures were assessments of QOL, functional ability, cardiac function, body mass index and readmission rate.[Results] ① Patients with cardiovascular diseases are strongly recommended to participate exercise rehabilitation (Ⅰ Class). Intervention strategy should be made from three aspects, cognitive behavior, procedure and social culture background (Ⅰ Class) And nurses should play active roles in secondary prevention (Ⅱ a Class). Safety is the most important for older adults. Exercise should include endurance, muscle strength, balance and flexibility training. ② Nowadays, there are a few trials about exercise in older adults with cardiovascular diseases during transitional period. But exercise mode was mainly about daily activities and walk. Exercise intensity, duration and frequency of exercise were not mentioned, and participants were younger.③A total of 153 retired military veteran cadres were investigated who were advanced ages (82.73±7.07 years old). They lacked strength and flexibility training (M=0, Q=0). Aerobic training time seemed enough (M=195min, Q=195min), but training intensity should be set scientifically. Ordinal regression analysis indicated that age, discharged time and self-efficacy were the influential factors of aerobic training (P<0.05). ④The protocol comprised risk evaluation, execise mode and intervention strategy. Execise mode comprised breathing exercises,14-type joint exercises and walking. ⑤Sixty-one participants completed the full trial at last. The exercise compliance was over 81.4 percent. There were no adverse cardiovascular events during the study. Regarding the interaction effects (timexgroup), in the intervention group compared to the control group, as for QOL, there was significant improvement in Physical functioning, Role-Physical, Bodily Pain and Vitality (p< 0.05); as for SFT, there was significant improvement in Chair stands, Arm curls, Timed Up and Go (TUG) and 6 Minute Walk Distance (MWD) (p< 0.05); but as for LVEF, body mass index and readmission rate, there were no significant improvements (p>0.05).[Conclusions] ①It is necessary for older adults with cardiovascular diseases to participate exercise rehabilitation. The exercise protocol should be made according to advanced ages’ traits. ②Execise rehabilitation in advanced ages with cardiovascular diseases in transitional period is urgent to be studied. ③Exercise in retired military veteran cadres with cardiovascular diseases need to be directed scientifically. According to the influential factors, health-care workers should take interventions to increase self-efficacy and perform individual exercise protocol in the transitional period. ④The protocol was based on the guidelines, previous studies, the physical activity state and health-education need of the veteran cadres, and health promotion theories. The protocol is safe, scientific, feasible and intresting. ⑤The transitional exercise led by nurses is useful to improve QOL and functional ability in retired cadres of PLA recently discharged from the hospital for CVD.