| Research Purposes:The incidence rate and mortality rate of chronic heart failure in the elderly population has been increasing year by year,which has become the first cause of death in the elderly in China.The study found that with the progress of the patient's disease,it will show a significant decline in cardiac function and cognitive function,but the exercise intervention in cardiac rehabilitation can improve the patient's cardiac function and cognitive function.Patients with chronic heart failure can choose two different modes of exercise intervention at home or in the center.Because the two modes of exercise management are limited by the implementation environment,the choice of aerobic exercise mode in exercise prescription will be different.This paper mainly adopts two different exercise management modes:home-based and central-based exercise intervention,compares the rehabilitation effects of exercise intervention on cardiac function,cognitive function and motor function of patients with chronic heart failure,and finds a exercise intervention method which is more conducive to the physical,mental and brain health of patients with chronic heart failure.Research methods:This study conducted an experimental study on the improvement of cardiac function and cognitive function in patients with chronic heart failure by different modes of exercise intervention through randomized controlled experiment.According to the inclusion and exclusion criteria,50 patients with chronic heart failure were randomly divided into two groups: center-based cardiac rehabilitation(CBCR)group and home-based cardiac rehabilitation(HBCR)group,with 25 people in each group.According to the physical condition of patients and the results of cardiopulmonary exercise experiment,personalized exercise prescriptions were formulated,Exercise intervention was carried out for 3 months.General information of patients before and after exercise intervention;Basic information includes BMI,body composition,body circumference,basal metabolic rate,resting heart rate and blood pressure;Cardiac function includes 6-minute walking distance and cardiopulmonary exercise experiment;Cognitive function includes Montreal cognitive experiment(Mo CA),attention,symbol number conversion,spatial memory span and digit symbol substitution test;Motor function includes muscle strength,flexibility and balance ability.which are tested and then statistically analyzed.Research results:Basic information: after 3 months of home exercise intervention,the body weight,BMI,waist circumference,body fat rate,visceral fat rate and subcutaneous fat rate of patients in HBCR group decreased significantly compared with those before intervention(P < 0.05).There was no significant difference in hip circumference,waist hip ratio,muscle content,basal metabolic rate,resting heart rate and resting blood pressure.After 3 months of community exercise intervention,the body weight,BMI,waist circumference,body fat rate,subcutaneous fat rate,visceral fat rate,muscle content,basic metabolism and resting heart rate in CBCR group were significantly different from those before intervention(P < 0.05).There was no significant difference only in hip circumference,waist hip ratio and resting blood pressure.There was no significant difference in the indexes of basic information between the two groups after different modes of exercise intervention.Cardiac function: after 3 months of home exercise intervention,the 6-minute walking distance,VO2 /HR,VO2 peak and VO2 AT in HBCR group were significantly higher than those before intervention(P < 0.05).There was no significant difference only in METs.After3 months of community exercise intervention,the 6-minute walking distance,VO2 /HR,VO2 peak,VO2 AT and METs of CBCR group were significantly higher than those before intervention(P < 0.05).There were significant differences in VO2 /HR and VO2 AT between the two groups after different modes of exercise intervention(P < 0.05).Cognitive function: after 3 months of home exercise intervention,the total score of MOCA,simple response time,spatial memory span,trail A,trail B and digit symbol substitution test in HBCR group were significantly higher than those before intervention(P <0.05).There was no significant difference in naming,language,delayed recall and orientation in cognitive function.After 3 months of community exercise intervention,the total score of Mo CA,simple response time,spatial memory span,Trail A,Trail B,digit symbol substitution test in CBCR group were significantly improved compared with before intervention(P <0.05).There was no significant difference in naming and orientation in cognitive function.In the comparison between the two groups after different modes of exercise intervention,the total score of Mo CA,language,delayed recall and simple response time were significantly improved(P < 0.05).Motor function: after 3 months of home exercise intervention,the patients' 30-second sitting up,left and right seat forward extension distance,left and right back grasping test and left and right standing time on one foot in HBCR group were significantly higher than those before intervention(P < 0.05).There was no significant difference in hand grip strength,trunk rotation and functional protrusion.After 3 months of community exercise intervention,the CBCR group had significant improvement in 30-seconds sitting up,left and right seat extension,left and right improved rotation,left and right upper limb back grasping test,left and right standing time on one foot and functional extension(P < 0.05).There was no significant difference only in the grip strength of the upper limbs.In the comparison between the two groups after different modes of exercise intervention,there was no significant difference in upper and lower limb muscle strength,flexibility,trunk flexibility and balance ability between the two groups.Research conclusion:(1)Two different exercise management modes,home-based and center-based,can have a good rehabilitation effect on the overall function of patients with chronic heart failure.Improve the cardiac function,cognitive function and motor function of patients with chronic heart failure,(2)The central-based exercise intervention mode has more obvious effects on the improvement of oxygen pulse,anaerobic threshold oxygen uptake,language,memory and responsiveness in patients with chronic heart failure.In order to achieve better rehabilitation effect,it is suggested to choose central exercise intervention for patients who are qualified to complete central-based rehabilitation. |
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