| Objective:This study uses the method of Meta analysis system evaluation to evaluate the impact of sports rehabilitation training on the exercise tolerance,cardiac function and structure of patients with heart failure after treated with implantable cardioverter defibrillators or cardiac resynchronization therapy,and evaluates the safety of sports rehabilitation training for device therapy Provide a reference for the health management of patients after heart failure.Methods:Studies were searched in Pub Med,The Cochrane Library,EMbase,CBM,China Knowledge Network,wanfang Database and China Biomedical Literature Database,etc.,and collects the related randomized controlled trials of exercise rehabilitation for heart failure patients who are implanted with cardioverter defibrillators or cardiac resynchronization therapy.The search time limit is from January 2000 to December 2020.The searched literatures were screened and included in the standard randomized controlled trials,and the literatures were evaluated.The data in the literatures were statistically analyzed by RevMan5.3 software,and the bias risk was evaluated by Stata15.1.The heterogeneity of the analysis results included in the research was tested,and the movement forms were analyzed in subgroups.Results:A total of 947 related literatures were initially retrieved and screened according to the inclusion criteria.Finally,12 literatures were studied,with 1670 patients,including 880 in the sports training group and 790 in the routine group.The results showed that compared with the routine group,the exercise rehabilitation group(1)had higher peak oxygen uptake [MD=1.49,95%CI[0.64,2.34],P=0.0006],(2)had higher gas exchange rate [MD=0.06,95%CI[0.04,0.08],P < 0.00001],(3)had no significant difference in ejection fraction between the two groups [MD=2.29,95% CI [-1.15,5.73],P=0.19],(4)There was no significant difference in left ventricular end diastolic volume between the two groups [MD =-7.44,95%CI[-44.62,30.08],P=0.70],(5)There was no significant difference in left ventricular end diastolic diameter [MD =-1.91,95%CI[-5.00,1.19],P=0.23],(6)Quality of life was improved.(7)There were no exercise-related adverse events during exercise rehabilitation among CRT/ICD patients.Subgroup analysis by form of exercise showed that the LVEF of patients with CRT/ICD implantation in the aerobic exercise group was significantly higher than that in the control group [MD=4.98,95%CI[1.78,8.18],P=0.002],while the difference between the high-intensity intermittent exercise group and the control group was not statistically significant [MD =-2.36,95%CI[-8.24,3.52],P=0.43].Conclusion:1.Exercise rehabilitation training can effectively improve the exercise tolerance of patients with heart failure implanted with a cardioversion defibrillator or cardiac resynchronization therapy;2.Different forms of exercise may have different effects on the heart function of patients after CRT/ICD involved in exercise rehabilitation.Among them,moderate-intensity continuous aerobic exercise and higher-intensity intermittent exercise may be more suitable for patients with heart failure after CRT/ICD implantation.Rehabilitation exercise3.In the improvement of cardiac structure,exercise rehabilitation does not significantly improve LVEDD and LVEDV,suggesting that exercise rehabilitation does not significantly improve the cardiac structure.4.Exercise rehabilitation training can be safely used in patients with heart failure after CRT/ICD implantation. |
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