| ObjectsPrevalence and death rates of Cardiac Artery Disease(CAD)in the last 10 years were rising.Percutaneous coronary intervention(PCI)has become the main clinical treatment of CAD tools,but PCI cannot be effective in reducing risk factors for CAD.Cardiac Rehabilitation(CR)based on exercise as an effective means for CAD patients after PCI therapy,has been widespread clinical attention.With the rapid development of technology and the influence of COVID-19,online exercise supervision of homebased CR became an important way in CR,which had been subjected to clinical attention.But there is no research into online exercise supervision of home-based CR as clinical effect in CAD patients with post PCI.Therefore,this study aims to compare the traditional education and traditional education combined with 6 weeks online exercise supervision of home-based CR in CAD patients with post PCI and analysis of its benefit from the effects of behavior management,physical function and blood profile to serve as the online exercise supervision of home-based CR provide motivation in ChinaMethodsThis study was approved by the Human Subjects Committee of Xinhua Hospital Affiliated to Shanghai Jiao Tong University school of Medicine and the Human Subjects Committee of Shanghia University of Sports,and registered in the Chinese Clinical Registration Center.One hundred patients were recruited,and completed the baseline test,intervention and follow-up.①Baseline test:Completed behavior management,physical function and blood tests before discharge.Behavior management include Bandura’s exercise self-efficacy(ESE),Godin-Shephard LeisureTime Physical Activity Questionnaire(GSLTPAQ),Coronary Artery Disease Education(CADE-Q SV)and Coronary Artery Disease Self-management scale(CSMS).Physical function tests include Hand Grip strength(HG)test,Timed up and go(TUG)test,30second sit to stand(30-s STS)test and Six-minute walk test(6MWT).Blood tests include Low Density Lipoprotein(LDL),High Density Lipoprotein(HDL),Total Cholesterol(TC),Triglycerides(TG)and Fasting blood glucose(FBG).②Intervention:exercise intensity according to the result of 30-s STS test and 6MWT.Sit to stand as the resistance exercise and walking as the aerobic exercise.Sit to stand exercise for 23 sets every day,repetition per set as the result of(80%-100%)×2×30-s STS at 60%80%of maximum heart rate.Aerobic exercise included walking for 30 to 60 minutes every day and calculated 80%×(5-10)×6MWT distances for intensity.Patients were randomly assigned into online exercise supervision group(M:W=35:15;Age=65.3±8.7;single:double:above=23:16:11)or control group(M:W=39:11;Age=67.7±7.6;single:double:above=19:19:12),and added them to WeChat virtual community.For online exercise supervision group,a CR physical therapist online conducted every day to complete the home exercise program.③Follow-up:participants were followed up as outpatients for a 6-week period.Behavior management of questionnaires were administered again at 2-and 6-weeks,physical function and blood profile were evaluated again after the 6-week intervention.The intragroup comparison was conducted via repeated measures analysis of variance(ANOVA)and intergroup comparison of value changes by independent sample t-test.ResultsThere were 97 patients completed the 6-week intervention,the ratio of drop was 5%.There were no adverse events reported during the intervention period.(1)The scores of questionnairesThe intragroup comparison in online exercise supervision group showed compared with baseline,the scores on ESE was significantly improved at 6-week(p<0.01,95%CI:2.8～13.8).The scores on GSLTPAQ,CADE-Q SV and CSMS were significantly improved at 2-and 6-week(2-week,GSLTPAQ:p<0.01,95%CI:2.9～10.9.CADE-Q SV:p<0.01,95%CI:0.6～2.6.CSMS:p<0.01,95%CI:19.6～29.9.6-week,GSLTPAQ:p<0.01,95%CI:4.2～14.6.CADE-Q SV:p<0.01,95%CI:1.7～3.4.CSMS:p<0.01,95%CI:19.3～30.9).The intragroup comparison in control group showed compared with baseline,the scores on CADE-Q SV were significantly improved at 6-week(p=0.02,95%CI:0.2～1.9).The scores on CSMS improved at 2-and 6-week(2-week:p<0.01,95%CI:6.0～16.2.6-week:p<0.01,95%CI:6.1～17.6).The intergroup comparison for the score changes in GSLTPAQ and CSMS showed significantly greater progress at 2-and 6-week in the online exercise supervision group compared with CG(2-week,GSLTPAQ:p<0.01,95%CI:2.1～1.4.CSMS:p<0.01,95%CI:7.8～19.6.6-week,GSLTPAQ:p<0.01,95%CI:3.1～15.2.CSMS:p<0.01,95%CI:6.6～19.9).The score of CADE-Q SV showed significantly greater progress at 6-week in the online conducted group compared with CG(p<0.01,95%CI:0.5～2.5).(2)Physical functionThe intragroup comparison in online exercise supervision group showed compared with baseline,the time of TUG was significantly decreased(10.7±3.5s vs 9.9±3.0s,p<0.01,95%CI:0.3～1.2).The repetitions of 30-s STS were significantly improved(11.9±3.5 vs 14.3±4.7,p<0.01,95%CI:1.4～3.4).The distance of 6MWT was significantly improved(445.6±36.6m vs 489.2±48.8m,p<0.01,95%CI:32.7～54.7).The intragroup comparison in control group showed compared with baseline,the time of TUG was significantly decreased(10.6±2.0s vs 9.7± 1.9s,p<0.01,95%CI:0.4～1.3).The distance of 6MWT was significantly improved(436.8±43.6m vs 453.4±50.7m,p<0.01,95%CI:5.6～27.6).The intergroup comparison for the repetitions of 30-s STS showed significantly greater progress in the online exercise supervision group compared with control group(2.4±3.6 vs 0.4±3.5,p=0.01,95%CI:0.5～3.3).The distance change in 6MWT showed significantly greater progress in the online conducted group compared with control group(Online conducted group:43.7±39.2m,Control group:16.6±39.1m,p<0.01,95%CI:11.5～42.6).(3)Blood profileThe intragroup comparison in online exercise supervision group showed compared with baseline,the level of LDL and HDL were significantly improved(LDL:2.2±0.9mmol/L vs 1.8±0.6mmol/L,p<0.01,95%CI:0.1～0.5.HDL:1.1±0.3mmol/L vs 1.2±0.4mmol/L,p<0.01,95%CI:0.1～0.2).The level of FBG was significantly retrogress(5.7±1.5mmol/L vs 6.5±1.8mmol/L,p<0.01,95%CI:0.5～1.2)The intragroup comparison in control group showed compared with baseline,the level of LDL and HDL was significantly improved(LDL:2.3±0.9mmol/L vs 1.8±0.7mmol/L,p<0.01,95%CI:0.3～0.7.HDL:1.1±0.2mmol/L vs 1.2±0.4 mmol/L,p<0.01,95%CI:0.0～0.1).The level of FBG retrogress significantly(5.8±1.7mmol/L vs 6.4±1.3mmol/L,p<0.01,95%CI:0.2～0.9).The intergroup comparison for the change compared with baseline in blood profile showed no significantly greater change in the online conducted group compared with control group.Conclusion1.Combine traditional education comparing 6 weeks online exercise supervision of home-based CR in CAD patients with post PCI is a safe,viable,effective,and lowcost.2.In clinical,for CAD patients with post PCI,traditional education and traditional education comparing 6 weeks online exercise supervision of home-based CR in behavior management,physical function and blood profile is beneficial.3.Traditional education comparing 6 weeks online exercise supervision of homebased CR can further improve patients’ behavior management and physical function.So,traditional education comparing 6 weeks online exercise supervision of homebased CR can be used as effective way for CAD patients with post PCI in clinical application. |
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