高知人群体检结果分析及保健策略研究

随着社会生活节奏的加快,现代人压力越来越大,身体状况令人担忧,尤其是社会主义现代化建设的领航人-高级知识分子,不断受到各种慢性病的困扰,严重干扰了正常的工作和生活。本文通过对武汉市的高校教职工及党政机关干部的体检结果进行统计,分析高知人群最常患的疾病特征,以及这些疾病产生的原因,并对提高我国高知人群的健康水平提出有效的保健策略。     

慢性肾脏病的运动康复临床实践指南及专家共识解读CSCD

体力活动和运动逐渐成为慢性肾脏病管理的“良药”。2021年4月8日,英国肾脏协会发布《慢性肾脏病的运动和生活方式临床实践指南》,该指南围绕非透析慢性肾脏病、血液透析以及肾移植受者的体力活动/运动、体质量管理、其他生活方式改变等3方面,提供了指导意见。本文就体力活动/运动这一模块,结合我国专家共识进行解读。     

Evaluation of implementation of the ParkFit program: A multifaceted intervention aimed to promote physical activity in patients with Parkinson's disease

Objectives

We recently completed the ParkFit study, a two-year randomized controlled trial including 586 sedentary Parkinson's disease (PD) patients, that evaluated a multifaceted intervention (ParkFit program) to promote physical activity. The results showed that the ParkFit program enables PD patients to become physically more active, suggesting that this intervention should now be further implemented into clinical practice. To facilitate this process, we here evaluate the implementation of the ParkFit program.

Methods

The ParkFit program was evaluated in three ways: (a) experiences of patients and physiotherapists, as investigated using interviews and questionnaires; (b) factors associated with changed activity levels; and (c) subgroup analyses to identify differential effects in subgroups of patients based on baseline physical activity level, age, gender, disease severity, disease duration, and mobility.

Results

The ParkFit program was well received: 73% of patients indicated they would recommend the program to other patients, and 90% of physiotherapists indicated they wanted to use the ParkFit program in other patients. Multiple forward regression analysis resulted in a model with two variables: less baseline physical activity, and better mobility were associated with larger changes in levels of physical activity (R² = 38%). The program was effective in almost all subgroups. In women, most sedentary patients and patients with higher disease severity, the estimated effect size was largest.

Conclusion

We conclude that the ParkFit program was effective in almost all specific subgroups. Therapists and patients experienced no major hurdles. Suggestions for improvement are: (1) improve education for therapists with respect to theories about behavioral change; (2) formulate concrete and specific examples of exercise goals; and (3) pay more specific attention to patients with co morbidities, cognitive dysfunction and a lack of motivation during education     

氧疗对中重度慢性阻塞性肺疾病患者运动能力的影响

目的：观察氧疗对中重度慢性阻塞性肺疾病（ＣＯＰＤ）患者运动能力、运动时血氧饱和度和生理指标的影响。方法：选择３０例中重度ＣＯＰＤ患者,应用自行车功率仪分别在吸空气和３０％氧气条件下进行两次增量运动试验。结果：在第一、第二级运动负荷时,氧疗对低氧血症组和无低氧血症组的影响十分接近。但在第三级运动负荷及最大可比负荷时氧疗能降低低氧血症组的ＶＥ、ＶＣＯ２、ＤＩ、ＨＲ、Ｂｏｒｇ评分,而对无低氧血症组则影响不明显。极量运动时氧疗可使低氧血症组总运动时间、最大运动负荷、最大每分氧耗量和运动时最低血氧饱和度均显著提高,但对每分通气量、呼吸频率、潮气量、ＣＯ２排出量、气急指数、心率和ＴＣＤ／ＶＴ等指标均无明显影响。吸氧对无低氧血症组各项指标均无显著影响。结论：氧疗能显著提高运动时低氧血症患者的运动能力和运动时最低血氧饱和度,同时降低相同运动负荷时的每分通气量、ＣＯ２排出量、心率和呼吸困难程度;氧疗对运动时无低氧血症患者能降低初始负荷运动时每分通气量和ＣＯ２排出量,但对最大运动能力无明显的影响。     

A randomized controlled trial of weight-bearing versus non-weight-bearing exercise for improving physical ability after usual care for hip fracture

OBJECTIVE: To compare the effects of weight-bearing and non-weight-bearing home exercise programs and a control program on physical ability (strength, balance, gait, functional performance) in older people who have had a hip fracture. DESIGN: Randomized controlled trial with 4-month follow-up. SETTING: Australian community-dwellers (82%) and residents of aged care facilities who had completed usual care after a fall-related hip fracture. PARTICIPANTS: One hundred twenty older people entered the trial, 40 per group (average age +/- standard deviation, 79+/-9y) and 90% completed the 4-month retest. INTERVENTION: Home exercise prescribed by a physical therapist. MAIN OUTCOME MEASURES: Strength, balance, gait, and functional performance. RESULTS: At the 4-month retest, there were differences between the groups in the extent of improvement since the initial assessment for balance (F(10,196)=2.82, P<.001) and functional performance (F(6,200)=3.57, P<.001), but not for strength (F(12,190)=1.09, P=.37) or gait (F(8,200)=.39, P=.92). The weight-bearing exercise group showed the greatest improvements in measures of balance and functional performance (between-group differences of 30%-40% of initial values). CONCLUSIONS: A weight-bearing home exercise program can improve balance and functional ability to a greater extent than a non-weight-bearing program or no intervention among older people who have completed usual care after a fall-related hip fracture.     

运动疗法加音乐疗法对COPD患者生活质量影响的研究

目的 评价运动加音乐疗法对改善慢性阻塞性肺疾病(COPD)患者生活质量的效果.方法 对40例中度和重度慢性阻塞性肺疾病患者进行6个月的运动康复训练和音乐治疗,在治疗前、后分别进行6 min步行试验(6MWT)测量和生活质量评价,然后进行统计学分析.结果 与训练前比较,患者训练后6 min行走距离较训练前明显延长(P=0.000);同时生活质量各方面(日常生活能力、社会活动能力和抑郁焦虑症状)都有明显改善(P=0.000).结论 对COPD患者实施长期、个体化的运动和音乐治疗可有效改善其生活质量.     

即时适配干预在慢性病患者久坐与身体活动中应用的研究进展

即时适配干预是一种新兴的技术驱动行为改变的干预类型;可以在最有可能改变不良行为的时候;为参与者提供量身定制的行为支持。该文从即时适配干预概述、应用、干预效果等3个方面;对即时适配干预在慢性病患者久坐与身体活动中的应用进行综述;以期为改善其久坐行为;增加身体活动量提供借鉴。     

75岁及以上稳定性冠心病患者运动康复中国专家共识

2015年《中国心血管病报告》指出随着我国人口老龄化的到来,以冠心病为主的心血管病发病率和病死率仍呈逐年上升趋势,老年冠心患者群的生活质量和二级预防日益引起整个社会的关注。运动康复是心血管康复的核心措施之一,是指在综合评估的基础上通过运动处方或运动指导的方式采用适当的机体运动来帮助患者恢复生活能力、促进身心健康的一种康复手段。为推动我国高龄稳定性冠心病患者运动康复工作的进一步开展,保证运动康复工作的安全性和有效性,中华医学会老年医学分会特组织高龄稳定性冠心病患者运动康复中国专家共识写作组及相关专家撰写了本共识,旨在为高龄稳定性冠心病患者的运动康复工作提供科学实用的指导与帮助。年龄≥75周岁人群;\"稳定性冠心病\"的人群范畴,包括慢性稳定性劳力型心绞痛、急性冠状动脉综合征(ACS)后稳定期、无症状缺血性心脏病,以及痉挛性心绞痛和微血管病性心绞痛 ^{[ 1, 2, 3]} 。     

基于慢病特点践行健康管理理念的思考与构想

随着经济的发展,生活方式的改变,工作压力的增大,慢性非传染性疾病(以下简称“慢病”)已是威胁全球人类健康的重大公共卫生问题之一。慢病具有病程长、病因复杂、很难治愈且危害严重等特点,使慢病的管理工作持久而艰巨,如何解决当前医疗卫生服务和健康需求两者之间的矛盾这一管理难题,本文从健康管理的视角出发,分析慢病的流行病学特征、慢病防治与健康管理的内在联系,探讨践行健康管理的基本策略。