| Background Coronary atherosclerotic heart disease is the leading cause of death in worldwide.Acute myocardial infarction is the most serious type of it’s manifestation.It has the characteristics of acute onset,serious morbidity,high mortality,accompanying with many complications,and poor prognosis.Although early reperfusion therapy in patients with acute myocardial infarction can greatly improve clinical outcomes and survival rates,reduce mortality,and promote patient’s short-term prognosis,but the improvement of long-term prognosis,such as improving risk factors and quality of life,as well as reducing recurrence rate of acute cardiac events,depends on exercise-based cardiac rehabilitation of myocardial infarction.The development of cardiac rehabilitation among patients with acute myocardial infarction in China is still at an exploratory stage.There is no perfect cardiac rehabilitation practice guide and professional heart rehabilitation team.After discharged from hospital,patients with acute myocardial infarction haven’t received professional cardiac rehabilitation support.What might be the natural heart recovery process of a patient?How should a patient perform self-management and secondary prevention?This study defined active exercise as the main measurement indicators,to describe daily exercise and subjective symptom experience of patients within 14 days after discharged from hospital,and discuss the process of cardiac rehabilitation in patients with acute myocardial infarction in natural state.Objective(1)Describe and analyze daily exercise of patients with acute myocardial infarction within 14 days after discharge;(2)Describe and analyze the patient’s daily subjective symptoms experience within 14 days after discharge;(3)Discuss the feasibility on using wearable exercise monitoring bracelet to record six-minute walking test.Method Choose patients with acute myocardial infarction,had accepted by percutaneous coronary intervention therapy and the disease condition was in a stable period and was about to discharge from hospital,could master the use of smart-phone and wearable exercise monitoring wristbands.The research study was conducted in coronary heart disease ward and heart failure ward of Fuwai Hospital from April 2017 to February 2018.Researchers collected general data,basic exercise habits data before admission,and 6-minute walking test measurement data before patients discharge.During the 14-day period,patients were asked to collect daily information on the patient’s physical activity and subjective symptom experience,and were supposed to collect 6 minutes of walking distance and heart rate data at the end of per week.Result(1)A total of 100 patients with acute myocardial infarction were recruited for a 14-day follow-up exercise survey.A total of 55 patients took part in daily exercise,mainly related to education background,daily working hours before admission,quantity of stent implantation,Killip heart function classification and left ventricular ejection fraction,etc.;(2)Daily exercise length of time from day 1 to day 14 after discharge from hospital increased from 9.38±16.20 minutes to 38.06±29.98 minutes.Daily exercise duration showed an overall upward trend,and the 2nd week was generally higher than the 1st week;(3)The number of AMI patients who exercised from day 1 to day 14 after discharge from hospital increased from 14 to 37,which showed an overall upward trend.(4)The quatity of patients who exercised regularly in the 2nd week(38 cases,38.0%)was significantly higher than that in 1st week(17 cases,17.0%),but choosing walking as the main exercise method,the exercise pattern was simple and the exercise intensity was low;(5)Walking distance and heart rate variability were different between 1St week and 2nd week;heart rate variability mainly related to age,quantity of stent implantations,left ventricular ejection fraction and Killip heart function classification;(6)Symptoms of self-experience based reporting within 14 days after discharge were common.The number of patients suffering from chest discomfort symptoms was ranked as "consciousness of fatigue">"consciousness of dyspnea.">"consciousness of chest tightness">" consciousness of chest pain" and majority frequencies of chest tightness,chest pain and dyspnea symptoms occured from 1 to 5 times;fatigue occured at frequencies above 10.Conclusion(1)The duration of time in patients with acute myocardial infarction was generally on rise within 14 days exercise after discharged from hospital;(2)There is conservativeness and risk of active exercise during 14-day-follow-up in patients with acute myocardial infarction;(3)The experience of subjective symptoms among patients with acute myocardial infarction are widespread within 14 days after discharged from hospital;(4)Data collection method based on smart-phone and wearable devices are still worthy to discussion in the future. |
PDF Full Text Request