2023+CSANZ立场声明:心脏康复中运动和体力活动的评估和处方临床指南(英文版).pdf
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1、Heart,Lung and Circulation(2023)-,-1443-9506/23/$36.00https:/doi.org/10.1016/j.hlc.2023.06.854POSITION STATEMENTA Clinical Guide for Assessment andPrescription of Exercise and PhysicalActivity in Cardiac Rehabilitation.A CSANZ Position StatementChristian Verdicchio,PhDa,b,1,*,Nicole Freene,PhDc,d,1,
2、Matthew Hollings,PhDa,1,Andrew Maiorana,PhDe,f,Tom Briffa,PhDg,Robyn Gallagher,PhDa,Jeroen M.Hendriks,PhDb,h,Bridget Abell,PhDi,Alex Brown,PhDj,David Colquhoun,MBBS,PhDk,l,Erin Howden,PhDm,n,Dominique Hansen,PhDo,Stacey Reading,PhDp,Julie Redfern,PhDaaFaculty of Medicine and Health,University of Syd
3、ney,Sydney,NSW,AustraliabCentre for Heart Rhythm Disorders,University of Adelaide,SAHMRI and Royal Adelaide Hospital,Adelaide,SA,AustraliacPhysiotherapy,Faculty of Health,University of Canberra,Canberra,ACT,AustraliadHealth Research Institute,University of Canberra,Canberra,ACT,AustraliaeAllied Heal
4、th Department,Fiona Stanley Hospital,Perth,WA,AustraliafCurtin School of Allied Health,Curtin University,Perth,WA,AustraliagSchool of Population and Global Health,University of Western Australia,Perth,WA,AustraliahCaring Futures Institute,College of Nursing and Health Sciences,Flinders University,Ad
5、elaide,SA,AustraliaiAustralian Centre for Health Services Innovation and Centre for Healthcare Transformation,School of Public Health and Social Work,Queensland University of Technology,Brisbane,Qld,AustraliajTelethon Kids Institute,Australian National University,Canberra,ACT,AustraliakFaculty of Me
6、dicine,University of Queensland,Brisbane,Qld,AustralialFaculty of Medicine,Wesley Medical Centre,Brisbane,Qld,AustraliamBaker Heart and Diabetes Institute,Melbourne,Vic,AustralianBaker Department of Cardiometabolic Health,University of Melbourne,Melbourne,Vic,AustraliaoUHasselt,REVAL/BIOMED(Rehabili
7、tation Research Centre),Hasselt University,Hasselt,BelgiumpDepartment of Exercise Sciences,University of Auckland,Auckland,New ZealandReceived 19 June 2023;accepted 27 June 2023;online published-ahead-of-print xxxPatients with cardiovascular disease benefit from cardiac rehabilitation,which includes
8、 structured exerciseand physical activity as core components.This position statement provides pragmatic,evidence-basedguidance for the assessment and prescription of exercise and physical activity for cardiac rehabilitationclinicians,recognising the latest international guidelines,scientific evidenc
9、e and the increasing use oftechnology and virtual delivery methods.The patient-centred assessment and prescription of aerobic ex-ercise,resistance exercise and physical activity have been addressed,including progression and safetyconsiderations.KeywordsCardiac rehabilitation?Secondary prevention?Cor
10、onary disease?Cardiovascular disease?Exerciseassessment?Exercise prescription?Physical activity?Position statement*Corresponding author at:Dr Christian Verdicchio,Faculty of Medicine and Health,University of Sydney,Sydney,NSW,Australia;Centre for Heart RhythmDisorders,University of Adelaide and Roya
11、l Adelaide Hospital,Adelaide,SA,Australia;Email:christian.verdicchiosydney.edu.au;Twitter:c_verdicchio1Co-first authors?2023 The Author(s).Published by Elsevier B.V.on behalf of Australian and New Zealand Society of Cardiac and Thoracic Surgeons(ANZSCTS)and the CardiacSociety of Australia and New Ze
12、aland(CSANZ).This is an open access article under the CC BY license(http:/creativecommons.org/licenses/by/4.0/).HLC3932_proof 24 July 2023 1/14Please cite this article in press as:Verdicchio C,et al.A Clinical Guide for Assessment and Prescription of Exercise and PhysicalActivity in Cardiac Rehabili
13、tation.A CSANZ Position Statement.Heart,Lung and Circulation(2023),https:/doi.org/10.1016/j.hlc.2023.06.854IntroductionCardiovascular disease(CVD)is the leading cause of deathand disease burden globally 1.Improvements in diagnosis,treatment and long-term management have improved survi-vorship and re
14、duced hospitalisations following a cardiacevent,howevertheyhavealsogreatlyincreasedthenumberofpatients requiring ongoing and lifelong CVD risk manage-ment 2,3.To reduce the risk of future events,internationalguidelines recommend all eligible patients have access to,andparticipate in,secondary preven
15、tion programs,includingcardiacrehabilitation4,5.Cardiacrehabilitationisacomprehensive,multidisciplinary intervention consisting ofpatient assessment and individualised risk profile manage-ment,dietary advice,exercise prescription and physical ac-tivity counselling and psychosocial support 6.The Nati
16、onalHeart Foundation of Australia,the Australian CardiovascularHealth and Rehabilitation Association(ACRA)and the Na-tional Heart Foundation of New Zealand all promote cardiacrehabilitation and have online resources that can provide re-ferrers with a list of local services available for their patien
17、ts.Exercise-based cardiac rehabilitation has demonstrated effec-tiveness for reducing hospitalisations and myocardial infarc-tion rates,whilst improving risk profile,exercise capacity andquality of life in patients with coronary disease 7,8.Exerciseprogrammingalso benefits patientswith other cardiov
18、ascularconditions such as heart failure(both reduced and preservedejection fraction)9,10,atrial fibrillation 11,peripheralvascular disease 12,congenital heart disease 13,valve dis-ease 14,pulmonary hypertention 15 and,more recently,with cardio-oncology patients 16.A graduated program of structured e
19、xercise and physicalactivity is a core component of comprehensive cardiac reha-bilitation 17.Recent studies have described new exercisetrainingtechniques,which haveimprovedour understandingof the physiological adaptations from exercise training acrossdiverse patient groups.Furthermore,recent data ha
20、ve alsoprovided a greater understanding of technology and virtualdelivery methods for the prescription of exercise and physicalactivity within cardiac rehabilitation programs.A patient-centred approach is important,and communication with pa-tients should be non-judgemental and respectful.Shared de-c
21、ision making,where patients and their carers are activelyinvolved in the care process,results in personalised in-terventions that are more likely to improve engagement,treatment adherence,and clinical outcomes 18.Concomi-tantly,health professionals should consider evidence,guide-lines and behaviour
22、change theories,techniques,and toolswhen collaborating with patients,identifying their individualexercise and physical activity needs,values and preferences.Realistic short-and medium-term goal setting may beconsidered,andfollow-upshouldbediscussedandsupportedby the entire multidisciplinary team as
23、they are central to thepatients rehabilitation journey 18.The objective of this position statement is to providepragmatic,evidence-based guidance for the assessment andprescription of exercise and physical activity by all cliniciansworking within cardiac rehabilitation(e.g.,exercise physiol-ogists,n
24、urses,physiotherapists)in the Australian and NewZealand context.Specifically,the aim is to summarise theassessment and prescription recommendations for aerobicexercise,resistance exercise and physical activity for all pa-tients referred for secondary prevention of their recent car-diac event or a ne
25、w diagnosis.To do this,a multidisciplinarywriting group was convened comprising of experts fromrelevant disciplines,with regional,gender and cultural rep-resentation to ensure diversity.A consensus process wasthen followed to draft,review,and refine the document.Theposition paper was then submitted
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- 2023 CSANZ 立场 声明 心脏 康复 运动 体力 活动 评估 处方 临床 指南 英文
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