Effects of exercise rehabilitation combined with psychotherapy in elderly patients with coronary heart disease after percutaneous coronary intervention / 中华老年医学杂志

ABSTRACT

Objective:To investigate the effect of exercise rehabilitation combined with psychotherapy and exercise rehabilitationn alone in elderly patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods:A total of 150 elderly patients(≥65 years)admitted to our hospital with CHD after primary PCI were enrolled and randomly divided into the group A(conventional drug therapy), group B(conventional drug therapy+ exercise rehabilitation)and group C(conventional drug therapy + exercise rehabilitation+ psychotherapy), with 50 patients in each group.Patients in groups B and C were intervened at two weeks after PCI, once a week for 12 weeks.Changes of Hamilton anxiety scale(HAMD)scores, Hamilton depression scale(HAMA)score, 6 min walking test, left ventricular ejection fraction(LVEF)and metabolic equivalents(METs)were compared among the three groups.Results:Before treatment, the METs were significantly lower in the group B(3.58±0.14)compared with the groups A(3.69±0.18)and C(3.68±0.15), and were similar between groups A and C. After 12 weeks of treatment, compared with the indicators before treatment, the HAMA scores were similar in the group A(12.98±2.51 vs. 12.16±2.91, P>0.05), and were significantly decreased in groups B(12.90±2.12 vs.8.06±2.11, P<0.05)and C(13.03±2.52 vs.6.96±2.13, P<0.05); HAMD scores were all markedly decreased in all three groups(group A 22.38±2.52 vs.20.87±2.12; group B 22.58±2.57 vs.17.25±2.32; group C 22.23±2.35 vs.13.39±2.25), and were decreased most in the group B, followed by groups A and B( P<0.05). Furthermore, the LVEF group A (49.08±1.59)% vs.(52.15±1.91)%; group B (48.99±2.11)% vs.(57.56±2.13)%; group C (49.04±2.02)% vs.(59.92±1.93)%, 6 min walking distance test(m)(group A 360.78±12.50 vs.370.16±12.41; group B 359.21±10.54 vs.394.19±15.56; group C 363.12±15.28 vs.413.29±18.15)and METs(group A 3.69±0.18 vs.3.91±0.21; group B 3.58±0.14 vs.4.89±0.09; group C 3.68±0.15 vs.5.77±0.13)were significantly improved in all groups after the treatment.Among them, group C was improved most, followed by groups B and A(all P<0.05). Conclusions:Exercise rehabilitation combined with psychotherapy is of great significance to improve the physical condition of elderly patients with CHD after PCI, and it is better than the routine exercise rehabilitation alone.