應用腳踏復健器之運動方案改善心臟衰竭個案之活動無耐力

Pedlar Inexpensive Ergometer-Based Exercise Program Improves Activity Intolerance in a Heart Failure Case

本文為應用腳踏復健器之運動方案於心臟衰竭個案，主要改善其活動無耐力之健康問題，護理照護期間為2010年5月15日至5月20日，病患5月20日出院後並持續家訪追蹤至8月8日。照護期間筆者運用身體評估技巧，觀察及會談方式，收集個案資料，發現個案因疾病導致無力等生理症狀，無法完成日常生活事務，有活動無耐力、營養少於身體所需及組織灌流減少之健康問題。除了給予營養及飲食指導外，也設計使用腳踏復健器進行運動方案，以改善個案活動無耐力之情形，從個案住院期間至居家復健訓練，協助個案透過腳踏復健器，並以測量六分鐘走路距離、血壓、心跳速率、血氧飽和度及自覺感受，評值個案活動無耐力改善的情況。經由12週運動方案訓練後，個案從無法完成到可完成走路六分鐘，並且增加走路距離54公尺，運動時心跳速率均可達最大心跳速率40-60%，休息時收縮壓及心跳有明顯下降和穩定，自覺疲憊及呼吸困難情形亦明顯改善。所以，腳踏復健器之運動方案能明顯改善心臟衰竭病患活動無耐力的情形。

This paper reports on the efficacy of a pedlar inexpensive ergometer-based structured exercise program in improving activity intolerance in a heart failure case. Data were collected between May 15, 2010 and May 20, 2010 using physical assessments, observations, and interviews. Several home visits were conducted after hospital discharge until August 8. Health problems identified included diseaserelated weakness, inability to complete daily activities, activity intolerance, malnutrition, and ineffective tissue perfusion. In addition to providing nutrition and dietary guidance, we designed an exercise rehabilitation program to improve activity intolerance both during hospitalization and after hospital discharge. Outcome measurements included the six-minute walk test, blood pressure, heart rate, oxygen saturation, and self-perceived improvement. Improvements achieved by the 12th week of the exercise training program included: (1) Able to complete the six-minute walk test (initially unable). (2) Walking distance increased by 54 meters. (3) Target heart rate achieved 40-60% of the maximum heart rate. (4) Resting systolic blood pressure and heart rates decreased tremendously, and (5) Fatigue and shortness of breath improved greatly. Results indicate the pedlar inexpensive ergometer exercise program may help improve the health of heart failure cases suffering from activity intolerance.