Research and Practice of Cardiopulmonary Rehabilitation Training Programs ()
1. Introduction
Cardiopulmonary diseases are among the critical health threats globally, with high morbidity and disability rates imposing heavy burdens on societies and families [1] [2]. With the transformation of medical models and the development of rehabilitation medicine, cardiopulmonary rehabilitation training plays an increasingly crucial role in the rehabilitation treatment of patients with cardiopulmonary diseases [2]. Nevertheless, the formulation and implementation of cardiopulmonary rehabilitation training programs still face numerous issues and challenges, such as lack of scientific and personalized approaches, simplistic assessment methods, and inadequate long-term follow-ups. Consequently, this study aims to explore a scientific, effective, and personalized cardiopulmonary rehabilitation training program to enhance patients’ rehabilitation outcomes and quality of life.
2. Theoretical Basis
2.1. Aerobic Exercise
Definition and role: Aerobic exercise is a core component of cardiopulmonary rehabilitation training. It involves continuous, regular, and moderate physical activity that stimulates the cardiorespiratory system, enhancing the heart’s pumping capacity and the lungs’ ventilation capacity, thereby increasing the body’s oxygen uptake and utilization efficiency.
Common forms: This includes walking, jogging, swimming, cycling, among others, which steadily and consistently improve cardiorespiratory fitness.
Scientific principles: Aerobic exercise augments the heart’s stroke volume, lowers resting heart rate, enhancing cardiac efficiency and endurance [3]. Additionally, it promotes the dilation of pulmonary capillaries, reinforcing lung ventilation capabilities.
Application and influence: Aerobic exercise is considered the basis of rehabilitation program design, which aims to gradually improve the patient’s cardiorespiratory fitness by providing continuous and moderate physical activity. The direct impact of aerobic exercise on patient outcomes is reflected in its ability to increase the heart’s pumping capacity and the lungs’ ability to ventilate, which not only helps to improve the patient’s ability to perform daily activities, but also reduces symptoms associated with cardiopulmonary disease.
2.2. Interval Training
Definition and characteristics: Interval training integrates periods of high-intensity activity with intervals of low-intensity exercise or rest, triggering an adaptive response in the cardiorespiratory system. This alternation between intensities boosts training efficiency [3].
Advantages: Not only does interval training markedly strengthen cardiorespiratory function, but it also substantially increases exercise tolerance, fostering profound adaptive changes within the cardiorespiratory system.
Application scenarios: Ideal for patients requiring rapid improvements in cardiorespiratory fitness or as an adjunctive measure when traditional aerobic training falls short.
Application and influence: Interval training is used as an effective training strategy in the design of rehabilitation training programs, especially when patients need to rapidly improve their cardiorespiratory fitness. The direct impact of interval training on patient outcomes is that it significantly enhances cardiorespiratory function and exercise tolerance. With interval training, patients are able to achieve better training results in a shorter period of time, which is especially important for patients who have limited time or need a quick recovery.
2.3. Strength Training
Definition and role: Strength training is a vital part of cardiopulmonary rehabilitation training. It focuses on specific muscle contractions and relaxations to fortify muscular strength and endurance, elevating overall metabolic levels [4], including basal metabolic rate.
Indirect effects on cardiopulmonary function: By boosting muscle mass, strength training elevates the body’s metabolic demands, indirectly enhancing cardiorespiratory function. Moreover, well-developed muscle groups better support respiratory movements, optimizing breathing efficiency.
Comprehensive effects: Strength training not only optimizes cardiorespiratory function but also enhances patients’ overall athletic capacity, accelerates rehabilitation processes, and heightens treatment outcomes.
Application and influence: Strength training is considered an important part of the design of rehabilitation training programs, and it is designed to improve muscle strength and endurance and improve overall metabolic levels through training that targets specific muscle groups. The direct impact of strength training on patient outcomes is reflected in its ability to optimize cardiopulmonary function and improve the patient’s overall exercise capacity. By increasing muscle mass, patients are better able to support respiratory movements, optimize breathing efficiency, and reduce dyspnea.
3. Implementation Strategies for Rehabilitation Training Programs
1) Personalized Training Programs
Content customization: Thoroughly analyze key individual information such as patients’ age, gender, disease severity, baseline exercise capacity, overall health status, and past medical history to tailor a highly personalized rehabilitation training program for each patient.
Exercise type selection: Consider patients’ personal preferences and rehabilitation goals when selecting suitable aerobic exercises (e.g., walking, jogging, swimming) and supplementing with strength training, flexibility training, and possibly balance and respiratory training to comprehensively enhance patients’ physical fitness. Introduce interval training methods at appropriate times to further stimulate cardiopulmonary function and improve training effectiveness through alternating high-intensity and low-intensity exercises [5].
Intensity and duration: Determine reasonable exercise intensity based on patients’ physical condition and tolerance using scientific methods (e.g., heart rate zone control, Borg rating system) and plan challenging yet safe and feasible exercise durations.
Progress planning: Develop a detailed rehabilitation schedule specifying exercise frequency, training cycles, and expected rehabilitation goals for each phase. Studies like those of Hu Dayi [6] have shown that this schedule not only provides clear guidance for patients’ rehabilitation training but also serves as an essential reference for subsequent rehabilitation outcome monitoring and assessment.
2) Comprehensive Interventions
Multidimensional rehabilitation approaches: Combine multiple rehabilitation means beyond exercise training, including medication, nutritional guidance, and psychological intervention. Medication controls the disease and alleviates symptoms; nutritional guidance ensures balanced nutrition intake to support the rehabilitation process; psychological intervention helps patients adjust their mindset to actively face rehabilitation challenges.
Comprehensive patient improvement: Aim to comprehensively improve patients’ conditions in physiological, psychological, and social functions [7]. Physiologically, enhance cardiopulmonary function and exercise endurance through exercise training and medication; psychologically, alleviate anxiety, depression, and other negative emotions through psychological intervention; socially, restore patients’ daily life and work abilities.
3) Multidisciplinary Collaboration
a) Interdisciplinary team: An interdisciplinary team is composed of experts from various disciplines such as cardiology, respiratory medicine, rehabilitation medicine, psychology, etc., ensuring that team members possess extensive professional knowledge and practical experience. Team members need to have good communication skills and teamwork spirit to provide comprehensive and coordinated services to patients during the rehabilitation process [7].
b) Clear responsibilities and division of labor: Each disciplinary expert in the team should have clear responsibilities and division of labor to ensure that their respective professional fields are fully utilized. Team members need to regularly exchange information on the patient’s rehabilitation progress and jointly formulate and adjust the rehabilitation plan to achieve the best rehabilitation effect.
c) Joint decision-making and plan formulation: The interdisciplinary team should jointly participate in the assessment of patients and the formulation of rehabilitation plans to ensure the scientific nature and personalization of the plans. Team members need to fully discuss and negotiate on elements such as the patient’s rehabilitation goals, training content, intensity, frequency, etc., to reach a consensus.
4) Patient Education
a) Popularizing rehabilitation training knowledge: Explain to patients and their families the purpose, importance, and expected effects of cardiopulmonary function rehabilitation training, so that they fully understand the significance of rehabilitation training for restoring health and improving quality of life. Introduce the basic methods, steps, and techniques of rehabilitation training to ensure that patients and their families can correctly understand and actively cooperate with the training [5]. Emphasize precautions during the rehabilitation training process, such as proper diet, sufficient rest, avoiding excessive fatigue, etc., to ensure the safety and effectiveness of the training.
b) Enhancing self-management capabilities: Educate patients on how to self-manage, including how to arrange training time reasonably, adjust training intensity, monitor physical condition, etc., so that they can continue and effectively carry out rehabilitation training after discharge. Emphasize the importance of self-management for long-term recovery, encourage patients to establish a positive and proactive rehabilitation attitude, and cultivate self-recovery awareness and abilities.
c) Monitoring physical condition and training effect: Teach patients how to monitor their physical condition, such as heart rate, blood pressure, respiratory rate, and other physiological indicators, as well as subjective feelings such as fatigue level and sleep quality. Guide patients on how to assess the effectiveness of training, including improvements in cardiopulmonary function and exercise endurance, to enhance their confidence and motivation for recovery.
d) Identifying and managing discomfort and complications: Educate patients on how to identify discomfort and complications during the training process, such as chest tightness, shortness of breath, palpitations, etc., and teach them corresponding management measures. Emphasize that in case of severe discomfort or complications, they should seek medical attention promptly and consult professional doctors for advice.
5) Regular Follow-up
a) Establishing records: Establish a detailed health management record for each patient, which should include the patient’s basic information, diagnosis, rehabilitation training plan, important records during the training process (such as changes in physiological indicators, training logs, etc.), and follow-up records. Ensure the completeness and systematicness of the records for easy access and tracking of the patient’s rehabilitation process.
b) Formulating a follow-up plan: Based on the patient’s rehabilitation status and needs, formulate a personalized follow-up plan, specifying the time nodes, methods (telephone, outpatient visits, etc.), and content of follow-up. Ensure the rationality and feasibility of the follow-up plan to promptly understand the patient’s recovery status and existing problems. Conduct regular telephone or outpatient follow-up with patients according to the follow-up plan, inquire about their recovery status [8], training progress, and problems encountered in daily life. Provide necessary guidance and support based on patient feedback, such as adjusting the training plan, answering questions, providing psychological support, etc. Encourage patients to continue with rehabilitation training and emphasize the continuity and long-term nature of rehabilitation effects.
c) Recording follow-up results and adjusting the plan: Record the results of each follow-up in the patient’s health management record, including their rehabilitation progress, existing problems, and provided guidance and support. Adjust the patient’s rehabilitation training plan in a timely manner based on the follow-up results to ensure the continuity and maximization of rehabilitation effects.
4. Application Status of Cardiopulmonary Rehabilitation Training Programs
4.1. Wide Application Scope
Cardiopulmonary rehabilitation training plans are widely used in hospitals, rehabilitation centers, sports stadiums, gyms, and other places, providing personalized training programs for people of different ages and health conditions [9]. This rehabilitation method not only targets patients with cardiopulmonary diseases such as heart disease and chronic obstructive pulmonary disease (COPD) but also extends to the elderly, individuals who have been bedridden for a long time, and the general population who need to improve their exercise endurance.
4.2. Importance of Interdisciplinary Collaboration
With the transformation of medical models, cardiopulmonary rehabilitation training is increasingly emphasizing interdisciplinary collaboration. A typical interdisciplinary team usually includes physicians with rehabilitation knowledge, physical therapists (or exercise training experts), occupational therapists, psychological consultants, nutritionists, nurses, and social workers. This multidisciplinary joint diagnosis and treatment model can comprehensively consider the physiological, psychological, and social functions of patients, formulating more comprehensive and personalized rehabilitation programs.
4.3. Updates and Improvements in Techniques and Methods
In recent years, with the continuous advancement of medical and rehabilitation technologies, the methods and means of cardiopulmonary rehabilitation training have also been continuously updated and improved. Various training methods such as aerobic exercise training [10], respiratory training, and strength training have been widely used in clinical practice. At the same time, some emerging technologies such as high-intensity respiratory muscle training technology, noninvasive ventilation technology, and intelligent lung function assessment systems have also been gradually introduced into the field of cardiopulmonary rehabilitation training, improving rehabilitation outcomes and treatment efficiency.
4.4. Close Integration of Research and Clinical Practice
The field of cardiopulmonary rehabilitation training actively conducts multiple clinical studies to explore more effective rehabilitation methods and means. These research results not only provide a scientific basis for clinical practice but also promote the continuous development and improvement of cardiopulmonary rehabilitation training techniques. Meanwhile, the accumulation of experience in clinical practice also provides rich material and inspiration for scientific research work.
4.5. Improvement in Patient Satisfaction and Rehabilitation Outcomes
With the continuous promotion and application of cardiopulmonary rehabilitation training plans, patient satisfaction and rehabilitation outcomes have significantly improved. Multiple studies have shown that patients who have undergone cardiopulmonary rehabilitation training have significant improvements in exercise endurance, cardiopulmonary function, and quality of life. Furthermore, patient satisfaction with rehabilitation training services is generally high, which further promotes the popularization and promotion of cardiopulmonary rehabilitation training plans.
4.6. Challenges and Future Prospects
Although cardiopulmonary rehabilitation training plans have achieved significant results, they still face some challenges. For example, there are differences in rehabilitation levels and resource allocation between different regions and medical institutions; some patients have a low awareness and cooperation level regarding rehabilitation training; and there may be complications and adverse events during the rehabilitation process [11]. In the future, with the continuous advancement of medical technology and the deepening of interdisciplinary collaboration, cardiopulmonary rehabilitation training plans will become more personalized, scientific, and intelligent, bringing benefits to more patients.
5. Scientific Significance and Application Prospects of Cardiopulmonary Rehabilitation Training Programs
5.1. Scientific Significance
Promoting cardiopulmonary function recovery: Cardiopulmonary rehabilitation training employs specific exercises and workouts to assist patients with heart and lung diseases in improving their cardiopulmonary function, enhancing the body’s oxygenation capacity, and boosting physical endurance and resistance. This is crucial for the physiological recovery of patients during rehabilitation [12].
Reducing complications: Cardiopulmonary rehabilitation can lower the incidence of complications among patients with cardiopulmonary diseases, such as heart attacks, strokes, and pneumonia. Through scientific rehabilitation training, patients can alleviate symptoms like chest pain, shortness of breath, and fatigue, thereby improving their quality of life.
Enhancing quality of life: Cardiopulmonary rehabilitation training not only focuses on the recovery of patients’ physiological functions but also emphasizes the improvement of their psychological and social functions. Through rehabilitation training, patients can enhance their self-confidence, improve social skills, better participate in daily activities and social interactions, and ultimately enhance their overall quality of life.
Saving medical resources and costs: With a scientific cardiopulmonary rehabilitation training program, patients can shorten their hospital stays, reduce drug dependence, and thereby lower medical expenses. This holds significant economic importance for both patients and society.
Preventing disease recurrence: Cardiopulmonary rehabilitation also emphasizes the management of patients’ lifestyle, including guidance on diet, sleep, exercise, and other aspects. By establishing good living habits, patients can prevent the recurrence of diseases and reduce the rate of rehospitalization [13].
5.2. Application Prospects
Increasing market demand: With the improvement of people’s living standards and the enhancement of health awareness, the incidence of heart and lung diseases is gradually increasing. At the same time, advancements in medical technology have enabled more patients to survive through surgery or medication, leading to a growing demand for cardiopulmonary rehabilitation.
Innovation in rehabilitation models: With the development of technology, cardiopulmonary rehabilitation training will continue to introduce new technologies and methods. For example, utilizing big data and artificial intelligence to develop intelligent rehabilitation systems that provide personalized training programs and guidance for patients [14]; researching and developing specialized cardiopulmonary combined training equipment to more effectively improve cardiopulmonary function and health levels.
Strengthening interdisciplinary collaboration: Cardiopulmonary rehabilitation training involves multiple fields such as medicine, rehabilitation medicine, and sports science. In the future, with the strengthening of interdisciplinary collaboration, experts from different fields will jointly research methods and techniques for cardiopulmonary rehabilitation training, promoting its continuous development and improvement.
Community promotion and popularization: Cardiopulmonary rehabilitation training can not only be conducted in hospitals but also promoted and popularized in communities. By establishing community rehabilitation centers and conducting health education activities, public awareness and attention to cardiopulmonary rehabilitation can be increased, benefiting more patients.
Increasing policy support: With the deep implementation of the “Healthy China” strategy and the continuous improvement of the medical insurance system, government support for cardiopulmonary rehabilitation will continue to increase. This will provide stronger policy support for the promotion and application of cardiopulmonary rehabilitation training programs.
In summary, cardiopulmonary rehabilitation training programs hold significant scientific significance and application prospects. In the future, with the continuous advancement of technology and the improvement of policies, cardiopulmonary rehabilitation will be applied and promoted in more fields, making greater contributions to the rehabilitation and health of patients.
Funding
This work was supported by the Yunnan Rehabilitation Clinical Medicine Center Cultivation Project (ZX2019-04-02).
NOTES
*These authors contributed equally to this study.
#Corresponding authors.