心臟康復(fù)—德國(guó)模式課件

1、心臟康復(fù)德國(guó)模式Dr. Max Joseph Oertel (1835-1897)德國(guó)醫(yī)生首先倡導(dǎo)“運(yùn)動(dòng)處方”漸進(jìn)式增加運(yùn)動(dòng)對(duì)血壓、心率和健康狀況有積極影響德國(guó)心臟康復(fù)/二級(jí)預(yù)防發(fā)展史德國(guó)心臟康復(fù)/二級(jí)預(yù)防發(fā)展史他山之石 可以攻玉康復(fù)/二級(jí)預(yù)防 50年1950S 末， Terell/Hellerstein提出漸進(jìn)增加運(yùn)動(dòng)量的分級(jí)心臟康復(fù)方案1960S末，Hellerstein啟動(dòng)第一個(gè)門診心臟康復(fù)系統(tǒng)If there were a pill that would unite following properties:如果一種藥物可以綜合以下功能reduction of myocardial o

2、xygen demand, 減少心肌耗氧量increase myocardial oxygen supply, 增加心肌氧氣供給inhibiting the development of arteriosclerosis, 阻止動(dòng)脈硬化的惡化 improve the flow properties of blood, 改善血流特性 favoring an optimal development of body and mind, 輔助提高最佳的身心發(fā)展 avoiding physical and mental age-related degradation combined with an a

3、nti-thrombotic effect, 避免身心老齡退化結(jié)合抗血栓效果 counteract the Adipositas with what great drama such a drug would be celebrated probably worldwide?“ 有效減少肥胖，這種藥物可能受全世界的歡迎 In this case, this medication is available: 現(xiàn)在這種藥物就有it means suitable, individually tailored physical training from childhood to old age. H

4、is application is unfortunately the physical law of inertia contrary, and we have to live after all. “ 這就是適用于兒童到老人的運(yùn)動(dòng)療法 。很遺憾，這種療法是是非慣性的，而且這種療法是需要終生持續(xù)進(jìn)行的。(Hollmann 1995) 成熟發(fā)展的心康體系德國(guó)模式Cardiac Rehab Institutes in Germany德國(guó)的專業(yè)心臟康復(fù)機(jī)構(gòu)分布根據(jù)德國(guó)心臟康復(fù)質(zhì)控標(biāo)準(zhǔn)機(jī)構(gòu)2012數(shù)據(jù)Residential 住院ambulatory 門診residential and ambulat

5、ory 住院+門診Cardiac rehab = Multidisziplinary Approach心臟康復(fù)=多學(xué)科相結(jié)合的綜合康復(fù)解決方案Super ordinate goals 高級(jí)目標(biāo)to achieve the best possible regeneration of the patients cardiac capacities 為了達(dá)到最佳心功能重建目標(biāo)respect to all psychosocial aspects 考慮各方面社會(huì)心理學(xué)因素thereby reintegrate the patient into his social and job-related en

6、vironment促進(jìn)患者重回社會(huì)與工作環(huán)境 averting impending high-maintenance of chronically impaired防止進(jìn)一步慢性損傷的導(dǎo)致的高額維護(hù)preventing progress of the disease by means of secondary prevention.防止二次發(fā)病5 Prescriptions of Cardiac rehab心臟康復(fù)五大處方運(yùn)動(dòng)處方Sport Therapy心理 處方Psychotherapy藥物處方 medaicatonPatient 患者戒煙 處方 quit somking營(yíng)養(yǎng)處方Nutri

7、tionalManagement穩(wěn)定型心絞痛無(wú)癥狀性心肌缺血急性心肌梗死陳舊性心肌梗死冠狀動(dòng)脈搭橋術(shù)后心臟瓣膜置換術(shù)后慢性穩(wěn)定性心力衰竭外周血管病出現(xiàn)間歇性跛行有冠心病危險(xiǎn)因素患者，如血脂異常、高血壓、糖尿病、肥胖吸煙等心臟康復(fù)的適應(yīng)癥ICF Rehab Circle & Individual ProposalICF康復(fù)流程及個(gè)體化運(yùn)動(dòng)處方的制定Extensive initial diagnosis / Risk classification全面的初次診斷/風(fēng)險(xiǎn)分類patients individual rehabilitation goals are formulated (somatic,

8、 educative, psychological, and socio-medical) 制定患者的個(gè)人康復(fù)目標(biāo)（軀體、教育、心理、和社會(huì)醫(yī)學(xué)）為患者量身定制個(gè)性化的康復(fù)計(jì)劃（制定適當(dāng)?shù)倪\(yùn)動(dòng)治療措施、身體機(jī)能測(cè)試、常規(guī)和特有病癥的教育和培訓(xùn)、必要的心理輔導(dǎo)和/或社會(huì)醫(yī)療措施）Continuous medical attendance and monitoring在康復(fù)過(guò)程中，患者接受全面的醫(yī)療護(hù)理和監(jiān)督包括診斷、醫(yī)療等；如果需要，可以根據(jù)康復(fù)情況調(diào)整康復(fù)目標(biāo)最終結(jié)束時(shí)，對(duì)患者進(jìn)行全面的檢查測(cè)試，根據(jù)之前的康復(fù)目標(biāo)，評(píng)估治療結(jié)果和康復(fù)效果（基于最終評(píng)估結(jié)果，將為患者制定一份社會(huì)醫(yī)療評(píng)估表（比如

9、關(guān)于重返工作和/或護(hù)理需求的問(wèn)題等），同時(shí)也會(huì)提供一份建議書和病后護(hù)理方案邀請(qǐng)函）phases of rehabilitation 康復(fù)階段Phase I 第一期physical therapy 物理療法mobilization 活動(dòng)Hocker“ Gymnastics “凳子”體操 （無(wú)椅背、無(wú)把手） Phase II 第二期inpatient or outpatient“ 住院病人或門診病人rehabilitation immediately after myocardial infarction, heart surgery, etc.在心肌梗塞、心臟手術(shù)之后立即進(jìn)行康復(fù)。Phase I

10、II 第三期secondary prevention 繼發(fā)性預(yù)防lifelong after care 終生療法Functional Area Design & active rehab training program心臟康復(fù)功能區(qū)設(shè)計(jì)及主動(dòng)康復(fù)訓(xùn)練技術(shù) MTT, sport therapy 醫(yī)學(xué)訓(xùn)練療法/運(yùn)動(dòng)療法 Ergometer training (Ergoline) Erogline心臟功能康復(fù)訓(xùn)練 functional exercise 功能訓(xùn)練 Physical therapy 理療 Occupation therapy OT作業(yè)療法 Nutrition consulting 營(yíng)

11、養(yǎng)咨詢 Psychological consulting 心理咨詢 Social worker consulting 社會(huì)工作協(xié)調(diào) Speech therapy ST言語(yǔ)治療Health Education 健康教育Super ordinate goals are: - to achieve the best possible regeneration of the patients cardiac capacities with respect to all psychosocial aspects in order to thereby reintegrate the patient in

12、to his social and job-related environment, - averting impending high-maintenance of chronically impaired, preventing progress of the disease by means of secondary prevention.心臟康復(fù)最終目標(biāo)： - 實(shí)現(xiàn)了心臟病患者心功能恢復(fù)，并結(jié)合社會(huì)心理因素，促進(jìn)患者盡早重回社會(huì)，重返工作崗位。 - 預(yù)防長(zhǎng)期心功能受損所引發(fā)的高額醫(yī)療保險(xiǎn)維護(hù)。- 預(yù)防疾病進(jìn)展，即二次患病預(yù)防。Phases II Cardiac Rehab in Ger

13、many德國(guó)II期心臟康復(fù)Most important goals are: - overcoming loss in cardiovascular and musculoskeletal function resulting from immobilization, improvement of physical performance support of psychosocial stabilization運(yùn)動(dòng)療法的最重要的目標(biāo)： 防止患者制動(dòng)導(dǎo)致的心血管功能及肌肉骨骼功能降低提高患者身體機(jī)能為患者的社會(huì)心理穩(wěn)固性提供支持 Phases II Cardiac Rehab in Germa

14、ny德國(guó)II期心臟康復(fù)exercise therapy 運(yùn)動(dòng)療法Effectiveness of exercise only or exercise as part of a comprehensive cardiac rehabilitation programme on all cause mortality and cardiac mortality.單純運(yùn)動(dòng)訓(xùn)練和包括運(yùn)動(dòng)訓(xùn)練在內(nèi)的綜合性心臟康復(fù)方案對(duì)于整體死亡率和心源性死亡率的影響%n = 8440 (CAD, MI, ACVB-OP PTCA)Joliffe JA et al. The Cochrane Libary (2002)h

15、ttp: /Exercise therapy is an essential part of the Therapie and consumes 30-50% of the time spent on therapeutic measures.運(yùn)動(dòng)療法占心臟康復(fù)的主要訓(xùn)練部分?；颊呖祻?fù)的30-50的時(shí)間需要用于運(yùn)動(dòng)療法。 Phases II Cardiac Rehab in Germany德國(guó)II期心臟康復(fù)exercise therapy 運(yùn)動(dòng)療法PT & MTTPT 區(qū)與MTT醫(yī)學(xué)訓(xùn)練療法區(qū)（肌肉力量訓(xùn)練）Cardiac Rehab Area心肺康復(fù)功能專區(qū)（有氧耐力訓(xùn)練）Phases II

16、 Cardiac Rehab in Germany德國(guó)II期心臟康復(fù)Phases II Cardiac Rehab in Germany德國(guó)II期心臟康復(fù)心肺功能康復(fù)訓(xùn)練（有氧耐力訓(xùn)練）The attending doctor decides on the patients individual training load based on the results gained in the initial diagnosis (including incremental bicycle-ergometry, (stress) echocardiography, 24-hours-ECG).

17、Ergometer training with ECG-, heart rate-, (blood pressure, SpO2)-monitoring is executed 5-6 times per week - performed as group training.主治醫(yī)師根據(jù)患者初次測(cè)試診斷的結(jié)果（包括運(yùn)動(dòng)負(fù)荷試驗(yàn)（心電運(yùn)動(dòng)負(fù)荷試驗(yàn)&心肺運(yùn)動(dòng)負(fù)荷試驗(yàn)和癥狀限制運(yùn)動(dòng)負(fù)荷試驗(yàn)（負(fù)荷恒定/負(fù)荷遞增）、（運(yùn)動(dòng)）超聲心動(dòng)圖、24小時(shí)心電圖（Holter）確定患者的個(gè)人訓(xùn)練負(fù)荷Ergoline ERS功率自行車訓(xùn)練，帶有心電圖、心率、（血壓、血氧飽和度）監(jiān)測(cè)每周訓(xùn)練5-6次以小組訓(xùn)練方式進(jìn)行I

18、n this context, symptom-limited cardiac exercise toleranceis primarily respected (defined as the load the patient wasable to bear during the incremental bicycle-ergometry test without showing pathological symptoms) training load is usually being set to 70-85% of symptom-limited cardiac exercise tole

19、rance and significantly below the load causing myocardial ischemia. 這種情況下，主要測(cè)試的是癥狀限制性的心臟運(yùn)動(dòng)負(fù)荷耐受量（也就是患者在功率自行車遞增負(fù)荷試驗(yàn)中所能承受的未出現(xiàn)病理癥狀時(shí)的最大負(fù)荷水平）訓(xùn)練負(fù)荷通常設(shè)為癥狀限制性心臟運(yùn)動(dòng)耐受量的70-85%，此強(qiáng)度顯著低于可以引起心肌缺血時(shí)的負(fù)荷強(qiáng)度。Phases II Cardiac Rehab in Germany德國(guó)II期心臟康復(fù)心臟功能康復(fù)訓(xùn)練（有氧耐力訓(xùn)練）Cardio rehab process - Phase II心臟康復(fù)階段二期diagnostic by doc

20、tor 醫(yī)生診斷是否可實(shí)施（前期篩查） Patient will be classified by class A-D 分為A-D四類 A: no limited 無(wú)功能受限 B: limited LVEF, OP, age 大于 75, NYHA I, CCS0, inactive B：射血分?jǐn)?shù)受限，術(shù)后，年齡大于 75，心功能I級(jí)，加拿大心角痛分級(jí)，缺乏體力活動(dòng) C: LVEF50%, NYHA II, CCSI D: LVEF30%, CCSII Doctor decides treatment (trainings) methods. 醫(yī)生根據(jù)患者運(yùn)動(dòng)負(fù)荷試驗(yàn)（有氧運(yùn)動(dòng)能力評(píng)估、心電運(yùn)

21、動(dòng)試驗(yàn)（運(yùn)動(dòng)平板+運(yùn)動(dòng)踏車）、心肺運(yùn)動(dòng)負(fù)荷試驗(yàn)、6分鐘步行試驗(yàn)）骨骼肌力量評(píng)估、超聲心動(dòng)、平衡能力測(cè)試、柔韌性測(cè)試、協(xié)調(diào)性測(cè)試等測(cè)試評(píng)估為患者制定訓(xùn)練處方（運(yùn)動(dòng)處方） Doctor notices the limitation of training. 醫(yī)生注意訓(xùn)練禁忌及患者服用藥物心臟康復(fù)功能專區(qū)Ergoline ERS 可控心臟功能康復(fù)訓(xùn)練中央控制電腦(運(yùn)動(dòng)處方管理,一拖16)無(wú)線心電監(jiān)控(直徑100米范圍)心臟康復(fù)功能專區(qū)Ergoline ERS 可控心臟功能康復(fù)訓(xùn)練Cardio rehab process - Phase II心臟康復(fù)階段二期90% patients use the E

22、rgoline system90%患者使用Ergoline系統(tǒng)進(jìn)行訓(xùn)練 basic treatment: 基礎(chǔ)訓(xùn)練30 min. Ergometer training, 5 times/week30分鐘功率計(jì)訓(xùn)練，每周5次 30-60 min. group training, 4-5 times/week (endurance and strength)30-60分鐘小組訓(xùn)練，每周4-5次：耐力與力量訓(xùn)練 options 選項(xiàng)：MTT, swimming, nordic walking, step recording, nutrition, quit smoking course, healt

23、h education course, relax training)MTT醫(yī)學(xué)訓(xùn)練療法、北歐行步、記步行走、營(yíng)養(yǎng)管理、戒煙課程、健康教育課程、放松訓(xùn)練Highest Quality Level 最高質(zhì)量等級(jí)Production 100 % made in Germany 100%德國(guó)制造 Accurate: power maximum coefficient of variation is not more than 2% 精確：功率最大變異系數(shù)不大于2%Compatibility, the most widely used brand of ergometer 兼容性，應(yīng)用最廣泛的踏車品牌

24、。 Why would 90% patients use the Ergoline system？為什么90%患者使用Ergoline系統(tǒng)進(jìn)行訓(xùn)練？超聲心動(dòng)圖功率車Why would 90% patients use the Ergoline system？為什么90%患者使用Ergoline系統(tǒng)進(jìn)行訓(xùn)練？多種功率車選擇。躺式功率車常規(guī)型舒適型上肢型Why would 90% patients use the Ergoline system？為什么90%患者使用Ergoline系統(tǒng)進(jìn)行訓(xùn)練？多種功率車選擇。康復(fù)型ers.2 ergometer configurations齊全的心肺功能康復(fù)功率

25、車配置ERS.2 心肺功能康復(fù)系統(tǒng)可兼容運(yùn)動(dòng)負(fù)荷測(cè)試、超聲心動(dòng)圖及肺功能測(cè)試根據(jù)患者測(cè)試數(shù)據(jù)為患者制定運(yùn)動(dòng)處方（設(shè)定訓(xùn)練靶心率及報(bào)警心率/血氧/血壓/功率限制），并在訓(xùn)練過(guò)程中實(shí)時(shí)監(jiān)控患者并自動(dòng)保存患者訓(xùn)練數(shù)據(jù)追蹤康復(fù)進(jìn)程的ERS.2軟件系統(tǒng)。Why would 90% patients use the Ergoline system？為什么90%患者使用Ergoline系統(tǒng)進(jìn)行訓(xùn)練？Why would 90% patients use the Ergoline system？為什么90%患者使用Ergoline系統(tǒng)進(jìn)行訓(xùn)練？詳細(xì)的患者管理系統(tǒng)： Why would 90% patients

26、use the Ergoline system？為什么90%患者使用Ergoline系統(tǒng)進(jìn)行訓(xùn)練？ 與患者進(jìn)行的運(yùn)動(dòng)負(fù)荷測(cè)試、超聲心動(dòng)及肺功能測(cè)試兼容：可輸入并保存心電圖運(yùn)動(dòng)負(fù)荷測(cè)試、超聲心動(dòng)及肺功能測(cè)試數(shù)據(jù)Why would 90% patients use the Ergoline system？為什么90%患者使用Ergoline系統(tǒng)進(jìn)行訓(xùn)練？與患者進(jìn)行的心電圖運(yùn)動(dòng)負(fù)荷試驗(yàn)兼容：可根據(jù)患者進(jìn)行的心電圖運(yùn)動(dòng)負(fù)荷測(cè)試、超聲心動(dòng)及肺功能測(cè)試數(shù)據(jù)設(shè)置訓(xùn)練警告，及超過(guò)警告數(shù)值后的自動(dòng)措施（警告、恢復(fù)及停止訓(xùn)練）Why would 90% patients use the Ergoline syst

27、em？為什么90%患者使用Ergoline系統(tǒng)進(jìn)行訓(xùn)練？（一）與患者進(jìn)行的心電圖運(yùn)動(dòng)負(fù)荷試驗(yàn)兼容：可根據(jù)患者進(jìn)行的心電圖運(yùn)動(dòng)負(fù)荷測(cè)試、超聲心動(dòng)及肺功能測(cè)試數(shù)據(jù)選擇并設(shè)置訓(xùn)練方案（運(yùn)動(dòng)處方）、訓(xùn)練心率及心率控制類型（緩和、正常、嚴(yán)格、非常嚴(yán)格）。訓(xùn)練處方分為以下幾類：恒定負(fù)荷心率控制血氧飽和度控制間歇模式間歇（心率控制）自定義模式恒定負(fù)荷訓(xùn)練訓(xùn)練心肺耐力和運(yùn)動(dòng)耐力（骨骼?。?。心率控制在嚴(yán)格控制心率的前提下，訓(xùn)練心臟耐力。血氧飽和度控制在嚴(yán)格控制血氧飽和度的前提下，訓(xùn)練心肺耐力。Load curveHeart rate curveDiastolic blood pressureSystolic b

28、lood pressure心率控制訓(xùn)練模式分析間歇模式通過(guò)間歇交替可控的高低負(fù)荷訓(xùn)練，促使心肺進(jìn)入最大或失常狀態(tài)（可控穩(wěn)定的輕度/中度心肌缺血狀態(tài)），訓(xùn)練機(jī)體產(chǎn)生耐受性。間歇（心率控制）在嚴(yán)格控制心率的前提下，通過(guò)間歇交替可控的高低負(fù)荷訓(xùn)練，促使心肺進(jìn)入最大或失常狀態(tài)（可控穩(wěn)定的輕度/中度心肌缺血狀態(tài)），訓(xùn)練機(jī)體產(chǎn)生耐受性。自定義模式可以根據(jù)患者的測(cè)試數(shù)據(jù)與疾病種類相應(yīng)的相對(duì)自由的為患者制定適合的訓(xùn)練方案（運(yùn)動(dòng)處方）、訓(xùn)練心率、心率控制類型及血壓測(cè)量周期。Why would 90% patients use the Ergoline system？為什么90%患者使用Ergoline系統(tǒng)進(jìn)行訓(xùn)

29、練？（二）精確監(jiān)控患者訓(xùn)練：可實(shí)時(shí)監(jiān)控多位患者的訓(xùn)練數(shù)據(jù)功率、踏車轉(zhuǎn)速、心電、血氧飽和度及血壓。Why would 90% patients use the Ergoline system？為什么90%患者使用Ergoline系統(tǒng)進(jìn)行訓(xùn)練？（三）追蹤患者康復(fù)進(jìn)程。自動(dòng)保存患者每次訓(xùn)練數(shù)據(jù)（心電圖、代謝當(dāng)量、消耗能量、血壓、血氧、訓(xùn)練時(shí)間等數(shù)據(jù)），客觀記錄患者訓(xùn)練數(shù)據(jù)，追蹤患者康復(fù)進(jìn)程。Why would 90% patients use the Ergoline system？為什么90%患者使用Ergoline系統(tǒng)進(jìn)行訓(xùn)練？（四）自帶卡爾文靶心率公式。The heart rate reser

30、ve (HRR) is the difference between maximal heart rate and resting heart rate, as determined in maximal exercise stress test. 心率儲(chǔ)備（HRR）是指最大心率和安靜心率的差值，通過(guò)最大運(yùn)動(dòng)耐量試驗(yàn)確定。Example calculation target intensity 60% of heart rate reserve案例：計(jì)算目標(biāo)強(qiáng)度 心率儲(chǔ)備的60%Resting heart rate 安靜心率= 60 beats/min Maximal heart rate i

31、n exercise test= 100 beats/min運(yùn)動(dòng)負(fù)荷試驗(yàn)中的最大心率 100 次/分 Target heart rate for exercise training = 60 + (100-60) x 0,6 = 84 beats/min 運(yùn)動(dòng)訓(xùn)練中的靶心率 = 60 + (100-60) x 0,6 = 84 次分100- 80 - 70 - 60 -beat/minHow to calculate target heart rate using heart rate reserve如何利用心率儲(chǔ)備計(jì)算靶心率 (Karvonen 公式)ischemic threshold M

32、aximal heart rate 118 beats/min 最大心率118次/分Heart rate at ischemic threshold 109 beats /min 缺血心率閾值109次/分Exercise heart rate clearly below the ischemic threshold (at least 10 beats/min) maximal at 99 beats/min 運(yùn)動(dòng)心率最大為99次/分，明顯低于缺血閾值（至少10次/分）Target heart rate 75% of maximal heart rate at 90 beats/min 靶心率

33、為最大心率的75%，90次/分75% HRmax = 90/min and 87 wattPatient: 52 years old man post Acute Coronary Syndrome and PCI患者：52歲，男性，急性冠脈綜合征和經(jīng)皮冠脈介入術(shù)后Medication: -receptor-blocker, statins and ASS藥物治療：受體阻滯劑、他汀類藥物和阿斯匹林訓(xùn)練案例20 19extremely hard 非常累 1817very hard 很累1615hard / heavy 累 1413somewhat hard 有點(diǎn)累 1211light 輕松109

34、 very light 很輕松87 extremely light 非常輕松6The Borg-Scale (Rate of Perceived Exertion, RPE) （主觀疲勞感/主觀用力等級(jí)，RPE）RPE 12 40% VO2peakRPE 12-1340-60% VO2peakRPE 14-1660-85% VO2peak The Borg主觀疲勞度量表MTT醫(yī)學(xué)訓(xùn)練療法區(qū)Ergoline ERS 可控心臟功能康復(fù)訓(xùn)練訓(xùn)練區(qū)專業(yè)設(shè)計(jì)示范中心Inselspital, Bern CH 瑞士伯爾尼Inselspital醫(yī)院心臟康復(fù)醫(yī)學(xué)中心German Sports Universit

35、y, Cologne GER 德國(guó)科隆體育大學(xué)Policlinico San Donato, Milano 意大利米蘭Policlinico San Donato中心為什么要進(jìn)行肌力訓(xùn)練？無(wú)法因制動(dòng)無(wú)法行走或因功能障礙無(wú)法完成足夠數(shù)量的行走時(shí)會(huì)怎樣？肌肉：臥床2周丟失30%肌力骨骼：臥床每天丟失大約1%Projects Space research - MoscowAim: 目標(biāo)：To prevent muscle and bone loss due to immobilization 預(yù)防因制動(dòng)導(dǎo)致的肌肉和骨質(zhì)的流失Training of the neuromuscular system t

36、o keep muscle power 訓(xùn)練神經(jīng)肌肉系統(tǒng)來(lái)保持肌肉的功率No drug can prevent bone or muscle loss without exercise 沒有任何一種藥物可以在沒有訓(xùn)練的前提下預(yù)防骨骼或肌肉的流失訓(xùn)練目標(biāo) Start 3 Months 7Months72 kg September 200164 kg December 200173 kg June 2002ESA Bedrest-Study, ToulouseMTT醫(yī)學(xué)訓(xùn)練療法區(qū)BTE Eccentron 可控離心抗阻力量訓(xùn)練通過(guò)Eccentron進(jìn)行下肢離心閉鏈功能訓(xùn)練，無(wú)需大強(qiáng)度的有氧訓(xùn)練或者爆發(fā)力訓(xùn)練即可顯著增強(qiáng)下肢肌肉力量及平衡性。Eccentron軟件操作簡(jiǎn)易，提供安全、精確的訓(xùn)練方案。通過(guò)顯示器提供的生物反饋功能能夠更好地幫助患者正確控制訓(xùn)練量。Eccentron還能夠記錄患者數(shù)據(jù)，并生成客觀報(bào)告，有助于控制訓(xùn)練進(jìn)度。（通過(guò)ergoline無(wú)線心電監(jiān)控和Borg主觀疲