可穿戴设备在老年心脏康复中的应用研究进展

doi:10.3969/j.issn.1003-9198.2026.05.017

摘要/Abstract

摘要： 心脏康复作为老年心血管疾病非药物干预的核心手段,对改善心肺运动功能、降低再住院率具有显著价值。然而,老年患者常合并慢性心功能不全等复杂情况,传统康复模式面临患者依从性差、监护不足等挑战。可穿戴设备凭借其适老性设计、实时监测与远程交互能力,为老年人心脏康复提供了创新性解决方案。本文系统阐述可穿戴设备在运动处方调整、心肺运动功能及生活改善、安全预警监测三大领域的应用进展,结合国内外临床研究证据,探讨其在老年心脏康复中的实用价值与未来方向。

关键词: 可穿戴设备, 老年人, 心脏康复, 心血管疾病

Abstract: Cardiac rehabilitation serves as a cornerstone of non-pharmacological intervention for cardiovascular diseases in the elderly, demonstrating significant value in improving cardiopulmonary exercise capacity and reducing rehospitalization rates. However, elderly patients often present with complex conditions such as chronic heart insufficiency, and traditional rehabilitation models face challenges including poor adherence and insufficient monitoring. Wearable devices, leveraging age-friendly design, real-time physiological monitoring, and remote interaction capabilities, have emerged as innovative solutions for geriatric cardiac rehabilitation. This article systematically reviews advancements in wearable device applications across three domains: exercise prescription adjustment, cardiopulmonary exercise capacity and quality-of-life improvement, and real-time safety alert monitoring. Drawing on domestic and international clinical evidence, it explores the practical value and future directions of wearable devices in geriatric cardiac rehabilitation, providing references for clinical implementation and practice.

Key words: wearable devices, aged, cardiac rehabilitation, cardiovascular diseases

中图分类号:

R 493
R 54

罗政轩, 贾坚, 姜艳, 涂嘉雯, 许之阳, 占伊扬. 可穿戴设备在老年心脏康复中的应用研究进展[J]. 实用老年医学, 2026, 40(5): 520-524.

LUO Zhengxuan, JIA Jian, JIANG Yan, TU Jiawen, XU Zhiyang, ZHAN Yiyang. Advances in the application of wearable devices in geriatric cardiac rehabilitation[J]. Practical Geriatrics, 2026, 40(5): 520-524.

参考文献

[1] BROWN T M, PACK Q R, ABEREGG E, et al. Core components of cardiac rehabilitation programs:2024 update:a scientific statement from the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation[J]. Circulation, 2024, 150(18):e328-e347.
[2] MOLLOY C D, LONG L, MORDI I R, et al. Exercise-based cardiac rehabilitation for adults with heart failure - 2023 Cochrane systematic review and meta-analysis[J]. Eur J Heart Fail, 2023, 25(12): 2263-2273.
[3] 何竟, 贾杰, 陈欣, 等. 老年慢性心力衰竭全周期康复专家共识[J]. 康复学报, 2025, 35(2): 112-123.
[4] 杨莹. 《心力衰竭早期筛查与一级预防中国专家共识(2024年)》解读[J]. 心脑血管病防治, 2025, 25(7): 1-4.
[5] MCDONAGH T A, METRA M, ADAMO M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure[J]. Eur Heart J, 2021, 42(36):3599-3726.
[6] SAVARESE G, BECHER P M, LUND L H, et al. Global burden of heart failure: a comprehensive and updated review of epidemiology[J]. Cardiovasc Res, 2023, 118(17): 3272-3287.
[7] TERADA T, HAUSEN M, WAY K L, et al. Wearable devices for exercise prescription and physical activity monitoring in patients with various cardiovascular conditions[J]. CJC Open, 2025, 7(5): 695-706.
[8] HUGHES A, SHANDHI M M H, MASTER H, et al. Wearable devices in cardiovascular medicine[J]. Circ Res, 2023, 132(5): 652-670.
[9] BAYOUMY K, GABER M, ELSHAFEEY A, et al. Smart wearable devices in cardiovascular care: where we are and how to move forward[J]. Nat Rev Cardiol, 2021, 18(8): 581-599.
[10] THOMAS R J, BEATTY A L, BECKIE T M, et al. Home-based cardiac rehabilitation: a scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology[J]. J Am Coll Cardiol, 2019, 74(1): 133-153.
[11] SEFFAH K, ZAMAN M A, AWAIS N, et al. Exploring the role of wearable electronic medical devices in improving cardiovascular risk factors and outcomes among adults: a systematic review[J]. Cureus, 2023, 15(3): e36754.
[12] HODKINSON A, KONTOPANTELIS E, ADENIJI C, et al. Interventions using wearable physical activity trackers among adults with cardiometabolic conditions: a systematic review and meta-analysis[J]. JAMA Netw Open, 2021, 4(7): e2116382.
[13] LIGUORI G. ACSM’s Guidelines for Exercise Testing and Prescription, 11th Edition[M]. Philadelphia:Lippincott Willoms & Willkms, 2021: P70.
[14] MALHOTRA R, BAKKEN K, D’ELIA E, et al. Cardiopulmonary exercise testing in heart failure[J]. JACC Heart Fail, 2016, 4(8): 607-616.
[15] ONG M K, ROMANO P S, EDGINGTON S, et al. Effectiveness of remote patient monitoring after discharge of hospitalized patients with heart failure: the better effectiveness after transition: heart failure (BEAT-HF) randomized clinical trial[J]. JAMA Intern Med, 2016, 176(3): 310-318.
[16] JONES A K, YAN C L, RIVERA RODRIQUEZ B P, et al. Role of wearable devices in cardiac telerehabilitation: a scoping review[J]. PLoS One, 2023, 18(5): e0285801.
[17] STEINHUBL S R, WAALEN J, EDWARDS A M, et al. Effect of a home-based wearable continuous ECG monitoring patch on detection of undiagnosed atrial fibrillation: the mSToPS randomized clinical trial[J]. JAMA, 2018, 320(2): 146-155.
[18] 于晓燕, 汤婷, 赵佳文, 等. 个体化康复运动训练联合八段锦运动对冠心病PCI术后患者心功能、生活质量和心境状态的影响[J]. 现代生物医学进展, 2022, 22(2): 294-298.
[19] MACKINNON G E, BRITTAIN E L. Mobile health technologies in cardiopulmonary disease[J]. Chest, 2020, 157(3): 654-664.
[20] NAGATOMI Y, IDE T, HIGUCHI T, et al. Home-based cardiac rehabilitation using information and communication technology for heart failure patients with frailty[J]. ESC Heart Fail, 2022, 9(4): 2407-2418.
[21] 潘海燕, 夏轩, 陈丽华, 等. 远程心电监护指导下家庭运动康复对慢性射血分数降低型心力衰竭患者的疗效及安全性研究[J]. 临床心血管病杂志, 2022, 38(6): 478-483.
[22] BÄUERLE A, MALLIEN C, RASSAF T, et al. Determining the acceptance of digital cardiac rehabilitation and its influencing factors among patients affected by cardiac diseases[J]. J Cardiovasc Dev Dis, 2023, 10(4): 174.
[23] MADDISON R, NOURSE R, DARYABEYGIKHOTBEHSARA R, et al. Digital home-based self-monitoring system for people with heart failure: protocol for development of SmartHeart and evaluation of feasibility and acceptability[J]. JMIR Res Protoc, 2025, 14: e62964.
[24] FERGUSON T, OLDS T, CURTIS R, et al. Effectiveness of wearable activity trackers to increase physical activity and improve health: a systematic review of systematic reviews and meta-analyses[J]. Lancet Digit Health, 2022, 4(8): E615-E626.
[25] FUKUTA Y, ARIZONO S, TANAKA S, et al. Effects of real-time remote cardiac rehabilitation on exercise capacity and quality of life: a quasi-randomised controlled trial[J]. BMC Geriatr, 2023, 23(1): 388.
[26] SHANDHI M M H, HERSEK S, FAN J, et al. Wearable patch-based estimation of oxygen uptake and assessment of clinical status during cardiopulmonary exercise testing in patients with heart failure[J]. J Card Fail, 2020, 26(11): 948-958.
[27] KOEHLER F, WINKLER S, SCHIEBER M, et al. Impact of remote telemedical management on mortality and hospitalizations in ambulatory patients with chronic heart failure: the telemedical interventional monitoring in heart failure study[J]. Circulation, 2011, 123(17):1873-1880.
[28] CHANDRASEKARAN R, KATTHULA V, MOUSTAKAS E. Too old for technology? Use of wearable healthcare devices by older adults and their willingness to share health data with providers[J]. Health Informatics J, 2021, 27(4): 14604582211058073.
[29] ABOUZAHRA M, GHASEMAGHAEI M. The antecedents and results of seniors’ use of activity tracking wearable devices[J]. Health Policy Technol, 2020, 9(2): 213-217.
[30] GORODESKI E Z, GOYAL P, HUMMEL S L, et al. Domain management approach to heart failure in the geriatric patient: present and future[J]. J Am Coll Cardiol, 2018, 71(17): 1921-1936.
[31] 姜衡, 于曼丽, 李彬, 等. 远程心电监测在冠心病合并慢性心力衰竭患者心脏康复中的应用价值[J]. 心血管康复医学杂志, 2022, 31(6): 723-728.
[32] INDRARATNA P, TARDO D, YU J, et al. Mobile phone technologies in the management of ischemic heart disease, heart failure, and hypertension: systematic review and meta-analysis[J]. JMIR Mhealth Uhealth, 2020, 8(7): e16695.
[33] HALCOX J P J, WAREHAM K, CARDEW A, et al. Assessment of remote heart rhythm sampling using the AliveCor heart monitor to screen for atrial fibrillation: the REHEARSE-AF study[J]. Circulation, 2017, 136(19): 1784-1794.
[34] 芦婷婷, 曹瑞华, 王雨嘉, 等. 便携式掌式12导联心电信号采集装置在老年心血管疾病中的诊断效能[J]. 中华老年多器官疾病杂志, 2023, 22(11): 842-846.
[35] INDRARATNA P, BISWAS U, MCVEIGH J, et al. A smartphone-based model of care to support patients with cardiac disease transitioning from hospital to the community (TeleClinical care): pilot randomized controlled trial[J]. JMIR Mhealth Uhealth, 2022, 10(2): e32554.
[36] ANTONIOU V, XANTHOPOULOS A, GIAMOUZIS G, et al. Efficacy, efficiency and safety of a cardiac telerehabilitation programme using wearable sensors in patients with coronary heart disease: the TELEWEAR-CR study protocol[J]. BMJ Open, 2022, 12(6): e059945.
[37] PEREZ M V, MAHAFFEY K W, HEDLIN H, et al. Large-scale assessment of a smartwatch to identify atrial fibrillation[J]. N Engl J Med, 2019, 381(20): 1909-1917.
[38] LUNDE P, BYE A, BERGLAND A, et al. Long-term follow-up with a smartphone application improves exercise capacity post cardiac rehabilitation: a randomized controlled trial[J]. Eur J Prev Cardiol, 2020, 27(16): 1782-1792.
[39] BROUWERS R W M, SCHERRENBERG M, KEMPS H M C, et al. Cardiac telerehabilitation: current status and future perspectives[J]. Neth Heart J, 2024, 32(1): 31-37.
[40] KOLK M Z H, RUIPÉREZ-CAMPILLO S, WILDE A A M, et al. Prediction of sudden cardiac death using artificial intelligence: current status and future directions[J]. Heart Rhythm, 2025, 22(3): 756-766.
[41] FREDERIX I, CAIANI E G, DENDALE P, et al. ESC e-Cardiology Working Group Position Paper. Overcoming challenges in digital health implementation in cardiovascular medicine[J]. Eur J Prev Cardiol, 2019,26(11):1166-1177.
[42] GRUSKA M, AIGNER G, ALTENBERGER J, et al. Recommendations on the utilization of telemedicine in cardiology[J]. Wien Klin Wochenschr, 2020, 132(23/24): 782-800.