Corvera-Tindel Teresita, Doering Lynn V, Woo Mary A, Khan Steven, Dracup Kathleen
Greater Los Angeles, Veterans Affairs Health Care System, Los Angeles, Calif, USA.
Am Heart J. 2004 Feb;147(2):339-46. doi: 10.1016/j.ahj.2003.09.007.
Hospital-based exercise programs using a bicycle ergometer or a combination of exercise modalities have shown positive benefits in heart failure, but may not be readily accessible to many patients. Thus, we sought to evaluate the effects of a 12-week home walking exercise program on functional status and symptoms in patients with heart failure.
A randomized controlled trial comparing a 12-week progressive home walking exercise program (n = 42) to a "usual activity" control group (n = 37) was conducted in patients with heart failure (78 [99%] male; mean age 62.6 +/- 10.6 years; ejection fraction 27% +/- 8.8%; 63 [80%] New York Heart Association class II; 15[20%] New York Heart Association class III-IV) from a Veterans Affairs medical center and a university-affiliated medical center. Functional status (peak oxygen consumption via cardiopulmonary exercise testing, 6-minute walk test, the Heart Failure Functional Status Inventory), and symptoms (Dyspnea-Fatigue Index score with a postglobal rating of symptoms) were measured at baseline and 12 weeks.
No adverse events related to exercise training occurred. Overall mean compliance to training was 74 +/- 37%. Peak oxygen consumption and the Heart Failure Functional Status Inventory were unchanged with training. Compared to the usual activity group, the training group had significantly longer walking distances measured by the 6-minute walk test (1264 +/- 255 vs 1337 +/- 272 feet, P =.001), and improved postglobal rating of symptoms (P =.03).
In patients with heart failure, a progressive home walking exercise program is acceptable, increases walking distance, and decreases global rating of symptoms.
基于医院的使用自行车测力计或多种运动方式组合的运动项目已显示出对心力衰竭有积极益处，但许多患者可能无法轻易参与。因此，我们试图评估一项为期12周的家庭步行运动项目对心力衰竭患者功能状态和症状的影响。
在一家退伍军人事务医疗中心和一家大学附属医院对心力衰竭患者（78名[99%]男性；平均年龄62.6±10.6岁；射血分数27%±8.8%；63名[80%]纽约心脏协会II级；15名[20%]纽约心脏协会III-IV级）进行了一项随机对照试验，将一项为期12周的渐进性家庭步行运动项目（n = 42）与一个“日常活动”对照组（n = 37）进行比较。在基线和12周时测量功能状态（通过心肺运动测试、6分钟步行试验、心力衰竭功能状态量表评估的峰值耗氧量）和症状（症状综合评分后的呼吸困难-疲劳指数评分）。
未发生与运动训练相关的不良事件。总体训练依从率为74±37%。训练后峰值耗氧量和心力衰竭功能状态量表未发生变化。与日常活动组相比，训练组通过6分钟步行试验测得的步行距离显著更长（1264±255英尺对1337±272英尺，P = 0.001），且症状综合评分有所改善（P = 0.03）。
对于心力衰竭患者，渐进性家庭步行运动项目是可行的，可增加步行距离，并降低症状综合评分。
