Senden P Jeff, Sabelis Louise W, Zonderland Maria L, Hulzebos Erik H, Bol Eduard, Mosterd Willem L
Meander Medical Centre, Cardiology, Amersfoort, The Netherlands.
Int J Cardiol. 2005 Apr 20;100(2):293-300. doi: 10.1016/j.ijcard.2004.10.039.
To investigate the effect of physical training (PTr) on upper leg muscle area, muscle strength and muscle endurance expressed as upper leg muscle function (ULMF) in relation to exercise performance in CHF.
Randomised to a training (TG) or control group (CG).
Outpatient cardiac rehabilitation centre of community hospital.
77 CHF patients (59 men and 18 women), NYHA class II/III, age 59.8+/-9.3 years, LVEF 27+/-8%. Sixteen patients dropped out during the intervention period, 61 patients (M/F:46/15) completed the study.
PTr (combined strength and endurance exercises) four times per week, twice supervised and twice at home, during 26 weeks.
LVEF, body composition, daily physical activity, exercise performance, upper leg muscle area and isokinetic leg muscle variables.
Workload and peak oxygen consumption decreased in the CG (-4.1% and -4%) but increased in the TG (+5% and +4%) following PTr (p<0.05, ANOVA repeated measures). Hamstrings area decreased in the CG and did not change in the TG (p<0.05, ANOVA repeated measures). ULMF improved in the TG, but remained unchanged in the CG (+13.0% and 0.0, respectively, p<0.05; ANOVA repeated measures). At baseline and after intervention nearly 60% of the variance in maximal workload was explained by ULMF and quadriceps muscle area (multiple regression analysis).
In CHF patients, home-based training in conjunction with a supervised strength and endurance training program is safe, feasible and effective and does not require complex training equipment. Physical training prevented loss of hamstrings muscle mass and improved exercise performance by enhancing muscle strength and endurance.
研究体育训练（PTr）对心力衰竭（CHF）患者大腿上部肌肉面积、肌肉力量和以大腿上部肌肉功能（ULMF）表示的肌肉耐力与运动表现之间的关系。
随机分为训练组（TG）或对照组（CG）。
社区医院门诊心脏康复中心。
77例CHF患者（59例男性和18例女性），纽约心脏协会（NYHA）心功能II/III级，年龄59.8±9.3岁，左心室射血分数（LVEF）27±8%。16例患者在干预期退出，61例患者（男/女：46/15）完成研究。
每周进行4次PTr（力量和耐力综合训练），2次有监督训练和2次在家训练，为期26周。
LVEF、身体成分、日常身体活动、运动表现、大腿上部肌肉面积和等速腿部肌肉变量。
PTr后，CG组的工作量和峰值耗氧量下降（分别下降4.1%和4%），而TG组增加（分别增加5%和4%）（p<0.05，重复测量方差分析）。CG组腘绳肌面积减少，TG组无变化（p<0.05，重复测量方差分析）。TG组的ULMF改善，而CG组保持不变（分别增加13.0%和0.0，p<0.05；重复测量方差分析）。在基线和干预后，最大工作量近60%的方差由ULMF和股四头肌面积解释（多元回归分析）。
在CHF患者中，家庭训练结合有监督的力量和耐力训练计划是安全、可行且有效的，并且不需要复杂的训练设备。体育训练可防止腘绳肌肌肉量的流失，并通过增强肌肉力量和耐力来改善运动表现。
