Degache Francis, Garet Martin, Calmels Paul, Costes Fédéric, Bathélémy Jean-Claude, Roche Frédéric
Service de Physiologie Clinique et de l'Exercice - Groupe PPEH, CHU Nord, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, Saint-Etienne, France.
Clin Physiol Funct Imaging. 2007 Jul;27(4):225-30. doi: 10.1111/j.1475-097X.2007.00741.x.
Patients with congestive heart failure (CHF) exhibit an impaired exercised tolerance that dramatically limits their functional capacity and alters their quality of life.
The aim of this study was to compare the effects of two types of training programmes on isokinetic muscle strength and aerobic capacities in patients with CHF.
A group of 23 stable CHF patients included consecutively followed an exercise training programme, 3 days a week for 8 weeks. The first group (P1, n=11) exercised on a cycloergometer for 45 min at 65% of peak VO2. The second group (P2, n=12) followed a 45-min combined bicycle and quadricipital strength training. Strength training consisted of 10 series of 10 repetitions at 70% of maximal voluntary force. Incremental maximal cardiopulmonary exercise tests as well as an isokinetic quadricipital dynamometry evaluation were performed before and after training.
In P1, peak VO2 increased by 20% (22.3+/-4.9 versus 17.8+/-4.5 ml min(-1) kg(-1); P<0.05) without any significant change in isokinetic muscle strength. In P2, peak VO2 improved within the same range (20.5+/-2.8 versus 18.6+/-3.7 ml min(-1) kg(-1); P<0.01). This last rehabilitation programme significantly increased isokinetic muscle strength at each angular velocities (+10.5+/-13.5%, P<0.04; +5.6+/-7.0%, P<0.03; for 180 degrees s(-1) and 60 degrees s(-1) respectively). Only the combined endurance/strength training programme was associated with an improvement in both peak VO2 and peripheral muscle strength, two significant parameters of outcome and quality of life in CHF.
充血性心力衰竭（CHF）患者表现出运动耐力受损，这极大地限制了他们的功能能力并改变了他们的生活质量。
本研究的目的是比较两种训练方案对CHF患者等速肌力和有氧能力的影响。
一组连续纳入的23例稳定CHF患者，每周进行3天运动训练，共8周。第一组（P1，n = 11）在功率自行车上以峰值摄氧量（VO2）的65%进行45分钟运动。第二组（P2，n = 12）进行45分钟的自行车和股四头肌力量联合训练。力量训练包括以最大自主力量的70%进行10组，每组10次重复。在训练前后进行递增式最大心肺运动试验以及等速股四头肌测力评估。
在P1组，峰值VO2增加了20%（22.3±4.9对17.8±4.5 ml·min⁻¹·kg⁻¹；P < 0.05），等速肌力无显著变化。在P2组，峰值VO2在相同范围内改善（20.5±2.8对18.6±3.7 ml·min⁻¹·kg⁻¹；P < 0.01）。最后这种康复方案在每个角速度下均显著增加了等速肌力（分别在180°·s⁻¹和60°·s⁻¹时增加了+10.5±13.5%，P < 0.04；+5.6±7.0%，P < 0.03）。只有耐力/力量联合训练方案与峰值VO2和外周肌肉力量的改善相关，这两个是CHF患者结局和生活质量的重要参数。
