Herbsleb M, Hilberg T
Department of Sports Medicine, Friedrich-Schiller-University Jena, Germany.
Haemophilia. 2009 Jan;15(1):114-21. doi: 10.1111/j.1365-2516.2008.01860.x. Epub 2008 Aug 16.
Maximal exercise testing, including the determination of maximal performance and maximal oxygen uptake (VO(2max)), is considered the gold standard for assessing maximal endurance performance. The effectiveness of such testing is often reduced in haemophilic adults owing to musculoskeletal impairments or pain rather than because of cardiac exertion. The measurement of submaximal performance parameters overcomes many limitations of maximal exercise testing but a testing standard is still lacking. The aim of this study was to investigate maximal and particularly submaximal endurance performance of adult patients with severe haemophilia A and B. Eleven patients and 11 matched healthy controls were tested by spiroergometry with a specific treadmill test and the power was calculated in Watts. The haemophilic group achieved lower absolute (210 +/- 63 W) and weight-related (2.94 +/- 0.98 W kg(-1)) maximal endurance performance compared with the control group (287 +/- 50 W resp. 3.82 +/- 0.53 W kg(-1); P </= 0.05). The patients also showed a lower submaximal endurance performance at the individual anaerobic threshold (IAT = 147 +/- 56 W) and fixed lactate values (2 mmol = 98 +/- 60 W; 4 mmol = 158 +/- 56 W) compared with the healthy controls (IAT = 210 +/- 41 W; 2 mmol = 153 +/- 30 W; 4 mmol = 223 +/- 39 W; all P </= 0.05). The heart rate and lactate value at the IAT were not different. The disease-related musculoskeletal changes in haemophilic adults lead to a reduced maximal and submaximal endurance performance, which can be easily measured by the described test procedure.
最大运动测试，包括最大运动能力和最大摄氧量（VO₂max）的测定，被认为是评估最大耐力表现的金标准。由于肌肉骨骼损伤或疼痛而非心脏负荷，这种测试在成年血友病患者中的有效性常常降低。次最大运动表现参数的测量克服了最大运动测试的许多局限性，但仍缺乏测试标准。本研究的目的是调查重度甲型和乙型血友病成年患者的最大耐力，特别是次最大耐力表现。通过特定跑步机测试的运动心肺功能测试对11名患者和11名匹配的健康对照进行测试，并以瓦特计算功率。与对照组（分别为287±50 W和3.82±0.53 W kg⁻¹）相比，血友病组的绝对最大耐力表现（210±63 W）和与体重相关的最大耐力表现（2.94±0.98 W kg⁻¹）较低（P≤0.05）。与健康对照（个体无氧阈IAT = 210±41 W；2 mmol = 153±30 W；4 mmol = 223±39 W；所有P≤0.05）相比，患者在个体无氧阈（IAT = 147±56 W）和固定乳酸值（2 mmol = 98±60 W；4 mmol = 158±56 W）时的次最大耐力表现也较低。个体无氧阈时的心率和乳酸值无差异。成年血友病患者与疾病相关的肌肉骨骼变化导致最大和次最大耐力表现降低，这可以通过所描述的测试程序轻松测量。
