Kim Do Jun, Mayo Nancy E, Carli Franco, Montgomery David L, Zavorsky Gerald S
Department of Kinesiology, McGill University, Montreal, Quebec, Canada.
Tohoku J Exp Med. 2009 Feb;217(2):109-15. doi: 10.1620/tjem.217.109.
Surgical patients often show physiological and metabolic distress, muscle weakness, and long hospital stays. Physical conditioning might help recovery. We attempted to identify the most responsive measure of aerobic fitness from a four-week pre-surgical aerobic exercise program (prehabilitation) in patients undergoing major bowel resection. Twenty-one subjects randomized two to one (exercise: control) scheduled for colorectal surgery. Fourteen subjects [Body Mass Index (BMI) = 27 +/- 6 kg/m(2); maximal oxygen uptake (VO(2max)) = 22 +/- 10 ml/kg/min] underwent 3.8 +/- 1.2 weeks (27 +/- 8 sessions) of progressive, structured pre-surgical aerobic exercise training at 40 to 65% of heart rate reserve (%HRR). Peak power output was the only maximal measure that was responsive to training [26 +/- 27%, Effects Size (ES) = 0.24; Standardized Response Mean (SRM) = 1.05; p < 0.05]. For the submaximal measures, heart rate and oxygen uptake during submaximal exercise was most responsive to training (decrease by 13% +/- 15%, ES = -0.24; SRM = -0.57; and 7% +/- 6%, ES = -0.40; SRM -0.97; p < 0.05) at an exercise intensity of 76 +/- 47 W. There was no change to maximal or submaximal measures in the control group. The distance walked over six minutes improved in both groups (by approximately 30 m), but the effect size and t-statistic were higher in the exercise group. Heart rate and oxygen uptake during submaximal exercise, and peak power output are the most responsive measures to four weeks of prehabilitation in subjects with low initial fitness.
外科手术患者常表现出生理和代谢紊乱、肌肉无力以及住院时间延长。身体机能训练可能有助于康复。我们试图从一项为期四周的术前有氧运动计划（术前康复训练）中，确定接受大肠切除术患者有氧适能最敏感的测量指标。21名受试者按2:1随机分为运动组和对照组，计划进行结直肠手术。14名受试者[体重指数（BMI）=27±6kg/m²；最大摄氧量（VO₂max）=22±10ml/kg/min]在心率储备的40%至65%（%HRR）下，接受了3.8±1.2周（27±8节）的渐进式、结构化术前有氧运动训练。峰值功率输出是唯一对训练有反应的最大测量指标[26±27%，效应量（ES）=0.24；标准化反应均值（SRM）=1.05；p<0.05]。对于次最大测量指标，在运动强度为76±47W时，次最大运动期间的心率和摄氧量对训练反应最敏感（分别降低13%±15%，ES=-0.24；SRM=-0.57；以及7%±6%，ES=-0.40；SRM=-0.97；p<0.05）。对照组的最大或次最大测量指标无变化。两组六分钟步行距离均有所改善（约30米），但运动组的效应量和t统计量更高。次最大运动期间的心率和摄氧量以及峰值功率输出是初始体能较低的受试者对四周术前康复训练最敏感的测量指标。
