Aamot Inger-Lise, Moholdt Trine, Amundsen Brage H, Solberg Hilde S, Mørkved Siv, Støylen Asbjørn
Clinical Services, St. Olav University Hospital, 7006 Trondheim, Norway.
Eur J Cardiovasc Prev Rehabil. 2010 Aug;17(4):387-92. doi: 10.1097/HJR.0b013e328333edf9.
Exercise training is an important part of cardiac rehabilitation to reduce morbidity and mortality. Low-intensity exercise training can start as soon as the myocardial infarction (MI) patient is stable. Our objective was to evaluate the effect of an early start of exercise training in MI patients.
A randomized controlled trial.
Thirty-nine MI patients were randomized to either an early start of exercise training group (EG) or to a delayed start control group (CG). The EG participated in an outpatient low-intensity EG (phase 2a) two times a week for 4 weeks before entering ordinary exercise training of moderate-to-high intensity (phase 2b). CG entered phase 2b directly after 4 weeks of delay. Primary outcome measure was peak oxygen consumption (VO2peak), measured at baseline, after 4 weeks and after 16 weeks. Secondary outcome measure was health-related quality of life.
VO2peak did not change from baseline to 4 weeks, either in EG [30.6+/-6.7 ml/kg/min vs. 30.7+/-6.2 ml/kg/min, not significant (NS)] or CG (29.8+/-6.1 ml/kg/min vs. 30.7+/-6.2 ml/kg/min, NS). After 16 weeks VO2peak increased in both groups to 33.1+/-7.1 ml/kg/min in EG (P<0.005) and 33.0 ml/kg/min+/-8.6 in CG (P<0.005), group differences NSH. Health-related quality of life increased in every domain but physical functioning for both groups (group differences NS).
An early start of exercise training did not increase VO2peak compared to 4 weeks of delay. For low-risk patients with high motivation for exercise training, home-based walking is an option as a moderate start of cardiac rehabilitation the first weeks after MI.
运动训练是心脏康复的重要组成部分，可降低发病率和死亡率。一旦心肌梗死（MI）患者病情稳定，即可开始低强度运动训练。我们的目的是评估MI患者早期开始运动训练的效果。
一项随机对照试验。
39例MI患者被随机分为早期开始运动训练组（EG）或延迟开始对照组（CG）。EG在进入中高强度常规运动训练（2b期）前，每周两次参加门诊低强度运动训练（2a期），持续4周。CG在延迟4周后直接进入2b期。主要结局指标是在基线、4周和16周时测量的峰值耗氧量（VO2peak）。次要结局指标是健康相关生活质量。
从基线到4周，EG组[30.6±6.7 ml/kg/min对30.7±6.2 ml/kg/min，无显著差异（NS）]和CG组（29.8±6.1 ml/kg/min对30.7±6.2 ml/kg/min，NS）的VO2peak均未改变。16周后，两组的VO2peak均增加，EG组为33.1±7.1 ml/kg/min（P<0.005），CG组为33.0 ml/kg/min±8.6（P<0.005），组间差异无统计学意义。两组各领域的健康相关生活质量均有所提高，但身体功能领域除外（组间差异无统计学意义）。
与延迟4周相比，早期开始运动训练并未增加VO2peak。对于运动训练积极性高的低风险患者，在家行走是MI后最初几周心脏康复适度起始的一种选择。
