Department of Physical Therapy, Virginia Commonwealth University, Medical College of Virginia Campus, Richmond, VA 23298, USA.
J Cardiopulm Rehabil Prev. 2010 Jul-Aug;30(4):209-23. doi: 10.1097/HCR.0b013e3181c56b78.
Aerobic and resistance exercise training programs produce an abundance of physiologic and clinical benefits in patients with heart failure (HF). Improved maximal aerobic capacity, submaximal aerobic endurance, muscle force production, perceived quality of life, and skeletal muscle characteristics are among the more established outcomes resulting from these rehabilitation techniques. Moreover, both aerobic and resistance exercise training appear to portend a low risk to patients with HF when appropriate exercise prescription methods are followed. While the aforementioned training techniques will undoubtedly continue to be at the center of a well-formulated rehabilitation program, other adjunctive interventions, which are presently underutilized in clinical practice, may prove beneficial in patients with HF. Specifically, both neuromuscular electrical stimulation (NMES) and inspiratory muscle training (IMT) appear to significantly improve several physiologic, exercise, symptomatologic, and quality-of-life parameters. NMES targets skeletal muscle abnormalities, whereas IMT primarily targets the weakened respiratory musculature, both often encountered in patients with HF. A PubMed search using relevant key words identified 19 original investigations examining the impact of NMES (13 studies) and IMT (6 studies) training programs in patients with HF. The resultant review (1) provides a summary of the original research outcomes of both NMES and IMT in patients with HF; (2) addresses current research gaps, providing a direction for future investigations; and (3) provides clinical scenarios where NMES and IMT may prove to be beneficial during the rehabilitation of patients with HF.
有氧运动和抗阻运动训练方案在心力衰竭（HF）患者中产生了大量的生理和临床益处。改善最大有氧能力、亚最大有氧耐力、肌肉力量产生、感知生活质量和骨骼肌特征是这些康复技术带来的更确定的结果之一。此外，当遵循适当的运动处方方法时，有氧运动和抗阻运动训练似乎对 HF 患者的风险较低。虽然上述训练技术无疑将继续成为精心制定的康复计划的核心，但目前在临床实践中未得到充分利用的其他辅助干预措施可能对 HF 患者有益。具体来说，神经肌肉电刺激（NMES）和吸气肌训练（IMT）似乎都能显著改善多个生理、运动、症状和生活质量参数。NMES 针对骨骼肌异常，而 IMT 主要针对衰弱的呼吸肌，这两者在 HF 患者中经常遇到。使用相关关键词在 PubMed 上进行的搜索确定了 19 项原始研究，这些研究调查了 NMES（13 项研究）和 IMT（6 项研究）训练方案对 HF 患者的影响。综述（1）总结了 NMES 和 IMT 在 HF 患者中的原始研究结果；（2）探讨了当前的研究空白，为未来的研究提供了方向；（3）提供了 NMES 和 IMT 在 HF 患者康复期间可能有益的临床情况。
