Université de Poitiers, Laboratoire des Adaptations Physiologiques aux Activités Physiques, Poitiers, France.
J Card Fail. 2011 Aug;17(8):676-83. doi: 10.1016/j.cardfail.2011.04.008. Epub 2011 May 31.
Exercise training is included in cardiac rehabilitation programs to enhance physical capacity and cardiovascular function. Among the existing rehabilitation programs, exercises in water are increasingly prescribed. However, it has been questioned whether exercises in water are safe and relevant in patients with stable chronic heart failure (CHF), coronary artery disease (CAD) with normal systolic left ventricular function. The goal was to assess whether a rehabilitation program, including water-based gymnastic exercises, is safe and induces at least similar benefits as a traditional land-based training.
Twenty-four male CAD patients and 24 male CHF patients with stable clinical status participated in a 3-week rehabilitation. They were randomized to either a group performing the training program totally on land (CADl, CHFl; endurance + callisthenic exercises) or partly in water (CADw, CHFw; land endurance + water callisthenic exercises). Before and after rehabilitation, left ventricular systolic and cardiorespiratory functions, hemodynamic variables and autonomic nervous activities were measured. No particular complications were associated with both of our programs. At rest, significant improvements were seen in CHF patients after both types of rehabilitation (increases in stroke volume and left ventricular ejection fraction [LVEF]) as well as a decrease in heart rate (HR) and in diastolic arterial pressure. Significant increases in peaks VO(2), HR, and power output were observed in all patients after rehabilitation in exercise test. The increase in LVEF at rest, in HR and power output at the exercise peak were slightly higher in CHFw than in CHFl.
Altogether, both land and water-based programs were well tolerated and triggered improvements in cardiorespiratory function.
运动训练被纳入心脏康复计划中，以增强身体能力和心血管功能。在现有的康复计划中，水中运动越来越受到重视。然而，对于稳定型慢性心力衰竭（CHF）和左心室收缩功能正常的冠状动脉疾病（CAD）患者，水中运动是否安全和有效仍存在争议。本研究旨在评估包括水上体操运动在内的康复计划是否安全，以及其是否能带来与传统陆地训练至少相似的益处。
24 名男性 CAD 患者和 24 名男性 CHF 患者稳定的临床状态参与了为期 3 周的康复。他们被随机分为两组，一组在陆地上进行训练计划（CADl、CHFl；耐力+体操运动），另一组在水中进行部分训练（CADw、CHFw；陆地耐力+水中体操运动）。康复前后，测量左心室收缩和心肺功能、血流动力学变量和自主神经活动。两种方案均未出现特殊并发症。在休息时，两种康复方案均使 CHF 患者的左心室收缩功能和心功能得到显著改善（心搏量和左心室射血分数增加），同时心率和舒张压降低。在运动试验中，所有患者在康复后峰值 VO2、心率和功率输出均显著增加。与 CHFl 相比，CHFw 患者在休息时左心室射血分数增加、峰值时心率和功率输出增加略高。
总之，陆地和水上训练方案均耐受良好，并能改善心肺功能。
