Deliva R D, Hassall A, Manlhiot C, Solomon M, McCrindle B W, Dipchand A I
Division of Physiotherapy, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Pediatr Transplant. 2012 Dec;16(8):879-86. doi: 10.1111/petr.12003. Epub 2012 Oct 11.
This prospective interventional study investigated the impact of a three-month, ambulatory HA or HB, semi-individualized, PT-prescribed exercise program following pediatric HTx or LTx. SMW distance, strength, and flexibility were assessed at start and completion of the program and one yr after enrollment. Subjects received either an HB or HA exercise program three times per week. The cohort demonstrated clinically and statistically significant improvements in SMW distances at three months (425.7 ± 109.4-500.6 ± 93.6 m, p < 0.001) and at one yr (528.5 ± 66.6 m, p = 0.001), although there was no difference between the two groups at any time. Similar improvements were also observed in strength and flexibility measures. Correlates with higher SMW distance at three months and one yr included older age, male gender, and underlying diagnosis other than CHD. Male gender and diagnosis other than CHD were associated with a slower improvement in the SMW distance. This is the first report of institutionally based, outpatient exercise rehabilitation in the recovery following pediatric thoracic transplantation. We found similar improvements to HB interventions up to one yr after surgery. Further study of the role of exercise rehabilitation and long-term fitness outcomes is needed.
这项前瞻性干预性研究调查了小儿心脏移植或肺移植后为期三个月的门诊HA或HB半个体化、由物理治疗师规定的运动计划的影响。在该计划开始和结束时以及入组一年后评估6分钟步行距离、力量和灵活性。受试者每周接受三次HB或HA运动计划。该队列在三个月时（425.7±109.4 - 500.6±93.6米，p<0.001）和一年时（528.5±66.6米，p = 0.001）的6分钟步行距离有临床和统计学上的显著改善，尽管两组在任何时候都没有差异。在力量和灵活性测量方面也观察到了类似的改善。与三个月和一年时较高的6分钟步行距离相关的因素包括年龄较大、男性性别以及除冠心病以外的潜在诊断。男性性别和除冠心病以外的诊断与6分钟步行距离的改善较慢有关。这是关于小儿胸段移植后基于机构的门诊运动康复的首次报告。我们发现术后长达一年的时间里，与HB干预有类似的改善。需要进一步研究运动康复的作用和长期健康结果。
