通过直流电浴与运动疗法相结合改善外周动脉疾病患者的步行参数

Remission of Walking Parameters in Peripheral Arterial Disease through Association of Galvanic Baths and Kinesytherapy.

作者信息

Pătru Simona, Bighea A C, Popescu Roxana

机构信息

Department of Medical Rehabilitation, University of Medicine and Pharmacy of Craiova, Romania.

出版信息

Curr Health Sci J. 2014 Jan;40(1):51-6. doi: 10.12865/CHSJ.40.01.09. Epub 2013 Dec 29.

Abstract

Chronic peripheral obstructive arteriopathies (CPOA), together with their determinations, play an important role in the elderly pathology and represent one of the most frequent causes of disability, thus having a negative impact on the patient's quality of life. Therefore, in this clinical randomized trial we proposed to study the efficiency of several treatment methods based on physical exercise together with other therapeutical approaches specific to physical medicine such as galvanic baths. We formed a group of 111 patients diagnosed with peripheral arterial disease in inferior limbs randomized into three groups: the control group (drug treatment and hygiene-dietary), the exercise group (12 weeks supervised exercises program, followed by another 12 weeks home unsupervised exercises) and the exercise and procedure group (kinesitherapy and galvanic baths). All the subjects performed the exercise treadmill test, according to the Gardner protocol, at the beginning of the study, after 12 weeks and after 24 weeks, at the end of the study and were measured: the time to pain onset (TDC) and the time to maximum pain onset (maximum walking time=TDD). We observed quite high TDC differences in the two groups that performed physical exercises compared to the control group, while the amelioration of walking periods was recorded after the first 12 weeks, and after 24 weeks they reached walking periods 2.5 times higher than at the beginning of the study. Adding hydrotherapy to the physical exercise led to even higher TDC values. After 12 weeks, we obtained a 54% TDD remission in the exercise group (p<0.005) and a 65% remission in the exercise and hydrotherapy group (p<0.005) and at the end of period, the TDD remission was 90% in the exercise group (p<0.005) and 100% in the exercise and hydrotherapy group (p<0.05). The kinetic-physical modalities show its efficiency in ameliorating the walking parameters in the patients with claudication and may offer low risks compared to the revascularization methods, high addressability, diminished costs.

摘要

慢性外周阻塞性动脉病(CPOA)及其相关因素在老年病学中起着重要作用,是导致残疾的最常见原因之一,因此对患者的生活质量产生负面影响。因此,在这项临床随机试验中,我们提议研究几种基于体育锻炼的治疗方法以及其他物理医学特定治疗方法(如直流电浴)的疗效。我们选取了111名被诊断为下肢外周动脉疾病的患者,随机分为三组:对照组(药物治疗和卫生饮食)、运动组(12周的监督锻炼计划,随后是12周的家庭无监督锻炼)和运动与治疗组(运动疗法和直流电浴)。在研究开始时、12周后、24周后以及研究结束时,所有受试者均按照加德纳方案进行运动平板试验,并测量疼痛发作时间(TDC)和最大疼痛发作时间(最大步行时间=TDD)。与对照组相比,我们观察到进行体育锻炼的两组患者的TDC差异相当大,而在最初的12周后记录到步行时间有所改善,到24周时,他们的步行时间比研究开始时高出2.5倍。在体育锻炼中加入水疗可使TDC值更高。12周后,运动组的TDD缓解率为54%(p<0.005),运动与水疗组为65%(p<0.005),在该阶段结束时,运动组的TDD缓解率为90%(p<0.005),运动与水疗组为100%(p<0.05)。运动物理疗法在改善间歇性跛行患者的步行参数方面显示出其有效性,与血管重建方法相比,可能具有低风险、高适用性和低成本的特点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3870/4006336/712ab39527f3/CHSJ-40-1-051-fig1.jpg

本文引用的文献

[5]
Exercise training for claudication.

N Engl J Med. 2002-12-12

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