Ellis Rachel, Shields Nora, Lim Kwang, Dodd Karen J
Physiotherapy, Northern Health, Epping, Australia
Department of Physiotherapy, La Trobe University, Melbourne, Australia Allied Health, Northern Health, Epping, Australia.
Clin Rehabil. 2015 Dec;29(12):1178-97. doi: 10.1177/0269215515574783. Epub 2015 Mar 10.
To determine if eccentric exercise is effective, tolerable and safe for adults with chronic cardiorespiratory disease.
We searched electronic databases from inception until January 2015 (Medline, CINAHL, Embase, SportDiscus, PEDro, Cochrane Central and AMED) supplemented by citation tracking and reference list scanning.
Included articles had to report effects of eccentric exercise, alone or as a primary component of intervention, of any intensity and duration, on adults with chronic cardiorespiratory disease. Trials needed to be reported as full text in a peer-reviewed journal and include control data (randomised, quasi-randomised and single group cross-over design trials). Any outcomes or comparison interventions were accepted. Methodological rigor was assessed using the PEDro scale.
Of 22 potentially relevant articles, 10 met inclusion criteria. They reported results from seven trials with a total of 112 participants across the diseases. PEDro scores were low (median 3). Eccentric exercise increased strength and mobility to comparable levels as concentric exercise, however, it did so with lower oxygen consumption (effect size as large as d = -3.07 (-4.12, -1.80)), and four-fold power output (effect size d = -3.60 (-5.03, -1.66)). There were no adverse events reported for eccentric exercise. Pain was avoided with familiarisation sessions and individual exercise prescription.
Eccentric exercise is beneficial and at least comparable with traditional exercise in improving walking and strength for people with chronic cardiorespiratory disease. It was well tolerated and we identified no safety concerns for the use of this intervention for this population.
确定离心运动对患有慢性心肺疾病的成年人是否有效、可耐受且安全。
我们检索了从数据库建立至2015年1月的电子数据库（医学索引数据库、护理学与健康领域数据库、荷兰医学文摘数据库、体育与运动科学数据库、循证医学数据库、考克兰系统评价数据库和澳大利亚医学文献数据库），并辅以文献追踪和参考文献列表扫描。
纳入的文章必须报告离心运动单独或作为干预的主要组成部分，对任何强度和持续时间的慢性心肺疾病成年人的影响。试验需在同行评审期刊上全文发表，并包括对照数据（随机、半随机和单组交叉设计试验）。接受任何结果或比较干预措施。使用循证医学数据库量表评估方法的严谨性。
在22篇可能相关的文章中，10篇符合纳入标准。它们报告了7项试验的结果，涉及的疾病共有112名参与者。循证医学数据库量表得分较低（中位数为3）。离心运动使力量和活动能力提高到与向心运动相当的水平，然而，这样做时耗氧量更低（效应量高达d = -3.07（-4.12，-1.80）），功率输出提高了四倍（效应量d = -3.60（-5.03，-1.66））。没有关于离心运动不良事件的报告。通过熟悉训练课程和个性化运动处方可避免疼痛。
离心运动有益，在改善慢性心肺疾病患者的步行和力量方面至少与传统运动相当。它耐受性良好，我们未发现该干预措施用于该人群存在安全问题。
