Vromen T, Kraal J J, Kuiper J, Spee R F, Peek N, Kemps H M
Department of Medical Informatics, Academic Medical Center, Amsterdam, the Netherlands; Department of Cardiology, Maxima Medical Center, Veldhoven, the Netherlands.
Department of Medical Informatics, Academic Medical Center, Amsterdam, the Netherlands.
Int J Cardiol. 2016 Apr 1;208:120-7. doi: 10.1016/j.ijcard.2016.01.207. Epub 2016 Jan 25.
Although aerobic exercise training has shown to be an effective treatment for chronic heart failure patients, there has been a debate about the design of training programs and which training characteristics are the strongest determinants of improvement in exercise capacity. Therefore, we performed a meta-regression analysis to determine a ranking of the individual effect of the training characteristics on the improvement in exercise capacity of an aerobic exercise training program in chronic heart failure patients. We focused on four training characteristics; session frequency, session duration, training intensity and program length, and their product; total energy expenditure. A systematic literature search was performed for randomized controlled trials comparing continuous aerobic exercise training with usual care. Seventeen unique articles were included in our analysis. Total energy expenditure appeared the only training characteristic with a significant effect on improvement in exercise capacity. However, the results were strongly dominated by one trial (HF-action trial), accounting for 90% of the total patient population and showing controversial results compared to other studies. A repeated analysis excluding the HF-action trial confirmed that the increase in exercise capacity is primarily determined by total energy expenditure, followed by session frequency, session duration and session intensity. These results suggest that the design of a training program requires high total energy expenditure as a main goal. Increases in training frequency and session duration appear to yield the largest improvement in exercise capacity.
尽管有氧运动训练已被证明是治疗慢性心力衰竭患者的有效方法，但关于训练方案的设计以及哪些训练特征是运动能力改善的最强决定因素一直存在争议。因此，我们进行了一项meta回归分析，以确定训练特征对慢性心力衰竭患者有氧运动训练方案运动能力改善的个体效应排名。我们关注四个训练特征：训练频率、训练时长、训练强度和方案时长，以及它们的乘积：总能量消耗。我们对比较持续有氧运动训练与常规护理的随机对照试验进行了系统的文献检索。我们的分析纳入了17篇独特的文章。总能量消耗似乎是对运动能力改善有显著影响的唯一训练特征。然而，结果在很大程度上受一项试验（HF-action试验）主导，该试验占患者总数的90%，且与其他研究相比结果存在争议。排除HF-action试验后的重复分析证实，运动能力的提高主要由总能量消耗决定，其次是训练频率、训练时长和训练强度。这些结果表明，训练方案的设计需要以高总能量消耗为主要目标。训练频率和训练时长的增加似乎能使运动能力得到最大程度的提高。
