阻力训练对心力衰竭临床结局的影响：一项系统评价与荟萃分析。

The effect of resistance training on clinical outcomes in heart failure: A systematic review and meta-analysis.

作者信息

Jewiss D, Ostman C, Smart N A

机构信息

Schools of Rural Medicine, University of New England, Armidale, NSW 2351, Australia; Science and Technology, University of New England, Armidale, NSW 2351, Australia.

出版信息

Int J Cardiol. 2016 Oct 15;221:674-81. doi: 10.1016/j.ijcard.2016.07.046. Epub 2016 Jul 5.

DOI:10.1016/j.ijcard.2016.07.046

PMID:27423089

Abstract

OBJECTIVES

To quantify the change in effect sizes, for selected clinical outcome measures, in people with heart failure, from resistance exercise, either in isolation, or in combination with aerobic training.

BACKGROUND

Most exercise training data in heart failure, relates to aerobic exercise, we sought to provide current evidence for the benefits of resistance training in this population.

METHODS

We conducted a MEDLINE search (1985 to May 1, 2016), for exercise based rehabilitation trials in heart failure, using search terms 'resistance training, combined training, left ventricular dysfunction, peak VO2, cardio-myopathy and systolic heart dysfunction'.

RESULTS

The 27 included studies provided a total of 2321 participants, 1172 in an intervention and 1149 in either sedentary controls or aerobic exercise only groups, producing over 31,263 patient-hours of training. Mortality, hospitalization, resting blood pressure and Left ventricular fraction were all unchanged with resistance or combined aerobic and resistance training. Peak VO2 was improved in combined exercise vs. control MD of 1.43ml·kg(-1)·min(-1) (95% CI 0.63, 2.23, p=0.0004; and in resistance vs. control MD 3.99ml·kg(-1)·min(-1) (95% CI 1.47, 6.51, p=0.002). Quality of Life (MLwHFQ) was improved in combined vs. control MD -8.31 (95% CI -14.3, -2.33, p=0.006). Six-minute walk distance was improved combined exercise vs. control, MD 13.49m (95% CI 1.13, 25.84, p=0.03); and resistance vs. control MD 41.77m (95% CI 21.90, 61.64, p<0.0001): SMD 1.25 (95%CI 0.53, 1.98, p=0.0007).

CONCLUSIONS

Resistance only or combined training improves peak VO2, quality of life and walking performance in heart failure patients.

摘要

目的

量化心力衰竭患者进行抗阻运动单独训练或与有氧运动联合训练后，选定临床结局指标效应大小的变化。

背景

心力衰竭患者的大多数运动训练数据都与有氧运动有关，我们试图为该人群抗阻训练的益处提供最新证据。

方法

我们对MEDLINE（1985年至2016年5月1日）进行了检索，查找有关心力衰竭基于运动的康复试验，使用的检索词为“抗阻训练、联合训练、左心室功能障碍、峰值摄氧量、心肌病和收缩性心功能不全”。

结果

纳入的27项研究共涉及2321名参与者，其中1172名接受干预，1149名在久坐对照组或仅进行有氧运动的组中，产生了超过31263个患者小时的训练量。死亡率、住院率、静息血压和左心室分数在抗阻训练或有氧与抗阻联合训练后均未改变。联合运动组与对照组相比，峰值摄氧量改善，平均差值为1.43ml·kg⁻¹·min⁻¹（95%置信区间0.63，2.23，p = 0.0004）；抗阻训练组与对照组相比，峰值摄氧量改善，平均差值为3.99ml·kg⁻¹·min⁻¹（95%置信区间1.47，6.51，p = 0.002）。联合训练组与对照组相比，生活质量（明尼苏达心力衰竭生活质量问卷）改善，平均差值为 -8.31（95%置信区间 -14.3，-2.33，p = 0.006）。联合运动组与对照组相比，6分钟步行距离改善，平均差值为13.49m（95%置信区间1.13，25.84，p = 0.03）；抗阻训练组与对照组相比，6分钟步行距离改善，平均差值为41.77m（95%置信区间21.90，61.64，p < 0.0001）：标准化均值差为1.25（95%置信区间0.53，1.98，p = 0.0007）。