Giuliano Catherine, Karahalios Amalia, Neil Christopher, Allen Jason, Levinger Itamar
Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, Australia; Western Health, Melbourne, Australia.
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Australia.
Int J Cardiol. 2017 Jan 15;227:413-423. doi: 10.1016/j.ijcard.2016.11.023. Epub 2016 Nov 7.
Resistance training (RT) has been utilised to target muscle dysfunction associated with Chronic Heart Failure (CHF). However, there is limited meta-analysis evidence to support its use as a standalone therapy. This meta-analysis examined the effects of RT on muscle strength (one repetition maximum, 1RM and Peak Torque), aerobic capacity (VO and 6min walk distance) and quality of life (QoL) in patients with CHF.
We searched Medline, EMBASE, Cochrane and CINAHL for studies published up to July 2016, combining terms related to the population (eg, heart failure, CHF) with terms for the intervention (eg, resistance, strength training) and the outcomes (eg, QoL, VOpeakstrength, aerobic capacity).
Ten studies including 240 participants were included in our meta-analysis (aged 48-76years, Ejection Fraction 18-37%). Training duration ranged from 8 to 24weeks and intensity up to 80% of 1RM. RT increased 1RM (standardised change score=0.60; 95% Confidence Interval: 0.43, 0.77) but not strength measured via peak torque at 60°/s and 180°/s. RT increased VO (CSMD: 2.71ml/kg/min; 1.96, 3.45) and QoL (CSMD: -5.71; -9.85, -1.56).
RT as a single intervention can increase muscle strength, aerobic capacity and QoL in patients with CHF and may offer an alternative approach, particularly for those unable to participate in aerobic training. The effect of RT on muscle strength is mainly during slow controlled movements and not during rapid movements. Older adults and patients with advanced CHF are underrepresented in RT trials and future studies should seek to optimise their inclusion.
抗阻训练（RT）已被用于针对与慢性心力衰竭（CHF）相关的肌肉功能障碍。然而，支持其作为单一疗法使用的荟萃分析证据有限。本荟萃分析研究了抗阻训练对CHF患者肌肉力量（一次重复最大值、1RM和峰值扭矩）、有氧能力（VO和6分钟步行距离）和生活质量（QoL）的影响。
我们检索了截至2016年7月发表的Medline、EMBASE、Cochrane和CINAHL数据库中的研究，将与人群相关的术语（如心力衰竭、CHF）与干预措施（如抗阻、力量训练）和结局（如QoL、VO峰值力量、有氧能力）相关的术语相结合。
我们的荟萃分析纳入了10项研究，共240名参与者（年龄48 - 76岁，射血分数18 - 37%）。训练持续时间为8至24周，强度高达1RM的80%。抗阻训练增加了1RM（标准化变化评分=0.60；95%置信区间：0.43，0.77），但未增加通过60°/秒和180°/秒时的峰值扭矩测量的力量。抗阻训练增加了VO（CSMD：2.71毫升/千克/分钟；1.96，3.45）和生活质量（CSMD：-5.71；-9.85，-1.56）。
抗阻训练作为单一干预措施可增加CHF患者的肌肉力量、有氧能力和生活质量，并可能提供一种替代方法，特别是对于那些无法参加有氧训练的患者。抗阻训练对肌肉力量的影响主要发生在缓慢控制的运动中，而非快速运动中。在抗阻训练试验中，老年人和晚期CHF患者的代表性不足，未来研究应寻求优化他们的纳入情况。
