Xanthos Paul D, Gordon Brett A, Kingsley Michael I C
Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
Int J Cardiol. 2017 Mar 1;230:493-508. doi: 10.1016/j.ijcard.2016.12.076. Epub 2016 Dec 23.
Resistance training has demonstrated efficacy in cardiac rehabilitation programs, but the optimal prescription of resistance training is unknown. This systematic review with meta-analysis compared the effectiveness of cardiac rehabilitation consisting of resistance training either alone (RT) or in combination with aerobic training (CT) with aerobic training only (AT) on outcomes of physical function. Further, resistance training intensity and intervention duration were examined to identify if these factors moderate efficacy.
Six electronic databases were searched to identify studies investigating RT, coronary heart disease and physical function. The overall quality of evidence was assessed using the GRADE approach. Meta-analyses were performed when possible and qualitative analysis was performed for the remaining data.
Improvements in peak oxygen uptake (WMD: 0.61, 95% CI: 0.20-1.10), peak work capacity (SMD: 0.38, 95% CI: 0.11-0.64) and muscular strength (SMD: 0.65, 95% CI: 0.43-0.87) significantly favoured CT over AT with moderate quality evidence. There was no evidence of a difference in effect when comparing RT and AT. Shorter duration CT was superior to shorter duration AT for improving peak oxygen uptake and muscular strength (low quality evidence) while longer duration CT was only superior to longer duration AT in improving muscular strength (moderate quality evidence).
CT is more beneficial than AT alone for improving physical function. Although preliminary findings are promising, more high-quality evidence is required to determine the efficacy of high intensity resistance training. Shorter duration interventions that include resistance training might allow patients to return to their normal activities of daily living earlier.
抗阻训练已在心脏康复项目中显示出有效性，但抗阻训练的最佳方案尚不清楚。这项系统评价及荟萃分析比较了单纯抗阻训练（RT）或抗阻训练与有氧训练相结合（CT）的心脏康复与单纯有氧训练（AT）对身体功能结局的有效性。此外，还对抗阻训练强度和干预持续时间进行了研究，以确定这些因素是否会影响疗效。
检索六个电子数据库，以识别调查抗阻训练、冠心病和身体功能的研究。使用GRADE方法评估证据的总体质量。尽可能进行荟萃分析，并对其余数据进行定性分析。
峰值摄氧量（加权均数差：0.61，95%置信区间：0.20 - 1.10）、峰值工作能力（标准化均数差：0.38，95%置信区间：0.11 - 0.64）和肌肉力量（标准化均数差：0.65，95%置信区间：0.43 - 0.87）的改善在中等质量证据下显著支持CT组而非AT组。比较RT组和AT组时，没有证据表明效果存在差异。较短持续时间的CT组在改善峰值摄氧量和肌肉力量方面优于较短持续时间的AT组（低质量证据），而较长持续时间的CT组仅在改善肌肉力量方面优于较长持续时间的AT组（中等质量证据）。
对于改善身体功能，CT组比单独的AT组更有益。尽管初步结果很有前景，但需要更多高质量证据来确定高强度抗阻训练的疗效。包括抗阻训练的较短持续时间干预可能使患者更早恢复正常日常生活活动。
