O'Connor Ellen M, Koufaki Pelagia, Mercer Thomas H, Lindup Herolin, Nugent Eilish, Goldsmith David, Macdougall Iain C, Greenwood Sharlene A
Physiotherapy Department, King's College Hospital, London, United Kingdom.
Department of Renal Medicine, King's College Hospital, London, United Kingdom.
PLoS One. 2017 Feb 3;12(2):e0171063. doi: 10.1371/journal.pone.0171063. eCollection 2017.
This pilot study examined long-term pulse wave velocity (PWV) and peak oxygen uptake (VO2peak) outcomes following a 12-week moderate-intensity aerobic or resistance training programme in kidney transplant recipients.
Single-blind, bi-centre randomised controlled parallel trial. 42 out of 60 participants completed a 9-month follow-up assessment (Aerobic training = 12, Resistance training = 10 and usual care = 20). Participants completed 12 weeks of twice-weekly supervised aerobic or resistance training. Following the 12-week exercise intervention, participants were transitioned to self-managed community exercise activity using motivational interviewing techniques. Usual care participants received usual encouragement for physical activity during routine clinical appointments in the transplant clinic. PWV, VO2peak, blood pressure and body weight were assessed at 12 weeks and 12 months, and compared to baseline.
ANCOVA analysis, covarying for baseline values, age, and length of time on dialysis pre-transplantation, revealed a significant mean between-group difference in PWV of -1.30 m/sec (95%CI -2.44 to -0.17, p = 0.03) between resistance training and usual care groups. When comparing the aerobic training and usual care groups at 9-month follow-up, there was a mean difference of -1.05 m/sec (95%CI -2.11 to 0.017, p = 0.05). A significant mean between-group difference in relative VO2peak values of 2.2 ml/kg/min (95% CI 0.37 to 4.03, p = 0.02) when comparing aerobic training with usual care was revealed. There was no significant between group differences in body weight or blood pressure. There were no significant adverse effects associated with the interventions.
Significant between-group differences in 9-month follow-up PWV existed when comparing resistance exercise intervention with usual care. A long-term between-group difference in VO2peak was only evident when comparing aerobic intervention with usual care. This pilot study, with a small sample size, did not aim to elucidate mechanistic mediators related to the exercise interventions. It is however suggested that a motivational interviewing approach, combined with appropriate transition to community training programmes, could maintain the improvements gained from the 12-week exercise interventions and further research in this area is therefore warranted.
study number: ISRCTN43892586.
本初步研究调查了肾移植受者在进行为期12周的中等强度有氧或抗阻训练计划后的长期脉搏波速度（PWV）和峰值摄氧量（VO2peak）结果。
单盲、双中心随机对照平行试验。60名参与者中有42名完成了为期9个月的随访评估（有氧训练组 = 12人，抗阻训练组 = 10人，常规护理组 = 20人）。参与者完成了为期12周、每周两次的有监督的有氧或抗阻训练。在为期12周的运动干预后，使用动机访谈技术引导参与者过渡到自我管理的社区运动活动。常规护理组的参与者在移植诊所的常规临床预约期间接受关于身体活动的常规鼓励。在12周和12个月时评估PWV、VO2peak、血压和体重，并与基线进行比较。
协方差分析对基线值、年龄和移植前透析时间进行了协变量调整，结果显示抗阻训练组和常规护理组之间的PWV组间平均差异显著，为-1.30米/秒（95%置信区间 -2.44至-0.17，p = 0.03）。在9个月随访时比较有氧训练组和常规护理组，平均差异为-1.05米/秒（95%置信区间 -2.11至0.017，p = 0.05）。比较有氧训练组和常规护理组时，相对VO2peak值的组间平均差异显著，为2.2毫升/千克/分钟（95%置信区间0.37至4.03，p = 0.02）。体重和血压的组间差异不显著。干预措施未产生显著不良影响。
在9个月随访时，比较抗阻运动干预和常规护理，PWV存在显著的组间差异。仅在比较有氧干预和常规护理时，VO2peak存在长期的组间差异。本初步研究样本量较小，未旨在阐明与运动干预相关的机制性介质。然而，建议采用动机访谈方法，并适当过渡到社区训练计划，可以维持从为期12周的运动干预中获得的改善，因此有必要在该领域进行进一步研究。
研究编号：ISRCTN43892586。
