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一项居家步行计划可提高急性心肌梗死患者的呼吸耐力:一项随机对照试验。

A Home-Based Walking Program Improves Respiratory Endurance in Patients With Acute Myocardial Infarction: A Randomized Controlled Trial.

作者信息

Matos-Garcia Bruna C, Rocco Isadora S, Maiorano Lara D, Peixoto Thatiana C A, Moreira Rita Simone L, Carvalho Antonio C C, Catai Aparecida Maria, Arena Ross, Gomes Walter J, Guizilini Solange

机构信息

Cardiology Discipline and Cardiovascular Surgery, Sao Paulo Hospital, Escola Paulista de Medicina, Federal University of Sao Paulo, Brazil; Department of Human Motion Sciences, Physical Therapy School, Federal University of Sao Paulo, Santos, Brazil.

Cardiology Discipline and Cardiovascular Surgery, Sao Paulo Hospital, Escola Paulista de Medicina, Federal University of Sao Paulo, Brazil.

出版信息

Can J Cardiol. 2017 Jun;33(6):785-791. doi: 10.1016/j.cjca.2016.12.004. Epub 2016 Dec 10.

Abstract

BACKGROUND

The purpose of this study was to evaluate respiratory muscle strength and endurance in the inpatient period in patients who recently experienced myocardial infarction (MI) and investigate the effects of a home-based walking program on respiratory strength and endurance in low-risk patients after MI.

METHODS

Patients were randomized into a usual-care group (UCG) entailing regular care (n = 23) and an intervention group (IG) entailing an outpatient home-based walking program (n = 31). Healthy sex- and age-matched participants served as a control group for respiratory endurance variables. Respiratory muscle strength was evaluated through maximal inspiratory pressure (MIP) and endurance during the inpatient period, at 15 days, and at 60 days after MI. Submaximal functional capacity was determined by a 6-minute walk test (6MWT) at hospital discharge and 60 days after MI.

RESULTS

Both groups showed impaired inspiratory muscle strength at hospital discharge. When compared with healthy individuals, after MI, patients had worse respiratory muscle endurance pressure (PTH = 73.02 ± 8.40 vs 44.47 ± 16.32; P < 0.05) and time (Tlim = 324.1 ± 12.2 vs 58.7 ± 93.3; P < 0.05). Only the IG showed a significant improvement in MIP and PTH at 15 days and 60 days after MI (P < 0.05). When comparing groups, the IG achieved higher values for MIP, PTH, and Tlim 15 and 60 days after MI (P < 0.01). The 60-day assessment revealed that the 6MWT distance and level of physical activity was significantly higher in the IG compared with the UCG.

CONCLUSIONS

Low-risk patients recently experiencing MI demonstrate impaired MIP and respiratory endurance compared with healthy participants. A home-based walking program improved respiratory endurance and functional capacity.

摘要

背景

本研究旨在评估近期发生心肌梗死(MI)患者住院期间的呼吸肌力量和耐力,并调查居家步行计划对MI后低风险患者呼吸力量和耐力的影响。

方法

患者被随机分为接受常规护理的常规护理组(UCG,n = 23)和接受门诊居家步行计划的干预组(IG,n = 31)。健康的性别和年龄匹配参与者作为呼吸耐力变量的对照组。在住院期间、MI后15天和60天,通过最大吸气压力(MIP)和耐力评估呼吸肌力量。出院时和MI后60天通过6分钟步行试验(6MWT)确定次最大功能能力。

结果

两组出院时吸气肌力量均受损。与健康个体相比,MI后患者的呼吸肌耐力压力(PTH = 73.02±8.40 vs 44.47±16.32;P < 0.05)和时间(Tlim = 324.1±12.2 vs 58.7±93.3;P < 0.05)更差。仅IG在MI后15天和60天的MIP和PTH有显著改善(P < 0.05)。比较两组时,IG在MI后15天和60天的MIP、PTH和Tlim值更高(P < 0.01)。60天评估显示,与UCG相比,IG的6MWT距离和体力活动水平显著更高。

结论

与健康参与者相比,近期发生MI的低风险患者表现出MIP和呼吸耐力受损。居家步行计划改善了呼吸耐力和功能能力。

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