Sandberg Camilla, Hedström Magnus, Wadell Karin, Dellborg Mikael, Ahnfelt Anders, Zetterström Anna-Klara, Öhrn Amanda, Johansson Bengt
Heart Center and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
Congenit Heart Dis. 2018 Mar;13(2):254-262. doi: 10.1111/chd.12562. Epub 2017 Dec 4.
The beneficial effects of exercise training in acquired heart failure and coronary artery disease are well known and have been implemented in current treatment guidelines. Knowledge on appropriate exercise training regimes for adults with congenital heart disease is limited, thus further studies are needed. The aim of this study was to examine the effect of home-based interval exercise training on maximal endurance capacity and peak exercise capacity.
Randomized controlled trial.
Twenty-six adults with complex congenital heart disease were recruited from specialized units for adult congenital heart disease. Patients were randomized to either an intervention group-12 weeks of home-based interval exercise training on a cycle ergometer (n = 16), or a control group (n = 10). The latter was instructed to maintain their habitual physical activities. An incremental cardiopulmonary exercise test and a constant work rate cardiopulmonary exercise test at 75% of peak workload were performed preintervention and postintervention.
Twenty-three patients completed the protocol and were followed (intervention n = 13, control n = 10). Postintervention exercise time at constant work rate cardiopulmonary exercise test increased in the intervention group compared to controls (median[range] 12[-4 to 52]min vs 0[-4 to 5]min, P = .001). At incremental cardiopulmonary exercise test, peak VO increased 15% within the intervention group (P = .019) compared to 2% within the control group (P = .8). However, in comparison between the groups no difference was found (285[-200 to 535] ml/min vs 17[-380 to 306] ml/min, P = .10). In addition, peak workload at incremental cardiopulmonary exercise test increased in the intervention group compared to controls (20[-10 to 70]W vs 0[-20 to 15]W, P = .003).
Home-based interval exercise training increased endurance capacity and peak exercise capacity in adults with complex congenital heart disease. Aerobic endurance might be more relevant than peak oxygen uptake with regard to daily activities, and therefore a more clinically relevant measure to evaluate.
运动训练对获得性心力衰竭和冠状动脉疾病的有益作用已广为人知,并已纳入当前的治疗指南。关于先天性心脏病成人的适当运动训练方案的知识有限,因此需要进一步研究。本研究的目的是检验家庭间歇运动训练对最大耐力能力和峰值运动能力的影响。
随机对照试验。
从成人先天性心脏病专科单位招募了26名患有复杂先天性心脏病的成人。患者被随机分为干预组(16名,进行为期12周的基于家庭的自行车测力计间歇运动训练)或对照组(10名)。后者被指示保持其惯常的体育活动。在干预前后分别进行递增心肺运动试验和在峰值工作量的75%下进行恒定工作率心肺运动试验。
23名患者完成了方案并接受了随访(干预组13名,对照组10名)。与对照组相比,干预组在恒定工作率心肺运动试验中的干预后运动时间增加(中位数[范围]12[-4至52]分钟对0[-4至5]分钟,P = 0.001)。在递增心肺运动试验中,干预组的峰值VO增加了15%(P = 0.019),而对照组增加了2%(P = 0.8)。然而,在两组之间的比较中未发现差异(285[-200至535]毫升/分钟对17[-380至306]毫升/分钟,P = 0.10)。此外,与对照组相比,干预组在递增心肺运动试验中的峰值工作量增加(20[-10至70]瓦对0[-20至15]瓦,P = 0.003)。
基于家庭的间歇运动训练提高了患有复杂先天性心脏病成人的耐力能力和峰值运动能力。就日常活动而言,有氧耐力可能比峰值摄氧量更相关,因此是一个更具临床相关性的评估指标。