Centre for Sport and Exercise Science, Collegiate Campus, Sheffield Hallam University, Collegiate Crescent, Sheffield, S10 2BP, UK.
Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK.
Arthritis Res Ther. 2018 Jun 5;20(1):112. doi: 10.1186/s13075-018-1605-0.
Aerobic exercise in general and high-intensity interval training (HIIT) specifically is known to improve vascular function in a range of clinical conditions. HIIT in particular has demonstrated improvements in clinical outcomes, in conditions that have a strong macroangiopathic component. Nevertheless, the effect of HIIT on microcirculation in systemic sclerosis (SSc) patients is yet to be investigated. Therefore, the purpose of the study was to compare the effects of two HIIT protocols (cycle and arm cranking) on the microcirculation of the digital area in SSc patients.
Thirty-four limited cutaneous SSc patients (65.3 ± 11.6 years old) were randomly allocated in three groups (cycling, arm cranking and control group). The exercise groups underwent a 12- week exercise program twice per week. All patients performed the baseline and post-exercise intervention measurements where physical fitness, functional ability, transcutaneous oxygen tension (ΔTcpO), body composition and quality of life were assessed. Endothelial-dependent as well as -independent vasodilation were assessed in the middle and index fingers using LDF and incremental doses of acetylcholine (ACh) and sodium nitroprusside (SNP). Cutaneous flux data were expressed as cutaneous vascular conductance (CVC).
Peak oxygen uptake increased in both exercise groups (p < 0.01, d = 1.36). ΔTcpO demonstrated an increase in the arm-cranking group only, with a large effect, but not found statistically significant,(p = 0.59, d = 0.93). Endothelial-dependent vasodilation improvement was greater in the arm-cranking (p < 0.05, d = 1.07) in comparison to other groups. Both exercise groups improved life satisfaction (p < 0.001) as well as reduced discomfort and pain due to Raynaud's phenomenon (p < 0.05). Arm cranking seems to be the preferred mode of exercise for study participants as compared to cycling (p < 0.05). No changes were observed in the body composition or the functional ability in both exercise groups.
Our results suggest that arm cranking has the potential to improve the microvascular endothelial function in SSc patients. Also notably, our recommended training dose (e.g., a 12-week HIIT program, twice per week), appeared to be sufficient and tolerable for this population. Future research should focus on exploring the feasibility of a combined exercise such as aerobic and resistance training by assessing individual's experience and the quality of life in SSc patients.
ClinicalTrials.gov (NCT number): NCT03058887 , February 23, 2017.
有氧运动一般，高强度间歇训练（HIIT）特别改善血管功能在一系列临床条件。HIIT 特别是在有强烈的大血管成分的情况下，改善了临床结果。然而，HIIT 对系统性硬化症（SSc）患者的微循环的影响尚未被研究。因此，本研究的目的是比较两种 HIIT 方案（循环和手臂曲柄）对 SSc 患者指尖微循环的影响。
34 例局限性皮肤 SSc 患者（65.3±11.6 岁）随机分为三组（循环组、手臂曲柄组和对照组）。运动组每周进行两次为期 12 周的运动计划。所有患者均进行了基线和运动干预后的测量，评估了体能、功能能力、经皮氧分压（ΔTcpO）、身体成分和生活质量。使用 LDF 和乙酰胆碱（ACh）和硝普钠（SNP）的递增剂量评估内皮依赖性和非依赖性血管舒张。皮肤通量数据表示为皮肤血管传导率（CVC）。
两组运动组的峰值摄氧量均增加（p<0.01，d=1.36）。只有手臂曲柄组的ΔTcpO 增加，效果较大，但无统计学意义（p=0.59，d=0.93）。与其他组相比，手臂曲柄运动组的内皮依赖性血管舒张改善更大（p<0.05，d=1.07）。两组运动组均提高了生活满意度（p<0.001），并减少了因雷诺现象引起的不适和疼痛（p<0.05）。与骑自行车相比，手臂曲柄似乎是研究参与者更倾向的运动方式（p<0.05）。两组运动组的身体成分和功能能力均无变化。
我们的结果表明，手臂曲柄有可能改善 SSc 患者的微血管内皮功能。此外，我们建议的训练剂量（例如，12 周的 HIIT 计划，每周两次）对该人群似乎是足够和可耐受的。未来的研究应侧重于通过评估 SSc 患者的个体经验和生活质量来探索有氧和抗阻训练等联合运动的可行性。
ClinicalTrials.gov（NCT number）：NCT03058887，2017 年 2 月 23 日。
