Tomás Maria Teresa, Melo Xavier, Mateus Élia, Gonçalves Mafalda, Barroso Eduardo, Santa-Clara Helena
1 Escola Superior de Tecnologia da Saúde de Lisboa (ESTeSL) at Instituto Politécnico de Lisboa (IPL), Lisbon, Portugal.
2 Interdisciplinary Centre for the Study of Human Performance (CIPER) at Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal.
Prog Transplant. 2018 Dec;28(4):330-337. doi: 10.1177/1526924818800033. Epub 2018 Sep 27.
Supervised (SE) and home-based exercise (HBE) training regimes are effective on reconditioning patients with familial amyloidotic polyneuropathy (FAP) after liver transplantation, but research of the long-term retention of the benefits attained in patients with FAP has not yet been conducted.
In this 5-year follow-up study, we aimed to determine whether the exercise training gains in body composition, physical activity, and function promoted by a 24-week SE or HBE training regimes are retained in patients with FAP who resume normal activity.
Sixteen liver-transplanted patients with FAP were reassessed for body composition (dual X-ray absorptiometry), physical activity (questionnaire), and function (handgrip strength and 6-minute walk test).
Total body fat increased with both exercise regimes during follow-up ( P < .05; η = 0.432-0.625) as well as femoral neck bone density ( P = .048; η = 0.119). However, gains in upper limbs muscle quality during follow-up ( P < .001; η = 0.597) were only found in the SE group ( P = .042; η = 0.245). Both exercise regimes showed retaining aptitudes in walking capacity ( P < .05; η = 0.329-0.460) and muscle mass ( P = .05; η = 0.245). Still, none could retain the physical activity levels.
Long-term resumption of normal activity following a 24-week SE or HBE regime in patients with FAP resulted in loss of exercise induced increases in physical activity but counterweighted postoperative losses in bone mineral density and substantially retained the benefits in walking capacity, muscle mass, and quality, in particular, in the SE group.
监督式(SE)和居家锻炼(HBE)训练方案对肝移植后家族性淀粉样多神经病(FAP)患者的身体康复有效,但尚未对FAP患者所获益处的长期维持情况进行研究。
在这项为期5年的随访研究中,我们旨在确定,对于恢复正常活动的FAP患者,24周的SE或HBE训练方案所促进的身体成分、身体活动及功能方面的锻炼效果是否得以维持。
对16例肝移植FAP患者进行重新评估,内容包括身体成分(双能X线吸收法)、身体活动(问卷调查)及功能(握力和6分钟步行试验)。
在随访期间,两种锻炼方案均使全身脂肪增加(P < 0.05;η = 0.432 - 0.625),股骨颈骨密度也增加(P = 0.048;η = 0.119)。然而,随访期间上肢肌肉质量的增加(P < 0.001;η = 0.597)仅见于SE组(P = 0.042;η = 0.245)。两种锻炼方案在步行能力(P < 0.05;η = 0.329 - 0.460)和肌肉量(P = 0.05;η = 0.245)方面均显示出维持能力。不过,两种方案均未能维持身体活动水平。
FAP患者在接受24周的SE或HBE方案后长期恢复正常活动,导致锻炼引起的身体活动增加有所丧失,但抵消了术后骨矿物质密度的损失,并在很大程度上维持了步行能力、肌肉量及质量方面的益处,尤其是SE组。