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中高强度吸气肌训练可提高联合训练对冠状动脉旁路移植术后患者运动能力的影响:一项随机临床试验。

Moderate-to-high intensity inspiratory muscle training improves the effects of combined training on exercise capacity in patients after coronary artery bypass graft surgery: A randomized clinical trial.

机构信息

Functional Rehabilitation Graduate Program, Department of Physiotherapy and Rehabilitation, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil.

Cardiology Service of Hospital Universitário de Santa Maria (HUSM), Empresa Brasileira de Serviços Hospitalares (EBSERH), Santa Maria, Rio Grande do Sul, Brazil.

出版信息

Int J Cardiol. 2019 Mar 15;279:40-46. doi: 10.1016/j.ijcard.2018.12.013. Epub 2018 Dec 10.

Abstract

BACKGROUND

The effects of adding moderate-to-high intensity inspiratory muscle training (IMT) to short-term aerobic and resistance exercise (combined training [CT]), after coronary artery bypass grafting (CABG) are not established. This study aimed to determine the effects of moderate-to-high intensity IMT + CT on exercise capacity, respiratory muscle strength, inspiratory muscle endurance, quality of life (QoL), and laboratory biomarkers in patients after CABG who were participants of a phase II cardiac rehabilitation program.

METHODS

Twenty-four patients were randomly assigned to either the IMT + CT group (n = 12), who performed moderate-to-high intensity IMT with CT or the sham-IMT + CT group (n = 12). Patients completed two sessions per week for 12 weeks. Each patient underwent a cardiopulmonary exercise test, six-minute walk test (6MWT), respiratory muscle strength and endurance evaluation, QoL questionnaire, and serum advanced oxidation protein products, ferric reducing antioxidant power [FRAP], nitrate/nitrate, and high-sensitivity C-reactive protein, before and after the 12-week intervention.

RESULTS

The IMT + CT group showed significantly greater improvements in peak oxygen uptake (1.3 mL∙kg∙min; 95% confidence interval [95% CI], 0.5 to 2.2), distance covered during the 6MWT (78.8 m; 95% CI, 28.1 to 129.5), maximal inspiratory pressure (23.0 cmHO; 95% CI, 9.3 to 36.7), QoL (-15.1 points; 95% CI, -26.9 to -3.3), and FRAP (83.7 μmol/L; 95% CI, 20.2 to 147.1) compared to the sham-IMT + CT group as a result of the intervention.

CONCLUSIONS

Short-term moderate-to-high intensity IMT with CT provided additional benefits in exercise capacity, inspiratory muscle strength, QoL, and antioxidant profile in patients after CABG. Trial Registration clinicaltrials.gov Identifier: NCT02885077.

摘要

背景

在冠状动脉旁路移植术后(CABG),添加中高强度吸气肌训练(IMT)对短期有氧运动和抗阻运动(联合训练[CT])的影响尚不清楚。本研究旨在确定中高强度 IMT+CT 对 CABG 后参加二期心脏康复计划的患者的运动能力、呼吸肌力量、吸气肌耐力、生活质量(QoL)和实验室生物标志物的影响。

方法

24 名患者被随机分配到 IMT+CT 组(n=12)或 sham-IMT+CT 组(n=12)。患者每周完成两次治疗,共 12 周。每位患者在 12 周干预前后分别进行心肺运动试验、6 分钟步行试验(6MWT)、呼吸肌力量和耐力评估、QoL 问卷和血清先进氧化蛋白产物、铁还原抗氧化能力[FRAP]、硝酸盐/硝酸盐和高敏 C 反应蛋白的检测。

结果

与 sham-IMT+CT 组相比,IMT+CT 组的峰值摄氧量(1.3 mL·kg·min;95%置信区间[95%CI],0.5 至 2.2)、6MWT 距离(78.8 m;95%CI,28.1 至 129.5)、最大吸气压力(23.0 cmH₂O;95%CI,9.3 至 36.7)、QoL(-15.1 分;95%CI,-26.9 至-3.3)和 FRAP(83.7 μmol/L;95%CI,20.2 至 147.1)均有显著改善。

结论

CABG 后短期中高强度 IMT+CT 可进一步提高运动能力、吸气肌力量、QoL 和抗氧化谱。临床试验注册号:NCT02885077。

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