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有或无神经肌肉电刺激的运动心脏康复及其对慢性心力衰竭患者运动耐力和生活质量的影响。

Exercise-Based Cardiac Rehabilitation with and Without Neuromuscular Electrical Stimulation and its Effect on Exercise Tolerance and Life Quality of Persons with Chronic Heart Failure.

作者信息

Kucio Cezary, Stastny Petr, Leszczyńska-Bolewska Bożena, Engelmann Małgorzata, Kucio Ewa, Uhlir Petr, Stania Magdalena, Polak Anna

机构信息

Department of Physical Therapy, Academy of Physical Education in Katowice, Katowice, Poland.

Department of Internal Disease at the Multispecialty Hospital in Jaworzno, Jaworzno, Poland.

出版信息

J Hum Kinet. 2018 Dec 31;65:151-164. doi: 10.2478/hukin-2018-0045. eCollection 2018 Dec.

Abstract

The study compares the effect of an exercise-based cardiac rehabilitation program with a program combining physical exercise and lower extremity neuromuscular electrical stimulation (NMES) on the recovery of patients with chronic heart failure (CHF) with NYHA II-III symptoms. Seventy two patients with stable CHF were randomly distributed to four groups that received exercise-based cardiac rehabilitation and pharmacological treatment. Groups I and II were additionally administered NMES (35 Hz and 10 Hz, respectively) and in Group III sham NMES was applied. Group IV (controls) received solely pharmacological and exercise treatment. Exercise tolerance and quality of life were assessed in patients pre-treatment and at week 3. Three weeks of rehabilitation induced significant increases (p < 0.05) in the distance covered in the 6-minute walk test, the metabolic equivalent (MET), the duration of the treadmill exercise stress test, the left ventricle ejection fraction (LVEF) and improved quality of life in all groups, but between-group differences were not significant (p > 0.05). In none of the groups were the left ventricle end-systolic and end-diastolic diameters (mm) measured at week 3 significantly different from their baseline values (p > 0.05). Exercise-based cardiac rehabilitation contributed to higher exercise tolerance, LVEF and quality of life of CHF patients (NYHA II-III), contrary to cardiac rehabilitation combined with lower extremity NMES (35 Hz and 10 Hz) that failed to induce such improvements. More research is necessary to assess the therapeutic efficacy of NMES applied to CHF patients with NYHA IV symptoms.

摘要

该研究比较了基于运动的心脏康复计划与结合体育锻炼和下肢神经肌肉电刺激(NMES)的计划对纽约心脏协会(NYHA)II - III级症状的慢性心力衰竭(CHF)患者恢复的影响。72例稳定型CHF患者被随机分为四组,接受基于运动的心脏康复和药物治疗。第一组和第二组分别额外接受35Hz和10Hz的NMES,第三组接受假NMES。第四组(对照组)仅接受药物和运动治疗。在治疗前和第3周对患者进行运动耐力和生活质量评估。三周的康复治疗使所有组的6分钟步行试验中的行走距离、代谢当量(MET)、跑步机运动应激试验持续时间、左心室射血分数(LVEF)显著增加(p < 0.05),生活质量得到改善,但组间差异不显著(p > 0.05)。在任何一组中,第3周测量的左心室收缩末期和舒张末期直径(mm)与基线值相比均无显著差异(p > 0.05)。基于运动的心脏康复有助于提高CHF患者(NYHA II - III)的运动耐力、LVEF和生活质量,相反,结合下肢NMES(35Hz和10Hz)的心脏康复未能带来此类改善。需要更多研究来评估NMES应用于NYHA IV级症状的CHF患者的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fc3/6341955/e019f35c7d4e/hukin-65-151-g001.jpg

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