From Queen Square MRC Centre for Neuromuscular Diseases, Institute of Neurology (A.W., A.P., M.D., P.M.M., M.L., I.S., M.S., M.M.R., M.G.H., G.M.R.), Institute of Sport, Exercise and Health (P.H.), and Department of Statistical Science (G.B.), University College London; National Hospital for Neurology and Neurosurgery (E.D., K.J.), University College Hospitals, NHS Foundation Trust; Faculty of Health, Social Care & Education (M.D., G.M.R.), Kingston University/St George's University of London; Department of Psychology (A.S.), University of Surrey, Guildford; Charcot Marie Tooth United Kingdom (K.B.), Registered Charity Number 1112370; and Movelab (M.T.), Newcastle University, UK.
Neurology. 2019 Apr 9;92(15):e1773-e1785. doi: 10.1212/WNL.0000000000007265. Epub 2019 Mar 8.
The aim of this phase 2 trial was to ascertain the feasibility and effect of community-based aerobic exercise training for people with 2 of the more common neuromuscular diseases: Charcot-Marie-Tooth disease type 1A (CMT) and inclusion body myositis (IBM).
A randomized single-blinded crossover trial design was used to compare a 12-week aerobic training program using recombinant exercise bicycles compared to a control period. The training occurred 3 times per week in community gyms local to the participants. Support was available from trained gym staff and a research physiotherapist. The 2 disease groups were analyzed separately. The primary outcome measure was peak oxygen uptake (VO peak) during a maximal exercise test, with secondary measures of muscle strength, function, and patient-reported measures.
Data from 23 people with CMT and 17 people with IBM were included in the analysis. Both disease groups had high levels of participation and demonstrated improvements in VO peak, with a moderate effect size in the CMT participants (Cohen = 0.53) and a strong effect size in the IBM group (Cohen = 1.72). No major changes were observed in the secondary outcome measures. Qualitative interviews revealed that participants valued the support of gym instructors and the research physiotherapists in overcoming challenges to participation.
Twelve weeks of aerobic training in community gyms was feasible, safe, and improved aerobic capacity in people with CMT and IBM.
This study provides Class II evidence that for patients with CMT type 1A and IBM, an aerobic training program increases aerobic capacity.
本 2 期试验旨在确定基于社区的有氧运动训练对两种更为常见的神经肌肉疾病患者的可行性和效果：1A 型腓骨肌萎缩症（CMT）和包涵体肌炎（IBM）。
采用随机单盲交叉试验设计，比较了使用重组运动自行车进行的为期 12 周的有氧运动训练计划与对照期。训练在社区健身房进行，每周 3 次，地点在参与者所在地附近。有经过培训的健身房工作人员和研究物理治疗师提供支持。分别分析这两个疾病组。主要结局测量指标是最大运动试验中的峰值摄氧量（VOpeak），次要结局测量指标包括肌肉力量、功能和患者报告的测量指标。
纳入分析的 CMT 患者有 23 人，IBM 患者有 17 人。两个疾病组的参与度都很高，VOpeak 均有改善，CMT 组的效应量为中度（Cohen=0.53），IBM 组的效应量为强（Cohen=1.72）。次要结局测量指标未见明显变化。定性访谈显示，参与者重视健身房教练和研究物理治疗师的支持，以克服参与的挑战。
社区健身房进行 12 周的有氧运动训练是可行的、安全的，可以提高 CMT 和 IBM 患者的有氧运动能力。
本研究提供了 II 级证据，表明对于 1A 型腓骨肌萎缩症和包涵体肌炎患者，有氧运动计划可提高有氧运动能力。
