Department of Exercise Physiology, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, Faculty of Health Sciences, Sydney Medical School, University of Sydney, Lidcombe, New South Wales, Australia.
Br J Sports Med. 2020 Apr;54(8):452-461. doi: 10.1136/bjsports-2018-100205. Epub 2019 Apr 12.
Resistance training (RT) improves walking ability in persons with peripheral artery disease. We conducted a meta-analysis of randomised controlled trials (RCTs) investigating the effect of RT on peripheral artery disease (as measured by walking ability).
We included RCTs that investigated the effect of RT on treadmill and/or 6 min walk (6-MWT) distances. RT intensity was assessed according to the American College of Sports Medicine guidelines by 1 repetition maximum or rating of perceived exertion. Standardised mean (SMD) and mean differences (MD) were calculated using a random-effects inverse variance model. Heterogeneity and bias were assessed using RevMan V.5.3. Meta-regression and meta-analysis of variance were performed as moderator analyses.
Databases (Medline, Embase, Web of Science, Cinahl and Google Scholar) were searched until July 2018.
Fifteen trials isolated RT; 7 trials compared RT with aerobic exercise. We analysed 826 patients (n=363 completing RT), with a mean age of 67.1±3.8 years. Training ranged from low-high intensity, 2-7 times per week for 17±7 weeks, with a mix of upper, lower or whole body training. Overall RT significantly improved constant load treadmill claudication onset (COD) (SMD 0.66 [0.40, 0.93], p<0.00001) and total walking distance (WD) (SMD 0.51 [0.23, 0.79], p=0.0003), progressive treadmill COD (SMD 0.56 [0.00, 1.13], p=0.05) and total WD (SMD 0.45 [0.08, 0.83], p=0.02), and 6-MWT COD (MD 82.23 m [40.91, 123.54], p<0.0001). Intensity played a role in improvement, with high-intensity training yielding the greatest improvement (p=0.02).
RT clinically improved treadmill and flat ground walking ability in persons with peripheral artery disease. Higher intensity training was associated with better outcomes. Our study makes a case for clinicians to include high-intensity lower body RT in the treatment of peripheral artery disease.
CRD42017081184.
抗阻训练（RT）可改善外周动脉疾病患者的步行能力。我们对随机对照试验（RCT）进行了荟萃分析，以调查 RT 对外周动脉疾病（以步行能力衡量）的影响。
我们纳入了调查 RT 对跑步机和/或 6 分钟步行（6-MWT）距离影响的 RCT。RT 强度根据美国运动医学学院指南通过 1 次重复最大或感觉用力程度进行评估。使用随机效应逆方差模型计算标准化均数差值（SMD）和均数差值（MD）。使用 RevMan V.5.3 评估异质性和偏倚。进行了荟萃回归和方差分析作为调节分析。
检索数据库（Medline、Embase、Web of Science、Cinahl 和 Google Scholar），检索时间截至 2018 年 7 月。
15 项试验单独研究了 RT；7 项试验比较了 RT 与有氧运动。我们分析了 826 名患者（n=363 名完成 RT），平均年龄 67.1±3.8 岁。训练强度从低到高，每周 2-7 次，持续 17±7 周，包括上肢、下肢或全身训练。总体而言，RT 显著改善了恒定负荷跑步机跛行起始（COD）（SMD 0.66 [0.40, 0.93]，p<0.00001）和总步行距离（WD）（SMD 0.51 [0.23, 0.79]，p=0.0003），跑步机递增 COD（SMD 0.56 [0.00, 1.13]，p=0.05）和总 WD（SMD 0.45 [0.08, 0.83]，p=0.02），以及 6-MWT COD（MD 82.23 m [40.91, 123.54]，p<0.0001）。强度在改善方面发挥了作用，高强度训练的效果最好（p=0.02）。
RT 可显著改善外周动脉疾病患者的跑步机和平地步行能力。更高强度的训练与更好的结果相关。我们的研究表明，临床医生应将高强度下肢 RT 纳入外周动脉疾病的治疗方案中。
CRD42017081184。
