Department of Health Professions, Swinburne University of Technology, Melbourne, Vic, Australia.
Independent Researcher, Melbourne, Vic, Australia.
Heart Lung Circ. 2019 Oct;28(10):1549-1559. doi: 10.1016/j.hlc.2019.05.097. Epub 2019 May 29.
Despite no evidence to support weight limitations following median sternotomy, sternal precautions continue to be routinely prescribed. Moreover, international cardiac rehabilitation guidelines lack sufficient detail for the implementation of resistance training. This systematic review and meta-analysis aimed to determine what the literature defines as resistance training; how resistance training is applied, progressed and evaluated; and, whether resistance training improves physical and functional recovery postoperatively in the cardiac surgical population.
Five (5) electronic databases were searched from inception to 28 September 2018 for studies published in English that investigated the effects of a resistance training intervention on physical and functional recovery following median sternotomy.
Eighteen (18) trials (n=3,462) met eligibility criteria and were included in the analysis. Seven (7) randomised controlled trials shared common outcome measures, allowing meta-analysis. The performance of resistance training appears to be safe and feasible, and resulted in similar improvements in both cardiopulmonary capacity and anthropometry, when compared to aerobic training alone. However, the definition and application of resistance training is frequently a lower intensity and volume than recommended by the American College of Sports Medicine. Furthermore, sternal precautions are not reflective of the kinematics and weights used when performing many activities of daily living. For this reason, resistance training needs to be task-specific, reflecting functional tasks to promote recovery.
Resistance training, in isolation or when combined with aerobic training, may lead to greater improvements in physical and functional recovery following cardiac surgery via median sternotomy; however, further research is required to inform clinical guidelines.
尽管没有证据支持正中胸骨切开术后的体重限制，但胸骨预防措施仍在常规开具。此外，国际心脏康复指南对于阻力训练的实施缺乏足够的细节。本系统评价和荟萃分析旨在确定文献中阻力训练的定义；阻力训练的应用、进展和评估方式；以及阻力训练是否能改善心脏手术后人群的身体和功能恢复。
从开始到 2018 年 9 月 28 日，五个（5）电子数据库搜索了以英文发表的研究，这些研究调查了阻力训练干预对正中胸骨切开术后身体和功能恢复的影响。
有 18 项试验（n=3462）符合纳入标准，并纳入分析。7 项随机对照试验共享共同的结局指标，允许进行荟萃分析。阻力训练的表现似乎是安全可行的，与单独进行有氧运动相比，它可以使心肺能力和人体测量学都得到相似的改善。然而，阻力训练的定义和应用通常比美国运动医学学院推荐的强度和容量要低。此外，胸骨预防措施并不能反映日常生活中许多活动的运动学和重量。因此，阻力训练需要具有特定任务，反映促进恢复的功能任务。
单独或与有氧运动结合使用的阻力训练可能会通过正中胸骨切开术导致心脏手术后身体和功能恢复有更大的改善；然而，需要进一步的研究来为临床指南提供信息。
