Dean E, Ross J
School of Rehabilitation Medicine, University of British Columbia, Vancouver, Canada.
Arch Phys Med Rehabil. 1988 Dec;69(12):1033-8.
Modified aerobic exercise may have a role in the management of patients with symptoms of postpolio syndrome by improving biomechanical efficiency, alleviating secondary cardiorespiratory and muscular deconditioning, and avoiding some risks associated with traditional strengthening exercises. The effects of a walking program on the functional capacity of patients with symptoms of postpolio syndrome were studied. Three patients participated in full oxygen consumption studies during submaximal treadmill exercise tests before and after an eight-week period. Two patients participated in an eight-week program designed to prolong walking duration while maintaining perceived exertion and discomfort/pain at minimal levels. A third patient was tested before and after eight weeks but did not receive training. The untrained patient showed some reduction in the retest compared with the initial test at all workloads with respect to oxygen consumption, heart rate, and systolic blood pressure, but ratings of perceived exertion and discomfort/pain were comparable for the two tests. Reductions in metabolic responses during the retest could be explained by the effect of habituation to the testing situation. In contrast, the trained patients showed relatively marked reductions in both metabolic and subjective responses after training. These results suggest that patients with symptoms of postpolio syndrome can increase their functional work capacity after a modified aerobic walking program. This improvement reflects improved biomechanical efficiency and possible training effects at the cardiorespiratory and muscular levels. Further research is needed to elucidate the role and interactions of these mechanisms in improving the functional work capacity of patients with chronic neuromuscular dysfunction.
改良有氧运动可能通过提高生物力学效率、减轻继发的心肺和肌肉失健状况以及避免一些与传统强化锻炼相关的风险，在小儿麻痹后遗症患者的管理中发挥作用。本研究探讨了步行计划对小儿麻痹后遗症患者功能能力的影响。三名患者在为期八周的前后分别参加了次极量跑步机运动测试中的全氧消耗研究。两名患者参加了一项为期八周的计划，旨在延长步行时间，同时将自觉用力程度和不适/疼痛维持在最低水平。第三名患者在八周前后接受了测试，但未接受训练。与初始测试相比，未经训练的患者在所有工作量下的复测中，耗氧量、心率和收缩压均有所下降，但两次测试的自觉用力程度和不适/疼痛评分相当。复测期间代谢反应的降低可以用对测试情况的习惯化效应来解释。相比之下，经过训练的患者在训练后代谢和主观反应均有较为明显的降低。这些结果表明，小儿麻痹后遗症患者在进行改良有氧步行计划后，其功能工作能力可以提高。这种改善反映了生物力学效率的提高以及心肺和肌肉水平可能存在的训练效果。需要进一步研究以阐明这些机制在改善慢性神经肌肉功能障碍患者功能工作能力中的作用及相互作用。
