Department of Physiotherapy, Northern Health, Epping, Australia.
School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia.
Disabil Rehabil. 2022 Jun;44(12):2705-2714. doi: 10.1080/09638288.2020.1836679. Epub 2020 Nov 11.
To determine if eccentric exercise was effective, safe and feasible in increasing function and quality of life in people with heart failure compared to usual care and a waitlist control group.
A prospective, three-armed, parallel-design, assessor-blind, pilot randomised controlled trial with 1:1:1 allocation. Forty-seven participants (16 female; mean age 66 years) with mild to moderate heart failure were randomly allocated to either eccentric exercise, concentric exercise or a waitlist control group. Participants in the exercise groups completed twice-weekly exercise for eight weeks. Primary outcome was walking capacity. Secondary outcomes were quality of life, leg strength and fatigue. Outcomes were assessed at baseline, post intervention and three-month follow-up. Attendance, tolerability and adverse events were used to determine safety and feasibility.
Intention-to-treat analysis showed no differences between eccentric exercise and either concentric exercise or waitlist for any outcome. Per-protocol analysis found improvements identified by the Minnesota living with heart failure questionnaire were significantly greater post-intervention for eccentric exercise compared to concentric exercise (-17.99 units, 95% confidence interval -35.96 to -0.01). No major adverse events were reported.
In this small trial, eccentric exercise did not demonstrate superior outcomes to concentric exercise or a waitlist control group.
The protocol for this trial was registered at clinicaltrials.gov, registration number: NCT02223624, registration date: 22 August 2014.IMPLICATIONS FOR REHABILITATIONRegular physical activity and referral to rehabilitation is recommended for people with chronic heart failure, however exercise can be challenging for this group.Eccentric exercise was safe and tolerable for participants with heart failure.Documentation of exercise progression is important to demonstrate a dose-response relationship.In this study there were no differences between groups who received eccentric exercise, concentric exercise or no exercise.
确定与常规治疗和候补对照组相比，离心运动在增加心力衰竭患者的功能和生活质量方面是否有效、安全和可行。
这是一项前瞻性、三臂、平行设计、评估者盲法、试验性随机对照试验，分配比例为 1:1:1。47 名参与者（16 名女性；平均年龄 66 岁）患有轻度至中度心力衰竭，随机分配至离心运动组、向心运动组或候补对照组。运动组的参与者每周进行两次运动，持续 8 周。主要结局是步行能力。次要结局是生活质量、腿部力量和疲劳。在基线、干预后和 3 个月随访时评估结局。出勤率、耐受性和不良事件用于确定安全性和可行性。
意向治疗分析显示，在任何结局上，离心运动与向心运动或候补对照组之间均无差异。基于方案分析发现，与向心运动相比，离心运动后明尼苏达州心力衰竭生活质量问卷的改善更为显著（-17.99 分，95%置信区间-35.96 至-0.01）。未报告重大不良事件。
在这项小型试验中，离心运动并未显示出比向心运动或候补对照组更好的结果。
该试验方案在 clinicaltrials.gov 上注册，注册号为 NCT02223624，注册日期为 2014 年 8 月 22 日。
建议慢性心力衰竭患者进行常规身体活动和康复治疗，但是对于这组患者，运动可能具有挑战性。
对于心力衰竭患者，离心运动是安全且可耐受的。
记录运动进展对于证明剂量反应关系很重要。
在这项研究中，接受离心运动、向心运动或不运动的组之间没有差异。
