Blears Elizabeth E, Elias Jessica K, Tapking Christian, Porter Craig, Rontoyanni Victoria G
Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA.
Allegheny Health Network, Pittsburgh, PA 15212, USA.
J Clin Med. 2021 May 19;10(10):2193. doi: 10.3390/jcm10102193.
Supervised resistance training appears to be a promising alternative exercise modality to supervised walking in patients with peripheral artery disease (PAD). This meta-analysis examined the efficacy of supervised RT for improving walking capacity, and whether adaptations occur at the vascular and/or skeletal muscle level in PAD patients. We searched Medline, CINAHL, Scopus, and Cochrane Central Register of Controlled Trials databases for randomized controlled trials (RCTs) in PAD patients testing the effects of supervised RT for ≥4 wk. on walking capacity, vascular function, and muscle strength. Pooled effect estimates were calculated and evaluated using conventional meta-analytic procedures. Six RCTs compared supervised RT to standard care. Overall, supervised RT prolonged claudication onset distance during a 6-min walk test (6-MWT) (101.7 m (59.6, 143.8), < 0.001) and improved total walking distance during graded treadmill walking (SMD: 0.67 (0.33, 1.01), < 0.001) and the 6-MWT (49.4 m (3.1, 95.6), = 0.04). Five RCTS compared supervised RT and supervised intermittent walking, where the differences in functional capacity between the two exercise modalities appear to depend on the intensity of the exercise program. The insufficient evidence on the effects of RT on vascular function and muscle strength permitted only limited exploration. We conclude that RT is effective in prolonging walking performance in PAD patients. Whether RT exerts its influence on functional capacity by promoting blood flow and/or enhancing skeletal muscle strength remains unclear.
对于外周动脉疾病（PAD）患者而言，有监督的阻力训练似乎是一种比有监督的步行更有前景的替代运动方式。这项荟萃分析研究了有监督的阻力训练对改善步行能力的效果，以及PAD患者在血管和/或骨骼肌水平是否会出现适应性变化。我们在医学文献数据库（Medline）、护理学与健康领域数据库（CINAHL）、Scopus数据库以及Cochrane对照试验中央注册库中检索了关于PAD患者的随机对照试验（RCT），这些试验测试了为期≥4周的有监督阻力训练对步行能力、血管功能和肌肉力量的影响。采用传统的荟萃分析程序计算并评估合并效应估计值。六项随机对照试验将有监督的阻力训练与标准护理进行了比较。总体而言，有监督的阻力训练延长了6分钟步行试验（6-MWT）中的跛行起始距离（101.7米（59.6，143.8），P<0.001），并改善了分级跑步机步行中的总步行距离（标准化均数差：0.67（0.33，1.01），P<0.001）以及6分钟步行试验中的距离（49.4米（3.1，95.6），P = 0.04）。五项随机对照试验比较了有监督的阻力训练和有监督的间歇步行，两种运动方式在功能能力上的差异似乎取决于运动计划的强度。关于阻力训练对血管功能和肌肉力量影响的证据不足，仅允许进行有限的探索。我们得出结论，阻力训练在延长PAD患者的步行表现方面是有效的。阻力训练是否通过促进血流和/或增强骨骼肌力量对功能能力产生影响仍不清楚。
