监督下的运动训练可改善有症状的下肢外周动脉疾病患者在无痛行走状态下的 6 分钟步行距离和步态模式。
Supervised Exercise Training Improves 6 min Walking Distance and Modifies Gait Pattern during Pain-Free Walking Condition in Patients with Symptomatic Lower Extremity Peripheral Artery Disease.
机构信息
Heart and Vessel Department, Division of Angiology, Lausanne University Hospital, 1011 Lausanne, Switzerland.
Institute of Sport Sciences, University of Lausanne, 1015 Lausanne, Switzerland.
出版信息
Sensors (Basel). 2021 Nov 30;21(23):7989. doi: 10.3390/s21237989.
This study aimed to investigate the effects of supervised exercise training (SET) on spatiotemporal gait and foot kinematics parameters in patients with symptomatic lower extremity peripheral artery disease (PAD) during a 6 min walk test. Symptomatic patients with chronic PAD (Fontaine stage II) following a 3 month SET program were included. Prior to and following SET, a 6 min walk test was performed to assess the 6 min walking distance (6MWD) of each patient. During this test, spatiotemporal gait and foot kinematics parameters were assessed during pain-free and painful walking conditions. Twenty-nine patients with PAD (65.4 ± 9.9 years.) were included. The 6MWD was significantly increased following SET (+10%; ≤ 0.001). The walking speed (+8%) and stride frequency (+5%) were significantly increased after SET ( ≤ 0.026). The stride length was only significantly increased during the pain-free walking condition (+4%, = 0.001), whereas no significant differences were observed during the condition of painful walking. Similarly, following SET, the relative duration of the loading response increased (+12%), the relative duration of the foot-flat phase decreased (-3%), and the toe-off pitch angle significantly increased (+3%) during the pain-free walking condition alone ( ≤ 0.05). A significant positive correlation was found between changes in the stride length (r = 0.497, = 0.007) and stride frequency (r = 0.786, ≤ 0.001) during pain-free walking condition and changes in the 6MWD. A significant negative correlation was found between changes in the foot-flat phase during pain-free walking condition and changes in the 6MWD (r = -0.567, = 0.002). SET was found to modify the gait pattern of patients with symptomatic PAD, and many of these changes were found to occur during pain-free walking. The improvement in individuals' functional 6 min walk test was related to changes in their gait pattern.
本研究旨在探讨监督运动训练（SET）对有症状下肢外周动脉疾病（PAD）患者在 6 分钟步行测试中时空步态和足部运动学参数的影响。纳入了进行 3 个月 SET 方案后处于慢性 PAD（Fontaine Ⅱ期）的有症状患者。在 SET 前后，对每位患者进行 6 分钟步行测试以评估 6 分钟步行距离（6MWD）。在此测试过程中，在无痛和疼痛行走条件下评估时空步态和足部运动学参数。共纳入 29 例 PAD 患者（65.4±9.9 岁）。SET 后 6MWD 显著增加（+10%，≤0.001）。SET 后行走速度（+8%）和步频（+5%）显著增加（≤0.026）。仅在无痛行走条件下步长显著增加（+4%，=0.001），而在疼痛行走条件下则无显著差异。同样，SET 后，仅在无痛行走条件下，负荷反应期的相对持续时间增加（+12%），足平期的相对持续时间减少（-3%），趾离地角度显著增加（+3%）（≤0.05）。在无痛行走条件下，步长（r=0.497，=0.007）和步频（r=0.786，≤0.001）的变化与 6MWD 的变化之间存在显著正相关。在无痛行走条件下，足平期的变化与 6MWD 的变化之间存在显著负相关（r=-0.567，=0.002）。SET 被发现改变了有症状 PAD 患者的步态模式，其中许多变化发生在无痛行走期间。个体 6 分钟步行测试功能的改善与他们的步态模式的变化有关。
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