高强度间歇训练和中等强度持续训练在肾移植受者中的可行性和可接受性：PACE-KD研究
Feasibility and acceptability of high-intensity interval training and moderate-intensity continuous training in kidney transplant recipients: the PACE-KD study.
作者信息
Billany Roseanne E, Smith Alice C, Hutchinson Ganisha M, Graham-Brown Matthew P M, Nixon Daniel G D, Bishop Nicolette C
机构信息
Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK.
出版信息
Pilot Feasibility Stud. 2022 May 21;8(1):106. doi: 10.1186/s40814-022-01067-3.
BACKGROUND
Kidney transplant recipients (KTRs) exhibit unique elevated inflammation, impaired immune function, and increased cardiovascular risk. Although exercise reduces cardiovascular risk, there is limited research on this population, particularly surrounding novel high-intensity interval training (HIIT). The purpose of this pilot study was to determine the feasibility and acceptability of HIIT in KTRs.
METHODS
Twenty KTRs (male 14; eGFR 58±19 mL/min/1.73 m; age 49±11 years) were randomised and completed one of three trials: HIIT A (4-, 2-, and 1-min intervals; 80-90% watts at V̇O), HIITB (4×4 min intervals; 80-90% V̇O) or MICT (~40 min; 50-60% V̇O) for 24 supervised sessions on a stationary bike (approx. 3x/week over 8 weeks) and followed up for 3 months. Feasibility was assessed by recruitment, retention, and intervention acceptability and adherence.
RESULTS
Twenty participants completed the intervention, and 8 of whom achieved the required intensity based on power output (HIIT A, 0/6 [0%]; HIITB, 3/8 [38%]; MICT, 5/6 [83%]). Participants completed 92% of the 24 sessions with 105 cancelled and rescheduled sessions and an average of 10 weeks to complete the intervention. Pre-intervention versus post-intervention V̇O (mL/kg/min) was 24.28±4.91 versus 27.06±4.82 in HIITA, 24.65±7.67 versus 27.48±8.23 in HIIT B, and 29.33±9.04 versus 33.05±9.90 in MICT. No adverse events were reported.
CONCLUSIONS
This is the first study to report the feasibility of HIIT in KTRs. Although participants struggled to achieve the required intensity (power), this study highlights the potential that exercise has to reduce cardiovascular risk in KTRs. HIIT and MICT performed on a cycle, with some modification, could be considered safe and feasible in KTRs. Larger scale trials are required to assess the efficacy of HIIT in KTRs and in particular identify the most appropriate intensities, recovery periods, and session duration. Some flexibility in delivery, such as incorporating home-based sessions, may need to be considered to improve recruitment and retention.
TRIAL REGISTRATION
ISRCTN, ISRCTN17122775 . Registered on 30 January 2017.
背景
肾移植受者（KTRs）表现出独特的炎症升高、免疫功能受损和心血管风险增加。尽管运动可降低心血管风险，但针对该人群的研究有限，尤其是围绕新型高强度间歇训练（HIIT）的研究。这项初步研究的目的是确定HIIT在KTRs中的可行性和可接受性。
方法
20名KTRs（男性14名；估算肾小球滤过率[eGFR]为58±19 mL/min/1.73 m²；年龄49±11岁）被随机分组并完成三项试验之一：HIIT A（4分钟、2分钟和1分钟的间歇；摄氧量[V̇O₂]时功率为80 - 90%）、HIIT B（4×4分钟间歇；80 - 90% V̇O₂）或中等强度持续训练（MICT，约40分钟；50 - 60% V̇O₂），在固定自行车上进行24次有监督的训练课程（约8周内每周3次），并随访3个月。通过招募、留存率以及干预的可接受性和依从性来评估可行性。
结果
20名参与者完成了干预，其中8名根据功率输出达到了所需强度（HIIT A组，0/6[0%]；HIIT B组，3/8[38%]；MICT组，5/6[83%]）。参与者完成了24次训练课程的92%，有105次训练课程被取消并重新安排，平均需要10周完成干预。干预前与干预后HIIT A组的V̇O₂（mL/kg/min）分别为24.28±4.91和27.06±4.82，HIIT B组分别为24.65±7.67和27.48±8.23，MICT组分别为29.33±9.04和33.05±9.90。未报告不良事件。
结论
这是第一项报告HIIT在KTRs中可行性的研究。尽管参与者难以达到所需强度（功率），但这项研究凸显了运动在降低KTRs心血管风险方面的潜力。在进行一些调整后，在自行车上进行的HIIT和MICT对KTRs可能是安全可行的。需要进行更大规模的试验来评估HIIT在KTRs中的疗效，特别是确定最合适的强度、恢复期和训练时长。在实施过程中可能需要考虑一些灵活性，比如纳入居家训练课程，以提高招募率和留存率。
试验注册
国际标准随机对照试验编号（ISRCTN），ISRCTN17122775。于2017年1月30日注册。
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