联合阻力训练与有氧运动训练可改善冠心病患者的身体机能：一项随机对照临床试验的二次分析
Combined resistance training with aerobic training improves physical performance in patients with coronary artery disease: A secondary analysis of a randomized controlled clinical trial.
作者信息
Kambic Tim, Šarabon Nejc, Lainscak Mitja, Hadžić Vedran
机构信息
Cardiac Rehabilitation Unit, Department of Research and Education, General Hospital Murska Sobota, Rakičan, Slovenia.
Faculty of Health Sciences, University of Primorska, Izola, Slovenia.
出版信息
Front Cardiovasc Med. 2022 Aug 24;9:909385. doi: 10.3389/fcvm.2022.909385. eCollection 2022.
BACKGROUND
The efficacy of combined resistance training (RT) and aerobic training (AT) compared with AT alone is well established in cardiac rehabilitation (CR); however, it remains to be elucidated whether RT load (high load [HL] vs. low load [LL]) modifies the outcomes. The aim of our study was to investigate the effects of HL-RT and LL-RT combined with AT in comparison to AT alone on body composition and physical performance in patients with coronary artery disease (CAD) enrolled in phase II CR.
METHODS
We randomized 79 patients with a stable CAD to 12 weeks of lower limb LL-RT + AT (35-40% of one repetition maximum [1-RM]; = 28), HL-RT + AT (70-80% of 1-RM; = 26), or AT ( = 25). Fifty-nine patients (75% men) with mean (standard deviation) age 61 (8) years and left ventricular ejection fraction 53 (9)% completed LL-RT ( = 19), HL-RT ( = 21) and AT ( = 19). Body composition and physical performance (upper and lower submaximal muscle strength, flexibility, balance, and mobility) were measured at baseline and post-training.
RESULTS
Training intervention had no significant impact on time × group interaction in the body composition measures. There was a significant time × group interaction for the gait speed test, chair sit-and-reach test, arm curl test, Stork balance test, up and go test, STS-5, and 6-min walk distance (-values ≤ 0.001-0.04) following the training intervention. After the training intervention, HL-RT improved gait speed (+12%, = 0.044), arm curl (+13%, = 0.037), and time of Up and Go test (+9%, < 0.001) to a greater extent compared with AT group, while there was a greater improvement in time of Up and Go test (+18%, < 0.001) and time of five sit-to-stand tests (+14%, = 0.016) following LL-RT when compared with AT. There were no differences between HL-RT and LL-RT in post-training improvement in any of the physical performance measures.
CONCLUSION
The combination of AT with HL-RT or LL-RT promoted similar improvements in physical performance, which were superior to AT. Therefore, both types of combined AT and RT can be applied to patients with CAD.
CLINICAL TRIAL REGISTRATION
[https://clinicaltrials.gov/ct2/show/NCT04638764] Identifier [NCT04638764].
背景
在心脏康复（CR）中，联合抗阻训练（RT）和有氧训练（AT）相较于单纯的AT的疗效已得到充分证实；然而，RT负荷（高负荷[HL]与低负荷[LL]）是否会改变结果仍有待阐明。我们研究的目的是调查在参加II期CR的冠心病（CAD）患者中，HL-RT和LL-RT联合AT与单纯AT相比，对身体成分和身体机能的影响。
方法
我们将79例稳定型CAD患者随机分为三组，分别进行为期12周的下肢LL-RT + AT（1次重复最大值[1-RM]的35 - 40%；n = 28）、HL-RT + AT（1-RM的70 - 80%；n = 26）或AT（n = 25）。59例患者（75%为男性），平均（标准差）年龄61（8）岁，左心室射血分数53（9）%，完成了LL-RT（n = 19）、HL-RT（n = 21）和AT（n = 19）。在基线和训练后测量身体成分和身体机能（上下肢次最大肌肉力量、柔韧性、平衡能力和活动能力）。
结果
训练干预对身体成分测量中的时间×组间交互作用无显著影响。训练干预后，在步态速度测试、椅子坐立前屈测试、臂弯举测试、鹳式平衡测试、起身行走测试、5次坐立测试和6分钟步行距离方面存在显著的时间×组间交互作用（P值≤0.0（01 - 0.04）。训练干预后，与AT组相比，HL-RT在更大程度上改善了步态速度（+12%，P = 0.044）、臂弯举（+13%，P = 0.037）和起身行走测试时间（+9%，P < 0.001），而与AT相比，LL-RT后起身行走测试时间（+18%，P < 0.001）和5次坐立测试时间（+14%，P = 0.016）有更大改善。在任何身体机能测量的训练后改善方面，HL-RT和LL-RT之间没有差异。
结论
AT与HL-RT或LL-RT联合应用在身体机能改善方面促进了相似的效果，且优于单纯AT。因此，两种类型的AT和RT联合应用均可应用于CAD患者。
临床试验注册
[https://clinicaltrials.gov/ct2/show/NCT04638764]标识符[NCT04638764]。
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