Volterrani Maurizio, Caminiti Giuseppe, Perrone Marco Alfonso, Cerrito Anna, Franchini Alessio, Manzi Vincenzo, Iellamo Ferdinando
Department of Rehabilitation Cardiology, IRCCS San Raffaele Pisana, 00163 Rome, Italy.
Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.
J Clin Med. 2023 Jan 17;12(3):750. doi: 10.3390/jcm12030750.
The best format of exercise training (ET) in the setting of cardiac rehabilitation in patients with chronic heart failure (CHF) is still to be defined. Current guidelines recommend aerobic exercises, such as running and cycling, including some sessions per week of resistance exercise.
The aim of this study was to address the effectiveness of a concurrent exercise training program utilizing a circuit of sequential endurance and resistance exercises on functional capacity and muscular strength in patients with CHF.
Ninety-five consecutive male patients (age 63.1 ± 6 years) with CHF (EF < 40%) in NYHA functional class II/III, were randomly assigned on 1:1 basis to a 12-week aerobic continuous training (AT) or concurrent CT), aerobic + resistance, training (CT), three times a week, with each session lasting 80 min. We used high quality, specifically designed ergometers, connected with each other and governed by a central console, and managed by a single physiotherapist. Before and after training all patients performed a symptoms-limited exercise test on a treadmill and a 6-min walking test (6MWT). Patients in the CT group also performed resistance exercises of upper and lower body.
The 6MWT and exercise duration at ergometric test increased significantly in both AT and CT groups, with the increase being greater in CT group ( < 0.001; ES = 0.13; < 0.01; ES = 0.07). Muscular strength increased significantly in the CT group, particularly in the lower body muscular districts ( < 0.001). Quality of life improved in both groups, with a significantly greater improvement in the CT group ( < 0.05). No side effects leading to discontinuation of training were observed.
These findings indicate that concurrent, within-session training results in larger improvements in functional capacity, in addition to muscle performance, in patients with CHF, in comparison to single-mode aerobic training.
慢性心力衰竭(CHF)患者心脏康复中运动训练(ET)的最佳形式仍有待确定。当前指南推荐有氧运动,如跑步和骑自行车,包括每周进行一些阻力训练课程。
本研究的目的是探讨在CHF患者中采用连续耐力和阻力运动循环的联合运动训练计划对功能能力和肌肉力量的有效性。
95例连续入选的男性CHF患者(年龄63.1±6岁,纽约心脏协会心功能II/III级,射血分数<40%),按1:1随机分为12周的有氧持续训练(AT)组或联合训练(CT)组,即有氧+阻力训练组,每周3次,每次训练持续80分钟。我们使用了高质量、专门设计的测力计,它们相互连接并由中央控制台控制,由一名物理治疗师管理。训练前后,所有患者均在跑步机上进行症状限制性运动试验和6分钟步行试验(6MWT)。CT组患者还进行了上下肢的阻力训练。
AT组和CT组的6MWT和测力计试验中的运动持续时间均显著增加,CT组增加幅度更大(P<0.001;效应量=0.13;P<0.01;效应量=0.07)。CT组肌肉力量显著增加,尤其是下肢肌肉区域(P<0.001)。两组患者生活质量均有所改善,CT组改善更为显著(P<0.05)。未观察到导致训练中断的副作用。
这些发现表明,与单模式有氧训练相比,CHF患者进行联合的、同期训练除了能改善肌肉性能外,还能更大程度地提高功能能力。