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监督下的运动训练可改善间歇性跛行外周动脉疾病患者的心肺适应性,并降低围手术期风险。

Supervised exercise training improves cardiorespiratory fitness and reduces perioperative risk in peripheral artery disease patients with intermittent claudication.

机构信息

Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK.

Vascular Medicine Unit, Centre Hospitalier Universitaire de Caen Normandie, 14000 Caen, France.

出版信息

Ann R Coll Surg Engl. 2024 Feb;106(2):185-194. doi: 10.1308/rcsann.2022.0169. Epub 2023 May 2.

Abstract

INTRODUCTION

This study examined to what extent supervised aerobic and resistance exercise combined with continued unsupervised exercise training improves cardiorespiratory fitness and corresponding perioperative risk in peripheral artery disease (PAD) patients with intermittent claudication.

METHODS

A total of 106 patients (77% male) were enrolled into the study, alongside 155 healthy non-PAD control participants. Patients completed supervised exercise therapy (aerobic and resistance exercises of the upper and lower limbs) twice a week for 10 weeks. Thereafter, 52 patients completed 12 weeks of an unsupervised tailored home-based exercise. Pain-free walking distance (PWD), maximum walking distance (MWD), peak oxygen uptake ([Formula: see text]) and perioperative risk were assessed before and after both exercise interventions.

RESULTS

Patients were highly unconditioned relative to healthy controls ([Formula: see text]=11.9 vs 24.2ml/kg/min, =<0.001) with 91% classified as high perioperative risk (peak oxygen uptake <15ml/kg/min). Supervised exercise increased PWD (+44±81m, =<0.001), MWD (+44±71m, =<0.001) and [Formula: see text] (+1.01±1.63ml/kg/min, =<0.001) and lowered perioperative risk (91% to 85%, =<0.001). When compared with supervised exercise, the improvements in PWD were maintained following unsupervised exercise (+11±91m vs supervised exercise, =0.572); however, MWD and [Formula: see text] decreased (-15±48m, =0.030 and -0.34±1.11ml/kg/min, =0.030, respectively) and perioperative risk increased (+3%, =<0.001) although still below baseline (=<0.001).

CONCLUSIONS

Supervised aerobic and resistance exercise training and, to a lesser extent, unsupervised tailored exercise improves walking capacity and cardiorespiratory fitness and reduces perioperative risk in PAD patients with intermittent claudication.

摘要

简介

本研究旨在探讨监督下的有氧运动和抗阻运动联合持续非监督运动训练在改善间歇性跛行的外周动脉疾病(PAD)患者心肺功能和相应围手术期风险方面的效果。

方法

共纳入 106 名患者(77%为男性)和 155 名健康非 PAD 对照组参与者。患者每周接受两次监督下的运动治疗(上下肢的有氧运动和抗阻运动),共 10 周。此后,52 名患者完成了 12 周的非监督个体化家庭运动。在两次运动干预前后评估了无痛行走距离(PWD)、最大行走距离(MWD)、峰值摄氧量([Formula: see text])和围手术期风险。

结果

与健康对照组相比,患者的身体状况较差([Formula: see text]=11.9 比 24.2ml/kg/min,<0.001),91%的患者被归类为高围手术期风险(峰值摄氧量<15ml/kg/min)。监督下的运动增加了 PWD(+44±81m,<0.001)、MWD(+44±71m,<0.001)和[Formula: see text](+1.01±1.63ml/kg/min,<0.001),并降低了围手术期风险(91%降至 85%,<0.001)。与监督下的运动相比,非监督运动后 PWD 的改善得以维持(+11±91m 比监督运动,=0.572);然而,MWD 和[Formula: see text]下降(-15±48m,=0.030 和-0.34±1.11ml/kg/min,=0.030,分别),围手术期风险增加(+3%,<0.001),尽管仍低于基线(<0.001)。

结论

监督下的有氧运动和抗阻运动训练,以及在较小程度上的非监督个体化运动,可以改善间歇性跛行的 PAD 患者的行走能力、心肺功能,并降低围手术期风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81c4/10846411/417dc2a035a2/rcsann.2022.0169.01.jpg

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