Garcia Eduardo Lima, Pereira Adamastor Humberto, Menezes Marcio Garcia, Pereira Alexandre Araújo, Stein Ricardo, Franzoni Leandro Tolfo, Danzmann Luiz Claudio, Dos Santos Antônio Cardoso
Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brasil.
Hospital de Clínicas de Porto Alegre - HCPA, Porto Alegre, RS, Brasil.
J Vasc Bras. 2023 Aug 28;22:e20230024. doi: 10.1590/1677-5449.202300242. eCollection 2023.
Decreased walking ability in patients with peripheral arterial disease is often a clinical problem and limits the quality of life and daily activities of these subjects. physical exercise is important in this scenario, as it improves both the daily walking distance and the ability to withstand intermittent claudication related to the limitations of the peripheral disease.
Our aim was to compare the effects of two types of exercise training (aerobic training and aerobic training combined with resistance exercises) on pain-free walking distance (PFWD) and health-related quality of life (HRQoL) in a sample composed of patients with peripheral artery disease (PAD).
Twenty patients with claudication symptoms were randomized to either aerobic control (AC) or combined training (CT) N= 8, (24 sixty-minute sessions, twice a week). The total walking distance until onset of pain due to claudication was assessed using the 6-minute walk test and HRQoL was measured using the WHOQOL-bref questionnaire (general and specific domains) at baseline and after training. We used generalized estimating equations (GEE) to assess the differences between groups for the PFWD and HRQoL domains, testing the main group and time effects and their respective interaction effects. P values < 0.05 were considered statistically significant.
Seventeen patients (mean age 63±9 years; 53% male) completed the study. Both groups experienced improvement in claudication, as reflected by a significant increase in PFWD: AC, 149 m to 299 m (P<0.001); CT, 156 m to 253 m (P<0.001). HRQoL domains also improved similarly in both groups (physical capacity, psychological aspects, and self-reported quality of life; P=0.001, P=0.003, and P=0.011 respectively).
Both aerobic and combined training similarly improved PFWD and HRQoL in PAD patients. There are no advantages in adding strength training to conventional aerobic training. This study does not support the conclusion that combined training is a good strategy for these patients when compared with classic training.
外周动脉疾病患者行走能力下降常常是一个临床问题，限制了这些患者的生活质量和日常活动。在这种情况下，体育锻炼很重要，因为它既能增加每日行走距离，又能提高患者耐受与外周疾病限制相关的间歇性跛行的能力。
我们的目的是比较两种运动训练（有氧训练和有氧训练结合抗阻运动）对一组外周动脉疾病（PAD）患者无痛行走距离（PFWD）和健康相关生活质量（HRQoL）的影响。
20名有跛行症状的患者被随机分为有氧训练对照组（AC）或联合训练组（CT），每组8人，进行24次每次60分钟、每周两次的训练。在基线和训练后，使用6分钟步行试验评估因跛行导致疼痛发作前的总步行距离，并使用世界卫生组织生活质量简表问卷（一般和特定领域）测量HRQoL。我们使用广义估计方程（GEE）评估两组在PFWD和HRQoL领域的差异，检验主要组和时间效应及其各自的交互效应。P值<0.05被认为具有统计学意义。
17名患者（平均年龄63±9岁；53%为男性）完成了研究。两组患者的跛行情况均有改善，表现为PFWD显著增加：AC组从149米增加到299米（P<0.001）；CT组从156米增加到253米（P<0.001）。两组的HRQoL领域也有类似改善（身体能力、心理方面和自我报告的生活质量；P值分别为0.001、0.003和0.011）。
有氧训练和联合训练在改善PAD患者的PFWD和HRQoL方面效果相似。在传统有氧训练中增加力量训练并无优势。与经典训练相比，本研究不支持联合训练对这些患者是一种良好策略的结论。
