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患有和未患有先天性心脏病的唐氏综合征成人的日常身体活动和心肺适能

Daily physical activity and cardiorespiratory fitness in adults with Down syndrome with and without congenital heart disease.

作者信息

Clina Julianne G, White David A, Sherman Joseph R, Danon Jessica C, Forsha Daniel E, Helsel Brian C, Washburn Richard A, Donnelly Joseph E, Ptomey Lauren T

机构信息

Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA.

Ward Family Heart Center, Children's Mercy Kansas City, Kansas City, MO, 64108, USA.

出版信息

Disabil Health J. 2025 Jul;18(3):101778. doi: 10.1016/j.dhjo.2025.101778. Epub 2025 Jan 28.

Abstract

BACKGROUND

Individuals with Down syndrome (DS) typically exhibit lower cardiorespiratory fitness and reduced moderate-to-vigorous physical activity (MVPA) compared to persons without disability. Approximately 50-55 % of individuals with DS have congenital heart disease (CHD), which is associated with cardiopulmonary deficiencies and reduced MVPA participation in non-DS populations. It is unknown if CHD related comorbidities compound with DS associated deficits in physical activity and fitness.

OBJECTIVE

To compare physical activity, cardiorespiratory fitness, and cardiovascular function, of persons with DS with and without CHD.

METHODS

Baseline data were used from a 12-month randomized controlled physical activity intervention of adults with DS. Participants with DS were age and sex matched based on presence of CHD. Measures of physical activity through accelerometry (n = 42; CHD, n = 21), cardiorespiratory fitness (VO; n = 34, CHD n = 17), and cardiovascular function (anaerobic threshold, chronotropic index, O pulse; n = 34, CHD n = 17) were compared by CHD status using Wilcoxon rank sum tests.

RESULTS

There were no differences in VO between those with and without CHD (CHD 20.3 ml/kg/min; no CHD 21.3 ml/kg/min, p = 0.44). MVPA was lower for those with CHD vs. without CHD (10.0 vs 13.3 min/week, p = 0.05). There were no differences in cardiovascular function by group.

CONCLUSION

Fitness and physical activity were low regardless of CHD status. Adults with DS and CHD may engage in less physical activity than those without CHD, however fitness and cardiovascular function were not further impaired by CHD. Given the prevalence of CHD in DS, it is important to include those with CHD in work increasing physical activity and fitness.

摘要

背景

与非残疾人士相比,唐氏综合征(DS)患者通常表现出较低的心肺适能以及较少的中等到剧烈身体活动(MVPA)。约50%-55%的DS患者患有先天性心脏病(CHD),这与心肺功能缺陷相关,并且在非DS人群中会导致MVPA参与度降低。目前尚不清楚与CHD相关的合并症是否会与DS相关的身体活动和适能缺陷叠加。

目的

比较患有和未患有CHD的DS患者的身体活动、心肺适能和心血管功能。

方法

使用一项针对成年DS患者的为期12个月的随机对照身体活动干预的基线数据。根据是否患有CHD对DS患者进行年龄和性别匹配。通过加速度计测量身体活动(n = 42;CHD患者,n = 21)、心肺适能(VO;n = 34,CHD患者n = 17)以及心血管功能(无氧阈、变时指数、O脉搏;n = 34,CHD患者n = 17),并使用Wilcoxon秩和检验按CHD状态进行比较。

结果

患有和未患有CHD的患者在VO方面无差异(CHD患者为20.3 ml/kg/min;未患CHD患者为21.3 ml/kg/min,p = 0.44)。与未患CHD的患者相比,患CHD的患者MVPA较低(分别为10.0分钟/周和13.3分钟/周,p = 0.05)。两组在心血管功能方面无差异。

结论

无论CHD状态如何,适能和身体活动水平均较低。患有DS和CHD的成年人可能比未患CHD的成年人身体活动更少,然而CHD并未进一步损害适能和心血管功能。鉴于DS患者中CHD的患病率,将患有CHD的患者纳入增加身体活动和适能的工作中很重要。

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