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外周动脉疾病患者的血管康复干预:一项综合综述。

Vascular rehabilitation interventions in people with peripheral arterial disease: an integrative review.

作者信息

Perdigão Kauane Flechas Arruda, Costa Larissa Pereira, Freitas Annicia Lins, Lima José Heriston de Morais, de França Eduardo Ériko Tenório, Pedrosa Rafaela

机构信息

Universidade Federal da Paraíba - UFPB, João Pessoa, PB, Brasil.

出版信息

J Vasc Bras. 2025 Mar 14;24:e20240088. doi: 10.1590/1677-5449.202400882. eCollection 2025.

DOI:10.1590/1677-5449.202400882
PMID:40109307
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11922327/
Abstract

BACKGROUND

Peripheral artery disease, which occurs due to lower limb artery disorders, is associated with high cardiovascular mortality rates. Studies show that supervised exercise is an effective option for controlling symptoms.

OBJECTIVE

This study identified exercise types and complementary therapies used for vascular rehabilitation in people with peripheral artery disease and discusses the best recommendations in the literature.

METHODS

This integrative literature review is based on studies published in the last 5 years. The search was performed in the following databases: PubMed, SciELO, LILACS (BVS), and Cochrane. In addition to supervised exercise, the interventions in the clinical trials included other approaches that contributed to patient rehabilitation. Duplicate articles, articles whose full text was unavailable, and those whose title or abstract indicated they were unrelated to the topic were excluded.

RESULTS

Nine articles were included in the analysis. The results indicate that supervised exercise is the gold standard treatment method. However, therapies such as blood flow restriction, heat therapy, hydrotherapy, and resistance training can help improve treatment adherence, and their complementary effects benefit cardiovascular and physical function.

CONCLUSIONS

In patients with peripheral artery disease, exercise-based rehabilitation is fundamental. However, resistance training with blood flow restriction can optimize muscle strength, while heat therapy and hydrotherapy can act as adjuvants to exercise.

摘要

背景

外周动脉疾病因下肢动脉紊乱而发生,与心血管高死亡率相关。研究表明,有监督的运动是控制症状的有效选择。

目的

本研究确定了用于外周动脉疾病患者血管康复的运动类型和辅助疗法,并讨论了文献中的最佳建议。

方法

本综合文献综述基于过去5年发表的研究。检索在以下数据库中进行:PubMed、SciELO、LILACS(BVS)和Cochrane。除了有监督的运动外,临床试验中的干预措施还包括有助于患者康复的其他方法。排除重复文章、全文不可用的文章以及标题或摘要表明与主题无关的文章。

结果

9篇文章纳入分析。结果表明,有监督的运动是金标准治疗方法。然而,诸如血流限制、热疗、水疗和阻力训练等疗法有助于提高治疗依从性,其辅助作用有益于心血管和身体功能。

结论

在外周动脉疾病患者中,基于运动的康复至关重要。然而,血流限制下的阻力训练可优化肌肉力量,而热疗和水疗可作为运动的辅助手段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04d7/11922327/3b99ffea62d1/jvb-24-e20240088-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04d7/11922327/5c7bc5a56a09/jvb-24-e20240088-g01-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04d7/11922327/3b99ffea62d1/jvb-24-e20240088-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04d7/11922327/5c7bc5a56a09/jvb-24-e20240088-g01-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04d7/11922327/3b99ffea62d1/jvb-24-e20240088-g01.jpg

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本文引用的文献

1
Exercise Training for Patients With Peripheral Arterial Occlusive Disease.外周动脉闭塞性疾病患者的运动训练
Dtsch Arztebl Int. 2023 Dec 27;120(51-52):879-885. doi: 10.3238/arztebl.m2023.0231.
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Low-intensity resistance exercise with blood flow restriction for patients with claudication: A randomized controlled feasibility trial.伴有血流限制的低强度抗阻运动治疗跛行患者:一项随机对照可行性试验。
Vasc Med. 2023 Dec;28(6):554-563. doi: 10.1177/1358863X231200250. Epub 2023 Oct 11.
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Peripheral arterial disease (PAD) - A challenging manifestation of atherosclerosis.
外周动脉疾病(PAD)——动脉粥样硬化的一种具有挑战性的表现形式。
Prev Med. 2023 Jun;171:107489. doi: 10.1016/j.ypmed.2023.107489. Epub 2023 Apr 7.
4
The Impact of Controlled Physical Training with Hydrotherapy on Changes in Swelling and Claudication Distance in Patients with Atherosclerotic Ischemia of the Lower Limbs.水疗结合控制性身体训练对下肢动脉硬化缺血患者肿胀和跛行距离变化的影响。
Int J Environ Res Public Health. 2022 Nov 25;19(23):15715. doi: 10.3390/ijerph192315715.
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Peripheral artery disease: a comparison of urgent open and endovascular revascularizations on the public health system in Brazil, from 2010 to 2020.外周动脉疾病:2010年至2020年巴西公共卫生系统中紧急开放血管重建术与血管腔内血管重建术的比较
J Vasc Bras. 2022 Jul 29;21:e20220016. doi: 10.1590/1677-5449.202200161. eCollection 2022.
6
Effect of a Home-Based, Walking Exercise Behavior Change Intervention vs Usual Care on Walking in Adults With Peripheral Artery Disease: The MOSAIC Randomized Clinical Trial.基于家庭的步行锻炼行为改变干预与常规护理对下肢动脉疾病患者步行能力的影响:MOSAIC 随机临床试验。
JAMA. 2022 Apr 12;327(14):1344-1355. doi: 10.1001/jama.2022.3391.
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Supervised Exercise Therapy Using Mobile Health Technology in Patients With Peripheral Arterial Disease: Pilot Randomized Controlled Trial.外周动脉疾病患者使用移动健康技术的监督运动疗法:试点随机对照试验
JMIR Mhealth Uhealth. 2021 Aug 16;9(8):e24214. doi: 10.2196/24214.
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Lower Extremity Peripheral Artery Disease: Contemporary Epidemiology, Management Gaps, and Future Directions: A Scientific Statement From the American Heart Association.下肢外周动脉疾病:当代流行病学、管理差距与未来方向:美国心脏协会科学声明。
Circulation. 2021 Aug 31;144(9):e171-e191. doi: 10.1161/CIR.0000000000001005. Epub 2021 Jul 28.
9
Effect of Low-Intensity vs High-Intensity Home-Based Walking Exercise on Walk Distance in Patients With Peripheral Artery Disease: The LITE Randomized Clinical Trial.低强度与高强度家庭步行运动对下肢动脉疾病患者步行距离的影响:LITE 随机临床试验。
JAMA. 2021 Apr 6;325(13):1266-1276. doi: 10.1001/jama.2021.2536.
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Exercise therapy in routine management of peripheral arterial disease and intermittent claudication: a scoping review.运动疗法在周围动脉疾病和间歇性跛行常规管理中的应用:一项范围综述
Ther Adv Cardiovasc Dis. 2020 Jan-Dec;14:1753944720924270. doi: 10.1177/1753944720924270.