Fletcher B J, Dunbar S B, Felner J M, Jensen B E, Almon L, Cotsonis G, Fletcher G F
Department of Rehabilitation Medicine, School of Medicine, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia 30322.
Am J Cardiol. 1994 Jan 15;73(2):170-4. doi: 10.1016/0002-9149(94)90209-7.
A prospective, randomized, controlled clinical trial in patients with coronary artery disease (CAD) and a concurrent physical disability evaluated the effects of a home exercise training program on cardiovascular function and blood lipids. Eighty-eight men between the ages of 42 and 72 years (mean 62) with documented CAD and a physical disability with functional use of > or = 2 extremities including 1 arm were randomized to either a 6-month home exercise training program using wheelchair ergometry or to a control group that received usual and customary care. Both groups received dietary instructions and were requested to follow a fat-controlled diet. Exercise test variables with echocardiography and blood lipids were measured at baseline and at 6 months. The home exercise training group significantly improved both peak exercise left ventricular ejection fraction (p = 0.007) and fractional shortening (p = 0.01) between baseline to 6 months, whereas the control group showed no significant changes. Exercise training effects of decreased resting heart rate (p = 0.03) and decreased peak rate pressure product (p = 0.03) were also found in the treatment group. No exercise-related cardiac complications occurred. Both groups significantly (p < or = 0.01) increased high-density lipoprotein cholesterol levels. These results indicate that physically disabled men with CAD can safely participate in a home exercise training program which may result in intrinsic cardiac benefits. The metabolic cost of activities of daily living imposed on this disabled population may also have a positive effect on high-density lipoprotein cholesterol levels.
一项针对冠心病（CAD）合并身体残疾患者的前瞻性、随机、对照临床试验，评估了家庭运动训练计划对心血管功能和血脂的影响。88名年龄在42至72岁之间（平均62岁）、有CAD记录且身体残疾（包括1只手臂在内的≥2个肢体功能可用）的男性被随机分为两组，一组接受为期6个月的使用轮椅测力计的家庭运动训练计划，另一组为接受常规和惯常护理的对照组。两组均接受饮食指导，并被要求遵循控制脂肪的饮食。在基线和6个月时测量运动试验变量、超声心动图和血脂。家庭运动训练组在基线至6个月期间，峰值运动左心室射血分数（p = 0.007）和缩短分数（p = 0.01）均显著改善，而对照组无显著变化。治疗组还发现运动训练有降低静息心率（p = 0.03）和降低峰值心率血压乘积（p = 0.03）的效果。未发生与运动相关的心脏并发症。两组的高密度脂蛋白胆固醇水平均显著（p≤0.01）升高。这些结果表明，患有CAD的身体残疾男性可以安全地参与家庭运动训练计划，这可能会给心脏带来内在益处。施加于该残疾人群体的日常生活活动的代谢成本也可能对高密度脂蛋白胆固醇水平产生积极影响。
