急性心肌梗死后不久进行重量训练的安全性和有效性。

Safety and efficacy of weight training soon after acute myocardial infarction.

作者信息

Stewart K J, McFarland L D, Weinhofer J J, Cottrell E, Brown C S, Shapiro E P

机构信息

Cardiac Rehabilitation and Prevention Program, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA.

出版信息

J Cardiopulm Rehabil. 1998 Jan-Feb;18(1):37-44. doi: 10.1097/00008483-199801000-00005.

DOI:10.1097/00008483-199801000-00005

PMID:9494881

Abstract

BACKGROUND

To determine if weight training used during cardiac rehabilitation as soon as 4 weeks after myocardial infarction (MI) is safe, and if weight training combined with aerobic exercise improves aerobic fitness and muscle strength more than aerobic exercise alone.

METHODS

Twenty-three men within 6 weeks of an acute MI and without exercise-induced ischemia, complex arrhythmias, anterior Q wave MI, or ejection fraction < 40% were randomly assigned to combined weight and cycle training versus cycle training for 10 weeks. The main measures were change in maximal oxygen uptake (VO2max), muscle strength, resting left ventricular (LV) wall segment motion and early diastolic filling by resting echocardiograms, exercise ECG, heart rate, and blood pressure responses [corrected].

RESULTS

VO2max increased 14% (P < 0.01) and cycle time increased 10% (P < 0.01) in the combined training group. The 8% increases in VO2max (P = 0.15) and cycle time (P = 0.08) in the cycling group were not significant. Arm and leg strength increased (P < 0.01) in each group. However, the change was greater for the combined training group--31% versus 16% (P < 0.03) for leg strength and 20% versus 10% (P < 0.001) for arm strength. There were no changes for either group in resting hemodynamics, body weight and composition, LV wall segment motion, LV fractional shortening, and early diastolic function, and no adverse clinical events or exercise-related complications.

CONCLUSIONS

Combined training soon after MI improved aerobic and muscle fitness more than cycling alone, and was performed without complication.

摘要

背景

确定心肌梗死（MI）后4周即在心脏康复期间进行的重量训练是否安全，以及重量训练与有氧运动相结合是否比单独进行有氧运动能更有效地提高有氧适能和肌肉力量。

方法

23名急性心肌梗死后6周内、无运动诱发的缺血、复杂性心律失常、前壁Q波心肌梗死或射血分数<40%的男性被随机分配至重量训练与循环训练相结合组或单纯循环训练组，为期10周。主要测量指标包括最大摄氧量（VO2max）的变化、肌肉力量、静息超声心动图测量的静息左心室（LV）壁节段运动和舒张早期充盈、运动心电图、心率及血压反应[校正后]。

结果

联合训练组的VO2max增加了14%（P<0.01），循环时间增加了10%（P<0.01）。循环训练组VO2max增加8%（P=0.15），循环时间增加8%（P=0.08），差异无统计学意义。两组的手臂和腿部力量均增加（P<0.01）。然而，联合训练组的变化更大——腿部力量分别为31%和16%（P<0.03），手臂力量分别为20%和10%（P<0.001）。两组在静息血流动力学、体重和组成、LV壁节段运动、LV缩短分数及舒张早期功能方面均无变化，也未出现不良临床事件或运动相关并发症。