High-intensity interval training in facioscapulohumeral muscular dystrophy type 1: a randomized clinical trial
High-intensity interval training in facioscapulohumeral muscular dystrophy type 1: a randomized clinical trial
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DOI：
10.1007/s00415-017-8497-9
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发表时间：
2017-06-01
影响因子：
6
通讯作者：
Vissing, John
中科院分区：
文献类型：
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作者：
Andersen, Grete;Heje, Karen;Vissing, John
越来越多的证据表明，高强度训练(HIT)是一种提高体能的省时运动策略。HIT从未在神经肌肉疾病中被研究过，可能是因为它看起来可能违反直觉。对于面部肩周型肌营养不良症1型(FSHD1)患者，只进行了一次高强度运动的研究，没有发现肌肉损伤的迹象。在一项随机对照平行研究中，我们的目标是确定HIT在FSHD1中是否安全有效。经过遗传验证的FSHD1(n=13)未受过训练的成年人能够进行自行车运动，他们被随机分为8周的监督训练(n=6)(3×10分钟的自行车训练/周)或8周的常规护理(n=7)。之后，所有参与者都进行了8周的无监督HIT(3x10分钟循环测功机HIT/周)。主要结果是健康，最大摄氧量/分钟/公斤体重。此外，还测量了工作量、6分钟步行距离、5次坐立时间、肌肉力量和日常活动水平。监测疼痛、疲劳和血浆CK。12名患者完成了研究的随机部分。血浆CK水平和疼痛评分不受HIT的影响。监督HIT改善体能(3.3mlO-2/min/kg，CI 1.2~5.5，P<；0.01，n=6，NNT=1.4)。无监督HIT也提高了体能(2.0mlO-2/min/kg，CI 0.1~3.9，P=0.04，n=4)。训练对其他结果没有影响。患者更喜欢击打而不是力量和中等强度的有氧训练。在肌营养不良患者中实施HIT似乎是违反直觉的，但这项随机对照试验表明，常规HIT是安全、有效的，并且受到中度FSHD1患者的欢迎，这表明HIT是一种可行的FSHD1患者康复方法。
Increasing evidence suggests that high-intensity training (HIT) is a time-efficient exercise strategy to improve fitness. HIT has never been explored in neuromuscular diseases, likely because it may seem counterintuitive. A single session of high-intensity exercise has been studied without signs of muscle damage in facioscapulohumeral muscular dystrophy type 1 (FSHD1). We aimed to determine whether HIT is safe and effective in FSHD1 in a randomized, controlled parallel study. Untrained adults with genetically verified FSHD1 (n = 13) able to perform cycle-ergometer exercise were randomized to 8 weeks of supervised HIT (n = 6) (3 x 10-min cycle-ergometer-HIT/week) or 8 weeks of usual care (n = 7). Following this, all participants performed 8 weeks of unsupervised HIT (3 x 10-min cycle-ergometer-HIT/week). Primary outcome was fitness, maximal oxygen uptake/min/kg body weight. Furthermore, workload, 6-min walk distance, 5-time sit-to-stand time, muscle strength, and daily activity levels were measured. Pain, fatigue, and plasma-CK were monitored. Twelve patients completed the randomized part of the study. Plasma-CK levels and pain scores were unaffected by HIT. Supervised HIT improved fitness (3.3 ml O-2/min/kg, CI 1.2-5.5, P < 0.01, n = 6, NNT = 1.4). Unsupervised HIT also improved fitness (2.0 ml O-2/min/kg, CI 0.1-3.9, P = 0.04, n = 4). There was no training effect on other outcomes. Patients preferred HIT over strength and moderate-intensity aerobic training. It may seem counterintuitive to perform HIT in muscular dystrophies, but this RCT shows that regular HIT is safe, efficacious, and well liked by moderately affected patients with FSHD1, which suggests that HIT is a feasible method for rehabilitating patients with FSHD1.