Bicycle exercise training improves ambulation in patients with peripheral artery disease
Bicycle exercise training improves ambulation in patients with peripheral artery disease
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DOI：
10.1016/j.jvs.2019.06.188
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发表时间：
2020-03-01
影响因子：
4.3
通讯作者：
Nakamura, Yoshihiko
中科院分区：
文献类型：
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作者：
Haga, Makoto;Hoshina, Katsuyuki;Nakamura, Yoshihiko
目的：运动训练对动脉粥样硬化疾病患者有多种有益作用;然而，这些作用的确切潜在机制尚未完全了解。本研究旨在评估有监督的运动计划在改善外周动脉疾病（PAD）和间歇性跛行（IC）患者的步态参数，包括下肢运动的变异性和步行性能方面的有效性。方法：16例有PAD和IC病史的患者被招募参加本研究，他们完成了为期3个月的有监督的自行车运动计划。评估踝臂指数和对生活质量（QOL）问卷的反应。还进行了近红外光谱法测定小牛的血红蛋白氧饱和度。患者的运动学和动力学，包括关节活动范围和肌肉张力，使用光学运动捕捉系统进行评估。通过手动勾画评估每块肌肉的计算机断层扫描图像。结果：有监督的自行车运动前后的步长、踝臂指数、血红蛋白氧饱和度无显著性差异;然而，IC距离（P = 0.034）、最大步行距离（P = 0.006）和所有QOL问卷评分（P <0.001）均显示出显著改善。双侧髋关节活动度（P = 0.035）、最大髋关节扭矩（右侧，P = 0.031;左侧，P = 0.044）、臀大肌最大张力（右侧，P = 0.044;左侧，P = 0.042）和最大髋关节功（右侧，P = 0.048;左侧，P = 0.043）也显著降低。计算机断层扫描图像显示，腹部，躯干和大腿肌肉的横截面积显着增加，但不是在小腿肌肉的监督运动程序intervention.Conclusions后：在这项研究中，自行车运动训练提高了生活质量和步行距离，减少髋关节运动。结果表明，在PAD患者中，骑自行车可能与步行一样有用。
Objective: Exercise training has multiple beneficial effects in patients with arteriosclerotic diseases; however, the exact underlying mechanisms of the effects are not completely understood. This study aimed to evaluate the effectiveness of a supervised exercise program in improving gait parameters, including the variability and walking performance of lower limb movements, in patients with peripheral artery disease (PAD) and intermittent claudication (IC).Methods: Sixteen patients with a history of PAD and IC were recruited for this study, and they completed a 3-month supervised bicycle exercise program. The ankle-brachial index and responses to quality of life (QOL) questionnaires were evaluated. Near-infrared spectroscopy was also performed to determine the hemoglobin oxygen saturation in the calf. Patients' kinematics and dynamics, including joint range of motion and muscle tension, were evaluated using an optical motion capture system. Computed tomography images of each muscle were assessed by manual outlining. Data were collected before and after the supervised bicycle exercise program, and differences were analyzed.Results: Significant differences were not found in step length, ankle-brachial index, and hemoglobin oxygen saturation before and after the supervised bicycle exercise program; however, IC distance (P = .034), maximum walking distance (P = .006), and all QOL questionnaire scores (P < .001) showed significant improvement. Hip range of motion (P = .035), maximum hip joint torque (right, P = .031; left, P = .044), maximum tension of the gluteus maximus muscle (right, P = .044; left, P = .042), and maximum hip joint work (right, P = .048; left, P = .043) also significantly decreased bilaterally. Computed tomography images showed a significant increase in the cross-sectional area of the abdominal, trunk, and thigh muscles but not in that of the lower leg muscles after the supervised exercise program intervention.Conclusions: In this study, bicycle exercise training improved the QOL and walking distance and decreased hip movement. The results showed that bicycling might be as useful as walking in patients with PAD.