Comparison of the effect of upper body-ergometry aerobic training vs treadmill training on central cardiorespiratory improvement and walking distance in patients with claudication
Comparison of the effect of upper body-ergometry aerobic training vs treadmill training on central cardiorespiratory improvement and walking distance in patients with claudication
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DOI：
10.1016/j.jvs.2011.01.077
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发表时间：
2011-06-01
影响因子：
4.3
通讯作者：
Leon, Arthur S.
中科院分区：
文献类型：
--
作者：
Bronas, Ulf Gunnar;Treat-Jacobson, Diane;Leon, Arthur S.
背景资料：有监督的跑步机步行锻炼计划已被证明是一个非常有效的改善周围动脉疾病（PAD）患者的步行距离与生活方式限制性跛行。关于运动训练对改善这些患者步行能力的中枢心肺功能的作用，目前的信息有限。（21名男性;年龄，65.6岁; 92.7%有吸烟史，36.6%有糖尿病），生活方式限制PAD相关跛行，每周3小时监督运动训练12周，采用臂测力法（n = 10）或跑步机步行法（n = 10）与常规护理对照组（n = 8）。在次最大负荷训练前后、跛行发作时（无痛步行距离[PFWD]）和最大步行距离[（MWD）]时，对患者的呼吸功能进行评估。采用协方差分析，分析各组中这些功能相对于基线的变化。变量之间的关联由Pearson偏相关系数确定。结果：各组之间的平均基线人口统计学、医疗和运动变量相似。两个运动组与对照组相比，在次最大双乘积（心率×收缩压）和MWD、跛行阈值、跛行发作时的跛行摄氧量（VO（2））以及训练后的VO（2）峰值方面存在相似的显著差异。具有统计学显著性，中度相关性所有心肺变量的变化与PFWD或MWD的变化之间存在相关性（r = 0.60-0.68）。手臂测力或跑步机训练后心肺功能的改善与PFWD和MWD的改善显著相关，为跛行患者中观察到的运动训练相关步行能力改善的全身性贡献提供支持性证据。（J Vase Surg 2011; 53：1557-64.）
Background: Supervised treadmill-walking exercise programs have been proven to be a highly effective in improving walking distance in peripheral arterial disease (PAD) patients with lifestyle-limiting claudication. Limited information is available on the contributions of central cardiorespiratory functions for improving these patients' walking capacity with exercise training.Methods: This study randomized 28 participants (21 men; age, 65.6 years; 92.7% smoking history, 36.6% with diabetes) with lifestyle-limiting PAD-related claudication to 3 hours/week of supervised exercise training for 12 weeks, using arm-ergometry (n = 10) or treadmill-walking (n = 10) vs a usual-care control group (n = 8). Cardiorespiratory function measurements were assessed before and after training at a submaximal workload and at the onset of claudication (pain-free walking distance [PFWD]) and at maximal walking distance [(MWD]). Changes in these functions from baseline were analyzed among the groups with analysis of covariance. Associations between variables were determined by Pearson's partial correlations.Results: The mean baseline demographic, medical, and exercise variables were similar among the groups. There were similar significant differences in the submaximal double product (heart rate x systolic blood pressure) and at MWD, ventilatory threshold, ventilatory oxygen uptake (VO(2)) at onset of claudication, and VO(2) peak in response to training in both exercise groups vs the control group. Statistically significant, moderate correlations (r = 0.60-0.68) were found between changes in all cardiorespiratory variables and changes in PFWD or MWD.Conclusion: Improvements in cardiorespiratory function after arm-ergometry or treadmill-training were significantly associated with improvements in both PFWD and MWD, providing supporting evidence of systemic contributions to exercise training-related improvements in walking capacity seen in patients with claudication. (J Vase Surg 2011; 53:1557-64.)