Gender Differences in Outcomes Following a Pain-Free, Home-Based Exercise Program for Claudication.
Gender Differences in Outcomes Following a Pain-Free, Home-Based Exercise Program for Claudication.
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DOI：
10.1089/jwh.2018.7113
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发表时间：
2019-09
期刊：
影响因子：
--
通讯作者：
Lopez Soto PJ
中科院分区：
文献类型：
--
作者：
Manfredini R;Lamberti N;Manfredini F;Straudi S;Fabbian F;Rodriguez Borrego MA;Basaglia N;Carmona Torres JM;Lopez Soto PJ
背景：外周动脉疾病（PAD）是一种常见的影响活动能力的心血管疾病。在之前的研究中，有监督的运动（一种推荐的治疗跛行的方法）对女性的效果较差。本研究回顾性调查了PAD患者进行无痛家庭运动后的功能结果是否存在性别差异。材料和方法：对2003年至2016年参加结构化家庭项目的PAD和跛行患者进行研究。该计划是在医院制定的，以每天两次10分钟无痛步行为基础，以逐渐增加的速度进行。在基线和出院时评估的结果测量是跑步机测试中的疼痛阈值速度（PTS）和最大（Smax）以及无痛步行距离（PFWD）和6分钟内步行总距离（6MWD）。测定踝肱指数（ABI）、项目持续时间和患者依从性。结果：共纳入1007例患者（女性，n = 264, 26%）。基线时，与男性相比，女性表现出相似的ABI值，但PTS和PFWD值较低（p < 0.001）。出院时，两组依从性相似（评分均为3/4±1），PTS（各0.8±0.8 km/h）、Smax（各0.4±0.5 km/h）、PFWD（女性95±100；男性86±104）、6MWD（女性32±65；男性35±58）和ABI（女性0.07±0.12；男性0.06±0.11）均有重叠改善，组间无差异（经倾向分析证实）。结论：为PAD患者提供个性化的、结构化的无痛运动计划，每天在家中进行几分钟，对两性都同样有效。支持妇女依从性和功能结局的方案应在前瞻性研究中进行测试。
Background: Peripheral artery disease (PAD) is a common cardiovascular pathology that affects mobility. In previous research, supervised exercise, a recommended treatment for claudication, was less effective in women. This study retrospectively investigated whether functional outcomes exhibit sex differences following a pain-free, home-based exercise program for PAD patients. Materials and Methods: Patients with PAD and claudication enrolled to a structured home-based program from 2003 to 2016 were studied. The program was prescribed at the hospital and based on two daily 10-minute pain-free walking sessions at progressively increasing speed. Outcome measures, which were assessed at baseline and discharge, were pain threshold speed (PTS) and maximal (Smax) during a treadmill test and pain-free walking distance (PFWD) and total distance walked in 6 minutes (6MWD). The ankle-brachial index (ABI), program duration, and patient adherence were determined. Results: A total of 1007 patients (women; n = 264; 26%) were enrolled. At baseline, compared to men, women exhibited similar ABI values but lower PTS and PFWD values (p < 0.001). At discharge, with similar adherence (score 3/4 ± 1 each) in both groups, superimposable improvements were observed for PTS (0.8 ± 0.8 km/h each), Smax (0.4 ± 0.5 km/h each), PFWD (women 95 ± 100; men 86 ± 104), 6MWD (women 32 ± 65; men 35 ± 58), and ABI (women 0.07 ± 0.12; men 0.06 ± 0.11) without between-group differences (confirmed after propensity analysis). Conclusion: A personalized, structured pain-free exercise program for PAD patients performed inside the home for a few minutes a day was equally effective in both sexes. Programs favoring adherence and functional outcomes in women should be tested in prospective studies.
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作者：
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