Step-monitored home exercise improves ambulation, vascular function, and inflammation in symptomatic patients with peripheral artery disease: a randomized controlled trial.
Step-monitored home exercise improves ambulation, vascular function, and inflammation in symptomatic patients with peripheral artery disease: a randomized controlled trial.
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DOI：
10.1161/jaha.114.001107
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发表时间：
2014-09-18
影响因子：
5.4
通讯作者：
Blevins SM
中科院分区：
文献类型：
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作者：
Gardner AW;Parker DE;Montgomery PS;Blevins SM
这项前瞻性、随机、对照临床试验比较了跛行发作时间（COT）和步行高峰时间（PWT）的主要结局指标的变化，以及次极量运动能力、每日步行活动、血管功能、炎症、症状性外周动脉疾病（PAD）患者在使用步表进行新的运动训练后的腓肠肌血红蛋白氧饱和度（StO2）（下一步）家庭锻炼计划，监督锻炼计划和注意力控制组。180例患者接受了随机分组。下一步计划和监督运动计划包括间歇性步行至轻度至中度跛行疼痛12周，而对照组进行轻度阻力训练。更改COT的分数（P<0.001），PWT（P<0.001），6分钟步行距离（P=0.028），日平均踏频（P=0.011），运动期间至小腿肌肉StO2最小值的时间（P=0.025），大动脉弹性指数（LAEI）（P=0.012）和高敏C反应蛋白（hsCRP）（P=0.041）在3组之间存在显著差异。NEXT Step家庭计划和监督锻炼计划均显示COT、PWT、6分钟步行距离、每日平均步频和至最低小腿StO2的时间较基线显著增加。只有NEXT Step家庭组的LAEI和hsCRP较基线有所改善（P<0.05）。在有症状的PAD患者中，利用最少工作人员监督的NEXT Step家庭锻炼具有低损耗、高依从性，可有效改善COT和PWT，以及次极量运动能力、每日步行活动、血管功能、炎症和小腿肌肉StO2的次要结局。URL：ClinicalTrials.gov.唯一标识符：NCT 00618670。
This prospective, randomized, controlled clinical trial compared changes in primary outcome measures of claudication onset time (COT) and peak walking time (PWT), and secondary outcomes of submaximal exercise performance, daily ambulatory activity, vascular function, inflammation, and calf muscle hemoglobin oxygen saturation (StO2) in patients with symptomatic peripheral artery disease (PAD) following new exercise training using a step watch (NEXT Step) home‐exercise program, a supervised exercise program, and an attention‐control group. One hundred eighty patients were randomized. The NEXT Step program and the supervised exercise program consisted of intermittent walking to mild‐to‐moderate claudication pain for 12 weeks, whereas the controls performed light resistance training. Change scores for COT (P<0.001), PWT (P<0.001), 6‐minute walk distance (P=0.028), daily average cadence (P=0.011), time to minimum calf muscle StO2 during exercise (P=0.025), large‐artery elasticity index (LAEI) (P=0.012), and high‐sensitivity C‐reactive protein (hsCRP) (P=0.041) were significantly different among the 3 groups. Both the NEXT Step home program and the supervised exercise program demonstrated a significant increase from baseline in COT, PWT, 6‐minute walk distance, daily average cadence, and time to minimum calf StO2. Only the NEXT Step home group had improvements from baseline in LAEI, and hsCRP (P<0.05). NEXT Step home exercise utilizing minimal staff supervision has low attrition, high adherence, and is efficacious in improving COT and PWT, as well as secondary outcomes of submaximal exercise performance, daily ambulatory activity, vascular function, inflammation, and calf muscle StO2 in symptomatic patients with PAD. URL: ClinicalTrials.gov. Unique Identifier: NCT00618670.