Adults with complex congenital heart disease have impaired skeletal muscle function and reduced confidence in performing exercise training
Adults with complex congenital heart disease have impaired skeletal muscle function and reduced confidence in performing exercise training
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患有复杂先天性心脏病的成年人骨骼肌功能受损，进行运动训练的信心降低
DOI：
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发表时间：
2015
影响因子：
8.3
通讯作者：
B. Johansson
中科院分区：
文献类型：
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作者：
C. Sandberg;U. Thilén;K. Wadell;B. Johansson
背景 与对照组相比，患有先天性心脏病 (ACHD) 的成年人的有氧运动能力通常较低。然而，它们的骨骼肌功能研究较少。材料和方法 在这项横断面研究中，对 85 名 ACHD 患者（35 名女性，平均年龄 36.8±14.8 岁）进行了单侧等张肩部屈曲、单侧等张足跟抬起、最大吸气压 (MIP) 和最大呼气压 (MEP) 测试，分为“复杂”(n = 43) 或“简单” (n = 42)，以及 42 名年龄和性别匹配的对照组（16 名女性，平均年龄 36.9±14.9）。测量肩部弯曲和脚跟抬起的最大次数。 MIP/MEP 使用手持式呼吸压力计进行测试。评估了运动自我效能，衡量进行运动训练的信心。结果 与对照组和简单病变患者相比，复杂病变成人的肩部屈曲次数较少（28.2±±11.1 vs 63.6±±40.4，p<±0.001 和 28.2±±11.1 vs 54.9±±24.9， p < 0.001），以及与对照组和单纯病变患者相比，足跟抬高次数较少（17.6 ± 7.7 vs. 26.3 ± 12.8，p < 0.001和17.6 ± 7.7 vs. 23.2 ± 7.0， p = 0.024），MIP 低于对照组（80.7 ± 26.7 对比 111.1 ± 29.9 cm H2O，p < 0.001），并且 MEP 低于对照组（110.8 ± 39.9 对比 111.1± 29.9 cm H2O）。 141.8 ± 39.5，p < 0.001）。他们的运动自我效能低于对照组（28.0±8.3 vs. 33.4±6.1，p=0.002）。在线性回归模型中，复杂的心脏病变与肢体肌肉功能受损独立相关。结论 与单纯病变患者和健康对照相比，成人复杂先心病患者骨骼肌功能受损。他们对进行运动训练的信心也较低。因此，这一人群可能有潜力进行康复治疗，重点是改善肌肉功能和进行运动训练的信心。
Background Adults with congenital heart disease (ACHD) usually have reduced aerobic exercise capacity compared with controls. However, their skeletal muscle function is less studied. Material and methods In this cross-sectional study, unilateral isotonic shoulder flexion, unilateral isotonic heel-lift, maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) were tested in 85 patients with ACHD (35 women, mean age 36.8 ± 14.8 years), classed as either ‘complex’ (n = 43) or ‘simple’ (n = 42), and 42 age and gender matched controls (16 women, mean age 36.9 ± 14.9). Maximum number of shoulder flexions and heel-lifts were measured. MIP/MEP was tested using a handheld respiratory pressure meter. Exercise self-efficacy, measuring confidence in performing exercise training, was evaluated. Results Adults with complex lesions performed fewer shoulder flexions compared with controls and patients with simple lesions (28.2 ± 11.1 vs. 63.6 ± 40.4, p < 0.001 and 28.2 ± 11.1 vs. 54.9 ± 24.9, p < 0.001), as well as fewer heel-lifts compared with controls and patients with simple lesions (17.6 ± 7.7 vs. 26.3 ± 12.8, p < 0.001 and 17.6 ± 7.7 vs. 23.2 ± 7.0, p = 0.024), lower MIP than controls (80.7 ± 26.7 vs. 111.1 ± 29.9 cm H2O, p < 0.001) and lower MEP compared with controls (110.8 ± 39.9 vs. 141.8 ± 39.5, p < 0.001). Their exercise self-efficacy was lower than controls (28.0 ± 8.3 vs. 33.4 ± 6.1, p = 0.002). In a linear regression model complex heart lesions were independently associated with impaired limb muscle function. Conclusion Adults with complex congenital heart disease have impaired skeletal muscle function compared with patients with simple lesions and healthy controls. They also had lower confidence in performing exercise training. Thus, this population might have a potential for rehabilitation focusing on improving muscle function and confidence in performing exercise training.