Structured Home-Based Exercise Versus Invasive Treatment: A Mission Impossible? A Pilot Randomized Study in Elderly Patients With Intermittent Claudication
Structured Home-Based Exercise Versus Invasive Treatment: A Mission Impossible? A Pilot Randomized Study in Elderly Patients With Intermittent Claudication
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DOI：
10.1177/0003319715618481
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发表时间：
2016-09-01
期刊：
影响因子：
2.8
通讯作者：
Manfredini, Fabio
中科院分区：
文献类型：
--
作者：
Lamberti, Nicola;Malagoni, Anna Maria;Manfredini, Fabio
我们比较了原始结构的家庭运动计划和血管重建术在老年外周动脉疾病患者中的作用，为期4个月。27名中度至重度跛行的受试者（n = 21;年龄= 68 +/- 7岁）被随机分配至（1）试验训练组（Ti-To; n = 18），在医院进行处方和控制的家庭步行计划，或（2）血运重建组（Rev; n = 9），接受血管内和/或外科手术。主要终点是生活质量，通过医学结局研究简表36问卷的身体成分总结（PCS）评分进行评价。次要结局指标包括初始跛行距离（ICD）和绝对跛行距离（ACD）、6分钟步行距离（6 MWD）和无痛步行距离（PFWD）、踝臂指数（ABI）和每米步行成本。随访时，两种治疗的PCS评分均显著增加，无显著组间差异，ICD、ACD和PFWD也是如此。Rev组的6 MWD和ABI显著改善，Ti-To组的每米增益成本显著降低。两种治疗方法的可比性需要在更大规模的随机对照试验中证实。
We compared the effects of an original structured home-based exercise program and revascularization in elderly patients with peripheral arterial disease over a 4-month period. Twenty-seven participants (n = 21; age = 68 +/- 7 years) with moderate to severe claudication were randomized into (1) a test in-train out group (Ti-To; n = 18) that performed a home-based walking program prescribed and controlled at the hospital or (2) a revascularization group (Rev; n = 9) that underwent an endovascular and/or surgical procedure. The primary end point was quality of life as evaluated by the physical component summary (PCS) score of the Medical Outcomes Study Short Form 36 questionnaire. Secondary outcome measures included initial claudication distance (ICD) and absolute claudication distance (ACD), 6-minute walk distance (6MWD) and pain-free walk distance (PFWD), ankle-brachial index (ABI), and cost per walking meter gained. The PCS score significantly increased for both treatments at follow-up without a significant intergroup difference, as did ICD, ACD, and PFWD. The 6MWD and ABI significantly improved in the Rev group, and the Ti-To group exhibited a markedly lower cost per meter gained. The comparable effects of the 2 treatments need to be confirmed in a larger, randomized controlled trial.