EXERCISE FOR ELDERLY PERIPHERAL REVASCULARIZED PATIENTS

描述（改编自研究者摘要）：外周动脉 患有严重肢体缺血的闭塞性疾病（PAOD）患者， 改善腹股沟下血管重建后的外周循环。 尽管有这种血流动力学益处，但功能状态几乎没有变化， 许多患者具有残留的行走功能障碍。缺乏功能性 血管重建患者的改善可能是由于肌肉萎缩，肌病， 和极端的身体不适，其次是他们先前存在的关键 威胁肢体的缺血因此，研究人员假设， 有计划的有氧运动训练是必要的， 自由生活的日常身体活动，以及健康相关的生活质量， 改善肌肉结构和功能，步行经济性， 心肺功能，并进一步获得外周循环。这 一项随机对照临床试验， 分级踏车行走计划和延迟进入非运动控制 工作组将讨论以下两个目标：（1）确定是否有6个月的 运动康复计划将改善跛行距离， 自由生活的日常身体活动，以及与健康相关的生活质量， 年龄较大的PAOD血运重建患者，以及（2）确定 运动康复影响上述的主要机制 功能性结果是通过肌肉结构和功能的改变， 步行经济性、外周循环和心肺功能。八十 PAOD患者将随机分为运动组（n=40）或 延迟入组非运动对照组（n=40），术后3 - 6个月 下肢动脉搭桥成功。为期6个月的演习计划将 包括每周3次的分级跑步机行走， 运动时间从15分钟增加到40分钟， 运动强度从50%增加到80%。 总的目的是，这项研究将证明， 康复是血管重建手术的重要辅助手段， 临床上有意义的增加，在amnesia，自由生活的日常体力活动， 严重威胁肢体缺血的PAOD患者的生活质量。

DESCRIPTION (adapted from Investigator's abstract): Peripheral arterial occlusive disease (PAOD) patients with critical limb-threatening ischemia have improved peripheral circulation following infrainguinal revascularization. Despite this hemodynamic benefit, little change in functional tatus occurs, and many patients have residual ambulatory dysfunction. The lack of functional improvement in revascularized patients may be due to muscle wasting, myopathy, and extreme physical deconditioning secondary to their pre-existing critical limb-threatening ischemia. Therefore, the investigators hypothesize that a program of aerobic exercise training is necessary to optimize ambulation, free-living daily physical activity, and health-related quality of life through the mechanisms of improved muscle structure and function, walking economy, cardiopulmonary function, and further gains in peripheral circulation. This randomized controlled clinical trial comparing an exercise group undergoing a program of graded treadmill walking, and a delayed entry non-exercise control group will address the following two aims: (1) to determine whether a 6-month exercise rehabilitation program will improve claudication distances, free-living daily physical activity, and health-related quality of life of older, revascularized patients with PAOD, and (2) to determine whether the primary mechanisms by which exercise rehabilitation affects the above functional outcomes are through alterations in muscle structure and function, walking economy, peripheral circulation, and cardiopulmonary function. Eighty PAOD patients will be randomized into either the exercise group (n=40) or the delayed entry non-exercise control group (n=40) three to six months following successful lower extremity arterial bypass. The 6-month exercise program will consist of graded treadmill walking 3 times per week with progressive increments in exercise duration from 15 to 40 minutes, and progressive increments in exercise intensity from 50 to 80 percent of exercise capacity. The overall intent is that this study will demonstrate that exercise rehabilitation is an important adjuvant to revascularization surgery to achieve clinically meaningful gains in ambulation, free-living daily physical activity, and quality of life in PAOD patients with critical limb-threatening ischemia.