EXERCISE FOR ELDERLY PERIPHERAL REVASCULARIZED PATIENTS

描述(改编自调查者摘要)：外周动脉 伴有严重肢体威胁缺血的闭塞症(PAOD)患者 腹股沟下血管重建术后改善外周循环。 尽管有这种血流动力学方面的好处，但功能状态几乎没有变化，而且 许多患者有残存的不卧床功能障碍。功能的缺失 血运重建患者的改善可能是由于肌肉萎缩，肌病， 和极端的物理解除条件，而不是他们先前存在的关键 危及肢体的缺血。因此，调查人员假设一个 有氧运动训练计划是优化步行的必要方案， 自由生活-日常体力活动，以及与健康相关的生活质量 改善肌肉结构和功能的机制，步行经济， 心肺功能，以及外周循环的进一步改善。这 一项随机对照临床试验，比较运动组在 分级跑步机步行计划和延迟进入非运动控制 集团将解决以下两个目标：(1)确定是否有6个月的 运动康复计划将改善跛行距离， 自由生活的日常体力活动和与健康相关的生活质量 老年、血运重建的PAOD患者，以及(2)确定 运动康复影响上述的主要机制 功能的结果是通过肌肉结构和功能的改变， 步行经济、外周循环和心肺功能。八十 PAOD患者将被随机分为运动组(n=40)或 延迟入院非运动对照组40例，术后3~6个月 下肢动脉搭桥术成功。为期6个月的锻炼计划将 包括分级跑步机每周步行3次，循序渐进 锻炼时间从15分钟增加到40分钟，并逐步增加 运动强度从运动能力的50%增加到80%。 总体意图是，这项研究将证明这项工作 康复是血管重建术实现的重要辅助手段 在临床上有意义的步行，自由生活的日常体力活动， 严重肢体威胁缺血的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.