Joanie Gagnon MD candidate, PHT , Mickaël Martin MSc , Louise Gosselin RN , Philippe Chetaille MD, MSc
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引用次数: 0
Abstract
Background
Fontan physiology is characterized by a single functional systemic ventricle that reduces cardiac output adaptation and exercise capacity. Peripheral muscle pump is crucial for venous return, and resistance training of the peripheral muscles may be particularly beneficial for cardiac function in these patients. This study explores the feasibility of a training programme including safety and effectiveness, maximal exercise capacity, cardiorespiratory endurance, and quality of life in a Fontan population.
Methods
Twelve Fontan patients (18-32 years old) with New York Heart Association functional classes I and II were recruited. The intervention was 12 weeks of home-based exercise programme of 3 sessions per week supervised online by a physiotherapist. Pre- and postintervention evaluations assessed lean body mass, segmental forces with a hand-held dynamometer, maximal oxygen consumption (VO2max), cardiovascular endurance, leg endurance with a 1-minute-sit-to-stand test, and quality of life with a 36-item Short-Form Survey.
Results
A total of 11 of 12 participants completed 35 of 36 workouts, exceeding our 80% threshold for completion. No adverse events were reported. Leg muscle strength increased significantly (knee extensors improved by 22.8 ± 22.8 N m [17.7%], P = 0.019). Despite no change in VO2max, endurance time showed a significant improvement of 5.3 minutes (72%). Perceived physical condition evaluated with a self-perception scale improved significantly. There was no significant difference in the lean body mass and in quality of life.
Conclusion
In this small group of post-Fontan patients with mild functional impairments, we describe a structured, accessible, and feasible home-based resistance training programme that seems safe and show improvements in strength and perceived physical condition.
Fontan生理学的特点是单一功能的系统心室降低了心输出量的适应能力和运动能力。外周肌肉泵对静脉回流至关重要,外周肌肉的阻力训练可能对这些患者的心脏功能特别有益。本研究探讨了训练计划的可行性,包括Fontan人群的安全性和有效性、最大运动能力、心肺耐力和生活质量。方法12例Fontan患者(18-32岁),纽约心脏协会功能分级为I级和II级。干预措施是12周的家庭锻炼计划,每周3次,由理疗师在线监督。干预前后的评估评估了瘦体重、手持测功机的节段力、最大耗氧量(VO2max)、心血管耐力、1分钟站立测试的腿部耐力,以及36项简式调查的生活质量。结果12名参与者中共有11人完成了36项训练中的35项,超过了我们80%的完成阈值。未报告不良事件。腿部肌肉力量显著增加(膝伸肌改善22.8±22.8 N m[17.7%],P=0.019)。尽管VO2max没有变化,但耐力时间显示出5.3分钟(72%)的显著改善。用自我感知量表评估的感知身体状况显著改善。瘦体重和生活质量没有显著差异。结论在这一小群患有轻度功能损伤的Fontan后患者中,我们描述了一个结构化、可访问和可行的家庭阻力训练计划,该计划似乎是安全的,并显示出力量和感知身体状况的改善。