手臂测力对周围动脉疾病患者心肺功能和步行距离的影响:ARMEX 随机临床试验。

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
ACS Applied Electronic Materials Pub Date : 2024-09-01 Epub Date: 2024-09-03 DOI:10.1097/HCR.0000000000000878
Sandra Magalhães, Mário Santos, Sofia Viamonte, Fernando Ribeiro, Joana Martins, Cristine Schmidt, Daniel Martinho-Dias, Henrique Cyrne-Carvalho
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引用次数: 0

摘要

目的:比较臂力测定法和跑步机督导运动训练对外周动脉疾病(PAD)患者心肺功能和步行距离的影响:ARMEX是一项单中心、单盲、平行分组、非劣效试验,招募了有症状的PAD患者。患者被随机(1:1 比例)分配到为期 12 周的臂力测定(AEx)或标准跑步机(TEx)监督运动训练方案中。供电的主要终点是12周时在跑步机心肺运动测试(CPX)上测量的峰值摄氧量(VO2)的变化。次要结果包括第一通气阈值(VT-1)的 VO2 变化、通气效率(分钟通气[VE]与二氧化碳产生[VCO2]之比,VE/VCO2)、CPX 和 6 分钟步行测试(6MWT)的步行距离以及自我报告的步行限制:56 名患者(66 ± 8 岁;88% 为男性)接受了随机治疗(AEx,28 人;TEx,28 人)。12 周后,尽管只有 AEx 组的 VO2 峰值显著增加,但各组间的 VO2 峰值变化无明显差异(0.75 mL/kg/min; 95% CI, -0.94 to 2.44; P=0.378)。两组 VT-1 时的 VO2 均有改善,但无组间差异,AEx 的 VE/VCO2 斜率改善更大。通过 CPX(121.08 米;95% CI,24.49-217.66;P= .015)和 6MWT(25.08 米;95% CI,5.87-44.29;P= .012)以及自我感觉步行距离,TEx 的步行距离得到了更大改善:结论:就 VO2 峰值而言,臂力测量法并不比标准跑步机训练差,而且跑步机训练与步行距离的更大改善相关。我们的数据支持将跑步机作为 PAD 患者提高步行能力的一线选择,但臂测高法也可作为特定患者的选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of Arm-Ergometry Versus Treadmill Supervised Exercise on Cardiorespiratory Fitness and Walking Distances in Patients With Peripheral Artery Disease: The ARMEX Randomized Clinical Trial.

Purpose: To compare arm-ergometry and treadmill supervised exercise training on cardiorespiratory fitness and walking distances in patients with peripheral artery disease (PAD).

Methods: ARMEX was a single-center, single-blinded, parallel group, non-inferiority trial enrolling symptomatic patients with PAD. Patients were randomized (1:1 ratio) to a 12-wk arm-ergometry (AEx) or standard treadmill (TEx) supervised exercise training protocol. The powered primary end point was the change in peak oxygen uptake (VO 2 ) at 12 wk, measured on a treadmill cardiopulmonary exercise test (CPX). Secondary outcomes included changes in VO 2 at the first ventilatory threshold (VT-1), ventilatory efficiency (ratio of minute ventilation [VE] to carbon dioxide production [VCO 2 ], VE/VCO 2 ), walking distances by CPX and 6-min walking test (6MWT), and self-reported walking limitations.

Results: Fifty-six patients (66 ± 8 yr; 88% male) were randomized (AEx, n = 28; TEx, n = 28). At 12 wk, VO 2peak change was not significantly different between groups (0.75 mL/kg/min; 95% CI, -0.94 to 2.44; P = .378), despite a significant increase only in AEx. VO 2 at VT-1 improved in both groups without between-group differences, and VE/VCO 2 slope improved more in AEx. The TEx attained greater improvements in walking distance by CPX (121.08 m; 95% CI, 24.49-217.66; P = .015) and 6MWT (25.08 m; 95% CI, 5.87-44.29; P = .012) and self-perceived walking distance.

Conclusions: Arm-ergometry was noninferior to standard treadmill training for VO 2peak , and treadmill training was associated with greater improvements in walking distance. Our data support the use of treadmill as a first-line choice in patients with PAD to enhance walking capacity, but arm-ergometry could be an option in selected patients.

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CiteScore
7.20
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