后COVID病患者的功能限制和运动不耐受:一个随机交叉临床试验
Andrea Tryfonos1,2, Kaveh Pourhamidi3, Gustav Jörnåker1
1Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
JAMA network open
|April 4, 2024
概括
患有后COVID疾病 (PCC) 的患者通常耐受炼,没有表现出增加的疲劳. 然而,他们表现出有氧能力和肌肉力量的降低,这表明谨慎的运动可能会防止脱水.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 运动生理学 运动生理学
背景情况:
- 后COVID状态 (PCC) 经常涉及持续的疲劳,肌肉疼痛和认知问题,通常因炼 (后炼不适) 而加剧.
- 目前的建议不鼓励PCC患者运动,以防止症状恶化,但长期不活动会带来长期的健康风险.
研究的目的:
- 与对照组相比,评估PCC患者在各种运动类型后的运动后症状.
- 调查导致PCC的潜在生理机制.
主要方法:
- 一个随机交叉试验,涉及非住院PCC患者和匹配的对照.
- 参与者进行了全面的生理评估,并按随机顺序完成了高强度间歇训练 (HIIT),中等强度持续训练 (MICT) 和力量训练 (ST).
- 症状报告 (疲劳,肌肉疼痛,认知功能) 发生在基线,运动后立即,以及运动后48小时.
主要成果:
- 虽然PCC患者总体上报告了更多的症状,但运动后疲劳恶化在所有运动类型的组之间没有显著差异.
- 与对照组相比,PCC患者在HIIT后经历了更大的肌肉疼痛恶化,在MICT后经历了更多的注意力集中困难.
- 基线评估显示,PCC患者的心脏和肺功能得到保护,但峰值氧气消耗显著降低,肌肉力量减少. 患者还报告说,每天的中度至强度体力活动明显减少.
- 显著的百分比的PCC患者表现出姿态正静性心动减速 (13%) 和肌痛 (62%) 的迹象.
结论:
- 非住院的PCC患者通常耐受运动,与对照组相比,疲劳没有显著增加.
- 在PCC患者中观察到生理限制,包括降低有氧能力,肌肉强度和潜在的自主功能障碍 (Postural orthostatic tachycardia) 和肌病.
- 这些发现支持PCC患者谨慎运动进展的建议,以减轻骨肌肉脱和相关健康损伤.
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