家庭散步炼对外围动脉疾病的安全性和有效性
Neela D Thangada1, Dongxue Zhang1, Lihui Zhao2
1Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Journal of vascular surgery
|October 18, 2024
概括
在家进行步行运动显著改善了周围动脉疾病 (PAD) 患者的6分钟步行距离. 特定的患者特征没有预测运动的益处,但可能会影响严重不良事件的发生率.
科学领域:
- 心血管医学 心血管医学
- 运动生理学 运动生理学
背景情况:
- 在家进行步行炼是对外周动脉疾病 (PAD) 的首要治疗方法.
- 对于PAD的家庭散步运动的有效性在个体之间有所不同.
- 确定影响炼效益和风险的因素对于优化PAD管理至关重要.
研究的目的:
- 为了确定临床特征是否与PAD患者在在家进行步行运动后改善6分钟 (6MW) 步行距离有关.
- 调查特定的患者因素是否与在PAD的家庭运动干预期间出现更高严重不良事件 (SAE) 的比率相关.
主要方法:
- 来自两项随机临床试验的综合数据,比较PAD患者的家庭散步炼与对照组.
- 利用行为干预来增强对家庭炼方案的坚持.
- 评估了主要结果,即PAD参与者在6MW距离中实现至少20米的改善的比例.
- 定义SAE为在试验期间发生的一夜性住院或死亡.
主要成果:
- 在家进行运动导致54.9%的PAD参与者在6MW中改善20米,而对照组的28% (OR,3.13;P <.001).
- 年龄,性别,种族,并发症,基线6MW和收入等临床因素并没有显著改变运动对6MW改善的影响.
- 在运动组的28.1%和对照组的23.3%发生了SAE (P = .29).
- 显著的相互作用表明,与同行相比,在黑人参与者,冠状动脉疾病 (CAD) 患者和心力衰竭病史患者中,在家中炼增加了SAE率.
结论:
- 超过一半的PAD患者通过在家进行运动,实现了6MW距离的有意义改善.
- 患者的特征,如年龄较大,女性性别,黑人种族和某些并发症,并没有妨碍从家庭炼中获得功能上的收益.
- 需要进一步的研究,以了解患者的因素,特别是CAD病史,如何影响PAD患者接受家庭运动计划的SAE率.
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