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JAMA：低强度步行vs高强度步行锻炼对下肢外周动脉疾病步行能力的影响

2021-04-08 MedSci原创 MedSci原创

PAD下肢外周动脉疾病6分钟步行距离
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指南建议下肢外周动脉疾病（PAD）患者进行高强度地行走锻炼以改善步行能力，但高强度运动会导致PAD患者出现腿部缺血性症状，降低运动依从性。有证据表明，高强度行走运动导致的下肢缺血也可能会损伤小腿骨骼肌

指南建议下肢外周动脉疾病（PAD）患者进行高强度地行走锻炼以改善步行能力，但高强度运动会导致PAD患者出现腿部缺血性症状，降低运动依从性。有证据表明，高强度行走运动导致的下肢缺血也可能会损伤小腿骨骼肌。以舒适速度进行的低强度步行，不会引起腿部缺血性症状，提高PAD患者的运动依从性，但低强度的步行对PAD患者步行能力的影响尚不清楚。

近日研究人员比较了低强度步行、高强度步行以及不运动对PAD患者步行能力的影响。

305名PAD患者随机分为低强度步行运动组（n=116）、高强度步行运动组（n=124）和非运动对照组（n=65），为期12个月。运动组在无监督的环境下每周步行锻炼5次，每次最多50分钟，佩戴计步设备记录运动强度和时间。低强度组参与者被要求控制步行速度，以不出现腿部缺血症状为限度。高强度组的步行速度可出现中度至重度腿部缺血症状，而非运动对照组接受为期12个月的每周电话教育指导。研究的主要终点为12个月时6分钟步行距离的平均变化。

参与者平均年龄69.3岁，女性占47.9%，黑人占59.3%，250名参与者（82%）完成了12个月随访。低强度运动组的6分钟步行距离从基线时的332.1米降低至12个月随访时的327.5米（组内平均变化为-6.4米），高强度运动组从338.1米增加至371.2米（组内平均变化为34.5米），运动组间的平均变化为-40.9米。非运动对照组6分钟步行距离从基线时的328.1米降低至12个月随访时的317.5米（组内平均变化为-15.1米），变化程度与低强度运动组相当（组间平均变化为8.7米）。总计出现184例严重不良事件，其中低强度组、高强度组和非运动对照组的不良事件发生率分别为0.64、0.65和0.46。

低强度 vs 高强度vs 对照组基线及12个月6min步行距离

研究认为，下肢外周动脉疾病患者，低强度家庭锻炼对患者步行能力无改善作用。

原始出处

Mary M. McDermott et al.Effect of Low-Intensity vs High-Intensity Home-Based Walking Exercise on Walk Distance in Patients With Peripheral Artery Disease The LITE Randomized Clinical Trial .JAMA. April 6， 2021.

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    2022-01-22 yuanming15

    #步行#

    0

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    2022-01-16 chenwq08

    #下肢外周动脉疾病#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1654845, encodeId=9b64165484564, content=<a href='/topic/show?id=4eb6632899b' target=_blank style='color:#2F92EE;'>#步行#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63289, encryptionId=4eb6632899b, topicName=步行)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6a5524567114, createdName=yuanming15, createdTime=Sat Jan 22 21:15:32 CST 2022, time=2022-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2058133, encodeId=01f820581337a, content=<a href='/topic/show?id=d104201831a' target=_blank style='color:#2F92EE;'>#下肢外周动脉疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=258, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20183, encryptionId=d104201831a, topicName=下肢外周动脉疾病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Sun Jan 16 14:15:32 CST 2022, time=2022-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1593347, encodeId=1bbb159334e5e, content=<a href='/topic/show?id=8d1342e95fa' target=_blank style='color:#2F92EE;'>#外周动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=196, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42795, encryptionId=8d1342e95fa, topicName=外周动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b27818121614, createdName=wujh_7312825, createdTime=Fri Apr 09 20:15:32 CST 2021, time=2021-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1604051, encodeId=6d4516040515f, content=<a href='/topic/show?id=67b81023e6ea' target=_blank style='color:#2F92EE;'>#高强度#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102376, encryptionId=67b81023e6ea, topicName=高强度)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=79d219134728, createdName=aids219, createdTime=Fri Apr 09 20:15:32 CST 2021, time=2021-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036565, encodeId=80681036565d0, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Apr 08 08:15:32 CST 2021, time=2021-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050350, encodeId=bc7b105035032, content=运动锻炼应该是健康第一要素，对各类疾病都应该有益。但是国内这方面研究太少, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=jingjing, createdTime=Thu Apr 08 08:15:32 CST 2021, time=2021-04-08, status=1, ipAttribution=)]
    2021-04-09 wujh_7312825

    #外周动脉#

    0

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    2021-04-09 aids219

    #高强度#

    0

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    2021-04-08 旺医

    顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1654845, encodeId=9b64165484564, content=<a href='/topic/show?id=4eb6632899b' target=_blank style='color:#2F92EE;'>#步行#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63289, encryptionId=4eb6632899b, topicName=步行)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6a5524567114, createdName=yuanming15, createdTime=Sat Jan 22 21:15:32 CST 2022, time=2022-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2058133, encodeId=01f820581337a, content=<a href='/topic/show?id=d104201831a' target=_blank style='color:#2F92EE;'>#下肢外周动脉疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=258, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20183, encryptionId=d104201831a, topicName=下肢外周动脉疾病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Sun Jan 16 14:15:32 CST 2022, time=2022-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1593347, encodeId=1bbb159334e5e, content=<a href='/topic/show?id=8d1342e95fa' target=_blank style='color:#2F92EE;'>#外周动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=196, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42795, encryptionId=8d1342e95fa, topicName=外周动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b27818121614, createdName=wujh_7312825, createdTime=Fri Apr 09 20:15:32 CST 2021, time=2021-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1604051, encodeId=6d4516040515f, content=<a href='/topic/show?id=67b81023e6ea' target=_blank style='color:#2F92EE;'>#高强度#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102376, encryptionId=67b81023e6ea, topicName=高强度)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=79d219134728, createdName=aids219, createdTime=Fri Apr 09 20:15:32 CST 2021, time=2021-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036565, encodeId=80681036565d0, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Apr 08 08:15:32 CST 2021, time=2021-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050350, encodeId=bc7b105035032, content=运动锻炼应该是健康第一要素，对各类疾病都应该有益。但是国内这方面研究太少, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=jingjing, createdTime=Thu Apr 08 08:15:32 CST 2021, time=2021-04-08, status=1, ipAttribution=)]
    2021-04-08 jingjing

    运动锻炼应该是健康第一要素，对各类疾病都应该有益。但是国内这方面研究太少

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