慢性心衰竭病患阻力（肌力）訓練之效果

Effectiveness of Resistance (Strength) Training for Patients with Chronic Heart Failure

陳彥文(Yan-Wen Chen)

《台灣復健醫學雜誌》 41卷2期 (2013/06) Pp. 79-91

https://doi.org/10.6315/2013.41(2)01

摘要

隨著心臟疾病醫療設備及藥物治療的不斷研發與進步，有助於慢性心衰竭病患存活率的提升，心衰竭伴隨之肌肉病變所造成的肌肉萎縮、肌肉疲勞現象，是造成病患運動不耐受性的重要原因。阻力（肌力）訓練可有效促進肌肉功能，但針對心衰竭病患，在左心室心肌再塑進展與血液動力變化的安全考量上，對於實施的適當性到目前仍受爭議。實證文獻回顧發現，對於穩定心衰竭（紐約心臟協會功能分級Ⅰ～Ⅲ級）病患，建議在提供嚴謹功能評估下，適當提供相關阻力（肌力）訓練計畫，除可以有效提升有氧運動耐受度外，骨骼肌肉的組織化學、代謝及功能上也具顯著的適應效果，阻力訓練進行也未引發左心室功能惡化，甚至可提升左心室射出率。本文經由實證文獻回顧，提供心衰竭阻力（肌力）訓練的臨床計畫指引參考。

關鍵字

慢性心衰竭 ； 阻力訓練 ； 肌肉假說 ； 運動處方

並列摘要

The recent advancements in cardiac disease treatments have remarkably enhanced the survival rate of patients with chronic heart failure. In patients with exercise intolerance, the accompanied peripheral myopathy plays an important role. Resistance training is beneficial for musculoskeletal function in patients with chronic heart failure. However, the left ventricular myocardial remodeling progression and the hemodynamic response are controversial. Some studies showed that for those with stable heart failure (New York Heart Association functional classes I to III level), the adequate resistance training was beneficial in improvement of aerobic capacity, muscle histology, metabolic function, and left ventricular ejection fraction. In this article we reviewed recent studies and hopefully these would offer medical care providers good references in clinical practices.

並列關鍵字

chronic heart failure ； resistance training ； muscle hypothesis ； exercise prescription