運動訓練對周邊動脈疾病患者周邊循環之療效：系統回顧與統合分析

Effects of Exercise Training on Peripheral Circulation in Patients with Peripheral Arterial Disease: A Systematic Review and Meta-Analysis

趙婉茹(Wan-Ju Chao) ； 吳英黛(Ying-Tai Wu) ； 劉千綺(Cian-Ci Liou)

《物理治療》 35卷1期 (2010/03) Pp. 38-50

摘要

背景及目的：有氧運動訓練已被證實可提升周邊動脈疾病患者的行走能力，近年來阻力運動訓練亦多用於心血管疾病，然而無論何種運動對周邊循環之效果均尚未有定論。本文採統合分析方式，探討有氧運動與阻力訓練對周邊動脈疾病患者周邊循環之成效。方法：搜尋1989年至2009年監測式運動訓練比一般療法之隨機分配對照試驗，進行系統回顧與統合分析，主要探討的量測結果為運動訓練後周邊循環相關的參數。結果：發現11篇隨機分配對照試驗的文獻，其中一篇含有氧和阻力訓練各一組，故納入有氧運動訓練9組(n=291)和阻力運動訓練3組(n=97)分析。大多數研究的病患年紀在中老年，運動介入以三個月和六個月居多。有氧運動顯著改善患肢最大充血時的小腿血流量2.83ml/100ml/min（95%信賴區間0.18至5.49），但是未改變休息時和運動後踝肱血壓比；阻力運動訓練對於休息時和運動後的踝肱血壓比，亦無顯著影響。結論：有氧運動訓練可增加周邊動脈疾病患者之最大充血時之小腿血流量，阻力訓練仍有待更多隨機分配對照試驗來驗證。

關鍵字

周邊動脈疾病 ； 有氧運動訓練 ； 阻力運動訓練 ； 周邊循環 ； 統合分析

並列摘要

Background and Purpose: Exercise therapy, mainly aerobic training, has been proved to be effective in improving the walking capability in patients with peripheral arterial disease (PAD). Resistance exercise has been introduced and used in individuals with cardiovascular diseases, including PAD in recent years. However, the effect of exercise on peripheral circulation was inconclusive. The purpose of this study was to review the evidence of aerobic and resistance training on parameters of peripheral circulation and make meta-analysis in patients with PAD. Method: A systematic review and meta-analysis were conducted, after searching for randomized controlled trials (RCT) of comparing supervised exercise therapy with usual medicine regimens between 1989 and 2009. Main outcome measurement included indices of peripheral circulation. Results: Eleven articles published were included, while one study investigated the effects of aerobic and resistance training respectively comparing with the control group. It came out with 9 studies in aerobic training (n=291) and 3 studies in resistance exercise (n=97). In most studies, participants were older adults and the exercise programs ranged from 6 week to 12 months with the majority of 3 months or 6 months. Aerobic training significantly improved maximal hyperemic calf blood flow by 2.83 ml/100ml/min (95% CI 0.18 to 5.49), but not the resting or post-exercise ABI. No beneficial effects on limb blood flow or ABI at rest or post-exercise were found after resistance training. Conclusion: Aerobic exercise training increased maximal hyperemic calf blood flow in PAD patients. More RCTs are needed to provide evidence of effects on peripheral circulation, especially the resistance training.

並列關鍵字

Peripheral arterial disease ； Aerobic training ； Resistance training ； Peripheral circulation ； Meta-analysis