摘要
目的:观察水中平板运动训练(UWTT)和普通平板运动训练(LTT)对外周动脉疾病(PAD)患者下肢经皮氧分压及运动能力的影响。方法:将58例轻、中度外周动脉疾病患者随机分为对照组(18例)、普通平板运动组(20例)及水中平板运动组(20例)。对照组只接受常规药物治疗,普通平板运动组和水中平板运动组,在常规药物治疗的基础上,分别给予普通平板运动训练和水中平板运动训练。训练频率均为每天1次,每周5天,持续12周。观察以下指数在治疗前后的评估结果:踝肱指数(ABI);PAD运动能力相关指标:运动平板测试、小腿经皮氧分压(TcPO_2)、6分钟步行距离测试(6MWDT)及行走受损问卷(WIQ);骨骼肌力量及平衡能力相关指标:肌肉力量测试、富尔顿高级平衡量表平衡评分(FAB-scale)。结果:所有测试指标,对照组治疗前后都无显著性差异(P>0.05);普通平板运动及水中平板运动与本组治疗前相比,ABI、诱发跛行疼痛时间及达到跛行严重疼痛时间、TcPO_2、6MWDT、WIQ、肌肉力量、FAB量表评分值均明显提高(P<0.05或P<0.01);与对照组治疗后相比,普通平板运动及水中平板运动诱发跛行疼痛时间及达到跛行严重疼痛时间均明显延长(P<0.001),TcPO_2、6MWDT、WIQ、肌肉力量、FAB量表评分均显著提高(P<0.05或P<0.01);水中平板运动与普通平板运动相比,诱发跛行疼痛时间及达到跛行严重疼痛时间、6MWDT、肌肉力量、FAB量表评分均显著升高(P<0.05或P<0.01)。结论:普通平板运动组与水中平板运动组均可以改善外周动脉疾病患者下肢经皮氧分压及运动能力,且水中平板运动效果优于普通平板运动。
Objective: To observe effects of underwater treadmill training(UWTT) and land treadmill training(LTT) on low limbs percutaneous oxygen tension and exercise capacity of patients with peripheral arterial disease(PAD).Method: Totally 58 mild-to-moderate PAD patients were randomly divided into control group(n=18), land treadmill training group(n=20) and underwater treadmill training group(n=20). The control group received only conventional drug therapy. Land treadmill training group and underwater treadmill training group, on the basis of conventional drug therapy, were given treadmill training and water treadmill training. Training is once a day, 5 days a week for 12 weeks. The following indices were taken before and after treatment: ankle-brachialindex(ABI); PAD exercise-related indicators: exercise treadmill test, transcutaneous oxygen tension(TcPO_2), 6-minute walking distance test(6 MWDT) and walking impairment questionnaire(WIQ); skeletal muscle strength and balance ability related indicators: muscle strength test, Fullerton advanced balance scale(FAB-scale).Result: All indexes of control group were not significantly increased after treatment(P>0.05). ABI, claudication pain beginning time, severe claudication pain time, TcPO2, 6 MWDT, WIQ, isokenetic muscle strength, and FAB-scale all significantly increased(P<0.05 or P<0.01) in both treatment groups. Compared with the control group after treatment, the time of induction of the claudication pain and the time to achieve severe pain of the average treadmill exercise group and the water treadmill exercise group were significantly prolonged(P<0.001), TcPO_2, 6 MWDT, WIQ, muscle strength, and FAB-scale were all significantly increased(P<0.05 or P<0.01). The time of induction of the claudication pain and the time to achieve severe pain, 6 MWDT, muscle strength, and FAB-scale were significantly more increased(P<0.05 or P<0.01) for the average treadmill exercise group compared with the water treadmill exercise group.Conclusion: Both the land treadmill training group and the underwater treadmill training group can improve the percutaneous oxygen tension and exercise ability of the lower limbs in patients with peripheral arterial disease. And the effect of underwater treadmill training is better than that of land treadmill training.
引文
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