下肢外周动脉疾病患者从坐到站的肌肉力量与基线时及监督性运动训练后的功能表现相关。

Sit to Stand Muscle Power Is Related to Functional Performance at Baseline and After Supervised Exercise Training in Patients with Lower Extremity Peripheral Artery Disease.

作者信息

Lanzi Stefano, Pousaz Anina, Calanca Luca, Mazzolai Lucia

机构信息

Division of Angiology, Heart and Vessel Department, Lausanne University Hospital, Switzerland. Electronic address: https://twitter.com/@ste_lanzi.

Division of Angiology, Heart and Vessel Department, Lausanne University Hospital, Switzerland.

出版信息

Eur J Vasc Endovasc Surg. 2023 Apr;65(4):521-527. doi: 10.1016/j.ejvs.2022.12.029. Epub 2022 Dec 31.

DOI:10.1016/j.ejvs.2022.12.029

PMID:36592654

Abstract

OBJECTIVE

Patients with peripheral artery disease (PAD) have decreased muscle power, contributing to functional limitations. The sit to stand (STS) is a validated test to assess muscle power in older individuals; however, it has never been investigated in patients with PAD. The relationship between STS muscle power, and common disease related outcomes was evaluated at baseline and following supervised exercise training (SET) in patients with PAD.

METHODS

This observational study investigated patients with Fontaine stage II. Before and after SET, maximum treadmill walking distance (MWD), functional performance tests (six minute walk, STS, stair climbing, habitual gait speed), and quality of life (Short Form 36 questionnaire) were assessed. Relative (W/kg) STS muscle power was calculated using a validated equation. Multiple regressions models were used.

RESULTS

Ninety-five patients with PAD were included (63.1 ± 12.1 years, 67% male). Relative STS muscle power before: 2.7 W/kg, 95% confidence interval [CI] 2.5 - 2.9; after: 3.3, 95% CI 3.1 - 3.6, MWD before: 367.0 m, 95% CI 302.4 - 431.5; after: 598.4, 95% CI 515.6 - 681.3, six minute walking distance before: 418.3 metres; 95% CI 399.4 - 437.2; after: 468.8; 95% CI 452.7-484.9, stair climbing performance before: 6.8 seconds 95% CI 6.2 - 7.4); after: 5.3; 95% CI 4.9 - 5.7, habitual gait speed before: 1.10 m/s, 95% CI 1.05 - 1.14; after: 1.18, 95% CI 1.14 - 1.22 increased significantly following SET (p < .001). Similarly, physical before: 31.4, 95% CI 29.4 - 33.3; after: 35.8, 95% CI 33.9 - 37.7 and mental before: 39.5, 95% CI 37.0 - 42.0; after: 43.1, 95% CI 40.9 - 45.4 component summaries of the SF-36 also increased significantly (p < .001). Greater relative STS muscle power at baseline was significantly related to greater baseline treadmill (β < .380; p < .002) and functional (β < .597; p < .001) performance, and quality of life (β < .291; p < .050). Larger increases in relative STS muscle power following SET were associated with greater improvements in functional performance (β < .419; p < .009).

CONCLUSION

The STS test is a valid clinical tool to monitor overall functional status in patients with symptomatic PAD.

摘要

目的

外周动脉疾病（PAD）患者肌肉力量下降，导致功能受限。从坐到站（STS）测试是评估老年人肌肉力量的有效方法；然而，从未在PAD患者中进行过研究。在PAD患者中，于基线时以及在监督性运动训练（SET）后，评估了STS肌肉力量与常见疾病相关结局之间的关系。

方法

这项观察性研究调查了Fontaine II期患者。在SET前后，评估了最大跑步机行走距离（MWD）、功能性能测试（六分钟步行、STS、爬楼梯、习惯性步态速度）以及生活质量（简短健康调查问卷36项）。使用经过验证的公式计算相对（W/kg）STS肌肉力量。采用多元回归模型。

结果

纳入了95例PAD患者（63.1±12.1岁，67%为男性）。SET前相对STS肌肉力量：2.7W/kg，95%置信区间[CI]2.5 - 2.9；SET后：3.3，95%CI 3.1 - 3.6，SET前MWD：367.0m，95%CI 302.4 - 431.5；SET后：598.4，95%CI 515.6 - 681.3，SET前六分钟步行距离：418.3米；95%CI 399.4 - 437.2；SET后：468.8；95%CI 452.7 - 484.9，SET前爬楼梯表现：6.8秒95%CI 6.2 - 7.4）；SET后：5.3；95%CI 4.9 - 5.7，SET前习惯性步态速度：1.10m/s，95%CI 1.05 - 1.14；SET后：1.18，95%CI 1.14 - 1.22，SET后均显著增加（p <.001）。同样，简短健康调查问卷36项的身体维度SET前：31.4，95%CI 29.4 - 33.3；SET后：35.8，95%CI 33.9 - 37.7，以及精神维度SET前：39.5，95%CI 37.0 - 42.0；SET后：43.1，95%CI 40.9 - 45.4也显著增加（p <.001）。基线时较高的相对STS肌肉力量与更高的基线跑步机性能（β<.380；p <.002）、功能性能（β<.597；p <.001）以及生活质量（β<.291；p <.050）显著相关。SET后相对STS肌肉力量的更大增加与功能性能的更大改善相关（β<.419；p <.009）。