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A study was undertaken to evaluate exercise performance in 18 dual chamber pacemaker patients believed to be chronotropically incompetent. All patients were paced in a DDD AV synchronous mode at 80 beats per minute (beats/min) as well as an externally triggered, activity responsive VVIR mode. Patients underwent two single blind, randomized symptom-limited treadmill tests (Sheffield protocol). Four of the 18 patients achieved intrinsic rates greater than 100 beats/min and were deleted from the primary study. It was noted that all four of these patients performed best with intrinsic rate response and AV synchrony. Thirteen of the remaining 14 patients demonstrated improved exercise tolerance in the VVIR mode. Average exercise time in the VVIR mode (7:25 +/- 3:12 min) was significantly greater (P less than 0.05) than the DDD mode (6:01 +/- 2:27 min). Work performed was significantly greater (P less than 0.05) in the VVIR mode (4.77 +/- 1.97 METS) than in the DDD mode (3.78 +/- 0.77 METS). Maximum heart rates were 83.86 +/- 5.11 beats/min in DDD mode versus 116.00 +/- 10.56 beats/min in VVIR mode. The results demonstrated that improved exercise tolerance can be achieved with single chamber rate variable pacing compared to DDD pacing in patients with chronotropic incompetence. However, potential symptoms associated with loss of AV synchrony should be ruled out.  相似文献
2.
LANGENFELD, H., ET AL.: The Six-Minute Walk—An Adequate Exercise Test for Pacemaker Patients? In many pacemaker patients bicycle and treadmill ergometry are not practicable. As an alternative, we performed a 6-minute walk on a 20-m corridor in 97 pacemaker patients, who were asked to walk as far as possible determining their speed by themselves. Results were compared with those of bicycle ergometry in 42 of these patients and with treadmill exercise of a group of 92 other pacemaker patients. In the 6-minute walk, performance and maximal heart rate were slightly lower (49 ± 18 W; 96 ± 23 beats/min) than in bicycle (57 ± 16 W; 110 ± 26 beats/min) and treadmill ergometry (50 ± 37 W; 102 ± 35 beats/min). A good correlation was found between walking and bicycling (r = 0.74) and in subgroups of patients with different pacemaker indications. All patients preferred the walk to bicycle ergometry considering it to be more related to daily physical activity. In conclusion, a 6-minute walk is a simple and physiological exercise test for nearly all pacemaker patients with good correlation to other types of exercise. It seems to be preferable to other tests because of its better acceptance and practicability.  相似文献
3.
Aim of this retrospective analysis was to evaluate the effects of ivabradine given primarily as a heart rate-lowering agent on allograft function and cardiopulmonary performance in heart transplant recipients with permanent sinus tachycardia. Starting May 2006, 26 heart transplant recipients with permanent sinus tachycardia received ivabradine (5 mg bid). It was discontinued early in 3 patients (11.5%) due to adverse events. In the remaining 23 patients, resting heart rate (HR) was significantly lowered from 106.3 ± 9.1 to 82.2 ± 6.3 bpm after 3 weeks of treatment. The effect remained constant during the remaining treatment period, whereas resting blood pressure was not affected. After 12 weeks of ivabradine treatment, the corrected QT interval was significantly reduced into the range seen in normal individuals. Left ventricular (LV) end-diastolic posterior wall thickness, LV mass and LV mass index were also found to have decreased significantly. There was a trend to improvement of cardiopulmonary performance and LV ejection fraction, both of which did not reach statistical significance, however. It may be concluded that ivabradine successfully reduced the resting HR of heart transplant recipients with sinus tachycardia without negatively influencing the blood pressure. The definitive impact of ivabradine on LV mass regression and cardiopulmonary performance require further prospective, randomized and controlled trials.  相似文献
4.

Objectives

To explore whether compliance with a prescribed home exercise program in elderly people with knee and/or hip osteoarthritis was influenced by mode of exercise instruction.

Design

Participants were randomised to one of three groups who received different modes of exercise instruction. Exercise performance was assessed at baseline and after 4 weeks and 8 weeks of home exercises.

Setting

Eighteen physiotherapy clinics in rural Victoria, Australia.

Participants

One hundred and fifteen males and females (mean age 70.5 years) with osteoarthritis of the knees and/or hips.

Interventions

Participants were randomised to receive verbal instructions on a home exercise program in addition to: (i) a home exercise brochure; (ii) a brochure together with an audiotape; or (iii) a brochure together with a videotape.

Main outcome measures

The Correctness of Exercise Performance scale and exercise log-sheets.

Results

Compliance with the home exercise program was good for all modes of exercise instruction where between 79% and 91% of exercises were performed correctly. Once provided with verbal instructions together with illustrated brochures, the provision of additional videotapes or audiotapes did not further enhance outcome.

Conclusions

Older people with osteoarthritis who received face-to-face instructions and a brochure on how to perform and comply with an 8-week home exercise program did not show additional benefits from other modes of instruction.

Key messages

Brochures can be as effective as additional audiotapes or videotapes to enhance correctness of exercise performance in older people with osteoarthritis of the knees and/or hips when given together with verbal instructions.
Audiotapes and videotapes may provide additional cues to maintain correctness of performance of exercises that are difficult to perform.
  相似文献
5.
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)对中老年超重患者心肺功能以及运动能力的影响。 方法:56例(男性33例,女性23例)习惯性久坐少动的中老年超重患者(BMI:24.0—27.9)采用随机数字表分为水中平板组(UG)30例和普通平板训练组(LG)26例。两组受试者以单次训练消耗相同的能量为原则进行每周4次,为期6周的平板运动训练(1—2周:150kCal;3—4周:200kCal;5—6周:250kCal)。训练前后采用运动心肺试验、坐—站试验、6分钟步行试验、Berg平衡量表对受试者的心肺功能以及运动功能进行评定。 结果:训练前后两组内受试者的最大耗氧量、无氧阈明显增加(P<0.05),组间比较无明显差异(P>0.05);水中平板组的下肢力量、步行能力以及平衡能力明显增加(P<0.05),且高于普通平板组(P<0.05)。 结论:水中平板运动训练与普通平板运动训练均能够不同程度改善中老年超重患者的心肺功能;水中平板运动训练还能够增加该类患者的下肢力量及耐力,改善平衡能力,增加康复训练的效率。  相似文献
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