早期康复运动对急性心肌梗死PTCA支架术后康复及预防再狭窄的影响

目的探讨早期康复运动对急性心肌梗死PTCA支架术后患者体力恢复及再狭窄等并发症的影响。方法300例急性心肌梗死PTCA支架术后的患者（无严重合并症）被随机分为运动组（观察组）和对照组各150例。运动组实施系统的早期康复运动护理。对照组进行常规护理,比较两组活动情况及再狭窄等心血管事件的发生率。结果运动组术后步行距离及上台阶数均显著优于对照组（P〈0．01）,且住院时间明显缩短（P〈0．01）,PTCA支架术后心血管事件及再狭窄发生率显著柢于对照组（P〈0．05）。结论早期康复运动可促进急性心肌梗死PTCA支架术后患者早期体力恢复,提高患者生活质量,降低再狭窄及心血管事件的发生率。     

运动疗法在心脏术后康复中的作用

目的：探讨运动疗法在心脏术后康复中的作用。方法：21例心脏手术后患者均接受功率自行车或／和跑台训练为主的康复训练，并采用常规心电运动试验对康复训练前后的各项指标进行比较。结果：运动训练后，运动时间和最大运动负荷显著增加，安静时，心率、血压（包括收缩压和舒张压）、心率－血压乘积均显著下降（P＜0．05，P＜0．01），安静时心电图最大ST段压低明显改善（P＜0．01）；同等负荷量运动时，心率、血压、心率－血压乘积及运动诱发的最ST段压低与安静状态时有相似的改变(P＜0．05，P＜0．01）。结论：心脏术后的康复训练有助于增加体能，减轻心肌缺血，增加心肌储备功能，从而改善了患者的生活质量。     

门诊和院外实施运动训练对经皮冠状动脉腔内成形术及支架术后患者心功能恢复的作用

目的：比较经皮冠状动脉腔内成形术(percutaneous transluminal coronary anooplasty，PTCA)或支架术后患者进行门诊和院外康复运动的效果，探讨PTCA或支架术后患者康复运动的特点和方法以及制定康复运动处方的原则。方法：根据术后无胸闷、胸痛等症状和体征，安静状态下心率&;lt;90次／min，血压&;lt;140／90mmHg(1 mmHg=0．133kPa)，心电图ST段压低&;lt;1mm，无运动诱发的心率失常等标准，共有在卫生部北京医院内科住院的51例患者入选，分为门诊康复运动组(n=24)和院外自我监护下康复运动组(n=27)，进行运动心肺功能评定，制定康复运动处方，进行8周康复运动训练。结果：康复运动训练后，两组患者的运动时间、最大运动功率、最大代谢当量、最大氧耗量和每分通气量均较训练前有显著提高(t=2．43～7．56，P&;lt;0.05)，而两组患者运动时间[(9.02&;#177;2.58)，(9．58&;#177;2.44)min]、最大运动功率[(122.92&;#177;32.90)，(129.63&;#177;33.28)W]、最大代谢当量[(7.59&;#177;1.77)，(7.53&;#177;1．36)METs]和最大氧耗量[(14．18&;#177;3．67)，(1．90&;#177;0．45)L／min]等反映患者康复运动效果的各项主要指标比较，差异均无显著性意义(P&;gt;0．05)。结论：康复运动训练使FTCA及支架术后患者的体力、运动耐力和肺通气容量提高，心脏功能容量增加。院外自我监护下康复运动与门诊心电监护下康复运动能够产生同样的康复效果。     

大强度训练对运动员有氧耐力影响的研究

目的,研究大强度训练对划艇运动员有氧耐力的影响,方法：进行跑台渐增负荷运动直到力竭为止,同时测定气体代谢最大吸氧量（VO2max),通气量（VE）,血乳酸（BLa),心率（HR）血睾酮（T（,皮质醇（Cor)及血红蛋白（Hb),结果：训练周期后无氧阈（AT）值与训练前相比较均有显性差异（P＜0．05）,但VO2－max却未有显性差异,训练周期后Hb 值与相比较均有显性差异（P＜0．05）,而T,Cor在训练期前后之间却未有显性差异,结论：周期性大强度的训练保持了稳定的VO2max,AT在有氧耐力训练中具有重要的作用。     

运动疗法对冠状动脉球囊成形术或支架术后患者心肺功能和运动能力的影响

目的 观察运动疗法对冠心病患冠状动脉球囊成形术（PTCA）或支架术后的影响。方法 42例PTCA或支架术后患随机分为运动组20例和对照组22例，同时进行心肺功能测定，运动组根据心肺功能测定结果制定运动处方，进行12周康复运动训练，对照组不进行训练。结果 运动组训练后患的运动时间、最大运动负荷量，心率增值运动中最高收缩压和心率－血压双每次积（ERP）、最大代谢当量、最大氧耗量和每分通气量有显提高，而对照组则无明显变化。结论 PTCA或支架术后病人坚持运动训练有益于体能的提高，心脏功能容量的增加。     

运动负荷气体交换法在老年人心肺功能状况评价中的应用

目的：比较正常组、慢阻肺组及冠心病组患者的心肺功能变化，评估无氧阈（AT）及相关指标在早期临床诊断及鉴别诊断的应用价值。方法：三组研究对象采用运动心肌功能仪和功率自行车，分别在AT时和峰值耗氧时刻，随机检测每人的AT出现时间，耗氧量（VO2）、公斤耗量（VO2／kg)、心率（HR）、通气量（VE）等心肺功能指标。结果：（1）AT出现时刻：冠心病组的AT出现时间明显早于正常组（P＜0．05），和慢阻肺组（P＜0．05），冠心病组的VO2/kg，VO2均明显地小于正常组与慢阻肺组（P＜0．05）；慢阻肺组的VE明显地小于正常组和冠心病组（P＜0．05）。（2）峰值耗氧时刻：慢阻肺组的VO2、VO2/kg和VE均明显地小于正常组（P＜0．05）。结论：在AT时，冠心病患者的AT出现时间明显提高，其VO2/kg和VO2均低于正常人，可做为早期诊断，指导康复治疗的指标，在峰值耗氧时刻，慢阻肺患者的VO2、VO2/kg和VE均明显小于正常人和冠心病患者，可做为评价心肺功能的病变程度的指标。     

有氧运动对PCI术后患者心功能及运动耐力的影响

【目的】探讨有氧运动对经皮冠状动脉介入治疗（PCI）术后患者心功能及运动耐力的影响。【方法】将96例PCI术后患者随机分为高强度组、低强度组、对照组,每组各32例。高强度组为心肺运动负荷所得峰值功率的80％的间歇有氧运动,低强度组为心肺运动负荷所得峰值功率的60％的有氧运动,对照组对照组不进行运动指导,自己安排进行康复活动。所有患者训练前后均行超声·心动图及心肺运动试验（CPET）评估患者心功能及运动耐力,记录所有患者入组时及康复运动后左室射血分数（LVEF）、峰值功率（PP）、峰值摄氧量（VO2peak）、无氧闽（AT）变化情况。【结果】入组时三组患者LVEF、PP、VO2peak、AT均无显著差异（均P〉0．05）;训练12周后高强度组与低强度组LVEF、PP比较差异均具有统计学意义（均P〈0．05）,且均优于对照组（P〈0．05）;低强度运动组与对照组VO2peak、AT差异并无显著性（P〉0．05）,但均与高强度运动组比较差异有统计学意义（均P〈0．05）。【结论】与低强度持续有氧运动相比,高强度间歇有氧运动可以更好地改善PCI术后患者的左室收缩功能及有氧代谢能力,可提高患者的运动耐力。     

运动治疗对老年冠心病患者冠脉介入治疗后运动耐力的影响

目的评价运动治疗对老年冠心病患者经皮冠状动脉介入治疗（PCI）后运动耐力的影响。 方法将成功进行PCI术后的老年冠心病患者42例随机分为康复组和对照组,每组21例。康复组行运动治疗3个月,运用6 min步行试验（6MWT）测定运动治疗前、后最大耗氧量（VO2max）、峰值心率、最大代谢当量、步行距离和每搏耗氧量。 结果康复组运动治疗3个月后分别与治疗前、对照组同期比较,VO2max、最大代谢当量、步行距离、每搏耗氧量均显著提高（P＜0.01）,峰值心率显著减慢（P＜0.05）。 结论运动治疗有助于提高老年冠心病患者PCI术后心脏功能贮备和耐力。     

运动疗法对冠状动脉球囊成形术或支架术后患者心肺功能和运动能力的影响

目的观察运动疗法对冠心病患者冠状动脉球囊成形术(PTCA)或支架术后的影响。方法42例PTCA或支架术后患者随机分为运动组20例和对照组22例,同时进行心肺功能测定,运动组根据心肺功能测定结果制定运动处方,进行12周康复运动训练,对照组不进行训练。结果运动组训练后患者的运动时间、最大运动负荷量,心率增值运动中最高收缩压和心率-血压双每次积(RPP)、最大代谢当量、最大氧耗量和每分通气量有显著提高,而对照组则无明显变化。结论PTCA或支架术后病人坚持运动训练有益于体能的提高,心脏功能容量的增加。     

门诊和院外实施运动训练对经皮冠状动脉腔内成形术及支架术后患者心功能恢复的作用

目的:比较经皮冠状动脉腔内成形术(percutaneoustransluminalcoronaryangioplasty,PTCA)或支架术后患者进行门诊和院外康复运动的效果,探讨PTCA或支架术后患者康复运动的特点和方法以及制定康复运动处方的原则。方法:根据术后无胸闷、胸痛等症状和体征,安静状态下心率<90次/min,血压<140/90mmHg(1mmHg=0.133kPa),心电图ST段压低<1mm,无运动诱发的心率失常等标准,共有在卫生部北京医院内科住院的51例患者入选,分为门诊康复运动组(n=24)和院外自我监护下康复运动组(n=27),进行运动心肺功能评定,制定康复运动处方,进行8周康复运动训练。结果:康复运动训练后,两组患者的运动时间、最大运动功率、最大代谢当量、最大氧耗量和每分通气量均较训练前有显著提高(t=2.43～7.56,P<0.05),而两组患者运动时间犤(9.02±2.58),(9.58±2.44)min犦、最大运动功率犤(122.92±32.90),(129.63±33.28)W犦、最大代谢当量犤(7.59±1.77),(7.53±1.36)METs犦和最大氧耗量犤(14.18±3.67),(1.90±0.45)L/min犦等反映患者康复运动效果的各项主要指标比较,差异均无显著性意义(P>0.05)。结论:康复运动训练使PTCA及支架术后患者的体力、运动耐力和肺通气容量提高,心脏功能容量增加。院外自我监护下康复运动与门诊心电监护下康复运动     

运动疗法的进展与差距

运动疗法是防治心、脑、肺疾病的重要方法之一,同时对这些疾病的危险因素(高血压、高脂血症、糖尿病和肥胖)也有确切的治疗作用。本文介绍了国内康复医学界运动疗法的进展与先进国家的差距以及对其改进提高和完善的一些设想。     

Potassium and ventilation during positive and negative work inpatients with chronic obstructive pulmonary disease

In patients with chronic obstructive pulmonary disease (COPD),reduced ventilatory reserves limit exercise tolerance. In these patients, the ventilatoryrequirements of eccentric exercise (negative work, W_neg) are lower thanthose of concentric exercise (positive work, W_pos) at similar workloads.In this study, we investigated the relationship between plasma potassium levels and ventilationduring W_pos and W_neg in these patients. Twelvepatients with stable COPD [mean (SD) FEV₁ 46% (16) of predicted]performed W_pos and W_neg on a cycle ergometer(6 min of exercise; interval ≥1 h) in a randomized order at a constant workload of50% of the individual maximum (positive) work capacity. Minute ventilation (V_E) and arterial plasma potassium concentration ([K⁺]_a) were measured at rest, and at 1-min intervals during exercise and during 3 min ofrecovery. V_E increased less during W_neg thanduring W_pos [6 (range 3–26) vs. 18 (range 8–28) l min^?1; P<0·01]. V_E during W_neg was reduced in proportion to VCO ₂.The increase in [K⁺]_a during W_pos and W_neg [0·45 (range 0·26–0·75) and0·34 (range 0·1–0·97) mM ] did not differsignificantly. V_E was closely correlated with VCO ₂ during both types of exercise. V_E was also closelycorrelated with [K⁺]_a, but the slope of the relationship between[K⁺]_a and V_E was steeper during W_pos than during W_neg [39·1 (range15·2–88·6) vs. 18·3 (range7·2–37·3) l min^?1 mM ^?1; P=0·012]. In contrast, the slope of the relationship betweenVCO ₂ and V_E was similar during bothtypes of exercise [27?8 (range 19·2–37·1) vs. 32·1 (range19·8–48·4)]. Thus, for a given increase in [K⁺]_a, the increase in V_E was significantly less during W_neg. In patients with COPD, potassium did not explain the difference inexercise ventilation between W_neg and W_pos, andmay not play a significant role in the control of breathing during low-intensity exercise.     

Exercise limitations and training for patients with cystic fibrosis

Summary

Exercise has much to offer to cystic fibrosis patients. Overcoming the limits of decreased pulmonary function by increasing fitness has a considerable potential to improve patients' quality of life; decreased breathlessness allows greater mobility and participation with peers in social and sporting activities, improves confidence and self-esteem and creates a greater pleasure in life for the individual patient. There are also immediate therapeutic gains and potentially long-term gains with improved survival. Above all, cystic fibrosis patients enjoy and prefer exercise as a therapeutic option to most other forms of therapy.     

等张运动和抗阻运动对心血管反应及相关激素的影响

目的 :比较等张运动和抗阻运动对心血管反应及儿茶酚胺激素的影响 ,探讨采用心率作为以等长运动形式为主的抗阻运动的强度指标的可能性。方法 :采用相同靶心率和相同运动时间对 8例健康男性分别进行等张运动和交替式抗阻运动 ,观察运动前后的心率、血压及儿茶酚胺的应激反应。结果 :两种运动后收缩压和两项乘积均显著增高 ,等张运动时脉压差明显增大 ,抗阻运动则表现为平均动脉压的升高 ,肌肉收缩力与心率呈直线性相关。去甲肾上腺素和多巴胺在两种运动后均显著增高 ,抗阻运动时升高尤为明显。运动前后血浆肾上腺素均无显著改变。结论 :心率作为运动强度的指标也适用于交替式抗阻运动 ,不同运动种类和强度影响儿茶酚胺的分泌程度     

轻中度哮喘患者与健康人的运动耐量对比研究

目的 :比较轻中度哮喘患者与健康人的运动心肺功能 ,研究运动对哮喘患者肺功能的影响 ,探讨轻中度哮喘患者提高运动耐量的可行性。方法 :采用负荷递增运动方案 ,对 2 0例轻中度哮喘患者及 2 0例健康志愿者进行了运动心肺功能试验。运动前后测一秒钟用力呼气容积 (FEV1 )、用力肺活量 (FVC)、最大呼气中段流量 (FEF 2 5 %- 75 % )、最大呼气末段流量 (FEF 75 % - 85 % )、呼气流量峰值 (PEF)等 ,运动中监测心率 (HR)、每分钟氧耗量(VO2 )、每分钟二氧化碳排出量 (VCO2 )、每分钟通气量 (VE)、氧脉搏 (O2 pulse)、呼吸频率 (BF)等。结果 :运动后 ,哮喘组与正常对照组的FVC、FEV1 、PEF、FEF 2 5 %— 75 %、FEF 75 %— 85 %均有所改善 ,有统计学意义 (P <0 .0 5) ,但两组在改善的差值上无显著意义 (P >0 .0 5)。哮喘患者的最大作功、最大氧耗量 (VO2max)、最大二氧化碳排出量 (VCO2max)、最大每分钟通气量 (VEmax)均显著低于健康人 (P <0 .0 5) ,无氧阈提前出现。结论 :轻中度哮喘患者的运动能力低于健康人 ,但通过小负荷运动可改善肺功能     

静松功结合有氧运动对糖尿病伴焦虑与抑郁情绪患者的影响

目的探讨静松功结合有氧运动对糖尿病伴焦虑与抑郁情绪患者的影响。方法将76例伴焦虑与抑郁情绪的2型糖尿病患者随机分为研究组40例和对照组36例,研究组患者采用有氧运动与医疗静松功相结合运动,对照组患者采用有氧运动。比较干预1、3、6个月后患者焦虑、抑郁状况及血糖各项指标。结果干预1、3、6个月后两组患者焦虑自评量表(self-rating anxiety scale,SAS)与抑郁自评量表(self-rating depression scale,SDS)得分、空腹血糖(fasting blood glucose,FBG)、餐后2h血糖(2hours postprandial bloodglucose,2hPBG)及糖化血红蛋白(glycosylated hemoglobin,GHB)均有明显改善,且研究组优于对照组,组间比较,差异具有统计意义(均P<0.05)。结论静松功结合有氧运动能更好地改善糖尿病患者焦虑与抑郁情绪,提高患者生活质量。     

Tired of being inactive: a systematic literature review of physical activity,physiological exercise capacity and muscle strength in patients with chronic fatigue syndrome

A systematic review was undertaken to examine whether patients with chronic fatigue syndrome (CFS) differ from healthy sedentary controls in physiological exercise capacity, physical activity level and muscle strength. From the available literature, it can be concluded that patients with CFS perform less physical activity during daily life, and have less peak isometric muscle strength compared to healthy sedentary control subjects. Conflicting data in relation to physiological exercise capacity of patients with CFS have been reported, but the weighted available evidence points towards a reduced physiological exercise capacity in CFS. Future studies should use a wash-out period for medication use, blinded assessments, a priori power calculation and a sedentary control group comparable for age, gender, body weight, body length and current physical activity level.     

运动后迟发性低血压的临床特征和意义

本文报告18例中老年健康人极量运动后发生迟发性低血压,其临床特征为运动后2—6分钟突然发生心率明显减慢（甚至短暂窦性停搏）,血压明显降低,伴有显著的头晕、恶心,在平卧后全部自行缓解。作者认为这一现象与心血管调节功能以及运动相对强度有关,不提示器质性血管疾病,但不能完全用迷走神经功能障碍解释,其机理仍有待研讨。     

Serum creatine kinase activity and its changes after a muscle biopsy

Summary. The significance of the absolute elevations of serum creatine kinase (CK) levels after intense exercise and injuries was studied by measuring CK activities from seven healthy active males during a 2-week period, with a muscle biopsy taken between the first and second week. Most of the subjects (three lifters and two runners) carried on their normal exercise activities, while two lifters stopped training during the 2 weeks. The weight of the biopsy, number of fibres, percentage of fibre types, and cross-sectional areas of the muscle fibres were measured. The CK levels of the nonactive subjects and runners remained consistently low during the control week, whereas those of the lifters were usually 500% greater than those of the other two groups, and fluctuated with the intensity of their workouts. A muscle biopsy, having a mean weight of 71.3 mg and containing 1800 fibres, increased the CK values by approximately 100 units litre^-1 (U1^-1) in most of the subjects. One runner injured his right hamstring muscles 2 days prior to the biopsy, and his CK values rose from 50 to 4400 U I^-1. The increases in CK after the biopsy were not related to fibre type, activity, weight of the biopsy, or number or size of fibres removed. These results indicate that:

• 1 CK values are consistently lower in normal subjects and runners than in lifters.
• 2 Weight training results in chronic elevations of CK.
• 3 Compared to a muscle biopsy, muscular injury dramatically increases CK levels.
• 4 Elevation of serum CK is observed as early as 1 h after an intense weight-lifting session.
• 5 The elevation of serum CK by 100 U 1^-1 is associated with damage to approximately 2000 fibres.

     

Gender comparisons of perceived benefits of and barriers to physical activity in middle school youth

Perceived benefits of and barriers to physical activity (PA) reported by 206 middle school boys and girls in a survey were compared. Only “take care of myself, stay in shape, and be healthier” emerged as a greater benefit for girls than boys. Among students not on a sports team, boys reported fewer barriers than girls. Among those selecting an active pursuit, boys perceived more barriers than girls. When controlling for sports team participation and perceived benefits and barriers, boys reported more minutes of vigorous PA than girls. As boys and girls reported relatively similar benefits of and barriers to PA, nurse counseling with both groups can focus on the same information. Effort is particularly needed to increase PA among girls. © 2008 Wiley Periodicals, Inc. Res Nurs Health 32:163–176, 2009