基于WHO-FICs架构有氧联合抗阻运动对老年冠心病并发高血压患者的效果

doi:10.3969/j.issn.1006-9771.2023.03.012

Abstract

Abstract:

Objective To analyze the effect of moderate intensity aerobic combined with low intensity resistance exercise on old patients with coronary heart disease and hypertension.

Methods From November, 2021 to May, 2022, 16 patients with coronary heart disease and hypertension in Wuhan Donghu Hospital were divided into control group (n = 8) and experimental group (n = 8). Based on the World Health Organization Family of International Classification (WHO-FICs), the exercise intervention program was constructed. The control group accepted routine treatment, and the experimental group accepted moderate intensity aerobic combined with low intensity resistance exercise in addition, for eight weeks. They were measured lung function and cardiac function with cardiopulmonary exercise test system, and assessed with Timed 'Up and Go' Test, 6-Minute Walk Distance, 2-Minute Step Test, 30-Second Sit to Stand Test and grip strength before and after intervention.

Results The vital capacity, forced vital capacity, forced expiratory volume in the first second, forced expiratory volume in the one second as percentage of predicted volume, peak expiratory flow and maximal voluntary ventilation improved in the experimental after intervention (|t| > 2.391, P < 0.05), and the vital capacity, force vital capacity and maximal voluntary ventilation were more in the experimental group than in the control group (|t| > 2.207, P < 0.05). Peak oxygen uptake, anaerobic subthreshold oxygen uptake, metabolic equivalents, oxygen pulse, maximum work load and exercise load time improved in the experimental group after intervention (|t| > 2.823, P < 0.05), and they all were better in the experimental group than in the control group (|t| > 2.295, P < 0.05). Systolic blood pressure improved in both the groups (|t| > 4.608, P < 0.01), and diastolic blood pressure improved in the experimental group (t = 5.964, P < 0.01); while systolic blood pressure was less in the experimental group than in the control group (t = -3.654, P < 0.01). The performances of Timed 'Up and Go' Test, 6-Minute Walk Distance, 2-Minute Step Test, 30-Second Sit to Stand Test and grip strength improved in the experimental group after intervention (|t| > 2.996, P < 0.05), and all the performances were better in the experimental group than in the control group (|t| > 2.220, P < 0.05).

Conclusion The moderate intensity aerobic combined with low resistance exercise developed based on WHO-FICs can improve the cardiac function, lung function, cardiac load and motor function of old patients with coronary heart disease and hypertension.

Key words: coronary heart disease, hypertension, aerobic exercise, resistance exercise, cardiac function, lung function, motor function

CLC Number:

R541

LI Muyao, WANG Mei, DU Liang, TONG Lu, XU Sanxiong. Functional effect of aerobic combined with resistance exercise on old patients with coronary heart disease and hypertension using WHO-FICs framework[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(3): 326-334.

Figures/Tables 22

References 55

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人群			干预方式	结局
健康状况	ICD-11编码	ICF编码	干预方式	结局
冠心病高血压	BA80 冠状动脉粥样硬化 L1-BA0高血压病	b身体功能 b4心血管、血液、免疫和呼吸系统功能 b7神经肌肉骨骼和运动有关的功能 d活动和参与 d4活动	方式：有氧运动/抗阻运动频率：每周3次强度：40%~50% VO_2peak； Borg疲劳评分13~14；目标心率=(最大心率-安静心率)×40%~50%+安静心率时间：每次50 min	b4心血管、血液、免疫和呼吸系统功能 b410心脏功能 b4100心率 b430血液系统功能 b4301血液传输氧气功能 b420血管功能 b4200血压升高 b4201血压降低 b440呼吸功能 b4450胸呼吸肌功能 b4451膈肌功能 b4452辅助呼吸肌功能 b455运动耐受功能 b730肌肉力量功能 b7302单侧身体肌肉力量 b7303下半身肌肉力量 b7305躯干肌肉力量 b760随意运动控制 d4活动 d410改变身体的基本姿势 d4154保持站姿 d4103坐下 d4104站起 d4106移动身体重心 d450步行 d4500短距离步行

项目	对照组(n = 8)	试验组(n = 8)	χ²/t值	P值
性别(男/女)/n	4/4	4/4	< 0.001	1.000
年龄/岁	84.12±12.11	80.75±7.92	-0.660	0.520
身高/cm	159.63±9.10	161.50±8.03	0.146	0.886
体质量/kg	57.25±12.20	60.12±4.61	0.623	0.549
体质量指数/(kg·m^-2)	22.26±2.91	23.07±1.64	0.687	0.503

运动阶段	运动类型	运动时间/min	运动强度
适应阶段(1~4周)	有氧运动	20	40% VO_2peak，Borg疲劳量表评分13~14分，目标心率 = (最大心率-安静心率)×40%+安静心率
适应阶段(1~4周)	抗阻运动	20	40% VO_2peak，Borg疲劳量表评分13~14分，目标心率 = (最大心率-安静心率)×40%+安静心率
强化阶段(5~8周)	有氧运动	20	50% VO_2peak，Borg疲劳量表评分13~14分，目标心率 = (最大心率-安静心率)×50%+安静心率
强化阶段(5~8周)	抗阻运动	20	50% VO_2peak，Borg疲劳量表评分13~14分，目标心率 = (最大心率-安静心率)×50%+安静心率

组别	n	干预前	干预后	t值	P值
对照组	8	833.251±192.530	824.252±208.978	0.331	0.751
试验组	8	813.125±205.434	1074.253±180.330	-3.282	0.013
t值		0.202	-2.562
P值		0.843	0.023

组别	n	干预前	干预后	t值	P值
对照组	8	625.875±142.277	620.000±128.699	0.258	0.804
试验组	8	608.875±104.992	784.375±97.220	-4.132	0.004
t值		-0.272	2.834
P值		0.790	0.013

Functional effect of aerobic combined with resistance exercise on old patients with coronary heart disease and hypertension using WHO-FICs framework

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组别	n	干预前	干预后	t值	P值
对照组	8	4.088±1.443	4.075±1.557	0.082	0.937
试验组	8	3.950±0.798	6.015±2.031	-2.823	0.026
t值		-0.236	2.295
P值		0.817	0.038

组别	n	干预前	干预后	t值	P值
对照组	8	6.770±1.717	6.700±1.457	0.316	0.761
试验组	8	6.900±1.673	9.350±2.059	-3.464	0.010
t值		0.147	2.971
P值		0.885	0.010

组别	n	干预前	干预后	t值	P值
对照组	8	68.375±26.403	65.250±20.429	1.448	0.191
试验组	8	66.750±16.977	85.875±12.845	-6.540	< 0.001
t值		-0.146	2.417
P值		0.886	0.031

组别	n	干预前	干预后	t值	P值
对照组	8	417.375±123.890	380.875±36.907	1.006	0.348
试验组	8	373.375±35.704	444.502±62.301	-6.127	< 0.001
t值		-0.965	2.485
P值		0.351	0.026

组别	n	干预前	干预后	t值	P值
对照组	8	147.750±3.693	139.750±4.950	4.608	0.002
试验组	8	146.375±3.962	131.252±4.334	14.507	< 0.001
t值		-0.718	-3.654
P值		0.485	0.003

组别	n	干预前	干预后	t值	P值
对照组	8	79.625±8.618	76.750±8.988	1.686	0.136
试验组	8	75.375±9.591	70.125±7.809	5.964	0.001
t值		-1.115	-1.574
P值		0.284	0.138

组别	n	干预前	干预后	t值	P值
对照组	8	2.285±0.255	2.291±0.342	-0.078	0.940
试验组	8	2.326±0.400	2.748±0.474	-2.689	0.031
t值		-0.309	-2.207
P值		0.762	0.044

组别	n	干预前	干预后	t值	P值
对照组	8	2.002±0.416	2.142±0.383	-1.778	0.119
试验组	8	2.190±0.341	2.943±0.379	-2.767	0.028
t值		-1.021	-4.201
P值		0.330	0.001

组别	n	干预前	干预后	t值	P值
对照组	8	1.716±0.357	1.821±0.367	-0.884	0.406
试验组	8	1.673±0.434	2.090±0.303	-3.119	0.017
t值		0.222	-1.578
P值		0.829	0.132

组别	n	干预前	干预后	t值	P值
对照组	8	64.195±10.424	64.565±11.204	-0.477	0.648
试验组	8	65.514±10.378	68.778±10.957	-3.118	0.017
t值		0.254	-0.762
P值		0.804	0.461

组别	n	干预前	干预后	t值	P值
对照组	8	60.450±15.319	58.546±16.792	1.205	0.267
试验组	8	64.740±23.292	77.468±17.364	-2.391	0.048
t值		-0.435	-2.216
P值		0.670	0.044

组别	n	干预前	干预后	t值	P值
对照组	8	7.750±2.435	9.250±2.375	-1.655	0.142
试验组	8	9.125±2.416	12.000±2.449	-3.451	0.011
t值		1.134	2.280
P值		0.276	0.039

组别	n	干预前	干预后	t值	P值
对照组	8	23.154±2.481	22.688±2.524	1.187	0.274
试验组	8	24.563±2.408	27.225±5.201	-2.996	0.020
t值		0.836	2.220
P值		0.417	0.043

[1]	CHEN Junwen, CHEN Qian, CHEN Cheng, LI Shuyue, LIU Lingling, WU Cunshu, GONG Xiang, LU Jun, XU Guangxu. Effect of modified Baduanjin exercise on cardiopulmonary function, motor function and activities of daily living for stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 74-80.
[2]	SUN Tengfang, REN Mengting, YANG Lin, WANG Yaoting, WANG Hongyu, YAN Xingzhou. Effect of hyperbaric oxygen therapy combined with repetitive peripheral magnetic stimulation on ankle motor function and balance of stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 875-881.
[3]	WANG Ya'nan, LIU Xihua. Correlation and predictive effect of subjective and objective balance function measurements in stroke patients with hemiplegia [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 890-895.
[4]	WANG Haiyun, WANG Yin, ZHOU Xinjie, HE Aiqun. Effect of transcranial direct current stimulation combined with acupuncture on central and upper limb function in stroke patients based on central-peripheral-central theory [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 919-925.
[5]	CHEN Yiting, WANG Qian, CUI Shenhong, LI Yingcai, ZHANG Siyu, WEI Yanxu, REN Hui, LENG Jun, CHEN Bin. Effect of bilateral sequential repetitive transcranial magnetic stimulation on motor function of upper limbs in stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 926-932.
[6]	LI Fang, HUO Su, DU Jubao, LIU Xiuzhen, LI Xiaoshuang, SONG Weiqun. Effect of transcranial direct current stimulation combined with task-oriented rehabilitation training on forelimb motor dysfunction in rats with spinal cord injury [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 777-781.
[7]	CUI Yao, CONG Fang, HUANG Fubiao, ZENG Ming, YAN Ruxiu. Brain and muscle activation under mirror neuron-based training strategies: a near-infrared spectroscopy and surface electromyography study [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 782-790.
[8]	LIU Hui, YIN Hang, JIA Shaohui, QIU Fubing. Structure, contents and psychometric properties of measurement of motor function and motor ability applicable to children and adolescents with disabilities: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 630-638.
[9]	WANG Yiji, ZHOU Hongjun, HE Zejia, LIU Genlin, ZHENG Ying, HAO Chunxia, WEI Bo, KANG Haiqiong, ZHANG Ying, LU Xiaolei, YUAN Yuan, MENG Qianru. Relationship between symmetry of lower limb function and gait symmetry in patients with incomplete spinal cord injury [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 639-645.
[10]	XU Miaomiao, LI Nan, YING Ying, YANG Kaixiang, YANG Jingrui, LI Jie, QIU Yanqun. Effect of repetitive peripheral magnetic stimulation on upper limb motor function of stroke patients after contralateral seventh cervical nerve transfer [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 686-690.
[11]	ZHENG Li, BAO Zhicheng, ZHANG Qi, REN Xuyan, SU Min. Effect of transcutaneous auricular vagus nerve stimulation combined with robot-assisted therapy on upper limb function of stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 691-696.
[12]	ZHANG Qian, SUN Xinting. Effect of video-based mirror therapy on lower limb motor function of stroke patients at recovery stage [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 703-707.
[13]	LIN Yufan, WEI Tianyuan, ZHANG Xiaoying, LI Chaojinzi, HE Jingjie, DU Xiaoxia. Effect of music therapy on post-stroke cognitive impairment [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 714-719.
[14]	JIN Zhenhua, CHEN Ling, LIU Yong. Effect of self-efficacy-based intelligent walking training on function of lower extremities of stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(5): 504-509.
[15]	JIA Fan, ZHAO Ying, WANG Zhao, CHEN Jie, LU Sihan, ZHANG Ming. Effect of graded motor imagery combined with repetitive transcranial magnetic stimulation on upper limb function of stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(5): 516-520.

组别	n	干预前	干预后	t值	P值
对照组	8	4.112±1.160	4.078±1.211	0.254	0.807
试验组	8	4.218±1.285	5.000±0.906	-2.449	0.044
t值		0.161	-1.732
P值		0.874	0.105

组别	n	干预前	干预后	t值	P值
对照组	8	44.125±8.323	44.750±9.528	-0.427	0.682
试验组	8	43.250±14.849	68.375±8.158	-6.203	< 0.001
t值		0.145	-5.327
P值		0.886	< 0.001

组别	n	干预前	干预后	t值	P值
对照组	8	325.375±22.090	327.125±20.677	-0.570	0.586
试验组	8	337.875±36.783	377.625±33.573	-8.751	< 0.001
t值		-0.824	-3.623
P值		0.424	0.003

组别	n	干预前	干预后	t值	P值
对照组	8	10.988±1.083	10.738±1.431	0.960	0.369
试验组	8	10.196±1.299	7.809±1.364	8.950	< 0.001
t值		-1.323	-4.190
P值		0.207	0.001