心臟移植患者之體適能

Physical Fitness in Cardiac Transplant Recipients

體適能與慢性病、心血管疾病的發生、病人的自覺健康相關，為當代醫學相關研究的重要課題之一。目前關於心臟移植患者運動表現的研究多僅探討有氧耐力部分，未見其他體適能表現項目的探討。本研究的目的即探討這類患者的各項體適能，並與正常人比較。受試者中16位為心臟移植患者（15男1女），平均年齡為51.4 ± 10.6歲，平均移植後29.0 ± 18.4個月，另外選取與他們年齡、性別、身高、體重相近之16位健康正常的人作為對照組。體適能的測驗共分五項：身體組成，肌力，肌耐力，柔軟度與心肺耐力。本研究發現心臟移植患者的肌耐力表現（一分鐘仰臥起坐與伏地挺身次數）、柔軟度（坐姿體前彎的距離）、心肺耐力（3分鐘登階測試的持續登階時間）皆明顯比對照組差（p＜0.05），而在身體組成（體脂肪比例與非脂肪組織重量）與肌力（慣用手最大握力）則與對照組無明顯差別。對照組全都能完成3分鐘登階測試，心臟移植組則只有7位，其平均登階時間為127.4 ± 49.9秒，恢復期心率則明顯較對照組高。本研究所使用之體適能測試可應用於心臟移植患者，作為定期評估體適能的方法。患者之肌耐力、柔軟度與心肺耐力均較正常對照組差，建議應加入相關的運動訓練項目，以增加健康體適能。

Background and Purpose: Health-related fitness have been associated with the occurrence of chronic cardiovascular problems and perceived status of health. Studies on exercise performance of heart transplant recipients were limited to aerobic endurance. The purpose of this study was to assess the differences in health-related fitness of heart transplant recipients and those of age, gender, and body stature matched healthy subjects. Methods: Sixteen heart transplant recipients (15 male and 1 female) averaged 29.0±18.4 months post surgery and 16 matched control subjects participated this study. Measurement of body composition, grip strength, muscle endurance (repetitions of sit-up and push-up in 1 minute), flexibility (sit-and-reach distance) and cardiopulmonary fitness (3-minute step test) were performed on all subjects. Results. Heart transplant recipients exhibited significantly lower values of muscular endurance, flexibility, and cardiopulmonary fitness (p<0.05). There were no differences in body composition and grip strength. All control subjects and 7 transplant recipients completed the 3-minute step test. The transplant group lasted an average of 127.4 ± 49.9 seconds in the 3-minute step test. Conclusion: The heart transplant recipients have lower muscular endurance, flexibility, and cardiopulmonary fitness than healthy subjects. Comprehensive exercise programs are indicated to improve health-related fitness in heart transplant recipients.