만성 심부전 환자의 심장이식 수술 전 하지 근력 및리컴번트 사이클링 운동 프로그램의 효과 대

The Effects of Lower Extremity Strengthening Exercise and Recumbent Cycling Exercise Program in Patient with Chronic Heart Failure Prior to Heart Transplantation

Purpose : Muscle weakness, especially leg muscle is the key characteristic that can be found in heart failure(HF) patients who are waiting for heart transplantation(HT) for a long time. Exercise training before HT is important to reverse muscular de-conditioning that place HT recipients at increased cardiovascular risk. The purpose of this study is to investigate the effect of lower extremity strengthening and recumbent cycle aerobic exercise program on muscular fitness in HF patients prior to HT. Methods : Each subject completed at least 24 sessions of lower extremity strengthening exercise(leg press 20 min / 1 session) and recumbent cycle aerobic exercise (20 min / 1 session) at Severance cardiac wellness center who was hospitalized waiting for HT. Knee extensor maximal voluntary isometric strength (MVIC), mean muscle power (MMP) and 6 minutes walking distance (6 MWD) were recorded at baseline (D1), and at the end of 24 training sessions (D2), and at discharge date after HT (D3). Results : The study population consisted of 8 HF patients (7 male, 35±19 years old, mean EF=18.3±6.4%). All subjects completed at least 24 training session with no adverse events. The MVIC (403.9±73.9 vs. 478±76.9 N, p=0.001), MMP (155.5±57 vs. 186.7±65 watt, p=0.003), and 6 MWD (441.6±64.9 vs. 520.3±53.9 m, p=0.002) measured at D2 were significantly increased compared with baseline, respectively. However, the MVIC (478±76.9 vs. 398±97.4 N, p=0.032) and MMP (186.7±65 vs. 145.5±77.6 watt, p=0.015) measured at D3 were significantly decreased compared with D2, whereas 6 MWD (520.3±53.9 vs. 520.7±35.4 m, p=0.708) were not different significantly. MVIC and MMP showed not significant differences compared D1 with D3, but 6 MWD (441.6±64.9 vs. 520.7±35.4 m, p=0.011) was improved significantly. Conclusion : Our study showed that lower extremity muscle strengthening and aerobic recumbent cycling exercise program prior to HT can improve HF patient’s muscular fitness and 6 MWD.