北欧式健走对心脏病患者运动能力和生活质量影响的Meta分析

Effect of Nordic walking on exercise capacity and quality of life in patients with heart disease:a Meta-analysis

目的系统评价北欧式健走(NW)对心脏病患者运动能力和生活质量的影响。方法通过计算机检索PubMed、The Cochrane Library、Web of Science、EMbase、CINHAL、MEDLINE、CNKI、WanFang Data、VIP和SinoMed数据库,搜集NW应用于心脏病患者的随机对照试验(RCT)文献,检索时限为建库至2022年3月。对纳入文献进行严格的质量评价和数据提取,采用RevMan 5.3软件进行Meta分析。结果经逐层筛选,本研究共纳入8项RCT,包括459例患者。Meta分析结果显示,NW在改善心脏病患者的6 min步行距离(6MWD)(MD=26.43,95%CI:7.81~45.04,P<0.01)和代谢当量(MET)(MD=0.60,95%CI:0.19~1.01,P<0.01)方面优于传统心脏康复,但在生活质量评分(SF-36量表生理领域和心理领域评分)、峰值摄氧量、焦虑评分和抑郁评分方面与传统心脏康复比较,差异无统计学意义(P>0.05)。结论相较于传统心脏康复措施,基于NW的心脏康复措施可增加运动强度,提高心脏病患者的运动能力,但受纳入研究数量和质量等的限制,未来还需纳入更多的高质量研究加以验证。

Objective To systematically review the efficacy of Nordic walking(NW)on exercise capacity and quality of life in patients with heart disease.Methods PubMed,The Cochrane Library,Web of Science,EMbase,CINHAL,MEDLINE,CNKI,WanFang Data,VIP and SinoMed databases were electronically searched for randomized controlled trials(RCTs)on effect of NW in patients with heart disease from inception to March,2022.Strict quality evaluation and data extraction were carried out for the included literature,RevMan 5.3 was used to perform a Meta analysis.Results A total of 8 RCTs were included,with 459 subjects in total.The results of Meta-analysis showed that NW could increase 6 min walking distance(6MWD)[MD=26.43,95%CI,7.81 to 45.04,P<0.01]and metabolic equivalent(MET)[MD=0.60,95%CI,0.19 to 1.01,P<0.01]compared with conventional cardiovascular rehabilitation.However,there were no significant differences in quality of life score(physical and psychological scores in SF-36 Scale),peak oxygen uptake,anxiety score and depression score compared with traditional cardiac rehabilitation(P>0.05).Conclusion Cardiac rehabilitation measures based on NW can increase the exercise intensity and improve the exercise ability of patients with heart disease compared to conventional cardiovascular rehabilitation.Due to limited quality and quantity of the included studies,higher quality studies are required to verify above conclusion.