心肺病人時常會有運動耐受度差以及喘的問題，並且會帶來不同的負面影響，而一個完善的運動計畫已經被證實可以有效改善這類的問題。然而患者有時會因症狀過於嚴重而無法完成運動。這時一個新的運動訓練模式或許可以試圖改善這類的矛盾。離心運動相較於傳統的向心運動，能夠在一樣的強度下消耗較少的能量。近幾年來離心腳踏車開始使用於心肺病人的復健，跟向心腳踏車相比，在一樣的強度下患者在使用離心腳踏車時，其自覺的疲勞程度以及症狀的嚴重度會下降。許多文獻也證實了離心腳踏車對於心肺病人是安全且可行的。然而離心腳踏車對於心肺病人的訓練效果卻尚未有定論，雖然大部分的文章指出離心腳踏車提升肌肉力量的效果較向心腳踏車來的好，但對於提升攝氧量的結果則較不一致。同時目前也沒有統一的方式來訂定離心腳踏車的運動處方。因此本篇系統性回顧希望能統整出離心腳踏車的效果，以及其運動處方的設計。方法：收錄及排除條件：實驗設計為單或雙組訓練前後測比較之已發表全文，需招募患有心肺疾病的成人，並且含有一項離心腳踏車的訓練計畫。回顧性的文章將會被排除。總共會搜尋六個資料庫，Embase, PubMed, Cochrane, CINAHL, SPORTDiscus, and Academic Research。誤差風險評估及研究品質將會使用RoB 2、ROBINS-I、PEDro、NIH quality assessment tool for before-after (pre-post) study without control group來完成。資料擷取會以手動的方式完成，若是合適則會進行統合分析。結果：總共收錄了十二篇文章，研究品質、誤差風險評估的結果分別為PEDro五到七、中等；有些疑慮、及嚴重風險，結果顯示離心腳踏車不但安全且可以有效提升運動耐受度。常見的運動處方為為期共五到十周的訓練、每周三到五次、每次三十分鐘、轉速為每分鐘十五到二十轉或六十轉。強度的指標包含了自覺用力係數、心跳、攝氧量、輸出功率等。共有七項統合分析，其中只有運動測試最大功率輸出有顯著的偏項離心腳踏車，其他項目在攝氧量、下肢肌力、六分鐘行走測試及身體組成等則沒有達到顯著差異。結論：離心腳踏車可以做為替代的訓練模式，幫助病人達到足夠的強度及訓練時間。運動處方的設計可以根據患者的情況做調整，同時考慮運動特異性，為訓練目標挑選合適的強度指標。

Background and Purpose: Cardiorespiratory diseases patients often showed symptoms like dyspnea and exercise intolerance. Exercise is effective in improving exercise intolerance and associated outcomes. However, due to severe symptoms, patients sometimes have difficulty completing exercise. Therefore, a new exercise modality is warranted. Eccentric (ECC) cycling training allows exercises to be performed at a lower cost of energy and RPE. Lots of studies investigated the feasibility and effectiveness of ECC cycling, and the results showed it was safe and can be completed with low level of symptoms and RPE. However, the effect of ECC cycling is controversial. Moreover, there has been a lack of agreement on how to prescribe ECC cycling in this population. The aim of this study is to determine the effectiveness, tolerability, and the preferred prescription methods of ECC cycling in this population. Methods: Inclusion criteria: published full-text articles with single- or two-group pretest-posttest interventional design, recruiting adults with cardiorespiratory diseases and including an ECC cycling program. Review articles were excluded. The following 6 databases were searched from their inception to July, 2022: Embase, PubMed, Cochrane Library, CINAHL, SPORTDiscus, and Academic Research. Risk of bias and quality assessment were done using RoB 2, ROBINS-I, PEDro, and NIH quality assessment tool. Data extraction and analysis was performed manually and meta-analysis would be performed when seems fit. Results: There were 12 reports included, and the results of PEDro, NIH quality assessment tool, RoB 2, and ROBINS-I were between 5–7, fair, mostly some concerns, and serious risks respectively. The findings showed that ECC cycling was safe with promising effect in improving muscle strength and mass, power output, VO2, and 6MWD. The common settings for ECC cycling training are: 5–10 weeks, 3–5 sessions/week, 30 min/session at 15–20 rpm or 60 rpm. Intensity can be defined using RPE, HR, VO2, and power output. Also, adopting a prior familiarization period was important in preventing muscle damage. There were 7 findings that underwent meta-analysis, among, only CPET peak power showed significant favouring of ECC cycling training, while the others were nonsignificant, for example, VO2, muscle strength, and body composition, etc. Conclusions: ECC cycling training is promising and safe. It can be used to improve exercise capacity in this population. Clinical Relevance: ECC cycling training can be an alternative exercise to allow the patients to be trained in sufficient intensity and duration. Clinical practitioner can customize the exercise design by selecting the more suitable method according to the clients’ condition and warranted effects.

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