Gulmans V A, de Meer K, Brackel H J, Faber J A, Berger R, Helders P J
Department of Pediatric Physiotherapy, Wilhelmina Children's Hospital, University Hospital for Children and Youth, Utrecht, The Netherlands.
Pediatr Pulmonol. 1999 Jul;28(1):39-46. doi: 10.1002/(sici)1099-0496(199907)28:1<39::aid-ppul7>3.0.co;2-8.
Exercise training is currently advocated as part of the treatment of patients with cystic fibrosis (CF). However, data are few that document physiologic benefits or changes in patients' perceptions of long-term training programs in children with CF. The aim of this study was to investigate the effects and acceptability of a home cycling program in children with CF. Fourteen patients (9 boys, 5 girls) with CF, mean (SD) age 14.1 (2.0) years, with mild to moderate impairment of lung function (forced expiratory volume in 1 s, mean (SD) 58.3 (16.3)% of predicted) were studied for 1 year. The first half of the study year was used to obtain baseline values at 0 and 6 months. During the second half of the year, a cycle program was carried out 5 times a week, for 20 min each day at a level of work that resulted in a heart rate of 140-160 beats/min. Once a week the cycle program was supervised by a physiotherapist. Measurements were repeated at 12 months. Effects of the exercise program were measured in terms of lung function, nutritional status, growth, muscle strength, exercise performance, perceived competence, and attitude towards the training program. Differences between the changes during the 6-month training period as compared to the 6-month control period were analyzed by multivariate statistics and nonparametric tests. Statistically significant differences (P < 0.05) between the two periods were found with respect to muscle strength of knee extensors and ankle dorsiflexors, and with respect to maximal oxygen consumption per kg body weight as well as per kg fat free mass. All changes were positive. No adverse effects were found. Perceived competence showed significant positive changes in feelings about physical appearance, general self-worth, and Total Perceived Competence Score. Scores concerning perceived acceptability of the program were significantly lower at the end of the training period; however, patients reported that they did want to continue with other sorts of training. We conclude that an exercise training program in the home can produce beneficial effects on oxygen consumption, muscle force, and perceived competence in children with CF. However, acceptability of the program was low, suggesting that long-term adherence would be poor, and hence, other sorts of training need to be identified.
运动训练目前被提倡作为囊性纤维化(CF)患者治疗的一部分。然而,关于CF患儿长期训练计划的生理益处或患者认知变化的记录数据很少。本研究的目的是调查家庭自行车训练计划对CF患儿的影响和可接受性。对14例CF患者(9名男孩,5名女孩)进行了为期1年的研究,他们的平均(标准差)年龄为14.1(2.0)岁,肺功能轻度至中度受损(第1秒用力呼气量,平均(标准差)为预测值的58.3(16.3)%)。研究的前半年用于获取0个月和6个月时的基线值。在下半年,每周进行5次自行车训练,每天20分钟,训练强度以心率达到140 - 160次/分钟为准。每周有一次自行车训练由物理治疗师监督。在12个月时重复测量。运动计划的效果通过肺功能、营养状况、生长、肌肉力量、运动表现、自我认知能力以及对训练计划的态度来衡量。通过多变量统计和非参数检验分析了6个月训练期与6个月对照期变化之间的差异。发现两个时期在膝伸肌和踝背屈肌的肌肉力量、每千克体重以及每千克去脂体重的最大耗氧量方面存在统计学显著差异(P < 0.05)。所有变化都是积极的。未发现不良反应。自我认知能力在身体外观感受、总体自我价值和总体自我认知能力得分方面显示出显著的积极变化。关于该计划可接受性的得分在训练期结束时显著降低;然而,患者表示他们确实希望继续进行其他类型的训练。我们得出结论,家庭运动训练计划可以对CF患儿的耗氧量、肌肉力量和自我认知能力产生有益影响。然而,该计划的可接受性较低,这表明长期坚持性较差,因此,需要确定其他类型的训练。