Nakamura Yoichi, Tanaka Kiyoji, Shigematsu Ryosuke, Homma Toshiaki, Sekizawa Kiyohisa
Comprehensive Human Sciences, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.
Respirology. 2004 Aug;9(3):326-30. doi: 10.1111/j.1440-1843.2004.00605.x.
The purpose of this study was to examine whether activities parallel to daily living (APDL) constitute a determinant index of cardiorespiratory fitness in patients with chronic obstructive pulmonary disease (COPD).
Four functional physical fitness parameters were investigated in 38 male patients (mean age 69.8 +/- 6.7 years) with moderate to severe COPD. The parameters measured were muscular strength (grip strength), muscular endurance strength (arm curl, keeping a half-squat position) and regulation (walking around two cones). In addition, cardiorespiratory fitness was measured using a 6-min walking distance test (6MWD) and peak oxygen uptake (VO(2peak)) was measured during bicycle ergometer testing. Maximal inspiratory pressure (MIP) and maximal expiratory pressure were measured so as to quantify respiratory muscle strength.
There were significant correlations (P < 0.05) between the VO(2peak), muscular endurance, pulmonary function and respiratory muscle strength. There were also significant correlations of VO(2peak) to muscular endurance, muscular strength, muscular endurance strength and regulation. In stepwise multiple regression analysis, per cent predicted forced expiratory volume in 1 s and MIP appeared to be significant determinants of VO(2peak), showing a total variance of 56% (P < 0.05). For the 6MWD, the significant determinants were forced vital capacity, MIP and performance in the half-squat test, showing a variance of 59% (P < 0.05).
The results suggest that cardiorespiratory fitness is strongly affected by MIP, pulmonary function and muscular endurance strength, as APDL depend on lower-limb use.
本研究旨在探讨与日常生活平行的活动(APDL)是否构成慢性阻塞性肺疾病(COPD)患者心肺适能的决定性指标。
对38例中度至重度COPD男性患者(平均年龄69.8±6.7岁)的四个功能性体能参数进行了研究。测量的参数包括肌肉力量(握力)、肌肉耐力(手臂卷曲,保持半蹲姿势)和协调性(绕过两个锥体行走)。此外,使用6分钟步行距离测试(6MWD)测量心肺适能,并在自行车测力计测试期间测量峰值摄氧量(VO₂peak)。测量最大吸气压力(MIP)和最大呼气压力以量化呼吸肌力量。
VO₂peak、肌肉耐力、肺功能和呼吸肌力量之间存在显著相关性(P<0.05)。VO₂peak与肌肉耐力、肌肉力量、肌肉耐力强度和协调性也存在显著相关性。在逐步多元回归分析中,1秒用力呼气量百分比和MIP似乎是VO₂peak的重要决定因素,总方差为56%(P<0.05)。对于6MWD,重要决定因素是肺活量、MIP和半蹲测试表现,方差为59%(P<0.05)。
结果表明,心肺适能受MIP、肺功能和肌肉耐力强度的强烈影响,因为APDL依赖于下肢的使用。