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步行辅助工具对接受氧疗的慢性阻塞性肺疾病患者的影响。

Effects of a walking aid in COPD patients receiving oxygen therapy.

作者信息

Crisafulli Ernesto, Costi Stefania, De Blasio Francesco, Biscione Gianluca, Americi Francesca, Penza Sergio, Eutropio Erika, Pasqua Franco, Fabbri Leonardo M, Clini Enrico M

机构信息

University of Modena-Reggio Emilia, Department of Pulmonary Rehabilitation, Ospedale Villa Pineta, Italy, Via Gaiato 127, 41026 Pavullo n/F (MO), USA.

出版信息

Chest. 2007 Apr;131(4):1068-74. doi: 10.1378/chest.06-2108.

Abstract

STUDY OBJECTIVES

To elucidate whether a simple walking aid may improve physical performance in COPD patients with chronic respiratory insufficiency who usually carry their own heavy oxygen canister.

DESIGN

Randomized crossover trial.

SETTING

Physiopathology laboratory of three rehabilitation centers.

PATIENTS AND INTERVENTIONS

We studied 60 stable COPD patients (mean age, 70.6 +/- 7.9 years; FEV(1), 44.8 +/- 14.3% of predicted [+/- SD]) with chronic respiratory insufficiency who randomly performed, on 2 consecutive days, a standardized 6-min walking test using two different modalities: a full-weight oxygen canister transported using a small wheeled cart and pulled by the patient (Aid modality) or full-weight oxygen canister carried on the patient's shoulder (No-Aid modality).

MEASUREMENTS AND RESULTS

The distance walked, peak effort dyspnea, and leg fatigue scores as primary outcomes, and other cardiorespiratory parameters as secondary outcomes were recorded during both tests. A significant difference (p < 0.05) between the two tests occurred for all the measured outcomes in favor of the Aid modality. Most importantly, significant changes for distance (+ 43 m, p < 0.001), peak effort dyspnea (- 2.0 points, p < 0.001), leg fatigue (- 1.4 points, p < 0.001), as well as for mean and nadir oxygen saturation and heart rate with the Aid modality (but not with the No-Aid modality) were recorded in the subgroup of patients walking < 300 m at baseline.

CONCLUSIONS

This study suggests that a simple walking aid may be helpful in COPD patients receiving long-term oxygen therapy, particularly in those with lower residual exercise capacity.

摘要

研究目的

阐明一种简单的助行器是否能改善慢性呼吸功能不全的慢性阻塞性肺疾病(COPD)患者的身体机能,这些患者通常需要自行携带沉重的氧气罐。

设计

随机交叉试验。

地点

三个康复中心的病理生理学实验室。

患者与干预措施

我们研究了60例稳定期COPD患者(平均年龄70.6±7.9岁;第1秒用力呼气容积[FEV(1)]为预测值的44.8±14.3%[±标准差]),这些患者存在慢性呼吸功能不全,他们在连续2天内随机采用两种不同方式进行标准化6分钟步行试验:使用带小轮的推车运送并由患者拉动全重氧气罐(助行器方式)或把全重氧气罐扛在患者肩上(无助行器方式)。

测量指标与结果

在两次试验中记录作为主要指标的步行距离、最大用力时的呼吸困难程度和腿部疲劳评分,以及作为次要指标的其他心肺参数。对于所有测量指标,两次试验之间存在显著差异(p<0.05),支持助行器方式。最重要的是,在基线步行距离<300 m的患者亚组中,记录到助行器方式下步行距离(增加43 m,p<0.001)、最大用力时的呼吸困难程度(降低2.0分,p<0.001)、腿部疲劳(降低1.4分,p<0.001)以及平均和最低氧饱和度及心率有显著变化(而无助行器方式下未出现这些变化)。

结论

本研究表明,一种简单的助行器可能有助于接受长期氧疗的COPD患者,尤其是那些残余运动能力较低的患者。

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