Pitta Fábio, Troosters Thierry, Probst Vanessa S, Langer Daniel, Decramer Marc, Gosselink Rik
Respiratory Rehabilitation and Respiratory Division, University Hospitals, Katholieke Universiteit Leuven, Leuven, Belgium.
Respiratory Rehabilitation and Respiratory Division, University Hospitals, Katholieke Universiteit Leuven, Leuven, Belgium.
Chest. 2008 Aug;134(2):273-280. doi: 10.1378/chest.07-2655. Epub 2008 Apr 10.
Despite a variety of benefits brought by pulmonary rehabilitation to patients with COPD, it is unclear whether these patients are more active during daily life after the program.
Physical activities in daily life (activity monitoring), pulmonary function (spirometry), exercise capacity (incremental cycle-ergometer testing and 6-min walk distance testing), muscle force (quadriceps and handgrip force, and inspiratory and expiratory maximal pressures), quality of life (chronic respiratory disease questionnaire), and functional status (pulmonary functional status and dyspnea questionnaire-modified version) were assessed at baseline, after 3 months of a multidisciplinary rehabilitation program, and at the end of a 6-month multidisciplinary rehabilitation program in 29 patients (mean [+/- SD] age, 67 +/- 8 years; FEV(1), 46 +/- 16% predicted).
Exercise capacity, muscle force, quality of life, and functional status improved significantly after 3 months of pulmonary rehabilitation (all p < 0.05), with further improvements in muscle force, functional status, and quality of life at 6 months. Movement intensity during walking improved significantly after 3 months (p = 0.046) with further improvements after 6 months (p = 0.0002). Walking time in daily life did not improve significantly at 3 months (mean improvement, 7 +/- 35%; p = 0.21), but only after 6 months (mean improvement, 20 +/- 36%; p = 0.008). No significant changes occurred in other activities or in the pattern of the time spent walking in daily life. Changes in dyspnea after the program were significantly related to changes in walking time in daily life (r = 0.43; p = 0.02).
If one aims at changing physical activity habits in the daily life of COPD patients, the contribution of long-lasting programs might be important.
尽管肺康复给慢性阻塞性肺疾病(COPD)患者带来了诸多益处,但尚不清楚这些患者在接受该项目后日常生活中是否更加活跃。
对29例患者(平均年龄[±标准差]为67±8岁;第1秒用力呼气容积[FEV₁]为预计值的46±16%)在基线期、多学科康复项目进行3个月后以及6个月多学科康复项目结束时,评估其日常生活中的身体活动(活动监测)、肺功能(肺量计)、运动能力(递增式功率自行车测试和6分钟步行距离测试)、肌肉力量(股四头肌和握力,以及吸气和呼气最大压力)、生活质量(慢性呼吸系统疾病问卷)和功能状态(肺功能状态和呼吸困难问卷 - 修改版)。
肺康复3个月后,运动能力、肌肉力量、生活质量和功能状态均有显著改善(均p<0.05),6个月时肌肉力量、功能状态和生活质量进一步改善。步行时的运动强度在3个月后显著改善(p = 0.046),6个月后进一步改善(p = 0.0002)。日常生活中的步行时间在3个月时无显著改善(平均改善7±35%;p = 0.21),但仅在6个月后有所改善(平均改善20±36%;p = 0.008)。其他活动或日常生活中步行时间的模式无显著变化。项目后呼吸困难的变化与日常生活中步行时间的变化显著相关(r = 0.43;p = 0.02)。
如果旨在改变COPD患者日常生活中的身体活动习惯,长期项目的作用可能很重要。