Shahin Barakat, Germain Michele, Kazem Alzahouri, Annat Guy
Department of Physiology, University of Claude Bernard Lyon I, Lyon, France.
Int J Chron Obstruct Pulmon Dis. 2008;3(3):423-7. doi: 10.2147/copd.s1822.
Abstract: Static lung hyperinflation has important clinical consequences in patients with chronic obstructive pulmonary disease (COPD). Given that most of these patients have respiratory and peripheral muscle weakness, dyspnea and functional exercise capacity may improve as a result of inspiratory muscle training (IMT). The present study is designed to investigate the benefits of a short outpatient program of IMT on inspiratory muscle performance, exercise capacity, perception of dyspnea, and the inspiratory fraction (IF). Thirty patients (24 males, 6 females) with significant COPD (forced expiratory volume in one second [FEV1] = 46.21% +/- 6.7% predicted, FEV1 = 33.6% +/- 8.04% predicted) were recruited for this study and had 3 months of IMT (30 minutes/day for 6 days/week) in an outpatient clinic. Following IMT, there was a statistically significant increase in inspiratory muscle performance (an increase of the maximal inspiratory pressure from 59% +/- 19.1% to 79% +/- 21.85% predicted; p = 0.0342), a decrease in dyspnea (from 5.8 +/- 0.78 to 1.9 +/- 0.57; p = 0.0001), an increase in the distance walked during the 6 minute walk test, from 245 +/- 52.37 m to 302 +/- 41.30 m, and finally an increase in the IF (the new prognostic factor in COPD) from 27.6 +/- 9.7% to 31.4% +/- 9.8%. The present study concludes that in patients with significant COPD, IMT results in improvement in performance, exercise capacity, sensation of dyspnea, and moreover an improvement in the IF prognostic factor.
静态肺过度充气在慢性阻塞性肺疾病（COPD）患者中具有重要的临床后果。鉴于这些患者中的大多数存在呼吸肌和外周肌肉无力，吸气肌训练（IMT）可能会改善呼吸困难和功能运动能力。本研究旨在探讨短期门诊IMT方案对吸气肌性能、运动能力、呼吸困难感知和吸气分数（IF）的益处。本研究招募了30例重度COPD患者（24例男性，6例女性）（一秒用力呼气容积[FEV1]=预测值的46.21%±6.7%，FEV1=预测值的33.6%±8.04%），并在门诊进行了3个月的IMT（每天30分钟，每周6天）。IMT后，吸气肌性能有统计学显著提高（最大吸气压力从预测值的59%±19.1%增加到79%±21.85%；p=0.0342），呼吸困难减轻（从5.8±0.78降至1.9±0.57；p=0.0001），6分钟步行试验中的步行距离增加，从245±52.37米增加到302±41.30米，最后IF（COPD中的新预后因素）从27.6±9.7%增加到31.4%±9.8%。本研究得出结论，在重度COPD患者中，IMT可改善性能、运动能力、呼吸困难感觉，此外还可改善IF预后因素。
