Nakamura Yoichi, Tanaka Kiyoji, Shigematsu Ryosuke, Nakagaichi Masaki, Inoue Masaki, Homma Toshiaki
Health and Sport Sciences, Ryutsu Keizai University, Ryugasaki-City, Japan.
Int J Rehabil Res. 2008 Dec;31(4):275-83. doi: 10.1097/MRR.0b013e3282fc0f81.
The purpose of this study was to evaluate whether strength or recreational activities are a useful addition to aerobic training in patients with chronic obstructive pulmonary disease (COPD). Thirty-three patients with moderate to severe COPD were randomly assigned to 12 weeks of aerobic combined with strength training (AERO+ST) or combined with recreational activities (AERO+RA). The AERO regimen consisted of three weekly 20-min walking exercise sessions; the ST regimen included three series of 10 repetitions of four exercises; and the RA regimen consisted of training using exercise balls to perform smoothly for instrumental activity of daily living. Baseline and after-training measurements of peripheral muscular strength and endurance, cardio respiratory fitness, and 6-min walking distance were obtained, whereas quality of life was assessed with the Short Form 36 questionnaire. Change in grip strength showed a significant difference between the AERO+ST group (8.3+/-6.7%) and the control group (-1.3+/-10.5%), and AERO+RA group (-4.7+/-5.6%) (P<0.05). A significant increase was found in percentage change in peak (.)V(O2) between the AERO+ST group (5.1+/-11.8%) and the control group (-9.2+/-8.6%) (P<0.05). In the health-related quality of life scores, there was a significant difference in mean percentage change in physical functioning between the AERO+ST group (7.9+/-24.4%) and the control group (-14.8+/-19.1%) (P<0.05). A significant difference was found in mean percentage change in social functioning between the AERO+RA group (9.4+/-20.0%) and the control group (-14.9+/-23.2%) (P<0.05). A significant difference in mean percentage change in mental health was also found between the AERO+RA group (12.2+/-12.4%) and the control group (-5.0+/-7.8%) (P<0.05). It is preferable to introduce various forms of exercise that use different muscles involving the whole body, such as recreational activities, as they are an appropriate approach to stimulating physical activity and to improving functional fitness gradually while improving health-related quality of life, though it is necessary to practice exercises for maintenance and improvement in patients with COPD.
本研究的目的是评估力量训练或娱乐活动是否是慢性阻塞性肺疾病（COPD）患者有氧训练的有益补充。33例中重度COPD患者被随机分为两组，分别进行为期12周的有氧训练与力量训练相结合（AERO+ST）或有氧训练与娱乐活动相结合（AERO+RA）。AERO方案包括每周三次、每次20分钟的步行锻炼；ST方案包括四组练习，每组10次重复，共三组；RA方案包括使用健身球进行训练，以顺利完成日常生活中的工具性活动。测量了外周肌肉力量和耐力、心肺适能以及6分钟步行距离的基线值和训练后值，同时使用简短健康调查问卷（Short Form 36 questionnaire）评估生活质量。握力变化在AERO+ST组（8.3±6.7%）与对照组（-1.3±10.5%）以及AERO+RA组（-4.7±5.6%）之间存在显著差异（P<0.05）。AERO+ST组（5.1±11.8%）与对照组（-9.2±8.6%）之间的峰值摄氧量（.V（O2））变化百分比有显著增加（P<0.05）。在健康相关生活质量评分方面，AERO+ST组（7.9±24.4%）与对照组（-14.8±19.1%）之间的身体功能平均变化百分比存在显著差异（P<0.05）。AERO+RA组（9.4±20.0%）与对照组（-14.9±23.2%）之间的社会功能平均变化百分比存在显著差异（P<0.05）。AERO+RA组（12.2±12.4%）与对照组（-5.0±7.8%）之间的心理健康平均变化百分比也存在显著差异（P<0.05）。最好引入各种涉及全身不同肌肉的运动形式，如娱乐活动，因为它们是刺激身体活动以及在改善健康相关生活质量的同时逐步提高功能适能的合适方法，不过对于COPD患者来说，进行维持和改善的练习是必要的。
