瑜伽疗法可减轻慢性阻塞性肺疾病患者与呼吸困难相关的痛苦并改善其功能表现：一项初步研究。
Yoga therapy decreases dyspnea-related distress and improves functional performance in people with chronic obstructive pulmonary disease: a pilot study.
作者信息
Donesky-Cuenco DorAnne, Nguyen Huong Q, Paul Steven, Carrieri-Kohlman Virginia
机构信息
Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA 94143-0610, USA.
出版信息
J Altern Complement Med. 2009 Mar;15(3):225-34. doi: 10.1089/acm.2008.0389.
BACKGROUND
There has been limited study of yoga training as a complementary exercise strategy to manage the symptom of dyspnea in patients with chronic obstructive pulmonary disease (COPD).
PURPOSE
The primary purpose of this pilot study was to evaluate a yoga program for its safety, feasibility, and efficacy for decreasing dyspnea intensity (DI) and dyspnea-related distress (DD) in older adults with COPD.
METHODS
Clinically stable patients with COPD (n = 29; age 69.9 +/- 9.5; forced expiratory volume in 1 second (FEV(1)) 47.7 +/- 15.6% predicted; female = 21) were randomized to a 12-week yoga program specifically designed for people with COPD or usual-care control (UC). The twice-weekly yoga program included asanas (yoga postures) and visama vritti pranayama (timed breathing). Safety measure outcomes included heart rate, oxygen saturation, dyspnea, and pain. Feasibility was measured by patient-reported enjoyment, difficulty, and adherence to yoga sessions. At baseline and at 12 weeks, DI and DD were measured during incremental cycle ergometry and a 6-minute walk (6MW) test. Secondary efficacy outcomes included physical performance, psychologic well-being, and health-related quality of life (HRQoL).
RESULTS
Yoga training was safe and feasible for patients with COPD. While yoga training had only small effects on DI after the 6MW test (effect size [ES], 0.20; p = 0.60), there were greater reductions in DD in the yoga group compared to UC (ES, 0.67; p = 0.08). Yoga training also improved 6MW distance (+71.7 +/- 21.8 feet versus -27.6 +/- 36.2 feet; ES = 0.78, p = 0.04) and self-reported functional performance (ES = 0.79, p = 0.04) compared to UC. There were small positive changes in muscle strength and HRQoL.
CONCLUSIONS
Elderly patients with COPD participated safely in a 12-week yoga program especially designed for patients with this chronic illness. After the program, the subjects tolerated more activity with less DD and improved their functional performance. These findings need to be confirmed in a larger, more sufficiently powered efficacy study.
背景
作为一种辅助运动策略，针对慢性阻塞性肺疾病（COPD）患者呼吸困难症状的瑜伽训练研究有限。
目的
这项初步研究的主要目的是评估一项瑜伽计划对患有COPD的老年人降低呼吸困难强度（DI）和与呼吸困难相关的痛苦（DD）的安全性、可行性和有效性。
方法
临床稳定的COPD患者（n = 29；年龄69.9±9.5；一秒用力呼气量（FEV₁）为预测值的47.7±15.6%；女性 = 21）被随机分为专门为COPD患者设计的为期12周的瑜伽计划组或常规护理对照组（UC）。每周两次的瑜伽计划包括体式（瑜伽姿势）和维萨玛·维里蒂呼吸法（定时呼吸）。安全测量结果包括心率、血氧饱和度、呼吸困难和疼痛。可行性通过患者报告的愉悦感、难度和对瑜伽课程的依从性来衡量。在基线和12周时，在递增式自行车测力计测试和6分钟步行（6MW）测试期间测量DI和DD。次要疗效结果包括身体表现、心理健康和健康相关生活质量（HRQoL）。
结果
瑜伽训练对COPD患者是安全可行的。虽然瑜伽训练在6MW测试后对DI的影响很小（效应量[ES]，0.20；p = 0.60），但与UC组相比，瑜伽组的DD有更大程度的降低（ES，0.67；p = 0.08）。与UC组相比，瑜伽训练还改善了6MW距离（+71.7±21.8英尺对 -27.6±36.2英尺；ES = 0.78，p = 0.04）和自我报告的功能表现（ES = 0.79，p = 0.04）。肌肉力量和HRQoL有小的积极变化。
结论
患有COPD的老年患者安全地参与了一项专门为患有这种慢性病的患者设计的为期12周的瑜伽计划。该计划结束后，受试者能够耐受更多活动，DD减少，功能表现得到改善。这些发现需要在一项更大、更有充分效力的疗效研究中得到证实。
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