Cheah Benjamin C, Boland Robert A, Brodaty Nina E, Zoing Margie C, Jeffery Sandra E, McKenzie David K, Kiernan Matthew C
Prince of Wales Medical Research Institute & Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia.
Amyotroph Lateral Scler. 2009 Oct-Dec;10(5-6):384-92. doi: 10.3109/17482960903082218.
Respiratory impairment, due to respiratory muscle weakness, is a major cause of morbidity and mortality in patients with amyotrophic lateral sclerosis/motor neuron disease (ALS/MND). Threshold loading may strengthen the inspiratory muscles and thereby improve patient prognosis. A phase II, double-blind, randomized-controlled trial was undertaken to determine whether a 12-week inspiratory muscle training programme attenuated the decline in respiratory function and inspiratory muscle strength in patients with ALS/MND. Nine patients were randomized to inspiratory muscle training and 10 to sham training. Primary endpoints were respiratory function (forced vital capacity, vital capacity), lung volumes and inspiratory muscle strength. Patients were assessed before, during and immediately after a 12-week training period, and at eight weeks follow-up. While improvements in inspiratory muscle strength were observed in both treatment arms, there was a non-significant increase in maximum inspiratory pressure of 6.1% in the experimental group compared to controls (standard error of mean, 6.93%; 95% confidence interval -8.58 -20.79; p=0.39). The gains in inspiratory muscle strength were partially reversed during a period of training cessation. In conclusion, inspiratory muscle training may potentially strengthen the inspiratory muscles and slow the decline in respiratory function in patients with ALS/MND.
由于呼吸肌无力导致的呼吸功能障碍是肌萎缩侧索硬化症/运动神经元病（ALS/MND）患者发病和死亡的主要原因。阈值负荷可能会增强吸气肌，从而改善患者预后。开展了一项II期双盲随机对照试验，以确定为期12周的吸气肌训练计划是否能减缓ALS/MND患者呼吸功能和吸气肌力量的下降。9名患者被随机分配到吸气肌训练组，10名患者被分配到假训练组。主要终点指标为呼吸功能（用力肺活量、肺活量）、肺容量和吸气肌力量。在为期12周的训练期之前、期间、结束后以及随访8周时对患者进行评估。虽然两个治疗组的吸气肌力量均有改善，但与对照组相比，试验组的最大吸气压力非显著性增加了6.1%（平均标准误差为6.93%；95%置信区间为-8.58至-20.79；p = 0.39）。在训练停止期间，吸气肌力量的增加部分出现逆转。总之，吸气肌训练可能会增强ALS/MND患者的吸气肌，并减缓其呼吸功能的下降。
