Dekhuijzen P N, Folgering H T, van Herwaarden C L
Department of Pulmonary Diseases, University of Nijmegen, Medical Center Dekkerswald, Groesbeek, The Netherlands.
Lung. 1990;168 Suppl:502-8. doi: 10.1007/BF02718171.
The effects of a 10-week inspiratory muscle training (IMT) program at home were compared to IMT during a 10-week pulmonary rehabilitation program (PR) in 40 COPD patients with a ventilatory limitation of the exercise capacity. IMT was performed with a target-flow resistive device; the generated mouth pressure as well as the duty cycle were imposed. The mean age of the patients was 59, the mean FEV1 was 48% of predicted. In the training period the inspiratory muscle strength improved in both groups to the same degree. EMG fatigability of the diaphragm improved in the PR+ IMT group, but not in the IMT group. In the IMT group, the 12-min walking distance increased after the training period, but maximal workload (Wmax), VO2,max, and ADL scores did not change. In the PR + IMT group, however, Wmax, VO2,max, walking distance, and ADL scores improved significantly after the training period. Walking distance and ADL scores showed a significantly greater improvement in the PR + IMT group than in the IMT group. It is concluded that both isolated IMT and PR + IMT in COPD patients with a ventilatory limitation have a beneficial effect on inspiratory muscle strength, but PR + IMT improves the physical exercise capacity significantly more than IMT alone.
将40例存在运动能力通气限制的慢性阻塞性肺疾病（COPD）患者在家中进行的为期10周的吸气肌训练（IMT）计划的效果，与在为期10周的肺康复计划（PR）期间进行的IMT效果进行了比较。IMT使用目标流量阻力装置进行；设定了产生的口腔压力以及占空比。患者的平均年龄为59岁，平均第一秒用力呼气容积（FEV1）为预测值的48%。在训练期间，两组的吸气肌力量均有同等程度的提高。PR + IMT组膈肌的肌电图疲劳性有所改善，但IMT组未改善。在IMT组，训练期后12分钟步行距离增加，但最大工作量（Wmax）、最大摄氧量（VO2,max）和日常生活活动（ADL）评分未改变。然而，在PR + IMT组，训练期后Wmax、VO2,max、步行距离和ADL评分均显著改善。步行距离和ADL评分在PR + IMT组的改善明显大于IMT组。得出的结论是，对于存在通气限制的COPD患者，单独的IMT和PR + IMT对吸气肌力量均有有益影响，但PR + IMT比单独的IMT能更显著地提高身体运动能力。
