Grammatopoulou Eirini P, Skordilis Emmanouil K, Stavrou Nektarios, Myrianthefs Pavlos, Karteroliotis Konstantinos, Baltopoulos George, Koutsouki Dimitra
Department of Physical Education and Sport Sciences, National and Kapodistrian University of Athens, Athens, Greece.
J Asthma. 2011 Aug;48(6):593-601. doi: 10.3109/02770903.2011.587583. Epub 2011 Jun 13.
The mechanism of the breathing retraining effect on asthma control is not adequately based on evidence.
The present study was designed to evaluate the effect of physiotherapy-based breathing retraining on asthma control and on asthma physiological indices across time.
A 6-month controlled study was conducted. Adult patients with stable, mild to moderate asthma (n = 40), under the same specialist's care, were randomized either to be trained as one group receiving 12 individual breathing retraining sessions (n = 20), or to have usual asthma care (n = 20). The main outcome was the Asthma Control Test score, with secondary outcomes the end-tidal carbon dioxide, respiratory rate, spirometry, and the scores of Nijmegen Hyperventilation Questionnaire, Medical Research Council scale, and SF-36v2 quality-of-life questionnaire.
The 2 × 4 ANOVA showed significant interaction between intervention and time in asthma control (F = 9.03, p < .001, η(2) = 0.19), end-tidal carbon dioxide (p < .001), respiratory rate (p < .001), symptoms of hypocapnia (p = .001), FEV1% predicted (p = .022), and breathlessness disability (p = .023). The 2 × 4 MANOVA showed significant interaction between intervention and time, with respect to the two components of the SF-36v2 (p < .001).
Breathing retraining resulted in improvement not only in asthma control but in physiological indices across time as well. Further studies are needed to confirm the benefits of this training in order to help patients with stable asthma achieve the control of their disease.
呼吸再训练对哮喘控制的作用机制尚无充分的证据支持。
本研究旨在评估基于物理治疗的呼吸再训练对哮喘控制及哮喘生理指标随时间变化的影响。
进行了一项为期6个月的对照研究。40例在同一位专科医生照料下的稳定期轻至中度哮喘成年患者被随机分为两组，一组接受12次个体化呼吸再训练课程（n = 20），另一组接受常规哮喘护理（n = 20）。主要结局指标为哮喘控制测试评分，次要结局指标为呼气末二氧化碳分压、呼吸频率、肺功能测定，以及奈梅亨过度通气问卷、医学研究委员会量表和SF - 36v2生活质量问卷的评分。
2×4方差分析显示，干预与时间在哮喘控制（F = 9.03，p <.001，η(2)= 0.19）、呼气末二氧化碳分压（p <.001）、呼吸频率（p <.001）、低碳酸血症症状（p =.001）、预计第一秒用力呼气容积百分比（p =.022）和呼吸困难残疾程度（p =.023）方面存在显著交互作用。2×4多变量方差分析显示，干预与时间在SF - 36v2的两个分量表方面存在显著交互作用（p <.001）。
呼吸再训练不仅能改善哮喘控制情况，还能随时间改善生理指标。需要进一步研究来证实这种训练的益处，以帮助稳定期哮喘患者控制病情。
