比较有和无慢性阻塞性肺疾病的老年患者吸气肌力量训练效果。
Comparison of inspiratory muscle strength training effects between older subjects with and without chronic obstructive pulmonary disease.
机构信息
Department of Physical Therapy, Tzu Chi University, Taipei, Taiwan.
出版信息
J Formos Med Assoc. 2011 Aug;110(8):518-26. doi: 10.1016/S0929-6646(11)60078-8.
BACKGROUND/PURPOSE: Inspiratory muscle strength training (IMST) has been traditionally recommended for patients with chronic obstructive pulmonary disease (COPD) to improve respiratory strength. Respiratory strength is reduced as age increases. However, few studies have focused on the effects of IMST on older adults without COPD.
METHODS
Subjects were divided into training non-COPD (TNC, n = 24) and training COPD (TC, n = 12) according to their forced expiratory volume in 1 second (% predicted). Both groups received 6 weeks of IMST, with training at 75-80% of maximal inspiratory pressure using pressure threshold trainers. A second group of COPD subjects served as controls (CC, n = 24), which received no training. Dyspnea was measured using the basic dyspnea index. Health-related quality of life was measured using the SF-36. The SF-36 subcategories, physical component summary and mental component summary were compared. A 6-minute walk test was performed to determine functional status. Two-way repeated measures analysis of variance was used to compare group effects and training effects of IMST.
RESULTS
Maximal inspiratory pressure was increased in both training groups (TNC: 59.1 cmH(2)O pre-IMST to 82.5 cmH(2)O post-IMST; TC: 53.2 to 72.6), but not in the CC group. Therefore, the basic dyspnea index was improved in both training groups (TNC: 9.6 to 10.8; TC: 6.2 to 7.3). Functional status was improved in the TNC group (TNC: 392.1 m to 436.3 m), but not in the TC or CC groups. Quality of life was improved in the physical component summary in both training groups.
CONCLUSION
IMST increases maximal inspiratory pressure, relieves dyspnea and improves health-related quality of life in older adults. IMST especially improves functional status in subjects without COPD. IMST benefits subjects with COPD and those without COPD. Therefore, IMST as a treatment tool is not confined to patients with COPD.
背景/目的：吸气肌力量训练（IMST）传统上被推荐用于慢性阻塞性肺疾病（COPD）患者，以改善呼吸力量。随着年龄的增长，呼吸力量会下降。然而，很少有研究关注 IMST 对无 COPD 的老年患者的影响。
方法
根据第一秒用力呼气量占预计值的百分比（%预计值），将受试者分为训练非 COPD（TNC，n = 24）和训练 COPD（TC，n = 12）两组。两组均接受 6 周的 IMST，使用压力阈值训练器以 75-80%最大吸气压力进行训练。COPD 患者的第二组作为对照组（CC，n = 24），不进行训练。呼吸困难采用基本呼吸困难指数（BDI）测量。健康相关生活质量采用 SF-36 量表测量。比较 SF-36 亚类、生理成分摘要和心理成分摘要。进行 6 分钟步行试验以确定功能状态。采用双向重复测量方差分析比较组间效应和 IMST 的训练效应。
结果
两组训练组的最大吸气压力均增加（TNC：IMST 前的 59.1cmH2O 增加至 IMST 后的 82.5cmH2O；TC：53.2 增加至 72.6），但 CC 组没有增加。因此，两组训练组的基本呼吸困难指数均改善（TNC：9.6 增加至 10.8；TC：6.2 增加至 7.3）。TNC 组的功能状态改善（TNC：392.1m 增加至 436.3m），但 TC 组和 CC 组没有改善。两组训练组的生理成分摘要的生活质量均改善。
结论
IMST 可增加最大吸气压力，缓解呼吸困难，改善健康相关生活质量，尤其改善无 COPD 患者的功能状态。IMST 对 COPD 患者和无 COPD 患者均有益。因此，IMST 作为一种治疗工具不仅限于 COPD 患者。
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