Veterans Affairs Western New York Healthcare System, Buffalo, NY 14215, USA.
J Cardiopulm Rehabil Prev. 2012 May-Jun;32(3):155-62. doi: 10.1097/HCR.0b013e31824e16e4.
Exercise training in patients with chronic obstructive pulmonary disease (COPD) can be challenging because whole-body exercise often elicits disabling symptoms of dyspnea before the exercising muscles reach their critical limits. The extent that this factor limits training has not been totally defined. The purpose of this study was to compare the response to training of patients with moderate to severe COPD with that achieved by healthy elderly subjects who were exercising using an identical program.
Eight healthy subjects and 20 patients with COPD (forced expiratory volume in 1 second 42 ± 13% predicted) exercised 3 times a week for 8 weeks. Outcome measures included 6-minute walk distance, maximal exercise capacity (Wmax) during an incremental cycle ergometer test, and submaximal constant workload (60%-70% of subject Wmax) exercise time.
Six-minute walk distance and Wmax increased after training to a significantly greater extent in the healthy controls compared with the patients with COPD; 65 ± 24 versus 32 ± 50 m, P = .03; and 25.1±13.9 versus 11.5±13.1 watts, P = .025, respectively. However, these differences disappeared when data were expressed as percent improvement, 12.1 ± 5.3% versus 10.0 ± 15.8%, and 25.6 ± 13.5% versus 23.1 ± 33.3%. Improvement in submaximal constant workload exercise time after training was similar in healthy controls 21.6 ± 6.1 versus patients with COPD 18.8 ± 11.2 minutes.
Patients with COPD can show similar relative improvements in exercise capacity compared with healthy elderly subjects. The difference in absolute values reflects, at least in part, the greater baseline exercise capacity.
由于全身运动通常会在运动肌肉达到其极限之前引起呼吸困难的致残症状，因此，对慢性阻塞性肺疾病（COPD）患者进行运动训练可能具有挑战性。该因素限制训练的程度尚未完全确定。本研究的目的是比较中重度 COPD 患者与接受相同方案锻炼的健康老年受试者的训练反应。
8 名健康受试者和 20 名 COPD 患者（第 1 秒用力呼气量占预计值的 42±13%）每周运动 3 次，持续 8 周。评估指标包括 6 分钟步行距离、递增式踏车测力计测试中的最大运动能力（Wmax）以及亚最大恒定负荷（60%-70%的个体 Wmax）运动时间。
与 COPD 患者相比，健康对照组的 6 分钟步行距离和 Wmax 在训练后增加的幅度要大得多；分别为 65±24 与 32±50 米，P=0.03；25.1±13.9 与 11.5±13.1 瓦，P=0.025。然而，当以百分比改善表示时，这些差异消失，分别为 12.1±5.3%与 10.0±15.8%，25.6±13.5%与 23.1±33.3%。健康对照组和 COPD 患者的亚最大恒定负荷运动时间的改善相似，分别为 21.6±6.1 与 18.8±11.2 分钟。
与健康老年受试者相比，COPD 患者的运动能力可以显示出相似的相对改善。绝对值的差异至少部分反映了更大的基线运动能力。
