心力衰竭患者的吸气肌训练：一项系统评价
Inspiratory muscle training in patients with heart failure: a systematic review.
作者信息
Lin Suh-Jen, McElfresh Jessica, Hall Benjamin, Bloom Rachel, Farrell Kellie
机构信息
Texas Woman's University, T. Boone Pickens Institute of Health Sciences - Dallas Center, School of Physical Therapy, Dallas, TX.
出版信息
Cardiopulm Phys Ther J. 2012 Sep;23(3):29-36.
PURPOSE
The purpose of this review was to assess the quality of evidence on inspiratory muscle training (IMT) in patients with heart failure and to provide an overview on subject selection, training protocols, and outcome achieved with IMT.
METHODS
Literature search was first performed via the PubMed database, and additional references were identified from the Scopus citation index. Articles of the review type and of clinical trials published in English were included. Quality of the articles was assessed using Sackett's levels of evidence and rigor of methodology was assessed using PEDro (Physiotherapy Evidence Database) criteria for randomized controlled trials and the Downs & Black tool for cohort studies.
RESULTS
Twelve articles of clinical trials were included. Typical training protocols involved daily training with intensity greater than 30% of maximal inspiratory pressure (PImax), duration of 20 to 30 minutes (continuous or incremental) and using a pressure threshold muscle trainer. The effect sizes of PImax, walk test distance, and dyspnea were moderate to large across these studies. Effects on quality of life scores were inconsistent.
CONCLUSION
Inspiratory muscle training is beneficial for improving respiratory muscle strength, functional capacity, and dyspnea in patients with stable heart failure and respiratory muscle weakness.
目的
本综述的目的是评估心力衰竭患者吸气肌训练（IMT）的证据质量，并概述IMT的受试者选择、训练方案以及所取得的结果。
方法
首先通过PubMed数据库进行文献检索，并从Scopus引文索引中识别其他参考文献。纳入以英文发表的综述类型文章和临床试验文章。使用Sackett证据等级评估文章质量，使用PEDro（物理治疗证据数据库）标准评估随机对照试验的方法严谨性，使用Downs & Black工具评估队列研究的方法严谨性。
结果
纳入12篇临床试验文章。典型的训练方案包括每日训练，强度大于最大吸气压力（PImax）的30%，持续时间为20至30分钟（连续或递增），并使用压力阈值肌肉训练器。在这些研究中，PImax、步行试验距离和呼吸困难的效应大小为中度至高度。对生活质量评分的影响不一致。
结论
吸气肌训练有利于改善稳定型心力衰竭和呼吸肌无力患者的呼吸肌力量、功能能力和呼吸困难。
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