Clinical Trial Unit, Swiss Paraplegic Center, CH-6207 Nottwil, Switzerland.
J Rehabil Med. 2013 Mar;45(3):248-53. doi: 10.2340/16501977-1097.
To compare the effects of inspiratory resistance training and isocapnic hyperpnoea vs incentive spirometry (placebo) on respiratory function, voice, thorax mobility and quality of life in individuals with tetraplegia.
Randomized controlled trial.
PATIENTS/METHODS: A total of 24 individuals with traumatic, complete tetraplegia (C5-C8, American Spinal Injury Association (ASIA) Impairment Scale; AIS A) were randomly assigned to 1 of 3 groups. They completed 32 supervised training sessions over a period of 8 weeks. Before and after the training period, the following tests were performed: body plethysmography, inspiratory and expiratory muscle strength, subjective breathing parameters using a visual analogue scale, voice measurements, thorax mobility and quality of life. Cohen's effect sizes and Kruskal-Wallis tests for differences between pre- and post-training values were calculated.
Compared with placebo training, inspiratory resistance training showed high effect sizes for inspiratory muscle strength (d = 1.13), the subjective ability "to blow one's nose" (d = 0.97) and the physical component of quality of life (d = 0.82). Isocapnic hyperpnoea compared with placebo showed a high effect size for breathlessness during exercise (d = 0.81). We found a significant effect of inspiratory resistance training vs placebo (p = 0.016) and vs isocapnic hyperpnoea (p = 0.012) for inspiratory muscle strength.
In individuals with motor and sensory complete tetraplegia during the first year post-injury, inspiratory resistance training is more advantageous than isocapnic hyperpnoea, performed 4 times a week for 10 min.
比较吸气阻力训练和等二氧化碳过度通气（安慰剂）对四肢瘫痪患者呼吸功能、声音、胸廓活动度和生活质量的影响。
随机对照试验。
患者/方法：共有 24 名创伤性、完全性四肢瘫痪患者（C5-C8，美国脊髓损伤协会（ASIA）损伤量表；AIS A）被随机分配到 3 个组中的 1 个。他们在 8 周的时间内完成了 32 次监督训练。在训练前后，进行了以下测试：体描法、吸气和呼气肌肉力量、使用视觉模拟量表的主观呼吸参数、声音测量、胸廓活动度和生活质量。计算了训练前后值之间的科恩效应大小和 Kruskal-Wallis 检验。
与安慰剂训练相比，吸气阻力训练对吸气肌肉力量（d=1.13）、主观能力“擤鼻子”（d=0.97）和生活质量的生理成分（d=0.82）具有较高的效应大小。等二氧化碳过度通气与安慰剂相比，运动时呼吸困难的效应大小较高（d=0.81）。我们发现吸气阻力训练与安慰剂（p=0.016）和与等二氧化碳过度通气（p=0.012）相比，吸气肌肉力量有显著差异。
在受伤后第一年的运动和感觉完全性四肢瘫痪患者中，每周进行 4 次、每次 10 分钟的吸气阻力训练比等二氧化碳过度通气更有利。
