Mueller Gabi, Hopman Maria T E, Perret Claudio
Clinical Trial Unit, Swiss Paraplegic Centre , Nottwil , Switzerland ; Swiss Paraplegic Research , Nottwil , Switzerland.
Top Spinal Cord Inj Rehabil. 2012 Spring;18(2):118-21. doi: 10.1310/sci1802-118.
To compare the effects of inspiratory resistance training (IRT) and isocapnic hyperpnea (IH) versus incentive spirometry (placebo) on respiratory function, voice, and quality of life in individuals with motor complete tetraplegia.
In this randomized controlled trial, 24 individuals with traumatic, motor complete (AIS A) tetraplegia (C5-C8), 6 to 8 months post injury, were randomly assigned to 1 of 3 groups. They completed either 90 repetitions of IRT, 10 minutes of IH, or 16 repetitions of placebo training in 32 supervised training sessions over 8 weeks. Before and after the training period, the following tests were performed: bodyplethysmography, inspiratory and expiratory muscle strength, subjective breathing parameters using the visual analogue scale (VAS), voice measurements, and an adapted SF-12 quality of life questionnaire. A Friedman test and Cohen's effect sizes for IRT and IH versus placebo were calculated for differences between pre- and posttraining values.
Compared to placebo training, IRT showed high effect sizes for inspiratory muscle strength (d = 1.19), VAS values of "cleaning the nose" (d = 0.99), and the physical component of subjective quality of life (d = 0.84). IH compared to placebo training showed only medium and low effect sizes. The Friedman analysis showed a significant effect for IRT versus placebo on inspiratory muscle strength (P = .030). Neither all other parameters of respiratory function nor voice measurements, subjective breathing parameters, or quality of life were significantly improved by one of the tested training methods.
In individuals with motor complete tetraplegia, inspiratory muscle strength can be improved by IRT. Therefore, IRT is advantageous compared to IH for this group of patients and during the first year post injury.
比较吸气阻力训练（IRT）和等碳酸血症性深呼吸（IH）与激励肺活量测定法（安慰剂）对运动完全性四肢瘫痪患者呼吸功能、嗓音和生活质量的影响。
在这项随机对照试验中，24名创伤性运动完全性（美国脊髓损伤协会损伤分级A）四肢瘫痪（C5-C8）且受伤6至8个月的患者被随机分配到3组中的1组。他们在8周内的32次监督训练课程中，分别完成90次IRT重复训练、10分钟IH训练或16次安慰剂训练。在训练期前后，进行了以下测试：体容积描记法、吸气和呼气肌肉力量、使用视觉模拟量表（VAS）的主观呼吸参数、嗓音测量以及一份改编后的SF-12生活质量问卷。计算IRT和IH与安慰剂相比的Friedman检验以及训练前后值差异的科恩效应量。
与安慰剂训练相比，IRT在吸气肌肉力量（d = 1.19）、“清洁鼻腔”的VAS值（d = 0.99）以及主观生活质量的身体成分方面（d = 0.84）显示出高效应量。与安慰剂训练相比，IH仅显示出中等和低效应量。Friedman分析显示，IRT与安慰剂相比在吸气肌肉力量方面有显著效果（P = .030）。所测试的训练方法之一并未使呼吸功能的所有其他参数、嗓音测量、主观呼吸参数或生活质量得到显著改善。
在运动完全性四肢瘫痪患者中，IRT可改善吸气肌肉力量。因此，对于该组患者以及受伤后的第一年，IRT比IH更具优势。
