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长期肺康复计划可逐渐提高 COPD 患者的运动耐量、生活质量和心血管危险因素。

A long-term pulmonary rehabilitation program progressively improves exercise tolerance, quality of life and cardiovascular risk factors in patients with COPD.

机构信息

Physical Therapy School, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil -

出版信息

Eur J Phys Rehabil Med. 2013 Aug;49(4):491-7. Epub 2013 Mar 13.

Abstract

BACKGROUND

Support and treatment options have been widely discussed in recent decades with the aim of improving morbidity, mortality and quality of life of chronic respiratory disease (COPD) patients. Although it is believed that longer pulmonary rehabilitation programs can provide better results, most of the evidence comes from short-term programs.

AIM

To determine the effects of an outpatient pulmonary rehabilitation program on exercise tolerance, dyspnoea, hemodynamic variables and quality of life.

DESIGN

Case series study.

SETTING

Rehabilitation Centre.

POPULATION AND METHODS

A convenience sample of COPD patients was enrolled in this study. The intervention consisted of a 96-wk exercise training program, including aerobic training, upper-limb exercises and inspiratory muscle training. Pulmonary function tests, blood biochemistry, six-minute walking distance test and health-related quality of life were recorded at baseline and after completion of the 6th, 12th, 18th, 24th months.

RESULTS

Forty one consecutive COPD patients were recruited and thirty six completed the study. There was a significant improvement in hemodynamics, demonstrated by the gradual reduction in heart rate, blood pressure and MvO2 (double product) starting from the 12th month. Lipid profile showed a reduction of low density lipids and an increase of the high density lipids levels starting from the 6th month. Exercise tolerance, dyspnoea, respiratory muscle strength and quality of life also improved starting from the 6th month.

CONCLUSION

A 24-month pulmonary rehabilitation program leads to a progressive improvement in quality of life, dyspnoea and exercise tolerance, and reduces cardiovascular risk factors in patients with chronic obstructive pulmonary disease.

IMPACT

Our study suggests that long-term pulmonary rehabilitation programs can result in further improvements in the aforementioned cardiorespiratory variables.

摘要

背景

近几十年来,人们广泛讨论了支持和治疗选择,旨在改善慢性呼吸道疾病(COPD)患者的发病率、死亡率和生活质量。尽管人们认为更长时间的肺康复计划可以提供更好的效果,但大多数证据来自短期计划。

目的

确定门诊肺康复计划对运动耐量、呼吸困难、血液动力学变量和生活质量的影响。

设计

病例系列研究。

地点

康复中心。

人群和方法

本研究纳入了便利抽样的 COPD 患者。干预措施包括 96 周的运动训练计划,包括有氧运动、上肢运动和吸气肌训练。在基线和第 6、12、18 和 24 个月时记录肺功能测试、血液生化、六分钟步行距离测试和健康相关生活质量。

结果

共招募了 41 名连续 COPD 患者,其中 36 名完成了研究。从第 12 个月开始,血液动力学逐渐改善,表现为心率、血压和 MvO2(双乘积)逐渐降低。从第 6 个月开始,血脂谱显示低密度脂蛋白降低,高密度脂蛋白水平升高。从第 6 个月开始,运动耐力、呼吸困难、呼吸肌力量和生活质量也得到改善。

结论

24 个月的肺康复计划可导致慢性阻塞性肺疾病患者的生活质量、呼吸困难和运动耐力逐渐改善,并降低心血管危险因素。

影响

我们的研究表明,长期肺康复计划可以进一步改善上述心肺变量。

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