Molgat-Seon Yannick, Road Jeremy D, Sheel A William
a School of Kinesiology, University of British Columbia, 6108 Thunderbird Blvd., Vancouver, BC V6T 1Z3, Canada.
Appl Physiol Nutr Metab. 2013 Sep;38(9):996-8. doi: 10.1139/apnm-2013-0045. Epub 2013 May 27.
Dyspnea, the subjective feeling of shortness of breath, is a hallmark feature of chronic obstructive pulmonary disease (COPD). Pulmonary rehabilitation (PR) programs aim to improve dyspnea, thereby increasing exercise tolerance and health-related quality of life in patients with COPD. Exercise training is proven to be an essential component of PR; however, there is no consensus regarding which training modality confers the greatest therapeutic benefit. Secondary to pulmonary impairment, many COPD patients develop limb muscle dysfunction (LMD), particularly in the leg muscles. Mounting evidence suggests that peripheral limitation to exercise as a result of LMD is frequent in patients with COPD. LMD of the legs, or lower limb muscle dysfunction, has been shown to markedly influence ventilatory and dyspnea responses to exercise. Accordingly, isolated training of leg muscles may contribute to reducing dyspnea and increase exercise tolerance in patients with COPD. Indeed, relative to the largely irreversible impairment of the pulmonary system, the leg muscles are an important site by which to improve patients' level of function and quality of life. Isolated leg exercises have been shown to improve LMD and may constitute an effective training modality to improve dyspnea and exercise tolerance in COPD within the context of PR.
呼吸困难，即呼吸急促的主观感受，是慢性阻塞性肺疾病（COPD）的一个标志性特征。肺康复（PR）计划旨在改善呼吸困难，从而提高COPD患者的运动耐力和与健康相关的生活质量。运动训练被证明是PR的一个重要组成部分；然而，关于哪种训练方式能带来最大的治疗益处，目前尚无共识。继发于肺部损害，许多COPD患者会出现肢体肌肉功能障碍（LMD），尤其是腿部肌肉。越来越多的证据表明，COPD患者因LMD导致的运动外周限制很常见。腿部的LMD，即下肢肌肉功能障碍，已被证明会显著影响运动时的通气和呼吸困难反应。因此，单独训练腿部肌肉可能有助于减轻COPD患者的呼吸困难并提高其运动耐力。事实上，相对于肺部系统在很大程度上不可逆转的损害，腿部肌肉是提高患者功能水平和生活质量的一个重要部位。单独的腿部运动已被证明可改善LMD，并且在PR的背景下，可能构成一种有效的训练方式，以改善COPD患者的呼吸困难和运动耐力。
