Morris Theresa, Sumners David Paul, Green David Andrew
Centre of Human & Aerospace Physiological Sciences, King's College London, London, United Kingdom.
Applied Science, Engineering, Science and the Built Environment, London South Bank University, London, United Kingdom.
PLoS One. 2014 Mar 20;9(3):e91291. doi: 10.1371/journal.pone.0091291. eCollection 2014.
Direct chest-wall percussion can reduce breathlessness in Chronic Obstructive Pulmonary Disease and respiratory function may be improved, in health and disease, by respiratory muscle training (RMT). We tested whether high-frequency airway oscillation (HFAO), a novel form of airflow oscillation generation can modulate induced dyspnoea and respiratory strength and/or patterns following 5 weeks of HFAO training (n = 20) compared to a SHAM-RMT (conventional flow-resistive RMT) device (n = 15) in healthy volunteers (13 males; aged 20-36 yrs). HFAO causes oscillations with peak-to-peak amplitude of 1 cm H2O, whereas the SHAM-RMT device was identical but created no pressure oscillation. Respiratory function, dyspnoea and ventilation during 3 minutes of spontaneous resting ventilation, 1 minute of maximal voluntary hyperventilation and 1 minute breathing against a moderate inspiratory resistance, were compared PRE and POST 5-weeks of training (2 × 30 breaths at 70% peak flow, 5 days a week). Training significantly reduced NRS dyspnoea scores during resistive loaded ventilation, both in the HFAO (p = 0.003) and SHAM-RMT (p = 0.005) groups. Maximum inspiratory static pressure (cm H2O) was significantly increased by HFAO training (vs. PRE; p<0.001). Maximum inspiratory dynamic pressure was increased by training in both the HFAO (vs. PRE; p<0.001) and SHAM-RMT (vs. PRE; p = 0.021) groups. Peak inspiratory flow rate (L.s(-1)) achieved during the maximum inspiratory dynamic pressure manoeuvre increased significantly POST (vs. PRE; p = 0.001) in the HFAO group only. HFAO reduced inspiratory resistive loading-induced dyspnoea and augments static and dynamic maximal respiratory manoeuvre performance in excess of flow-resistive IMT (SHAM-RMT) in healthy individuals without the respiratory discomfort associated with RMT.
直接胸壁叩击可减轻慢性阻塞性肺疾病患者的呼吸困难,呼吸肌训练(RMT)在健康状态和患病状态下均可改善呼吸功能。我们测试了高频气道振荡(HFAO)这种新型气流振荡产生形式,在健康志愿者(13名男性,年龄20 - 36岁)中,与假RMT(传统的流阻式RMT)设备(n = 15)相比,经过5周HFAO训练(n = 20)后是否能调节诱发的呼吸困难以及呼吸强度和/或模式。HFAO产生峰 - 峰值幅度为1 cm H₂O的振荡,而假RMT设备与之相同但不产生压力振荡。在5周训练前后(每周5天,以70%峰值流量进行2×30次呼吸),比较了在3分钟自主静息通气、1分钟最大自主过度通气和1分钟对抗中度吸气阻力呼吸过程中的呼吸功能、呼吸困难和通气情况。训练显著降低了两组在阻力负荷通气期间的数字评分量表(NRS)呼吸困难评分,HFAO组(p = 0.003)和假RMT组(p = 0.005)均是如此。HFAO训练使最大吸气静态压力(cm H₂O)显著增加(与训练前相比;p<0.001)。HFAO组(与训练前相比;p<0.001)和假RMT组(与训练前相比;p = 0.021)的最大吸气动态压力均因训练而增加。仅在HFAO组中,最大吸气动态压力操作期间达到的峰值吸气流量率(L·s⁻¹)在训练后显著增加(与训练前相比;p = 0.001)。在健康个体中,HFAO减轻了吸气阻力负荷诱发的呼吸困难,增强了静态和动态最大呼吸操作表现,超过了流阻式IMT(假RMT),且没有RMT相关的呼吸不适。