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抗阻训练对慢性阻塞性肺疾病急性加重期患者的影响。

Impact of resistance training in chronic obstructive pulmonary disease patients during periods of acute exacerbation.

机构信息

Physical Therapy Department, School of Medicine, University of São Paulo, São Paulo, Brazil; University Hospital, University of São Paulo, São Paulo, Brazil.

Physical Therapy Department, School of Medicine, University of São Paulo, São Paulo, Brazil.

出版信息

Arch Phys Med Rehabil. 2014 Sep;95(9):1638-45. doi: 10.1016/j.apmr.2014.05.007. Epub 2014 May 28.

Abstract

OBJECTIVE

To evaluate the effects of whole-body resistance training on exercise capacity, health-related quality of life (HRQOL), and muscle strength in patients hospitalized for exacerbation of chronic obstructive pulmonary disease.

DESIGN

Randomized controlled trial.

SETTING

University hospital.

PARTICIPANTS

Patients (N=46) were randomized to either a control group (CG) or training group (TG), and 29 patients completed the study.

INTERVENTION

Training consisted of weight-lifting exercises for 6 muscle groups in the upper and lower limbs (2 sets of 8 repetitions each), and the initial load was set at 80% of the 1-repetition maximum load.

MAIN OUTCOME MEASURES

Patients were evaluated on the second day of hospitalization, at hospital discharge, and 30 days postdischarge. Patients were evaluated on the basis of the 6-minute walking distance (6MWD), HRQOL, muscle strength, systemic inflammatory markers, and level of physical activity in daily life (PADL).

RESULTS

The CG showed a reduction in the strength of lower-limb muscles (P<.05) but not in the 6MWD (P>.05). In contrast, patients from the TG improved strength in the lower-limb muscles and 6MWD during and 30 days after hospitalization (P<.05). The TG also improved the impact domain in HRQOL after hospitalization. No improvement in PADL was observed in the TG. Finally, a reduction in the blood levels of inflammatory markers was observed only in the TG after hospitalization.

CONCLUSIONS

Our results suggest that resistance training during hospitalization improves the 6MWD, HRQOL, and lower-limb muscle strength, without altering the levels of systemic inflammation. However, future research should explore this intervention in larger randomized trials.

摘要

目的

评估全身抗阻训练对慢性阻塞性肺疾病加重住院患者运动能力、健康相关生活质量(HRQOL)和肌肉力量的影响。

设计

随机对照试验。

设置

大学医院。

参与者

将患者(N=46)随机分为对照组(CG)或训练组(TG),29 名患者完成了研究。

干预

训练包括举重练习,针对上下肢的 6 个肌肉群(每组 2 组,每组 8 次重复),初始负荷设定为 1 次重复最大负荷的 80%。

主要观察指标

患者在住院第二天、出院时和出院后 30 天进行评估。根据 6 分钟步行距离(6MWD)、HRQOL、肌肉力量、全身炎症标志物和日常生活中的体力活动水平(PADL)对患者进行评估。

结果

CG 组下肢肌肉力量下降(P<.05),但 6MWD 无变化(P>.05)。相比之下,TG 组患者在住院期间和住院后 30 天内下肢肌肉力量和 6MWD 均得到改善(P<.05)。TG 组在住院后还改善了 HRQOL 的影响领域。TG 组的 PADL 无改善。最后,仅在住院后 TG 组观察到炎症标志物的血液水平降低。

结论

我们的结果表明,住院期间的抗阻训练可改善 6MWD、HRQOL 和下肢肌肉力量,而不会改变全身炎症水平。然而,未来的研究应在更大的随机试验中探索这种干预措施。

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