Department of Physiotherapy, Faculty of Physiotherapy, University of A Coruña, A Coruña, Spain -
Eur J Phys Rehabil Med. 2016 Apr;52(2):169-75. Epub 2014 Sep 5.
Muscular training is the corner stone of pulmonary rehabilitation programs.
To evaluate the effects of a muscular training program - carried out on chronic obstructive pulmonary disease (COPD) subjects with antecedents of moderate or severe exacerbation - on exercise tolerance, Health Related Quality of Life (HRQoL) and illness prognosis.
A quasi-experimental study.
University Hospital.
Twenty-five subjects with COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) degrees II, III and IV); with moderate or severe exacerbations and functional deterioration due to respiratory disability; with commitment and capacity to participate in the program. Subjects were selected by consecutive sampling.
Subjects underwent 20 muscular training sessions consisting of 30 minutes of inspiratory muscle training, 15 minutes of warm-up protocol of upper limb exercises, 30 minutes of muscle training in ergometric cycle, 5 minutes of stretching protocol of lower limbs plus illness awareness. The main outcome measures were six minute walking test (6MWT), specific HRQoL questionnaires (St. Georges Respiratory Questionnaire (SGRQ), Chronic Respiratory Disease Questionnaire (CRDQ) and Airways Questionnaire 20 (AQ20)) and the BODE Index.
All subjects improved significantly (P<0.001) their HRQoL in the SGRQ, the CRDQ and the AQ20, and this was demonstrated in each one of the evaluated dimensions. A positive response in relation to exercise tolerance and illness prognosis was observed. Following the program subjects walked an average of 56 meters more (P<0.001) and the BODE index was a mean of 1.5 less regarding the initial value (P<0.001).
A 20-session muscular training program contributes to an improvement in HRQoL, exercise tolerance and illness prognosis in COPD subjects with moderate or severe exacerbations.
The intervention program could be easily implemented since it needs a minimum of human and technological resources.
肌肉训练是肺康复计划的基石。
评估肌肉训练计划对有中重度恶化史的慢性阻塞性肺疾病（COPD）患者的运动耐量、健康相关生活质量（HRQoL）和疾病预后的影响。
准实验研究。
大学医院。
25 名 COPD 患者（全球慢性阻塞性肺疾病倡议（GOLD）II、III 和 IV 期）；有中重度恶化和呼吸功能障碍导致的功能恶化；有承诺和能力参加该计划。通过连续抽样选择受试者。
受试者接受 20 次肌肉训练，包括 30 分钟吸气肌训练、15 分钟上肢运动热身方案、30 分钟运动自行车肌肉训练、5 分钟下肢伸展方案加疾病意识。主要结局指标为 6 分钟步行试验（6MWT）、特定 HRQoL 问卷（圣乔治呼吸问卷（SGRQ）、慢性呼吸疾病问卷（CRDQ）和气道问卷 20（AQ20））和 BODE 指数。
所有患者的 HRQoL 在 SGRQ、CRDQ 和 AQ20 方面均显著改善（P<0.001），且在每个评估维度均得到改善。在运动耐量和疾病预后方面观察到了积极的反应。在计划结束后，患者平均多走了 56 米（P<0.001），BODE 指数平均减少了 1.5（P<0.001），较初始值有所降低。
20 次肌肉训练计划有助于改善 COPD 患者中重度恶化患者的 HRQoL、运动耐量和疾病预后。
该干预计划可轻松实施，因为它只需要最少的人力和技术资源。
