一项针对社区医院中晚期慢性阻塞性肺疾病患者的简单且低成本运动训练计划的疗效
Efficacy of a simple and inexpensive exercise training program for advanced chronic obstructive pulmonary disease patients in community hospitals.
作者信息
Pothirat Chaicharn, Chaiwong Warawut, Phetsuk Nittaya
机构信息
Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
出版信息
J Thorac Dis. 2015 Apr;7(4):637-43. doi: 10.3978/j.issn.2072-1439.2015.04.13.
BACKGROUND
Exercise training is an important part of pulmonary rehabilitation; however it may not be appropriate for large-scale practice in community hospitals due to the complexity of the program and expensive training equipment, including cycle ergometry and treadmills. This study therefore aims to evaluate the efficacy of a more simplified exercise training program with inexpensive training equipment.
METHODS
A multicentre study of a mild to moderate intensity exercise training program was conducted based on incremental strength and endurance with two 35-40-minute sessions per week for 8 weeks. The program was performed by 30 outpatients from five community hospitals. Patients were monitored regularly for various parameters including strength of trained muscles, level of dyspnea, 6-minute walk distance, and quality of life (QoL) at baseline at 1, 2, 3, 6, 9 and 12 months. Unpaired t-tests were applied to determine the progress of trained muscle strength and minimal clinically important differences (MCIDs) were used to assess clinical outcomes.
RESULTS
Thirty patients (13 males, 17 females) were enrolled with a mean age of 69.1±8.9 years, body mass index 20.5±4.4 kg/m(2), and mean % of predicted forced expiratory volume in the first second (FEV1) 45.1±10.8. According to GOLD classification, eight (26.7%) cases were in stage II, 20 (66.7%) cases in stage III, and two (6.6%) cases in stage IV. Limb and chest wall muscle strength, dyspnea level, exercise capacity and QoL showed statistically significant improvements throughout the 12-month follow-up (P<0.01). There were clinically significant improvements in QoL throughout the 12-month follow-up, exercise capacity from months 2 to 12, and dyspnea levels at months 2, 3 and 9.
CONCLUSIONS
The implementation of a simplified and inexpensive exercise training program was shown to be effective for advanced chronic obstructive pulmonary disease patients in community hospitals.
背景
运动训练是肺康复的重要组成部分；然而，由于该项目的复杂性以及昂贵的训练设备，包括功率自行车和跑步机，它可能不太适合在社区医院大规模开展。因此，本研究旨在评估使用廉价训练设备的更简化运动训练项目的疗效。
方法
进行了一项多中心研究，采用轻度至中度强度的运动训练项目，基于渐进性力量和耐力，每周进行两次35 - 40分钟的训练，共8周。该项目由来自五家社区医院的30名门诊患者执行。在基线、第1、2、3、6、9和12个月时定期监测患者的各种参数，包括训练肌肉的力量、呼吸困难程度、6分钟步行距离和生活质量（QoL）。采用非配对t检验来确定训练肌肉力量的进展情况，并使用最小临床重要差异（MCIDs）来评估临床结果。
结果
共纳入30例患者（13例男性，17例女性），平均年龄69.1±8.9岁，体重指数20.5±4.4 kg/m²，第一秒用力呼气量（FEV1）占预计值的平均百分比为45.1±10.8。根据全球慢性阻塞性肺疾病倡议（GOLD）分类，8例（26.7%）为Ⅱ期，20例（66.7%）为Ⅲ期，2例（6.6%）为Ⅳ期。在整个12个月的随访中，肢体和胸壁肌肉力量、呼吸困难程度、运动能力和生活质量均有统计学显著改善（P<0.01）。在整个12个月的随访中，生活质量有临床显著改善，2至12个月运动能力改善，2、3和9个月呼吸困难程度改善。
结论
在社区医院中，实施简化且廉价的运动训练项目对晚期慢性阻塞性肺疾病患者有效。
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