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呼吸肌训练联合收腹动作对慢性脊髓损伤患者肺功能下降的短期影响:一项初步随机对照试验。

Short-term effects of respiratory muscle training combined with the abdominal drawing-in maneuver on the decreased pulmonary function of individuals with chronic spinal cord injury: A pilot randomized controlled trial.

作者信息

Kim Chang-Yong, Lee Jung-Sun, Kim Hyeong-Dong, Lee Dong-Jin

机构信息

a Department of Health Science , The Graduate School, Korea University , Seoul , Republic of Korea.

b Department of Epidemiology and Health Informatics , The Graduate School of Public Health, Korea University , Seoul , Republic of Korea.

出版信息

J Spinal Cord Med. 2017 Jan;40(1):17-25. doi: 10.1080/10790268.2016.1198576. Epub 2016 Jul 27.

Abstract

OBJECTIVE

To investigate the effects of respiratory muscle training (RMT) combined with the abdominal drawing-in maneuver (ADIM) on the pulmonary function in patients with chronic spinal cord injury (SCI).

METHODS

Thirty-seven subjects with SCI (level of injury: C4-T6, time since injury: 4-5 years) were randomly allocated to three groups; the integrated training group (ITG), the RMT group (RMTG), and the control group (CG). The ITG performed RMT using an incentive respiratory spirometer (IRS) and the ADIM using a stabilizer. The RMTG received only RMT using an IRS. Subjects in the CG received alternative and routine physical therapy or usual care. The interventions were conducted over an eight-week period. Pulmonary function was evaluated using spirometry to measure the forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV).

RESULTS

The differences between the pre- and post-test values for FVC (0.47 ± 0.05 versus 0.15 ± 0.06 versus -0.03 ± 0.01) and FEV (0.74 ± 0.07 versus 0.27 ± 0.17 versus 0.02 ± 0.67)were significant among the groups. Post-test, in the ITG, the FVC and FEV values showed significant differences from those in the RMTG and CG (F = 11.48 and 11.49, P = 0.002 and 0.001). Furthermore, following the 8-week intervention, the change ratio values of the FVC and FEV of the ITG were increased further by an average of 9.75% and 7.91%, respectively, compared with those of the RMTG.

CONCLUSION

These findings suggest positive evidence that RMT with additional ADIM training can improve pulmonary function in SCI pulmonary rehabilitation.

摘要

目的

探讨呼吸肌训练(RMT)联合收腹呼吸法(ADIM)对慢性脊髓损伤(SCI)患者肺功能的影响。

方法

37例SCI患者(损伤平面:C4-T6,受伤时间:4-5年)被随机分为三组;综合训练组(ITG)、呼吸肌训练组(RMTG)和对照组(CG)。ITG使用激励式肺量计(IRS)进行呼吸肌训练,并使用稳定器进行收腹呼吸法训练。RMTG仅使用IRS进行呼吸肌训练。CG组的受试者接受替代和常规物理治疗或常规护理。干预为期8周。使用肺量计评估肺功能,测量用力肺活量(FVC)和1秒用力呼气量(FEV)。

结果

三组间FVC(0.47±0.05对0.15±0.06对-0.03±0.01)和FEV(0.74±0.07对0.27±0.17对0.02±0.67)的测试前后值差异有统计学意义。测试后,ITG组的FVC和FEV值与RMTG组和CG组相比有显著差异(F=11.48和11.49,P=0.002和0.001)。此外,经过8周的干预,与RMTG组相比,ITG组FVC和FEV的变化率值分别平均进一步提高了9.75%和7.91%。

结论

这些发现表明,有积极证据表明,呼吸肌训练联合额外的收腹呼吸法训练可改善SCI患者肺康复中的肺功能。

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Abdominal muscle training can enhance cough after spinal cord injury.腹部肌肉训练可以增强脊髓损伤后的咳嗽。
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